TWELVE STEP GROUPS
The most well-known 12-step group is Alcoholics Anonymous, ie AA. There are at least 30 others, and they definitely are not the same. Not everyone understands that you don't have to be a drug addict, or be involved with a drug addict, in order to benefit from participation in any of these groups. Many people do not understand what it means to be a member of a 12-step group. There is no registration. All you have to do is attend, and be willing to give your first name, and say that you are there to, “ check it out”. You are then a member. Of course many people choose to make involvement in 12-step groups a significant part of their life for many years. That's not a requirement at all. More over, there are no experts or leaders in any 12-step group meeting. It's just plain folks, like you. There may be as secretary, who is maintaining the organization for a particular meeting, but they are not a leader. If any mental health professionals are there, they are participants and just members like everybody else. They do not have any leadership role. Moreover, so that 12-step groups are safe for the various attendees, there is no "Crosstalk", in most meetings. This means that nobody can cross examine you or demand private information. If that happens, just ask whether or not Crosstalk is allowed in the meeting you have chosen to attend. If you don’t like the answer, just leave. I've also noticed that some people get very anxious when they think about going to a meeting with a bunch of strangers. They're afraid that they will have to talk. For those people, I recommend that they intentionally go to the meeting five minutes late, say they don't have to make any social chitchat before the meeting starts. If they want to, they can also leave five minutes early, again so that they can avoid having to talk to strangers. You might be surprised to find out that even though you went five minutes late on purpose, you felt comfortable with somebody who "shared" during the meeting. If so, you might consider staying after the meeting ends, going up to the person you identified, and saying something like, “I liked what you said about "blah blah blah". This might start a comfortable and productive conversation. Shy people often don't realize that it's just as hard for others to initiate conversation with them as it is for them to initiate contact with others. You might also find that you feel safe to say something during the meeting. If so that will give others a chance to get some idea of what you're like, and it will make it easier for them to talk to you. It’s not likely that you will be the only shy person there.
The different 12-step groups tend to focus on different psychological issues. I've learned to identify the kind of psychological issues which are dealt with during attendance at the various kinds of meetings. Also different kinds of people tend to attend the meetings in different locations. A given meeting will tend to be comprised of individuals from the geographical vicinity of the meeting. Therefore, just because you don't feel comfortable in one meeting, doesn't mean you will not feel comfortable in some different 12-step meeting. For example, no two AA meetings are the same, because the membership is not the same. The same goes for the rest of the 12-step groups.
To use an example about the focus of one particular kind of 12-step group, let's discuss CODA, ie., codependents anonymous. Al Anon is similar to coda, except that members will usually be in a relationship with someone who is actively addicted to drugs. Nevertheless, both groups deal with the issue of "codependency". This is not a true psychiatric diagnosis. Nevertheless the term refers to a collection of belief systems and behaviors which make it more difficult for the “codependent person” to enjoy relationships. In the terminology of 12 step groups, attendance at “coda” helps a person recover from “codependency”. The codependent person tends to feel guilty if they say, "no" to people close to them, so that they repeatedly betray themselves by agreeing to do things, that they don't really want to. In more technical terms, they have difficulty setting limits and with being assertive with other people. Moreover, when they are merely being assertive, they falsely believe that they are being aggressive (like a bully), so they tend to be overly passive (doormats). At the most extreme, they go through life feeling like the victims of various people around them, or of all the circumstances in their lives. Perhaps you would be surprised to learn that many alcoholics are also codependent, and they don't realize it. It's also true in my experience that a great percentage of people with excessive anxiety and/or depression also have problems with codependency. In my experience, concurrent participation in a 12-step group, can be more powerful than individual therapy alone.
Unfortunately many psychotherapists are not very knowledgeable about 12-step groups. Also, chemical dependency specialists have not been trained in psychotherapy. Worse yet, one or the other of these two kinds of therapists, may disparage the participation by their clients in these 12-step groups or in individual therapy out of their ignorance. As a psychiatrist, it has been my experience that the situation is even worse for psychiatrists. It is uncommon to find a psychiatrist who is well-informed about psychiatric medications, individual psychotherapy, and also about the treatment of drug addiction with and without 12-step group participation. Nowadays, most psychiatrists choose to become experts only in psychopharmacology. There's nothing wrong with that, as long as they recognize and support the value of these other forms of “treatment” and have a referral network. Combined treatment by different kinds of mental health professionals can be better. Many people with psychological problems have a hard time opening up to anybody about what's really going on for them. Seeing different professionals can help them discover that they can be understood by more than one person. Some people are not initially comfortable seeing a therapist, one on one. Others are not initially comfortable enough to attend a group meeting with strangers. You have to start where you are. Regular participation in a 12-step meeting can help you to understand that you are not alone. You will learn that you are not somehow more weird or crazy than other people. I haven't yet met a perfect person. I'm sure I will die imperfect. My attitude about myself is, "I am okay, and yet there are some things I hope to change about myself". This is very different from, "I am not OK, because there are some things I want to change about myself."