Understanding Twelve-Step Programs

Elevator to sobriety out; use the steps
For 40 years I have had people ask why I would/how I could work with people who have a substance use disorder.  I have stopped trying to answer the question in such a way as to help the asker appreciate my reasons.  Instead, I ask what prompts the question.

Frequently I hear something along the lines of how difficult "those people" are to work with or how frustrating/heartbreaking/exasperating it is to try and facilitate change with someone who "just is not ready."  Instead of an answer intended to change the views of someone who has likely already made up his or her mind about "those people," I ask if they have ever visited places where "the changed" congregate.  I generally get a look that communicates, "what are you talking about" to which I say, "You know...to a 12-step meeting."  Invariably the answer is no.

If anyone has doubts that individuals with substance use disorders change, they need go no further than the nearest "open" AA or NA meeting, take a seat at the back of the room, settle in, and just listen.  The stories of recovery range from heartbreaking to hilarious, but they are all genuine and inspirational.

If you have ever wondered about addiction or are curious about what leads someone with a substance use disorder to pursue change, then attending several open 12-step meetings is highly recommended.  If this sounds like something you might consider, here are some guidelines I provide to my students when directing them to attend meetings as part of my Introduction to Addictive Disorders class.  Considering them may make attending a bit less intimidating and significantly more enjoyable:

What to Expect When Attending “Open” 12-Step Meetings:
 Suggestionsregarding Etiquette

1.    Unlessyou are personally addicted to the substance being addressed at a particular12-step meeting, e.g., alcohol at an AA meeting, only attend "open"meetings of a 12-step group. "Open" meetings are just that, open toanyone who may want to attend a meeting or learn more about the 12-step programof recovery.
2.    Expectto be greeted at the door when you arrive. The greeter may shake hands occasionallys/he may offer a "hug" (this is not all that common). Be prepared forthe greeter to ask something like, "Is this you first meeting?" or"Have you been to a ___ meeting before?" Do not hesitate to say thatyou are attending because you want to learn more about ___ meetings and this ispart of a class assignment. Ask to be sure that the meeting is"open."
3.    Whilerare, do not be surprised if the person becomes a bit "cool" if yousay you are attending as a student in order to learn (this is more likelyindicative of the person's lack of confidence when speaking with "aprofessional" than a rejection of you as a person or "outsider."Remember that "open" meetings are open to anyone.
4.   Unlessadvertised as a "non-smoking" meeting, expect smoking.
5.    Expectthe meetings to last between 1 and 1.5 hours. Some will take a brief breakafter 30 - 45 minutes (usually the smoke-free meetings).
6.    Mostmeetings begin with some variation of the following ritual - the SerenityPrayer, greetings from the "chair" for the evening, a reading of the12-step (perhaps the 12-traditions), perhaps a reading from the big book orother 12-step literature to set the stage for the group.
7.    Expectthe chair to ask if there are any new comers attending for the first time. DONOT feel obligated to raise your hand. If you do, expect to be personallywelcomed. It is also likely that someone will approach you at the break orafter the meeting and ask if you have questions. DO NOT hesitate to say you area student and attending the meeting to learn. The person may appear"cool," but this is probably because s/he felt comfortableapproaching you as a new comer to the program, i.e., an addict, but isuncomfortable speaking with you as "a counselor."
8.    Expect that a basket will be passed fordonations. DO NOT feel obligated to put something in the basket, but if you do,$1 is plenty.
9.   Do not be surprised if you are asked toread something or asked if you would care to speak. I suggest reading theparagraph or step or whatever, but as regards speaking, just say, "I'mhere to learn and would like to pass" or something of the sort.
10.      Do not hesitate to let anyone know youare a student and why you are there. MOST members are pleased to answerquestions and may even tell you how pleased they are that you are.
111.        Do not be surprised if someoneapproaches you after the meeting and offers you her/his phone number. This iscommon practice and part of the tradition of helping, NOT someone trying to hiton you.
112.        Consider attending the meetings with afriend, preferably someone from the class. This will assuage the anxiousnesssome students experience when attending their first meeting. It is also anexcellent way to process the experience after the meeting - remember, you haveto write a paper on your experience attending the meetings.

    Enjoy yourself   
    Dr. Robert


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