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The 12 Steps of Alcoholics Anonymous

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1 The 12 Steps of Alcoholics Anonymous
An Insight Into the Science, Spirituality, and Discipline of How They Work Burns M. Brady, MD, FASAM

2 History of the factors that influenced their writing
Shared common problem Shared common solution

3 I. History of the factors that influenced their writing
Oxford Group Richard Peabody Emmanuel Movement Father Ed Dowling Other Sources

4 A. The Oxford Group Frank Buckman 1878 – Lutheran background
Ordained as minister in 1905 Serious resentment and rebuff at orphanage where he was director 1908 – Keswick Convention Keswick, England – where he had a rapture experience of Jesus while listening to a sermon by a little-known minister, Jessie Penn-Lewis (spiritual awakening of the sudden “light experience”) vs (educational experience)

5 He talked of sin and acceptance of Christ
Alcoholics Anonymous, 27 years later, talked of resentment and a spiritual awakening as the result of these steps

6 He spent 6 years at Penn State as a YMCA secretary where he developed his philosophy of the Oxford Group, which was primarily the “Key Man and Abstinence” position (alcohol and smoking)

7 Initially, from 1920 to 1928, the group was called “First Century Christian Fellowship”
From 1928 to 1938 it was known as the “Oxford Group” - (first called by South African press when a group from Oxford came there to preach)

8 In this 10-year period were developed the concepts of:
A. House parties B. Change C. Guidance D. Maximum

9 Attempts to refer to the 6 steps of the Oxford Group (as precursors of the 12 Steps of AA) were only loosely connected since the Oxford Group referred to the “four absolutes”, not the 6 steps: Honesty Unselfishness Love Purity Derived from Robert Speer in his 1902 book “The Principles of Jesus”

10 The Oxford Group did have some critical points that were emphasized
Men are sinners Men can be changed Confession is prerequisite to change The changed soul has direct access to God The age of miracles has returned Those who have been changed must change others

11 These absolutes and 6 points were the foundation of anecdotal communication prior to the writing of the book “Alcoholics Anonymous” with its Twelve Step Program

12 Bill Wilson related that the steps, in essence, which came from these 6 points were:
We admitted we were licked, that we were powerless over alcohol We made a moral inventory of our defects We confessed or shared our shortcomings with another person in confidence We made restitution to all those we had harmed by our drinking We tried to help other alcoholics with no thought of reward in money or prestige We prayed to whatever God we thought there was for power to practice these precepts

13 In 1908 Harold Begbie wrote “Twice-Born Men” – a report of the Salvation Army results using religious methods In 1923 he wrote “More Twice-Born Men” – a report of Buckman and the first century Christian movement

14 His report focused on: Anonymity Chaos Conviction Commitment Conversion based on inventory, amends, restitution and continuance

15 Reports pro and con developed with suggestions of “cult”, “dangerous delusion”, “inculcating morbid introspection”, “discontinuing use of one’s intelligence and substituting a purely emotional subconscious guidance from God” Many churchmen had given their blessing as a “spiritualizing influence”

16 In 1936, a huge June meeting (10,000) occurred of the Oxford Group in Stockbridge, Mass.
It was international in attendance and flags from countries represented were flown. This procedure exists today in AA’s international conferences, which began in Cleveland in 1950 and occur every 5 years in various locations

17 Bill and Lois Wilson were in attendance at this conference.
Bill and New York withdrew from the Oxford Group in 1937. Dr. Bob and Akron would later withdraw in

18 History has told us that Bill had great reservation about the “public” awareness of Buckman and the entire Oxford Group. He also had noted that public opinion had deteriorated about Buckman due to what was seen as Nazi support (not true, but reported)

19 In 1938, the Oxford Group became known as MRA – Moral Rearmament
It still exists with its headquarters in Caux, Switzerland Its membership and support declined greatly after Buckman’s death in 1961

20 B. Richard Peabody In , Peabody was treating alcoholics one block away from Calvary Episcopal Church where Bill and Lois were attending Oxford Group meetings Peabody had written a book, “The Common Sense of Drinking”. Bill did not know this man, but would have read this book since it was high profile at that time

21 Peabody believed completely in abstinence and powerlessness over alcohol.
He believed deeply in honesty.

22 Contents of the book referred to “halfway measures are of no avail”.
This book also contained a story of a man who, after years of abstinence and getting his business in order, picked up again and died within 3 years

23 While he believed the alcoholic was born different in regard to alcohol (disease), he did not focus on resentment, fear, and self-pity; nor did he develop the group support idea or the spiritual roots of surrender and responsibility.

24 His primary focus was in the belief that therapy and cognitive behavioral adjustment of self-knowledge, retraining, discipline, and cultivation of new habits were enough to establish and maintain sobriety

25 C. Emmanuel Movement This movement was started in 1905 – by two Episcopal ministers in Boston at the Boston Emmanuel Church

26 Initial efforts were directed for the establishment of a clinic for TB to be used by the indigent population. It expanded naturally into a clinic for the treatment of alcoholics, or ‘nervous sufferers’ as they were called

27 This was the first successful effort to bring medicine and clergy into the primary treatment of alcoholism. Thus, a medical problem with a spiritual solution.

28 Peabody had recovered in this movement, but subsequently dropped the spiritual solution in favor of self-based cognitive power.

29 D. Father Ed Dowling A Jesuit priest from St. Louis who befriended Bill Wilson in 1940 He was Bill’s most cherished and spiritual confidant from 1940 until 1960 when Dowling died

30 His contribution was huge as he reminded Wilson of his “divine dissatisfaction” as Bill’s great gift from God

31 Dowling also noted the significant similarity of the Jesuits “Ignatian spiritual exercises” and the twelve steps “The common property of all mankind”

32 He helped Bill see the “divine guidance” that Dr
He helped Bill see the “divine guidance” that Dr. Bob, his wife Anne, and Bill had received when they were led in the summer of 1935 to read the Bible books of James and Paul’s letter to the Corinthians on love.

33 Finally Dowling interjected the Jesuit discipline of daily spiritual preparation, execution, and closure to the AA miracle

34 E. Other Sources Multiple other sources such as old time revivalist, i.e. Moody, Finney & Booth (Salvation Army), and more modern preachers such as Sam Shoemaker and Emmet Fox were all significant contributors to Bill Wilson’s thinking as he constructed the 12 Steps.

35 Major influences by Carl Jung, William James, William Silkworth, Roland Hazard and Ebby Thatcher were of inestimable value to Bill’s “moment of clarity”.

36 While we love to marvel at Bill’s report of putting the steps together in a few minutes to a few hours, history reports clearly that Bill experienced and researched voraciously multiple sources for that defining moment.

37 II. Shared Common Problem
The population to which Wilson was appealing: 1) “A condition of pitiful and incomprehensible demoralization” 2) “The old pleasures were gone. They were but memories. Never could we recapture the great moments of the past. There was always one more attempt - and one more failure.”

38 3) “The less people tolerated us, the more we withdrew from society, from life itself. As we became subjects of King Alcohol, the chilling vapor that is loneliness settled down. It thickened, ever becoming blacker.”

39 “Now and then a serious drinker, being dry at the moment, says, ‘I don’t miss it at all. Feel better’. He fools himself. He isn’t happy with his sobriety. He cannot picture life without alcohol. Some day he will be unable to imagine life either with alcohol or without it. Then he will know loneliness such as few do. He will be at the jumping-off place. He will wish for the end.”

40 Wilson experienced complete hopelessness
Wilson experienced complete hopelessness. He painted a picture of hopelessness. He appealed to those who had been defeated, to those who were going to make a decision to live or die.

41 Real Alcoholic (William D. Silkworth, MD)
Bodily and mentally different Bodily 2) Mentally Genetics Thinking a) Brain “peculiar mental twist” b) Gut the thinking that leads to the drinking c) Liver unresolved character defects

42 Bodily Different Brain:
Absolute or down regulated Dopamine system in both Type I (Adult) and Type II (Adolescent) alcoholism. Up regulated serotonin system in Type II and down regulated serotonin system Type I. This involves the neurotransmittor, reuptake, and receptor sites.

43 The condition produced from this in AA terminology is “irritable, restless, discontented”.
In mental health terminology anxiety, depression, mood disorders, ADD and ADHD.

44 The individual genetically so programmed can correct (or even overcorrect) these chemical conditions with alcohol and essentially all common drugs of reward, i.e., opiates, stimulants, marijuana, nicotine.

45 Gut: Deficient Alcohol Dehydrogenase (ADH) in the gut leads to higher concentrations of alcohol upon absorption with greater exposure of organ systems to the toxic effects of alcohol.

46 The female alcoholic is more deficient in ADH than the male – thus resulting in more rapid physical deterioration for the female -vs- the male

47 Liver: Abnormal metabolism resulting from acetaldehyde dehydrogenase (ALDH) function in the alcoholic.

48 Both the gut and liver are peculiar for alcohol metabolism and not other drugs of reward.

49 Summary: The alcoholic drinks for the effect – for relief. The drug addict uses for the effect – for relief.

50 Brain Dopamine irritable Serotonin restless discontent Gut ADH
Bodily Different Genetics Brain Dopamine irritable Serotonin restless discontent Gut ADH Liver effect drink ALDH relief drug

51 2) Mentally Different Peculiar mental twist Alcoholic thinking
Delusional thinking that rationalizes the drink or drug with little or no insight into the consequences –relief at all cost.

52 This type of thinking, according to the text book of Alcoholics Anonymous, arises out of unrecognized or unresolved character defects which the individual has.

53 So named by Wilson, they are:
Resentment Fear Harms to others Sex conduct Dishonesty Self-centered (Reliance on personal power rather than a higher power. Alcohol and drugs serve as great teachers in illustrating this paradigm failure)

54 The irritable, restless, and discontented condition which occurs when the alcoholic leaves unresolved the feelings and behavior of these defects can lead to “Jim’s” famous example of no harm if “scotch is put in milk”. Crazy thinking – but “relief” if he is not too far in his brain resetting.

55 Jim’s Story ~from the text book

56 Mentally Different thinking
Character Defects Resentment Fear Harms to others (shame) Sex conduct (shame) Dishonesty – anybody can recover if they are honest. Nobody can recover if they are dishonest. Self-centered – source of power

57 An established and maintained spiritual condition to deal with these defects is the mandatory basis of the twelve step solution.

58 III. Shared Common Solution
Fred’s story 1) Spiritual Answer Steps 1, 2, 3 2) Program of Action Steps 4, 5, 6, 7, 8, 9, 10, 11, 12

59 “Faith without works is dead”
Faith alone is insufficient; it must be followed by 1) Self sacrifice Steps 1, 2, 3 2) Unselfish constructive action Steps 4, 5, 6, 7, 8, 9, 10, 11, 12 “Faith without works is dead”

60 Spiritual answer – self sacrifice
Step 1: “We admitted we were powerless over alcohol, that our lives had become unmanageable” Powerless over alcohol (compulsivity) Life is unmanageable (planning necessary – control outcome deadly)

61 Step 2: “Came to believe that a power greater than ourselves could restore us to sanity”
Lack of power is our dilemma Believe or be willing to believe in power greater than self (abandon survival skills – all based on self power) Own concept of greater power

62 Step 3: “Made a decision to turn our will and our lives over to the care of God as we understood him” This is only the beginning. Note Third Step Prayer – And it’s lead into the program of action.

63 With these 3 steps we have admitted the chaos, solidified our conviction, and made the commitment to our limitations and therefore our humility.

64 Program of Action Step 4: “We made a searching and fearless moral inventory of ourselves” Character Defects Resentment Fear Harms to others Sex conduct Dishonesty Self-centered – source of power We have identified and swallowed huge chunks of truth about ourselves

65 Step 5: “Admitted to God, to ourselves, and to another human being the exact nature of our wrongs”
We are only as sick as our secrets. We must be honest with somebody. “Confession”

66 Step 6: “Were entirely ready to have God remove all these defects of character”
Willing, Work, Want

67 Step 7: “Humbly ask him to remove our shortcomings”
A prayer for unconditional love and a spiritual condition dedicated to helping others.

68 Step 8: “Made a list of all persons we had harmed, and became willing to make amends to them all”
This list came from our inventory Step 4 and was spiritually dedicated in Step 6 and Step 7

69 Step 9: “Made direct amends to such people wherever possible, except when to do so would injure them or others” This step is delivered only following completion of the first 8 steps, consultation with a sponsor, and much prayer.

70 Step 10: “Continued to take personal inventory and when we were wrong promptly admitted it”
An insight into progress rather than perfection, the staples of prayer, share, inventory, and service, and finally the 6th sense or God awareness. “How can I best serve thee.” This step is clear in its promise of a daily reprieve and the admonition for a life-time discipline of the step process How to live each day

71 Step 11: “Sought through prayer and meditation to improve our conscious contact with God, as we understood him, praying only for knowledge of his will for us and the power to carry that out” How to begin each day and how to end each day. – Discipline

72 “Having had a spiritual awakening as the result of these steps”
B) We tried to carry this message to alcoholics (experience, strength, hope) Practice these principles in all our affairs” (Design for living)

73 “Those of us who have spent much time in the world of spiritual make-believe have eventually seen the childishness of it. This dream world has been replaced by a great sense of purpose, accompanied by a growing consciousness of the power of God in our lives.” “Our real purpose is to fit ourselves to be of maximum service to God and the people about us”

74 In summary: Trust a Higher Power Clean House Help Others

75 The total is greater than the sum of its parts
The Great Mystery The total is greater than the sum of its parts

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