People with addiction issues might hear this from a therapist: "Twelve-step programs are a good start, but only therapy will help you understand yourself and address deeper issues." And they might hear this in the rooms: "Everything you need, you get by working the steps."
Of course, the truth is much more complex than either simple statement. For people who struggle with addiction-related issues, the integration of psychotherapy and the 12 Steps is often the best approach; many of the elements of good therapy, and of 12-step programs, are similar or complementary. Undertaking the work of recovery can bring up a host of old patterns, ways of being in the world, and relationship dynamics that benefit from the more individualized and exploratory work of therapy; if your therapist understands the principles of 12-step programs, he or she can better understand your struggles and be supportive around an important part of your life. In this article, I will illustrate some ways in which therapy and 12-step programs are similar, and other ways in which the two approaches are complementary.
Similarities The first step - admitting that you are powerless over your addiction and that your life has become unmanageable - is also the critical beginning for therapy. You acknowledge that you have a problem and step outside of yourself to fully comprehend the destructive nature of the compulsions that undermine your life, conflict with your interests, and interfere with your ability to mature and to grow.
Step 2 (coming to believe that a Power greater than yourself can restore you to sanity) and Step 3 (deciding to turn your will and your life over to the care of God as you understand God) have an analog in therapy. For change to occur, you come to trust your therapist and have faith that he or she can help you. You open up to them and believe that they can have compassion and caring, and that they have your best interests in mind.
Steps 4 and 5 are also similar to therapy, in that they address self-exploration, self disclosure, and confession. Step 4 involves making a searching and fearless moral inventory of yourself, and step 5 is admitting to God, yourself, and another person the exact nature of your wrongs. In a 12-step program, it is often your sponsor who listens to your inventory or your expression of secrets that you have hidden and feel shame about. Trust is an essential and necessary element in both relationships.
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