“Half measures availed us nothing…”
Step 1: “We admitted we were powerless over alcohol – that our lives had become unmanageable.” (Page 59)
Addictions are Forever. Therefore, The Solution Must be Forever.
AA works for Alcoholics, Narcotics Anonymous works for Addicts, etc.
The 12 Steps, originally established by the program of Alcoholics Anonymous, are often used today by the better, or most effective, treatment facilities. They are designed to assist individuals to recover from alcoholism and, as modified, other addictions, through an orderly process where each step builds upon those preceding it.
For clients in addictions treatment facilities, the 12 Steps are often presented through various workbooks, worksheets, presentations, etc. Clients are told to read about, and then write about each step, how they feel about it, etc. All this is well and good, however, what is often missed, is the emphasis or in-depth meaning associated with each individual step. Without an understanding of such meanings, the steps are often taken without comprehension of the purpose behind thoroughly completing the work. Oftentimes these meanings will come later, but unfortunately for many, such comprehension (“Oh, that’s what they meant!”) comes too late.
For clients in an individual therapeutic setting, where addictions counseling is offered, the 12 steps of recovery are often glossed over in favor of delving into the client’s psyche for causes and conditions of their presenting symptoms. This of course, is appropriate. However, doing so will not facilitate recovery from their addiction, typically because alcohol and/or other drug use has been their ‘solution’ – often the only one – that has worked to temporarily alleviate their deeper emotional sufferings. In this therapeutic model, the client often leaves counseling with knowledge of a reason why they feel as they do, but still without an effective solution for their addictive disorders. Better therapists will guide their clients to appropriate 12 step programs for continuing care and assistance.
So why the emphasis on the First Step? It sounds fairly straight forward: “1. We admitted we were powerless over alcohol - that our lives had become unmanageable.” (Page 59). At first glance, and that’s typically the only ‘glance’ this step is given, the client may think: “Yes, alcohol or other drugs may be causing me some problems, and yes, those problems seem to make my life appear unmanageable. Okay, that was easy, Step One is finished, let’s move on to Step Two.”
Well, not so fast. For a thorough comprehension of the First Step, clients need to consider the actual state of their lives, the conditions that caused their difficulties, and recognize that their difficulties not only affect them, but everyone around them as well. In the chapter titled: “The Family Afterwards,” we read: “Cessation of drinking is but the first step away from a highly strained, abnormal condition.” (pg 122). In this statement we see the words “first step” which, although in a slightly different context, still indicates that this concept comes first. Secondly, we see the words “highly strained, abnormal condition.” This sentence implies that stopping drinking must come first, but then profoundly serious abnormal conditions will remain. If the first step to resolving these issues is the cessation (stopping) of drinking (using), and the conditions that remain are not ‘normal’ conditions, but rather significant, highly strained, abnormal ones, then it stands to reason that the client should understand that not stopping, or a resumption of, drinking or using will be catastrophic to any resolution of their condition.
Experience proves that, for sustained recovery, it is imperative that clients fully comprehend the meaning and purpose of the First Step in the 12 Step program of recovery, for upon it, all other steps are built, and without it, all other steps are meaningless.
This issue has been constant for alcoholics throughout history and had to be addressed in the fledgling program of Alcoholics Anonymous. The chapter “More About Alcoholism” (pg. 30) discusses problemed drinker’s relevant feelings concerning themselves and their relationship with alcohol as: a) Unwilling to admit that they were real alcoholics; b) refusal to consider that they are bodily and mentally different from others; c) despite repeated difficulties (jails, fights, blackouts, DUI’s, car crashes, loss of jobs, loss of family and friends, etc., they fail to see that alcohol has played a key role in these calamities and continue drinking under the delusion that: “This time it will be different,” and to prove they are not unlike their non-problemed peers; and, d) the belief that someday they will be able to again, “control and enjoy their drinking.” Such delusional thought processes are typical. Such a failure to recognize their problem, that is so obvious to those around them, is a classic symptom of alcoholism.
The loss of the ability to control their drinking, and the consequences that follow often lead to a feeling described by alcoholics as: “pitiful and incomprehensible demoralization.” Pitiful and incomprehensible demoralization sets in when clients begin to realize that if they try to control their drinking, they can’t enjoy it. And, if they drink for the desired effect – to enjoy it – they are no longer able to control it. When they can’t control it, the consequences of their actions tend to become increasingly more devastating. “The idea that somehow, someday he will control and enjoy his drinking is the great obsession of every abnormal drinker. The persistence of this illusion is astonishing. Many pursue it into the gates of insanity or death.” (pg. 30).
Such ‘alcoholic behavior’ will continue unabated until the client comes to terms with the first, first step, which states:
“We learned that we had to fully concede to our innermost selves that we were alcoholics. This is the first step in recovery. The delusion that we are like other people, or presently may be, has to be smashed.” (Page 30)
Alcoholism is a disease the tells the alcoholic that they don’t have a disease. Hence, even though they know that a problem exists, they don’t believe that their problems have anything to do with alcohol consumption. They tell themselves that someone or something or some situation is at fault for their difficulties. This type of belief is what is meant by the term, delusion in the statement above. Where alcohol is concerned, to them the reality of their situation doesn’t exist.
Additionally, to alleviate some of their problems, some clients may stay sober for relatively long periods of time. Reasons for maintaining such temporary sobriety may include: completing court ordered DUI programs; attempts to save or repair relationships; to satisfy an employer; etc. Such clients may even dutifully take all the steps and do all the things suggested of them in Alcoholics Anonymous or other program. Surprisingly, some such clients may actually catch alcoholism and begin actual recovery. However, if they have not thoroughly completed the First Step, they are usually doomed to fail. They may remain sober long enough to satisfy the judge, their probation officer, their church, a significant other, an employer, etc., but once the heat is off, and they have avoided, or not fully come to terms with the first step, they will not have a firm foundation to cling to, and will fail in their attempts, if any, to remain sober. They will again experience what Dr. Silkworth describes as feeling: “restless, irritable, and discontented” (Page xxviii). Alcohol instantly removes these feelings – and alcohol works every time. However, once relapse occurs, despite their length of sobriety, the consequences of their drinking/using often return with a vengeance, regardless of their attempts to regain control of their drinking. Their period of sobriety is gone in an instant and is soon replaced by the feelings of pitiful and incomprehensible demoralization that a return to drinking always brings to the true alcoholic, or otherwise addicted individual.
As such, it is vital that the alcoholic, or otherwise addicted client, be guided to look honestly at his or her life and see the reality of their disease and its ramifications. Hopefully, they can begin to identify as one who has this disease. Alcoholism has physical, mental, and spiritual components. The physical aspect contains a genetic predisposition* to alcoholism. As such, those who experience alcoholism can be categorized as being born with a genetic tendency towards development of this disease. [This often-ignored detail is important for therapeutic interventions particularly when alcoholic clients are interspersed with ‘addicts’ who have no such genetic component.] Alcoholism is a physical allergy of the body, an obsession of the mind (delusion – “This time it will be different”), and a spiritual malady (Disharmony with powers that exist outside of their comprehension).
Once clients understand these concepts, identify with them, and relate them with patterns in their own personal lives, then they can begin to admit to their innermost selves that they are alcoholic or otherwise addicted. Thus, they are on their way to having completed the firm foundation of step one, which is the first step in the recovery process. With the reality of this step now fully understood, it is always worthwhile to point out that their addictions are forever. As such, it is also imperative for them to understand that their solution must be forever (ongoing) as well. Recovery is a remission of their disease. It is not a cure. Each day is a new day in sobriety. Continued sobriety occurs “One day at a time.” Counseling regimens, treatment programs, medications, etc., often provide a beneficial start, but they are not a cure for addictions.
Additionally, it should be understood, that Alcoholics Anonymous works for alcoholics. The first step involves the client’s recognition of the characteristics of alcoholism. Once clients identify with these characteristics and admit that they possess them, then they can fully admit to themselves that they are alcoholic. AA works for Alcoholics. If clients do not believe that they possess the symptoms and characteristics of alcoholism, then they will not feel that they have this condition. Thus, if they don’t identify themselves as alcoholic, then regardless of the actions they take, or the longevity of the period of their time sober, they will sooner-or-later succumb to the restlessness, irritability, and discontentment that always reemerges. They will begin to romance the thought that “this time it will be different.” Soon, they will drink again. Some might speculate from such failures that the AA program doesn’t work. However, if we recognize that, for recovery purposes, alcoholism is a self-diagnosed disease, consider then that, there can be no effective remedy for a disease that the client doesn’t believe they have.
AA has worked, and continues to work, for millions of alcoholics. Hence, the first step, recognizing that they have the manifestations of the disease, is vital to their recovery. Thus too, other 12 step programs will work for those who honestly seek assistance for their particular addiction. Without the First Step, all other work in recovery is meaningless.
With this in mind for your clients, let’s look again at this first, seemingly simple, step:
Step 1. “We admitted we were powerless over alcohol – that our lives had become unmanageable.” (Page 59).
As you begin your work, special attention is to be paid to the words: Powerless and Unmanageable in relation to the term Alcohol. Ask clients to consider: "Do you drink because your life is unmanageable?" Or "is your life unmanageable because you drink?" To find an answer to that question let us consider first, cessation of drinking, and then see what happens.
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“We know that while the alcoholic keeps away from drink, as he may do for months or years, he reacts much like other men. We are equally positive that once he takes any alcohol whatever into his system, something happens, both in the bodily and mental sense, which makes it virtually impossible for him to stop…” “…If you ask him why he started on that last bender, the chances are he will offer you any one of a hundred alibis. Sometimes these excuses have a certain plausibility, but none of them really makes sense in the light of the havoc an alcoholic's drinking bout creates.” (Pages 22-23)
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All cited ‘Page’ references are from the fourth edition of the book: Alcoholics Anonymous.
*O’Neal, H.S. (2011). Genetic Predisposition: A Review of Primary Chemical Addictions, their Etiology and Possible Implications for Treatment and Recovery. Journal of Addictive Disorders.
