09/12/2009 05:12 am ET Updated Nov 17, 2011

The 12 Steps: A Necessary But Not Sufficient Cause For Recovery

Thank you to all of the readers out there, especially those who contributed to the lively discussion about the efficacy of the 12 Steps. I'll continue in the next post on some suggested methods for dealing with narcissism and other forms of self-centeredness. But first, I'd like to address a few points that I hope will be helpful to people who suffer from addictions and their many related consequences. I encourage comments and if you're a little shy, please feel free to drop me an email through my website,

My position is that I encourage anyone who is suffering from addictions to try anything and everything they can to find relief. I've found mine in an integrated, comprehensive, multifaceted approach to recovery that includes, but is not limited to full participation in 12-Step groups, psychotherapy, medication, community service and involvement with Buddhist and other spiritual communities. Incidentally, there is a difference between spiritual and religious. Many methods are listed in each chapter of the 12-Step Buddhist book. You might not need all or any of them. But in my case, some are sicker than others. If you're like me, and are tired of suffering, then it makes sense to try anything and everything you can.

While I'm not a representative of AA, NA, OA, CA, SA, GA or any other "A", I do have over 25 years of experience with the 12-Step model. I used it for 10 years, abandoned it, almost died and took it up again. Now in my second decade of recovery, I feel better than I ever thought possible. I attribute this to the methods I outline in the book.

For those who need proof of the efficacy of the 12-Step programs, I offer my own experience. If you're an addict and have found other methods that work for you, that is fantastic! In my case, it (12-Step recovery) works when I work it. It won't if I don't. I've tried it both ways and prefer the results I get when I put my heart into my 12-Step community. But for those who'd rather not participate in 12-Step, for whatever reason, then of course they will do what they decide to do.

If an individual doesn't want to go to 12-Step meetings, they should of course be free to choose any other method that they like. If the courts do send someone to a particular type of 12-Step group, such as AA or NA, and they don't want to participate then they of course should still comply with the court. But outside of institutions, I'm not sure that will work long term, particularly if it is against the person's will. There is some data to suggest that forced compliance in non 12-Step treatment is beneficial for some kind of reduction in incidents of drug and alcohol abuse. But for the 12 Steps to work for extended happiness and spiritual growth, my opinion is that the individual has to be willing.

Some of the criticisms of 12-Step culture have a basis in reality. But it's a mistake to think that the 12-Step world is some kind of static entity. Most meetings are dynamic in that they change topics and speakers each week. There's no such thing as "AA, SA, OA, NA" in reality, just as there really is no such fixed entity as "the government," or "the self," for that matter. Everything is fluid, impermanent and dependently arising. So remember if you have a fixed idea based on limited experience, you may get different results with a little open mindedness. Or not. It's up to the individual.

Here's a little advice. If you go to meetings and someone tells you that you have to believe in their form of a higher power, please go to another meeting, talk to other people and read the literature very carefully. In smaller towns, this variety may be harder to find. There are alternatives, such as online communities. Finding the right fit for you may require diligence and fortitude. But remember, as my friend Chuck recently said, we always find what we're looking for.

For me, participation in the 12-Step world-by that I don't mean any single group or meeting or town or individual, but the overall concept of being an active member of a 12-Step community-has no substitute. Let me repeat that. In my experience, there is no substitute for one addict talking to another. If you've found one that works for you, that's great. Personally, I'm a lot happier when I am able to interface with addicts who understand not only the mind of the addict, but the principles and practices of recovery. I feel more whole and complete in a way that I've never encountered anywhere else when I'm interacting with fellow recovering addicts. But it wasn't always the case, and I wrote about these difficulties in my book. Many people have written to me that they strongly relate with such experiences. It is my hope and intention with the work that I do to help anyone who wants it to find as much relief as they can. I have been unsuccessful without the 12-Step community. Maybe that makes me a loser. But I prefer to be this kind of loser than the kind I was outside of recovery.

These programs work well for those who want them to work - most of the time. But there are some people who just don't get it, no matter how hard they try. If you're one of those, I wrote the 12-Step Buddhist for you. If you feel that the 12 Step communities, be they AA, NA, OA, GA or any other "A", are religious cults or will force a particular spiritual view on you, then I encourage you to read the book, try lots of different meetings and groups and talk to different people. If you're in a part of the country that has a heavy Christian influence and you don't feel that you relate, then certainly look at my article on how to start your own meditation oriented meeting based on the 12 Steps but with more of a Buddhist view. This is one example. I realize that there are alternatives but I have no experience with SMART Recovery or similar programs. I've written about what works for me and it works extremely well.

Below is a contribution of some research by a reader, Chris Hoff. Thanks to Chris for putting this together. I hope that readers find this beneficial.


After the last post it seems that opponents of the 12 step model believe that there is something missing when it comes to research validating the 12 steps effectiveness. Actually, to the contrary, there is a wealth of current research out confirming that greater 12 step group attendance leads to greater abstinence (Andreas & O'Farrell, 2009; McCrady et al, 2004; Morgenstern et al, 1997; and Ritsher, McKellar, Finney, Otilingam, and Moos 2002). Even now valuable research is taking place that has broad implications for those suffering from substance dependence and their forgotten victims, their children.

In a groundbreaking new study titled Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems in the January 2009 issue of the Journal of Substance Abuse Treatment researchers Jasmina Andreas and Timothy O'Farrell in association with Brown University, Harvard Medical School and VA Boston Healthcare System proposed that fathers' greater treatment involvement in 12-step attendance would benefit later child behavior. The findings were staggering, over the 15-month study period Andreas & O'Farrell found significant reductions in behavior problems of the children of the alcoholics who continued AA attendance posttreatment. Another side benefit of this continued AA attendance was that the fathers experienced longer abstinence. A win/win if there ever was one.

This study has broad implications for the silent victims of addiction, the children. It also shows that the 12-steps have a positive effect not just on the sufferer, but all those around sufferer. This research and other studies like it show the healing and powerful effect the 12 steps have on family systems. Still think there is a lack of research stating positive 12-step outcomes? Not anymore.

Chris Hoff
Two Roads Professional Resources, Inc.
Huntington Beach, CA 92649