[S669]Social Support And Depression

Alcoholics Anonymous (AA) and other 12-step groups (e.g., Narcotics Anonymous, Cocaine Anonymous, Marijuana Anonymous, etc.) suggest that in order to recover from addiction you must accept that you are powerless to recover on your own. Only with inspiration from a higher power, recognition of your own character defects, and fellowship in the group, among other steps, will you be successful. If this perspective makes sense to you, then 12-step groups may be just what you need. But the higher power concept is not acceptable to many, and it probably isn't the foundation of the limited success AA actually achieves.

AA was established in 1935. Other groups have followed, with several hundred types of 12-step groups now in existence. These groups have been attended by millions around the world. Many participants report that their success is directly attributable to participation in the groups and acceptance of a higher power in their lives.

An alternative perspective is that many who have been helped by 12-step groups have benefited primarily from what might be called "social support," as well as some of the useful behavioral guidance of 12-step groups, rather than from a deep acceptance of the 12-step philosophy. Of course, there may be are a few individuals who will recover only by following AA's philosophy precisely and entirely. Most individuals, however, might benefit from a variety of approaches to change. Unfortunately, there are also individuals who may not significantly benefit from any.

If social support is the primary factor in AA, how does it work? The social support provided by 12-step groups is similar to the support provided by any discussion group of individuals with common problems. In such a group participants can describe their own experiences and express their feelings about them, identify individuals (models) to emulate, realize that however much they have struggled others may have struggled even more, discover alternative solutions for problems they have faced, learn about problems that might occur in the future and ways to solve them, experience the care and concern of others, and momentarily transcend their own problems by caring for others. Regardless of the underlying philosophy of such a group, or even in the absence of a philosophy, these experiences are likely to be therapeutic for most individuals.

In physical health care it is recognized that when patients are well connected to others and speak with them regularly, whether it is a support group, friends, family or others, health, well-being and longevity are better. Love is the best drug. Evidence is now emerging that 12-step based treatment may be as helpful as proven treatments. What is probably being observed, in most cases, is the power of social support, not the power of the 12 steps.

AA's program of recovery is based on the acceptance of powerlessness. However, for many who attend 12-step groups the result of group participation is, ironically, a sense of empowerment derived from the processes of social support. Consequently, even if you are committed to an alternative perspective on recovery, you might find 12-step meetings helpful. Some of my own clients have attended them regularly. If alternatives are not available in your locality, 12-step groups might be a sensible option for you. They do not conduct a "belief test" at the door. If you are quiet about your points of disagreement you might benefit from the social support as well as other aspects of the meeting. You might even leave feeling empowered!