Sunday, November 13, 2005

ptsd and 12 step programs

I think for the next few days I'll write about ptsd and 12 step programs like Alcoholics Anonymous (AA), Narcotics Anonymous (NA), AlAnon, Adult Children of Alcoholics (ACOA or ACA), Survivors of Incest Anonymous, Sex Addicts Anonymous, Emotions Anonymous, and one I didn't know about, Trauma Anonymous. There are many more, but these are the ones I have had experience with (except the last one). They all use the twelve steps developed by AA as a system of recovery. All of these groups are ostensibly focused solely on the addiction or condition they each target. This keeps controversy to a minimum and recovery from the particular addiction or condition primary.

AA is the most no-nonsense of the groups and the one I have the most experience with. During my first six years of recovery in the second half of the 1980s I went to seven to ten meetings a week, mostly AA with some NA, AlAnon, and ACOA thrown in. AA seemed to be the place where people most often actually got better. In the other groups, I felt that things often got bogged down in the illness and skimped on the recovery part. That may have been denial on my part, but that is the logic I used at the time and I kept clean and sober, which is something I was utterly unable to do alone.

After that first six years, and some traumatic experiences with people in 12 step recovery, I moved away and slowed down on meetings for a while. When I moved again, I went back to almost daily meetings for another few years, but then finally stopped going when I moved once again. I haven't been to any meetings for a couple of years now, and my life has improved as a result. I have been clean and sober over 21 years now, something I am grateful for, as I never would have made it this far while still using, and I never would have gotten sober without 12 step programs. I am pretty lucky to have survived my active addiction as it was. I don't think I would have made it this far using. I won't rule out going back to a 12 step program, but right now its not on the horizon for a number of reasons I'll eventually go into.

When I was in trauma rehab a few years ago for my ptsd, 12 step programs were part of the recovery agenda. What I discovered there though was that people from twelve step programs were part of my trauma and meetings were a trigger. Ultimately, I stopped going to meetings while at the treatment center, something I think is kind of unusal, but they and I decided it was better to skip the meetings and the attendant flashbacks than to go. I wasn't about to run out the door and get drunk. My drug and alcohol addiction is not really an issue any more. Its the underlying problems that mess up my life, most of which are trauma and ptsd related. If I pick up, maybe I'll make it back to the rooms, maybe not, but I have no desire to use anymore. It just is no longer a part of my life and that's that.

I mentioned in my first post that ptsd combined with alcoholism or drug addiction made recovery from any of them much more challenging (pdf). Because individual 12 step groups are focused on single issues, they tend to push aside all other issues. The ones that don't do this, like ACOA in my own experience, are the ones that get bogged down in negativity and never get around to the recovery aspects. So it is sort of a bind. There are some 12 step groups that seem to be aware of this, like Dual Recovery Anonymous and Trauma Anonymous, but I don't have any direct experience with them and the other programs' meetings that I went to at the time I went were adamant in their single purpose.

This made me feel like some kind of fuck-up, like I wasn't getting it, or I was lazy, or just not doing the steps right. If it doesn't work, the people that are invested in it working -- remember, their very lives depend on it working -- tend to blame the person it is not working for. They have to. I can't be the program that doesn't work, they have to much invested in it for it not to work, so it must be ME that is at fault and if I just got over it/got off the pity pot/accepted it/forgave/stuffed my anger/worked the steps harder then I'd be fine like them.

So I left. This was hard. AA trains you to think that if you stop going you will pick up eventually, and maybe that is so. A lot of people that go regularly end up picking up too though. Nonetheless, my fear of living without going to meetings was an obstacle to leaving, especially since I had already tried to get sober by working the steps on my own and it failed miserably. I have sort of thought all this through and in some ways de-programmed myself with some help from my friends.

I think single purpose 12 step groups are made for a certain type of addict, and this single focus works for them but not for all addicts. I'll go into that next post. If you have read this far, let me know what you think by leaving a comment!

8 comments:

reallynotimportant said...

I've not been to one myself but have seen the harm that they can do to people close to me. I have posted my views on this elsewher 12 steps

Anonymous said...

After over 3 years clean (peaceful and happy) I quit going to meetings and began binge drinking. I still held a job and took care of my children, until things began to go downhill RAPIDLY. One evening, I was taken deep into the woods and brutally raped by a stranger. I had drank a few drinks, and carried the guilt of a rape that wasn't my fault or right, for years. The rape made me extremely sick, and I began drinking excessively, and then ended up on crack, living on the streets. I gave up my children, and lived a sick miserable existance, tring off and on to get clean. I finally had enough....wanted to die. Rehab, moved, AA, NA, trying so very hard and feeling (and being told) that I just wasn't doing it right...not good enough. I did everything they said, so much better than my previous 3 years of sobriety, due to my desperation. Brief periods of sobriety, followed by more frequent relapse. Even the most kind, humble, of the sober folk, lost hope, and got angry at me, thinking that I HAD TO BE DOING SOMETHING WRONG, BECAUSE AA WORKS. One night, at a friends, I was surfing the web, and read an artical (statistical) about trying to work on alcohol/drug recovery without working on the severe Post Traumatic Stress Disorder from the rape. My chances were low. But now.... I had hope. I wasn't "NOT DOING IT RIGHT". I had other issues, and others had recovered. I began going to church because, there was just no where left, and volunteering at the womens center, hopeing I could grab some free counsiling. Thank God.......I'm okay now. I'm not perfect, but I no longer have to be. I have peace most days. I love me for the first time ever. I have a home, and I work in accounting in a good job and am well respected and loved. God not only gave me a chance, but so much more. I'll be acting in play next month to raise money for the womens center, and now have full insurance for my therepy. I am blessed more than I can say. There's much more growning to do....but God can do ANYTHING. We can recover. We can.....be okay and have peace and be useful. If anyone were ever to tell me to go to hell.....I'd smile and say....I've been there. No thank you.

Anonymous said...

Hi,

I have PTSD and Bipolar Disorder and have a therapist who is very familiar with the 12 Step program of AA.

Per discussion with my sponsor and my therapist I avoid any open discussion meetings at this point unless I go with my sponsor to avoid setting off my PTSD triggers. The open discussion meetings in my city are frequently like cheap group therapy without a therapist. People air their emotional baggage and abuse history's which sets my PTSD off. Per the above discussion I walk out when shares set off my triggers and return to the meeting when I am able to.

I attend study meetings where will not have to deal with this sort of emotional indulgence therapy. If I do go to an open meeting with my sponsor and share I ask that no one cross talk with me or provide advice. As part of the AA meetings we agree to no cross talking but many people in my area including people with years in the program don't know what cross talking is or choose to ignore the rule. I have to gently educate the cross talkers and advice givers. This sets good boundaries. The chairs in this area will not stop cross talkers or advice givers as a general rule.
I also will not share if I am upset in any way.

A good example of a Dual Diagnosis Program with strong success is Double Trouble in Recovery by Howie Vogel.

grateful nita said...

i have struggled with PTSD throughout my life. stuffed the trauma with food. attended OA and FAA. will power, and maintained for years. found the FAA meeting so controlling that i was back to suicidal feelings. it was all about looking good for the program, compartmentalizing emotions in different meetings.
and they had the audacity to not permit people to use anti depressants.
(practicing medicine without a licence ?) i left the program.
now i have regained some weight, but i am dealing with the chaos inside, taking antidepressants, and being counseled. i hope that the outside will catch up. i believe it will.
i’m finally listening to my own better judgment. staying far away from abusive family members.
i am in such a better place now.

Anonymous said...

I have to be very careful going to meetings because meetings and the lack of anonymity in meetings and outside the rooms by "anonymous" people" is a trigger for my ptsd to the point where I cannot function in my life. I do work the steps, I don't go to meetings. I sometimes go to online meetings using a fake name. I too am a "type B" alcoholic, and appreciated the comments about that. I also think that sometimes having both addiction and ptsd it is a trade off of which thing to treat, because for me, the treatment for one disease triggers a relapse in the other....very often. I am lucky to have a day that is free of symptoms of ptsd or obsession.....thanks for these posts

Gadfly said...

I recommend non-12 step recovery programs to start with.

They include "secular sobriety" programs such as Lifering Secular Recovery, SMART and SOS.

First, you get a whole new paradigm for recovery from alcohol or drugs, where you don't have to shoehorn yourself, how you have dealt with substance abuse in the past, or how you plan to recover from the problem, into a one-size-fits-all set of "steps."

Second, and related to that, you get empowerment from a truly self-help focused approach.

Find out more about Lifering Secular Recovery, with which I am involved, at http://lifering.org

Anonymous said...

In find it interesting but not surprising, how any people are triggered by others in AA. Let's face it, there are a lot of sick people in the rooms. Many addicts will steal anything that isn't nailed down, and that includes YOUR self-esteem, if given the chance. Yes, there is all kinds of jockeying for position as though that's why we're there, and it's mostly done by people who have severe jealousy issues or didn't get common decency in childhood.
The steps can give them that if they're willing though.
I'm beginning to think about leaving AA actually after many years, as I've had enough abuse, including from my sponsor who wounded me while I was getting well.
Narcissism is an epidemic.
Watch who you're trusting and who you're sharing with. I've also foud that asking ANYONE for ANYTHING in AA is an invitation to be manipulated.
One other thing: most AAs allow other AAs to dominate their thinking. Remember these are sick people we're dealing with and type A's have different symptoms than us.
Most of us qualify for Alanon and ACA anyway, but the solution really is in AA, so it's hard.
Godspeed. Hope everyone is doing ok today. Me? I just had me a good cry after an extremely stressful day and did some
Grieving. Try it. It helps.

GettingBetter said...

anon said:

>The steps can give them that if they're willing though.

Kind of the point of the post was that the steps are not the answer to everything. when the steps fail to produce the "that" that you say they will give, then the answer is to blame the person the steps did not work for as not willing to be hones or not working it. I beat my head against that wall for a few years, then left 12 step programs when I had 16 yrs clean. I now have 31, and the last 15 have been way better for being away from the rooms and the steps. The steps do work for some, and in fact I got clean and sober by them, but beyond that, they did not restore my mental health. I had to go to other places for that, and stop getting blamed for the program not working!



and then anon said:
>Most of us qualify for Alanon and ACA anyway, but the solution really is in AA, so it's hard.

But for some people, AA is not the solution, but the member response (even though it goes against the big books humble closing lines of "we know but a little") is that the person AA fails for is "just not working it." Just about drove me to suicide trying that route...what's that definition of insanity? doing the same thing over and over and expecting different results?" for me that "same thing" was the 12 step approach. When I stopped, it opened the door for a long slow process of actually getting better.