Cliff Straehley III MD


Contact Us
Medical Legal Services
Self-Help Options
Twelve Step Groups
Reference Books
Spiritual Emergence


Twelve Step Groups

The most well-known 12-step group is called Alcoholics Anonymous, ie AA. There are at least 30 others, and they definitely are not the same. Gamblers anonymous and Debtors anonymous are other examples. Not everyone understands that you don't have to be a drug addict, or be involved with a drug addict, in order to benefit from participation in one of these groups. Many people do not understand what it means to be a member of a 12-step group. There is no registration. All you have to do is attend, and be willing to give your first name, and say that you are there to “check it out”. You are then a member. Of course many people choose to make their involvement in a 12-step group a significant part of their life for many years. That's not a requirement at all. Also, there are no experts or leaders in any 12-step group meeting. It's just other participants who are there. There may be a group secretary who is maintaining the organization of a particular meeting, but they are not really a leader. If any mental health professionals are present, they are just present as participants, and they do not have any leadership role. Moreover, so that 12-step groups feel safe for the participants, there is no "Crosstalk" in most meetings. This means that nobody can cross examine you or ask you questions about your private information. If that happens at a meeting you attend, just ask whether or not Crosstalk is allowed in the meeting you have chosen to attend. If the answer is Yes, you can just leave. I've also noticed that some people get very anxious when they even think about going to a meeting with a bunch of strangers. They're afraid that they will have to talk. For shy or anxious people, I recommend that they intentionally go to the meeting five minutes late, so they don't have to make any small talk before the meeting starts. If they want to, they can also leave five minutes early, again so that they can avoid having to talk to strangers. A shy person might be surprised to find out that even though they went five minutes late on purpose, they came to feel comfortable enough with somebody who "shared" or spoke during the meeting to talk with them after the meeting. They might consider staying after the meeting ends to approach that person. A short conversation could be started by saying something like, “I liked what you said about that.” This might be the beginning of a helping relationship. Shy people often don't realize that it may be just as hard for others to initiate a conversation with them, as it is for them to start talking with others. Perhaps they might also feel safe enough to say something to everyone during the meeting. If so that will give others a chance to get some idea of what they are like. Probably there are several shy people there.

A particular 12 step meeting will tend to be comprised of individuals who live near the meeting. Therefore, just because you don't feel comfortable in one meeting, it doesn't mean that you will not feel comfortable in some different 12-step meeting. Also no two AA meetings are the same, because the membership is not the same. The same goes for the rest of the 12-step groups.

As examples of other 12-step groups, let's briefly discuss CODA, ie., codependents anonymous and Al Anon. People at Al Anon meetings will usually be in a relationship with someone who is actively addicted to drugs This doesn’t necessarily apply to CODA meetings. Both groups deal with the issue of "codependency". This is not a true psychiatric diagnosis. Nevertheless the term refers to belief systems and behaviors which make it more difficult for the codependent person to be assertive and to enjoy relationships. A codependent person tends to feel guilty if they say, "no" to people they care about or rely upon. They repeatedly betray themselves by agreeing to do things that they don't really want to do. In more technical terms, they have difficulty setting limits and with being assertive with other people. It is hard for them to keep personal boundaries. Moreover, when they are merely being assertive, they falsely believe that they are being aggressive (like a bully), so they tend to be overly passive (doormats). At the most extreme, they go through life feeling like they are the victims of various people around them. In my experience a high percentage of people with excessive anxiety and/or depression also have problems with codependency. It may be very helpful to go to a group at the same time as you do psychotherapy or take psychiatric medications.

Unfortunately many psychotherapists are not very knowledgeable about 12-step groups. Also, chemical dependency specialists have not necessarily been trained in psychotherapy. Some patients are not initially comfortable seeing a therapist, one on one. Others are too shy to attend a group meeting with strangers. You have to start from where you are. Regular participation in a 12-step meeting can help you to understand that you are not alone. The 12-step fellowship that you develop can be tremendously supportive. You will learn that you are not really so different.