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the 12 - step habit
you get with the program?
Pollack Seid, Ph.D.
confess, I really look forward to my stiff cocktail every
night, eat-more fat laden calories than I intended to and
worry a lot - even in my sleep - about my husband, children
and our careers. Am I an alcoholic? Foodalcoholic? Workaholic?
Codependent? Should I get off the treadmill and begin some
You'd think so. Twelve -step recovery programs have been
sweeping the nation, and an estimated 15 million to 45 million
of us now participate in them. Book on codependency top
best-seller lists, and in April, a cable station all about
recovery, the Recovery Network, began airing two hours a
day and already reports to have 15 million viewers. Even
President Clinton and Vice President Al Gore use recovery
lingo in some of their speeches.
all began in 1935, when stockbroker Bill Wilson, struggling
to stay sober, sought help from a fellow drinker. Wilson
found that the mutual support, mixed with spirituality,
was effective in keeping him sober, and he went on to write
Alcoholics Anonymous (aka "The Book") which spells
out the 12-step program he created.
In many ways, The Book shaped our current views of addiction
by pointing out that, whether physical or psychological,
it is not a contemptible moral defect; it's the product
of a tragic, incurable disease. The best alcoholics can
hope for is remission, which only comes with abstinence,
because even a sip can trigger craving and abuse.
to 12-step philosophy, you must get support by attending
meetings with other recovering addicts for the rest of your
life. The meetings are free and enforce anonymity, in part
to encourage honesty: Hence the famous introduction, "Hi,
my name is (first names only) and I'm an alcoholic."
Meets the '90s
the late 1950s, applications of the 12-step model had spread
from chemical dependency to compulsive behaviors (Gamblers
Anonymous in 1957 and Overeaters Anonymous in 1960, for
example). But in the past decade, the term addiction has
ballooned to mean any activity or emotion we feel powerless
to control: work, sex, shopping, love, moods, you name it.
At the same time, "codependent" has expanded from
its original meaning - family members of alcoholics only
- to include anyone involved in, or dependent on, any unhealthy
relationship, regardless of whether alcohol is involved.
By the new definitions, it seems that nearly everyone suffers
from or is affected by, some sort of addiction.
Today, 12-step philosophy is pervasive. Many therapists
refer patients to such programs, and courts often order
convicted drunken drivers to attend A.A. Millions who struggle
with destructive behavior have found healing in the 12 steps.
"Try it," says Laura, a thirteen-year member of
Emotions Anonymous. "If you don't like it, we'll refund
There's a Plot Twist
research is starting to cool the 12-step fervor. A recent
study by the National Institute on Alcohol Abuse and Alcoholism
indicates that A.A. is no more successful in curbing alcoholism
than behavioral or motivational psychotherapy treatments.
Other studies suggest that A.A.'s strict insistence on abstinence
According to Reid Hester, Ph.D. director of division of
the research Behavior Therapy Associates in Albuquerque,
N.M., ex-drinkers who equate "one slip" with "relapse"
end up bingeing more often than those who are more tolerant
of their lapses. In fact, European alcoholic treatment programs
generally encourage moderation rather than abstinence.
When it comes to drugs, studies have begun to challenge
the assumption that one hit of an addictive substance begins
a lifelong downhill spiral of dependency that only 12-step
or professional intervention can control. Most of the soldiers
addicted to heroin during the Vietnam War got over their
addiction simply as a result of returning home. Of those
who used heroin on their return, only 12 percent became
addicted again. What's more, research suggests that by age
35, most substance abusers "mature out" of the
abuse and become moderate users or abstainers, without intervention.
also are concerned about the psychological impact of the
12-step philosophy. Addiction often is symptom of other
problems, and fellow sufferers, while often offering precious
support, don't have the training to treat such problems,
says Stan J. Katz, M.D., and Aimee E. Liu in their book
The Codependency Conspiracy: How to Break the Recovery Habit
and take Charge of Your Life (Warner, 1991). In addition,
the authors point out that we can become hooked on the recovery
programs themselves, substituting one addiction for another.
recent codependency craze also troubles some experts. Several
codependency theorists contend that the modern family is
dysfunctional, leaving more than 95 percent of us with a
starved "inner child" and a personality primed
for dependency. Many argue that the terms codependent and
dysfunctional become meaningless when they include so many
of us, and this viewpoint encourages us to perceive ourselves
as victimized or diseased.
fact, 12-step thinking may lead us to interpret potentially
harmful behavior - like drinking a glass of wine every night
- as an addiction. Some experts believe this label is counterproductive
at best. Stanton Peele, Ph.D., author of Diseasing of America:
Addiction Treatment out of Control (Lexington, Books, 1989),
suggests that the A.A. message is dangerous because it implies
that we don't have the willpower to change without help
12-stepping may fill a deep need. "It's really a religious
movement," says Harry Levine, Ph.D., professor of sociology
at Queen's College City University of New York. Wilson modeled
A.A. on evangelical ideas, but modern psychology infiltrated
it and changed the words. You confess you're an addict as
opposed to a sinner, and you seek recovery rather than salvation.
In fact, the religious nature of A.A. has prompted some
legal scholars to contend that courts violate the First
Amendment's freedom of religion
when they order drunken drivers to attend A.A., while new
groups are sprouting for those who don't believe in a higher
Perhaps this movement just continues our historical search
for perfection or the age-old struggle to deal with our
destructive impulses. Surely, it has helped many improve
their lives. But blaming our troubles on an addiction, or
on dysfunctional upbringing, may not help us or our culture.
before you assume you're addicted to something, consider
the inner strengths you do have. Rather than nurturing your
inner child in a 12-step program for the rest of your days,
you might find more power in improving your coping skills
and facing life's responsibilities head-on.
P. Seid, Ph.D., a historian/writer in
Santa Monica, Calif., is author of Never Too Thin: Why Women
Are at War With Their Bodies (Prentice Hall press, 1989).
SHAPE, November 1997)