What’s Missing in a 12-Step Program for Addiction Treatment?

If you or a loved one is struggling with addiction to alcohol, drugs, gambling, or food, you may seek help from a 12-step program. Alcoholics Anonymous (AA) and other 12-step programs can be very beneficial for people struggling with addictions. However, there is one key element that’s missing from these addiction recovery programs—the brain.

THE MISSING KEY FROM 12-STEP PROGRAMS

When AA was started in 1935, the founders did not have access to sophisticated neuroimaging techniques. Because of this, they never considered the brain as an integral part of addiction treatment. Today, with advanced brain-imaging tools, we know now that brain health is a critical component of recovery from a substance use disorder or behavioral addiction. AA, along with Narcotics Anonymous (NA), Cocaine Anonymous (CA), Gamblers Anonymous (GA), Overeaters Anonymous (OA), and similar programs are powerful, time-tested, and have worked for millions of people around the world. Yet they clearly do not work for everyone. For example, a study conducted by the Department of Veterans Affairs showed 43% of AA attendees were sober at 18 months. This means over half relapsed. One of the reasons for the lower efficacy is that this program and many other addiction recovery programs include no steps to address the physical functioning of the brain, which is the missing link to breaking any addiction. With this in mind, it’s time for a new 12-step program that is based on neuroscience. This advanced approach builds on the strengths of earlier methods to create a more powerful addiction recovery program. This updated program uses a more balanced model that includes biological, psychological, social, and spiritual factors. As you will see, each of these aspects of life play an important role in a person’s ability to overcome alcohol abuse, drug abuse, and other addictions. Alcoholics Anonymous (AA) and other 12-step programs can be very beneficial for people struggling with addictions. However, there is one key element missing from these addiction recovery programs—the brain.

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A BRAIN-BASED 12-STEP PROGRAM FOR ADDICTION RECOVERY

Here are the 12 steps to recovery using an updated brain-based addiction treatment model:

Step 1: Know what you want.

Most addiction-recovery programs start with acknowledging trouble, by knowing when you are powerless over a substance or behavior. In fact, it’s better to start one step earlier by knowing exactly what you want in life. To break free from the chains of addiction, you must know your life goals. What do you want in your relationships, career, and physical and spiritual health? Write it down on a sheet of paper, then ask yourself every day, Is my behavior getting me what I want?

Step 2: Know when your addiction has taken you hostage.

This step is similar to Step 1 in the AA model. Know when you’re powerless and your life has become unmanageable. What are the signs of addiction? In general, if your behavior (drinking, drugs, eating, shopping, gambling, sex, etc.) gets you into trouble with your relationships, health, work, money, or the law—and you do it again, you have a problem.

Step 3: Make a decision to care for, balance, and repair your brain.

The missing link in nearly all addiction treatment programs is that they don’t look at and assess brain function on a routine basis. If your brain isn’t working at an optimal level (and most addicted brains aren’t), you will have a much harder time getting and staying sober, despite your best efforts.

Step 4: Reach for forgiveness for yourself and others.

To overcome any addiction, you need self-love, self-care, and forgiveness of yourself and others. If you do not love yourself, you won’t take proper care of your brain, and you will likely continue to hurt it. Forgiveness is the gift that keeps on giving. It is powerful medicine. Research shows a connection between forgiveness and reduced anxiety, depression, and psychiatric disorders. Improving mental health symptoms may lower the tendency to self-medicate.

Step 5: Know your addiction brain type.

All brains are not the same. The brain-imaging work at Amen Clinics shows that there are different brain types related to personality. Understanding your own brain type is critical to getting the right help for addictions. Here is a quick summary of the 5 basic brain types:

• Brain Type 1: Balanced—People with this type tend to have healthy brains overall, which makes them less likely to have addictions.
• Brain Type 2: Spontaneous—The brain SPECT scans of this type typically have lower activity in the front of the brain in the prefrontal cortex (PFC), which is associated with impulsivity and risk-taking.
• Brain Type 3: Persistent— People with this brain type often have increased activity in the front part of the brain, in the anterior cingulate gyrus (ACG). Too much activity here means people can get locked into compulsive worries and behaviors that don’t serve them.
• Brain Type 4: Sensitive—The SPECT scans of this type generally show increased activity in the limbic or emotional centers of the brain. This can make people prone to negativity, which may lead to self-medicating with alcohol, drugs, or food.
• Brain Type 5: Cautious—On SPECT, this brain type is associated with heightened activity in the anxiety centers of the brain, such as the basal ganglia, insular cortex, or amygdala. These individuals may use alcohol and other substances to calm anxiousness.

Step 6: Lock up cravings.

All of us are vulnerable to cravings. When you have addictions, seeing something that reminds you of the substance you use can spark the emotional memory centers in the brain and trigger cravings to indulge in your old behavior. Even after decades of sobriety or steering clear of gambling, bulimia, video games, or porn, your brain is still vulnerable to cravings and those old patterns of behavior. To conquer your cravings, keep your blood sugar levels balanced, manage stress, and get adequate sleep. In addition, take nutritional supplements that help control cravings, such as N-acetyl L-cysteine (NAC), alpha lipoic acid, and chromium.

Step 7: Drip dopamine; stop dumping it to keep the brain’s pleasure centers healthy.

Dopamine is a feel-good chemical. When people take drugs, the amount of dopamine released can be 2-10 times higher than what their brain produces for natural rewards. High-fat, high-sugar food combinations can also light up the brain’s dopamine pathway similar to the way drugs and alcohol do. Dumping dopamine wears out your brain’s pleasure centers. Find ways to drip dopamine, rather than dumping it. High-value activities that drip dopamine include exercise, meditation, yoga, massage therapy, pleasurable music, hugs, and hand-holding.

Step 8: Eliminate the Pushers and Users who make you vulnerable.

Cultivating bad habits—and good ones—is a team sport. You become like the people you spend time with. Pushers and Users are people who encourage or are complicit in your negative behaviors. Addictions need lots of accomplices to start and sustain them. Avoid them as much as possible.

Step 9: Tame your Dragons from the Past and Kill the ANTs.

Dragons from the Past are the internal beasts that breathe fire on the emotional centers of the brain and keep us stuck in the past. ANTs are automatic negative thoughts that also prevent us from making the changes necessary to achieve an addiction-free life. Take time to understand how past experiences are driving your addictions. In addition, learn to challenge the ANTs by asking yourself if your negative thoughts are true.

Step 10: Get help from those who have tamed their own addictions.

Success leaves clues. Addiction mentors and support groups are often critical pieces to the healing process. The people you meet at support groups have walked your path and may have strategies that can help you. You can create your own support group. Simply write down the names of 10 people who will encourage you in your addiction recovery efforts and spend as much time as possible with them.

Step 11: List the people your addictions have hurt, share it with a mentor or sponsor, and make amends if you can.

This is a combination of AA steps that is essential to improve your relationships and to have a better sense of yourself. Now, you can do this step with a better-balanced brain. None of us exists in a vacuum. Admitting your wrongs to others, asking for forgiveness, and making amends if you’re able can make you less likely to continue the behavior that is hurtful to others.

Step 12: Carry the message of brain health to others and continue to practice these 12 steps.

This last step is similar to the 12th Step of AA and other anonymous programs. If you want to keep your sobriety, you need to share the principles with others. It completely works for brain health, too. Your brain is always listening to what you do, but it is also listening to the actions of others. Make sure you are sharing brain health, not illness, with those you love. When you follow these brain-based steps, you will be more likely to achieve and maintain freedom from your addictions and bad habits. Addictions and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.