On June 10th of 1935, a New York stockbroker named Bill Wilson and a surgeon named Bob Smith met in Akron, Ohio to share their struggles with alcoholism, which became the first meeting of Alcoholics Anonymous. AA has developed into a worldwide fellowship of individuals coming together for in-person and virtual meetings across the globe to offer each other support on the journey of sobriety. The organization uses “12 steps” to guide their journey as well as regular sharing within AA meetings. Each member is encouraged to find a “sponsor”, a fellow recovering alcoholic, who is their mentor and guide through the 12 steps.
Many other “12-step” groups have sprouted out of the framework of AA. Some of those groups include:
Al-anon: a group for family members and friends of alcoholics
NA: Narcotics Anonymous, a group for individuals recovering from drug addiction
EDA: Eating Disorders Anonymous
ACA: Adult Children of Alcoholics
SAA: Sex Addicts Anonymous
LAA: Love Addicts Anonymous
CoDA: Codependents Anonymous
GA: Gamblers Anonymous
And many, many more.
There are legitimate criticisms of the 12-step model, including that there is a cult-like feel to the community and that younger or newer members can be mistreated and preyed upon (sometimes called “13th Stepping”). It also perpetuates an absolute identity model that can become a self-fulfilling prophecy. Each time a person shares at an AA meeting, the person begins with: “I am an alcoholic”.
The 12-step model of addiction recovery is one that can be integrated into a medical and spiritual understanding of recovery.
The medical model views addiction through the lens of genetics. Some people think that a genetic predisposition for addiction means that there is an actual “addiction gene”. This idea is not accurate and can be a dangerous understanding, again leading to a self-fulfilling prophecy.
There ARE genetic MARKERS that are common across people prone to addiction. Scientists have identified multiple genes associated with addiction.
What does that mean? For example, the dopamine receptor gene (DRD2) is a genetic marker. With this gene, a person has less dopamine levels in their brain. Thus, individuals with this gene are more likely to seek out any behavior that can increase dopamine and that includes any substance, carbohydrates, and even fast food.
There is no “addictive personality”. It is important that we make this clear. The idea of there being an “addictive personality” or one “addiction gene” leaves a person to feel disempowered and a victim of circumstances: “This is just who I am. There is nothing I can do.”
Addiction develops as a result of a combination of complex factors including genetic predisposition due to decrease production of dopamine, norepinephrine and other hormones alongside of environmental factors.
Sometimes it isn’t a genetic issue that causes less production of these hormones.
Sometimes it is environmental. Our context and relationships MATTER. For example, studies show that when raised in a less enriching environment, there is more susceptibility to addiction because of how the less enriching environment affects dopamine in the body.
A few years ago, I was given some new language around addiction. Rather than thinking about it as a failure of will or a disease of the body, addiction can be understood as a disorder of connection. Rather than turning towards human connection for comfort, the person turns towards the object of their addiction. I write more about this idea in a previous post.
In a group I have run for the past few years, we explore the relationship between adult children and their parents. The group members share a common story of having parents who they experienced as being emotionally unavailable, relationally unskilled or emotionally mis-attuned. The parents lacked the internal resources (due to their own upbringing and genetic factors) to be able to be present with their kids in a way that was appropriately responsive. There are four types of emotionally unskilled parents: The Emotional Parent, the Driven Parent, the Passive/Negligent Parent, and the Rejecting Parent. A person might have one or both parents who fit one or a combination of these categories.
As we explore and process, we often talk about what or who we turned to for emotional comfort and attunement. Who or what was available to us when we were hurt, afraid, sad, or angry if a parent wasn’t? Quite often these adults struggle to turn to other adults in healthy ways because it was never modeled for them. They don’t have the experiential knowledge of what that looks or feels like to turn towards a person and be appropriately comforted. We learn how to relate to others through our first relationship teachers: parents and caregivers. What were we taught about seeking out comfort, sharing emotions, and sitting with difficult feelings?
During one such conversation in group, we had this aha moment around substance abuse: “Alcohol is a really ‘good’ mother”. What was meant by this outlandish statement? Alcohol is available, it is consistent, and it brings warmth. Yes, yes…there obviously are huge ramifications of this statement. Turning towards alcohol or any other substance for comfort is what leads the way to addiction and a host of physical, mental and relational health concerns.
But, still, it is such an interesting and powerful concept. Relationships with humans are messy, unpredictable, and hard. We learn to navigate those ups and downs within a relationship that isn’t perfect, but holds space for humanity, growth, conflict, differences, and love. With parents who are present and responsive, we learn how to sit with our difficult feelings…that they are not scary or something to run from. We learn how to disagree, have conflict, and repair. “I am sorry I got angry. I was stressed and took it out on you. That isn’t ok. I want to make it right.” If a person did not have relationships that taught them how to tolerate the discomfort of the imperfections of human relationships within an unconditionally loving relationship container, then instead of turning to people for comfort and connection, it makes complete sense that a person would turn towards some THING. That thing is not (in the moment) messy and unpredictable. It is a place to run, crawl into, and hide from the pain.
On Valentine’s Day this year I came across a post on Instagram that I loved. It was a quote by Nora Bateson: “The ultimate act of love is allowing ourselves and others to be complex.”
Relationships and the people within them are complex. We are layers and layers of stories, woundings, and dreams. To love and be loved within those layers is a journey of staying connected to ourselves and to the other person in the midst of micro- and macro-, little and big, moments of connection, attunement and love alongside of moments of disconnection, mis-attunement, and hurt.
Relationships are really a journey of rupture, repair, rupture, repair…moments of disconnection, mis-attunement, and turning away followed by moments of reconnection, re-attunement, and turning towards. Ruptures are inevitable in relationships…big and small…every day. Repair…reconnection…is not inevitable and is where the most important work of love takes place.
If we do not have a template of how repair can look and feel, ruptures will feel huge…like the end of a relationship. If we do not have the model that normalizes disconnection and then reconnection we will experience disconnection and mis-attunement as the END of a relationship rather than a PART of a relationship. So, we will avoid, avoid, avoid…conflict…and also deep connection with others. And, perhaps, we will turn to something to fill in it’s place.
I wonder if one of the reasons AA (and other 12-step groups) has been so helpful for some on their journey towards recovery from addiction isn’t the steps (or solely the steps), but its community. Even when things are messy…even when you have relapsed…your 12-step group is there. You can find one anywhere anytime including online. AA and its people become the place and the relationship a person turns to instead of the substance. When things get hard you will hear someone in AA say: “I need to find a meeting”.
AA becomes a holding space for all that is hard, messy, and good about community. It helps recovering addicts learn to tolerate the discomfort of relationships being “good enough” for help…not perfect, but good.
One of my favorite quotes is from the book East of Eden by John Steinbeck: “And, now that you don’t have to be perfect, you can be good.”
When we don’t demand that our relationships (or the people in them) be perfect, they have the room to be GOOD.
When we have grown up in homes where hard, messy, imperfect, loving relationships did not model unconditional love with connection, disconnection and reconnection…ruptures and repairs…turning away, but then turning back towards…we often have a low tolerance for the normal ups and downs of relationships.
It is hard to stay close in conflict because no one in our lives when we were growing up ever did that for us.
Conflict meant painful, cold separation and rejection.
The idea that we can stay close in the midst of disagreement and imperfections is a novel concept and experience.
And, more than ever…we need one another. We need community. We need relationships. The world is filled with so much that is hard…so many opportunities for misunderstandings, miscommunication…so many instances of not completely agreeing with someone.
So many chances to turn away. So many reasons to disconnect…to experience a rupture, but no repair. Rupture and then never re-engage.
In 1953 Donald Winnicott, a famous British pediatrician and psychoanalyst, coined the term “good enough mother”. In fact, we know from Attachment research that in order for a child to have the opportunity to develop a secure attachment, the caregiver needs to be appropriately responsive at least 30% of the time.
Good enough. Not perfect.
If a relationship in your life is “good enough”…not perfect…(not abusive either!)…but good enough…appropriately responsive to you, provides a soft space to land 30% of the time…consider sticking it out. Consider practicing tolerating the discomfort of ruptures and repairs, the cycle of connection, disconnection and reconnection.
We need good enough community right now more than ever.
Not perfect. Just GOOD.
Postscript: In the readable version of this post on Substack you will find helpful links throughout the transcript of what is heard on the audio podcast version. The podcast and Substack is called Letters from a Therapist.
That’s what I have to say today. I am guessing you have something to say, too. Happy to hear it.
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