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Substance Abuse: Growing Beyond 12 Step Program Dependency
10 CEUs Substance Abuse: Growing Beyond 12 Step Program Dependency

Section 13
Addiction and 12 Step

CEU Question 13 | CEU Test | Table of Contents | Addictions CEU Courses
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

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On the last track we talked about how according to Tina Tessina author of “The Real 13th Step” the 12 steps can actually impede autonomy.

On this track, we will discuss addictions to the 12 step program.

Have you found, like I, that often addicts participating in 12-step programs will develop an addiction to the program for the following five reasons? Lack of healthy replacement habits, lack of information about functional living, lack of models for healthy relationships, replication of dysfunctional family patterns, and dependency on the group. Sound interesting? Let’s look at some of these reasons more closely as you listen to David’s story.

David, age 25 addicted to cocaine, was getting bored now that he had started recovery. He stated, “The group helped me to stop spending my time using cocaine, but it didn’t help me figure out what to do with all the free time I had.” An old friend offered to take David to a casino, and he accepted.

The excitement gave David a psychological high, and there was always plenty of alcohol to drink. As you may have guessed, soon David found himself going to the casino every night and drinking heavily in the time he wasn’t spending at his group. Sound like a relapsing client of yours?

Reasons for Developing an Addiction to the Program

Reason #1- Replacing Habits
In David’s case, the 12-step program did not help him deal with the first issue of replacing habits. To avoid relapse to his cocaine addiction, David began gambling and drinking. For many addicts, after cycling through several addictions, the 12-step group itself becomes an addiction. Successful attendance at a group meeting may not be enough to stop the cycle because it may not teach autonomy or self-management. The strength of the 12 steps is that they help stop destructive habits, but the ongoing addiction to the program demonstrates that complete healing has not yet occurred.

Reason #2 - Lack of Information on Functional Living
The second reason that addicts can become addicted to the 12 step program is the lack of information about functional living. As you know, most of the information the program provides is about maintaining sobriety one day at a time.

Addicts like David may have little opportunity to learn competent everyday living skills, such as: how to think clearly and rationally, evaluate people and situations, and make choices; how to create a sense of purpose in their lives free of addiction; how to handle change and normal upsets of life; how to create their own ethics and guidelines for living; and how to learn to trust themselves and make commitments they can keep. For David, his inability to evaluate people and situations led him to begin a new addiction to gambling.

We can analyze the other three reasons for addicts developing an addiction to the program from Maggie’s experience.

For Maggie, age 54 addicted to alcohol since her divorce at age 33, it seemed that recovery was going really well. Maggie’s sponsor, Georgia, was very supportive in helping her to overcome her addiction to alcohol. At first she had success, but she began to rely on the program heavily. After a couple of months, Maggie’s old rage at her abusive mother surfaced and she yelled at Georgia after she suggested Maggie lead a meeting.

Reason #3 - Lack of Models for Healthy Relationships
In addition to a lack of replacement habits and a lack of information about functional living, the third reason addicts may become addicted to the program is the lack of models for healthy relationships. The 12 step meetings often teach little about steps in coping with common problems addicts have with relationships, like trusting other people, creating internal intimacy, and setting limits. Because other group members come from similar backgrounds, they usually provide no better role models for addicts like Maggie than the addict’s own dysfunctional families did.

Reason #4 - Replication of Dysfunctional Family Patterns
The fourth reason addicts like Maggie become addicted to the program is a replication of dysfunctional family patterns as mentioned on an earlier track. As a sponsor, Georgia had taken on a parental role in Maggie’s life. Because her relationship with her abusive mother had been dysfunctional, Maggie’s relationship to Georgia was also dysfunctional. The two re-enacted past feelings of anger, fear, hurt, rejection, and shame.

Maggie was not aware of the re-enactment, because these feelings were so familiar through her relationship with her mother. She stated, “I just felt like Georgia was controlling me, the same way my mom used to. When I didn’t do what Mom said, she used to hit me. I guess a part of me was afraid that Georgia would end up doing that, too.” Addicts like Maggie will usually choose the familiar over the healthy, no matter how painful the familiar may be. Do you agree?

Reason #5 - Dependency on the Group
The fifth reason that addicts develop an addiction to the program is because of a dependency on the group. After an addict has been with a group and sober for a period of time, he or she may begin to feel that he or she is incapable of success without the group as mentioned in track 9 the dream of dependency.

Again, we can look at Maggie’s case. Once she entered recovery by stopping her addiction, Maggie wanted to keep her group’s approval by remaining in recovery. As you can see, the group was some what functioning as a substitute addiction.

'Coping with Fear' Exercise
For David and Maggie, as you can see, a main problem they faced was fear of leaving the group. To cope with this fear, I asked each to participate in the “Coping with Fear” exercise.
First, I asked David and Maggie to list their three biggest fears in recovery.

David wrote, “I’m afraid that I will mess up something at work because I’m too nervous to do the job sober. I’m afraid that the boss will yell at me or fire me for a mistake I make because I’m nervous. I’m afraid I might relapse if I lose my job.” Maggie wrote, “I’m afraid that if I leave the group, I will start drinking again. I’m afraid that the group won’t support me if I leave. I’m afraid that I will have no friends if I leave the group.”

Once each had listed their fears, I explained to them ways to manage that fear. I stated:
--1. First, accept that fear is normal.
-- 2. Second
, live one day at a time; worrying about the future and trying to change the past stops us from living in the present.
--3. Third
, take problems one at a time; you don’t have to solve them all at once.
--4. Finally
, use the ‘dump-it’ button. If you can’t change something right now, press the dump-it button and forget about it.”

Do you have a client like David or Maggie who is simply replacing one addiction with another or is becoming addicted to the program? Would he or she benefit from doing the “Coping with Fear” exercise?

On this track we have discussed the reasons that addicts can become addicted to the program. The five reasons that addicts become addicted to the program are lack of healthy replacement habits, lack of information about functional living, lack of models for healthy relationships, replication of dysfunctional family patterns, and dependency on the group. We also talked about the “Coping with Fear” exercise. Would it be beneficial to plaly this track in your next session for a client who feels they are ready to branch out from the 12 step program.

On the next track, we will discuss the relationship between 12 step programs and childhood dependence.

- Peiser, K., & Martin, S. (2000). In The Universal 12-Step Program: How to Overcome Any Addiction and Win! Massachusetts: Adams Media Corporation.
- Tessina, T. B., Ph. D., (2001) The Real 13th Step. New Jersey: Career Press.

Peer-Reviewed Journal Article Reference:
Freimuth, M. (2018). A new look for addiction training in psychology programs: Comment on Dimoff, Sayette, and Norcross (2017). American Psychologist, 73(5), 693–694.

Greenfield, B. L., & Tonigan, J. S. (2013). The General Alcoholics Anonymous Tools of Recovery: The adoption of 12-step practices and beliefs. Psychology of Addictive Behaviors, 27(3), 553–561.

Wilcox, C. E., Pearson, M. R., & Tonigan, J. S. (2015). Effects of long-term AA attendance and spirituality on the course of depressive symptoms in individuals with alcohol use disorder. Psychology of Addictive Behaviors, 29(2), 382–391.

Online Continuing Education QUESTION 13
What are five reasons addicts can become addicted to the program? To select and enter your answer go to CEU Test.

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