The Secret of NA

Narcotics Anonymous is the hero not seen in the spotlight. This organization has saved so many people from the suffering of addiction...Myself included.

The following study is a qualitative analysis of the 12-step fellowship Narcotics Anonymous (NA). Over a one-week period interviews were conducted along with attending various meetings to obtain an answer to the question: Does NA work and how? Through an analysis of testimonials presented at the meeting level, a theory of the process of identity specifically that becoming a “recovering addict” has been posited. For the purpose of this article an addict is “a man or woman whose life is controlled by drugs” (Anonymous, Baisc Text, 2008). However, findings have shown that addiction does not start or end with the use of or not using of drugs. Addiction can show up in other areas of one’s life. In interviewing recovering (to get back normal or what was lost or stolen) addicts, one commonality is their addiction to the lifestyle of using (people, places, and things), along with addiction to certain behaviors (procrastination, manipulation, dishonesty, and denial). With that said, addiction is defined as the psychological and physical component to any mind-altering or mood-changing substance. In this study, fellowship is defined as the name given to the community of people in any given twelve-step program.

            In order to better understand the nature of this study one must first know what is the NA program? According to The Basic Text written by NAWS (Narcotics Anonymous World Service Inc), the NA program is a nonprofit fellowship or society of men and women for whom drugs have become a major problem. NA is categorized as recovering addicts who meet regularly to stay clean. This is a program of complete abstinence from all drugs. There is only one requirement for membership the desire to stop using. The program is a set of principles written so simply that an addict can follow them in their everyday lives. There are no strings attached to NA. It is not affiliated with any other organization, have no initiation fees or dues, no pledges to sign, no promises to make to anyone. It is not connected with any political, religious, or law enforcement groups and are under no surveillance at any time. Anyone may join regardless of age, race, sexual identity, creed, religion, or lack of religion.

            A lot of individuals including critics have wondered how NA works and if the program has anything to do with recovery. The NA program focuses on individual suffering as a universal psychology and offers practical ways to eliminate it. The importance of this study is to show how and why NA works in the lives of addicts or if it does. This study has some limitations: first, the researcher is a part of the program and is a firm believer that it works, however, to take a researcher point of view bias and judgment was left out as much as possible and contrary evidence is presented. The present research has focused on the 12-step program which provides a pragmatic approach to coping with suffering through spirituality recovery. Despite reported empirical successes, the 12-step program is not a panacea, nor does it work for everyone. Second, the explicit mechanism of spirituality underlying self-change in the 12-step program is still unclear. Also in this research, only a few participants (8) were involved. Such samples are not random and cannot be considered representative reflections of all recovered people or all 12-step participants; therefore, no generalizations can be made.

                            Literature Review
            In the process of doing research it was interestingly hard to find contrary evidence for the purpose of this study. Even though NA does not work for everyone critics suggest it is due to (1) one’s lack of understanding, (2) unwillingness to participant, and/or (3) failure to work the steps. Even in the Basic Text it explains, “One thing that will defeat us in our recovery is an attitude of indifference (unresponsive or unconcerned) or intolerance (prejudice or bias); but three of these that are indestructible (incapable of being destroyed) is honesty, open-mindedness, and willingness (Anonymous, Baisc Text, 2008). In other words the program works if one work it. However, Nicholas Boeving states in the issue Tikkun that “recovery (the blanket term used to describe twelve-step programs) works for only a minority of addicts” (Abstinence Does Work, 1997). Unfortunately, that minority is a rather large number: millions around the world according to NAWS; and because recovery is such a large and growing movement, Boeving criticism"which for the most part is valid"only speak to a certain aspect of the twelve-step paradigm.

            The goal of self-work in the 12-step program is to counter self-centeredness “principles before personalities” (the twelfth tradition). “Self-work is based on choice and humility as a way of life; as opposed to the pride that characterizes addictive behavior” (Kaufman, 2011). “The 12-step program recognizes the importance of an individual’s experience of suffering and surrender and regards both as crucial for recovery” (Chen, 2010). Acknowledgement of human suffering is already expressed in Step 1: “We admitted we were powerless over our addiction, that our lives had become unmanageable” (Anonymous, It Works How and Why: The Twelve Steps and Twelve Traditions of Narcotics Anonymous, 1993). Step 1 focuses on the addict’s suffering and his/her sense of helplessness. Powerlessness is at the core of addiction and recovery. Powerlessness is manifested in the loss of one’s ability to control his/her drug habit, and admission is an essential step for recovery, replacing the addict’s omnipotent self-perception with acknowledgement and acceptance of his/her powerlessness (a predicator of one’s ability to avoid drug use). “The spiritual principles of the first step are honesty, acceptance, surrender, and humility” (Anonymous, Living Clean: The Journey Continues, 2011). Honesty begins with addict’s admission of his/her addiction and sense of helplessness. This admission leads to self-acceptance. Honesty and acceptance lead the addict to surrender, which forces him/her to acknowledge that fact that s/he is affiliated with the “disease” of addiction. “Recovery is an outcome of humility, which entails that addict’s recognition of his/her personal limitations and need for assistance” (Rafalovich, 1999). “Step 2 is characterized by the spiritual principle of openness and hope” (Anonymous, Living Clean: The Journey Continues, 2011). Openness is formed by the addiction suffering by defeat and hitting bottom, while hope is a door to recovery. In Step 2, when the addict has already acknowledged that s/he is powerless and cannot cope alone, s/he is encouraged to believe “that a power greater than ourselves could restore us to sanity” (Anonymous, It Works How and Why: The Twelve Steps and Twelve Traditions of Narcotics Anonymous, 1993). During the interviews, research has shown that a Higher Power does not have to come in the form of a God just something greater than them; such as the fellowship. “The appeal to a Higher Power is in the form of a prayer similar to the serenity prayer” (Kaufman, 2011). Step 3 represents the decision to choose either spiritual recovery or a decent into disease; which states, “We made a decision to turn our will and our lives over to the care of God as we understood him” (Anonymous, It Works How and Why: The Twelve Steps and Twelve Traditions of Narcotics Anonymous, 1993). The ‘we understood him’ is the most import part of this step because it lets the individual choose their own God to which there are no limitations or objections to who their God is. It gives each individual a sense of relief and openness to believe. Step 4 is “We made a searching and fearless moral inventory of ourselves” (Anonymous, It Works How and Why: The Twelve Steps and Twelve Traditions of Narcotics Anonymous, 1993). Step 4 is a crucial part in NA because it starts to get to the ‘core’ of addiction. “A written inventory will unlock parts of the subconscious that remain hidden. Once it is down on paper, it is much easier to see and harder to deny our true nature. Honest self-assessment is one of the keys to our new way of life” (Anonymous, Baisc Text, 2008). Step 4 is the process of examining moral inventory that includes seeing the damage created by addiction. Step 5 is about sharing insights gained in Step 4 with another human being. Step 6 and 7 involve advice on further spiritual growth, particularly in terms of recognizing stumbling blocks to spiritual progress. Step 8 and 9 are restitution steps involving the recovering addict’s willingness to name and make amends to those who might have been harmed as a result of past behaviors. In the Basic Text is reads, “take action…we want to step away from further antagonisms and ongoing resentments…to free ourselves from guilt and shame” (Anonymous, Baisc Text, 2008). Steps 10, 11, and 12 are referred to as maintenance steps. Focused on the present, these steps emphasize continuous spiritual practices and reliance on a Higher Power. “Step 12 is primarily about the spiritual awakening that follows implementation of the preceding steps and sharing the message with other suffering addicts to offer hope” (Rafalovich, 1999). In essence, “the therapeutic value of one addict helping another addict is without parallel” (Anonymous, Baisc Text, 2008).

            During the research, all participants suggested that one do the steps with a sponsor. Five out of the eight quoted that, “an addict alone is in bad company” suggesting that no one in the process of recovery can work the steps alone and it become effective. The researcher went on to ask what a sponsor is. “Sponsorship is a personal and private relationship that can mean different things to different people. A sponsor is a member of NA, living the program of recovery, who is willing to build a supportive one-on-one relationship with other addicts” (Anonymous, Baisc Text, 2008). Most of the participants think of a sponsor as someone to help them work the twelve steps and someone to share things with that they may not feel comfortable sharing in a meeting. Others value the objectivity and detachment a sponsor can offer, relying on their direct and honest input even when it may be difficult to accept. Seven out of the eight participants stated that sponsorship along with their Higher Power was their source to having the program work for them.

            The 12-step program helps the addict overcome distress derived from pain, loss, and fear by attending social meetings that provide them with social support. “Social support has gained widespread recognition for its contribution to one’s sense of wellbeing and its effect on the drug addiction recovery process, decreasing the need for substance abuse and strengthening drug abstinence” (Chen, 2010). “The social aspect of meetings, including the circle of friends found in NA, help individuals overcome a sense of social alienation and loneliness by providing them with a sense of belonging” (Kaufman, 2011). “NA provides opportunities for shared leadership, learning skills, participation in organizational tasks, and the development/ reconstruction of new identities” (Kurtz, 2003).  

            While attending various meetings, one major commonality jumped out. At the beginning and the end of each meeting the members constantly repeated the phrase “Just for Today”. When asked around what that phrase meant the results were that ‘Just for Today’ represents a philosophy through which most NA members approach continued abstinence. “Getting clean and absorbing NA recovery can be a physical and mental struggle, so the individual is encouraged to look at staying clean not as a lifelong chore, but as a goal to accomplish for only one day” (Rafalovich, 1999). “Living for today relieves the burden of the past and the fear of the future. “Addicts learn to take whatever actions are necessary, and to leave the results in the hands of their Higher Power” (Anonymous, Baisc Text, 2008).

            NA labels addiction as a “disease that has no known cure, however, it can be arrested at some point and recovery is then possible” (Anonymous, Living Clean: The Journey Continues, 2011). During the interview process it was asked is there a difference between sobriety and recovery? The answer was always the same: yes. “To stay abstinence from drugs is considered a pre-step into the first step of recovery. People can have years of ‘clean time’ and no experience in recovery. Recovery is ‘the new way of life’"to live as a productive and active member in society” (Chen, 2010). When newer members (also known as newcomers) come into NA they are constantly presented with the dilemma of the word ‘disease’. “The jargon and the heavy use of the term can be off-putting and alienating. Being told one has a disease can, indeed, feel pathologizing; but it can also help dislodge the stigma that so many addicts feel” (Kaufman, 2011).

            Since most addicts act out of suffering and usually suffers alone, it may be comfortable to find a place where they are welcomed and loved just as they are. No matter the situation or person everyone is equally welcomed and according to the article Keep Coming Back, it’s this welcome that keeps individuals coming back (Rafalovich, 1999). The perception of suffering is a subject of ongoing debate among researchers. Some claim that suffering is destructive and negative. For example Weil (1977) argued that “suffering causes pain, has a negative effect on one’s self, crushes the sufferer’s spirit and leads to humiliation and despair” (Chen, 2010). Similarly, the existential philosopher Levinas (1988) argued that “suffering is useless, meaningless, causes self-alienation, and destroys one’s ability to enjoy life” (Chen, 2010). Other researchers relate to the ambivalence of suffering, claiming that it should not be considered only as destructive and damaging, but that it should also be viewed as a positive factor that could potentially initiate a positive process of self-change. This becomes important due to the fact that “many addicts act out of suffering and become addicted to whatever that thing is that soothes their souls” (Chen, 2010). The 12-step program suggests practical ways to cope with addiction suffering through spiritual recovery which is closely related to the meaning of life. Acknowledgement of the value of life’s meaning and spiritual growth in eliminating human suffering is already expressed in Step 12. “Studies have shown that motivation for recovery is related to the degree to which the addict is suffering (hitting bottom)” (Anonymous, Living Clean: The Journey Continues, 2011). It is only when things get bad enough or, according to Narcotics Anonymous, “when the suffering becomes unbearable” (Anonymous, Baisc Text, 2008), that the individual has the will to change; and with the will the program stands a chance to work. The 12-step program describes drug addiction as “loss of control over a behavior that causes continued suffering to the addict and others. It represents the spiritual foundation of the belief that drug addiction recovery is a spiritual journey and that the 12-steps are the means to achieve spiritual growth” (Kaufman, 2011). The 12-step program expresses the individual’s goals, which include cessation of drug use, development of belief in a Higher Power"in “God as we understand him”"and a spiritual awakening. The 12-step program represents a holistic approach to which addiction, like any other behavioral disorder, is manifested on three aspects: bio, psycho, social.

Set-Up for Research

            In doing observations at NA there were ethical considerations particular to “sensitive” arenas like 12-step fellowships. NA is “anonymous” for many reasons. One of these is the belief that much of mainstream society lacks understanding of the nature of addiction, and similarly lacks empathy toward persons involved with the drug underworld. The extensive field work informing this study has revealed that NA testimonials comes in a somewhat generic form, impossible to trace to any one individual, and is independent at any one location. Therefore, the researcher has intentionally not quoted anyone that was interviewed; but rather speaks in general to the NA context, yet illustrative of particular points essential to this study; Because of this, the study in no way breeches the anonymity of any member of NA.

Participants

            Candidates for participation came from the rooms of Narcotics Anonymous. Race and ethnical background was not a factor; although 5 were African-American/Black and 3 were Native-American/White (4 women, 4 men). All eight participants were considered “predecessors” (someone with more than two years clean and has been applying the 12-steps to their lives). Of the eight, only 3 (2 women, 1 man) were open to interview. The interviewees pertained 5 or more years clean and active in service work. The main question proposed to each participant was how has NA worked for you?

Method

            The primary data collection for this project came from participant observation based on an ethnographic approach. The intention behind this method is to gain an understanding into strategic site of study in the same manner as would a “native” to that environment. The researcher intermittently attended NA meetings for approximately one-week beginning January 27, 2013 and ending on February 2, 2013. During this time the researcher attended 9 meetings; where the testimonies were committed to memory and documented in the field log immediately following a meeting. Three interviews were given using open-ended questions and a tape recorder. Out of the eight participants five interviews were scheduled but due to scheduled times and being recorded 2 were omitted. A confidentiality contract (informed consent) was produced and signed to maintain anonymity and to give each participant understanding that the tapes would be discarded after the initial text was written.

            After recording the testimonials, the researcher proceeded to employ systematic coding techniques to the raw data. In examining the field notes the process of “open coding” began: taking the dialogue that had been recorded and categorizing it indiscriminately. Open coding is a minimal obtrusive way to begin a preliminary organization of qualitative data. Once the schemes were categorized, “selective coding” for patterns of testimony (which would be considered evidence for the study presented: does the program work and how?) came next.

Results

            The program works if you work it.