The Science of Step 10 AA

Step 10 of Alcoholics Anonymous (AA) is when participants “continued to take personal inventory and when [they] were wrong promptly admitted it.”1 This step puts the prior nine steps into practice and allows you to balance emotions, stay sober, and live with purpose.

However, is there scientific or evidence-based backing to this approach? As it turns out, the science of Step 10 AA is robustly comparable with other research-supported psychological treatments (RSPTs). This correlation between the science of Step 10 AA and scientifically grounded therapy methods demonstrates that living life in the AA way is effective to recovery.

In this article:

What Is Step 10 of Alcoholics Anonymous?

Step 10 consists of a continuous evaluation of our own assets and liabilities.1 This step is about searching yourself, admitting and accepting what you find, and then trying to right your wrongdoings. Step 10 utilizes the comparison of a physical hangover to an emotional hangover, which is a result of excessive negative emotions. This emotional hangover must be eliminated to live serenely.1

Step 10 requires you to admit and then correct your errors.1 Doing so allows you to make peace with yourself and face numerous challenges as they come. Thus, Step 10 prompts participants to do the following:1

  • Exercise self-restraint
  • Honestly assess whatever and whoever is involved
  • Be willing to admit personal faults
  • Forgive when the fault lies elsewhere

Practicing Self-Restraint

The first objective of Step 10 is developing self-restraint.1 When acting or speaking hastily or rashly, your ability to be fair-minded is impacted. If left undeveloped, it is likely that you will have an unkind tirade or willful snap judgments that may ruin relationships. You must train yourself to take a step back from the situation and think.

Honest Analysis of Everything and Everyone Involved

As you analyze the situation, you must routinely check yourself against “big-shot-ism.”1 Remember to see yourself and everyone else as emotionally ill to some extent. This reminder helps you approach situations with tolerance and love.

During Step 10, you also create a balance sheet, which prompts you to give yourself credit for all the things done well and pay your debts when wrongdoing has occurred.1

Willingness to Admit Your Faults and Forgive Others

As you fail others, and they fail you, you must promptly admit it to yourself and to them.1 To be in harmony with others, there are several keynote characteristics including:1

  • Courtesy
  • Kindness
  • Justice
  • Love

In addition to these characteristics, one question you can ask yourself is, “Am I doing to others as I would have them do to me—today?”

Step 10 is truly about learning how to each day spot, admit, and correct your flaws to build your character and live well. It requires:1

  • An honest sense of regret for any wrongdoings of the day
  • A genuine sense of gratitude for all the blessings you received
  • A willingness to try for better things the following day

Focusing on Progress Not Perfection

Step 10 focuses on progression rather than achieving perfection. This stance can help you discover realistic expectations of yourself and others. You will have setbacks, and you will respond to situations with negative emotions, yet if you focus on accurately taking inventory of your actions, you will continue to improve. When focusing on perfection, something no one can achieve, it can place additional pressure and set you up for failure. The key is to focus on getting better with each passing day.

When you focus on your progress, be open to your own criticism as well criticism of others. As you open yourself to feedback, you will be able to have a deeper insight into your thoughts, emotions, and behaviors. This deeper understanding of yourself will promote change, leading to a change in perception, which can help you feel happier and have an increased ability to effectively adapt to your environment.

Concluding Step 10 AA Treatment

When completing Step 10, participants conduct an accurate self-appraisal.1 You may want to discuss your conclusions with your sponsor or spiritual adviser.

How the Science of Step 10 AA Complements Evidence-Based Therapies

Step 10 is a maintenance step. At this point in your recovery, you have worked through the nine previous steps and ideally have established several skills. Many individuals will seek behavioral therapies in addition to their peer support groups.2

What is the Science Behind Cognitive-Behavioral Therapy?

A common therapy is cognitive-behavioral therapy (CBT). CBT is focused on addressing your thoughts, emotions, and behaviors and recognizing their interconnected influence on each other: your thoughts influence your emotions, which influence your behavior, which then impacts your continued thoughts and emotions.

Cognitive-behavioral therapy is one of the most studied forms of therapy.3 It is designed to reduce your distressing symptoms and improve your level of functioning. It helps you begin to process and challenge the validity of the thoughts you experience, especially thoughts that are maladaptive, or unhelpful. It can also help modify unhelpful patterns of behavior.

Evidence for CBT

An analysis of existing research has shown CBT is effective in treating many disorders, especially anxiety and general stress. CBT also has been shown effective for individuals of all ages. When reviewing the level of effectiveness of CBT for treating substance use disorders, there are mixed results especially when CBT is used without additional supportive therapies (e.g., contingency management, support groups).3

Recently, research-supported psychological treatments (RSPTs) have had their criteria systematically reassessed and revised. Among these treatments, CBT proves to have the largest evidential base, especially in literature reviews.4

How CBT Overlaps with the Science of Step 10 AA

Like some of the Steps in AA, a CBT-based approach will teach you how to:2

  • Manage cravings
  • Cope with cravings
  • Challenge your thoughts about substance use
  • Engage in assertive communication
  • Use alternative behaviors instead of substance use

As with the goal of CBT, the goal of the Steps of AA is to identify things that cause problems and replace them. These things include:2

  • Ideas
  • Emotions
  • Attitudes

A tool that is used in CBT is a thought record. While using this tool you write down all of your:2

  • Activities of the day
  • At least an hourly mood rating (e.g., 0 being the worst mood, 10 being the best)
  • Internal thoughts

You will make a similar daily inventory in Step 10 AA. While you make these records, you identify belief and thinking patterns and analyze the validity and rationality of these thoughts. Like activities completed in Step 4, you and your sponsor can identify areas of “stinking thinking.”2

How AA and CBT Promote Cognitive Restructuring

In general, CBT and the 12 Steps of AA overlap in more areas than their focal points (i.e., thoughts, emotions, behaviors) and activities.

Both CBT and AA Steps rely on participants to address their maladaptive thinking patterns and emotions that influence their drinking behaviors. This process is known as cognitive restructuring. As you complete the Steps of AA, specifically Step 4, you will examine your irrational and maladaptive thoughts of viewing:2

  • Yourself
  • Others
  • The world

Once these patterns are examined, you will work on developing more adaptive thought patterns. AA has several slogans that are utilized in this process, such as “this too shall pass” and “one day at a time,” whereas CBT will focus on challenging these unhelpful thoughts and providing evidence for such distorted thinking patterns.2

Developing Prosocial Behaviors in AA and CBT

Throughout the use of CBT, you will be encouraged to engage with others and use prosocial behaviors to help promote a positive sense of self and others. In AA this same principle is seen in your fellowship (i.e., going to meetings).2

Why AA and CBT Use Relaxation and Imagery

CBT encourages interventions for substance use disorders that include practicing relaxation techniques (e.g., deep breathing) and imagery exercises (e.g., meditation). Similarly, Step 11 will include encouragement in the development of a daily meditation practice. These interventions are designed to:2

  • Increase positive coping
  • Reduce stress
  • Increase motivation toward recovery

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How Can Taking a Daily Inventory Help?

Research continues to show that AA and other 12-Step Facilitation is effective in treating alcohol use disorder.5 Step 10 prompts its members to “continue to take personal inventory and when [they] were wrong promptly admitted it,” which is especially helpful in recovery. Completing an inventory and then taking responsibility for wrongdoings helps you to settle issues.1 This settling prevents things from becoming heavier and weighing down on your conscience.

Without these weights on your conscience, it frees up space to do many things, such as:

  • Practicing gratitude
  • Examining problems more rationally
  • More effectively deal with cravings and wrongdoings
  • Reducing negative emotions that lead to alcohol use

Strengthening Relationships

In addition, Step 10 helps you strengthen relationships and how you interact with others. This is especially helpful in recovery. Your willingness to accept fault and mend when able can maintain, grow, and flourish your relationships. Ultimately, AA helps you add a layer of support to your recovery efforts.6

Step 10 helps you identify and deal with emotions that can attribute to the reoccurrence of alcohol use. Identifying and overcoming the following emotions can help prevent reoccurrence:

  • Shame
  • Anger
  • Resentment
  • Isolation

If you are interested in seeking treatment for your alcohol use, please call 800-839-1686Who Answers? to speak with a treatment specialist.

Resources

  1. Alcoholics Anonymous World Services, Inc. (2012). Step Ten. In Twelve steps and twelve traditions (77th ed., pp. 88-95). Alcoholics Anonymous.
  2. Breuninger, M. M., Grosso, J. A., Hunter, W., & Dolan, S. L. (2020). Treatment of alcohol use disorder: Integration of alcoholics anonymous and cognitive behavioral therapy. Training and Education in Professional Psychology, 14(1), 19-26.
  3. Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy Research, 36(5), 427-440.
  4. Hayes, S. C., & Hofmann, S. G. (2018). The History and Current Status of CBT as an Evidence-Based Therapy. In S. C. Hayes & S. G. Hofmann (Eds.), Process-Based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy (pp. 7-22). New Harbinger Publications.
  5. Kelly, J. F., Humphreys, K., & Ferri, M. (2020). Alcoholics anonymous and other 12-step programs for alcohol use disorder. Cochrane Database of Systematic Review, 3(CD012880).
  6. National Institute on Drug Abuse. (2020). Principles of drug addiction treatment: A research-based guide (3rd ed.).

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