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The Real 13th Step
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Autonomy, Part 2
The Real 13th Step: Discovering Confidence, Self-Reliance, and Independence Beyond the 12-Step Programs
by Tina B. Tessina, Ph.D.

(Page 3 of 3)

Causes of Relapse

People in denial often minimize the problem and believe they're cured as soon as the twelve-step program begins to help them gain control and they stop the damaging behavior. They then leave the program's support prematurely, before completing the work of the Twelve Steps. Hence, the danger of continual relapses (frequently demonstrated by public figures such as Robert Downey Jr, Charlie Sheen, and Whitney Houston) into the old, destructive behavior.

Former child star, now actress and director, Drew Barrymore learned this fact the hard way, when she prematurely announced that she was "cured" of her alcoholism in media interviews, then had several public relapses. She told People magazine: "The truth is that you are never fully mended. There is no happy ending because there is no end to the struggle for a clean and sober life." She has since been successful in recovery and in her career.

The addict's "quick fix" mentality is another factor in causing relapses for those who leave the program prematurely. If you have been addictive, compulsive, or obsessive you are probably familiar with this tendency to look for a quick or easy answer.

The twelve-step programs and most of the other recovery groups combat the relapses caused by denial and the quick fix mentality by reminding you that quitting destructive behavior alone is not enough and telling you that you will never get beyond recovery. That's why the twelve-step programs urge you not to refer to yourself as "recovered" but "in recovery." In order to tell your story at meetings, you must first say, "I am a recovering alcoholic (addict, overeater, and so on)...." As an AA pamphlet states: "...alcoholism does not go away... recovery is forever..."

In recent years, sponsors, researchers, and alcoholism counselors within the program are recognizing that there are different stages of recovery. People who have been in recovery for enough time to work a program, gain experience in sobriety, and mastered all the steps eventually are said to attain "second and third stage" recovery. I agree with these stages, and maintain that growth can continue even beyond them.

Recovery only lasts forever when nothing is done to combat addiction's underlying causes - when the emotional problems and dependent attitudes that precipitated the addictive behavior still exist.

One sign of this failure to address the patterns that created the addiction is a condition Alcoholics Anonymous calls a dry drunk. This occurs when someone has stopped drinking, but still exhibits "absence of favorable change in ...attitudes and behavior... or the reversion to these attitudes and behavior by the alcoholic who has experienced a period of successful sobriety." A dry drunk is someone who is not recovering from the addictive process and the unhealthy attitudes that created it.

As Dr. R. J. Solberg, alcoholism expert, puts it in the A.A. publication The Dry Drunk Syndrome, "The alcoholic, when drinking, has learned to rely on a deeply inadequate, radically immature approach to solving life's problems. And this is exactly what one sees in the dry drunk." Dr. Solberg describes the "obvious traits" of a "full-blown dry drunk":

Grandiosity -unrealistic expectations of your own abilities,
Judgmentalism - being highly critical of others,
Intolerance - not accepting others' individual mistakes or differences,
Impulsivity - acting without thinking,
Indecisiveness - inability to make up your mind,
Dishonesty - lying, cheating, making false promises,
Controlling - pressuring others into doing what you want, and
Self-centeredness - unable to consider others' feelings and needs.

According to Anne Wilson Schaef, the "dry drunk syndrome" means you can be in recovery and still be addicted: "Individuals who are not chemically dependent and yet function in the addictive process are on a dry drunk." Recovery literature implicitly recognizes the connection between relapse and failure to address the causes of addictive behavior. Dr. Solberg writes that the condition is dangerous because "...every relapse is preceded by a dry drunk which was allowed to go untreated."

The remaining reason that sponsors and members of twelve-step programs believe that recovery is forever is that those who created and maintained the program did so as a result of their own involvement with compulsion and obsession. In short, their conviction that recovery is forever may be a symptom of the very lack of self-trust and self-confidence that led to their own difficulties in recovering from addiction. Having spent years unsuccessfully struggling, unable to manage their own addiction without the constant support of a group, they become convinced that no one can. In fact, their very expertise in the field may be a resolution of a dilemma: How do you continue to grow and challenge yourself and still remain in recovery? The answer is: Become more and more expert about addiction.

However, the constant admonition to "keep coming back" can also mean that a member who has recovered sufficiently to venture out independently from the group will feel guilty for leaving. Members whose developing self-esteem is undermined by the resulting guilt feelings tend to react in one of two ways: Either they abandon their fledgling impulses toward autonomy and further growth and return to an even more complete dependency on the group; or they escape back into their old addictive behavior.

Because twelve-step programs often feel like "family," they can have a powerful influence. To the degree that you allow them to undercut your autonomy, and keep you dependent, they can replicate your original, dysfunctional family.

Susan

Susan, a thirty-two - year- old recovering from codependency, faithfully worked her program for two years, and began to feel stronger. She sought the encouragement of friends outside the program, and began to realize her dream: to open her own flower shop. Things went very well, at first, because Susan had a flair for floral design, and was personable with customers.

Then, the shop began to get very busy. Susan felt stressed. She was attending three meetings a week, and working constantly at her shop. After being exhausted and stressed for several months, she decided to drop her meetings. This gave her the extra time she needed for herself, but it had consequences: she felt guilty and afraid of relapse, and her friends from meeting began telling her she needed her meetings, and she was making a big mistake. Soon, they stopped calling her. Susan ignored her fear and stress for a while, but without emotional support, her enthusiasm for her business began to falter. She began overeating and bingeing, she became panicky and disorganized, and she eventually gave up her store lease and moved the faltering floral business into her home. She was in despair, and ready to give up, go back to being a secretary (which she hated), and attend all her old meetings. Susan says: "I was a mess - worse than before I joined CoDA. I even talked to a Doctor and tried prescription drugs, but they just made me drowsy. The anxiety was still there. I began to feel suicidal."

A concerned friend, seeing that Susan was overloaded with guilt and self-doubt, suggested therapy. In counseling, Susan got the help she needed to examine her decisions of the past year. Soon she was able to see that her problems had merely been the normal things that happen with a new business, and her relapse occurred because she let her guilt and fears override her thinking ability. We worked to resolve her fear of failure, which originally came from a family belief that she was the "pretty one" and "not too bright"; but was exaggerated by her twelve-step friends' insistence that she would fail if she left the group. She got in control of her eating again, made friends among other people in the floral business, and reevaluated what she wanted to do with floral design. This time, she designed her business to meet her needs and desires, kept it smaller, to be less overwhelming, and took some courses in business, and ignored what friends thought she should do. Susan is now enjoying a small, exclusive and thriving business, and she has time for a social life, recreation, friends and romance. She says, " Without advice or help from anyone who knew floral business skills, I got frightened and confused, and stopped doing what I already knew how to do to keep myself healthy. I know now that it's my responsibility - not the program's, to keep me doing what I know is right, and to learn what I need to know."

Feeling stuck in the Twelve Steps is like being admitted into school to learn a skill, and never told how to graduate, no matter how competent you become. In this (twelve- step) school, a student may turn around and become a teacher (a sponsor), but there are no instructions for graduating honorably and finally.

This lack of encouragement begins to undermine the self-esteem so painstakingly won through the program. Although many people have successfully withdrawn from the program, they generally feel guilty and insecure about their ability to succeed on their own for years after leaving. This guilt and insecurity, coupled with a lack of information about achieving autonomy, can be a cause for relapse, which provides an excuse to return to the safety of the group. The less adventurous never leave at all. To encourage health and growth, twelve-step programs need a provision for graduation and moving on. They need a Thirteenth Step.

Ready for the Thirteenth Step

Recovery is not a quick and easy process, but although the skepticism caused by relapses is understandable, you do not have to be in recovery forever. The experience of many people who have achieved autonomy beyond the twelve step programs proves that it is possible for a dysfunctional or "radically immature" person to mature, to become functional, and to develop a permanent and enduring ability to remain free from dependency and addiction.

You may already feel that you are ready for graduation and to take the Thirteenth Step to personal autonomy. Or, if you still believe that recovery is forever, you may be ready to take the step and not be aware of it - you may have dismissed the restless signs as denial, or further evidence of your own emotional problems. How do you tell if your feeling of restlessness and of having gotten all you can out of the group is simply denial or if it is a legitimate indication that you are ready to move on to healing and autonomy? The following quiz is designed to help you decide if you have completed the work of recovery and are ready for the Real Thirteenth Step. Answer the questions yes or no:

Quiz: Are You Truly Ready to Complete Recovery?

1. Have you identified and admitted your obsessive, compulsive or addictive behavior?

2. Have you maintained abstinence or sobriety for six months to one year without relapse?

3. Have you completed each of the Twelve Steps at least once, or completed the steps of another recovery program?

4. Have you been following your program faithfully for at least this time period?

5. Do you have a sponsor, buddy, therapist or other knowledgeable person with whom you discuss your problems in recovery?

6. Do you devote some time each day to meditation, prayer, or solitary contemplation?

7. Have you become aware of the difference between your conscious personality and the Higher Power within?

8. Have you learned to recognize and handle successfully the triggers and mechanisms that set off your compulsive/addictive behavior?

9. Have you shared your story repeatedly with others, and listened to theirs?

10. Are you able to rely on others for support and ask for help when you need it?

11. Have you had a successful relationship with a sponsor, buddy or other support person for a significant time?

12. If you are from a severely dysfunctional family, or a survivor of abuse or incest; have you had sufficient therapy, individually, and/or in group, to heal the damaging legacy of your childhood?

13. Have you severed or limited all relationships with people who supported your addictions and compulsions; unless they are also fully in recovery?

14. Can you say "no" when tempted or pressured?

15. Do you know the difference between instant and deferred gratification, and can you choose intelligently between them?

16. Can you act on thoughtful decisions instead of impulsively react to events and circumstances?

17. Do you have a clear sense of who you are, and what your goals are?

If you can answer yes to most of these seventeen questions, you are probably ready to take the Thirteenth Step.

If most of your answers were no, you need to do further work within a recovery group to overcome the worst of your dependency and addiction while you learn the additional skills you need to complete recovery.

Either way, you'll find that the exercises, guidelines, case histories information in this book will help you understand the underlying causes of your addictive behavior, and help you develop the emotional maturity and psychological tools necessary for autonomy.

Surrendering the Dream of Dependency

What is completing recovery? Of course it begins with entering recovery in the first place, but eventually moves beyond it. "My Wednesday night meeting has so many new people... I need to hear more recovery." said Ava, thirty- five, describing her changing attitudes after a few years in CoDA, "It's good for me to go to that meeting and share my recovery, that's my Twelfth Step; but I'm also joining another meeting where I can hear less of 'I'm having this terrible problem, and it's awful.' and more of 'I'm having a problem, and here's what I'm doing about it.'" Ava's description pinpoints the essence of recovery - moving from absorption with the problem to focus on the solution. In order to move beyond recovery toward a healthy and independent life, you must have laid that groundwork; but there are still hurdles to overcome. "As the price of liberty is vigilance - so the price of independence is self-determination, the price of dignity is self-assertion, and the price of respect is self-respect," wrote psychiatrist Dr. Thomas Szasz.

Self-determination and self-respect are the necessary keys most dependent people need to be able to take full responsibility for and control over their own lives. Without these keys, dependent people are like Teddy, a well-educated and talented man who, when he began to be aware of his internal attitudes, said in frustration, "I'm 36, and I still live my life as though someone else is in charge of it." Why does Teddy feel this way? Because he believes others can take care of him and advise and protect him from harm better than he could himself. To feel wholly in charge of himself and his life Teddy must give up the dream that there is someone else who can make it better, who can take total care of him, who can be responsible for him more effectively than he can himself.

My clients in recovery all exhibit this lack of belief in themselves - it is what I call the Dream of Dependency. This dream is seductive, because it encourages a fantasy view of life without responsibility or consequences.

Clients have this dream for three reasons: 1) when they were little their parents led them to believe that someone would take care of them and make it better; 2) dysfunctional parents failed to teach them the skills necessary to take care of themselves and consequently, 3) they never learned to feel capable of being responsible for themselves.

Why Autonomy Is Not Learned in Childhood

Taking care of and being responsible for yourself requires skills that are usually learned in early childhood. However, in a dysfunctional family you don't always get the healthy positive examples you need to learn these skills. Christina Crawford, eloquently describes this condition in Survivor:

Maybe I never knew who I was. Maybe I never had time to spend knowing who I was. My life as a child was spent concentrating on saving myself from a crazy person. But when, as an adult, you can't get your needs met because as a child no one was there to validate and love you and you never developed interpersonal life skills, that is how you live.

This is not unusual, or entirely the fault of your parents. If you were gradually taught and encouraged to be self-reliant from early childhood, you would learn the necessary skills and attitudes for autonomous living one step at a time. Unfortunately, many parents were not trained in autonomy either, and could not teach their children. Dr. Charles Whitfield, author of Healing The Child Within, notes this fact:

Rarely does anyone find a mother, other parent figure or close friend who is even capable of providing or of helping us to meet all our needs... Many mothers or other parent figures are mentally and emotionally impoverished. A likely reason is that their needs were not met as infants, children and/or adults."

The pressure of growing up dependent upon adults who are themselves dependent distorts the child's development, writes Timmon Cermak, in A Time To Heal:

Children of alcoholics are forced to crystallize their identities under circumstances that are far from optimal. Their environment lacks a core feeling of safety. Communication is distorted by denial, leading to the deafening silence of secrets. Self-care is misinterpreted as selfishness. Roles become rigid so that the family can protect itself from change. A sense of continuity does not exist. Neither is there any significant privacy. In the midst of this unhealthy environment, CoAs must pass through the critical stages of developing trust, autonomy, mastery, identity and the ability to separate themselves from those around them.

Even the popular idea of parents' responsibility for children can be counterproductive. Because parents think in terms of controlling their offspring rather than teaching them to make choices on their own, most children are taught dependency, not autonomy. The result of this emphasis on dependency, writes Editor Connie Zweig in To Be A Woman, is far- reaching:

Psychologically, deep within, many of us do not...develop fully balanced egos or a sense of real individuality in our society; we remain dysfunctional in some essential ways. We continue to carry mother and father within us, not only following in their footsteps but often actually walking in their shoes. We re-create our parents' patterns, becoming second-generation alcoholics, abusive parents, or compulsive high achievers. Or we rebel against them, believing ourselves to have broken the patterns, but actually remaining unconsciously trapped within them.

Another reason autonomy can seem difficult is because most of our society actively discourages it. Media images of love and caring, a parental "I know what's best for you" attitude among helping professionals, religious and political leaders, and the generally accepted idea of parents' duty create an atmosphere in which autonomy appears to be selfish and alien. Children are taught to value caring for self as self-centered and egotistic. Alice Miller, the famed psychoanalyst who writes about harmful attitudes of parenting, says parents often operate on false beliefs:

A high degree of self-esteem is harmful in children. Such parents punish, denigrate and belittle their children, producing "good little boys and girls" who learn to look outside for approval. This is the "spare the rod and spoil the child" attitude.

A low degree of self-esteem makes a person altruistic. Such parents often express their belief as: "It is better to give than to receive," with the added idea that you don't deserve to receive anyway.

A feeling of duty produces love. Such parents do not believe that their children will love them if allowed to choose autonomously. It is child-management by guilt: "If you love me, you'll..." or shame: "You're a bad little girl/boy if you don't...".

Such societal and parental attitudes prevent children from learning self-esteem and the pleasure of self-love. As we shall see in the next chapter, children who don't learn self-esteem grow into dependent adults. Children who don't learn self-love and self-control (rather than learning guilt and duty) become addictive adults. Those children who are taught self-esteem and autonomy and therefore take care of themselves are viewed with disbelief ("She can't be that good") suspicion ("Yes, but if we only knew...") and envy ("Some people have all the luck") by other parents.

Recovery programs are challenging the social attitudes of addictive and dependent adults by defining caring for others without regard for self as codependency and enabling. Books such as CoDependent No More by Melody Beattie and When Society Becomes an Addict by Anne Wilson Schaef have popularized a concept long established in psychology theory: that it is unhealthy to be too dependent on another. However, although all these have indicated that dependency is unhealthy, they haven't yet learned to value autonomy.

Components of Autonomy

Autonomy begins when you understand that no one can take care of you better than yourself, that only you are responsible for your life - and when you start to learn effective methods for doing these things yourself. Autonomy is composed of many things:

Self-reliance - this is the dictionary definition of autonomy; making your own rules and living by them; also called self-governing.

Self-determination - deciding your own future through planning and careful action.

Higher purpose - a desire to create and accomplish, for a purpose beyond outer rewards, for the satisfaction of accomplishment.

Self-motivation - the ability to generate your own enthusiasm, and find your own reasons to reach your goals.

Self-confidence - the security that comes from having a sense of purpose, and the confidence to accomplish your purpose.

Self-esteem - appreciation of your talents and abilities, the recognition that you are a healthy, capable and loveable person.

Self-love - learning to care for yourself the way you care for your friends.

Benefits of Autonomy

When you achieve autonomy, you gain three important benefits:

First, you acquire the emotional strength necessary to free yourself from dependency. Dependent people, when faced with a problem, wait helplessly (or demand hysterically) for someone else to solve it. To be responsible is to be able to make effective decisions and choices for yourself, to weigh alternatives, and to evaluate ethical dilemmas and solve problems. Instead of blaming someone else or escaping through denial or addictive behavior when a problem arises, the autonomous person follows five steps.

a) She faces it squarely,
b) learns as much as possible about it,
c) considers many options,
d) weighs the possible outcome of each option, and
e) often seeks advice and counsel before reaching a decision.

As an autonomous person you can ask directly for help, but you remain in charge of how much and what kind of help you accept, and you can make clear agreements about what is expected in return.

The second benefit of autonomy is a healthy role model that forms a basis on which you choose appropriate friends and a suitable mate. When you learn to interact in a healthy way with yourself you create a new pattern of interaction which replaces your early dysfunctional habits and improves all your relationships. For example, if you criticize yourself frequently, you're more likely to stay around others who are critical, because it feels familiar. And conversely, if you are kind to yourself, you'll be more comfortable around others who are kind.

In addition, achieving autonomy helps you recognize it in others. When you are caring and responsible toward yourself, you learn those skills from your own intimate experience, which you can then use as in your friendships and intimate relationships with others. The more experienced you are at identifying healthy friendships, the more your circle of good friends grows - beginning with your relationship with yourself, expanding to a few new friends, and eventually growing into a supportive "family of choice" who reinforce your autonomy and independence.

The third benefit of autonomy is responsibility - knowing that you must learn whatever it takes to make your life successful, functional, and happy. Dependency is based on the belief that you need someone else to fix the problems of your life. When you learn to be self-sufficient, you gain control over your own well-being and happiness. This becomes an enormous source of self-esteem.

These benefits of autonomy - emotional strength, an internal role model and responsibility actually enhance relationships with others, and allow giving and receiving to be truly unconditional. Only a person who is fully able to care for him- or herself can be free to love and give freely; deprived people give grudgingly. The chart on the next page will help you compare what autonomy is and isn't:

Autonomy is

Knowing yourself.

Liking yourself.

Being committed to take care of yourself - no matter what.

Being able to enjoy your own company.

Making your own decisions and carrying them out.

Doing what's important and good for you even when others don't like it.

Enjoying others, but not making them more important than yourself.

Making thoughtful decisions.

Thinking clearly in a crisis.

Being a competent adult who can play and be childlike, but always think like a grown-up; loving wholeheartedly, but still thinking clearly about yourself, your lover and your relationship.

Autonomy Is Not

Narcissism.

Being selfish.

Dependence or neediness.

Loneliness, hiding out, rudeness, rejecting behavior.

Procrastination, helplessness.

Co-dependency, pleasing others at great cost to your well-being or self-esteem.

Sacrificing and martyrdom, rescuing (helping those who haven't asked for it).

Avoidance.

Hysterical panic.

Childishness, reacting, acting out, grimness, joylessness, limerance, self-destructive love, loving those who are unavailable.

Developing Autonomy

As children, our natural curiosity is powerful. Young children are intensely focused on learning through their five senses. Research shows that children are "turned on" by situations in which they can learn. Their bodies produce hormones such as adrenaline and endorphins - natural substances that produce a "natural high" - the body's own, internal motivation and reward system for learning.

When faced with a new experience young children are highly motivated to explore and learn, as long as they feel safe and unthreatened. Secure toddlers are irresistibly drawn to bright colors, new sounds, and new experiences - they find your jingling car keys fascinating. To a child who has supportive, loving, functional parents, the world is a fun, safe place to be, and learning is exciting and exhilarating. Children who feel secure are compelled by their joy in learning to venture forth, to begin to take small risks, and begin to act independently of their parents. By taking such small risks, under parental supervision and support at first and increasingly independently as the child grows older, he or she gradually learns the necessary skills of independence.

Autonomy grows out of these healthy learning experiences. Through taking risks as children, we learn how to solve problems and how to deal effectively with disappointment and failure. Mastering these skills produces confidence that we can rely on ourselves to experiment, to solve new problems we encounter, and to comfort our disappointment and correct our mistakes. When we know these things, we know we are capable of autonomy, and we become more successful in life.

A frightened, insecure child, in contrast, is dependent on the adults around him. He will be too unsure to take even a small risk, and he'll look to others to solve his problems and care for his feelings. Growing up insecure leaves you unaware of your motives, feelings, wants and attitudes toward yourself and thus out of control, unable to figure out how to satisfy yourself. It is indeed as though you don't own your life, as though someone else must be running it.

Autonomy vs. Dependency

To illustrate the difference between how a dependent person handles life and how an autonomous person approaches the same situations, here are several situations that are common for people who have dependency problems:

You find yourself letting your exercise routine go, because your new partner doesn't exercise. Dependency: You notice this, but you do nothing about it. Autonomy: You notice it, and go on to discuss the situation with your partner, explain how important your routine is to you, and discuss possible solutions until you find a mutually satisfactory plan.

Your raise is due, and you deserve it, but it hasn't been mentioned. Dependency: You're afraid to ask about it. Autonomy: You request an appointment with your supervisor, and calmly remind her of the due date.

You call a plumber to fix a stopped-up drain, and he wants to tear out the whole wall and replace all the pipes. Dependency: Even though you think he's wrong, and you'd like another opinion, you let him do it. Autonomy: You ask him for a clear explanation of why he wants to do the extra work. When you find out that boring the drain out would be a temporary solution, you ask him to do that, and give yourself time to get another estimate on the larger job. When you have two or three estimates, you make your decision.

You feel anxious, and you go to the doctor to see if your thyroid is overactive. Your physical says everything's OK, but the doctor prescribes a tranquilizer to calm you down. Dependency: You don't think it's good for you, but you take it because he said so. Autonomy: You tell her that you're unwilling to take tranquilizers or relaxants, and ask for alternatives. She recommends therapy, yoga or meditation. You ask your friends for recommendations and join a class in relaxation techniques.

Your friend, who has had a number of accidents, asks to borrow your car. Dependency: You worry about it, but you give him the car keys. Autonomy: You say, "I'm sorry. I'd like to help, but I can't loan you my car. Can I drive you somewhere?"

Your brother, who's always in debt, and never pays you back, asks for money. Dependency: You resent it, but you give it to him. Autonomy: You explain that you don't have extra to give away, and carrying the debt he owes you is beginning to hurt your relationship. You care too much about him to let it go any further.

Your wife always wants to spend Thanksgiving at her mother's. Dependency: Even though you miss holidays at your family, and they complain that they miss you, you give in to keep the peace at home. Autonomy: You tell her that you miss holidays at your family, and they complain that they miss you, so you want to talk about other options. Together, you discuss the problem, talk to your respective families, and decide that this year you'll go to your parents on Thanksgiving, and your wife's family on the Sunday after.

Your husband is much harsher with your children than you think is right. Dependency: You say nothing because you're afraid of him. Autonomy: You call a child psychologist to get an independent opinion, and when the psychologist says the behavior is abusive, you request that your husband go with you to family counseling. If he refuses, you go to counseling yourself to find out how to protect yourself and your children.

Your former roommate has too much to drink at your party. Dependency: You don't think she should drive home, but when she insists, you let her. Autonomy: You don't think she should drive home, so you call a taxi and keep her car keys. The next day, you call and make arrangements for her to get her car.

You hear that your friend spread a rumor about you. Dependency: You're hurt and confused, but you don't ask her about it; you just let the friendship deteriorate. Autonomy: You're hurt and confused, so you ask her to have lunch with you. At lunch, you tell her what you heard, ask her if it's true, and get an explanation that clears things up.

When you understand the difference between dependency and autonomy, and have acquired the skills you need, every situation of your life becomes easier to handle.

Graduating From Recovery

When you achieve a solid sense of autonomy, graduating from your recovery program feels like a natural next step. You begin to choose your friends independently of the group, keeping those friends from the program that enhance your life and making other friends outside the program. Gradually, you will want to do more activities that are not program-related. As your life becomes more fulfilling and active, you will need meetings less. You'll begin to revise and change your original program to a discipline and pattern that expresses your own uniqueness, and incorporates what you've learned about yourself. For example, your Twelfth Step may evolve into sharing your experience of autonomy with others, both in and out of recovery programs, rather than continuing to attend meetings and sponsor people.

Self-regulation and Setting Limits

Many people new to therapy and recovery ask: "Does taking the Real Thirteenth Step mean I can ever safely engage in my old addictive behaviors again without relapsing?" No client of mine who has worked a program and been sober for a while has ever asked this question. Their attitude is: "I feel so great without it, why should I hurt myself?" Or, as Richard O. said earlier, "I don't want, desire nor have a yen for booze."

Mary L. seconds this idea: "The last thing I would want to do is go back to my old, dependent relationships - I'm finally free, and I don't need my old behavior any more."

Susan, when asked if she misses her old overeating behavior, says: "The food I eat now is right for me. It's healthy, delicious and satisfying. I don't feel deprived at all - why would I want to mess this up?"

There are many addictive substances: cocaine, cigarettes, alcohol, fat, sugar, salt, caffeine, marijuana, some over-the-counter, prescription and all street drugs. In small doses, some of the above are not a serious health problem. If you can limit your intake to small doses, it might be safe for you. But, (unless your doctor prescribes something) you don't need them; so why ingest what's not good for you? Some people choose to have small amounts - they have only one cigarette a month, or one glass of wine a week, or only drink decaf coffee. Small amounts of fat, salt and sugar can be part of a healthy, balanced diet.

Dr. Andrew Weil, professor of addiction studies at the University of Arizona, in a lecture on our confusion about drugs, gave an excellent overview of the autonomous person's attitude toward substances with a potential for abuse:

Drugs, sex and food are the areas most concerned with pleasure and the areas of human experience that I see emotion most strongly affect... Think of the psychological effects... Does it make you calm and centered? Does it make you jangled? Does it make you sexually aroused? Do you feel like going out and beating someone up? Pay attention to those kinds of things...try to be aware of how they affect you and make some conscious choices about what happens to you. Make conscious choices about how and with what you nourish yourself.

Like many other aspects of taking care of yourself, setting limits with substances can be difficult. Achieving autonomy means knowing your sensitivity and capacity, being realistic about it, and acting accordingly. When you understand how to handle the inner dynamics that underlie your struggle, you will acquire the self-confidence and self-reliance you need to cope with and overcome the temptation of a relapse without the need to go to a meeting or call a sponsor every time the issue comes up. Learning to set your own limits is part of completing the Real Thirteenth Step.

Denton Roberts, a minister and psychotherapist, describes autonomy in his book Able and Equal:

Autonomy is the knowledge that we are the owners of our lives. We are not owned by parents, bosses, government, church, neighbors, spouses, children or cars....We are not, sometimes much to our dismay, victims of people and institutions. No longer being a victim means we determine our lives and what to do with them. Our ability to respond to life is both and asset and a challenge. Without the indulgent feeling of being victimized by the world or circumstances, we take possession of life.

After completing the exercises and processes in this book, you will have enough experience in what autonomy feels like to build upon what you know, and, with practice, take full and complete responsibility for your life. You will also begin to be aware of how well the people around you have developed their own autonomy, and how to choose appropriate partners for friendship and intimate relationships. You will have a sense of your value to yourself, your worth within the society, and your power as a healthy individual. As Roberts writes, "When we possess a healthy sense of our autonomy we are no longer willing to define ourselves by what we are against; instead we define and direct ourselves by what we are for."

Personal power that comes from taking care of yourself feels so good, that it becomes quite easy to develop the motivation you need to maintain it. Any lack of personal power quickly becomes obvious. It is similar to the experience of serenity you found while working your recovery program. Once you feel serenity, a sense of inner peace, you can tell when it's missing. Once you feel the joy and power of taking full responsibility for yourself, and the satisfaction of a life you have carefully chosen for yourself, your motivation to maintain the feeling will be high.

Internal Resistance

But getting to that feeling of motivation requires overcoming resistance. As you take steps toward autonomy you will encounter internal emotional resistance, which will cause you to feel embarrassed, discouraged, anxious, helpless, and often hopeless. There are three main reasons for this resistance:

The fear of pain of emotion: Because dysfunctional family experience creates emotional pain and hopelessness where self-confidence and self-esteem should be, this pain must be faced and cleared in order to move on to autonomy. Because you were overwhelmed and underequipped to deal with this pain as a child, you will tend to feel inadequate to handle it as an adult. Therefore, you will resist bringing it into your awareness.

The fear you can't learn, will fail, aren't worthy: Toxic families prevent the development of healthy risk-taking, problem-solving and self-confidence - all of which are essential to learning. The fear that you can't learn, and the belief that learning is painful or impossible, interferes with your thinking. This fear will come up when you begin to learn the new tools and techniques necessary to attain autonomy.

The belief that you can't succeed: This type resistance causes you to feel discouraged, hopeless and helpless: "What's the use, it won't work anyway." It is another mechanism to avoid the expected pain of risk-taking and learning, and is based on the false belief that learning is too hard for you.

Overcoming Resistance

Internal resistance can be overcome by replacing the old, toxic experiences with new supportive and encouraging attitudes. By correcting the hopeless, helpless and mindless attitudes you developed while growing up and learning new skills, you can attain the self-confidence you need to overcome your reluctance. There are three skills that correct and remove resistance:

1. Awareness: By learning to pay attention to your thinking, you can become aware of your resistance and other destructive thoughts or behaviors when they occur, so that you can begin to correct the old, frightening, false thinking with new, reassuring information.

2. Learning: Through exercises and information, you can create a new internal environment in which you support yourself in the three skills necessary for learning: risk-taking, problem-solving and self-confidence. Once you develop these skills, learning will no longer be frightening, and your resistance will fade.

3. Forgiveness: If you never have experienced forgiveness, you never learned to forgive yourself. Not forgiving yourself creates and perpetuates your toxic shame. Learning what healthy forgiveness is, how it is different from just accepting destructive behavior, and how to create it, removes the last of your resistance to autonomous thought and living.

Together, these three skills give you the confidence you need to face the self - the internal toxic shame and pain resulting from your childhood. By doing this, you will find your true self - the innocent, enthusiastic, loving, healthy and autonomous person you really are, when the underlying causes of your dependency and addiction are resolved.

This book is divided into three sections: In the first, you will learn about recovery: what it is, its benefits and problems, and why it is beneficial to move beyond it.

• In Chapter Two, "Addicted to Recovery" we will explore what recovery is, how to know if you have achieved it, why it is a replacement addiction, and how you can progress beyond recovery to full autonomy.

In the second section of the book, you will learn how to complete your recovery.

• In Chapter Three "Beyond Recovery: From Dependency to Autonomy", you will learn how the roots of both addiction and autonomy develop, and begin the process of moving beyond recovery.

• In Chapter Four, "Deep Recovery: Learning How to Change", you'll learn the basic tools you need to change your deep-rooted subconscious beliefs.

• In Chapter Five, "Completing Recovery: Facing the Self", you'll learn specific techniques for completing your recovery and moving on to autonomous living.

In Section Three, you'll explore Developing Autonomy. Building upon your twelve-step experience and your completion of recovery, you'll move to autonomous living.

• In Chapter Six, "Autonomous Thinking: Learning About Choice" you'll find exercises designed to help you learn what autonomous thinking is, and how to develop it.

• In Chapter Seven, "Autonomous Loving: Choosing Healthy Relationships" you'll learn why dependency destroys relationships, and what autonomous, healthy relationships look like. Here, you'll find guidelines for recognizing and maintaining autonomous friendship and intimacy, and exercises to help you create the proper balance between intimacy and independence.

• In Chapter Eight, "Autonomous Living: The Promise and The Challenge", you'll explore the adventure of fully autonomous living. You'll experiment with discovering your Job on Earth, and learn how to live according to Inner Wisdom, without losing your perspective.

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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.

More by Tina B. Tessina, Ph.D.
  In this book
» Preface
» Autonomy, Part 1
» Autonomy, Part 2
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