TRAUMA AND THE 12 STEPS, REVISED AND EXPANDED : AN INCLUSIVE GUIDE TO ENHANCING RECOVERY
A research-based, trauma-informed guide to working the 12 steps for clinicians, sponsors and those in recovery
About the book
For some who struggle with substance addiction, a 12-step recovery model offers the support they need when transitioning to recovery. And for many people also coping with lived trauma, it’s not nearly enough.
Recovering addicts are frequently faced with a host of additional, often interrelated, challenges including grief, dissociation and more. According to the latest research, these experiences are apt predictors of a person’s capacity for long-term sober living. Yet conventional 12-step programs like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) have largely failed to catch up to the science. Still today, a recovering addict may not feel welcome at their local 12-step meeting if they identify as LGBTQIA+; are atheist, agnostic or otherwise spiritually marginalized or traumatized; have had a negative or traumatizing experience at an AA or NA meeting; or have been discouraged from exploring the relationships between trauma and addiction within the context of their own recovery. Many 12-step fellowships still discourage meeting attendees from “dwelling” on their past experiences, which we now know may very likely inhibit a person’s recovery.
About the author
Jaime Marich, Ph.D., LPCC-S, LICDC-CS, travels internationally speaking on EMDR therapy, trauma, addiction, expressive arts and mindfulness while maintaining a private practice in Warren, OH. She is the developer of the Dancing Mindfulness practice and co-creator of the Yoga Unchained approach to trauma-informed yoga. Marich is the author of seven books, including the popular EMDR Made Simple and EMDR Therapy and Mindfulness for Trauma Focused Care, written in collaboration with Dr. Stephen Dansiger.
Adapted excerpt: There is a solution
One evening, Nancy showed up at the community drug and alcohol facility in her county with an all-too-familiar feeling: I’ve been here before. Her feeling was justified. In the previous 12 years, Nancy had gone through 12 or 13 treatment facilities. She lost count somewhere around five. Additionally, she participated in AA during and after each treatment episode at the suggestion of each facility, yet she was never able to piece together any more than four months of sobriety. The funny thing was that Nancy never really minded going to AA; she always knew she belonged there. Something just never quite clicked for her.
Nancy sat down with the assessment counselor, still dressed up from an exhausting day of work at a job she hated. There was weariness in her eyes as she explained that the municipal court sent her for treatment after her third driving under the influence (DUI) charge. Nancy knew the lingo of 12-step recovery and treatment and did not need any convincing that she was an alcoholic or an addict.
“Oh, you don’t have to diagnose me, I know,” she said candidly. “But I can never seem to stay sober, even when I try my hardest.”
The assessment counselor, pretty sure that she had established enough rapport with Nancy, began to ask some very tough questions about her history. What emerged from the rest of the interview was the picture of a woman with a complex case of post-traumatic stress disorder due to multiple sexual assaults accompanied by life-threatening violence. Sadly, the perpetrator in many of these assaults was her one time husband.
“I know that all of this is an issue,” Nancy told the counselor, “I just can’t seem to get it all out. And when it comes time for me to do a fourth and fifth step in AA, I just run. I can’t look at myself. All I see is garbage—it’s too painful, and I run.”
Too often, people labeled as “chronic relapsers” are really just struggling with the aftereffects of unresolved trauma. The legacy of this wounding can last for years, even decades, making tasks like doing fourth and fifth steps paralyzing impossibilities for the traumatized. This is not to say that a person with unresolved trauma can never do fourth and fifth steps. On the contrary, working all 12 steps can actually be beneficial for a traumatized person. When worked within a safe context that honors the wounds and scars left by trauma, the individual’s chances of success in working the steps and staying sober are optimized.
Honor the struggle. Sounds simple, no? Yet every time a treatment provider dismisses the impact of a client’s history in favor of the “they’re just addicts” mentality, they reject this simple solution. I first heard the phrase, “honor the struggle,” from one of the best bosses I ever worked for, Ken Lloyd. The CEO of the community facility where I was on staff when I first met Nancy, Mr. Lloyd, always stressed the importance of honoring the struggle that our clients experienced before coming to us. He asked us to continue honoring their struggle as they attempted to learn a new way of life in sobriety.
There are those who argue that placing too much emphasis on a client’s history before entering recovery is the kiss of death. A major aspect of 12-step recovery is to teach an addict to live in today. Several major psychotherapeutic schools of thought like reality therapy or choice theory and rational-emotive (RE) behavioral therapy also emphasize the importance of living in the now and not dwelling on the past. However, it is important to consider that our histories shape the people we are today. So, is there a balance? Can we teach recovering addicts to live one day at a time while honoring the struggle of their past, present and future?
Example “Toolkit Strategy” from the book:
Self-inquiry—taking a look at yourself, your tendencies and your biases—is a skill. Knowing where you currently stand on your approach to working with people affected by addiction is critical. This knowledge includes self-inquiry about your thoughts, feelings and experiences with developing a trauma-sensitive approach to this healing work.
- Take a few minutes to write down how you would describe your approach to working with people in recovery. You can use the language of psychotherapeutic theory (e.g., 12- step model, cognitive behavioral therapy, somatic psychotherapy), or you can keep your language informal, especially if you are not a treatment professional (e.g., “working a 12-step program”). If writing is not feasible to you, simply spend three to five minutes in silent reflection or with a trusted person in conversation.
- Consider if there is room in your current approach to take on new, trauma-informed skills. If you have reservations about considering the role of trauma and how it can affect treatment, spend a few moments and jot down what your reservations may be about learning these new approaches. This is not intended to be an exercise in shaming or judgment. If you are willing, perhaps consider sharing some of these reservations with a person (e.g., fellow colleague, another member of a recovery program) and notice what you notice about yourself.
- What might you need in the way of support to take a more open view of this material? As a hint, you may find it more useful to replace the phrase “open-minded” with “open-hearted.” Being open-hearted invites us into a greater sense of empathy in connecting with our fellow human beings. When we can connect with each other at the heart level, the sense of separateness and division can vanish. Bridges are more likely to be built.
- Contact Info
Jamie Marich (she/they), Ph.D., LPCC-S, LICDC-CS, REAT, RYT-500, RMT
Founder, Mindful Ohio & The Institute for Creative Mindfulness
EMDRIA Certified Therapist/Approved Consultant/Trainer