August Newsletter: Core Principles in the 12 Steps

SteinbergBy John Steinberg, MD – The Bergand Group

Concluding our series of newsletters on the twelve steps of fellowship programs such as Narcotics Anonymous and Alcoholics Anonymous, we come now to Step Twelve (AA version):

“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.”

This step has three elements embodying two principles. The first reference is to a “spiritual awakening.” In The Varieties of Religious Experience, by William James, (1902), James referred to “spiritual awakenings” as being either slow or fast, intellectual or theological. Bill Wilson, a co-founder of AA, once referred to James as being one of AA’s founders, so influential were his works on Bill Wilson. James’ book is also referenced in the AA “Big Book” on page 38 of the 1st edition and on page 28 in the 2nd, 3rd, and 4th editions. A spiritual awakening has been characterized as a coming to consciousness of a higher order or a higher purpose to life that frees one (the alcoholic or addict) of the blinding self-centeredness that locks the addict/alcoholic into a cycle of unremitting use of drugs and alcohol. AA actually states that alcohol is “but a symptom” of the disease whose true roots lie in “selfishness and self-centeredness.”

Just as with awakening from sleep, the dichotomy of the sleep/wakefulness experience can only be experienced from one side of the dichotomy. When one is asleep, one has no awareness of or conception of being awake. When one awakens, one becomes aware of his surroundings and realizes, “I was asleep but have now awoken.” When one suffers from a substance dependency disorder, one has no conception of being “spiritually awake.” Through the processes of the steps (identity/insight/change/responsibility/continuity), one comes to wakefulness as a fully functional human being. This awakening can be as rapid as the sudden wakefulness that follows the ringing of an alarm clock or it may be as gradual as the slow return to consciousness as seen in many life processes, such as finally grasping calculus or carpentry after weeks/months/years of diligent study and application. The awakening can be as deeply religious as a personal experience of God (as Bill Wilson’s was- while hospitalized in the Charles Towne Hospital in December of 1934 under the care of Dr. Silkworth) where Bill heard a rushing wind and the voice of his personal deity. It can be as abstract and intellectual as the internalization of the conception of processes enumerated above as a means of obtaining a secular higher power and enjoying freedom from the use of drugs and alcohol. For each recovering alcoholic/addict, the conception of awakening, the time course, and the nature of the experience are as individualized as the people themselves. What is irreduceable is that, after a long drug and alcohol induced moral sleep, in recovery, one finally awakens. That this will occur it is the core promise of the twelve steps.

The next element of the step is the principle of altruism- carrying the message to the still suffering alcoholic. The genesis of this concept is embodied in the apocryphal story that, when Bill complained to his wife, Lois, that none of the alcoholics he had shared his vision with, whom he had nurtured and, in many cases, whom he had brought into his home, had stayed sober, she begged to differ. Lois informed Bill that one alcoholic, after many years of failed sobriety, had actually stayed sober. Bill asked, “Who might that be?” Lois replied, “You.” Thus Bill grasped that he could stay sober by working with other alcoholics, even if they, themselves, could not remain sober. This was his message to Bob Smith on Mother’s Day, 1935, when they met and has been the basis of both ongoing recovery and the genesis of the concept of AA/NA sponsorship. One of the program sayings is that one must “give it away to keep it.” Altruism, getting out of self, is the basis upon which the continuing recovery obtained once awake, persists. One can avoid falling back asleep by altruistically working with other addicts and alcoholics without thought of personal reward.

The final admonition of the entire body of steps and of step twelve itself is to “practice these principles in all our affairs.” Once acquired, tools are only as helpful as they are applied in a task. The powerful tools of the twelve steps are akin to a set of woodworking tools given to a child. Perhaps at first, one makes a key-holding pegboard. After gaining control and manual dexterity, perhaps building a table comes next. Eventually, the now-skilled woodworker can make furniture, cabinetry, and build a deck. He is using the same tools he started with. He’s just become more proficient in their use. So too with the tools of AA. The early identification of the nature of the problem, the insights and changes, the acceptance of personal responsibility, and the commitment to ongoing recovery are first applied to solve the drinking/drugging problem. Once abstinence from alcohol and drugs is obtained- the foundation of successful recovery in AA and NA- the very same tools can then be applied to improve one’s self-esteem, emotional health, relationships with others, ability to be a decent employee or boss, to be a good parent. Indeed, the possibilities of growth are boundless. I once heard AA referred to as “the college of knowledge.” You can learn as much as you like. The course work is never ending. You can go at your own pace and go in any direction you desire. You can apply (practice) these principles to all your affairs. The steps embody a way of life that first offers “freedom from active addiction,” NA’s sole promise, and then offers unlimited further growth potential.

Awakening, altruism, and application- the elements of Step Twelve allow one to fully recover and grow as a human being. Cessation of active use is the predicate for entry into recovery. The goal is progressive growth and personal happiness through becoming a truly better individual. Another AA member once told me, “Pay attention to how you live your life. You may be the only copy of the Big Book someone else reads.” Remember, as AA states on page 132 of its Big Book, “We absolutely insist on enjoying life.”

John Steinberg, MD
Medical Director, The Bergand Group