The next issue of DDN will be out on 7 July — make sure you send letters and comments to email@example.com by Wednesday 25 June to be included. Letters may be edited for space or clarity – please limit submissions to 350 words.
I was pleased to see some support, in among the hornets’ nest of letters and tweets, for the inclusion of Stanton Peele’s take on recovery (DDN, April, page 8). It is easy to believe in the effectiveness of a 12-step model when surrounded by people who describe themselves as in recovery – as might be the case if you go to lots of fellowship meetings or work in a treatment centre, or indeed both. Can it be helpful to question beliefs and practices which seem to support so many people making positive changes?
Richard Craven’s letter (DDN, May, page 16) helpfully refers to the shameful and shaming practices sometimes to be found in 12-step based residential approaches in the 1980s. Take for example the instruction ‘shape up or ship out’ – encapsulating the belief that snags and difficulties in treatment were always the responsibility of the client and never the organisation.
Steps 2 and 3 neatly embedded the necessity of handing over one’s will to a power greater than oneself and who would that be, in the case of fresh-off-the-street addicts who’d been burning their bridges, if it wasn’t the counsellor or the group? Fine if it worked, but for many rehab quitters this was surgical removal of any surviving vestiges of dignity and self-belief. Years were to pass before ‘vulnerable adults’ entered the treatment discourse.
Twelve-step rehab has been on a long, let us hope continuing, journey since that time, in the direction of recognising the needs, resources, qualities and circumstances of the individual. When an agency has been especially smug and self-satisfied – in other words, resistant to change – the journey has been especially painful, not infrequently ending in liquidation.
Let’s hope the journey into the light continues, but let’s also recognise the inherent resistance of many organisational cultures. Right now, broadly speaking, 12-step rehab continues on a rough rule of thirds – some clients get it, some don’t, and some might if we went at it differently. Why is that, and what do we need to consider here? Long may we have outspoken commentators like Stanton Peele to raise questions which frighten us.
Paul Taylor, firstname.lastname@example.org
Each to their own
Further to last month’s debate, I also believe there is a great deal of lack of understanding of 12-step programmes. Addiction is a life-threatening problem, and if something is helping people to recover their lives without a substance dictating their days, why would anyone disagree with that?
I believe there are other ways to recover. Harm reduction is vital to begin with, but does it make sense to spend a life on a substance like methadone and many other so called solutions?
AA in particular has had a huge success rate for many years – if it works, don’t fix it. I have never witnessed anyone being kidnapped to go to a programme, it is their own choice. If one chooses to go another path why does 12-step have to be their problem? Would it not be a good idea to just get on with their own solutions and leave others to get on with theirs?
A final point: 12-step programmes are free and self funding; would that be a reason? Or maybe it is the choice of individuals not to be abstinent, or they confuse 12 steps with orders not suggestions – I could go on and on. Surely the best thing is to choose your own solution and stop criticising. It seems that this debate is looking for what is wrong and not at what works for many, though (obviously) not all.
Rita Matthews NCS (Acc), MBACP, AHPP certified reality therapist, FDAP, associate member of the Royal Society of Medicine