July Newsletter: Core Principles in the 12 Steps – Step 11

SteinbergBy John Steinberg, MD – The Bergand Group

Continuing our newsletter series, we turn now to Step 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.” (Italics in the AA step from AA approved literature)

This step produces no problem for most who find their way to AA or to NA and yet it is, of all the steps, perhaps the single most insurmountable barrier to those who identify as agnostic or atheist. As to the theological connotations, there is no ambiguity in this step- much as we find in the AA prologue, read at many meetings: God exists and one needs to find Him to recover.

From a personal point of reference, working with clients across the philosophical spectrum, from the very religious to the religious to the spiritual to the agnostic to the atheist, and convinced of the benefits offered by shared recovery within a fellowship such as is offered by the twelve step programs, I have found a bifurcated approach to explaining this step useful. For the first three categories of patients, there is no problem in discussing this step and this approach will be discussed first. For the secular minded patients, a very different approach is required, especially for those who are not satisfied by the as we understood Him language, or for those who are alienated or offended by religiosity of any degree.

From the religious/spiritual perspective, this second of the three maintenance steps carries the concept of continuity further. Having stated in the AA Big Book that “lack of power was our dilemma” this step reminds those who have found their way to sobriety through the first ten steps that an ongoing effort to make a deep and meaningful connection with whatever spiritual concept of a higher power has gotten them this far is essential. Some understand this to mean doing so by engaging in daily prayer in a classical sense. Many recovering individuals rely upon prayer, whether the formalized morning and evening prayers, whether the “third step prayer” found in AA literature, or the prayers commonly offered to open or close meetings (The Serenity Prayer, The Lord’s Prayer), to develop, maintain, and “improve” their “conscious contact” with their higher power. Some use the prayerful condensed version of the first three steps: “I can’t. He can. Let him.” Others who are less formally religious, find that a period of peaceful meditation and contemplation suffices. The reliance first gained in achieving abstinence from alcohol and drugs is nurtured and enhanced by a progressive application of religious or spiritual processes and imbues the recovering person with a sense of confidence that the process of recovery can be maintained. Many describe this process as simply learning to “get out of their own way.”

For the secular persons in recovery, the concept of a secular higher power, embodied by the five principles expounded in the twelve steps, allows the nurturing of a relationship with that “higher power” to proceed along entirely rational grounds, devoid of any supernatural or paranormal phenomenon or requirements. I advise such persons to view the process of maintaining conscious contact to simplify this expression as the generic statement “staying in touch.” If the actively using phase of the disease of substance addiction can be viewed as the acting out upon the character defects, identified in steps four and five, and minimized, though not eliminated, in steps six and seven; then, in step eleven, the process of conscious contact can be interpreted as giving voice to one’s higher nature rather than one’s baser instincts. Continuity, rather than any specific belief requirement, is the point to be emphasized to the secular person in recovery.

One of my patients forwarded to me a completely secular (and non-approved by AA or NA) version of the twelve steps. It can be found at here. In this version, Step Eleven reads as follows: “Sought through meditation to improve our spiritual awareness and our understanding of the AA way of life and to discover the power to carry out that way of life.” I find this approach quite useful in affording our secular clients a means by which they can benefit from participation in a twelve step fellowship. Of course, directing such clients to find meetings and mentors in the program where religiosity is minimized and tolerance is maximal helps as well.

In conclusion, as health professionals working in the field of addiction medicine, it is incumbent upon us to help each of our clients develop an approach to recovery that has practical results and which can be acted upon by each particular patient. Recovery and continuous, progressive personal growth, free from active use and addiction is our goal. Our patients’ stability and comfort is our highest goal, not imparting any particular belief system. In thirty years in this field, I have seen people in recovery evolve as in AA’s Big Book Chapter Three, To the Agnostic- from a context of agnosticism to one of religion or spirituality and I have also seen quite the opposite- patients who begin their recovery from a theological or spiritual frame of reference and with the passage of time become less and less convinced that anything beyond the rational world either exists or is required to enjoy progressive personal development and recovery. As people change in recovery, so long as they remain in recovery, any perspective that helps them stay in recovery, is something we in the profession can and should capitalize upon.

John Steinberg, MD, FASAM
Medical Director, The Bergand Group