We introduce a new multi-part series focused on working “The 12 steps” or Principles of Recovery as introduced by Dr. Patrick Carnes. He created IITAP, the the nationwide network of CSATs who give us accreditation and training as sex therapists, while helping us know how to help our clients recover from emotional trauma.
These “12 principles” Dr. Carnes teaches are connected to the steps commonly used by Alcoholics Anonymous. They prompt important questions for those of us recovering in our mental health to consider in our lives. Of course, these questions cannot be answered by asking a wise old sage, or an oracle, or even a sponsor. The answers are revealed to us as we live each day, work the steps and live the principles the best we can.
TRANSCRIPT: A Year of Growth: The 12 Steps | Principles for Recovery
Today's episode I'm going to be introducing a series I'm going to be focused on here in our addiction and recovery podcast in the next few episodes. I'm anticipating a long series. There's going to be twelve or more episodes because there's twelve topics. I'm not promising they're going to be consecutive because I do have some guests that I'm working on dates lining up. Some of those may jump the line a little bit or at least be in the middle of these tweleve episodes in this series.
So as I was thinking about the new year and some things that maybe I wanted to re-look at or focus on in the podcast episodes, one of the things that I kept coming back to was thinking about this process that I went through several years ago, and working on the 12 principles of recovery.
Now some of you, my friends in the CSAT community are familiar with the 12 principles as they’ve been outlined and introduced by Dr. Patrick Carnes. Some of you who are listening may not be familiar with the 12 principles and are wondering if I’m talking about the 12 traditions, you’ve heard of those if you’re attending 12 step meetings, or the 12 steps if I meant to say steps and not principles, so I wanted to spend 12 episodes kind of dedicated to and talking about the 12 principles as Dr. Carnes outlined them and introduced them to us and just kind of get back to people.
I know at the beginning of the year a lot of people are maybe refocusing on or planning their vision for the future, and so I think it’s always good to kind of go back to a certain, I don’t want to say concrete, but a certain format to maybe work on or look at.
I know for me when I am standing in January, the next December, not the previous December, but the next December seems so long away, and so much is going to happen. For me, it’s cold in January and we have an inversion here in Salt Lake. There’s snow. We don’t have a lot of snow this year, but it has been cold, and the idea of spring and summer where it’s so hot moving into fall and then again, another winter, it just seems like that’s so long away, and sometimes it’s helpful for me to have something that I’m stretching out over that year and I’m going to be checking in with myself and allowing myself, just like the year has different seasons and each month has its own little feel to allow myself as a person to have something different be revealed in each month or something for me to learn or think about or question or ask.
So in this episode I just kind of want to introduce you to this idea of the 12 principles and maybe where it starts from, and then I am going to read some parts from Dr. Carnes’ book “A Gentle Path Through the Twelve Principles” in today’s episode, but I would encourage you to get a copy if you haven’t heard about the book. It’s a great book for those in recovery from anything. I think it’s just a great book to maybe refer back to as a guide as you’re working on various projects or goals or transformations for yourself throughout the year.
So just kind of going back to this idea of addiction, although I would not say that recovery is only for addicts, but this is where the idea of recovery kind of has evolved from the addiction communities. So we know that addiction hijacks the brain. We also know that addiction is about escape. Over time, addiction damages the brain so that it consistently makes harmful choices, even when the person doesn’t want to or didn’t intend to.
Research has shown us through brain scans that have revealed the neurochemistry behind addictive behavior. All addictions partially damage or disrupt the frontal lobes of the brain. These are the parts of the brain responsible for judgment, discernment, and common sense.
Now this disruption we know is biological. It has nothing to do with a lack of willpower or just poor moral judgment or poor moral failings of the individual, and as such these biological changes require significant biological healing. This healing takes time, and it closely parallels the healing of a stroke victim’s brain. Neuroscientist Bryan Kolb explains, “People with addictions or strokes can’t just sit back and wait for the brain to heal itself. Deliberate, ongoing effort is essential.”
Now in the 21st Century, we know something that Bill W. and Dr. Bob didn’t, and the other founders of AA. Maybe they intuited it, but they couldn’t prove it scientifically, and that is we know how and why recovery works. What the founders of AA discovered through trial and error, luck and grace, has now been validated by science.
Recent developments in neuroscience, radiology, genetics, and psychobiology give us a clear picture of how addiction hijacks the brain. They also give us equally clear pictures that working a 12 step program literally can rewire the brain for recovery for re-claiming what the individual has lost.
Through CT scans, MRIs, and other high-tech tools, we know a couple of things. We know that addiction changes the brain, deadening certain cognitive areas and laying down neural networks that chemically encourage us to compulsively repeat harmful behaviors. We know that addictions, including those that do not involve alcohol or other drugs, which we call behavioral addictions, create similar wounds in the same centers of the brain.
We also know that addictions interact in the brain in several different ways. One addiction can trigger, replace, or heighten another addiction through a measurable biochemical process. We know that trauma, whether it’s physical, sexual, or emotional, changes the brain’s chemistry, predisposing it to addictions and compulsions.
We know that new thoughts and behaviors produced by working the 12 steps appear to heal the brain in observable, predictable ways, building and deepening new neuron pathways. We also know that as these neural pathways deepen, we create new, healthy patterns of thinking and acting.
We know that no matter how addicted we are or how unmanageable our life has become, our brains retain the potential for healing and recovery in its very cells. We also know that safety is a prerequisite for healing the brain. Only when the brain feels safe, when it isn’t functioning in a crisis mode, can it optimally reconstruct itself.
We know that if we are not safe, we are chronically in a state of evaluation and defensiveness. This comes out of the work of Stephen Porges. We know that if we’re chronically in this state of evaluation and defensiveness, we’re going to make less-than-ideal choices from that vantage point.
Now over the years that I’ve been working in addiction recovery, I’ve had clients who really just don’t resonate with the 12 step program, and some of them have still put together a solid recovery program that moves them into long-term recovery, even if they aren’t actively regularly participating in a 12 step fellowship.
What I find is that if they don’t find similar guidelines that are found in the 12 step programs that lay out a strategy for changing thinking and behavior, most likely they’re going to fall back into addiction. If they are able to put together a program that follows similar guidelines, things like recognizing limits, development of honest and vulnerable relationships, regular accountability and amends making, connecting to something bigger than self, self-awareness, intent and acceptance of self, then their thinking begins to change and their behavior follows.
Now as I talked about, Dr. Carnes wrote this book, A Gentle Path Through the Twelve Principles. Now prior to that book, he had written a book called, “A Gentle Path Through the Twelve Steps”, which was released in 1993. In that book, he writes:
“Our understanding of the 12 steps and the wisdom and science behind them has evolved and deepened considerably, creating some dramatic changes in 12 steps life. We now know that the great majority of addicts, some studies say over 80%, have two or more addictions. We also know that the 12 steps work in exactly the same way for every type of addiction, that multiple addictions need to be treated together and that addiction and mental illness often go hand-in-hand.
It has also become clear that as people have successfully learned to use the steps to overcome different addictions and problems, people in the various 12 step fellowships have much to offer each other. As the inner connections among 12 step fellowships have grown, so has the need to move beyond the rules, lists, and slogans that make up much of 12 step life, especially as people move past the early stages of recovery.
Hopeful as these steps are, we can limit our own recovery if we apply their wisdom only in a rigid or dogmatic way. Rigidity deprives the 12 steps of some of their vital force and deprives us of some of the steps’ most important life lessons.”
So what is beyond the 12 steps? Well, as I said, for many people, simply going to meetings and finding a sponsor is not enough. Even worse, many people go to meetings conscientiously for years and never get the full benefits because they aren’t given a map or nobody in their meeting has meaningful recovery that they want in their own life or that they even admire or trust.
Or I have several clients who go to 12 step meetings because I asked them to go to 12 step meetings, and they sit for the duration of the meeting, and they feel shame, and then they leave and go home. Dr. Carnes writes: “I have long felt that many people who have been in recovery or more need a book that condenses and presents the essentials of long-term recovery in a practical, deliberate way. Such a book ought to provide a curriculum to help create more robust recoveries, fewer and briefer relapses, and greater serenity.” This is his book, “A Gentle Path Through the 12 Principles.”
Now in 2013 Dr. Carnes led a series of weekend retreats, for people in recovery in leadership roles, and for therapists. I had the opportunity of attending these retreats over the three-year period that he held them. We met once a quarter for 12 quarters, so three years, and it was a wonderful experience. I learned and I grew a lot over this time period.
Each time we met, we studied a different principle and we set goals and intentions for implementing this principle in our lives until we met again, and we worked on this during these weekend retreats. We worked on it in a large group with everybody who was attending the 12 step principles, and then we were also divided into small groups, 8 or 9 people in a group that we consistently worked with throughout the 12 steps, and we got much more personal and much more connected to each other in these smaller groups, but we also interacted and got to know and connect with the larger group as a whole.
Working the 12 steps can take us to a place of safety, sanity, and serenity, but the 12 steps are the beginning of a journey. They’re not the destination in and of itself. Over time as recovery deepens, we need to internalize and practice the principles that are suggested by the steps.
Carnes writes, “Principles require a higher level of thinking and learning than any rule because a principle requires both reflection and mindful implementation. As a result, principles use far more of the bandwidth of our brains and more oxygen and energy as well. It takes almost no thought or energy to follow a sign’s instructions to keep off the grass, but it takes discernment, humility, focus, and self-awareness to practice courage.”
Dr. Carnes writes, “The 12 principles also help us integrate the many different areas of the brain. This is an observable biological process, not a metaphor. Full integration requires thousands of hours of focused effort, typically five years or more of working the steps and practicing the principles.”
This is really only laying the foundation for what is a lifelong process and journey. That’s one of the things when I’m working with clients, it’s important to get sobriety and it’s important to be focused on the steps and the rules and for them to just do what’s being asked of them and to make it as concrete as possible, but I also want them to understand that recovery is a lifelong process, and it’s exciting, and it’s expansive, and it’s rewarding.
To the brain, recovery is very similar to learning a new language. At first, we focus on learning the basics—vocabulary, pronunciation, and the placement of nouns and verbs. As our fluency builds, we begin to naturally take the next step, picking the correct word or putting sentences together in the proper order. Over time, the new language has become fully integrated into our neural wiring.
Recovery is, among many positive things, a process of making sense of our life. Dr. Carnes writes, “When we were in the throws of our addiction, much of what we did made no sense to others. Sometimes it made no sense even to our addiction-damaged brain. By the time we were ready for recovery, our whole life no longer made sense.”
Now in recovery as we work the steps and we begin to live according to the principles, we start to see the world in an entirely new light. Things start to make sense again. Meanwhile, as we renew our brain cells, we also create new healthier organs of sensibility. We stop denying reality and we start to see things as they always have been, and this isn’t as frightening as it once was.
We begin to see ourselves both as we have been, as we have had to be, and as we can be. We embrace new ideas and viewpoints, and this process continues as long as we maintain our recovery. There’s no endpoint to learning and growth that a human being can have.
So as I said, this new series that I’m starting on the podcast is going to be focused on looking at each principle and the step that it’s connected to and the question that each principle prompts us to ask ourselves.
Now the 12 principles, this is helpful maybe for those of you in your left brain who want to kind of organize how this is, the 12 principles are divided into three stages. So the first stage is this awareness stage, so the principles that go along with awareness include acceptance, awareness, spirituality, responsibility, and openness.
Now I know I have more than one client who listens to my podcast, and when they heard me list spirituality, they were like, I’m skipping that week. I won’t be offended if you skip that week, and if there’s been spiritual pain in your life, you might find that outside of a rigid application, spirituality may start to look and feel differently, and it may bring meaning that perhaps is otherwise missing.
The second stage of the 12 principles is action principles or what Dr. Carnes describes working for congruence. So the principles included in this phase are responsiveness, commitment, courage, and honesty. Then the third stage are the core principles or principles that create vision, and these principles include generativity, meaning, and trust.
Now the way he has designed his book, each principle builds on the next, so we start with acceptance, and then that next principle is awareness, and awareness starts to build on acceptance. However, that’s kind of how that book is designed, and that’s how the program that I had attended was designed, but you can also practice the 12 principles according to what is happening and what you’re needing right there at that moment.
So as I said, the first stage of living in the 12 principles involves making sense of our life, and once we start to make sense of our life, we start to look outward, and we start to ask questions, and we try to make sense of the life around us and the people around us and our world, and if we need one thing right now, it’s for us to start looking around, making sense of our life and making sense of what’s happening around us.
As I said, the stage included in the first stage is acceptance, awareness, spirituality, responsibility, and openness. In this first stage, as we connect to what is real, we begin to let go of fantasies, fantasies about who we are, how the world works, and what and who we can control, and we begin to replace those fantasies with reality, and reality becomes less threatening and more safe, even when reality turns out to be difficult and painful.
Dr. Carnes also includes with each principle a question that the principle prompts us to seek answers and understanding for. So if you think about the 12 steps, step one, we admitted we were powerless over alcohol and that our lives had become unmanageable, the principle that goes with that is acceptance, and the key question that it prompts is, what are my limits?
Now I may need to learn how to live within my limits, and a lot of times at the beginning of recovery or the beginning of getting sober, we’re starting to learn to live within limits, and that’s an important part of recovery, and then we start to ask questions about maybe I’m living within limits that I’ve imposed myself or somebody else has imposed for me and that are holding me back, and maybe I need to push this limit, not in my addictive way, but in a way that leads me into growth and learning.
Step 2: Came to believe that a power greater than ourselves could restore us to sanity. So the principle that goes along with step 2 is awareness, and the question that goes with that is, how do I know what is real?
Step 3: Made a decision to turn our will and our lives over to the care of God as we understand God. Now I know the 12 steps says “him”. For Jackie being inclusive, I say God. The principle that goes with step 3 is of course spirituality, and for a lot of people I’ve worked with, this one is hard for them to swallow because there has been spiritual abuse or there’s been spiritual pain, or there’s been spiritual manipulation.
The key question is, am I lovable? Sometimes when I’m working principles with people, it’s important to say, am I lovable to the God of my understanding and others? That’s how Carnes writes it out. Sometimes I just end it with, am I lovable?
Step 4: Made a searching and fearless moral inventory of ourselves. The principle that goes along with this is responsibility, and the key question is, who am I?
Step 5: Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. The principles that goes with this is openness, and the question that this prompts is, how do I trust? And for most people when they’re working the steps and they’re working the principles, for most people when we hit a certain age in life, that question of how do I trust is complex, and it’s scary.
So again, when we start to work the principles, we’ve started to work the steps. We’ve started to see growth and progress and change happen into our life, and that’s a good thing, and that came about by some pretty concrete steps, and recovery was concrete, which is why I could start doing it, which is why I could start making sense of it and start working it, but going forward, we may need to start making that more expansive. We may need to move it from something that was concrete like Dr. Carnes talked about, something that was concrete and rigid and we start need to move it into having some fluidity and some expansiveness and some space.
Now of course we’re not going to find answers to these questions by trying to get them from some wise sage or an oracle or even our sponsor. We probably aren’t going to find it from the person sitting next to us because our journey is personal and our recovery is personal. We do discover the answers one day at a time by living our lives, working the steps, and applying the 12 principles as best we can.
Now we’re at a time in history where I think we’re looking at the beginning of a movement. I’m not sure what the movement is. I don’t have a hashtag for it or the words for it, like #metoo, but I think we saw it start to rumble and fray over the summer, over the past year. I think we saw the beginning of it. I think we can feel it rising to the surface, and I think it’s gaining some momentum. I think I can feel that.
Now one of the things that I know is I’m in the business of pain. I witness and sit with and hear and validate people’s pain every day. I know how much pain people are in and how much pain they’ve been in for a while, and yet, I’ve been doing this for 27 years, and yet I will say I feel that the pain is intensifying and spilling out.
Now what I know is that healing doesn’t happen when we are divided the way that we are. I think we’re seeing a vitriolic response whose source is pain. We can’t bypass the pain, and we can’t whitewash the pain. We can’t keep pushing it down or kicking it down the road or asking other people to just adapt to it. We have to validate the place of pain, the source, and the root.
One of the things that I learned from 12 steps and as I’ve watched so many clients over the years work the 12 steps is that we heal by our secrets. We heal through our darkness, and we heal through our shadow.
I also know that healing always, always, always starts with the individual. We have to ask ourselves, what next? What does this movement ask of me, from me? What does this moment ask of me? What will be the helpful next step, or what will be the principle that I need to apply in my life in this moment?
So I hope as we start to explore each of these principles that you’ll find a way to practice it in a way that begins to integrate it as part of who you are, as part of how you are, and as part of what you give and receive from others.