The Twelve Steps as a Healing Resource for Addicted Survivors of Trauma – Part 1

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Adapted from Trauma and the Twelve Steps: A Complete Guide to Recovery Enhancement

The twelve-step approach gets a bad rap in many trauma treatment circles for being outdated and insufficient in addressing the complex needs of trauma survivors. Admittedly, the twelve steps can rarely provide a comprehensive plan of healing in and of themselves for addicted survivors of trauma. However, elements of twelve-step philosophy and approaches to recovery, if explained to trauma survivors in a user-friendly, “meet them where they’re at” manner, may actually help with recovery from the addiction and the unresolved trauma concerns simultaneously. Let’s consider the benefits of positive sober support that recovery fellowships can provide, the opportunities for mutual support through listening, and the flexible structure offered by the twelve steps that can serve as a blueprint of dual recovery.

In treating trauma-related disorders, regardless of whether or not the person struggles with an addictive disorder, stabilization is essential. A wise treatment provider would not expect a person who is new to recovery (whether that be from the addiction, the trauma, or both) to address the root disturbances associated with their traumatic stress unless a person has a set of coping skills to help him self- soothe in a healthy way. Developing a healthy, mutual support, for so many addicted survivors of trauma is a critical component of stabilization. Positive trauma- related social support is important in the development of a strong, early therapeutic alliance; lack of support is one of the strongest predictors in the development of PTSD.

The benefits of mutual support offered by twelve-step groups are twofold: first, many individuals entering recovery are surrounded by friends and family who are not sober or otherwise healthy, so the meetings can offer an outlet to start building a network of people who support the individual’s recovery. Second, because isolation due to shame is such a common phenomenon with both recovering addicts/alcoholics and traumatized individuals, many people enter recovery believing that the behaviors they in engaged in or the feelings they experience are some unique brand of crazy or defective. Hearing others share similar experiences, thoughts, and feelings at meetings facilitates the healing process. In hearing others share, many addicted survivors hear messages that help convey more positive beliefs in the vein of “You are not alone.”

For many, once they address some of the barriers about opening up to others (solutions for these barriers will be discussed in chapters 6 and 7), getting involved with people in a twelve-step fellowship becomes a powerful mechanism of action in the healing process. After Mae, an African-American woman in her late forties who was the survivor of childhood sexual abuse, got over the initial social barrier of getting involved with the groups, the benefits were astounding:

At the time of a treatment follow- up interview, Mae credited the involvement in her fellowship and the receipt of outside counseling help as vital in her attaining six and a half years of sobriety, the most she had ever experienced in her long history of attempts.

People have differing reasons for wanting to make friends and support contacts within twelve- step fellowships. For Michelle, a young college student who grew up in a home with significant emotional abuse and family discord, most of her peer group consisted of people who drank, especially because she lived on campus. By coming to meetings, she was able to connect with other people who did not drink, and thus found a totally new social outlet for herself. Once she met her need for sober social interaction, she was gradually able to benefit from listening and sharing with the people in her new network of friends. What is interesting is that I have even heard critics of AA admit that as long as a person can find a reasonable meeting, at the very least, AA offers a social outlet that is preferable to going to a bar. However, for people with social needs in early recovery, the opportunities for socialization that AA offers cannot be underestimated.

The twelve steps also offer survivors a sense of flexible structure. At first glance, the term flexible structure might seem like an oxymoron, yet it is epitomized in the twelve steps. Moreover, flexible structure is what an addicted survivor of trauma may need to obtain solid footing on the road to recovery.

In my investigation of addiction recovery programs, which includes programs informed by the twelve steps, programs that have nothing to do with the twelve steps, and programs that blend approaches, one common denominator seems to emerge in what makes a successful addiction-recovery program: lifestyle change. Many individuals who have recovered from addictions contend that having structure was an absolutely critical element in making this change happen. Consider the case of Vince. A white male in his early thirties, Vince found himself in a place where he had lost everything as a result of his alcoholism: his girlfriend, his house, his business, and his driver’s license. Without insurance, and having burned too many bridges at the community-based treatment facility in his area, Vince’s only choice for structured treatment was to go to a Christian-based facility in a nearby town. Interestingly, Vince was an agnostic, but he somehow knew that he needed to go away somewhere for ninety days and “get back on track.” Vince credits the structure that the Christian facility gave him in initiating his sobriety. “I didn’t buy a word of what they were saying spiritually, but the structure I received there made all the difference.”

While the importance of structure in bringing about lifestyle change is important, we must also consider that people growing up in traumatic environments may respond to structure in different ways. Some people like the regimen because it is familiar to them; however, others feel completely turned off by structures, order, and being told what to do. That’s the tricky thing about trauma: its effects on a person are varied and unpredictable. Hence, the flexibility concept, or the ability to meet a person where he or she is “at” during any given point in his or her recovery becomes vital.

If not approached with a rigid mindset, so many facets of the twelve steps, not to mention the principles espoused by other recovery programs, are incredibly flexible. For instance, the traditions of Alcoholics Anonymous state that “the only requirement for membership is a desire to stop drinking.” Thus, a person who is afraid to come to a meeting because he fears he will have to introduce himself as an alcoholic or work the twelve steps can be assured that none of that is required to take part in AA…it is simply suggested.

Most twelve-step programs are suggestive only. I’m the first to admit that some very rigid-minded sponsors have lost this idea along the way somehow and have turned the suggestions into absolute orders. However, for a person who is resistant to structure and order, especially if this resistance is trauma- related, being assured that the components of the program and the steps are suggestive only can make all the difference. From a trauma- sensitive perspective, it can actually help with one’s sense of personal empowerment by making a personal choice to take the suggestions.

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