Lesson 1 of 7 - free your true Self to guide you

Battling Addiction: Are
12 Steps Too Many?

Yahoo News - 1/27/09
 from Time magazine

The Web address of this article is http://sfhelp.org/gwc/news/12steps.htm

  Updated  01-23-2015

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      This TIME magazine reprint illustrates several important themes common to recent media articles about addiction and addiction recovery. See my comments after the article. The links and hilights below are mine. - Peter Gerlach, MSW

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"This story has been updated  from its original version."

    January is a big month for winter sports and post-Christmas sales. It's also - as people who treat substance abuse know - a big month for drinkers who want to quit. The holidays are over and bank accounts are thin, but addicts can't stop partying. Many choose January to ask, at long last, for help. But what sort of help is the most useful? (See TIME "The Year in Medicine 2008: From A to Z.")

    For decades, the primary approach to (addiction) rehabilitation in the U.S. has been 12-step programs like Alcoholics Anonymous (AA). Twelve-step doctrine defines addiction in a contradictory way: as a medical problem, like a lifelong illness, with a spiritual solution (surrendering to a higher power). The model has become so culturally hegemonic that it's hard for many to imagine any other way to stop getting drunk or doing drugs - or gambling, overeating or watching porn, for that matter.

    When we see Anne Hathaway's character in the film Rachel Getting Married at a 12-step meeting or when we watch D-list celebrities work the steps on VH1's new reality show Celebrity Rehab Presents Sober House, it's easy to think 12-step is not only the best way to get well, but the only way. There's a growing body of evidence, however, that suggests that's not so. (Read a 1940 TIME article about Alcoholics Anonymous.)

    In last month's (12/08) Journal of Substance Abuse Treatment, University of New Mexico addiction specialist William Miller and his colleagues presented findings from two controlled trials in which patients underwent drug treatment. Some of the patients received spiritual guidance as part of the treatment - learning such practices as prayer, meditation and service to others, all of which are central to 12-step programs.

    Others received secular psychotherapy. Because of the enduring popularity of AA and similar pro-grams that involve a spiritual component, Miller and his team expected the patients in the spiritual group to do better than those in the secular group. They were wrong - at least in the short term.

    While both groups eventually benefited relatively equally from their treatment - abusing substances on fewer days - it took longer to see improvement among those in the spiritual group. What's more, those who received spiritual guidance reported being significantly more anxious and depressed after four months than those who got secular help.

    Those problems abated at about the eight-month point, but because substance abusers are at high risk for suicide, some worry that it may not be a good idea to put them through demanding spiritual calisthenics in the early months of their recovery. (Read a 2007 TIME cover story, "How We Get Addicted.")

    This study amplifies a fascinating paper Miller co-authored in 1997, which found that patients who reported knowing that someone was praying for them used significantly more substances after leaving treatment than those who didn't know someone was praying for them.

    Taken together, Miller's studies suggest that spirituality can be demanding - even when others are being spiritual on your behalf - and that many addicts may simply not be up to the pressure. For those people, non-faith-based treatments like cognitive behavioral therapy or mindfulness-based acceptance and commitment therapy might be better.

     These challenges to addiction orthodoxy come along as scientists and sufferers alike continue to look for a faster fix for substance abuse. New York cardiologist Dr. Olivier Ameisen - who now lives in France but remains a visiting professor at the State University of New York - has authored a new book describing his recovery from alcoholism, which was achieved with the aid of a common drug called baclofen, a muscle-relaxant designed to prevent the spasms behind a range of conditions from hiccups to multiple sclerosis symptoms.

    The claim is drawing a lot of attention, but it is too soon to say how effective the drug will be for other alcoholics or how widely it will be embraced by the addiction community. (Read a 1974 TIME cover story, "Alcoholism: New Victims, New Treatment.")

    Last month, investigators in the U.S. reported good test results for a monthly dose of the common antidrinking drug naltrexone - a medication that currently must be taken every day to be effective. But naltrexone is controversial because for some, it doesn't do anything to reduce the craving for alcohol until those addicts actually take a drink, whereupon it helps them resist taking more - a twisted bit of physiological irony if ever there was one. Twelve-step believers say the only proper response to alcoholism is total abstinence, and that a drug that allows you to drink a little puts you on a slippery slope to drinking a lot.

    About 1 in 5 people with alcohol dependence stop drinking without any treatment, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the field guide mental-health professionals use to diagnose illnesses. That means we have to figure out a way to help the 80% who won't get better through willpower. The latest evidence suggests that those who think that spirituality or a pill alone can save them are wrong. The answer almost certainly lies deeper inside ourselves.

Copyright 2009 Yahoo! Inc.


      This article doesn't speculate on the cause of addiction, tho it refers to other TIME articles that may do so. It also doesn't define what "recovery from addiction" means. It basically questions whether the traditional way to attain sobriety thru adopting the spiritually-based 12-step philosophy is the only way. It notes the reality that for most addicts, "willpower is not enough" to break their toxic compulsion.

      Based on research by William Miller, the article suggests that the 12-steps' reliance on belief in a Higher Power may put too much "pressure" on some addicts compared to "secular" (non-spiritual) therapy or some drug treatments. The article ignores a major benefit of traditional 12-step programs, which is the world-wide fellowship and support provided by regular non-denominational meetings

      This lay article, like many in the public media, does not mention the current clinical view that addiction is a sign of serious family dysfunction,  not just a personal problem. Currently, 12-step programs, pills, and most conventional therapies do not treat the family - so sobriety success rates are relatively low and relapse rates are high. Note the article's last two sentences.

      The anonymous author's suggestion  that "spirituality can be demanding" in the context of 12-step addiction recovery goes unexplained - and (in my opinion) demonstrates the author's ignorance of his subject. Turning over life-stressors that promote addiction to a benign, caring Higher Power is a keystone to relieving anxiety, shame, and guilt. Note that AAAA (Atheist and Agnostic Alcoholics Anonymous) is practically unknown, suggesting limited recovery benefits at best.

      By not challenging the "Anonymous" label attached to most 12-step programs, the article's author misses a chance to dispel the 5oxic old myth that addiction is a shameful "character flaw" or "weak will." This Web site proposes that addiction is neither of these - it is an unconscious attempt to reduce relentless inner pain (shame + guilts + fears + hurts + hopelessness + confusion + overwhelm) by self-medication and/or distraction. There s nothing shameful about trying to reduce inner pain!

      Premise  - "inner pain" results from a toxic social environment (e.g. a dysfunctional family) and inherited psychological "wounds" from unaware ancestors. Intentionally reducing psychological wounds (Lesson 1 here)  and raising coping skills by applying the knowledge in Lessons 2 thru 7 can help to pre-vent and reduce addictions. See this for more detail

      This YouTube clip proposes an updated version of the traditional 12 Steps for Grown Wounded Children (GWCs):

      Pause, breathe, and reflect - why did you read this article? Did you get what you needed? If not, what do you need? Who's answering these questions - your true Self, or ''someone else''?

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