Applying the 12-Step Approach to Post Traumatic Stress

Disorder, by Laura Russell, Ph.D.

Powerlessness

On 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.

Whether 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.

Applying 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 safety.

In 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 become willing to take the actions suggested in the remaining steps.

In 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 active.

This is a paradox. You admit you are powerless so that you are able to take action.

Spirituality

Many trauma survivors have a problem with spirituality. In fact, you likely 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 to me?
 I cannot forgive my perpetrator
 I am lacking in my faith.
 Why???
  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 protect anyone.
 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 Higher Power?
 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 and Shortcomings

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.

Twelve Steps

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 understand God.

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 God 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
understand God, praying only for knowledge of God’s 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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For as he thinks in his heart, so is he. Proverbs 23:7