Step 1 of the 12-step program goes like this:
We admitted we were powerless over alcohol
— that our lives had become unmanageable.
My very first step to recovery began with just the opposite.
I realized that I ultimately had the power over my life and with that understanding I chose to retake conscious control and responsibility for my life.
The 12-step program was founded in 1935 and is a product of its time and of the American Christian context in which it was born. In it the process to quit drinking is intimately linked to the belief in something greater than oneself that one needs to surrender to. The steps to recovery are detailed and follow each other in a way that easily reminds you of a machine or assembly line. The machine metaphor is easily available because the program was created in an industrial time when many thought models used the machine image.
In the 12-step program the person appears to be broken, and therefore needs to turn to the great mechanic in the sky to be repaired. The machine helps him/her to diagnose the problems that the mechanic needs to remove, but the main responsibility still lies with the mechanic.
The program has helped many people, but is surrounded by a belief to be able to help everyone, which is of course fundamentally wrong. No program, no action or intervention can help all people, because we are basically on different journeys, exploring different aspects of life and living in different realities.
People who do not believe in God, for example, often find it hard to embrace the 12-step program. Today many try to dechristianize the program to make it more accessible to non-believers, but the fact remains that the program is steeped in its history. Six of the twelve steps include direct reference to God, which is said to be a male entity.
The program also becomes problematic if the person finds it hard to work with the image that s/he is a machine that needs fixing, or if you like I have the understanding that the power to change is something internal. I do not recognize myself as powerless. I need quite the opposite – to remember that all power originates from me.
It’s good that the 12-step program is available, because there are people who feel the need to externalize power, who need to admit themselves powerless, who need to surrender and who furthermore need a detailed description of their recovery work beforehand. This does however become very problematic when participants believe that it is the only way, in the same way that many religions believe that they represent the only truth.
It becomes even more problematic that the 12-step program is so dominant that it is many times the only option, which is sometimes even forced upon people. Recently an American man was given a hefty settlement after a court forced him into a confessional sobriety program. In Sweden the alternatives to the 12-step program are hindered by authorities contributing to the 12-step program’s dominance. For example it is not uncommon that social assistance is conditioned with participation in the 12-step program, or that the only treatment available is based on the 12-step model.
At present there is an immense void when it comes to substance abuse treatment in Sweden, which leads to the majority not getting the help they need. There is a growing need for programs based on other belief systems, just as there is a growing need for programs that cater to atheists. We need programs that see people as organic beings, rather than machines. Or for that matter programs which liken the process to a journey, a release from a mental prison or a power struggle. The images we use for our recovery are extremely powerful tools. There is a need for programs that places the power to change within myself (all power in my life is based on me), just as there is a need for programs that place power outside of myself (I am powerless. God help me!).
This all stems from the fact that we need to help people based on their own beliefs about life – not from ours. To impose alien concepts on people in order to assimilate them in treatment is free of insight and thoroughly disrespectful. But above all, it is not good treatment, since it will be less effective.
Photo: So far by Stephen Cummings on Flickr