Geoff Thompson, MA, CCC

Geoff Thompson, Program Director for Sunshine Coast Health Centre, talks about finding happiness through asking life what it demands of you, rather than demanding that life treat you a in a certain way.

Geoff Thompson, MA, CCC

Geoff Thompson, Program Director for Sunshine Coast Health Centre, discusses taking a step back to reflect on where you are at in life and being aware of self-determination.

Geoff Thompson, MA, CCC

Geoff Thompson, Program Director for Sunshine Coast Health Centre, shares the 6-step progression to “finding your unique purpose” according to Dr. Edmund Bourne.

Geoff Thompson, MA, CCC

Geoff Thompson, Program Director for Sunshine Coast Health Centre, talks about the importance of finding a sense of belonging in the world as you strive for personal happiness.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services for Sunshine Coast Health Centre, discusses ways to be open and honest with your loved one when they are in early addiction recovery and seem more connected to others than to you.

Bill Wilson, the legendary co-founder of Alcoholics Anonymous, would find the program at Sunshine Coast Health Center (”Sunshine Coast”) very much to his liking. Sunshine Coast interprets addiction and recovery in the same spirit as Wilson did, the difference being that Sunshine Coast’s program is based on scientific research.

Key points

Influences on Bill Wilson

In 1961, two decades after the birth of AA, Bill Wilson wrote a thank-you letter to Carl Jung for his influence on AA. In the letter, Wilson mentioned the other three influences on the development of AA: William James, William Silkworth, and Samuel Shoemaker (from the Oxford Group).

We know from Bill Wilson’s psychoanalyst, Harry Tiebout, that Wilson read Jung’s work. And we know from the letter that Jung sent to Wilson that the Swiss doctor confirmed Wilson’s interpretation of addiction and recovery, arguing that alcoholism was a spiritual condition that demanded a spiritual solution. In his letter to Wilson, Jung wrote that the alcoholic’s “craving for alcohol was equivalent on a low level of the spiritual thirst for our being for wholeness, expressed in Mediaeval language: the union with God.” He went on to tell Wilson that “You see, alcohol in Latin is “spiritus” and you use the same word for the highest religious experience as well as the most depraving poison. The helpful formula therefore is: spiritus contra spiritum.”

Jung argued if someone suffered from an “unrecognized spiritual need,” then alcoholism was one response. Only spirituality (some conversion experience) was powerful enough to overcome the spirits provided by alcohol.

Bill Wilson learned about William James when a friend gave him a copy of The Varieties of Religious Experience while Wilson was detoxifying in Towns Hospital. In the book, James wrote that getting high on alcohol or nitrous oxide was a mystical experience, one form of religious experience.

William Silkworth had been Wilson’s personal physician. Silkworth had attempted to provide a biological basis for the common observation that alcoholics reacted qualitatively differently to alcohol than non-alcoholics, though Wilson did not share Silkworth’s specific interpretation that the alcoholics had an “allergy.” But what helped Wilson was knowing that there must be a biological basis to alcoholism, that it was not a matter of character weakness or sin.

Strangely, the ‘disease’ concept became linked to AA in the popular mind, though it was never really a fundamental part of AA. Wilson had never taken a medical course and knew nothing of Koch’s postulates that inform our current pathology models. He used the term as a metaphor and emphasized that “Alcoholism is a disease that only a spiritual experience can conquer.” If we take Wilson’s “disease” literally, it is the strangest ‘disease’ in the history of pathology, since no medicine can help the sufferer. That AA became linked to the disease model was likely the result of the public health professionals awarding prizes to AA, promoting the idea that AA’s influence was to interpret addiction as a “disease.” This interpretation was clearly antithetical to Wilson’s idea, which promoted addiction as a “spiritual” condition.

Samuel Shoemaker ran the local Oxford Groups that had helped Wilson and others in their early recovery and provided a rough version of the 12-step strategy: admit there is a problem, confess character defects, make amends for harm, and help others. Despite this early influence and Wilson’s recognition of it, he pulled the early AA out of the Oxford Group in less than a year because he believed that their views were too rigid.

SCHC and Wilson’s Interpretation of Addiction and Recovery

Sunshine Coast is very much in line with the 12-step interpretation of addiction and recovery, the difference is that we base our interpretation on research evidence and psychological theory.

Viktor Frankl had said that “Alcoholism is not understandable unless we recognize the existential vacuum underlying it.” Frankl believed that human beings had an inherent need to make sense of their lives at a deep level. When this need was persistently frustrated, then alcoholism could be one result. Research has confirmed that quality of recovery improves with an increase in personal meaning. Andersen & Berg (2001) conducted longitudinal studies and concluded that meaningful living was linked directly with abstinence, a conclusion that William White (2004) also found. Frankl’s therapy, known as logotherapy, has produced several treatments for addiction (Crumbaugh, 1980; Langle, 2005; Somov, 2007). Paul Wong, who developed the form of therapy that we use at Sunshine Coast, also has applied a form of Frankl’s work to help addicts recovery (2005).

Based on the influences of James, Jung, and Shoemaker, Wilson always maintained that alcoholism was a response to living the personally meaningless life. In 1943, at the Shrine Auditorium in LA, he described the alcoholic as the fellow “who was trying to get his religion out of a bottle, when what he really wanted was unity within himself, unity with God.” According to Wilson, the pursuit of drunkenness was the pursuit of a connection with oneself and a connection with some force that would provide him with a belief that he was ‘part of’, that he belonged in the world around him.

And the addict was disconnected even from himself. The “defects of character” and “wrongs” were symptomatic of alcoholism and maintained the alcoholic’s disconnection from the world: jealousy, anger, grandiosity, impatience, and so on. The Big Book uses the example of jealousy to show that what the jealous person really wants is to love and be loved; jealousy was merely the alcoholic’s tactic to protect himself from losing his lover. So, the alcoholic’s defects were those that prevented his being authentically true to himself.

The stories of AA members in the Big Book, which take up two-thirds of the book, are a catalogue of suffering that arises from this disconnection from the self and the world—and ultimately from any higher power that could provide some overarching meaning—as expressed through the ‘defects of character’.

If the alcoholic’s problem was essentially a separation from his true self, a separation from others, and a chronic feeling of emptiness, of something missing, then the solution must address this disconnection. The AA program is designed specifically to help the AA member reconnect with his authentic self, reconnect with others, and reconnect with a Higher Power. Silkworth contributed “The Doctor’s Opinion” to the Big Book, where he described the goal of recovery as “an entire psychic change.” Step 12 describes this as “a spiritual awakening.”

According to AA, this entire psychic change could be relatively quick, but more often was of the “educational variety,” a phrase borrowed from William James. This change specifically grew out of spiritual experiences, or what is called at one point in the Big Book, the development of “God-consciousness.”

Sunshine Coast also has as one its main clinical goals the beginning of the process of “transformational change,” a phrase from White (2004), though others have called this a “quantum change” (Miller & C’de Baca, 1994). Like Wilson, these psychologists concluded that abstinence may be the byproduct of transformational change, not the first step in recovery or the prerequisite to recovery.

Transformational change, for both Wilson and the psychologists, meant that a person began living a life that was true to their authentic self. For Wilson, comfort arose from a faith in some transcendent power, and thus the alcoholic had no need to distort or hide experience. For the psychologists, it was a matter of choosing a life that was true to the self, thus changing fragmented personality into a congruent one, aggressiveness into assertiveness, and conventionality into authentic living.

At Sunshine Coast, transformational change is essentially this process. We use narrative therapy to help clients understand how they have interpreted their lives in a way that is not working out for them. Their narrative also maintains they’re disconnection from self, others, and from anything that would provide some overarching meaning in their lives.

Wilson’s Interpretation of AA as a Personal Journey

The steps are deliberately vague. Wilson believed that each person had to find his or her own way through them. Recovery was a personal matter and no recipe could be provided. The most obvious example of this is Step 2: “Came to believe that a power greater than ourselves could restore us to sanity.” This is the end result, but the key to this step is to figure out ‘how’ to come to believe. AA provided a book, Came to Believe, to help members. This book is 100 stories of how 100 different members found 100 different ways to come to believe. Wilson’s strategy was to provide a framework, not a recipe for recovery. He believed that only a journey that was personally meaningful to the individual would be successful.

Wilson and Professional Help

It is an interesting phenomenon that many AA disciples believe that Bill Wilson was divinely inspired. This may be an artifact of the conservative Christian influence on AA, in that conservative Christianity pervaded American society at the time and was, for example, the driving force behind prohibition legislation in the US (as was the women’s rights movement). But it is logically impossible to understand this belief given that Wilson had specifically mentioned the influences on AA in his letter to Jung.

And Wilson, himself, would have been disturbed that others thought that he somehow had a direct line to God when they did not. He had repeatedly declared in public that “Nobody can cause more grief than a power-driven guy who thinks he has got it straight from God. These people cause [the world] more trouble than the harlots and drunkards.” And he often said that “AA is a terribly imperfect society because it is make up of terribly imperfect people.” Ernest Kurtz provides a more down-to-earth explanation that Wilson and AA had resurrected a form of spirituality that celebrated human imperfection as not merely a fact but as the stepping stone to a connection with God.

What Sunshine Coast does in it’s program that Bill Wilson would like

1. Our family program introduces the 12-step program to families.
2. Clients attend AA/NA weekly. And an on-site meeting with local AA/NA members helps clients become comfortable in a meeting environment (although, because we invite only alumni and friends of SCHC, this meeting cannot be sanctioned by AA/NA).
3. Each week we provide a workshop on one of AA/NA’s spiritual principles, which also have a basis in the scientific study of positive psychology. The steps emphasize that recover comes from practicing these principles.
4. Each week we provide a workshop on the 12-step program as interpreted by scholars such as Ken Hart and Ernest Kurtz. This workshop highlights the origins of AA as well as practical matters of membership. It also highlights the influence of 12-step based treatment on AA, so that clients are not confused about certain things they hear at meetings that contradict other parts of the program. As one example, a long-term AA member may share at a meeting about how miserable their life is, when the 12-step program itself emphasizes “what it was like, what happened, and what it is like now,” because Bill Wilson understood the importance of providing a message of “experience, strength, and hope.”
5. The overarching theme at Sunshine Coast, which informs every component, is that recovery means reconnecting with self, others, and with a Higher Power, which is how Bill Wilson defined “spirituality.”
6. Workshops are usually conducted offering a psychology point of view matched with the 12-step point of view. For example, clients learn that Viktor Frankl’s recipe for happiness is to ask oneself “What does life demand of me?” is matched with the 12-step saying “Live life on life’s terms.”

 Twelve-step principles are also infused throughout the program:

1.  Staff attitudes are based on empathy and unconditional positive regard, just as AA emphasizes “principles before personalities.” They do not succumb to power struggles with clients; they do not tell clients what to believe.
2. Staff practice the spiritual principles, under the 12-step principle of “attraction, not promotion.”
3. Each client is encouraged to find his own way through recovery.

Conclusion

The 12 Steps of Alcoholics Anonymous has become synonymous with addiction treatment even though it was never intended to be professionalized into therapy. However, Sunshine Coast recognizes the importance of spirituality as an important ingredient in recovery and has included psychoeducation group discussion that focuses on the evidence-based aspects of the Big Book. Furthermore, since 12 Step groups are often the only source of recovery (particularly in small communities) for many individuals in North America, Sunshine Coast believes it is important that clients have a better understanding of some of the misconceptions that have fueled the controversy surrounding the 12 Steps.

Readers with questions about the philosophy of Sunshine Coast Health Center are invited to contact us directly at info@schc.ca

References

Andersen, S., & Berg, J.E. (2001). The use of a sense of coherence test to predict drop-out and mortality after residential treatment of substance abuse. Addiction Research & Theory 9(3), 239-251.

Crumbaugh, J.C., Wood, W.M., & Wood, C.W. (1980). Logotherapy: New help for problem drinkers. Chicago, IL: Nelson Hall.

Langle, A. (February 4-5, 2005). Addiction and the search for meaning. Two-day workshop presented at Trinity Western University, Langley, BC.
 
Miller, W.R., & C’de Baca, J. (1994). Quantum change: Toward a psychology of transformation, in T.F. Heatherton, & J.L. Weinberger (Eds.). Can Personality Change? (pp. 253-280). Washington, DC: American Psychological Association.
 
Somov, P.G. (2007). Meaning of life group: Group application of logotherapy for substance use treatment. Journal for Specialists in Group Work 32 (4), 316-345.
 
White, W.L. (2004) Transformational change: A historical review. Journal of Clinical Psychology 60(5), 461-70.
 
Wong, P.T.P. (October 5, 2005). Meaning-centered approach to addiction prevention, treatment and recovery. Workshop presented at Vancouver Community and Family Services, Vancouver, BC.

Geoff Thompson - MA, CCC

Geoff Thompson, Program Director at Sunshine Coast Health Centre, discusses lessons that can be learned from the 12-step model of addiction recovery, and how these tie in with Wayne Dyer’s theory of internal orientation.

This week I have been reminded that sometimes it’s quite alright to be selfish. In fact, I would even go so far as calling selfishness a virtue. For some of our alumni who are in recovery from addictions, I would go one step further and say it’s a matter of survival.

The Paradox of Selfishness

So, how can selfishness be a virtue? After all, page 62 of the Big Book states:

“So our troubles, we think, are basically of our own making. They arise out of ourselves, and the alcoholic is an extreme example of self-will run riot, though he usually doesn’t think so. Above everything, we alcoholics must be rid of this selfishness. We must, or it kills us!”

However, Bill Wison himself understood the paradoxical nature of selfishness. In response to a letter from someone who was disturbed to hear someone say that “AA is a selfish program,” Bill wrote *:

“I can see why you are disturbed … The word “selfish” ordinarily implies that one is acquisitive, demanding, and thoughtless of the welfare of others. Of course, the AA way of life does not at all imply such undesirable traits … our own recovery and spiritual growth have to come first - a right and necessary kind of self-concern.”

* Source: Ernest Kurtz, in his historical account of the AA movement, Not-God: A History of Alcoholics Anonymous, pages 242 and 243.

Selfishness as an Antidote to Apathy and Resignation

As mentioned in the opening sentence, this week really drove the importance the importance of having this “necessary kind of self-concern” that Bill Wilson describes. A new alumni group has started up in Vancouver and, like any start-up endeavour, has had it’s share of ups and downs. Attendance has been spotty and some alumni have expressed frustration and doubt over its survival.

I, personally, have had a similar experience in my yoga group.  I, too, am grappling with poor attendance as a member of a yoga group in Richmond. The women that run this group out of a Hindu temple in Richmond are the kindest, most generous people you would ever want to meet and only ask for a small donation to the temple in return. However, there will be some days when there are only one or two participants.

I can think of countless other examples of other events or group activities and, regardless of whether its staying sober, losing weight, staying connected to god, etc. all groups struggle with consistent attendance.

It is at times like this when we are faced with apathy, resignation, and excuses that it’s necessary to reconnect with our own selfish interests and push on regardless of what others do or think.

Selfishness as a Necessary Survival Instinct for Early Recovery

In addiction recovery, particularly in early recovery, being selfish can be the difference between relapse and sobriety. Examples include:

1. turning down invitations to risky social events (e.g. weddings, Christmas parties, etc.)
2. staying away from friends and family members that are not supportive of your recovery
3. participating in 12 Step meetings or spending time with other people in recovery in spite of complaints from family members who may feel left out
4. keeping a healthy distance from fellow alumni who have relapsed if you feel being around them could jeopardize your own recovery
5. asking your employer for a new position or work schedule change to reduce the chance of relapse (overtime, isolation, boredom, etc.)

Conclusion

As Ernest Kurtz wrote in Not-God, ” sefishness [can] be directed and tempered - applied to its proper object with the help of another of the program’s (AA) maxims: ‘First Things First.’ ” Selfishness is something to be explored, not avoided, and is another fine example of the paradoxical nature of addiction.

About the Author

Daniel Jordan is the General Manager of Sunshine Coast Health Center and hopes that these postings will help  take away some of the mystery often associated with addiction and its treatment.