Autonomy, Part 1

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

(Page 2 of 3)

Part I

Recovery:
Stepping up from Addiction

Chapter I

Autonomy: The Real Thirteenth Step

The trouble with twelve-step programs is that they just replace the addiction - then you're stuck with the program for life. I know people who've been going to three meetings a week for ten years.

— Wayne Curtis, Psychologist

Through twenty-eight years of doing therapy, I have seen numerous clients who benefitted enormously from a recovery program and then came to me for private therapy either on the recommendation of a sponsor or a fellow member, because they still had problems in their lives and relationships. I have also seen clients who gained sobriety through other methods, including Rational Recovery, in-patient treatment programs, religious conversion and even some who have made it on their own, through sheer strength of will. Even though they overcame alcohol, drugs, gambling, compulsive overeating or overspending, they still had anxiety, depression, broken relationships and problems with emotional control, so they came to me.

Those who followed the program felt it made them strong in recovery, and they were grateful. Knowing they were strong enough, with the help of the program, to achieve recovery led them to believe that, with effective help, they could achieve even more.

Richard O., 45, a self-employed professional, said, "The program created a miracle for me, my freedom from addiction. Moreover, I have never seen any other recovery program work the way AA's works. It works! But it took me to govern my mind and control my excesses. I am entering my tenth year of being sober. I stopped attending meetings after six months, primarily because they were repetitive. I don't want, desire nor have a yen for booze and I keep a fully-stocked bar in my home for guests." He discovered the importance of autonomy on his own.

Bob D., 62, an aerospace engineer who began having heart problems: "I'm grateful to AA, I really feel the meetings saved my life. But, now that I've been sober for three years, I realize that there's more I need to do, and I can't seem to find it in AA."

Mary L., 33, a successful real estate agent and divorced mother of two, says: "I found that my whole life, my friends, my activities were all limited to the program. For a while it felt great, being surrounded by recovering people, but then I wanted more variety. I wanted a life of my own! I'm grateful to the program, more grateful than I can say; but I never felt completely healthy until I left."

Like these people, you may feel you've benefitted enormously, but sense that your ability to function on your own in the outside world is limited. Like many other clients, you may feel the time has come for you to graduate from your dependence on the group, and to develop the additional skills you need to manage your problems and to cope successfully and fearlessly on your own. Even if you don't feel dependent on any group to maintain your sobriety and recovery, you may have many questions about what living a truly healthy life entails.

Twelve-step and recovery groups indeed offer many benefits. The support of the group, the living examples of people overcoming addition and compulsions, the intelligence and power of the Twelve Steps, and the security of a proven plan for overcoming old thinking and destructive behaviors are all invaluable benefits of following the program. But some experts maintain that the program becomes a replacement for the addiction- addiction to recovery. What the program does not provide is a way to progress beyond the Twelve Steps.

If you have been a member of a Twelve Step program, or if you have achieved recovery by other means, you may be ready to move on to the Real Thirteenth Step. That is, to develop an understanding of the emotional dynamics underlying your original addiction that enables you to gain true mastery of every aspect of your life.

Moving beyond the Twelve Steps is a gradual process - it does not mean leaving your group prematurely, it does not mean abandoning your personal program, and it does not mean leaving the support of your friends in recovery. What it does mean is gaining new understanding beyond merely maintaining recovery - understanding and information not available within the limits of your Twelve Step program.

How do you know if you are ready to take the Real Thirteenth Step? Ask yourself the following questions:

• Have you remained free from your addiction or compulsion for several years?

• Are you realistically confident that your life is no longer unmanageable?

• Are you happy to be in recovery and particularly to be clean/abstinent/sober, but still at a loss about how to run the rest of your life?

• Are you tired of being told you are an addict/alcoholic/codependent and will always be an addict/alcoholic/codependent?

• Are you feeling restless and confined in the group?

• Are you beginning to feel you may have just traded one crutch for another?

• Do you feel you are missing out on life because of the pressure to constantly attend group meetings?

• Do you realize that all your former friends were connected to your addiction, all your present friends are involved in the Program, and you have trouble forming friends with others outside these groups?

• Would you like to let go of the program and try your "wings" as an independent, fully recovered human being, but you're afraid you may slip back into your old, destructive behavior, because you have been told no one ever recovers?

• Do you sense you may be cured and ready for life outside the group, but you're not sure you possess the skills for coping with the world successfully by yourself?

If you can answer yes to most of these questions, you are ready to graduate from recovery, understand the reasons behind your addictions or compulsions and take the Real Thirteenth Step to self-reliance and freedom from dependency.

Why Graduate?

Although twelve-step style recovery programs are unsurpassed in transforming destructive addiction, compulsion or dependency into a much healthier dependency on the Program, your recovery remains incomplete. It still leaves you dependent upon the group. Your current doubts about the group and feelings of restlessness may be prompted by your inner awareness of this lack of completeness. Your restlessness means you are ready to complete your recovery and graduate to taking full and complete charge of your own life - to achieve autonomy.

Autonomy, which means to be self-governing or self-regulating, may seem cold and scientific, but it represents personal empowerment. Rather than being cold, autonomy is a source of emotional warmth: only when you feel able to take care of yourself can you successfully take the necessary risks to love and be loved. The exercises and information in this book will help you build the essential foundation you need to create intimacy with yourself and others.

Here is the information you need to take one more step than your recovery program has provided - recovery from your final dependency on the group. You will learn how to take charge of your own life, and devise your own program to keep yourself from becoming dependent, addictive, or obsessive again. The Twelve Steps are like a tourniquet that stops a hemorrhage; they have saved your life, but the wound itself still needs to be treated. Unless the injury is healed, you will always be, as the programs put it, "recovering" but never "recovered".

Your replacement addiction to a sponsor, the steps and the meetings is vastly more functional than your original addiction, but it eventually limits your ability to live a full and emotionally complete life. Recovery can absorb your time and attention, much as your original addiction did, and prevent you from moving on.

When you first entered recovery, you probably abandoned old friends or left an addictive or compulsive mate or dysfunctional family, because their influence was harmful. Finding a ready-made group of friends at AA or other groups probably produced initial euphoria, but eventually you discover these new friends also have difficulties and problems. Like you, they have the emotional dysfunction that accompanies addiction.

As you progress in recovery you may long for people who share your interests (such as music, sports, art, politics or books) other than addiction. But if you believe you must attend the group regularly to remain in recovery, you don't have the time to make friends outside the group. If your family of origin is dysfunctional, you may be at a loss about how to find new friends, and your recovery program probably does not provide information, encouragement or guidance about how to make friends outside of the group.

After years of dependency and addictive behavior, becoming autonomous, confident and self-reliant may sound like an impossible goal. Perhaps you have always been afraid you couldn't function successfully on your own. Your dependence on drinking, eating, shopping, sex, overwork or other excesses may even have been partly caused by your fear that you were too weak or stupid to manage your own life. Ironically, your destructive behavior patterns may look like the proof that you are incompetent.

But others who have had the same problems have learned to end their addictions - even after years of apparent failure - and so can you! Instead of remaining dependent on a substance, a behavior or even a self-help program to maintain your recovery, you can learn to manage your own life independently. You can take the same step Carl, a thirty-three -year- old long-haul truckdriver, took - the Thirteenth Step, beyond mere recovery to health and autonomy.

Carl

Carl began drinking at age fourteen. It was the "in thing to do". His buddies would steal alcohol from home, or talk an older guy into buying some beer. At first, it just seemed "grown up" and exciting, but, soon it helped him forget his problems at home and school. His father was a truckdriver, and gone a lot. Carl missed having a father like the other kids', but he liked it better when Dad was gone. When Carl's dad was home, with nothing to do, he drank, became angry and violent, and Carl and his mother got the brunt. With his inner turmoil about the abuse, and no guidance from his troubled parents, Carl was unable to cope with school. Drinking became his only relief, and a big problem. Carl had hangovers, blackouts, arrests for drunk driving, and disastrous relationships.

Carl tells how he got to AA at age twenty-eight: "I went to the first meeting because I was ordered to by the judge after a DUI. I hated it, but they said 'keep coming back,' and I had to anyway." Being arrested for a DUI got his attention, and the court's referral to AA got him moving. "I went to meetings because I had been ordered to, but I never shared [spoke]. When I first said 'My name is Carl, and I'm an alcoholic', I began to face my problem. The Twelve Steps changed my life. For the first time, I had some hope."

Carl spent four years in AA, working the Steps, attending daily meetings, and even speaking at hospital alcohol programs to introduce AA. "AA was all I needed - until I fell in love. Suddenly, I had no idea what to do. When that relationship broke up, I was afraid to meet other women. I had nothing in my life to talk about except AA. I discovered that meetings were not a good place to meet women. They were there because they needed to work the Steps - they were not ready for healthy relationships. I got restless. Meetings seemed repetitious, I had gotten what I needed, but I was afraid to leave, because I knew I was supposed to be in recovery forever. I didn't know what to do instead."

Carl had several relapses in his first six months in AA, and he didn't trust himself to stay sober without frequent attendance, but after a year he wasn't learning anything new. Carl felt he needed more help than his sponsor had to offer.

Carl came into therapy, because although he was a handsome, well-built man, he needed to learn how to relate to women, and how to meet people outside AA. In therapy, Carl learned to confront his feelings, and he discovered his awkwardness and shyness around people he didn't know was a result of internal emotional pain and a poor self-image.

As Carl learned to face his own feelings, he began to heal the trauma of his childhood. His confidence and energy were increasing. His self-esteem grew as he learned autonomous thinking and self-governing. He began to trust himself, to discover what was healthy for him, and to take good care of himself. Carl reclaimed his life, from the painful legacy of a dysfunctional and abusive family, from the ravages of out-of-control drinking, and finally, from dependency on AA.

Carl says, "I will always be grateful to AA. Nothing else would have gotten me sober. But I'm glad I found a way to graduate. Now, my involvement is voluntary - I can do it if I want to help someone, or to remind myself of what drinking was like, but I don't need the group any more to stay sober or keep my serenity. Life is more fun, I'm enjoying myself more, I have more friends, and I'm successfully in love."

Healing Is More Than Recovery

If you're one of the millions of men, women and young people who have successfully stopped a destructive behavior - involving addictive substances, food binges, spending, gambling, abuse of others, or codependent relationships - through participation in one of the many twelve-step or twelve-step inspired recovery groups. You have learned, grown, and with the help of your program, become able to manage the biggest problem in your life: addiction. Through the powerful examples and support of others in the program, you have achieved a status called being in recovery - you've stopped an addictive habit, and its devastating effects are gone from your life.

The support of the twelve-step program, and the "family" feeling that develops among members, rebuilt your self-esteem, which was so devastated by addictive behavior. This self esteem begins to develop in much the same way it develops in a small child, based on rewards and approval for "good behavior" (maintaining abstinence or sobriety, and attending meetings). For many, it's the first time that their productive, healthy behavior has been rewarded.

Rebuilding self-esteem in those who have had it damaged can be a long-term process. Frequently the damage began in early childhood, and takes considerable support and encouragement to repair. As your self-esteem grows stronger, your investment in your recovery also grows, and your chances of remaining free of your addiction increase accordingly.

Twelve Step recovery programs are a brilliant combination of factors that help people who are caught up in overwhelming addictions get into, and stay in, recovery. Many components of the program contribute to keeping members invested in recovery - even when it's difficult.

Twelve Step Programs create a strong influence which effectively helps its members combat addiction through:

• The support of the group

• the accountability of regular meetings, (especially once you have made friends there)

• the constant availability of your sponsor

• the continuity and encouragement provided by receiving tokens for each month of sobriety (chips), and celebrating each anniversary of your sobriety (birthdays), and

• a program of corrective steps which provide an alternative to old, destructive behavior and thinking.

But most recovery programs stop there - they insist you can never move beyond recovery. The underlying emotional shortcomings (such as low self-esteem, lack of self-control, inability to establish intimacy, lack of motivation, and inhibited emotional expression) that made you addictive are not addressed. If you want to move from recovery to full healing (autonomy) you must confront and correct these deficiencies.

There are more accurate ways to measure health than simply looking at the duration of your sobriety. Factors such as self-esteem, self-awareness, self-control, emotional balance, and how you handle change, problems, and relationships all effect your emotional health.

Beyond Recovery

Overcoming dependency and moving beyond recovery means having the self-confidence to face your problems on your own, learning to think calmly and rationally about stressful situations, and knowing you can handle difficulty without resorting to an addiction to people, substances, or behaviors - in short, achieving autonomy.

A twelve-step group focuses on helping you get into recovery, then simply accepts that you will continue to remain addicted forever. That's why you are told to "keep coming back" and that "recovery is forever". The program does not confront the emotional patterns that accompany the addiction. For example: you may have stopped drinking, but you still have difficulties forming lasting relationships; you may have overcome bingeing, but you are still unable to work out problems on the job; You may have stopped working compulsively, but you don't know how to get along with your spouse and children.

Problems Underlying Addiction

From a therapist's viewpoint, addiction is not the problem but the symptom of greater underlying problems. What are these problems? What are the causes of addiction?

Experienced recovery counselors maintain that addictive behaviors are actually ineffective attempts to heal or relieve intolerable pain. As Anne Wilson Schaef says, when we have our addiction to hide in, "we do not have to deal with our anger, pain, depression, confusion, or even our joy or we feel them only vaguely. We stop relying on our knowledge and our sense and start relying on our confused perceptions to tell us what we know and sense. In time, this lack of internal awareness deadens our internal processes, which in turn allows us to remain addicted."

Yet, many people have faced enormous pain and suffering from childhood on without resorting to addictive behaviors to help them hide from it. People who are disabled, disadvantaged and from broken homes can often successfully cope with pain on their own in a healthy, functional manner, every day of their lives. They believe they can cope on their own.

Those who turn to addiction, in contrast, feel that they are not strong, capable or smart enough to cope with life on their own and needed outside help to survive their pain and suffering. Pain does not cause addiction - the conviction that you are unable to cope with pain does. When you believe you can't handle difficulty, you look for a place to hide, for a person, substance or behavior you can depend on to help avoid the problem. Therapists call this belief dependency and it, not the pain, is the cause of addiction, compulsion, obsession, and co-dependency.

To completely overcome your addiction requires that you change the mental attitudes that perpetuate dependency and develop into an autonomous individual dependent only on yourself. These attitudes are:

Hopelessness – Habitually thinking "what's the use" or "I'm not capable anyway"; often accompanied by a belief that you're undeserving.

Helplessness – This is an attitude related to hopelessness, a doubt that you can set intentions and keep them, or that you can take care of yourself when necessary

Dependence on others – Believing you must get motivation, support and comfort from outside yourself, because you lack the ability to depend on yourself.

Fear of pain – Not knowing how to heal your old hurts; experiencing constant self-criticism; and the inability to face unresolved emotions such as fear, rage and guilt.

Self-abandonment – Being disconnected with yourself, not understanding of your responsibility to yourself, and no experience of the security and comfort of self-awareness and self-love.

Mindlessness – Not thinking clearly and not being aware of your own thoughts because you habitually look for answers to problems from others - an inability to problem-solve or consider options, and the resulting lack of choice.

These attitudes create a feeling of powerlessness. (That is: I cannot help myself, I am not strong enough to cope with life, fear, pain, helplessness, choices, relationships, and so on.) Dependency is a conviction that you cannot survive without the addiction, person, substance or behavior that you rely on. When you try, feelings of rage, fear and panic begin to emerge, overwhelming you, and sending you back to the "safety" of addiction, which you depend upon to numb or deaden them. Facing your unresolved feelings and painful history seems more terrifying than the ravages of alcohol, abuse, or even the health risks of compulsive smoking, overeating or workaholism - because you believe you can't cope without help.

"An addiction," writes Anne Wilson Schaef , author of When Society Becomes an Addict, "is any process over which we are powerless. It takes control of us, causing us to do and think things that are inconsistent with our personal values and leading us to become progressively more compulsive and obsessive."

One of the underlying pains of addiction is the buried fear of helplessness and dependency that comes from growing up in a dysfunctional family. As Dr. Timmon Cermak, founder of the National Association of Children of Alcoholics, writes in A Time To Heal, "In the midst of this unhealthy environment, COAs [Children of Alcoholics] must pass through the critical stages of developing trust, autonomy, mastery, identity and the ability to separate themselves from those around them." In a healthy family, your parents would help you progress from an infant's normal dependency through childhood exploration and adolescent separation to autonomous adulthood. However, when family dysfunction prevents you from completing this process, you remain stuck in dependency. Because you never feel strong enough or confident enough to cope with life on your own, you look to something outside yourself to help you through it. The result can be addiction to anything from work to religion.

If you had grown up in a healthy, functional family, you would have been gradually encouraged to become increasingly autonomous and more self-reliant. You would have received support when you efforts went wrong, and approval when they turned out successfully. You would have learned you could trust and depend on your own abilities to cope with the problems you encounter in life, and that you did not need to depend on others to do so for you. As a self-dependent or independent person, able to face life on your own two feet, you would be far less likely to turn to addiction to help you through painful experiences.

Addiction is a symptom of a dysfunctional childhood, but it becomes so destructive and so all-absorbing that you have to stop the addiction and begin recovery before you can begin to handle the true, underlying problem. As Schaef says, "At some point we must choose to recover - to arrest the progress of the addiction - or we will die." By getting into a program, you have made that choice.

By numbing feelings, addiction also blocks learning and growth for the period of time covered by the addiction. For this reason, the AA Big Book defines alcoholism as "a state of being in which the emotions have failed to grow to the stature of the intellect." So, if you are addicted (to gambling, substances, or codependent relationships) from age fifteen to thirty-two, your emotional development, attitudes and reactions when you enter recovery will still be those of an adolescent. When you finally end your cycle of destructive behavior your social, emotional, and many of your mental skills will not have advanced much beyond the level of development they had reached when your addiction started, as Carl's story illustrates.

Carl (who drank heavily from age fourteen through age twenty-eight) had achieved five years of sobriety at age thirty-three, but was left with the social skills and the emotional development of an abused fourteen -year-old. He did not know socially polite "small talk" or etiquette, the correct approach to ask a woman for a date, or how to develop a lasting relationship. After getting sober, Carl had to catch up with his contemporaries and learn social skills, information and knowledge that he missed. He came to me wanting to know "how to talk to women" and completely mystified about how to make friends, ask for a date, or develop a relationship. He had missed all the skills adolescents and young adults are supposed to learn.

To make the difference between early recovery and completed recovery ( autonomy) clear, the following chart is a comparison of the related attitudes:

Recovery

Self-control: Overcoming my addiction/ compulsion is the most important thing - I still occasionally feel strong urges to revert to old behavior. I need a lot of support and encouragement.

Gratification: I am focused on instant gratification. I feel deprived when I don't get what I want.

The Program: I work hard at the steps of my program. I do it because it works, but I don't really understand why. Honesty: I struggle to tell the truth - to myself and others.

Competence: I have a lot of unanswered questions: What is functional living? What is a healthy relationship? I don't think I have everything I need to make my life work.

Change: Changes are scary - I want security, and I'm afraid of disappointment. Problems: Problems seem huge and difficult - they might threaten my recovery.

Feelings: I don't know what to do about my intense emotions. They frighten me.

Self-awareness: I don't know who I am and I usually don't know what I feel and can't figure out what I want.

Autonomy

Self-control: Addiction is no longer a big issue: a temptation may come up now and then, but I know how to control my impulses.

Gratification: I understand the value of long-term goals and delayed gratification, and I can motivate myself to keep my long term goals.

The Program: I understand what keeps me emotionally healthy. I've modified the steps and developed my own program to suit my individual nature.

Honesty: Telling the truth to myself and others is easier for me because I realize my life works better when I do.

Competence: I feel effective in everyday life. I have the skills I need to be successful, and when I need new skills, to achieve my goals, I know can learn them.

Change: Change is fun, a challenge, inevitable, an opportunity for growth. Disappointment is a part of learning and growth.

Problems: Problems may be frustrating, but they usually can be solved. I can trust myself to refrain from addiction even when things go wrong. Feelings: Emotions are natural, welcome, easy to handle. My feelings are important and I know what to do about them. Self-awareness: I know myself well, including what I want and how I feel. I am my best friend, my own partner in life.

Clearly, recovery can only be a halfway point. It is not possible or appropriate for recovery groups to attempt to fill all of a member's needs. The specific intent of the programs is to steer you into recovery and halt addiction. It is not the program's job to move you beyond recovery. Restructuring the psychic system that created the behavior in the first place is beyond their scope.

In early recovery, having a definite program of steps to follow was an enormous aid to your progress. It gave you the first concrete plan for dealing with your addiction and you welcomed the structure, even though you may have struggled with it. You learned and grew a lot.

But if you expected that ending your addiction would create a life-changing revelation you were probably disappointed. Even after you stopped your destructive behavior, you still had the same internal problems as before. Frequent meetings and endless talks with sponsors and members help, but when you are alone, your doubt and disappointment are still there.

You need something more than what your recovery program is giving you, but you're afraid to tamper with an effective formula that you don't understand. You've been warned if you don't follow the steps you can have a relapse at any time. "Keep coming back", which was encouraging before, has begun to sound oppressive. You're now feeling better - but you may also be feeling stuck.

Completing Recovery

To move from early recovery- beyond addiction and dependency - to autonomy, you need to replace the dysfunctional models of their past with new skills. The skills you need to achieve autonomy are:

• effective communication
• taking risks
• problem solving
• coping with failure
• facing pain
• learning
• forgiveness
• independent behavior

Stuck in Recovery: Does it Have to Be Forever?

Twelve-step programs insist you identify yourself as a lifelong addict for a good reason. You are far more likely to relapse if you leave the continuing influence of the group before you have mastered autonomous skills and changed your underlying dependency. This is a truth learned from experience, and not as unreasonable or arbitrary as it might seem at first glance. All group members have witnessed many actual relapses suffered when members, even of long standing, leave the support of the group.

Another good reason to identify yourself as a lifelong addict is that people caught up in addictive behavior have a truly astounding capacity to deny problems, to block them out. Addictive people often have learned to rationalize away even very destructive behavior - such as losing jobs and loved ones because of drinking, repeatedly going back to a battering spouse, or gambling away the rent money. Here's what denial sounds like:

I can stop anytime.
He/she really needs me.
I'll win it all back next week.
It's all my (husband, wife, boss)'s fault.
I just can't resist a good bargain.
No one else will get the work done right.
It's not so bad.
Everyone messes up.

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.