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Monday, January 16, 2012

Why Community Based 12-Step Programs Fail


I am one of those few people who got sober through a community based 12-Step program which has a success rate between 3%-7%. Just getting sober is hard enough and when taking the community based approach the caveats and labels are endless. Over the last few years I have been doing a lot of complaining about the rate of successes and failures of the 12-Step approach to recovery at the community level. I am not alone. I have felt this way about the 12-Step program for a long time and would like to point out some specifics about this. First, I need to be absolutely clear about the fact that I truly believe the 12-Step approach does have effective tools for people in early sobriety. However, as people earn more time in recovery they often find out far too late, after he or she relapses, that the 12 Steps that get people sober, do not keep them there. Over the years, as research on substance related disorders and recovery have gained ground, we are learning that people are dying at a far more rapid rate from relapse when compared to first-time use. For this reason it is even more critical that community based 12-Step programs are better evaluated.
Friends and family who watch an addict destroy his or her life feel tremendous relief when their friend or loved one who had almost succumbed to drug abuse finally enters the rooms of recovery. The hope is often short lived however because many who seek recovery who enter these rooms, quickly realize that everyone in these rooms is looking for the same answers and that they are all extremely desperate. While some of the real answers lie in the program of the 12 Steps, this is often not realized. The 12-Step approach has gotten a limited number of people long term recovery and for many who cannot afford to look deeper into his or her own recovery, getting real help is an impossible and financially unattainable dream.
Getting right down to the bottom of it however, when I was a newcomer in a community-based 12-Step program, I really found that I was victimized by a lot of people and found the program to be predatory, sexist and abusive to women of all ages. Sitting in women’s meetings and reading outdated text materials where every action and inaction was written in the masculine form was and is really quite offensive and of little help to any woman suffering from addiction, which also causes depression among other serious conditions.
It amazes me how a 501(c3) like Alcoholics Anonymous, which is tax exempt, cannot afford to, or will not properly edit material that is suitable and relates to the sensitivities of today’s reading audience, both male and female. The fact of the matter is that the basic text of the Big Book of Alcoholics Anonymous has not changed since 1934, which was written during alcohol prohibition, which began January 6th, 1920 (18th Amendment) and ended December 5th, 1933 (21st Amendment). It would certainly be reasonable to believe that anonymity (A.A.’s 11th Tradition) was a probably a good position to take during prohibition. However, these days talking about alcoholism or addiction openly, without rendering a person “hopeless” and damaged goods, is becoming a far more preferred trend because the public is beginning to see that real help is only for those who can afford it. Therefore, if we are going to help everyone, a more open and honest dialogue about the real causes of addiction is a path we must take.
There is an extremely dictatorial tone within the rooms of 12 Step meetings. Members request, even demand that a newcomer get a sponsor, yet among all the “approved literature” there is only a small pamphlet and no comprehensive book specifically geared towards sponsorship. Sponsorship is a serious responsibility and can be a real liability where freely handing out advice on how a person should manage his or her life is risky business. Too risky for A.A. it seems. Sponsee and sponsor relationships have unwritten mandates, accompanied by absurd rules that conflict with the personal decision making process of rational people who know they want recovery.
I remember falling for this idea in my first year of recovery and ending up getting “advice” from a mentally disturbed women who spoke in riddles and of her collection of angel figurines. She wanted to make pasta formed like angels for us while explaining to me how to live a sober life. She often mentioned how little money she had which made me feel sorry for her and so I even gave her money, something I later found out was against the unwritten rules of which there were many. She kept baiting me in with "more will later be revealed" which was spellbinding. My so-called sponsor also called my residence at seven in the morning, demanding from my then fiancĂ© that I get on the phone because I must be going to a meeting right away. She harassed him right out of my life, telling him he was a negative influence on me and telling me if I stayed with him I would drink again. Me being new and extremely gullible, I believed every word and my engagement ended up in a “War of the Roses” style break up.
The fear and scare tactics of “if you don’t wear your hair up, you’ll drink again. You should not be in a relationship in your first year.” Or “if you don’t clean dirty coffee pots and get a commitment, you won’t stay sober” made little sense to me. But I “took direction” and “abandoned myself” as I was told, did just about everything I was asked to do, abandoning my life, passions, a real job with real responsibilities, all to appease my various sponsors which I eventually all fired.
Then I read the book that made me see things differently. It was written by a guy named Chuck C. and it’s title was “A New Pair of Glasses.” This book was about self-sponsorship and that is what I ended up perusing and it has served me well so far as I have never relapsed. From exploring other areas of self-help, I learned that if I don’t expand my knowledge on recovery beyond the rooms of 12 Steps meetings, I would be stuck forever serving an establishment that offers little hope in a big city like Los Angeles. Rather than spend all my time sitting in wobbly chairs that hurt my back, in dirty rooms, day in and day out, waiting to help someone, I decided to help myself and get a real job, a career, and go back to school to earn an undergraduate degree. It made me realize that my true mission in life is like anyone else’s. To become a dignified, useful member of society and help solve problems by applying valuable skills, while exercising compassion and understanding for my fellow man and woman.
We should be cautious to accelerate anyone into a program of recovery too quickly by making him or her learn faster than they can process the information. Getting toxins out of the body is a very unpleasant experience as it is and the force-feeding of categorical and God forbid unrealistic demands can do more harm than good. It is my true belief that recovery should be governed by the mental health profession because the way community based 12-Step is handled, better compares to inmates running the asylum rather than a place where people can get real help. I do believe that within the 12 Steps, there is a program there somewhere that can work for all people who would like to live by structured principles of recovery. However, for the most part, the 12-Steps need to be brought into the 21st Century. Some reputable recovery organizations like the Hazelden Foundation have helpful literature taking the 12-Steps to a new, more 21st Century friendly audience. Hazelden Press has a book on how to be a sponsor that in my view should be in every 12-Step meeting anywhere and anyone who is a sponsor should have at least five to ten years in recovery and be certified, having taken at least one semester in psychology on substance related disorders.