Why Does AA Focus on Your Choices Instead of Other Causes of Alcoholism?

Get Help With Alcohol Addiction

Talk To Someone Now

Call toll free to:

• Find meetings near you
• Discover online or in person meetings
• Get 24 hour information on addiction

800-934-9518

All calls are 100% confidential

Who Answers?

Since its inception in 1935, Alcoholics Anonymous (AA) has been available to help people with alcohol use and misuse concerns.¹ A general theme that comes up time and time again when working the 12 Steps of AA is the importance of truly understanding the causes of alcoholism, the role you play in alcohol use or misuse, and how it affects you in your recovery.²

Are You Responsible for Your Addiction?

Mental health professionals recognize that alcohol use disorder (AUD) is a progressive disease. Understanding the “real causes” of alcoholism is a complex concept that includes accounting for contributing factors that do include characteristics and influences that are outside an individual’s personal control.

Examples include:^{3, 5, 6, 7}

• Adverse childhood experiences
• Age of exposure to substances
• Family history of substance misuse or addiction
• Lack of support or resources
• Undiagnosed or unmedicated mental or physical health concerns

Research indicates that these contributing factors can contribute to the first use of substances, the development of a pattern of misuse, and the progression and severity of AUD. None of these factors create or guarantee that a person will experience addiction, but they may impact the likelihood that one person will develop addiction if they misuse substances.

One of the criteria for a substance use disorder, including AUD, is a lack of control over your substance use.

AA describes this feeling in Step 1: “… we were powerless over alcohol… our lives had become unmanageable.” ¹

Understanding these factors can give perspective as to why your addiction has progressed in the way it has. Without a full understanding of the underlying causes that started the disease progression, it will be difficult for your provider to collaboratively work with you and help with your treatment goals.

Call 800-839-1686 Toll Free. Privacy Guaranteed. No Commitment.

Help is standing by 24 hours a day, 7 days a week.

Who Answers?

However, even mental health providers who firmly believe in the disease model of addiction, do not advocate for the idea that individual choices have no affect on an individual’s addiction. Your choices can change how AUD progresses and, perhaps more importantly, are the key to long-term recovery.

How Can You Be Responsible for Your Own Recovery?

The 12 Steps of Alcoholics Anonymous focus on you, your addiction, the part you played in it, and the part you now play in determining your own future. The 12 Steps are often used alongside evidence-based alcoholism treatment to allow you to receive treatment for the contributing causes of alcoholism.

AA focuses greatly on the personal responsibility and ownership involved in the recovery process. When working toward recovery, there is an expectation that you will be working on these steps. This is where the term “working the 12 Steps of AA” originates from.²

Working the steps in AA is often a profound experience that leaves you with more insight and understanding about yourself.

While the 12 Steps focus on you, they do not address other factors or causes of alcoholism, though they may be a vital tool on your journey to sobriety. It is not uncommon that you will feel things that might not have been felt before or have internal and external experiences that will lead to self-growth and healing. While the process might not always be easy, there is incredible value in understanding your responsibility and taking accountability for your AUD. This can help you better understand the nature of the disease and develop more empathy both towards yourself and others.

There are 12 Steps in AA, and a person working in recovery and using AA will often be guided by them. While there are 12 steps in total, and they are written in this order for a reason, it does not mean that once one step is done, it never needs to be revisited. As you move forward, you will learn things about yourself that may require you to revisit some previous steps.

A few steps specifically require a large amount of personal responsibility, accountability, and humility.

Step 4

In terms of accountability, Step 4 requires a great deal of thought. Making your moral inventory is the essence of taking personal responsibility. In your moral inventory, your explore which choices in your life have affected others and led to the progression of your addiction.

Many people working the 12 Steps of AA return to Step 4 multiple times in order to reflect on their decisions. ¹

Step 5

Part of taking true ownership in recovery is admitting aloud what you discover while making your moral inventory. In Step 5, you admit your wrongs to your higher power and yourself, but also crucially to someone else. ¹

While it may seem scary, this is yet another part of the recovery process. Honesty and openness are associated with positive outcomes in recovery.

Step 8

In addition to making a list of things you have done in your moral inventory, working the 12 Steps of AA also gives you the opportunity to identify individual people you have affected through those choices. The list you make in Step 8 is critical because it allows you to begin thinking about making amends in recovery. ¹

It is just one sentence but quite a powerful one. This requires a good deal of thought—looking into the past—and honesty. Many times, to move forward, there needs to be an opportunity for processing and working through the past. This can help you to heal relationships and allow for healthier boundaries and communication.

Step 9

After Step 4 and Step 8, you take the information you have learned about your personal responsibility in Step 9 to take action that affects people outside yourself. ¹

Making amends in recovery involves deliberately taking action to right wrongs you have identified. This requires a large amount of self-reflection and ownership. Step 9 can be a scary step for some, but know that you are not alone. If you find yourself struggling, contact your sponsor or your other supports to help you through this process.

Step 10

The completion of Step 9 lays the groundwork for a healthy look at personal responsibility moving forward. Step 10 is written so that you return to the act of taking personal inventory continuously, which can lead to new choices in your own life and relationships. ¹

How Do AA and Alcoholism Treatment Programs Help With Assigning Responsibility?

Learning to distinguish between circumstances you cannot control and choices you can make is part of recovery.

Externalizing Shame

One of the focuses of addiction treatment programs is learning  how to appropriately assign responsibility.³

Shame you may have felt for past actions can start to dissipate as you begin to realize there were instances you had no control over and identify what influenced you to make choices you wish you could undo. Those situations you did have control over, you work to address. In doing this, you will learn how to externalize negative feelings, which can then allow you to start forgiving yourself.

Unlearning Healthy Relationship Dynamics

The skills learned in alcoholism treatment and while working the 12 Steps of AA can help with rebuilding and maintaining relationships in your life, something that is often difficult for individuals with addiction. Neglect, abuse, and otherwise dysfunctional relationships are a well-documented contributing factor to addiction and potential issue related to addiction.^{4, 5}

Couples therapy and family sessions are often part of alcoholism treatment programs.⁵ You may sometimes hear addiction referred to as a family disease. Much of the time, it has to do with the breakdown of appropriate boundary setting.⁴

Call 800-839-1686 Toll Free. Privacy Guaranteed. No Commitment.

Help is standing by 24 hours a day, 7 days a week.

Who Answers?

When you take responsibility for your actions, you can work on appropriate boundary-setting. Often, appropriate boundaries in relationships are blurred to the point that it becomes unhealthy for the people involved. An example of this would be expecting that someone would give you money for alcohol. This is a boundary violation for both people, the one asking for the money and the one giving it.

Managing Co-Occurring Symptoms

Co-occurring conditions, including physical and mental health conditions, can contribute to addiction. Alcoholism treatment programs often work to address the impact the symptoms of undertreated or undiagnosed conditions have on substance misuse.⁷

Treatment does not necessarily take the place of AA, nor is AA a type of formal addiction treatment. However, both are interventions that can help you in your path to recovery.

You can find an Alcoholics Anonymous meeting in our directory. If you need information on treatment providers, please contact us at 800-948-8417 Who Answers? .

Resources

1. Alcoholics Anonymous World Services, Inc. (2001). Alcoholics Anonymous: the Story of How Many Thousands of Men and Women Have Recovered From Alcoholism (4th edition).
2. Krentzman, A. R., Robinson, E. A. R., Moore, B. C., Kelly, J. F., Laudet, A. B., White, W. K., Zemore, S. E., Kurtz, E., & Strobbe, S. (2011, July 20). How Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) Work: Cross-Disciplinary Perspectives. Alcoholism Treatment Quarterly, 29(1), 75-84.
3. Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884.
4. Crouch, E., Radcliff, E., Strompolis, M., & Wilson, A. (2018, June 07). Adverse Childhood Experiences (ACEs) and Alcohol Abuse among South Carolina Adults. Substance Use & Misuse, 53(7), 1212-1220.
5. Selbekk, A. S., Sagvaag, H., & Fauske, H. (2015). Addiction, Families and Treatment: A Critical Realist Search for Theories That Can Improve Practice. Addiction Research & Theory, 23(3), 196–204.
6. Studer, J., Gmel, G., Bertholet, N., Marmet, S., & Daeppen, J. (2019, May 06). Alcohol‐induced Blackouts at Age 20 Predict the Incidence, Maintenance and Severity of Alcohol Dependence at Age 25: a Prospective Study in a Sample of Young Swiss Men. Addiction, 114(9), 1556–1566.
7. Ruiz, M. A., Douglas, K. S., Edens, J. F., Nikolova, N. L., & Lilienfeld, S. O. (2012). Co-occurring Mental Health and Substance Use Problems in Offenders: Implications for Risk Assessment. Psychological Assessment, 24(1), 77–87.