Twelve-Step Healing: Beyond Disease Metaphors and God-Talk

AA Poster

While the Judeo-Christian language of recovery programs like Narcotics Anonymous sometimes alienate those in need, their overall success in treating and rehabilitating addicts shouldn't be overlooked. Credit: Creative Commons/Bob Stevens.

While it may be true, as Nicholas Boeving states in this issue of Tikkun, that recovery (the blanket term used to describe twelve-step programs) works for only a minority of addicts, that minority is a rather large number: millions around the world. And because recovery is such a large and growing movement, Boeving’s criticisms—which for the most part are valid—only speak to a certain aspect of the twelve-step paradigm.

As a recovering addict and a member of Narcotics Anonymous (NA), I should first state that I speak for myself only and do not in any way represent NA. That’s one of the brilliant aspects of “the program,” as we sometimes call it—no one represents or decides what it’s about for anyone else. So, protecting my anonymity with a pseudonym, I will speak here of my own experiences in recovery in hopes that doing so will make it accessible to people who, hearing Boeving’s arguments, might otherwise take a pass.

The First Step

If I could have found some other way to stop destroying myself, I gladly would have. I hated Narcotics Anonymous when I first started going to meetings. I went grudgingly and sparingly because I had promised my family that I would “get help,” but meanwhile I kept up my pill addiction on the sly. I was getting a Ph.D. and had managed to stay in school by the skin of my teeth, and because I didn’t let any of my friends in too close, I had maintained the appearance of a pseudo-functional adult. My father had died after a long illness and the experience had been so obliterating to me that I stopped coping with my life. I didn’t know how. My family was screwed up, but I didn’t know that yet, and since family was where I went for help, I was helpless. (One definition of an addict is “someone who doesn’t know how to ask for help.”) Whether the inheritance is genetic, environmental, bio-psycho-social, or all of the above, when the shit hit the fan in my life, the sleeping monster woke up. I went from being someone who rarely used drugs or drank to someone who would lie, cheat, and steal to get my hands on whatever I could get.


Credit: Creative Commons/Federico Morando.

I had been a super high achiever all of my life—a good girl, an excellent this and that, someone everyone wanted to be friends with, yadda yadda. The depression I had carried deep in my belly since childhood was compartmentalized and only emerged when I was safely alone (or in the very few romantic relationships I had with people, making them so very painful). I developed a “winning personality” so that people would love me—and they did—but I could not feel their love. I felt wretched and alone, “other,” left out, shameful, ugly. I had lots of friends but I tended to be a caretaker and focus on them, since I literally did not know how to share my internal world with people. Too scary. Too shameful. Too confusing.

And then the bottom just dropped out. It was like a switch flipped internally and I could no longer control myself. I wanted to consume and then pass out. In retrospect I wanted not to be alive. I wanted to die because life was too hard and it seemed like nobody else was struggling like I was (the narcissism of self-loathing). People around me were getting married and having babies. They had family inheritances. They got their work done on time. They paid their bills. I was stealing pills from people’s cabinets, shoplifting, spending endless hours online spaced out on opiates, missing appointments, showing up late everywhere. I got caught stealing from a grocery store and not three weeks later had a withdrawal seizure there. I dyed my hair a crazy color. I was screaming for help in all the wrong ways. And I was angry. I didn’t know at whom, but boy was I pissed at my lot. This highly educated superachiever did not like that my life had come to this. I could not get off the suicide train and my only option for survival was to join a weird cult of jargon-spouting lowlifes? And I did not like being told that I had a disease. Aside from wanting to be in a constant state of oblivion, I was perfectly healthy.

Addiction: A Social Condition, Disease, or Form of Insanity?

I completely agree with Boeving’s assessment that we are living in an addicted culture, that our problem is systemic and must be understood and treated as such. And yet, there’s a difference between the more mainstream, socially constructed addicts we might all be and the addict addicts only some of us are.


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Sherine Kaufman (a pseudonym) is a clinical psychologist in Northern California. She is a member of both Narcotics Anonymous and Adult Children of Alcoholics.

Source Citation

Kaufman, Sherine. 2011. Twelve-Step Healing: Beyond Disease Metaphors and God-Talk. Tikkun 26(4): 25.

tags: Culture, Health, Spirituality   
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One Response to Twelve-Step Healing: Beyond Disease Metaphors and God-Talk

  1. November 9, 2011 at 5:46 pm

    Great article. My story is very similar, indeed. And after six months clean and sober this is exactly my experience.

    And even though I wish nobody the terror of addiction (not even Michele Bachmann!), at times I wish that everyone would go through hitting bottom and doing ‘the steps’ once in their life time (… especially Michele Bachmann!). I think it would make the world a much better place.

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