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.


Most of the former do not steal useless crap from neighborhood stores, gobble down pills like tic tacs, drool in front of the television all night, and then wake up the next day and go, “Let’s do that again!” We who become addicted become insane. It may not be a disease but it’s definitely a form of insanity. There’s just no denying it. But for those of us for whom recovery “works,” there’s just no denying that, either. There is something of a miracle in it—to be delivered from such excruciating degradation and to find peace in “a new way of life.”

wanting more

"We want 'more' of something whether it's sex, food, money, spirituality, respect, Apple products, frozen yogurt, or literary knowledge," the author writes. "Many of us act out our suffering and become addicted to whatever that thing is that soothes our poor little souls." Credit: Creative Commons (top to bottom): Keith Ramsey, Marco Perry, Steven Depolo, David Ingram, and Jonathan Crowe.

Boeving’s reflections about the limitations of the twelve-step paradigm were all too real for me initially. The Judeo-Christian undertones, the jargon, and the heavy use of the term “disease” were off-putting and alienating, as they are to most “newcomers” who enter the rooms of recovery. But the truth is that most of us are so alienated from ourselves at that point that it’s impossible to have any kind of reliable discernment about our surroundings. Being told that you have a disease can, indeed, feel pathologizing, but it can also help dislodge the stigma that so many addicts feel. And it is possible to feel both at the same time. The idea that there is a genetic-biological component to our addiction, that we have been invaded by a menacing and malignant intruder that seeks to kill us (which is certainly how it felt to me), can give us some space from feeling so utterly and irredeemably responsible for the state of spiritual bankruptcy that brought us—if we are lucky—to our knees. Because it is only from that humbled angle that many of us are finally willing to seek help.

But conceptualizing addiction as a disease does not preclude us from properly understanding its relationship to modern culture. It is here that Boeving’s critique fails to imagine the metaphoric possibilities of the twelve-step paradigm and instead ascribes a kind of personalized, self-involved quality to the process of recovery that reminds me a bit of the critique leveled at Buddhists for being “navel gazers.” Sure, it captures a certain aspect of that reality, but nothing of its essence or its potential for both individual and collective transformation.

If we look systemically at the problem of addiction, the miracle of recovery is no miracle at all. Most of us at this time and place in our culture are alienated from one another. We are overworked and under-nurtured, we hate our bodies, we are on diets, we are struggling to pay the bills, we want “more” of something whether it’s sex, food, money, spirituality, respect, Apple products, frozen yogurt, or literary knowledge. We want a Ph.D., a Honda Fit, our own website, the perfect dog, the perfect wedding, a new couch, or the perfect beach vacation in Central America. We are in a rush. We are, many of us moderns, depressed. If we are not on antidepressants, then we are off sugar or gluten, we’re doing Bikram Yoga or a seven-day “cleanse,” or we’re meditating our asses off. There is not enough time for us to do all the things we are supposed to do in our short time here on earth and if we stop to rest we may miss something, or even worse, someone may think we are lazy. Many of us act out our suffering and become addicted to whatever that thing is that soothes our poor little souls. And the worst part? We don’t talk to each other about our struggles.

Healing in Community

Since most of us suffer alone, it really can feel like a miracle to find a place where you are welcomed and loved just as you are.

Whether you are homeless, whether or not you have teeth, whether you have murdered someone, whether you are a millionaire, whether you smell, whether you make sense, whether you are the life of the party, awkward, angry, black, white, transgender, just out of jail, a movie star, Mother Teresa, or an arrogant asshole—everyone is equally welcome. It is the only place I know of where there is genuine racial, class, economic, and gender diversity. Addiction is the great social leveler. Your friends—the people you admire for their wisdom, courage and perseverance—range from hookers to housewives. These people share honestly about their suffering and this honesty is the language of recovery. It is the language of authentic being, which we begin to feel if we keep going to meetings. We learn that we can share our fears, our shame, or hopes, and our pain in an atmosphere of nonjudgment. No one is allowed to “cross-talk”—to comment on or give advice about anything you share. You can be the CEO of a big firm during the day and come grumbling in your dirty sweats and slippers to your meeting at night, where you know people know you from the inside out.

Some people are not able to get past the “God” language. In my experience, people who rail against God in recovery are usually railing against a God that nobody else believes in either. It sometimes leads them to leave the rooms and seek help elsewhere. Some people are able to find that help; others aren’t. The rooms are filled with all types—Christians, Buddhists, Jews, Hindus, Muslims, atheists, pantheists, pagans. Most people keep that to themselves, sharing it only with their sponsor and closest friends. For me, recovery isn’t about religion, and the God of my understanding really is just that. No one has ever questioned me about my religious beliefs or tried to proselytize me to theirs. Many people call the fellowship—which is the name given to the community of people in any given twelve-step program—their “higher power” because it is a constant, loving presence and a source of faith and hope and healing for them. And there is so much humor—dark humor—in the rooms of recovery. People have been through some crazy shit and have lived to tell about it.

Meetings are a place where people sit and listen and find respite from the whirling world around them. There is no pretense. There’s no work to be done and there’s nowhere else to be. There’s coffee and sometimes cookies. Nothing is required of you. Not money, not God, not even the cessation of your drug use. Only the desire to stop using. It is the place where my lifelong sense of alienation, depression, and loneliness was healed. Without my addiction, I don’t think I would have healed these wounds. In this way, I am deeply grateful for my downfall.

Ultimately, society will continue to churn out addicts by the millions as long as it churns out false Gods. The corporate-owned media do everything they can to make you want what you don’t have, and the corporate-controlled government is, at this very moment, destroying the remedies for the diseases created by our consumption-obsessed culture. Twelve-step programs—which offer kindness and communion and strive to help people live lives of integrity, honesty, and service—are quite a radical alternative to societal addiction and greed. Recovery is a parallel universe that more and more people are choosing for themselves. And it is a choice. If you have the desire to stop using, you may want to try it out. Don’t let God scare you away. As a famous rabbi once said, “The God you don’t believe in doesn’t exist!”

(To return to the Fall 2011 Table of Contents, click here. For an attractively formatted, ready-to-print PDF of this article, click here.)

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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