Alcoholics Anonymous is founded on the concept of one addict helping another. This emphasis on service is not based on religious dogma or speculation, but rather decades of experience with what works in addiction recovery. Until recently, science has focused on discovering new medications to treat addiction. Few researchers have subjected the 12-Step principles, which have helped millions of people achieve long-term recovery, to rigorous study. As a result, many core principles of 12-Step recovery have been marginalized as “unscientific.”
Fortunately, we are on the precipice of a new era in addiction research – one that is determined to learn from the success of AA/NA and find out why 12-Step recovery has been effective for so many addicts.
Service Key to Long-Term Recovery
A new study by Maria Pagano, PhD, associate professor of psychiatry at Case Western Reserve University School of Medicine, sheds light on the science behind the directive to “carry the message to others” in Step 12. Using data from Project MATCH, Dr. Pagano found that recovering alcoholics who help others:
• Reduced alcohol use
• Increased consideration for others
• Did more Step work
• Attended more meetings
This latest study adds to a body of research Dr. Pagano has been instrumental in building over the past decade. In a 2004 study, she found that 40 percent of the alcoholics who helped other alcoholics during their recovery successfully avoided drinking in the 12 months following treatment, whereas only 22 percent of those that did not help others stayed sober. In a 2009 study, Dr. Pagano showed that 94 percent of alcoholics who helped other alcoholics during the 15-month study period continued to do so as part of their ongoing recovery. These helpers experienced the added benefit of lower levels of depression. Interestingly, research shows the benefits of service accrue to adolescents as well as adults.
The Helper Therapy Principle and How it Works
The helper therapy principle, embodied by AA/NA, holds that when a person helps another person suffering from a similar condition, they also help themselves. How? In large part, by minimizing selfishness and entitlement and restoring the capacity for empathy that was overtaken by addiction. Beyond making the addict feel good, helping others combats egocentrism and self-absorption, which are common perpetuators of addiction.
“Being interested in others keeps you more connected to your program and pulls you out of the vicious cycle of extreme self-preoccupation that is a posited root of addiction,” says Dr. Pagano.
Service also guards against isolation, providing the addict with a broader sense of purpose and belonging. Fellowship with other addicts, both veterans and those new to recovery, reminds the recovering addict how far they’ve come (and how easy it is to fall back into old patterns). These bonds create a certain sense of responsibility to stay sober as a role model to others.
Altruism is empowering. Some have even referred to a “helper’s high,” the feeling of warmth and gratitude felt by those who do for others. After months or years of feeling useless and ashamed, the addict discovers that they can make a positive difference. Giving back builds the addict’s confidence to set and accomplish goals. Perhaps it is this feeling of self-efficacy, combined with staying occupied in healthy pursuits, that reduces cravings for drugs and alcohol.
Endless Ways to Serve
Many recovering addicts are willing and able to serve, but don’t know where to start. Will any kind of service do? Dr. Pagano is trying to answer this question in ongoing research. While helping other addicts may be the strongest medicine, it appears that helping anyone, whether inside or outside of AA/NA, is beneficial for long-term recovery. Here are a few ways to give back:
• Share stories of your personal experience in recovery with other addicts, whether in AA/NA, at a treatment center or informally
• Commit to doing meeting chores (such as making coffee or setting up for a meeting) or a specific service position within AA/NA
• Call members to remind them about meetings
• Welcome newcomers
• Become a sponsor
• Volunteer in a homeless shelter, soup kitchen or other community service activity
• Help a friend, neighbor or family member in distress
Just as you don’t have to serve others to be part of AA/NA, you don’t have to be part of AA/NA to serve. Anyone can do it, at any stage of recovery, and the benefits start to accrue immediately. Service doesn’t cost anything and the options are endless; there is always someone in need.
Helping others is key to living a long, happy life, not only for addicts trying to hold onto their sobriety but also anyone interested in living a better life. If you’ve had any exposure to 12-Step recovery, you probably don’t need a study to tell you that it’s wise to get out of your head and get busy helping others. But for those who need scientific evidence to get mobilized, here you have it.
David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of addiction treatment centers that includes Promises Treatment Centers in California, The Ranch outside Nashville,The Recovery Place in Florida, Malibu Vista, Spirit Lodge, and Right Step. You can follow Dr. Sack on Twitter @drdavidsack.