According to the CDC, around 109,680 overdose deaths occurred last year, up from over 107,622 in 2021, but nothing like the 30% increase seen in 2020, and 15% increase in 2021. About 6% of American adults (about 15 million people) have an alcohol use disorder; only about 7% of those people ever get treatment. This is unfortunate because Alcoholics Anonymous is a free a free program with excellent success rates compared to expensive rehab centers; most of which free patients to AA for aftercare. See the research.
People don’t understand the 12-Step recovery process unless they have participated in a 12-Step program. Although they may encourage others to attend, they may feel perplexed or act patronizing. Often, therapists don’t realize that the 12 Steps are not merely for addiction, but are guidelines for nothing less than a total personality transformation. Bill Wilson, the founder of Alcoholics was influenced by Carl Jung, whom he wrote seeking treatment for alcoholism. Jung replied that the cure would have to be a spiritual one — a power equal to the power of spiritus vini, or alcohol. He thought that addicts were “misguided ‘seekers for the spirit,’ …in the world of Dionysus, the god of renewal through the light from below, from the earth rather than from the heavens…” (Whitmont, 227)
The 12 Steps provide a spiritual remedy. They outline a process of surrender of the ego to the unconscious, God, or a higher power, and very much resembles the process of transformation in Jungian therapy. Jung believed that unity and wholeness of the personality, which generates a sense of acceptance and detachment, occurs when both the conscious and unconscious demands are taken into account — when not the ego, but the Self, is at the center of consciousness. (Storr, 19) He felt his life was “a story of the self-realization of the unconscious,” and rediscovered, as suggested by the 12 Steps, that God was “a guiding principle of unity.” (Storr, 24–25)
The following is a summary of how the Steps work; however, any linear description is misleading, because, like transformation, the process is circular. Although these Steps apply to numerous addictions, whether to a person, a substance (e.g. alcohol, drugs, food,) or a process (e.g., sex, gambling, and debting), the focus here is on alcohol and drug addiction, and the family members who are in a codependent relationship with the alcoholic/addict. The addict is also codependent on the substance. The underlying problems of codependency can’t be addressed until abstinence is achieved and stable.
Facing the Problem
The beginning of recovery is acknowledging a problem involving drugs or alcohol, that there is help outside oneself, and the willingness to utilize it. This also represents the beginning of hope and trust in something beyond oneself (such as a therapist, sponsor, or the program). Invariably, it takes years to face the problem, but by opening a closed family system, and learning about addiction, denial starts to thaw.
The first part of “working the First Step” is an admission of powerlessness. Step 1 reads: “We admitted we were powerless over alcohol — that our lives have become unmanageable.” (Other words, such as “food”, “gambling” or “people, places and things” are often substituted for the word alcohol.) The substance abuser begins to understand s/he is powerless over drugs or alcohol, and the codependent slowly learns that she or he cannot control the substance abuser. The struggle not to drink and the codependent’s vigilance over the addict begin to slip away. Gradually, attention starts to shift away from the substance, or, for the codependent, from the substance abuser to focus on oneself. Before taking this Step, endless therapy sessions are spent by the alcoholic, wondering, “Why do I drink?” or the spouse complaining about the addict’s behavior.
There are deeper and deeper levels of working the First Step during recovery. The first stage is the acknowledgment that there is a problem with a substance; second, that it is a life-threatening problem over which we are powerless; and third, that actually the problem is not only with the substance, nor with the substance abuser or others, but lies in our own attitudes and behavior.
The acknowledgment of powerlessness leaves a void, which formerly was filled with a lot of mental and physical activity trying to control and manipulate the addiction or the substance abuser. Feelings of anxiety, anger, loss, emptiness, boredom, and depression arise. The emptiness that was masked by the addiction is now revealed. It is an awesome realization when you acknowledge that you or your loved one has a life-threatening addiction, subject only to a daily reprieve, over which you are powerless. Now, with a modicum of trust, and either out of desperation or faith, we acquire a willingness to turn to a power beyond ourselves. This is Step 2: “Came to believe that a Power greater than ourselves could restore us to sanity.”
In the book Alcoholics Anonymous, it states: “Without help it is too much for us. But there is One who has all power–that One is God.” (p. 59). That power can also be a sponsor, therapist, the 12-Step roup, the therapy process, or a spiritual power. In working the Steps, reality itself becomes a teacher, as we are asked to continually “turn over” (to that Power) an addiction, people, and frustrating situations. More and more, the ego relinquishes control, as we begin to trust that Power, the growth process, and life itself, as well.
What has been happening up until now is an increasing awareness and observation of our dysfunctional behavior and addiction(s) — what is referred to as “insanity” in the Second Step. This is a crucial development, because it signifies the genesis of an observing ego. With this new tool, we begin to exercise some restraint over addictive and undesirable habits, words, and deeds. The Program works behaviorally as well as spiritually. Abstinence and forbearance from old behavior are accompanied by anxiety, anger, and a sense of loss of control. New, preferable attitudes and behavior (often called “contrary action”) feel uncomfortable, and arouse other emotions, including fear and guilt. From a Jungian perspective, our “complexes” are being challenged:
“We regard and approach life in the light of our childhood values and conditioning, that is, in the light of our complexes. This would explain why our sense of being and of security are so tied to our familiar, personally-actualized frames of reference…Every challenge to our personal habit patterns and accustomed values is felt as nothing less than the threat of death and extinction of our selves. Invariably such challenges evoke reactions of defensive anxiety.” (Whitmont, 24).
Group support is important in reinforcing new behavior, because the emotions triggered by these changes are very powerful and can easily retard or arrest recovery. For the very same reasons, family, friends, and lovers may resist change in order to preserve the system’s homeostasis. The emotional discomfort may be so great that the substance abuser may revert to drinking or using and his or her family or partner to enabling.
The 12 Steps provide help in Step 3. Here we are asked to relinquish the ego’s central position as director, and to turn our life “over to the care of God as we understood God.” This is the practice of “letting go” and “turning it over” — meaning that we cannot control outcomes, others’ attitudes, and behaviors, or daily frustrations that can trigger a relapse.
In Jungian therapy, the individual “comes to change an attitude from one in which ego and will are paramount to one in which he acknowledges that we are guided by an integrating factor which is not of our own making …named the Self — a ‘God-image,’ or at least indistinguishable from one.” (Storr, 19). The idea of surrender can be particularly frightening to someone — like many addicts who have been traumatized by abuse or neglect. Building trust is a process, but as faith gradually grows, so does the ability to let go and move towards more functional behavior.
Inventory; Building Self-esteem
Now with a bit more ego awareness, self-discipline, and faith, we are ready to review our past. This is Step 4. It requires a thorough examination (“a searching and fearless moral inventory of ourselves”), with a view towards uncovering patterns of dysfunctional emotions and behavior, called “character defects.” The “exact nature of our wrongs” is then “admitted to God, to ourselves and to another human being,” in Step 5. Sharing our defects with another person helps to dissolve shame.
For Jung, the shadow is a “moral problem that challenges the whole ego personality” (Storr, 91), and “no progress or growth in analysis is possible until (it) is adequately confronted.” (Whitmont, 165) “The shadow personifies everything that the client refuses to acknowledge about himself and yet is always thrusting itself upon him directly and indirectly — for instance, inferior traits of character and other incompatible tendencies.” (Storr, 221) Awareness of the dark aspects of the personality, an essential condition for self-knowledge, requires “considerable moral effort,” and “painstaking work extending over a long period.” (Storr, 91). Individuals conscientious in working the Steps often do a few inventories with one or more sponsors over several years, each time experiencing greater honesty and insight.
Jung felt redemption was possible only by facing our “final guilt,” or “blackest shadow.” (Storr, 279, Whitmont, 226) whether in therapy or with a sponsor, the process of self-disclosure in a non-judgmental environment required by Step 5 further develops self-esteem and an observing ego.
Through conscious acknowledgment of our imperfections, we discover our frailty and humanity. Guilt, resentments, and paralyzing shame begin to gently dissolve, and with it, the false self, self-loathing, and depression. For some, particularly people in therapy, this process involves recalling childhood pain and grief work, which is the beginning of empathy for ourselves and others.
Self-acceptance and Transformation
The encounter with the shadow brings unavoidable conflict and pain. Following an acknowledgment of dysfunctional emotional and behavioral patterns, the person is still faced with the realization that awareness alone is not enough. Change doesn’t happen until old habits are replaced with healthier skills, and/or until the purposes they served are removed. With greater awareness, the old behaviors become increasingly uncomfortable and no longer work.
This is the process of surrender described in Step 6: “Were entirely ready to have God remove all these defects of character.” It is similar to Step 3; however, Step 3 is usually associated with surrendering control over situations or things outside of oneself, while Step 6 underscores the psychological process of personal transformation that evolves throughout recovery. This Step represents a further development of self-acceptance and opens the door to change.
Ideally, the person continues, pursuant to Step 10 to examine his or her patterns and “defects” with a sponsor or therapist as they show up on a daily basis to better understand feelings, motives, consequences, and alternative options. Like the movie Groundhog Day, attempts to change can be frustrating. For as long as we furtively try to change, and blame ourselves in the process, no movement occurs — not until we give up, does change happen.
Step 6 asks that we give up control and ego-clinging, and look for a source beyond ourselves. Jung knew there was nothing to be done, but to “wait, with a certain trust in God, until out of a conflict borne with patience and fortitude, there emerges the solution destined.” (Storr, 281) Then we are “entirely ready.” There is a parallel in Jungian therapy, where a critical point is reached:
“We then discover to our dismay that our attempts to solve (our problems) by an effort of will avails us nothing, that our good intentions, as the saying goes, merely pave the way to hell . . . We are faced up against a paradox that discipline and conscious effort are indispensable but do not get us far enough in our really critical areas . . . A resolution of this seemingly hopeless impasse eventually occurs by virtue of the awareness that the ego’s claim of a capacity to control rests on an illusion. . . Then we have come to a point of acceptance that initiates a fundamental transformation of which we are the object, not the subject.
Transformation of our personality occurs in us, upon us, but not by us. The unconscious changes itself and us in response to our awareness and acceptance of our station, of our cross . . . (We) are aware of our limitations, not merely intellectually but in the depths of our bowels, in our feelings and in our despair . . . The point of hopelessness, the point of no return, then is the turning point. . . The ways of resolution are usually those which conscious reason could never have discovered.” (Whitmont, 307–308).
This process of working with the shadow leads to the modesty needed to form relationships. “The perfect have no need of others, but weakness has, for it seeks support . . .” (Storr, 399–400) It is this humility in relation to God that is required by Step 7, which states: “Humbly asked God to remove our shortcomings.”
Compassion for Others
The review of our shortcomings in Step 5 reveals our effect on others, and awakens empathy for those we’ve harmed. Steps 8 and 9 suggest that we make a list of those people and make direct amends to them. Jung advises that where it is not possible to restrain the expression of the shadow, we can at least mitigate it with an apology, rather than blame the other person. (Whitmont, 168) This builds humility, compassion, and self-esteem.
Tools for Daily Growth
Recovery and spiritual growth are never completed, but a continual process. The 12 Steps provide tools for this ongoing process. Steps 10, 11, and 12 are referred to as maintenance steps, and it is recommended that they be commenced early in recovery.
The 12-Step Programs emphasize moral behavior — doing the right thing. Rather than wait, until we feel like doing the right thing, it is often said to: “Take the action, and the feelings will follow.” Jung believed that faith alone was empty, and that the patient needed “justification by works.” He needs “to do the right thing . . . with all his might.” (Storr, 281)
Step 10 recommends we take an ongoing inventory, and when wrong make prompt amends. This promotes self-responsibility and integrates awareness of the shadow on a daily basis to keep the slate clean in relationships with others. “Guilt feelings…have to be dealt with by converting them into rational responsibility, by promoting the realization that a law of cause and effect is operating. When someone feels he is wrong or something is amiss, he does have something to do with it and it is his own personal responsibility to act and to control himself — even to change himself.” (Whitmont, 281)
Step 11 recommends meditation and prayer to improve “conscious contact with God.” This strengthens the relationship to the Self and increases Self-awareness. It promotes new behavior, by reducing the reactivity and anxiety accompanying change, and by increasing tolerance for the experience of emptiness, which supports the Self as old behavior and ego structures fall away.
Step 12 recommends service and working with others, which reduces self-centeredness and enhances compassion. Additionally, sharing what we have learned is self-reinforcing. This Step also suggests practicing these principles in all areas of our life. This reminds us that spirituality and growth cannot be practiced in only one segment of our lives without contamination from other areas. For example, dishonesty in any area undermines serenity and self-esteem, affecting all of our relationships. It also protects against the tendency of many people to switch addictions to deal with the anxiety and depression that can accompany abstinence.
Copyright, Darlene A. Lancer, 2004, 2014
Published in The Therapist, November, 2004
(For a history of the 12 Steps and with,-depth analysis and exercises to work them, along with questions for self-examination, get my ebook, Spiritual Transformation in the Twelve Steps.)
Alcoholics Anonymous World Services, Inc. (1976). Alcoholics Anonymous. New York, N.Y Storr, Anthony (1983) The Essential Jung, Princeton, New Jersey: Princeton University
Press.Whitmont, Edward C. (1969). The Symbolic Quest. Princeton, New Jersey: Princeton University Press.