A.A.’s Step One: Confrontation With Reality

The founding members of Alcoholics Anonymous wanted to help others suffering from severe alcoholism find the relief and freedom they had achieved. They decided to record a description of the path to recovery that had worked for them. This became the 12 Steps of Alcoholics Anonymous, which they offered as a path to finding freedom from alcohol addiction. One way, not the only way. But, since it was the way that had worked for them, it was the way they had to offer others.

The First Step is where it all begins. By all, I mean both the path to recovery and the resistance many feel to following that path. This step, which needs considerable unpacking, reads as follows:

“We admitted we were powerless over alcohol — that our lives had become unmanageable.”

There are many ways to understand the meaning and implications of Step One[i], so I want to be clear that what follows is only one perspective filtered through my own experience as an addiction psychiatrist, during which I sat with innumerable patients struggling with recovery, and personally searched for ever deeper meanings of each of A.A.’s Twelve Steps.

The idea of being powerless is shockingly unacceptable for most people, but it is important to realize that the first step is not saying we are globally powerless. We all have the power to guide our lives in a variety of essential ways. We have the power to change jobs when we wish, live where we wish, marry, stay single, worship as we please, or not.

Step One only says that, if you are truly addicted to alcohol and/or other drugs, you are completely unable (i.e., powerless) not to be addicted. Even if you abstain for a while, as soon as you return to using alcohol or other drugs, the addiction will reawaken. You do not have the capacity to use any addictive substance in moderation. This reality is demonstrated time and again with severe addiction.

We now know that the basis of such powerlessness lies in a person’s addicted brain far more than in their character or circumstances. For reasons that are largely genetically determined, some people’s brains are more easily hijacked by addictive substances. By hijacked, I mean the brain’s reward center more quickly focuses on alcohol and other drugs as the primary source of pleasure. And, if not pleasure, at least of relief of suffering. Once hijacked, the reward center responds less to normal sources of pleasure and bends motivation toward repeated consumption of things that most stimulate the reward center – chemicals like alcohol, cocaine, meth, opiates, tranquilizers, cannabis, etc. The drug of choice depends on one’s personality, friends, and substances available.

When no alcohol or other chemicals bathe the addicted brain, its motivation to return to use is thwarted. The result is a chronic sense of need, restlessness, irritability, and discontent. Not feeding the beast does not make the beast disappear. Rather, the addicted brain’s demands only intensify and begin searching for opportunities and excuses to be satisfied. The person in whom an addicted brain exists is powerless to change this reality by dint of will power alone. This is the powerlessness referred to in Step One.

No one wants to admit powerlessness. But the founders of AA concluded that each had tried every strategy they could imagine to drink moderately – drinking only late in the day, drinking only beer, swearing abstinence to a minister, priest or rabbi, or to their boss, or their family. Nothing they had tried, or tried again harder, worked. They were personally convinced that they were unable to control the effect alcohol had on them. They were bankrupt as far as any new strategies were concerned.

There is an instructive, and important, wrinkle here, illustrated by the sibling Twelve Step program of Al-Anon. When the early recovering alcoholics met, their wives began congregating around the kitchen table wondering how the Twelve Steps might heal some of their wounds and often resentful behavior. They shared how each had pled, cried, demanded, shouted, withdrawn, over-controlled, and ignored their alcoholic husbands, but generally concluded that they too were powerless. In the wives’ case, they had to admit the reality of their absolute inability to force or cajole an alcoholic to change. Their lives too had become unmanageable if they tried to force solutions that had no chance of working. No one can control another person’s mind.

The problem with admitting powerlessness, even when all the evidence points in that direction, is that such an admission is not merely exchanging one belief for another more accurate one. It is rather the kind of severe blow to one’s pride, what therapists call a narcissistic wound, that comes from a deep loss of identity. Before the admission, the alcoholic was “he/she who could drink moderately (sometimes, or eventually if they could just find the right strategy). With admitting the reality of their powerlessness over alcohol and/or other drugs, they are now not that person. Who are they now? Too often they are cut adrift and left seeing themselves as a loser, weak, pathetic. No one, absolutely no one, wants to be that person.

Alcoholism Essential Reads

Why Findings on Alcohol and Health Are So Confusing

Alcohol Use Is Getting Deadlier in the United States

Admitting the full reality and weight of the first step plunges people into despair. Deep despair. Once acknowledged as powerless over alcohol and/or other drugs, there seems to be no hope left.

Like the television commercial, AA says, “But wait. There’s more. If you admit the reality of your powerlessness, there is Step Two, where you will find a different source of hope, one not dependent on your own hijacked brain.”

I will explore perspectives on Step Two in my next post.