A twelve-step program (12-Step program) is a set of guiding principles (accepted by members as ‘spiritual principles,’ based on the approved literature) outlining a course of action for recovery from addiction, compulsion, or other behavioral problems.
Originally proposed by Alcoholics Anonymous (AA) as a method of recovery from alcoholism, the Twelve Steps were first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism. The method was adapted and became the foundation of other twelve-step programs.
As summarized by the American Psychological Association, the process involves the following:
- admitting that one cannot control one’s addiction or compulsion;
- recognizing a higher power that can give strength;
- examining past errors with the help of a sponsor (experienced member);
- making amends for these errors;
- learning to live a new life with a new code of behavior;
- helping others who suffer from the same addictions or compulsions.
Recovery is sought in several areas: physical, mental, emotional, and spiritual.
For addicts and alcoholics, the physical dimension is best described by the allergy-like bodily reaction, which results in the compulsion to continue using substances after the initial use. For groups not related to substance abuse, this physical manifestation could be more varied including, but not limited to: compulsive hoarding, distractibility, eating disorders, dysfunctional enabling, hyperactivity, hypomania, insomnia, irritability, lack of motivation, laziness, mania, panic attacks, psychosomatic illnesses, poor impulse control, procrastination, self-injury and suicide attempts.
The statement in the First Step that the individual is “powerless” over the substance-abuse related behavior at issue refers to the lack of control over this compulsion, which persists despite any negative consequences that the person may endure as a result.
The emotional obsession is described as the cognitive processes that cause the individual to repeat the compulsive behavior after some period of abstinence, either knowing that the result will be an inability to stop or operating under the delusion that the result will be different. The description in the First Step of the life of the alcoholic or addict as “unmanageable” refers to the lack of choice that the mind of the addict or alcoholic affords concerning whether to drink or use again.
The illness of the spiritual dimension, or “spiritual malady”, is considered in all twelve-step groups to be self-centeredness. This model is not intended to be a scientific explanation, it is only a perspective that twelve-step organizations have found useful. The process of working the steps is intended to replace self-centeredness with a growing moral consciousness and a willingness for self-sacrifice and unselfish constructive action. In twelve-step groups, this is known as a spiritual awakening or religious experience. This should not be confused with abreaction, which produces dramatic, but ephemeral, changes. In twelve-step fellowships, “spiritual awakening” is believed to develop, most frequently, slowly over a period of time.
It is suggested that members regularly attend meetings with other members who share their particular recovery problem. In accordance with the First Step, twelve-step groups emphasize self-admission by members of the problem they are recovering from. It is in this spirit that members often identify themselves along with an admission of their problem, e.g. “Hi, I’m Wendy and I’m an alcoholic.” Such catchphrases are now widely associated with support groups. Some meetings are known as dual-identity groups which encourage attendance from certain demographics. Some areas have, for example, groups limited to women members; men’s groups; and groups for gay, lesbian, and transgender individuals. Some areas also have beginner’s groups as well as “old-timer” groups that limit who can share, or speak during the meeting, by the length of time the members have in that fellowship.
The scope of AA’s program is much broader than just abstinence from drinking alcohol. Its goal is to effect enough change in the alcoholic’s thinking “to bring about recovery from alcoholism” through a spiritual awakening. A spiritual awakening is achieved by taking the Twelve Steps, and sobriety is furthered by volunteering for AA and regular AA meeting attendance or contact with AA members.
The following are the original twelve steps as published by Alcoholics Anonymous:
- We admitted we were powerless over alcohol—that our lives had become unmanageable.
- Came to believe that a power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood Him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked Him to remove our shortcomings.
- Made a list of all persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory, and when we were wrong, promptly admitted it.
- Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
- In some cases, where other twelve-step groups have adapted the AA steps as guiding principles, these have been altered to emphasize principles important to those particular fellowships, and to remove gender-biased language.
Members are encouraged to find an experienced fellow alcoholic, called a sponsor, to help them understand and follow the AA program. The sponsor should preferably have experience of all twelve of the steps, be the same gender as the sponsored person, and refrain from imposing personal views on the sponsored person. Following the helper therapy principle, sponsors in AA benefit as much, if not more, from their relationship than do those they sponsor. Helping behaviors correlate with increased abstinence and lower probabilities of binge drinking.