This is the full, unedited version of an article from December 2019 edition of Essay, the official SA newsletter.
The missing physical aspect of Three-fold Recovery
I’ve lived most of my life in Australia. After being sexualized by an older boy, at age 5, I started acting out with my self and other boys. A few years later imagery became part of my MO. That deepened into pornography in my teens and relationships with much older men at 16, group sex and anonymous encounters by age 20.
I knew at the time there was something off about what I was doing but I was powerless to stop. I was seeking help continuously for my many difficulties with life.
I got the first hint of sexual recovery when I was travelling in the US at age 21 in 1980 when I came across a couple of isolated cases. It offered me hope. 12 Step became part of my life at age 30. By then I’d had 3 major relationships with men, each chaotic and dysfunctional in their own way.
I’d founded SA in Melbourne in 1992 after leaving another program. I immersed myself in service, step-work, sponsorship, conference recordings, local and international conferences. At 35 I began my first period of prolonged sobriety.
At some deep level, I knew it was all unsustainable. Even with all the inventory work, I sensed there was something deep inside I had trouble describing or identifying. After 8 years of sobriety, I lost it and struggled for the next 10 years.
In 2006 when visiting California, desperately in search of answers some members introduced me to the idea of brain scans to actually measure what was going on in my brain rather than just guessing.
My subsequent scans showed than even when sober and in recovery mode, my brain was a mess. They called it “highly dis-regulated”. I began to learn how the health of my brain affected my ability to do sobriety and recovery. I retired early from work and went on disability to focus on the neglected physical aspect of recovery.
Our literature says our problem is three-fold, requiring healing, physically, emotionally and spiritually. But then we rarely talk about the physical, apart from sobriety and don’t get too hungry angry lonely or tired. I came to see that my Inventory work was utterly incomplete until I added this physical element. As the White Book says “the whole person must be involved in recovery.” p 34
Dr. Silkworth in The Doctors Opinion chapter in AA Big Book writes that “any picture of the alcoholic which leaves out this physical factor is incomplete”. Modern medicine agrees. The Twelve Step program offers a solution that is worked out in the physical body which the Doctors Opinion clearly states may need medical treatment, ”before psychological measures can be of maximum benefit” p xv-xxvii
Dr. Silkworth writes further
it is imperative that a man’s brain be cleared before he is approached, as he has then a better chance of understanding and accepting what we have to offer” pp xxv-xxvi
Traditionally this has been interpreted to mean sober. As my various brain tests revealed there can be vastly more to clearing the brain than sobriety and step work. Dr. Silkworth asks if I am fit for the work of recovery. I had no clue how unfit physically I was for recovery.
This healing of the physical body and brain is what I now call Step Minus One: the necessity for medical intervention, for many, before recovery can be sustainable. This is exactly what happened in early AA. Most early AA groups required hospitalization before entering AA. Dr Bob treated 5000 alcoholics medically. Sister Ignatia, called the Angel of AA, nursed 15,000 alcoholics in the early decades of AA. In the member stories from the first edition of the AA Big Book the word hospital is mentioned 100 times.
In SA member stories neither of the words hospital nor treatment is mentioned. Roy K, the SA founder had spinal fusion surgery and took medication daily for low thyroid. Untreated, both of those conditions can lead to mood and cognitive problems. SA may not exist if Roy did not have access to good medical treatment.
For myself, and the members I work with, Step Minus One has been a key missing piece in recovery. I believe it is why sexual recovery programs, 12-step, religious and psychological have had such a high failure and burnout rate.
AA , GA, ACA and Marijuana Anonymous each have a Doctors Opinion in their official literature. Neither SA nor any of the other S programs have such literature. Why? Because the science has not been there to write it. This emerging science has proved the foundation of my current sobriety and enabled the program to become more effective in me and the members I work with. Dr. Burns Brady referred to this in his talks at SA Conferences. Until I’d done the inventory work of Step Minus One, recovery was something I could believe in, learn about or achieve with little reward on the effort. Ultimately that made it unsustainable.
There is a vast range of medical issues that can affect brain health and ultimately sobriety and recovery. These include gut health, nutrition, brain injuries, genetics, hormones, toxins. But it can be any medical issue that contributes to the buildup of stress, which leads us to the survival brain, where addiction lives.
I’ve adopted many of the nutrition and lifestyle habits of the 1930s that early AA members would have practised. We know now that these habits can make a profound difference for many with brain health.
Dr Sikworth’s 1951 obituary in the AA Grapevine sums up the approach that my sponsor and I take with members. Like Dr Silkworth we “have no formulas….. no stock answers” and come “ to each new case with a wonderfully open mind” because “the unexpected was to be expected in alcoholism”
The steps changed my life. They helped me see what was going on in my lust. How I was wanting to feel like others looked and hoping sex and romance would do that for me. Also how I was running from challenging emotions. However, even with all the program work, sobriety and recovery were unsustainable until I started addressing the multiple issues of Step Minus One.
I am still in the middle of some of my lengthy treatment. Each stage of that treatment has made sobriety and recovery more sustainable. Men, particularly, have a poor history of seeking medical help. Surrendering denial and ignorance has been crucial here for me.
One member I work with asked me to tell his story. He’s a minister, in the program five years, sponsor says he does great step work yet had trouble maintaining long-term sobriety. His brain scan revealed a 40-year-old brain injury from childhood and PTSD. Further testing revealed almost zero impulse control! With comprehensive treatment, he now has his best sobriety ever and is carrying the message of Step Minus One to others.
By looking at Step Minus One issues with members, I saw less of them walk away from the program or recovery. I saw more of them progress, sometimes quite slowly, yet surely.
After working this way with members for a few years I recently developed a Step Minus One workshop which goes into more detail. It’s been presented here in Melbourne, also in Singapore. The workshop is now available online.
I have been involved in religious, secular and 12 step sexual recovery programs since 1986. It’s been a graveyard of hopes, dreams, and hard work for far too many. By incorporating Step Minus One, the physical aspect of recovery, those hopes, dreams and hard work have a greater chance of materializing into sustainable, rewarding recovery.
Recovery is spiritual but it’s not just spiritual. There’s a spiritual component to everything, but that doesn’t make everything solely spiritual.
The program works if you work it. But only if it’s worked in the context it was designed: Physical as well as emotional and spiritual.
©Paul Hills November 2019