Origins and Development

Origins: this is a brief synopsis of the experience and theory out of which this workbook grew. It will appeal to those of you who like to know where things are coming from and/or to have a context.

Briefly, I am the son of a professor of sociology. I was exposed early on to a field of social psychology called “Symbolic Interaction.”   As far as I know, this theory is no longer part of mainstream sociology. However, you may recognize two terms from pop psychology which it left behind, “significant other” and “self-fulfilling prophecy.”   The most important principle I took from this early indoctrination was the Thomas Theorem, which postulated, “Situations which men define as real will be real in their consequences.”   I apply this principle every day in my clinical work.  The other principal I took from my father was the idea that no one theory explains everything. And each of the theories may be useful in any given context.  My clinical mentor, Jules Meisler (who never met my father), put it this way, “All of our theories are true, some of the time and none of them are true all of the time.” In the workbook, you will see 12 Step principles alongside and even combined with cognitive-behavioral principles, psychodynamic understanding, solution focused, Buddhist, and Judeo-Christian ideas.

Starting in 1972, the pragmatic spiritual psychology of Alcoholics Anonymous became an enduring part of how I approach this work.   A patient on the VA psychiatric ward where I worked took me to my first meeting to show me what was changing him.   In  the beginning, I saw Alcoholics Anonymous as brilliant applied sociology, consistent with everything I had learned to that point. If the “disease concept” and “powerlessness” changed the individuals “definition of the situation,” the 12 Traditions thwarted Michel’s “Iron Law of Oligarchy.” Generalized other, significant other, reference group, norms and rules – it was all there, along with the tangible and effective power of community. We! Us!  Eventually, I was to experience the benefits of actually working the Steps,  to know a spirituality based on practice and community, not just theory.  At the same time, I am haunted to this day by the specter of men and women who die of their disease, rather than pick up this kit of spiritual tools.

The second major influence, without which this workbook would never have happened,  arose in 1978.  I entered an apprenticeship in psychotherapy with Jules Meisler, MSW.  Jules introduced me to a form of psychotherapy somewhat transitional between traditional psychoanalytic or psychodynamic therapy and more cognitive behavioral approaches that were to come. Avoiding jargon, we worked with dreams and fantasies, with resistance and defenses, while looking for the cognitive distortions that continued to plague the client. The work with fantasy, in particular, greatly enriched my eventual understanding of “wishful thinking”  in the relapsing alcoholic/addict. The practical tool of having the client relive a recent problematic experience, applied in an alcohol treatment program, led directly to the observation of the two kinds of thinking at the moment of relapse in 1978. The question of what this means, that all of these people  – different addictions, different ages, different stages of the disease, different educations, cultural backgrounds – at the critical moment of picking up that first physical drink or drug of relapse all seem to succumb to just one of two ideas  –  became the work of a lifetime. How can we understand it? How can we help the relapsing alcoholic/addict understand? Most important, how can we translate that understanding into practical action that saves lives?

The decade of the 90s was both painful and productive.  A second devastating divorce threw me out of my ivory tower of theory. It was time for me to work the steps!  This, of course,led me to the humbling realization that the authors of the 12 steps were even more focused than I was on   “the mental states that precede a relapse into drinking, for obviously that is the crux of the problem. ”  In fact, I have come to see the   entire program of Alcoholics Anonymous as a structure and a  process for defeating the two kinds of relapse thinking,  what the the Big Book calls the “casual” and the “deliberate” relapses.  The 90s, with a push from managed care, also forced me to learn  Solution-Focused Brief Therapy and to study  Cognitive-Behavioral Therapy.  I also began to study mindfulness, as described by Thich Nhat Hanh.  And by the end of the decade I had begun to wrestle with motivational interviewing .

The first decade of this millennium has been a time of integration.   With a little help from  Solution-Focused Brief Therapy, I began to focus on why people do embrace their recovery programs and continue to do so. Intensive study of the first edition  of  ” “Motivational Interviewing” and of TIP 35 , helped me grasp the fundamental concept of   a “motivational discrepancy.”    It is a perceptual experience, a moment of realization,  of “getting it.”   This enabled me to apply the concept to those two kinds of relapse thinking.   Once I saw the potential discrepancies at the moment of relapse,  I was able to recognize that the founders of Alcoholics Anonymous had lived them, realized them, and developed a program motivated by them and for them.  I can match every discrepancy in the workbook with a quotation, tool, or principle of the program created in 1935 . Someone who continues to work their recovery program is motivated for maintenance because they “get it.”   If this workbook adds anything, it is to give counselors a way to increase the number of people who  “get it” and avoid there doom while finding at least relative peace.