I am often asked, "What about people who don’t like 12 step meetings, do you have any ideas about how to help them?"

As a matter of fact I do have a few ideas about people who “don’t like 12 step”.

Sometime after graduation from this DBH (doctor of behavioral health) program I am in, I would like to write an article titled, “If vegetarians embrace a lifestyle motto of ‘I don’t eat meat”, why can’t alcoholics embrace a lifestyle motto of “I don’t drink”?

Of course, stopping drinking is not the same as stopping eating meat because vegetarians aren’t addicted to meat. Addiction is not simply a cognitive behavioral issue, although some would have you believe that it is. The choice argument fails again and again, yet some people/professionals refuse to accept that addiction recovery requires a spiritual change. Not religious, not god – but a change at the core of existence. A change that resolves the question, “what gives my life meaning?”.

The self exploration required to answer this deeply personal question requires support from a community dedicated to individuation and spiritual growth. 12 step programs offer just that. If you don’t like 12 step programs you are going to have to find this community somewhere else. Churches often offer this kind of support, but usually people who “don’t like 12 step” are religion resistant.

People don’t like chemotherapy either, but when the physician orders chemotherapy as the best chance at survival from cancer, patients accept it and do it. Addiction is a chronic progressive, and potentially fatal disease that requires a specific course of treatment. It isn’t any different than cancer.

It is often not the patient, but rather the physician or other health professional (including the psychotherapist), who “doesn’t like 12 step”, he doesn’t accept 12 step as a viable addiction recovery method. The professional hides behind the guise that the patient won’t accept 12 step recovery – however, if the therapist believes in the model of therapy he is presenting – the patient will most often also accept the treatment. These professionals who lack expertise in addiction treatment derail the addicted patient before he ever boards the train.

Why is it that addiction treatment centers worldwide use 12 step recovery as the basis of their treatment? The answer simply is that 12 step recovery works. Consistently over time, 12 step recovery has been the only model of addiction treatment to produce results. The little known fact is that people get clean and sober all the time. Addiction treatment experts witness this daily, I sure do.

The problem is that people who recover in 12 step programs do so anonymously. The problem with anonymity is that the general public including doctors, judges, and psychotherapists don’t have reason to have contact with these recovering people. They are anonymously going about living their happy, joyous, and successful lives free from active addiction. The patients and plaintiffs the doctors, judges, and psychotherapists have contact with are the ones who “don’t like 12 step”. They are the ones getting arrested, med seeking in doctor’s offices, and showing up in emergency rooms and morgues after overdoses and alcohol/drug related accidents. Those things stop happening for people in anonymous 12 step recovery.

So I think the real question to ask is “Why do therapists and physicians without expertise in addiction treatment think they know better how to treat an addict than the experts?”

As Nick Cummings, PhD says, “all insight is soluble in alcohol”, therefore we need to sober up an alcoholic (or drug addict) prior to embarking on this expedition of self exploration. So the answer is ALWAYS abstinence. Not harm reduction, not controlled drinking – abstinence. Once a person has mastered abstinence for 1 year, he can decide if he wants to commit to an ongoing abstinent lifestyle. But not before one year.

And, by the way, anyone who can not possibly imagine one year without alcohol (or drugs) hints of addiction. A non-addict can take it or leave it. Only an addict will be emotionally attached to their chemical and fight for their right to use it.

At the root of addiction is a self-esteem issue. Although it may not appear this way on the surface, when you dig deep enough you will find that every addict suffers from the belief that he is not enough. Not smart enough, not pretty enough, not “whatever” enough; or simply stated, just plain “not enough”. Drugs and alcohol are used to buffer the person from that reality.

The fundamental belief system for the addict states “I can’t handle life without a chemical to get me through”. However, this belief system operates at the subconscious to unconscious level, so an addict presenting for treatment is walled off behind defense mechanisms that protect this belief. These defense mechanisms include; rage, people pleasing, “looking good”, hopelessness, workaholism, perfectionism, martyrdom, and a slew more. An untrained therapist will misinterpret these, and never see the suffering addict underneath.

So, leave addiction treatment to the addiction treatment experts, who will give the proper prescription to an addicted person. It will go something like this, “I am sorry to tell you that you have a chronic, progressive, and potentially fatal disease that will kill you if it is not arrested. That’s the bad news. The good news is that you have a 100% chance of 100% lifelong remission if you follow this treatment protocol. All you have to do is stop drinking/using, and go to AA or NA. Then, get a sponsor and work the steps – and one year from now you will be free from the active disease of addiction.”

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