12-Step Approach to Post Traumatic Stress Disorder
by Laura Russell, Ph.D.
the surface, this idea seems a simple one for trauma survivors.
You feel totally helpless and overrun by your trauma and your trauma
symptoms. In fact, when you were traumatized [whether this was child
abuse, a robbery, battery or an explosion…to name a few], you were
helpless in the face of an overwhelming event.
your trauma was last month or 30 years ago, you feel helpless in
the face of your symptoms. You struggle with issues of control and
mastery. You wish you could control your symptoms. And when you
are alone, you wish you could go back in time and somehow prevent
or stop your traumatic experience.
the twelve-step program of Alcoholics Anonymous requires an admission
of powerlessness that is quite different from being overwhelmed
by the traumatic force(s) that shattered your being and sense of
this instance, you admit that you could not control what happened
to you. Also, you admit that you cannot manage the symptoms you
experience. You hit a bottom in your experience of your life as
it is. So that you can become willing to take the actions suggested
in the remaining steps.
essence, the difference between your admission of powerlessness
and the helplessness of your trauma is one of a willingness to take
action. Trauma helplessness is passive. Recovery powerlessness is
is a paradox. You admit you are powerless; so that you are able
to take action.
trauma survivors have a problem with spirituality. In fact, you
have one or more of the following issues with spiritual beliefs
and a Higher Power concept.
- Where was God?
- What do I believe in now?
- How do I reconcile a belief in God with what has happened?
- How do I face the reality of my fragile life?
- How can I trust God again now that I know bad things can happen
- I cannot forgive my perpetrator
- I am lacking in my faith.
- How can I believe in a Higher Power when there is evil and cruelty
in the world?
- How does God view suffering in the world?
- What is the meaning of what happened?
- I don’t feel safe anywhere.
- My life no longer feels predictable
- I am angry with God, is He angry with me?
- I feel like God abandoned me.
- I feel betrayed by God.
- What is my relationship to God now?
- I feel ashamed; God wouldn’t want me anymore.
- I feel dirty; so, I cannot get close to God.
- I feel distanced from the community now that this happened.
- No one will ever understand.
- Am I at fault?
- I feel so powerlessness.
- What do I believe in now?
- How do I make sense out of what happened?
- I no longer understand the meaning of life.
- Where is there value in my suffering?
- My perpetrator was never punished, what now?
- I don’t feel like I belong anywhere anymore. Goodness doesn’t
- How can I believe in a loving, all-powerful God after what happened?
How do I resolve my feelings of guilt with a faith in a
- I still feel God abandoned me.
- It is difficult to think of God as a loving Father after what
my own father did to me.
These are very deep questions. You
have a right to this difficult struggle with ideas related to faith
and belief in God. Your struggle doesn’t prevent you from working
a 12-step program of recovery. In fact, being in this struggle is
one aspect of working a 12-step program of recovery on your PTSD.
All that is required to work this aspect of a 12-step program is
a willingness to face these issues. You do not have to believe in
God to start working a program of recovery. What is needed is an
open mind and a resolve to work through the spiritual damage done
to every trauma survivor. Spiritual recovery from trauma comes when
you make your peace with a belief in a higher power even though
this awful trauma happened to you.
Moral Inventory, Defects of Character
The easiest way for me to tell you
how to apply the ideas from steps four, five, six, and seven to
your PTSD is to tell you what this is not:
- It does not include all the things
your perpetrator told you to justify their behavior.
- It is not anything told you by another person about yourself;
especially those things that begin with the sentence: “The trouble
with you is….”
- It is not self-abuse.
- It is not the toxic shame many
of you feel
- It is not blaming yourself for
your traumatic experience.
- It is not taking responsibility
for another person’s bad behavior.
With these ideas in hand, you can
safely use the AA Big Book, Alcoholics Anonymous and the AA Twelve
Steps and Twelve Traditions to follow these steps and support your
recovery from PTSD.
1. We admitted we were
powerless over our trauma and the effects of the trauma--that our
lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore
us to sanity.
3. Made a decision to turn our will and our lives over to the care
of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves and
the effects of our trauma on our lives.
5. Admitted to God, to ourselves and to another human being the
exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing
to make amends to them all.
9. Made direct amends to such people wherever possible, except when
to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong
promptly admitted it.
11. Sought through prayer and meditation to improve our conscious
contact with God as we understood Him, praying only for knowledge
of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps,
we tried to carry this message to survivors of trauma, and to practice
these principles in all our affairs
adapted from The 12 Steps of Alcoholic Anonymous
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