A Trauma-Informed Interpretation of AA’s Step Four

trauma-addictionFor me, my trauma and addiction were intertwined. The 4th step says to recover, we must take a “resentment inventory” of where we are to blame. But what if you’re a victim of domestic or child abuse?

I came to 12-step recovery with a lengthy trauma history, and research says I’m not alone. Studies have found that between 50 and 96% of substance abusers seeking treatment report experiencing trauma and up to 34% of patients receiving substance abuse treatment have a co-existing PTSD diagnosis. With such high rates of trauma among people who struggle with addiction, it seems like addressing that trauma would be an important part of any recovery program.

But researchers Dusty Miller and Laurie Guidry argue in their book Addictions and Trauma Recovery: Healing the Body, Mind, & Spirit, that many models of addiction recovery don’t take potential trauma into account when offering a solution. And while they don’t discredit 12-step recovery, they suggest that the approach does not sufficiently address the role that trauma has played, which can set people up to fail in their recovery. But it doesn’t have to be that way.

Part of the problem is that many 12-step fellowships do not talk about trauma, focusing strictly on addiction. But for me, my trauma and addiction were intertwined. The more I used, the more I was victimized; the more I was victimized, the more I used. Kristin, a member of Alcoholics Anonymous (AA), says that trauma is something people are embarrassed to talk about, even in women’s meetings. If it’s hardly talked about in women’s meetings, it’s talked about even less in men’s meetings, according to Robert, who worked the steps as a way to cope with having several addicts in his family.

On a path to 12-step recovery, a person will eventually get to the 4th Step. In most 12-step programs, this step reads, “Made a searching and fearless moral inventory of ourselves.” In AA’s Big Book, it explains, “we searched out the flaws in our makeup which caused our failure,” and became convinced that “self, manifested in various ways, was what had failed us.” The number one manifestation of self that the book identifies as causing alcoholics’ problems is resentment. For people who have been abused in their life, it makes sense that they would harbor resentment towards the perpetrator of that abuse. And the way the program’s language is interpreted can make all the difference when it comes to helping a trauma survivor heal from their trauma and recover from their addiction.

“Finding Your Part”

In the Big Book, the 4th Step offers these instructions for the resentment portion of the moral inventory: “Putting out of our minds the wrongs that others had done, we resolutely looked for our own mistakes… though a situation may not have been entirely our fault, we tried to disregard the other person entirely. Where were we to blame?” This is sometimes known as the “4th column” of resentment inventory, or “turnarounds.”

This kind of language can be challenging for people who have experienced trauma like childhood sexual abuse, sexual assault, or domestic violence. In many cases of childhood sexual abuse or domestic violence, survivors are already likely to blame themselves for their abuse. Many of them have been told by their abusers that they were responsible for what happened to them. It also echoes much of the victim-blaming language sexual assault survivors receive from society about their own fault in their attacks. Rae, an AA member, was in an abusive marriage when she entered the halls. She says that she thought the abuse was her fault, because she was getting that message from both her abuser and the program itself. “So for a long time, I was scared to tell anyone in the program, and I kept trying to fix it,” she says. Read more “the fix”…

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