We are still under construction here but making progress.
One of the strongest challenges to twelve step recovery arises over the matter of the word "powerless" in the first step of the twelve steps of Alcoholics Anonymous (AA) and other twelve step groups. Secondary to that is the matter of "God talk" which is closely related to the "powerless" issue. These issues are complex and can be understood at many different levels. We thought it best to give this controversy a page of its own with links here from other pages that would have reason to include this topic. If you read further, you will see that we think some of this is just plain silly, but the use of the word "powerless" does raise some issues that we think warrant serious discussion.
The Alcoholics Anonymous (AA) reference to powerlessness in the first step is consistent with what the neuroscientists have observed as brain alteration in addiction, as is AA's observation that once an alcoholic always an alcoholic, because, for many if not most, the brain does not go back to normal once this change has occurred. Even after years of abstinence, one drink will start the process all over again, in some (probably most) people whose addictive process has progressed to an extreme. But it is also true that many problem drinkers that we have thought of as alcoholics do not have this sense of powerlessness, and understandably may have some legitimate resistance if pressured in a twelve step based program to claim powerlessness. AA loyalists would object, but we do not believe that everyone who has been a problem drinker will quickly revert to the worst of their old ways if they have one taste of alcohol. The problem is that there is only one way to find out. Those that roll the dice on this sometimes come to a tragedy as a result.
At the very simplest and most basic level people seeking help for what they believe is an addiction are not truly powerless, at the very least in the sense that they are not so powerless as to be unable to seek treatment or attempt to make changes in how they live and what they do. Some of the combatants in the very hostile criticisms of twelve step approaches hang their hats on this very simple point, and consider the matter settled. This is part of what we had in mind in the above paragraph where we said "just plain silly," except that people are getting hurt as this becomes a barrier to meaningful help. There is nothing funny about people getting hurt because of unprofessional attitudes from professionals. Professionals touting this line simply should know better.
Transparently, the AA pioneers knew that alcoholics are not powerless in this sense. For them the word "powerless" had a very different meaning. They had all tried to stop drinking and used a wide variety of resources to help them to do so, to know avail. They certainly did not think of themselves as powerless in all matters. They would have agreed that they were not so powerless as to be unable to choose to go to AA to take a new approach to stopping drinking. Clearly the meaning they attached to "powerless" was quite different from the usual meaning that the basis of this simple way of rejecting "powerless" Do the people promoting this way of thinking really believe that vast number of people who have participated in twelve step groups really think they are saying they are completely powerless to make any decisions for themselves or initiate any actions on their own behalf? Be serious. This very simple rejection of the term "powerless" comes down to a straw man argument that simply does not work.
The early pioneers of AA were people who had tried to stop drinking many times prior to turning to AA and had felt powerless to make that change until they became part of AA. We also note that not everyone who reached out to AA succeeded in becoming sober as a result of investing in AA. But some who had never experienced success in recovery until AA became available to them, did become sober and remained so with support from AA.
The founders of AA and many, probably most if not all of the very earliest participants, were already members of the Oxford Group, a Christian renewal fellowship. Many of the first AA meetings were special purpose meetings of the Oxford Group. In a Christian context, the word "powerless" is often used comparatively: "We are powerless over many things but God can do most anything. If we seek His help He can do the impossible on our behalf." The idea is that God is powerful and by comparison, we are powerless, is behind this concept historically. When AA stopped identifying as a specifically Christian group, and shifted to the more general concept of "higher power," the intended meaning of "powerless" remained. But it is intended to mean what it means in a Christian context. We are somewhat empathetic to mental health professionals missing the point here, but we still think what is going on here is obvious enough to warrant them figuring it out.
However there are more important reasons why the use of the term "powerless" remains an important topic of discussion and source of potentially meaningful disagreements. First, well qualified psychotherapists tend to see empowerment of their clients as central to their work, especially when confronted with a person who, like a severe alcoholic, feels he or she cannot change a behavior (in this case drinking) that he or she desperately want to change. It is central to the role of a psychotherapist -- at least to a psychotherapist who is not an addiction specialist -- to help the client overcome his/ her sense of powerlessness. To cast powerlessness in any positive light is at least antithetical to the basics of what psychotherapy is usually about. We don't think this validates all of the attacks on the use of "powerless" in the twelve step groups, but may help us to understand where this is coming from.
Probably more concerning in some quarters is that some see the word "powerless" as giving license to drinkers (and drug users) to avoid responsibility for their actions. This is a very legitimate concern. In our experience addiction professionals tend to be very careful not to let their clients use this for an excuse but it easy to see why this issue gets raised. We strongly oppose any mixed messages on this point. But in our observation of (open) AA meetings or closed meetings attended by permission of the group, we have not seen AA members in recovery using this to avoid responsibility. Please note that steps 4, 5, 8, and 9 appear to be about taking responsibility.
So let's go back and look at what is different between 2017 and 1935, when it all started. In 1935 no one, not even the finest mental health professionals (remember in 1935, these would in almost all cases be psychiatrists) could demonstrate success in helping alcoholic men to overcome their compulsion to drink. "Powerless" was not likely to be questioned by these men (remember in 1935 only men were understood to be alcoholic) who had fought their compulsion to drink and lost every time. The only known successes (all anecdotal, not based on actual research) were based faith based approaches, and none of them seemed to be very consistent in creating sobriety. Based upon the scant information we have from those days, the Oxford Group appeared to have had some modest success. But it was not consistent.
The approach taken by AA in its beginnings was experienced by people who would not in any way question or doubt their powerlessness over drinking. But AA was not then very well known, and we certainly did not have people outside AA trying to force people to join. Contrast that with 2017. At any well attended AA meeting an observer is likely to see a line-up of people getting a signature to document AA attendance, for judges and/or probation offices. Others will be there because of an intervention or pressure from a job or an Employee Assistance Program EAP). These are people who are unlikely to be there at least initially because they feel powerless. Of those, probably some are just as strongly addicted as the original AA people, but have not struggled against the addiction in so many different ways or over such a long time as the AA pioneers, so they have not felt powerless. Others are probably people who have gotten into negative consequences due to substance abuse in some form but do not cross the line into addiction as ASAM defines it. In neither situation is the person likely to feel powerless in the same way that the AA pioneers did.
We believe we would accomplish much more if we were to engage these people in a program that would include individual psychotherapy, aiming in part to discovering exactly what this person needs in order to be able to discontinue whatever brought the person into a need for treatment. Ideally, in our opinion, many of these people would benefit from moving into twelve step support, but not everyone. For those who are feeling powerless over making change, twelve step support may be the preferred approach. Some who do not have that problem, may still prefer twelve step as a comfortable place.
Our deep concern about practice in the substance abuse area related to the "powerless" statement is associated with a practice in many twelve step based treatment programs. Those programs in many cases (if not most or nearly all) pressure their clients to make the statement of the first step. In many of those situations, the person may not be experiencing powerlessness in any form. Their motivation to drink or use drugs or engage in other addictive behavior might have no connection with the sense of powerlessness that many other addicts and alcoholics feel. For others, there may be a very powerful compulsion to use, but they are pressured to commit to the first step before they have any self perception of the accuracy of that. The introduction of Motivational Interviewing as a technique at many programs mitigates this somewhat, but it still can be a problem even where Motivational Interviewing is well established.
One of the most serious consequences of this is that people who have been subject to this kind of experience are all at high risk for needing help with addiction issues in the future, even if they were not truly addicted (ASAM definition) this time. This tends to create resentments. These resentments get in the way of a person considering twelve step at a time later in life when it could benefit them.
We see the same emerge when a therapeutic program is presented as being twelve step when the only twelve step meeting that are attended are actually simulation meeting that do not truly conform to Twelve Step Traditions (especially Tradition 4). If the meetings are open to attendance only by people who are staff or clients of that treatment center, this is NOT a true AA meeting (or NA or GA or any of several others). It is not an autonomous group. The power of a twelve step fellowship will not be experienced unless the people attending it will experience the interaction with people not associated with that treatment center AND they have the opportunity to engage a sponsor of their own choosing, again outside the treatment program. If treatment staff attend, they are expected to function as they would at a meeting in town.
We do not object to treatment programs holding simulation meetings in order to transition their clients into becoming part of the twelve step community. What we object to -- strenuously -- is misleading participants into understanding participation in these meeting to fully participating in a twelve step fellowship. It is not. When treatment programs choose to offer these meetings they need also to be clear about what they are, what they are not, and why the difference is important. Programs using these kinds of meeting, please TELL YOUR CLIENTS that a real twelve step fellowship is much more than this kind of meeting.
Some people respond to this criticism by saying "Closed groups are allowed. This is just another closed group." Not so fast. Most twelve step fellowships have closed groups. That usually means only people in recovery and people seeking recovery for themselves may attend. With staff of a treatment center observing and listening, that is not the situation. With no influence other than the people the new participant encounters all the time in the treatment program, that is not the situation. AA especially has men's groups, women's groups, kid's groups, etc. That kind of thing is another expression of a group that is closed to some populations. AA meetings in a treatment facility are meetings listed in published meeting schedules in the area where they occur and the general public from nearby is invited. It might be a group for only one gender. It might even be a "closed" group, but then treatment staff who are not in recovery themselves do not come into the meeting.
This is not simply legalistic hair splitting. Treatment programs that have these kinds of meetings and pass them off as full participation in a twelve step fellowship are leading their clients to believe that this is the entirety of what a twelve step recovery group is all about. When trouble surfaces later the person quickly rejects twelve step approaches because they think they have experienced it and what they experienced is all that there is. it simply led them to another failure. But twelve step recovery is much more than that.
Applying the issues raised here:
- When selecting a facility to treat substance abuse related issues, ask what treatment resources they use. Ideally, their answer will show equal respect for both twelve step resources and methods and alternative resources and methods. Unfortunately very few will do that (see Destructive Controversy).
- If they do not seem to be promoting twelve step, ask under what circumstances they would encourage you (or the family member of concern) to take advantage of twelve step recovery. If they say "never" you are probably in the wrong place.
- If they appear to be primarily a twelve step facility, ask under what circumstances they would encourages you (or the family member of concern) to move toward one of the twelve step alternative resources. If they say "never" you probably should be talking to someone else.
- If this is a short term facility (100 days or less in all cases except extreme outliers), ask what will be accomplished in that period of time. If they want you to think that you (or the family member of concern) will be home and back to life as usual at the end of that time, stop right there and find a different facility.
More to come. We are still developing this page.
List of Twelve Steps.
We have grouped most references from this page here as there are alternative sources of information on most of the items linked.
Return to references to "powerless" and "powerlessness" as they appear in other pages about twelve step controversies:
Links to Twelve Step References on Other Websites:
- Alcoholics Anonymous -- Official Website
- Alcoholics Anonymous -- Wikipedia Listing
- Frank Buchman -- Founder of Oxford Group
- Oxford Group -- Wikipedia
- Sam Shoemaker -- Wikipedia
- Twelve Steps -- Simple List -- Official AA -- PDF
- Twelve Steps and Traditions -- With explanation, Official AA
- Twelve Steps (for people with no prior knowledge) -- Wikipedia
- Twelve Traditions -- Simple List -- Official AA -- PDF
Navigation Links Related to Substance Abuse and Addiction on this website:
- Back to Top
- Return to Introduction to this article.
- Return to Substance Abuse and Addiction (MSN)
- See Related article on Twelve Step Alternatives
- See Related article on The Destructive Battle over Recovery Methods
- See Related article on the History of Differences over Addiction Treatment
- See Related article on The Seven Challenges.
- See Related article on Motivational Interviewing, Stages of Change, Transtheoretical Model
- See Related article on Harm Reduction Model
Last Update December 12, 2017