In Sexaholics Anonymous (aka The White Book) Roy K, the SA founder, dismissed the role of medicine and therapy in his recovery:
Medicine, psychotherapy, and psychoanalysis didn’t work. Alcoholics Anonymous did!
Sexaholics Anonymous p21
However, such treatment may have played a significant role in preparing Roy for what AA and the Steps had to offer. This is certainly what Dr Silkworth suggests in the Doctor’s Opinion.
Roy had spinal fusion surgery, ongoing chronic back pain, nearsightedness and took medication daily for low thyroid. Untreated chronic back pain and thyroid problems can both lead to fatigue, mood disorders, aggressive behaviour, and cognitive impairment, which are all addiction triggers. Managing multiple health conditions including addiction creates its own stress, which can trigger the addiction.
Roy has written and spoken of childhood trauma: the death of his father when he was age 5 and subsequent traumatic experiences with his brother, being different as an immigrant family in a foreign culture. Further, Roy’s parents were survivors of the Armenian Genocide. Roy spoke of his parents’ participation in the Armenian death march in the Syrian Desert.
Epigenetic changes occurring from the emotional, physical and nutritional trauma of the death march could have contributed to Roy’s predisposition towards addiction. Nutrition, supplementation, therapy, spiritual practices, as well as the 12 steps, can all contribute to reversing epigenetic influences on addiction.
The 12 steps and fellowship may have been the final tools that, when added to medical treatment and therapy, enabled sustainable sobriety for Roy. This is consistent with the AA and SA concept of threefold recovery and early AA history. SA may not exist had Roy not had access to good medical and psychological treatment.