When used in conjunction with other treatments like therapy and/or medication, 12-Step programs can be a useful part of C-PTSD recovery.
The 12-Steps are taught at group meetings and run in a program format known as a 12-Step program. The 12-Step working model states that the Steps are guides or principles which can be followed and utilized to aid in living healthier, more fulfilling lives.
The 12-Step program experience offers a social support system in which exposure to interactive and self-regulatory experiences are shared and can be developed. This in turn helps those who are suffering to find a sense of purpose and a new way of life.
Group members are encouraged to use any or all of the 12-Steps as they see fit, and it is up to the individual to interpret how they are implemented into their life based on their own belief system. Eleven of these 12-Steps are spiritual and behavioral approaches that help people to reconnect both internally and externally.
12-Step groups can provide the opportunity to learn and practice these behavioural skills that will help improve Intra and interpersonal functioning.
The Steps are taught differently at different meetings, for example, the 12-Steps of Narcotics Anonymous are different from the 12-Steps of Co-dependents Anonymous. The only requirement for membership to Narcotics Anonymous is a desire to stop using and the only requirement for membership in Co-dependents Anonymous is a desire for healthy and loving relationships.
All the different 12-Steps are actually adaptations of the 12-Steps of Alcoholics Anonymous which is the original 12-Step program.
Though there is not an actual 12-Step program set out for people with C-PTSD, there are many people with C-PTSD in different, various 12-Step programs. For example, the program known as ACA (Adult Children of Alcoholics and Dysfunctional Families) has been an especially helpful 12-Step program for those with C-PTSD as much of the focus in this group is on trauma work and group participants are led to their Inner Child or True Self.
People in 12-Step recovery programs learn to manage their own lives and the programs provide support from peers and the opportunity for life improvement. In comparison to just going to therapy, the strengths of group involvement such as the experience and commitment of members and the overall focus of the group (Gartner, 1997) aid those in feeling supported. In a study of self-help groups, (Hatzidimitriadou 2002) found that group members felt more empowered and optimistic due to self-disclosure and sharing of feelings.
Eleven of the 12-Steps are spiritual and behavioral approaches, which help in reconnecting internally and externally. Eleven of the 12-Steps are spiritual and behavioral approaches, which help in reconnecting internally and externally.
12-Step groups can provide a network of friends who are invested in recovery. (Humphreys, Mankowski, Moos and Finney 1999) found that the social network provides a base of recovering friends who model appropriate, recovery-based behaviour that can mediate positive changes.
The Steps have a transformative quality and are a process practised daily. This allows the traumatised person in recovery access to the tools necessary for their healing.
Below are examples of how the 12-Steps aid in the recovery process.
Please note that “God” as mentioned in the Steps below is an understanding of a Higher Power greater than yourself. For example, science, the earth, the universe, humanity at large, or even mother nature.
The 12-Steps are inspired by spiritual ideals and the program itself is not a religious program. You do not have to be religious to benefit from 12-Step programs.
The Steps focus on spiritual ideals such as honesty, faith, humility, and repentance.
“We admitted we were powerless over ……………… – that our lives have become unmanageable”.
This Step acknowledges that there is a problem and that it is a problem that we are powerless over. The problem lies in one’s own attitudes, conditioning, and behaviours.
When working on Step 1, we start to realise and then honestly admit that there is a problem that has a role in how we play out our own lives.
“Came to believe that a power greater than ourselves could restore us to sanity”
The acknowledgment of powerlessness leaves a void so by putting forth trust one can acquire a willingness to turn to a power beyond oneself. The power spoken about must be outside of oneself and can be nature, the group itself, a sponsor, or spiritual power. This allows our ego to let go of control so that we can have hope in our recovery and healing and trust in an outer higher power to help us to grow.
“Made a decision to turn our will and our lives over to the care of God (or higher power) as we understood God (or higher power).”.
In this Step, we learn to have faith and a belief in a power outside of ourselves, so that we can practise letting go and turning it over. We start to understand that we cannot control outcomes, or others’ attitudes and behaviours.
“Made a searching and fearless moral inventory of ourselves.”
Step 4 is where we carry out self-reflection. This is where we investigate our strengths, weaknesses, and character defects and how all of these behaviours affect our thoughts and actions.
“Admitted to God (or higher power), to ourselves, and to another human being the exact nature of our wrongs.”
We allow someone to witness us admitting to our mistakes and character defects so that we can improve our lives. This involves sharing our humbleness.
“Were entirely ready to have God (or higher power) remove all these defects of character.”
In Step 6 we become ready to ask our spirituality or Higher Power to remove our shortcomings and help us improve our life.
“Humbly asked God (or higher power) to remove our shortcomings.”
This is the Step where we ask our Higher power to help us remove any barriers to our self-improvement.
“Made a list of all persons we had harmed and became willing to make amends to them all.”
Here we make a list of beings who we have harmed, and we become willing to ask them for forgiveness.
“Made direct amends to such people wherever possible, except when to do so would injure them or others.”
We ask for forgiveness from those people who we have harmed. You do not have to do this personally if the situation is unsafe for you.
“Continued to take personal inventory and, when we were wrong, promptly admitted it.”
We carry out a daily inventory of our behaviours and reflect on these.
“Sought through prayer and meditation to improve our conscious contact with God (or higher power), as we understand God (or higher power), praying only for knowledge of God’s (or higher power) will for us and the power to carry that out.”
In this Step, we strengthen our faith in our beliefs and improve our relationship with spirituality and we continually ask for guidance.
“Having had a spiritual awakening as the result of these Steps, we tried to carry this message to others who still suffer, and to practice these principles in all our affairs.”
We become of service to others, helping them and using the 12-Step program in all areas of our lives. This Step involves carrying the message to others with similar problems (kind of like what I am doing in this blog) and practicing all the Steps in all areas of life. The 12th Step allows for community integration and is healing for the traumatised individual in recovery.
When attending meetings, we notice how the program is working for those who have been in recovery for a length of time, and this leads to an understanding that these same principles can be applied to oneself.
Being in contact with other recovering people provides a supportive environment although some trauma victims do have difficulty connecting with others and this may require time.
Thus, socialization is seen as a factor in 12-Step meeting attendance, where sharing thoughts with other non-judgemental people provides safety to explore feelings and re-establish intimacy.
Through self-reflection, members begin to gain insight into their core problems. Introspection encourages the release of blocked emotions through insight (Prochaska, 1984). Also, discovering our strengths and weaknesses as we come about in meetings allows people to learn to accept themselves and others.
Group members also reinforce for each other how their High Power now influences their lives, and these spiritual beliefs are used to reinforce desired behaviours. Spirituality in the context of 12-Step meetings can help empower people.
Attending meetings and listening to the recovery stories of others gives hope, encouragement, and ideas for how to obtain spiritual health. Additionally, 12-Step literature can provide inspiration and motivation to re-evaluate one’s approach to spiritual issues that have been problematic. Further opportunities to help others and rely on others can enhance one’s sense of meaning, purpose, optimism, and well-being.
This article does not intend to suggest that 12-Step programs are the only manner of treatment for C-PTSD, but when used in conjunction with other treatments like therapy and/or medication, it can be a useful part of recovery.
Maxine grew up in South Africa and spent a year living in Israel, volunteering on a Kibbutz. She also worked in the financial sector in London prior to having her son and settling in New Zealand and then Australia.