Category Archives: Alcoholics Anonymous

Step 12: A Spiritual Awakening

Step 12:  Having had a spiritual awakening as the result of these steps, we tried to carry this message to addicts and to practice these principles in all our affairs.


The promise of the 12th step is that by the time we have reached this point in our program of recovery, we will have experienced a “spiritual awakening”.  Exactly what that means and what that entails will certainly vary from person to person.  However, the Big Book of Alcoholics Anonymous characterizes it as a “personality change sufficient to bring about recovery”.  Thus the essence of a “spiritual awakening”  for anyone is marked by a shift in attitude — or as Dr. Silkworth put it, “an entire psychic change” — brought about by working the preceding eleven steps and then implementing the foundational principles associated with each of them in one’s life.

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The Buddhism and Addiction Series (Part III of III)


Religious Dilemmas and Spiritual Solutions

Religion as a Barrier to Recovery

At first glance, it would seem that gay men with substance use disorder would be ideally matched to AA for post-treatment recovery maintenance or aftercare.  As previously noted, gay men are especially vulnerable to the development of a narcissistic personality structure.  The philosophy of the AA program is that addiction is essentially a “disorder of the self” characterized by narcissistic traits.  The AA program is unique in that it addresses both the underlying pathological personality structure, and the substance use disorder, by way of spiritual transformation.  However, when spirituality gives way to overt religiosity – as it often does in AA – the program becomes inaccessible and exclusive, and more foreboding than welcoming.

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The Buddhism and Addiction Series (Part II of III)

Part II:

Narcissism, Addiction and Sexuality

The Narcissistic Personality

Like spirituality, the concept of “narcissism” is one that defies simple reduction.  Infused with different meanings by different theorists to explain both normal and pathological conditions, narcissism is one of the oldest and most enigmatic terms in all of psychology (Drescher, 2010; Brown & Bosson, 2001).  Origins of the word may be traced to the Greek myth of Narcissus, a young man who was cursed by the goddess Nemesis, fell in love with his own reflection, and ultimately transformed into the flower which bears his name (Beck, Freeman, & Davis, 2003).  As a psychological construct, the term first appeared in a footnote to a 1905 essay by Sigmund Freud entitled Three Essays on the Theory of Sexuality (Rubenstein, 2010).  Use of the term, however, did not gain prominence in psychoanalytic circles until the late 1960’s and 1970’s at which time it was more fully explicated by object relations theorists.  These theorists posited that primary narcissism arises from early childhood when all of the infant’s needs are met, and its self is undifferentiated from that of its caretaker (Beck et al., 2003; Epstein, 1986).  In the absence of childhood trauma, the infant transitions from this state to one of a mature, normal self (Van Schoor, 1992).  Psychological disturbances arise, however, when there is inadequate caregiving during childhood (Beck et al., 2003; Kernberg, 1982; Kohut, 1972).  During this phase of development, called “rapprochement”, there is alternation between exploring moves into the environment and returning to the safekeeping of the caregiver, [but] the child sometimes receives inadequate support in these alternating efforts because caregivers are inconsistent, unavailable, or place self-centered demands upon the child. (Beck et al., 2003, p. 243)

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The Buddhism and Addiction Series (Part I of III)

Part I:

Spirituality, Addiction and Recovery

Exploring the Concept of Spirituality

Until recently, scientists have generally avoided the concept of spirituality in research and in clinical settings (Eliason, Amodia, & Cano, 2006).  One explanation for this omission is that spirituality is often mistakenly conflated with religion – the latter being viewed as largely off-limits due to professional ethical considerations (Eliason et al., 2006).  The rule of thumb has been that spiritual matters were best left to the realm of the clergy or mystics and kept outside of the boundaries of science.

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Killing Buddha: Reflections from Clouds in Water

Last December, when I learned that Clouds in Water Zen Center in St. Paul, Minnesota would host the 6th Annual Buddhism and 12-Step Retreat, I immediately began making plans to attend.  It was with great anticipation that I boarded a plane on March 7 and flew to the Land of 10,000 Lakes for the 3-day retreat.  What follows are my initial thoughts and reflections from this remarkable event; but first, some background information is in order…

A panoramic shot of the zendo at Clouds in Water

Upon reaching the 8th Step last summer, I had made substantial progress in freeing myself of the closed-mindedness towards spiritual matters that had previously blocked my recovery.  Leading up to that point, while working the 3rd Step, I had come across Lao Tzu’s Tao Te Ching and for the first time felt that I could honestly trust the process of recovery — an experience which I wrote about in an essay entitled An Appeal for Pantheism.  However, as I moved forward with the work of Steps 4 through 7, further spiritual investigation was forestalled in favor of Albert Ellis’ rational approach to cognitive restructuring.  Ellis’ techniques proved practical and effective.  But as I began to consider the 8th Step, I was drawn back to the search for a spiritual underpinning from which I could make sense of the amends process which I was about to undertake.  It was time for me to face, once and for all, the deep-seeded shame and resentment which had fueled my addiction.  And so, the search for a spiritual antidote to these problems resurfaced.

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Dr. William Duncan Silkworth, M.D.

Dr. William Silkworth, M.D.

Dr. William Silkworth, M.D.

Born in 1873, Dr. William D. Silkworth, M.D. gaduated from Princeton University in 1896 and earned his medical degree from New York University in 1900.  While in medical school, Dr. Silkworth interned at Bellevue Hospital where he first discovered his passion for treating alcoholics.  Thereafter, he was a member of the psychiatric staff at the U.S. Army Hospital in Plattsburgh, New York during World War I from 1917 to 1919.  He served as an associate physician at the Neurological Institute of Presbyterian Hospital in Manhattan from 1919 to 1929 and is believed to have specialized in neurology.  After incurring substantial losses in the stock market crash of 1929, Dr. Silkworth accepted the medical directorship at Charles B. Towns Hospital in New York which specialized in the treatment of alcoholism and drug addiction.

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