Twelve step programs

A twelve-step program is a fellowship primarily found in the USA and Canada which aims at the recovery of its members from the consequences of an addiction, a compulsion, or another harmful influence on their lives, with the help of the faith-based Twelve Steps. Also the specific program of recovery that is applied within such a fellowship, is called a twelve-step program. The fellowship, a bond of loosely organized, autonomous groups, functions on the basis of principles, formulated in the Twelve Traditions. Synonyms are anonymous program and A-program; the original twelve-step program is Alcoholics Anonymous (A.A).

Characteristics
All twelve-step programs follow some version of the Twelve Steps. Members meet regularly to discuss their problem(s) and share their victories. Common among all such programs is the view that members are dealing with an illness rather than a bad habit or a maladaptive behavior, that the illness is a combination of an allergy of the body that creates uncontrollable cravings coupled with an obsession of the mind that keeps finding rationalizations for returning to that which causes the cravings, and that recovery from the illness can occur by abandonment of individual will through the Twelve Steps. True to the Twelve Traditions, twelve-step programs do not take positions on outside issues such as medical ones. The word "illness" rather than "disease" was used by Bill Wilson, a co-founder of A.A. and the main writer of the Big Book, to make certain that the addiction would not be classified as a medical disease.

One of the most widely-recognized characteristics of twelve-step groups is the requirement that members admit that they "have a problem". In this spirit, many members open their address to the group along the lines of, "Hi, I'm Pam and I'm an alcoholic" &mdash; a catchphrase now widely identified with support groups.

Attendees at group meetings share their experiences, challenges, successes and failures, and provide peer support for each other. Many people who have joined these groups report they found success that previously eluded them, while others &mdash; including some ex-members &mdash; criticize their efficacy or universal applicability. Thus there is some controversy about twelve-step programs.

The Twelve Steps
These are the twelve steps of Alcoholics Anonymous.


 * 1. We admitted we were powerless over alcohol; that our lives had become unmanageable.
 * 2. Came to believe that a power greater than ourselves could restore us to sanity.
 * 3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
 * 4. Made a searching and fearless moral inventory of ourselves.
 * 5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
 * 6. Were entirely ready to have God remove all these defects of character.
 * 7. Humbly asked Him to remove our shortcomings.
 * 8. Made a list of all persons we had harmed, and became willing to make amends to them all.
 * 9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
 * 10. Continued to take personal inventory and when we were wrong promptly admitted it.
 * 11. 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.
 * 12. 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.

(Sources: Alcoholics Anonymous)

Other twelve-step groups have modified the twelve steps slightly from those of Alcoholics Anonymous to refer to problems other than alcoholism.

History
The first such program was Alcoholics Anonymous (AA), which was begun in 1935 by Bill Wilson and  Dr. Bob Smith, known to A.A. members as "Bill W." and "Dr. Bob." in Akron, Ohio. They established the tradition within the "Anonymous" twelve-step programs of using only first names. The Twelve Steps were originally written by Wilson and other early members of AA to codify the process that they felt had worked for them personally. The Twelve Steps were essentially a rewriting of the 6 steps of the Oxford Group (founded by Frank Buchman)with whom Wilson had contact. This "codex" is the book Alcoholics Anonymous, often referred to as the "Big Book."

After the unusual cures were realized by Bob and Bill, the Akron group authorized Wilson to write a book about the program. But Wilson returned to New York and wrote an entirely different program based primarily on what he had learned from the Rev. Samuel M. Shoemaker, Jr., rector of Calvary Episcopal Church in New York, and a leader of the Oxford Group people in America. To Shoemaker's ideas, which are found almost verbatim in the Twelve Steps, Bill added in his Big Book (the new basic text) ideas about alcoholism from Dr. William D. Silkworth, ideas about the necessity for a conversion from Dr. Carl G. Jung, ideas about a so-called "higher power" primarily from Professor William James and New Thought writers, thoughts from Anne Smith's (Dr. Bob's wife) Spiritual Journal, practical techniques from Richard Peabody set forth in his Common Sense of Drinking book, and a smattering of words and phrases with New Thought and New Age origin such as "Universal Mind," "Czar of the Universe," "fourth dimension of existence," and "higher power." Then Wilson declared there had been a program of recovery which consisted of Twelve Steps the pioneers had taken to find God. Bill asked Shoemaker to write the Steps, but Shoemaker declined. The Steps can be recognized in the Oxford Group teachings Wilson received from Rowland Hazard and Ebby Thacher in late 1934 and early 1935, but neither the Oxford Group nor early A.A. in New York or Akron had any "steps" at all.

A.A. was, at its origins, most assuredly a "religion" and a "religious organization." The concept of "spiritual, not religious," seems to have derived from the desire to keep religion separate from A.A. even though the precepts and practices of A.A. were Biblical in roots and nature. Thus early A.A. meetings in New York were those of "A First Century Christian Fellowship" then also known as the "Oxford Group." The "spirituality" idea was originally defined by Wilson as reliance on the Creator &mdash; truly a religious idea.

Some say that since the publication of the book "Alcoholics Anonymous," New Thought and New Age substitute words have driven A.A. talk and writing towards unbelief and substitutionary, secular universalism rather than toward a relationship with God &mdash; the avowed Big Book purpose of the Steps. Then again, A.A. circuit speakers can often be heard to say things like "if 'God' ran you out of A.A., alcoholism can run your rusty ass back in again."

The Twelve Steps were eventually matched with Twelve Traditions, a set of guidelines for running individual groups and a sort of constitution for the fellowship (e.g. AA) as a whole.

Many other programs since have adapted AA's original steps to their own ends. Related programs exist to help family and friends of those with addictions as well as those with problems other than alcohol. These programs also follow modified versions of the Twelve Steps of Alcoholics Anonymous and include groups like Al-Anon/Alateen, Overeaters Anonymous (OA), Gamblers Anonymous (GA), Narcotics Anonymous (NA), and Nar-Anon.

One organization which is often confused with an "Anonymous" twelve-step program, due to the intentional similarity of its name &mdash; but is not one &mdash; is Narconon. Narconon is a branch of the Church of Scientology, presenting Scientology doctrine and practices as a therapy for drug abusers. Narconon does not use the Twelve Steps, and is not related to either Narcotics Anonymous (NA) or to Nar-Anon, despite the similarity of names.

Acceptance of a Higher Power
A primary belief of members is that their recovery requires them to give up their self-reliance and willpower, and to put their reliance on God, or a "Higher Power". Proponents of twelve-step programs argue that agnostics and even atheists can be helped by the program as a member’s "Higher Power" may be the 12-step group itself or any other entity, thing or object that helps a member to accept that they are powerless over their problem but that a belief in a "Higher Power" will help them to recover.

The success of Twelve-step groups in aiding in recovery of addictive illnesses is an argument of significance in some parts of the United States, where the criminal justice system has ordered 12-step group participation to convicted felons as well as inmate addicts as a condition of parole or shortened sentences. U.S. judges have often required attendance at AA meetings as a condition of probation or parole or as an element of a sentence for defendents convicted of a crime. A federal appeals court ruled in 1999 that doing so compromises the Establishment Clause - because A.A. practices and doctrine are (in the words of the district court judge who wrote Griffin v. Coughlin) "unequivocally religious". The United States Supreme Court denied certiori and let this decision stand.

Critics of the 12-step programs, however, often hold that this reliance is ineffective, and offensive or inapplicable to atheists and others who do not believe in a salvific deity. Other critics see forms of authoritarian mind control in the 12 step approach. However, Neopagans tend to view the 12 steps as a tool of empowerment so they do not share these concerns over giving up self-reliance and willpower. Nor do they view the 12 step approach as a form of mind control; they view it as a ritual, a set of actions, which is used to help bring about a desired goal.

Some critics state that 12-step groups are religious in nature. The only authorized literature in most 12-step groups is their own publications. The members of 12-step groups make the distinction that they are "spiritual, and not religious." The presence of Neopagans in 12-step programs, clearly indicates that the 12 steps are spiritual in nature and not dependent upon a specific religion. Nearly every meeting, however, begins with the Serenity Prayer, a prayer addressed to the "Lord," and many meetings end with a recitation of the Christian Lord's Prayer. The Big Book states that its "main object" is not to help you stop drinking, but "to enable you to find a Power greater than yourself." Although in many meetings it may be unusual to find participants who do not find their "higher power" to be the Christian diety, it can be useful for anyone regardless of their religious belief.

Some critics also question the idea of giving up on self-reliance, which can be seen as a form of idealized despair. Secular alternatives to twelve-step programs, such as Rational Recovery, are for this reason in many ways opposite to the twelve-step process. Others, such as YES Recovery, acknowledge a debt to the twelve-steps movement but do not have a culture of belief in God. Neopagans, who do not have a culture of a belief in one God, view the 12 steps as means to increase one's personal freedom by eliminating their addiction and their addictive behaviors, and helping them to avoid causing harm to others.

Relation to religion
The original A.A. program fashioned in Akron was described as a Christian Fellowship, held "old fashioned prayer meetings," stressed Bible study and prayer and the reading of religious literature, and insisted on bringing people to an acceptance of Jesus Christ as the way to a relationship with God.

While meetings were held by drunks and Oxford Group members, the work was said to be that of a "clandestine lodge" of the Oxford Group because its stress was on helping drunks to recovery, abstinence, resistance of temptation, old fashioned revival meetings, and conversion to Christ &mdash; which seemed to derive from the ideas, principles and practices of United Christian Endeavor Society of Dr. Bob's youth.

This program supposedly achieved a 75% to 93% success rate. At Dr Bob's funeral, Bill W alluded to the true figure of around 5%. Its adherents said they felt the answer to their problems was in the "Good Book" (as they called the Bible). There were no Steps, no basic text, only one regular meeting. The emphasis was on Bible study, prayer, seeking God's guidance, conversion, visiting hospitalized drunks, fellowship and witnessing. In a word, it was called "love and service" &mdash; the watchwords of United Christian Endeavor.

As with the Bible and other similar texts, there are many different ways of interpreting the intent behind twelve-step programs. And as with the Bible, there are those who argue strongly for a relatively literal adherence to program literature (often referred to as "Big Book Thumpers"), and then there are those who advise "take what you like and leave the rest" and advocate a much more liberal approach. (Note: The phrase "take what you like and leave the rest" cannot be found in the Basic Text of AA or any other A.A. literature. The Big Book makes it abundently clear that following the 12 steps to the letter is one powerful way for an alcoholic of the kind described in the Big Book to stay sober, although it also says clearly that AA has no monopoly on the truth.) Two books that look at the twelve-step literature from a more liberal point of view are The Zen of Recovery by Mel Ash and A Skeptic's Guide To The Twelve Steps by Phillip Z. Another book, "The Recovery Spiral: A Pagan Path to Healing" by Cynthia Jane Collins, looks at the 12 steps through a Pagan perspective.

Twelve-Step-Groups
An incomplete list of 12-Step-Groups ( http://www.MethadoneAnonymous.info )
 * ACA - Adult Children of Alcoholics
 * ADD-Anonymous - for people suffering from ADD
 * Al-Anon/Alateen
 * CA - Cocaine Anonymous
 * CDA - Chemically Dependent Anonymous(http://www.cdaweb.org/)
 * CEA - Compulsive Eaters Anonymous ( http://www.ceahow.org/ )
 * CMA - Crystal Meth Anonymous ( http://www.crystalmeth.org/ )
 * DRA - Dual Recovery Anonymous(http://www.draonline.org/)
 * DA - Debtors Anonymous
 * EAA - Eating addictions anonymous
 * BA - Borderliners Anonymous
 * CoDA - Codependents Anonymous
 * GA - Gamblers Anonymous
 * GamAnon - family groups of gamblers
 * EDA - Eating Disorders Anonymous ( http://www.eatingdisordersanonymous.org/ )
 * I.S.A. - Incest Survivors Anonymous
 * MA - Marijuana Anonymous
 * MTC - Make Today Count (for someone with a terminal disease)
 * NA - Narcotics Anonymous
 * Nar-Anon - family groups of addicts
 * NicA - Nicotine Addicts Anonymous
 * OA - Overeaters Anonymous
 * PIR - Pagans In Recovery
 * RCA - Recovering Couples Anonymous
 * RSO - Rape Survivors Anonymous
 * SA - Sexaholics Anonymous ( http://www.sa.org/ )
 * SAA - Sex Addicts Anonymous
 * S-Anon - family groups of sex-addicts
 * SCA - Sexual Compulsives Anonymous
 * SIA - Survivors of Incest Anonymous
 * SLAA - Sex and Love Addicts Anonymous
 * SA - Spenders Anonymous
 * SRAA - Sexual Ritual Abuse Anonymous
 * WA - Workaholics Anonymous

Literature
For more literature, see Alcoholics Anonymous, Literature; Bill W., Literature; Dr. Bob, Literature.
 * Kramer, Joel, and Alstad, Diana, The Guru Papers: Masks of Authoritarian Power, North Atlantic, 1993.
 * The A.A. Service Manual combined with Twelve Concepts for World Service by Bill W.''. 2004-2005 Edition, New York: Alcoholics Anonymous, 2004.
 * Alcoholics Anonymous. The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism, New York: Alcoholics Anonymous, 4th ed. new and rev. 2001, ISBN 1893007162 ('Big Book').
 * Twelve Steps and Twelve Traditions, New York: Alcoholics Anonymous, 1953, ISBN 0916856011.
 * "The Steps We Took", by Joe McQ. (of "Joe & Charlie") 1990 August House ISBN 0-87483-151-2
 * http://www.orange-papers.org/orange-interpreted.html

Zwölf-Schritte-Programm Twaalfstappenprogramma Programa de Doze Passos Tolvstegsprogram