Preface

The Real 13th Step: Discovering Confidence, Self-Reliance, and Independence Beyond the 12-Step Programs
by Tina B. Tessina, Ph.D.

Tina Tessina asserts that, despite the millions who've found relief from addictive and compulsive habits through 12-step programs, these same programs' insistence that members always keep coming back unwittingly fosters attitudes that can undermine independence, self-confidence, and self-reliance, the foundations of a long, successful, healthy life.

The Real 13th Step dispels the bedrock recovery principle that some people are just born with addictive personalities. Instead, Tina Tessina targets the real problem as learned dependency, and she teaches readers how to develop the three central skills of true independence: risk-taking, problem-solving, and coping with failure. She then offers practical advice about applying these principles in every aspect of our lives: relationships, work, decision-making, and managing the continuing temptations of addiction.

Readers will discover how to take control of their own lives and remain free of the fear of relapse or setback in their recovery.

A number of things have changed in the ten years since The REAL Thirteenth Step was originally published. In that time I've worked with many more clients who are recovering with the aid of Twelve Step programs. In that time, sponsors have referred program members to me, and I have referred clients to the programs and to sponsors. The program continues to be powerfully helpful to clients with addiction problems.

Research in addiction has progressed, recognizing new stages in the recovery process. Experts now say that people in second and third stage recovery can benefit from changing their relationship to AA or Other Twelve Step programs. Clients, sponsors and experts all agree today that psychotherapy is an important adjunct to the program, helping people in recovery with the aspects of recovery that are not covered by the twelve steps and twelve traditions.

In spite of changes in the recovery movement, my clients continue to need the information in The REAL Thirteenth Step as an adjunct to their recovery. Sponsors and group members now acknowledge that psychotherapy is not only helpful, but probably essential to recovery. Treatment centers report their best success rates when they use a combination of twelve-step and group psychotherapy techniques. In-patient treatment is usually brief because of insurance constraints, so most centers recommend that patients continue therapy after treatment along with their twelve-step attendance. "Drug courts", new court programs which are designed to reduce jail time for non-violent drug convictions, and instead focus on treatment and recovery, also acknowledge the need for therapy along with twelve-step attendance.

This book contains - in exercises, information and guidelines - the tools a person in recovery needs to complete the process. I have updated it to include new ideas and techniques. This is the work my clients do in therapy, and by following the program set forth in these pages, you can complete the same work. I have made it as rich and effective as possible.

Contrary to what some people have said, The REAL Thirteenth Step is not critical of AA or any other twelve-step programs. What I do here is to show how people with judgment problems can misinterpret their program in damaging ways, and how to correct those problems. You'll find it totally supportive of your involvement and progress in your program, and also encouraging in your discovery process beyond the twelve step programs.

You can use this information by yourself, with your sponsor, with a peer group of others who have similar goals, or with a licensed therapist. In fact, in the years since the first edition was published, I have heard from many therapists who use this book with their clients, sponsors who use it with the members they sponsor, and treatment programs and alcohol counseling degree programs which make it part of their curriculum. If you decide to embark on this journey, it may take considerable time to effectively do all the exercises, but you'll find the process worthwhile and the results will be better than you dreamed.

Nothing is more gratifying for a counselor than watching a client struggle through the growth and recovery process, to succeed in building a new life. I have laughed and cried with my clients, and supported and congratulated them as they graduated from therapy into fulfilling and satisfying lives. Clients have reported back to me, years later, that their relationships are working better than they ever imagined, and that they are happy and content as they never thought they'd be. This book is designed to help people I cannot see in person achieve the same results.

I wish you the best of luck, and a life after recovery that is full of satisfaction and happiness.

Tina Tessina, Long Beach, CA 2000

THE REAL THIRTEENTH STEP

PREFACE

Support groups are the answer for 15 Million Americans... 500,000 ...will be attended ... this week... Support groups work

— Newsweek

In my work as a consultant, I have observed clients becoming addicted to the twelve-step program and unable to transcend it.

Drug Counselor Bob Holder, New Age Magazine

Since the founding of Alcoholics Anonymous in 1935, twelve-step based recovery programs have proved very effective in helping victims of addictive, obsessive and compulsive behavior put a stop to that behavior and the damage it has created in their lives. Up to now, these programs provide almost the sole support, hope, encouragement, and successful examples of people who were able to arrest their addiction and enter recovery.

In a nation that has eight million "problem drinkers," more than two hundred national Alcoholics Anonymous-style groups, and over two thousand meetings each week of support groups catering to those caught up in "relationship addiction" alone - and where millions of others attend groups specifically formed for recovery from problems such as substance abuse, alcoholic families, eating disorders and obsessive/compulsive behavior - there is no doubt that all these recovery programs based on the original Alcoholics Anonymous 12 steps have done a tremendous amount of good.

To my knowledge, they are the most effective programs known: most reputable alcohol and substance abuse treatment centers use the Twelve Steps or some variant of them in their own programs; and many therapists will not work with substance abuse patients unless they attend a twelve- step- style recovery program. For the last twenty years, these programs have done exactly what they were designed to do, to help people free themselves from whatever substance or behavior holds them in addiction.

No wonder a Scripps Howard News Service story back in 1989 maintained "Throughout the country, there is a rush to ... Alcoholics Anonymous, Cocaine Anonymous and Narcotics Anonymous. Nationally, AA membership has easily doubled in the last decade. The country's Cocaine Anonymous groups have seen an even more dramatic rise, from 169 to 1,042 in four years." Ask any experienced recovery counselor, and you'll hear that twelve step programs definitely work.

But recently another series of voices have begun to question certain aspects of the program. One of the foremost of these is psychologist Stanton Peele, author of The Diseasing of America: Addiction Treatment out of Control; who criticizes the 12-step process as "a religious conversion experience", and terms it "a kind of brainwashing."

"The... AA philosophy... that alcoholics... are unable to control their drinking from birth", writes Peele, means they "... are obligated to think of themselves as having a lifetime condition...alcoholics are taught to believe that they are exactly one drink away from total relapse and the need to start again at day one." Others criticize the program's insistence that "recovery is forever" as undermining self-esteem; the way groups absorb members' time to the exclusion of all outside activity; and the way many members seem to just transfer their addiction to the program without attempting any further growth or progress.

U.S. News and World Report called this "America's addiction to addiction". One social worker employed by a veteran's hospital alcohol treatment program voiced this concern recently when he said: "We need a Twelve Steps Anonymous to handle peoples' addiction to the program."

In fact, as the number of support groups and the problems they face has mounted, so has the controversy. Concern over whether they are to be viewed as effective methods for arresting addictions or simply as a means for transferring the addiction to a more benign and less disastrous form is becoming more widespread.

This growing doubt has penetrated so deeply among the public at large that it has even become the subject of comic strips. A Feiffer cartoon featured a woman worrying because she goes to her support groups "seven nights and three afternoons a week" for her eating, drinking, smoking, and intimacy "disorders". She couldn't "live without them." the woman says, and then concludes, somewhat crestfallen, that she may have a "support group disorder."

Recently, I have noticed that clients who had been in recovery groups and long ago stopped their addictive behavior were also beginning to voice these concerns and felt restless with the program. Among them are clients who have come to me feeling discouraged and disappointed with themselves because they couldn't achieve satisfying lives through the recovery programs alone, and clients who - after years spent going from one kind of a group to another (AA to Al-Anon to CoDA to Overeaters Anonymous) as they quit one addiction only to discover they still had others - are kept by the groups from noticing that the underlying cause of all these compulsions had yet to be addressed.

Friends also have expressed frustration with being "in recovery" for years, and wanting to get beyond it. And colleagues have expressed concern about clients who seem to be stuck because they can't transcend their recovery programs. Members of my weekly drop-in therapy group attend to work on issues not addressed in their twelve-step programs. Even as I write this, after overhearing a phone conversation about this book a young man who works for me (and incidentally is in recovery) said "Were you just talking about a book about something beyond the twelve steps? Where can I get three copies?"

Although twelve-step programs have limitations, their effectiveness can or should be discounted. When, in the second chapter, I analyze the problems of misusing the Twelve Steps, I am not attacking the steps or the program. Instead, I hope to show recovery group members how they can build on the foundation of continued long- term recovery from addictive behavior these groups have made possible to a full, autonomous life free of addiction and the fear of relapse, without feeling dependent on the program's support, whether or not they continue to attend.

My clients are justly grateful for the help they've gotten within these groups. "The twelve -step program saved my life" is a statement I hear often. As a therapist, I am also grateful, for the way these groups supply an ongoing, twenty-four-hour a day support structure and friendship that is both beyond the scope of, and an excellent adjunct to, private therapy.

But for many long- term recovery group members, It is no longer enough to remain "clean and sober", to learn the Steps, to be a part of the "family". Life beyond the group, beyond recovery calls to them; human beings have an innate need to grow, to accomplish, to achieve.

Their recovery program has done its work; its objectives have been achieved, and often successful group members have successfully completed recovery. But there is no culminating celebration, no movement to a new level. When students study diligently and learn their lessons in school or college, they get to graduate and move on to a higher level. But for members of recovery groups there is no graduation or recognition that they might have completed their work -no Thirteenth Step beyond recovery to a health and wholeness that transcends any further permanent dependency on the program to keep them free from addiction.

The philosophy and perspective of the twelve-step programs as they are currently constructed does not acknowledge that permanent recovery of any kind is possible. Members are convinced that nothing like a Thirteenth Step can ever exist, and they are convinced that addiction is a life long "illness" that can never be cured, that there is no such thing as graduation, and that all attempts to leave the group can only end in failure. This prevents them from learning the skills they need to know to fully enjoy their lives and relationships.

I agree that addiction is indeed a very serious problem, and very difficult to heal. But, just as people doubted the ability of anything to arrest addiction until Alcoholics Anonymous introduced the Twelve Steps and proved its effectiveness in the face of many doubts, there is increasing evidence that once addictive behavior has been stopped through the intervention of a recovery program, many people can recover further beyond the likelihood of relapse.

Because they do not believe in completing recovery, often program members and sponsors actively discourage members from leaving the group. As a result, even members who feel they've gotten all they can from the program and eventually leave feel burdened by a sense of incompleteness, self-doubt and guilt.

Helping clients, friends and colleagues resolve these conflicts and find meaning beyond their self-help programs led to the writing of The REAL Thirteenth Step, which addresses the following questions:

• How do you know you are ready to move beyond the program, and are not just in denial?

• What criteria must you meet to be ready for graduation from twelve-step programs?

• Does graduation mean you must leave the program forever? What is appropriate program participation once you achieve independence?

• How is self-reliant living different from arrogance and selfishness?

• What is healthy autonomy? Is it lonely?

• Why are some people on a treadmill of self-help group after group, and how do you stop the cycle?

The methods, exercises and ideas in this book build on what you have already learned in your recovery program, and are based on proven psychological theory and techniques. Through following the teachings here, you can both honor the accomplishments you achieved in recovery and effectively move beyond them, to normal, functional living. You can learn how to heal old dependency, old pain, and free yourself to enjoy the challenge of life. Because they are based on time-tested theories, (and because this book has been used by so many treatment programs) some of the exercises and teachings may seem familiar. But, never before has such a coherent, complete outline of the basic tools been presented in a way you can use on your own to effectively learn autonomy and create permanent, lasting recovery from the patterns of dependency that lie embedded in your subconscious mind.

Although this book is intended for people who are recovering from severe problems of addiction and dependency with the help of a recovery group, because of the social bias in most societies against independent thought and action almost everyone develops some degree of dependency and has their growth toward autonomy impaired. Therefore, the ideas and exercises in this book will also be useful for anyone striving to achieve a greater degree of personal freedom and autonomy in his or her daily life.

You may never have had problems with addiction, or obsessive compulsive behavior, but sometimes you might find it difficult to assert yourself in groups, to initiate conversations about painful topics, to ask salesclerks or repairpeople to correct errors, or to confront friends or relatives who need it. If so, by following the suggestions contained in this book, you'll find yourself able to deal with most of life's difficulties with greater ease and self-confidence.

I invite you to turn the page, and begin taking Thirteenth Step toward autonomy, self-confidence and self-reliance.

Author's Note:

As a member of a twelve-step recovery program, you may have heard the term thirteenth stepping used disparagingly to mean having inappropriate sexual intimacy with new members. In this book the phrase Thirteenth Step is used to mean completing recovery and achieving appropriate intimacy with yourself.

To me, taking the Thirteenth Step means taking the next step beyond the Twelve Steps and graduating from the group to healthy, fully autonomous living. That's why I have chosen to call this book The REAL Thirteenth Step, and any time I use the phrases Thirteenth Step or The REAL Thirteenth Step it is this healthy intimacy with self, not inappropriate intimacy with others, that I mean.

Although the twelve-step programs are among the best known of the self-help recovery groups, there are many others which are based on the Twelve Steps (such as Adult Children of Alcoholics (ACA), Overeaters Anonymous (OA), Gamblers Anonymous (GA), Narcotics Anonymous (NA), CoDependents Anonymous (CoDA), Debtors Anonymous (DA), and Al-Anon) or that, though they differ in the number of steps, or in some details, take basically the same approach.

Many incest survivor, codependency, or adult children of dysfunctional family and other self -help groups use a program based on the therapist's own feelings about the appropriate number of steps. But they are all very similar in their focus on a Higher Power, on fearlessly facing the self, and in making amends to those who have been injured. Since they all share the same focus on recovery through the support of the group, I have chosen to refer to them most often as recovery groups or programs. When you see these phrases, you will know I'm speaking about recovery groups in the most inclusive sense, and not exclusively AA-type twelve-step programs.

Addiction, obsession, compulsion and dependency all share common elements, since addictive behavior is compulsive and we become obsessed about anything we are dependent on. Although therapists and programs consider these to be technically different behaviors, for the purposes of this book I have used the terms addiction and addictive and related words (drunk, dry sober, abstinent) to include all compulsions, obsessions, and addictions.

Copyright © 2001 Tina Tessina

About the Author

www.tinatessina.com
Tina B. Tessina, Ph.D., has twenty years of experience as a licensed marriage and family counselor. She is the author of seven books, including: The Real Thirteenth Step: Discovering Confidence, Self-Reliance and Autonomy Beyond the Twelve Step Programs, Gay Relationships: How to Find Them, How To Improve Them, How to Make Them Last and Lovestyles: How to Celebrate Your Differences. She co-authored (with Riley K. Smith) How to Be a Couple and Still be Free and True Partners A Workbook for Developing Lasting Intimacy. Dr. Tessina has appeared on national TV and radio shows including: Oprah, Donahue, Dateline: NBC and Larry King Live.