May Newsletter: Step Two
By John Steinberg, MD, FASAM
Medical Director, The Bergand Group
It has been said that the fundamental insanity of alcoholism or drug addiction is doing the same thing, using drugs or alcohol, and expecting different results, The inability to connect cause and effect, to see the use of the drug of choice as the root cause of our problems is pervasive and powerful. A patient once said to me, after complaining about his job, his wife, his family, his finances, and his health, “If you had the life I have, you’d drink, too!” To which, I retorted, “If I drank the way you drink, I’d have the life you have.” All too often the alcoholic cart is put before the recovery horse.
Let’s take a more detailed look at the term “sanity.” Much of our focus is on defining the insanity which is inferred in the step. After all, sane people don’t have to be “restored” to sanity. When asked by a patient to offer some insight as to what, exactly, sanity would be, the following was suggested: Sanity is the ability to predict one’s behavior and actions, and their results and consequences, with confidence. It’s a frightening prospect, the insanity of addiction. When our disease is active, we start each day with the best of intentions, but, we never see the disasters coming. And we seem utterly unable to appreciate that in virtually every case, our misery is precipitated if not initiated by our drinking and drugging. Having been restored to sanity, we, as sane people, can be assured of our ability to control our behavior, to begin to control our emotional responses to events, and to have some sense of peace and predictability in our lives.
There is hope, as well, for those among us who feel that we have never actually been sane. Indeed, use of alcohol and drugs may have been one of our earliest attempts to “fix” our perceived abnormality. It is my experience, over decades, that once underway, the recovery process from addictions truly has the ability to help addicts and alcoholics become “weller” than they were before they got sick. All have the opportunity to be restored to sanity, at least as it relates to our addiction, irrespective of our pre-morbid state.
Now to address the second half of the step, a higher power. At its simplest, this merely represents an externalization of the solution to our problems. Externalization to achieve problem resolution is a very useful skill learned early in childhood. Have a problem? Ask a parent or adult to help solve it. This continues. Car break down? Ask a mechanic to help. Before embarking on a discussion of the Higher Power concept as it appears in this step, let’s be reminded that AA and NA, and all 12 step programs, are incredibly egalitarian in allowing complete freedom to define the higher power however one wishes.
A higher power may be explained as follows. There are two words:
- Higher: This implies a hierarchical ranking, something greater than.
- Power: This implies the ability to compel action.
A higher power is merely that which can make us do things we otherwise wouldn’t do. Higher powers come in six flavors: human or non-human, positive/neutral/or negative. Drugs are a negative, non-human, higher power: they get us to do things we would never otherwise consider doing. The step implies that there will be a nurturing higher power. While sponsors or parents or teachers can serve as human, nurturing higher powers, the clear inference in the steps is that the higher power referred to in the 12 steps is other than human. That leaves two broad categories to consider.
For the vast majority of 12 step program members, the nurturing higher power referred to in the steps is “God as we understand Him.” For a not insignificant minority, the higher power can take a secular form. For those who enter the 12 step recovery programs with a theological or spiritual perspective, the step reads just as it is and serves them well. For those who prefer a secular approach, I suggest they utilize the five concepts represented in the 12 steps as described in a previous chapter. For convenience, I’ll repeat them here:
- Identity/Steps 1-2-3
- Insight/Steps 4-5
- Change/Steps 6-7
- Responsibility/Steps 8-9
- Continuity/Steps 10-11-12
If one is of the agnostic or atheist perspective, these five steps can serve as a perfectly adequate higher power. I have used this concept with patients as follows, if they wish a secular approach to utilizing programs such as AA and NA:
- Left to your own devices, you are powerless over alcohol, over your addiction. It is the nature of the addict or alcoholic to use these substances to the detriment of self and others.
- HOWEVER- if you CHOOSE to surrender to a core set of concepts as articulated above, and yield to this higher power within the fellowship of a 12 step program, you, too, can recover. You can be restored to sanity.
- After hitting bottom, having experienced the depths of despair and the insanity of an utterly unpredictable life, feeling like a bit of debris tossed helplessly along by a raging river, we gain hope as we are thrown a rope. We can be restored to sanity. We have come to believe that our insanity can be ended. That is the promise of Step Two.
Having identified the problem and gained confidence that a solution is at hand, the actions step, Step Three, follows and that will be the topic of the next chapter.By John Steinberg, MD, FASAM
Medical Director, The Bergand Group