Michael*, a 52-year-old man who has recently reconciled with his wife, walks in his front door shortly after 9:00pm on a Monday evening. His wife is sitting on the sofa watching Law & Order on Netflix. She looks over at him suspiciously, “Did you work late today?” “No,” he says,” I went to a meeting.” “You go to your meetings on Tuesdays and Thursdays…” she says with a “gotcha” tone.  Michael, fighting becoming exasperated, looks her in the eye and says, “I’m going to have to work late tomorrow and I’ll end up missing that meeting, so I went today to keep up my routine of two meetings a week.”  Michael’s wife still looks discontented. Looking away, she says, “Fine.” Then she mutters, “Are you going to go to two of those meetings a week for the rest of your life? And, aren’t you still doing therapy too? I thought we’d eventually get our life back.”

Michael is an alcoholic and has been attending AA meetings for about nine months now, and has been in therapy for just as long. Why does he do both? How long will this go on?  First, AA or Alcoholics Anonymous is a self help group, and it’s not the only self help group out there for individuals struggling with an addiction. Let’s start by looking at what self help groups are and then we can look at what role therapy plays in a person’s recovery.

Here, in the Wilmington, NC area, we have a few different self-help/self-empowerment groups for those seeking self help for addiction. I’m going to talk about AA (Alcoholics Anonymous), NA (Narcotics Anonymous), CR (Celebrate Recovery), and SMART Recovery (Self Management And Recovery Training).  Most people have at least heard of AA and NA. These two groups are aimed at helping people in similar ways. The major difference is that AA is specifically geared toward alcoholics and NA is open to a variety of chemical dependency addictions. These two groups provide a support network and guidance for individuals who have a desire to live a clean and sober lifestyle. Individuals are encouraged to get a sponsor, someone who has experience in recovery and the AA/NA “program,” otherwise known as the 12-step program.  A sponsor guides the addict through working the steps and provides support for recovery and a lifestyle free of addictive behaviors. This program asks members to acknowledge a “higher power” to whom they will give over their will and in whom they trust to help them with their addiction. Although this program originally began based on biblical principles and Christianity, currently the wording is changed to include all forms of belief in a power greater than yourself.

Celebrate Recovery, on the other hand, is strictly a Christian self help group. This group covers all addictions, habits, and hang-ups that a person wants to change and can include everything from alcohol to sex, co-dependency and gambling. This program is similar to AA/NA in many other ways including a 12-step program and sponsorship.

SMART Recovery is not based in any form of spiritual belief system. It is specifically based on scientific research and the principles of cognitive-behavioral therapy. They teach the “4-Points” which include working on motivation, learning how to deal with urges, managing thoughts, feelings and behaviors, and living a balanced life. In SMART Recovery, there are usually fewer meetings offered in a community, and there is not as broad of a community of support as tends to be available through AA/NA and CR. Which one should you choose? Anecdotally, I know of success stories from individuals who have used each of these programs. I’m a firm believer in doing what works for you!

Why should a person do therapy and engage in self help? Self-help groups offer a level of support that is just not available through meeting with a therapist. However, a trained professional is able to identify and treat problematic behaviors and mental health issues. This is not something that self help groups are truly able to do. For example, individuals who have survived a trauma are especially vulnerable in a way that is best addressed by someone who is trained to do so. I have seen many trauma survivors relapse because someone well meaning addressed the individual’s trauma in a way that triggered nightmares or flashbacks that the trauma survivor was not skilled enough to handle yet. Issues related to mental health and trauma frequently rise to the surface once the addiction isn’t masking them. This is why many of the individuals who are successful at managing an addiction often attend therapy in addition to participating in self-help groups. It allows an individual to benefit from the strengths of both methods and increase the likelihood of success in reaching recovery goals.

Michael, mentioned in the outset, is a trauma survivor. He attends AA meetings to address his addiction, develop a new lifestyle, and gain support from those who understand his journey. He participates in therapy for all of those reasons and also to address his trauma and develop the skills he needs to deal with trauma symptoms without drinking. He will attend some kind of 12-step meeting for the rest of his life as part of his program of recovery. When his sponsor agrees that he is ready, he will sponsor those who need help and request his guidance. He will provide support for other members of AA and for “new comers” for years to come. Michael attended 90 meetings in the first 90 days of his sobriety, as suggested by his sponsor, and has now reduced down to twice per week. His personal goal is to always attend at least one meeting per week. However, if he finds himself struggling for whatever reason, he will attend as many meetings as he can, and he will call members of his support system for help. As far as therapy goes, when he started nine months ago, he attended intensive outpatient therapy for the first 90 days of his sobriety. This means that he attended nine hours of group therapy and one session of individual therapy per week. Upon completion of intensive outpatient therapy, he began attending two individual therapy sessions per week and is still doing so six months later. As he accomplishes therapy goals related to addiction and trauma, he will reduce down to attending one session per week, then one session every other week, then once per month, and then at some point, he will no longer need to participate in therapy. In the mean time, he also faces the challenge of helping his loved ones understand what he needs to do to be a healthy person. He will probably discuss this with his therapist and his sponsor before addressing the issue with family members who are struggling to understand how he spends his time and what it takes for him to stay in recovery. With support and the application of what he learns through AA and therapy, he has a good chance of succeeding!

*Michael is a fictional character used to demonstrate the real experience that individuals under these circumstances tend to face.

Lillian Hood, LPA, LCAS
Psychologist and Clinical Addictions Specialist
At the Chrysalis Center, I specialize in treating individuals with co-occurring disorders. This includes working with individuals who have trauma, depression, bipolar, anxiety, and/or eating disorders along with an addiction. I use evidence-based practices to help patients develop skills for successfully facing this unique challenge.

References:

Alcoholics Anonymous  www.aa.org

Celebrate Recovery       www.cr-inside.com

Narcotics Anonymous   www.na.org

SMART Recovery  http://www.smartrecovery.org