The Men s Program THE 12 STEP PROGRAM: A BEGINNER S GUIDE
TABLE OF CONTENTS 4 Introduction Destination Hope 2 5 The Twelve Steps: A Way of Life 7 A Brief History of Alcoholics Anonymous and the 12-Step Model 10 A Brief Overview of Addiction 12 Step One: Admit Powerlessness 14 Step Two: Find Your Higher Power 16 Step Three: Turn Your Will Over to Your Higher Power 18 Step Four: The Moral Inventory 20 Step Five: Admit the Nature of Our Wrongs 22 Step Six: Reflect and Find a Willingness to Change www.drugrehabfl.net 1 (888) 998-1927
TABLE OF CONTENTS 24 Step Seven: Ask Higher Power to Remove Your Shortcomings 26 Step Eight: Make a List of Those You Harmed 28 Step Nine: Make Amends 30 Step Ten: Maintain Recovery 32 Step Eleven: Improve Conscious Contact with Your Higher Power 34 Step Twelve: Spread the Word 36 What the Research Says About 12-Step Programs www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 3
INTRODUCTION Alcoholics Anonymous is one of the best-known organizations in the world and is the originator of the now-famous and widely used 12-step model of recovery. Alcoholics Anonymous groups and other 12-step fellowships can be found in virtually every corner of the U.S. and in scores of other countries. In many high-quality addiction treatment programs, participating in AA is an integral and essential part of recovery. www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 4
THE TWELVE STEPS: A WAY OF LIFE
The Twelve Steps are a group of spiritual principles that act as a clear, actionable guide for a way of life free of addiction. Moving through the steps ideally leads to long-term sobriety, a stronger sense of purpose in life, spiritual wholeness and overall happiness. While Alcoholics Anonymous created and defined the 12-step process and is the best-known example of a 12-step program, the 12 steps can apply to a wide range of addictions, compulsive behaviors and mental health problems. As such, 94 official fellowships have been established to address various issues. These include Narcotics Anonymous, Cocaine Anonymous, Gamblers Anonymous, Overeaters Anonymous and Sex Addicts Anonymous. www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 6
A BRIEF HISTORY OF ALCOHOLICS ANONYMOUS & THE 12-STEP MODEL
The National Prohibition Act took effect in 1920 and outlawed the manufacture, sale and consumption of alcohol. During its 13-year span, drinking behaviors were indeed curbed, but because people were purportedly not drinking, virtually all of the country's asylums closed their doors and self-help societies faded away. As a result, people who needed help grappling with an alcohol addiction were unable to find it. 1 In 1935, Bill W. of New York City and Dr. Bob S. of Akron, Ohio, met through their involvement with the Oxford Group, a more-or-less non-alcoholic fellowship that emphasized spirituality in everyday life. Through his affiliation with the group, Bill had overcome an intense alcohol addiction and maintained it by devoting his life to working with others who were addicted to alcohol. Dr. Bob was still struggling with alcoholism when he met Bill, who inspired him to become sober once and for all. Together, Bill and Dr. Bob went to work helping alcoholics at City Hospital in Akron, and after one patient quickly attained sobriety, the three men met frequently to support one another. This was the first Alcoholics Anonymous fellowship, and by 1939, two more were in full swing in New York and Cleveland. In four years, 100 men achieved successful recovery through regular fellowship meetings. In 1939, Bill wrote Alcoholics Anonymous, the textbook informally known as "The Big Book," which has been used for more than 80 years to help scores of people recover from alcohol addiction. www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 8
Alcoholics Anonymous explained the group's philosophy and methods, at the core of which were the Twelve Steps of recovery. After The Plain Dealer published a series of positive stories about AA in 1939, membership in that city's AA fellowship shot up from 20 to 500 in a matter of months. A trusteeship for the organization was established with friends of John D. Rockefeller serving as members of the board, which was known as The Alcoholic Foundation. An office was opened in New York to field inquiries and distribute The Big Book. By 1941, AA had 6,000 members spread across the U.S. and Canada, and by 1950, that number had reached 100,000, thanks to a great deal of positive publicity. Destination Hope 9 Today, it's estimated that there are over two million members of AA in over 117,000 groups worldwide, and The Big Book has been translated into 28 languages. www.drugrehabfl.net 1 (888) 998-1927
A BRIEF OVERVIEW OF ADDICTION
The National Institute on Drug Abuse characterizes addiction as the inability to stop using a substance despite the negative consequences it causes in your life. 2 These consequences may be related to finances, legal status, relationships or physical or mental health. Addiction is progressive, which means that without help, it almost always gets worse. It's also chronic and relapsing, meaning that while it can't be cured, it can be sent into remission through abstinence. However, using a substance again after a period of abstinence can lead to a relapse of the addiction, once again characterized by the inability to stop using despite negative consequences. In order to overcome an addiction, complete abstinence is essential. But without the help of a recovery program, facing challenges and overcoming barriers is an overwhelming prospect that, more often than not, leads quickly to relapse. Twelve-step programs provide support and education to help people new to recovery navigate the often-rocky road to long-term sobriety. Participants in 12-step groups move through the steps one by one, with each step leading seamlessly to the next. Following is a brief overview of each step as outlined in AA's guide, Twelve Steps and Twelve Traditions. 3 www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 11
STEP ONE: ADMIT POWERLESSNESS
"WE ADMITTED WE WERE POWERLESS OVER ALCOHOL [OR DRUGS] THAT OUR LIVES HAD BECOME UNMANAGEABLE." The negative consequences of substance abuse are often far-reaching and can destroy relationships, result in job loss and cause devastating health or legal problems. Still, someone with an addiction will continue to use a substance anyway, largely due to changes in the brain's learning, memory and reward centers that affect thought patterns and behavior. The first of the twelve steps involves admitting that you have lost control over your drug use, and as a result, negative consequences have left you feeling hopeless and defeated. This, according to The Big Book, is what leads many addicted individuals to AA, where they "discover the fatal nature of our situation." 3 Only then do they "become as open-minded to conviction and as willing to listen as the dying can be." Once you truly understand and come to terms with the fact that you're powerless over your drug-seeking and -using compulsions despite wanting or trying to quit, you're willing to do whatever it takes to defeat the addiction and reclaim your life. www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 13
STEP TWO: FIND YOUR HIGHER POWER
"WE CAME TO BELIEVE THAT A POWER GREATER THAN OURSELVES COULD RESTORE US TO SANITY." Step Two is about hope and faith. Despite disappointment, guilt, depression, a sense of failure and other destructive emotions, there is always hope for a better future. Hope, according to the Substance Abuse and Mental Health Services Administration, is the belief that the challenges of sobriety can be overcome through an individual's strengths, talents, resources, coping skills Destination Hope 15 and inherent values, and it's the very foundation of recovery. 4 Hope is supported by a power greater than ourselves. Whether you call this power "God," "the Universe," "love," "family" or something else entirely, this means having faith that something beyond yourself can imbue you with the strength to overcome the challenges of recovery. www.drugrehabfl.net 1 (888) 998-1927
STEP THREE: TURN YOUR WILL OVER TO YOUR HIGHER POWER
"WE MADE A DECISION TO TURN OUR WILL AND OUR LIVES OVER TO THE CARE OF GOD AS WE UNDERSTOOD HIM." The first two steps are deeply personal and serve to restore hope for the future and faith that a power beyond your own flawed self can help you overcome your addiction. In Step Three, your attention turns to the higher power you identified in Step Two as you acknowledge that recovery requires help beyond the flesh, blood and brain synapses that make you who you are. However you defined your higher power in Step Two, that power is something bigger and more powerful than you, and it's more accepting of you than you are of yourself. Step Three leads you to mindfully release the death grip you have on the minutia of your life and listen to a deeper voice that's far wiser and more compassionate than you are. It leads you to let go of your preconceived notions of yourself, release your guilt, anger, frustration and self-hatred and realize that your current state and the problems in which you're mired represent only a sliver of your greater self. In Step Three, you turn your life over to the forces that drive your deeper, spiritual self so that you can effectively navigate the difficult steps that follow and open your mind to new possibilities and ways of thinking about yourself. In doing so, you open yourself to the humbling life lessons coming your way in the following steps so that they will resonate in a deeply meaningful way. www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 17
STEP FOUR: THE MORAL INVENTORY
"WE MADE A SEARCHING AND FEARLESS MORAL INVENTORY OF OURSELVES." Step Four is a time of soul-searching. At the core of our inability to intimately know ourselves is denial, the act of ignoring our negative aspects and pretending they don't exist because confronting them is terrifying on so many levels. Denial enables us to justify or rationalize our harmful thoughts and behaviors to make ourselves feel better about them. The moral inventory is a comprehensive, brutally honest written list of all of the wrongs you perpetrated while mired in your addiction. It's undertaken fearlessly because in Step Three, you turned your life over to your higher power, which is eternally compassionate and forgiving. During Step Three, you withhold self-judgment and, for now, accept your failings as a part of your past and regard them with impartiality. The Substance Abuse and Mental Health Services Administration stresses that knowing exactly where you've come from is essential for finding your way to where you want to go. 5 In extracting the unfortunate deeds you've done, these can now be replaced by an indelible lightness of being. You exist in the present, and you now have the power to make choices that will preclude you from making the same mistakes again. www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 19
STEP FIVE: ADMIT THE NATURE OF OUR WRONGS
"WE ADMITTED TO GOD, TO OURSELVES, AND TO ANOTHER HUMAN BEING THE EXACT NATURE OF OUR WRONGDOINGS." Once the fearless moral inventory has been made, it's time to step out from behind the mask of guilt, self-deception and pride that isolates you from others and prevents you from being honest with yourself. It's time to knock down the walls you've constructed to hide your shame and self-loathing, walls that make it difficult to analyze the issues underlying the addiction and move forward with certainty and clarity. With Step Five comes a profound inner shift wherein who you are is no longer defined by your sordid deeds, but by self-forgiveness and sharing the weight of those deeds with a wise, supportive soul. Not only will you come out on the other side forgiven and whole, but you'll also find that you're no longer apart from humanity, no longer hiding behind a veil of deceit. You'll move into the next phase of recovery with open-mindedness and honesty. www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 21
STEP SIX: REFLECT AND FIND A WILLINGNESS TO CHANGE
"WE WERE ENTIRELY READY TO HAVE GOD REMOVE ALL THESE DEFECTS OF CHARACTER." Step Six is about reflection, preparation, and a willingness to change. Being willing and ready to surrender your "defects of character" to a higher power means that you're ready to let that higher power God, Love, Buddha, The Universe, Allah, Nature touch your life and move you in a spiritual direction. It's becoming willing and ready to let go of certain things in your life that prevent you from progressing in your recovery and your spiritual growth. Step Six is the process of reaching this state of readiness, the process of finding that you're truly prepared to make the daily effort required to evaluate and adjust your thoughts and behaviors to foster healthy expressions of your humanity. Being willing to surrender your deficits of character to your higher power and continue to move into the light even despite setbacks, which are a natural part of recovery is an indication of your readiness to mindfully and honestly address imbalances in your life to promote spiritual growth and long-term recovery. www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 23
STEP SEVEN: ASK HIGHER POWER TO REMOVE YOUR SHORTCOMINGS
"WE HUMBLY ASKED HIM [OR HER, OR IT] TO REMOVE OUR SHORTCOMINGS." Step Seven is about humility rather than the expectation that your higher power will swoop in and erase your shortcomings with a magic wand and instantaneously transform you into a brand-new being. You're human, after all, and shortcomings are a part of the fundamental human condition. Destination Hope 25 Humility is the ability to see yourself as you actually are comprised of both strengths and weaknesses so that you can make a sincere attempt to become what you want to be. Humility is essential for moving away from yourself and your limitations and toward others and your higher power. By humbly appealing to your higher power to remove your shortcomings, you're embracing hope and committing to doing your part to rid your life of stumbling blocks that will inhibit your spiritual growth. www.drugrehabfl.net 1 (888) 998-1927
STEP EIGHT: MAKE A LIST OF THOSE YOU HARMED
"WE MADE A LIST OF ALL PERSONS WE HAD HARMED, AND BECAME WILLING TO MAKE AMENDS TO THEM ALL." In Step Eight, you work toward repairing the damage you've done to others, attaining forgiveness and restoring relationships whenever possible. Similar to the moral inventory, Step Eight requires first making a list of the people you hurt and recording thoughts about how you might make amends. Then, you work toward a willingness to make those amends. Destination Hope 27 Step Eight demands honesty about your relationships with others. It's the beginning of the process of forgiving people who have hurt you and being forgiven by those you've hurt, and it helps build an awareness of your new and changing attitudes about yourself and your relationships. www.drugrehabfl.net 1 (888) 998-1927
STEP NINE: MAKE AMENDS
"MAKE DIRECT AMENDS TO SUCH PEOPLE WHENEVER POSSIBLE, EXCEPT WHEN TO DO SO WOULD INJURE THEM OR OTHERS." Step Nine serves to help clear your conscience and banish the lingering vestiges of guilt, regret and shame which may be long buried and all but forgotten that shapes and skews your self-perception and leads you to blame others, justify unjustifiable actions and make excuses for your behaviors, all of which are unhealthy and impact your clarity and serenity. Destination Hope 29 Shame and guilt can fuel denial and lead to other negative consequences. 6 By making amends to the best of your ability, you're able to clear your conscience, improve your self-esteem, relieve stress and let go of blame. The first step is forgiving yourself for your wrongdoings and forgiving others for any part they may have played in your wrongful actions. The second step is coming clean, trying to make up for your actions, and in most cases enjoying the forgiveness bestowed upon you. This step helps you examine your actions under a microscope and understand how what you do affects others. www.drugrehabfl.net 1 (888) 998-1927
STEP TEN: MAINTAIN RECOVERY
"WE CONTINUED TO TAKE PERSONAL INVENTORY AND WHEN WE WERE WRONG PROMPTLY ADMITTED IT." Step Ten is about maintaining recovery by staying ever vigilant of your actions, behaviors, attitudes and emotions to ensure you don't revert to old, harmful ways of thinking and behaving. Spot-checks throughout your day enables you to identify selfish, dishonest, or fear-driven behaviors that can cause others harm. This, in turn, gives you the opportunity to make amends immediately so that you can live free of guilt and shame. Destination Hope 31 Daily examination of your thoughts and actions helps you identify emotional states that tend to lead you to make mistakes that affect others and compromise your recovery. It also helps you forgive others for their undesirable attitudes and behaviors that at one time might have led you to make regrettable choices. Step Ten is a lifelong endeavor that helps you keep your slate clean. It enhances your sense of compassion for yourself and for others, and it keeps you honest. www.drugrehabfl.net 1 (888) 998-1927
STEP ELEVEN: IMPROVE CONSCIOUS CONTACT WITH YOUR HIGHER POWER
"WE 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." Step Eleven brings prayer and meditation into your daily life as an integral part of your ongoing recovery. The purpose of prayer in recovery, whether it's a plea to God or a heartfelt and earnest wish sent to the universe from your heart of hearts, is to be ever mindful of where you are and where you're going and to draw strength from your higher power. Meditation helps you make an explicit connection to a higher part of yourself to bring about meaningful change from the inside out. www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 33
STEP TWELVE: SPREAD THE WORD
"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." Step Twelve, the final step, is about spreading a message of hope to others who are just starting their recovery journey. By now, you've achieved emotional stability and live a mindful life mostly free of actions that lead to guilt, shame, confusion and other negative emotions. Now, you're qualified to be a sponsor to someone in need of personal guidance. You show others by example that you overcame the many barriers to recovery, and if you can do it, anyone can. Because you've been there and made the excuses and played the victim and lied to yourself and others, you're in a unique position to see through these behaviors in others struggling with addiction. You can show that hope is everything, that recovery is joyful and that even when life feels meaningless, it's anything but. You will always be a work in progress. You will always have to attend to steps nine and ten, and you'll still face challenges and experience setbacks. But by now, you're strong enough and know enough to be a beacon to light the way for others so that they, too, can transform their lives. www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 35
WHAT THE RESEARCH SAYS ABOUT 12-STEP PROGRAMS
For years, only a handful of studies set out to document the effectiveness of AA and other 12-step programs, largely due to the fact that to preserve anonymity, few statistics are kept by AA. According to the Hazelden Betty Ford Foundation, historian and author Charles Bishop, Jr. stresses that categorizing AA as a form of addiction therapy does it a disservice because it's a spiritual fellowship rather than a treatment strategy. 7 "The underlying difficulties of applying the scientific method to spirituality should give every scholar pause," he points out, noting that research on the effectiveness of the organization should be approached gingerly. Because it's a spiritually based program, science and medicine for many years scoffed at AA particularly the bits about personal powerlessness and higher powers. But over the years, science has changed its tune considerably, starting with a major federal study published in 1998 that found 12-step facilitation therapy to work as well as cognitive-behavioral therapy and motivational enhancement therapy for promoting total abstinence for the long-term. 7 www.drugrehabfl.net 1 (888) 998-1927 Destination Hope 37
A peer-reviewed study cited by an article published in the journal Alcoholism Treatment Quarterly found strong evidence for the effectiveness of Alcoholics Anonymous in the abstinence rates in those who attend AA, which is two times higher than the abstinence rates of those who don't. 8 Another study published in the Journal of Substance Abuse Treatment found that people who attended 12-step meetings prior to entering treatment Destination Hope 38 stayed in treatment longer and were more likely to complete the program. 9 The study also found that people who participate in both treatment and a 12-step program had higher abstinence rates than those who participated in just one or the other. Although some studies have found the evidence for AA inconclusive, the bottom line is that for many, it's an extremely important pathway to longterm successful recovery that enhances well-being, spirituality and purpose as well as leads to an overall higher quality of life. www.drugrehabfl.net 1 (888) 998-1927
SOURCES 1 ) Blocker Jr., J. S. Did Prohibition Really Work? Alcohol Prohibition as a Public Health Innovation. (2006, February). American Journal of Public Health, 96(2); 233-243. Retrieved from http://www.ncbi.nlm.nih.gov/ pmc/articles/pmc1470475/ 2 ) The Science of Drug Abuse and Addiction: The Basics. (2014, September). Retrieved from https://www. drugabuse.gov/publications/media-guide/science-drug-abuse-addiction-basics 3 ) Twelve Steps and Twelve Traditions. (2012, July). Retrieved from http://www.aa.org/pages/en_us/ twelve-steps-and-twelve-traditions 4 ) Recovery and Recovery Support. (2015, October). Retrieved from http://www.samhsa.gov/recovery 5 ) Chapter 4: From Precontemplation to Contemplation: Building Readiness. (1999). Treatment Improvement Protocol (TIP) Series, No. 35. Retrieved from http://www.ncbi.nlm.nih.gov/books/nbk64968/ 6 ) Substance Abuse Treatment for Adults in the Criminal Justice System: Major Treatment Issues and Approaches. (2005). Treatment Improvement Protocol (TIP) Series, No. 44. Retrieved from http://www. ncbi.nlm.nih.gov/books/nbk64124/ 7 ) Toft, D. (2000). Recent Research Offers Compelling Support for the Effectiveness of Twelve Step-Based Treatment. Retrieved from https://www.hazelden.org/web/public/vcsum0research.page 8 ) Krentzman, A. R., et. al. (2010, December 29). How Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) Work: Cross-Disciplinary Perspectives. Alcoholism Treatment Quarterly, 29(1); 75-84. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3140338/ 9 ) Fiorentine, R. and Hillhouse, M. P. (2000, January). Drug Treatment and 12-Step Program Participation: The Additive Effects of Integrated Recovery Activities. Journal of Substance Abuse Treatment, 18(1); 65-74. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10636609
Destination Hope is an addiction and mental health treatment center in Ft. Lauderdale, FL that provides specialized, gender-specific programs for substance abuse and dual diagnosis. We ve helped hundreds of clients break free from drug and alcohol addiction, and our programs are carefully designed to fit your loved one s needs and maximize their recovery. Whatever your situation is, we re there for you. The Men s Program 1 (888) 998-1927 www.drugrehabfl.net