Admitting powerlessness. Humbly accepting your shortcomings. Understanding the exact nature of your wrongs. Removing defects of character. Making direct amends. Taking a fearless moral inventory. Improving your conscious contact. Experiencing a spiritual awakening. Not only does the terminology of Twelve Step recovery from addiction seem a little like a foreign language (at least at first), many aspects of the program itself are widely misconstrued or misunderstood.
Whether you or a loved one is struggling with a substance use disorder (commonly referred to as drug or alcohol addiction, alcoholism or substance abuse), Twelve Step recovery programs could be an effective source of help and support. Here are answers to seven frequently asked questions about Twelve Step programs, principles and practices.
The Twelve Steps are a set of guiding principles as outlined in Alcoholics Anonymous, first published in 1939 and familiarly known as the Big Book. The Steps set forth a course of action for recovery from addiction and, more broadly, a new way of thinking and living. Core concepts of Twelve Step recovery are grounded in the acceptance of being "powerless over alcohol" the recognition that, as a result of alcohol use, your life has become unmanageable and the willingness to change whatever you can (your attitudes and your reactions to people and events) in order to get your life back from addiction. As a part of Twelve Step recovery, participants make a list of all persons they have harmed and, if it won't cause further harm, attempt to make amends. Taking an ongoing personal inventory and honestly acknowledging ways you have hurt yourself, your relationships and others is also a core Twelve Step recovery practice. Trust, acceptance, love, goodwill and forgiveness are also key components of a Twelve Step recovery model.
Twelve Step support groups are another core concept of Alcoholics Anonymous (AA) recovery. Participating in a mutual support group allows individuals to experience the recovery journey at their own pace—accepting responsibility for their behavior—with the help and understanding of a supportive peer environment.
A number of self-help groups have adopted variations of AA's Twelve Step program to address different types of addiction or compulsive behaviors. These self-help programs include:
First, you should know that the door is open to people of all socioeconomic backgrounds and faith traditions—no judgment or questions. The idea is to help you see that you are not alone in your struggles with addiction. As often noted, the first word of the First Step is "We."
The rules at Twelve Step meetings are simple: Be on time, be respectful and don't talk over others. Some other key points:
If you are nervous about attending your first meeting, remember that every person in the room was a newcomer once, too. They likely felt the same reservations before walking through the door.
You don't need to be religious to attend or benefit from Twelve Step support groups. While Alcoholics Anonymous embraces people from all different faith traditions and spiritual beliefs, atheists are just as welcome. What's important is that you accept the idea that you are not the center of the universe. The AA concept of "higher power" doesn't need to be interpreted as God. Your higher power could be the fellowship of Alcoholics Anonymous, love, family, nature or positive energy.
In communities throughout the U.S. and around the world, churches often donate space for Twelve Step meetings. You can also typically find Twelve Step meetings at schools, community centers, health care centers or addiction treatment centers.
Yes. If a Twelve Step approach doesn't feel like the right fit, other options to explore include SMART Recovery, LifeRing, Women for Sobriety and Moderation Management, as well as addiction recovery support groups that have a particular religious affiliation, such as The Calix Society and Jewish Alcoholics. Find more detailed descriptions about many alternative recovery support organizations.
Twelve Step recovery programs combine accountability measures, inspiration, education and connection to help participants change their inner dialogue. The group dynamic helps to reinforce healthy thinking and behaviors. As an evidence-based model, Twelve Step recovery has been studied and replicated for years. According to a study published in the National Center for Biotechnology Information, a branch of the National Institutes of Health (NIH), "Beginning 12-Step participation while in treatment, especially at group meetings held at the treatment program, and 12-Step attendance at the same time that one is enrolled in specialty addiction treatment, are associated with better outcomes. In addition, consistent, early, and frequent attendance/involvement is associated with better substance use outcomes. Although even small amounts of participation may be helpful in increasing abstinence, higher "doses" may be needed to reduce the likelihood of relapse."
Psychologists, psychiatrists and addiction counselors often recommend participation in Twelve Step groups as a form of aftercare following inpatient addiction treatment.. After completing an inpatient program, many continue their journey in outpatient treatment. (Think of managing other chronic diseases—you may take blood thinners after experiencing a heart attack or track your insulin after a diabetes diagnosis.) Twelve Step recovery programs offer safety and support during early recovery—setting patients up for long-term success.
According to the NIH, "Increased involvement in 12-Step meetings and activities following formal treatment may serve as an important source of support and a form of continuing care that has been shown to lead to decreased utilization of mental health and substance abuse treatment services and associated costs." Group meetings offer a safe place to share one's experience, strength and hope, and to give and receive support and fellowship. This social support helps individuals avoid relapse. Listening to personal stories of recovery and learning how others avoid triggers and cope with environmental cues or social stresses without resorting to alcohol or other drugs can be incredibly helpful on the path to healing.