The Next Step: Getting Beyond the 12 Steps

The Next Step… Getting Beyond The Twelve Step Disease Paradigm.

The umbrella group of treatments that originate from the original Alcoholics Anonymous, including ALANON,OA,NA, ACOA are otherwise known as 12 step programs. They teach awareness, ethics and skills for dealing with the problems of addiction. They promote honesty, surrender, apology and service. They foster fellowship, provide community and structure. They ask for accountability and responsibility. They offer hope, spiritual connection and support. They can be helpful to the addict and to the families who suffer from addiction. However, 12 step programs are not the exclusive places where these skills, ethics and healings can be found. Furthermore some ideas of 12 step programs seem to foster the disease they set out to cure.

Addiction is complex. We know much more now about the causes and conditions which foster addiction and ways to treat it than we did in the 1930’s when the first Alcoholics Anonymous group began. We understand much more about psychology, nurturing, neurobiology, diet and nutrition, genetics, alternative medicine, spirituality, human consciousness, and theories of recovery and healing.

The contradiction with the 12 step program is that it promotes a terminal disease model. According to it’s own theory, the addict will always have the disease of addiction. There is no cure. Not only is this a negative prognosis and fatalistic diagnosis, it is a self-fulfilling prophecy and has a built in cure.

In 12 step meetings, one has to declare ones self an addict at the beginning of every meeting. “Hi, my name is (_so and so__) and I am an addict” To state regularly one is never cured is a form of hypnosis and negative mental programming. It is a “curse” never healed by the spiritual force or “higher power” intended to lift such burdens, as prescribed by 12 step programs.

The placebo effect is the application of an inert idea or medicine that brings about positive result. A nocebo is a negative suggestion or medicine that brings about negative result. The use of a nocebo is a core belief of 12 step programs. Once an addict, always an addict, is the credo. It creates a disempowering dependence on the cure- the 12 step programs. This nocebo promotes the “stinking thinking”- a state of constant negativity and blaming, that the 12 step programs strive to cure.

The further use of nocebo comes with the 12 Step idea that “Addiction is a family disease.” Family members are believed to be as unhealthy and dysfunctional as the addict themselves. Dysfunctional family systems are likely to contribute to stressed and dysfunctional individuals. We do know that unhealthy family dynamics, genetics and emotional immaturity can be shared and passed down, but so can strength, emotional maturity and health. It is illogical to diagnose individuals or whole families as ill because one member is ill.

Many addicts suffer from low self-esteem. In light of the “12 Step systemic family dysfunction theory” they wonder why any healthy person would be in a relationship with them. They assume, since they are “sick” any person who loves them must be sick too. This is another form of nocebo or negative belief system fostered by 12 Steps.

Addiction is often illogical and destructive. Anyone dealing with an addict can be affected by unhealthy behavior. An emotionally immature person is bound to be confused while encountering addictive behaviors. This does not mean they are addicts or codependent.

Families and partners do need education and skills on how to live with addiction and dysfunction in healthy and constructive ways. People need ways to heal from the abuses that often accompany addiction. Dysfunction is not just the manifestation of addiction. Dysfunction is the nature of the immature or wounded psyche.

The 12 steps are conceptualized to remove the effects of the disease…. but not the disease it’s self! In this regard it is a lot like allopathic medicine, which focuses on the treatment of symptoms rather than the origins of the disease. This paradigm is not enough. One must strive to find the origins of disease.

12 step programs offer good tools for learning the language and basic dynamics for understanding addiction. They have important ideas about the dynamics of addiction that everyone could benefit from, but they have faults in their methods and ideas. The old 12 Step theories need to be integrated with newer ideas in psychology, psychotherapy, epi-genetics, nutrition, environmental medicine, spirituality and other healing modalities. Many variables can create an addictive disorder. Everything from family of origin, birth order, unhealthy relationships, epi-genetic makeup, nutritional deficiencies and allergies, environmental factors, trauma, microbial infections, all can contribute to a healthy or diseased state, including addiction.

As an acupuncturist and alternative medicine professional, I have found many cures are available for diseases otherwise thought to be terminal or incurable. Cures are dismissed due to their inconvenience or lack of societal acceptance or awareness. I have experienced addiction, not personally, but with family, friends, loved one’s. I have gained useful concepts from the 12 step programs and have watched suffering from the improper implementation of its ideas.

In my experience healing can happen in many ways. The universe is much too diverse, wise and forgiving. Just like spirituality, the path is wide. I prefer a pedagogical paradigm that encourages possibilities as well as limitations. I prefer placebos rather than nocebos. My philosophy is to utilize any source that speaks to you and heals you. Take what is true for you and leave the rest.

Knowledge must be a living, evolving thing. People and cultures grow and change with new and updated information and understanding. Perhaps, it is time for the 12 step programs to evolve with a culture that has grown exponentially since the 1930’s when the 12 steps came in to existence.

The disease paradigm and use of nocebos in 12 steps should be addressed in light of newer scientific ideas and psychological understanding. To define alcoholism as a disease that cannot be cured is a statement that corrupts the faith in science and research and any hope of human evolution and learning.

Lisa Baas 2014