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Cure or Cover? |
The Twelve Step program:
Ellen Herman OUT/LOOK
Anyone who cares to look can find serenity. It leaves tracks: neat rows of
folding chairs lined up in musty church basements; the dull buzz of fluorescent
lights in hospital lecture halls; schoolrooms where half-erased algebra problems
remain on green chalkboards. Hundreds of thousands of people across the country
and around the world make regular trips to such places-as often as once each
day. They are members of Twelve-Step and other recovery programs.
Alcoholics Anonymous (AA) is the oldest and best known of these self-help
programs, and its structure and philosophy have served as models for many
others: Narcotics Anonymous (NA); Overeaters Anonymous (OA); Incest Survivors
Anonymous (ISA); Emotional Health Anonymous (EHA); Emotions Anonymous (EA);
Gamblers Anonymous (GA); AI-Anon and Alateen (programs for family members and
friends of alcoholics); and, most recently, Sex and love Addicts Anonymous (SlAA).
The sole requirement for membership in any of them is a desire to stop substance
abuse or change a compulsive behavior.
In the past few years, such programs have become so popular that they constitute
a Twelve-Step movement. Many people know, through personal contact, that Twelve
Step programs, especially AA, can be lifesavers. But these programs sometimes
resemble modern-day cults. They describe themselves in universal terms, pride
themselves on excluding on one, suggest that their fellowship are supportive
without ever being critical, and claim to offer a philosophy of spiritual
enlightenment without religious trappings. To the uninitiated, this description
might sound like old-style evangelical religion or New Age pop psychology, with
a do-you-believe-in-magic touch thrown in for good measure.
I have never been a member of a Twelve-Step program. To research this article, I
attended a lot of meetings and talked to many people. I asked certain key
questions about the nature of addiction and the methods these programs offer for
recovery: Are all the problems addressed by Twelve-Step recovery the same? What
are the resources and analyses developed by feminists, gays, and progressives in
response to addiction and other personal life crises? Does Twelve Step
philosophy have anything to say about politics? What needs to these programs
address that could or should have been met by political movements? And how does
living in a Just Say No culture change the meaning of all of the above?
The Twelve Steps are the heart of Alcoholics Anonymous and the programs based on
the AA model. These 12 specific actions are the programs' official recipe for
recovery, the ingredients of an addiction-free life. Their purpose is "to
relieve pain and
suffering, fill our emptiness, help us find the missing something, help us
discover ourselves and the God within us, and release great quantities of the
energy, love, and joy dammed up inside ourselves"-all with a minimum of
discomfort and a maximum of self-awareness.
Unlike medical professionals, therapists, or some political activists,
Twelve-Step programs do not dwell on the causes of addiction. It is simply
understood that anyone who uses substances or activities in a way that
interferes with his or her life has an addiction problem.
Accordingly, Twelve-Step programs offer very simple explanations and a decidedly
behavioral approach, two important reasons why they seem to work for so many
people. They pay serious attention to ordinary pain by requiring people to pay
attention to it themselves by taking inventories, admitting wrongdoing, making
direct amends, praying and meditating, and spreading the message of spiritual
awakening. Working the steps one by one, and repeating them indefinitely, gives
people at least two things that neither science not politics consistently seems
to trust people with: A largely self-determined behavioral routine and
permission to understand our problems differently at different stages in our
lives, in ways that make sense to us even if they don't to anyone else.
On a day-to-day basis, Twelve-Step programs offer members handy directories of
meeting times and places, "Approved" literature on a range of topics, and
slogans to live by, like "One day at a time" and "Let go and let God." A set of
12 Traditions governs program structure. Members are strongly urged to
frequently attend meetings, although they are completely voluntary. Still, it is
not unusual for individuals to participate in four or five meetings each week
for many years. Meetings roughly follow a standard format: An opening statement,
a speaker who comes prepared to tell his or her story, spontaneous sharing by
those present, and a closing statement. When people speak, they do so for as
long as they wish to without interruption. No one responds directly to anything
that is said. There are slight variations on this format, and a meeting in rural
Nebraska would certainly feel different from one on Castro Street in San
Francisco, but a Twelve-Step meeting anywhere would be easily recognizable to
anyone who had ever attended one before. Predictability is the point.
Programs encourage a sponsorship system, where individuals who have been in the
program for a while act as buddies to newcomers, orienting them to program
philosophy and structure. In addition to their sponsors, members have no trouble
finding willing listeners outside meetings. Telephone numbers are exchanged and
used, at all hours of the day and night, when people need help or support or
just want the comfort that comes from making contact with other human beings who
care.
Twelve-Step programs also provide another thing that people are desperate to
find: a predictably safe place in which to feel understood and accepted. Safety
was almost tangibly present in many of the meetings I attended, and I believe
the feeling of uncritical acceptance people find in these programs may be one of
the main reasons they flock to the meetings. The safe environment has been
purchased at a rather high price, however: a community culture that does not
allow room for direct reaction or interaction of any kind, in particular,
criticism.
They look alike, but are all the Twelve-Step programs really the same? Does it
make sense to change compulsive eating behavior with the same techniques
alcoholics use to keep sober? Is sexual addiction different from food addiction,
and are they both different from addiction to mind-altering substances?
Food is something we all need to live; none of us needs drugs or alcohol to
survive, but alcoholism and drug addiction are characterized by a physiological
process of dependence completely unknown to most overeaters or sex and love
addicts. Food can be a way for people to establish and maintain relationships,
express their cultural identities, or spend leisure time. One progressive
political analysis of food and eatinggfat liberation-comes in direct conflict
with the Twelve-Step approach of Overeaters Anonymous.
In particular, feminists have exposed American society's cultural imperatives
about the physical body-what it is supposed to weigh, look like, feel like,
smell like, and act like-and claimed that accepted notions of clothing, diet,
and appearance are among the causes of women's self-hatred. Fat Iiberationists
have developed the convincing argument that fat itself is far less of a health
or self-esteem issue in the lives of fat people than are endless cycles of
debilitating diets or stereotypes about what fat (and thin) people must be like.
Sex is no more a survival need than alcohol. Yet, like the desire for food, the
desire for sex often exceeds the body's need to satisfy the basic hungers of
human emotion and spirit. It can be a tremendous source of pleasure, which is
why most people do not choose long-term celibacy. People, who enjoy sex because
of how it makes them feel about their partners, or those who simply look forward
to the next time they have an orgasm, may be considered perfectly normal. They
also can be considered slightly neurotic, or completely obsessive. Whether an
individual feels sexually normal or abnormal is determined by social attitudes
as much as by specifics of sexual pain and pleasure in her or his own life.
Sex and Love Addicts Anonymous (SLAA) is a relatively new program; it was
founded in Boston in 1976 by recovered alcoholics. An SLAA pamphlet, entitled
"40 Questions for Self-Diagnosis," asks: "Have you ever wished you could be less
emotionally dependent? Do you find yourself in a relationship you cannot leave?
Do you believe that sex and/or a relationship will make your life bearable?" I
think many peopleecertainly large numbers of women-would be inclined to answer
yes to questions such as these. Does that make us all sex and love addicts?
What exactly does recovery involve for an SLAA member? According to members, the
goal is to find love and sex within a true partnership, a kind of relationship
(generally understood to be monogamous) that does not fuel the addiction. If no
committed, continuing relationship is possible, then total sexual abstinence is
called for as the only method of maintaining sexual sobriety. Clearly, a
traditional hierarchy of sexual values is being upheld here; Monogamy is the
healthy ideal, and celibacy is preferable to promiscuity.
The Twelve-Step approach does not take up the significant differences between
addictions or people. The programs downplay contradictions and differences by
implying that all substances and activities are addictive when the enable the
user (or doer) to numb out and suggest that people are trying to fill painful
psychological/spiritual voids that no substance or activity can actually
satisfy. Can all human pain be collected into one big bundle labeled addiction?
Should it be? What about the feelings of pleasure that people derive from food,
drugs, alcohol, sex, and a host of other substances and activities? Are these
merely self-delusions, the sneaky evidence of addictions-in-the-making? Or are
Twelve-Step programs simply adding to the guilt already inflicted on us by our
pleasure-phobic culture?
If defining addiction is difficult, the Just Say No campaign has made it even
more so by throwing every manner of excess into the addiction pot and suggesting
that a stiff upper lip can solve everything from a monster federal deficit to
urban crime. Just Say No sounds catchy, but what the slogan really means is that
self-control is the entire answer, that saying no is an act of moral
significance, and that the people who do so are strong, whereas the people who
don't are pathetic weaklings. This trend toward championing the heroism and
romanticizing the virtue of the will is probably a significant contributing
factor to the popularity of Twelve-Step programs.
The current war on drugs, sex, and other modern "evils" is a hypocritical effort
to rub out the cultural changes of the past two decades by masquerading as a
caring crusade. Take, for example, the dismal state of sex education. The Regan
administration has suggested that parents instill the concept of chastity in
their children by whatever means they see fit. Millionaire John LaCorte
recently made national headlines with his modest contribution to the Just Say No
campaign: an offer to pay $1,000 to any girl who guarded her virginity until age
19.
AIDS educators know that they too must play by the rules that put them in an
impossible bind. They can squeak by only as long as they say no to frank
discussions about sexual pleasure, as a recent case in Massachusetts clearly
illustrates. In November 1987, when it looked like a long-fought-for state gay
rights law might finally pass, opponents of the bill instigated extensive
publicity about sexually explicit AIDS education materials and succeeded in
killing the bill for yet another year.
If our government were really interested in eradicating alcohol and drug abuse,
it would be spending time and money on rehabilitation, but it is not. In January
1987, while Nancy Reagan was having her picture taken with born-again drug
addicts, her husband cut nearly $1 billion from the national anti-drug budget
and actually recommended that not a single federal dollar be spent on treatment
programs. Meanwhile, 30 million Americans undergo drug screening today-in
prisons, workplaces, sports, the military and on campuses-and some estimates
indicate that 50 percent of the working population will be tested regularly for
drugs by 1992.
No matter where the political winds are blowing, however, the Twelve-Step
programs are determined to ignore them. In fact, avoiding public controversy at
all costs is one of the most consistent structural features of such programs. AA
publishes a booklet describing the "Twelve Traditions" that govern the structure
of Twelve-Step programs. The 10th tradition specifies: "Our fellowship has no
opinions on outside issues, hence our name ought never to drawn into public
controversy." This tradition implicitly recognizes that diverse individuals with
conflicting viewpoints participate in Twelve Step programs, and it indicates
that a formal, non-political identity is the only logical way to preserve
internal unity and prevent groups from being diverted from their purpose by
secondary issues. Some important questions do remain, however, about the
political implications of Twelve-Step philosophy and structure.
The programs' core concept-personal accountability for one's actions-is
decidedly apolitical: The responsibility for both addiction and recovery rest
squarely on the individual. In particular, the programs' philosophy that
addiction is a disease emphasizes the person and problem in isolation from any
outside social forces. This may ease some of the guilt that people feel for pain
that they and others have experience. One AI-Anon member, in great relief, told
me: "1 make no decisions. The disease does. I am sick." This kind of language
and the Twelve Steps constantly refer people back to themselves with the message
that their old negative ways of thinking and behaving are the sources of their
pain. Consequently, only new, positive approaches, nurtured by the programs
themselves, will produce serenity.
I rarely heard any speakers in meetings-whether recounting stories of assault,
workplace hassles, or matters of the heart-mention directly the realities of
physical power, economic inequality, racial bigotry, or sexual coercion, even in
instances where these were clearly being described. This is true even in Women
for Sobriety (WFS), a "new life" program for women alcoholics that differs from
Twelve-Step programs in that it tries to identify the unique recovery needs of
women. For example, one WFS member was talking happily about her new job as a
clerical worker in a big law firm but started sounding anxious when she
described her new boss as "a man with a bad reputation for kicking his
secretaries around like dogs." She concluded that this worrisome situation was
really a test of her sobriety, and she resolved to "meet the challenge to be a
pleasant person, no matter what." Because meeting rules do not permit direct
responses from others in the room, and because no larger social context is
officially recognized, no one in the room suggested to this young woman that she
did not deserve to be treated like an animal or that she was the potential
object of sex discrimination. As far as the program went, the answer was for her
to "think positive."
The conflict between seeing responsibility in purely individual or purely
political terms arises in the first of the Twelve Steps: "We admitted we were
powerless over ( )that our lives had become unmanageable." For many, this step
is problematic because it turns the progressive political goal of empowerment on
its head. But because
people generally do not like living with intense contradictions, politically
aware Twelve-Step members creatively manage the conflicts between their politics
and their Twelve-Step experiences. Here is how one politically active lesbian
explained the importance of taking the first step, admitting powerlessness, and
another sticky concept, the Higher Power.
When I was getting sober, AA was completely in opposition to my experience as a
politico because one of the big words was powerlessness. Every activist's hair
stands on end at the idea of embracing powerlessness, which you're supposed to
be wild about in AA .... 1 found a way to rework the philosophy. It was clear to
me that the minute you "give up," you begin a process of empowerment .... The
big stumbling block for me was the whole God thing .... To me, this was
completely patriarchal and repugnant. So someone suggested a concept of God that
wouldn't offend me - historical materialism [the orthodox Marxist theory of
history].
Members who aren't quite as good at fine-tuning the Twelve-Step approach to
their own personal philosophies are simply reminded to "take what you need and
leave the rest," a handy Twelve-Step slogan designed to minimize conflict and to
help people feel comfortable.
The custom fit of the Twelve-Step experience is undoubtedly part of its appeal,
but in the context of a Just Say No culture, it risks distorting personal pain
to a point where people who really do not have addiction problems are encouraged
to think they do. The most striking evidence of this is that many people who are
not alcoholics, overeaters, or drug addicts are regularly attending meetings and
adopting the Twelve-Step philosophy as their own, anyway. The presence of
non-addicts is controversial in some but not all meetings, where addicts
consider them to be diluting the program and distracting members from their main
goal of recovery.
As one follower said, "There are some people-I won't say they're addicted to the
programs because that's not an appropriate use of the word-who do use the
programs as a crutch. The meetings aren't about making friends. They're about
changing your life."
But for many, the programs are about making friends, and it is not unusual for
members' friendship networks to change radically, even completely, after
entering the program. For some, this is a necessary part of learning that
relationships that do not revolve around alcohol or drugs are possible. For
others, the programs are just new ways of feeding unsatisfiable hungers for
visibility and recognition and a place to experience contrived interactions
dressed up as a recovery. The latter experience is merely a new form of
dependency.
Substance and other abuses clearly exist in our society, taking horrible tolls
on individual lives. Total abstinence must be supported for those who feel it is
their only non-abusive option. But just because many things can be dangerous
does not mean that they always are. Positive and negative potentials exist side
by side. Drugs, sex, food, and other things can be quite wonderful. We should be
as determined to define our right to pleasure as we are to eradicate the reality
of our pain. To some degree, our dignity as a society will be measured by our
success or failure in this regard.
Progressive political movements should be taking notes on what is so appealing
about the recovery movement. Political leaders and artists inspire us with
visions of peace and social justice; activists discuss and strategize; foot
soldiers do the work of getting us from here to there. Meanwhile, we all have to
get through the day. Getting through the day might mean staying away from a bar,
finding a friend to cry with in a moment of sadness, or having wonderful sex all
afternoon. It might just be another day at work. Whatever it is, it is what
political movements should be about. Changing the structure of political power
is not as possible, certainly not as meaningful, when changing ourselves is
absent from the political agenda.
There is no doubt that Twelve-Step programs have helped people get through a lot
of days. But they do nothing to decipher or change the larger context in which
time passes, especially in a Just Say No culture that would like to wipe out
progressive gains for good.
Political movements can address the larger context, and they have something
unique to contribute to the recovery process: an understanding that prevailing
cultural messages affect how people feel about themselves just as much as "Think
Positive" slogans do. Self-hatred and self-love are not matters of luck or fate;
they do not come and go only on uncontrollable tides of willpower. People
struggle for and against them, and they will be won or lost just as all contests
of power are won or lost. We must keep our eyes on the prize of pleasure even
when we are in pain, not allowing suffering to become a symbol of sin or
sainthood, nor endorsing sickness as a test of moral character, and not making
addiction a prerequisite for support and community. If we succeed, we may all
get to serenity.
Excerpted with permission from Out/Look: National Lesbian and Gay Quarterly
(Summer 1988 Subscriptions:$19/yr. (4issues) from Box 46030, San Francisco, CA
ŠUtne Reader, Nov. Dec. 1988
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