How can therapy help members of twelve step fellowships?

For people who have struggled with addictions, going to a twelve step fellowship is a brave and potentially life changing decision. Alcoholics Anonymous and other twelve step fellowships offer a place where a person struggling with addictions or addictive behaviours can feel safe, be understood and start to understand both themselves and other people. The meetings and fellowship offer a great deal of support and the steps offer a programme of recovery which promise freedom from obsession and relief from the desire to drink, gamble, take drugs, compulsively eat or engage in other addictive behaviours. These extravagant promises become reality for many sufferers who have battled and been baffled by their addiction for much of their lives.

The kind of inventory that is undertaken as part of the twelve steps is invaluable when it comes to acknowledging and understanding the resentments that have fuelled an individual’s addiction. The steps also help the person focus on their part in contributing to negative experiences in their life. For many, these steps allow them to get sober, abstinent or clean. They use the tools that are available to them via the steps and the fellowship and get on with the business of living.

However, it is at this point that some people are in a position to ask some of the questions that they have been avoiding for much of their lives such as questions about traumatic or difficult events that are in the past.

Whilst not all people who suffer from addictions have had adverse or traumatic experiences in childhood, the Adverse Childhood Experiences study (Felitti, 1998) which looked at over 17,000 patients, suggests that the more adverse childhood experiences an individual has endured, the greater the incidence of: –

• Smoking
• Obesity
• Alcohol and drug use
• Depression
• Attempted suicide.

When the researchers talk about adverse childhood events they are referring to experiences such as a household where drugs and alcohol were used, a child’s parents separated or divorced, the presence of mental illness in the home, emotional, physical or sexual abuse of the child or a mother who was treated violently. The research suggests that the more events the person has encountered whilst growing up, the more vulnerable they are as an adult.

I would suggest that, for people who struggle with addiction-related issues, who have had one or a number of these experiences whilst growing up, having therapy alongside working the steps can be invaluable.

For these people, psychotherapy provides a safe place to begin to understand the impact of these adverse experiences and to work through and process the difficult emotions that may have been buried for a long time. The therapist not only provides a safe place but builds a relationship with the client, providing them with the opportunity to find new ways of relating to themselves and others.

In conclusion, I believe that twelve step fellowships can and do offer an invaluable resource to the struggling addict. For many people this is enough and enables them to go on and live a richer, more fulfilled life; others will need to seek the kind of help on offer from a professional psychotherapist to more fully understand how their early life experiences have led them into addictive behaviours and how they can begin to change.