The ladder to recovery

Which was responsible for the 12 Steps for combating addictions and compulsions – Christianity or Judaism? A new book by an esteemed octogenarian psychiatrist and rabbi reaches its own conclusions.

PROF. RABBI ABRAHAM TWERSKI (photo credit: Courtesy)
(photo credit: Courtesy)
The 12 Steps for climbing out of addiction are said to have originated in the 1930s, based on the thoughts of an Evangelical Christian movement that used self-examination and a surrender to God to escape from sin.
They were formalized and popularized by recovering alcoholic Bill Wilson, who together with Dr. Bob Smith set up Alcoholics Anonymous (AA) in Akron, Ohio.
Setting down the principle that participants in meetings should be anonymous, they insisted on the use of only first names when confessing and committing to the 12 Steps to recovery from addiction.
The original 12 Steps published by AA are :
• We admitted we were powerless over alcohol – that our lives had become unmanageable.
• Came to believe that a Power greater than ourselves could restore us to sanity.
• Made a decision to turn our will and our lives over to the care of God as we understood Him.
• Made a searching and fearless moral inventory of ourselves.
• Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
• Were entirely ready to have God remove all these defects of character.
• Humbly asked Him to remove our shortcomings.
• Made a list of all persons we had harmed, and became willing to make amends to them all.
• Made direct amends to such people wherever possible, except when to do so would injure them or others.
• Continued to take personal inventory, and when we were wrong, promptly admitted it.
• 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.
• Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
NOW COMES 86-year-old Prof. Rabbi Abraham Twerski, founder and medical director emeritus of Gateway Rehabilitation Center in Pennsylvania, who in a new book maintains that the 12 Steps in fact are all based on the principles of Jewish penitence and inspired by the Torah and Talmud.
Titled Teshuvah Through Recovery, the $28 volume issued by Menucha Publishers follows more than 60 other books he wrote or coauthored, as well as articles on addiction, stress, self-esteem, spirituality and Jewish topics that he has authored over his distinguished career.
Gateway, a non-profit drug and alcohol treatment system, has been praised by Forbes magazine as one of the 12 best drug and alcohol treatment centers in the US.
Twerski, who has just made aliya from Teaneck, New Jersey, to Jerusalem with his wife, is an ordained (by the Hebrew Theological College of Chicago) Orthodox rabbi with an impressive white beard, and is a scion of the Chernobyl hassidic dynasty. Born in Milwaukee, Wisconsin, he held a rabbinical pulpit until 1959 when he graduated from Marquette University Medical School and went on to complete his psychiatric residency at the University of Pittsburgh Western Psychiatric Institute.
For 20 years, he served as clinical director of the psychiatry department at St. Francis Hospital in Pittsburgh. Recognized as an international authority in treating chemical dependency, he began the first Pennsylvania program for nurses with alcohol or drug problems, served on the Governor’s Council on Drug and Alcohol Abuse and has appeared frequently on radio and TV programs that reached worldwide audiences.
He even collaborated with the late Peanuts comic strip creator Charles Schulz on two books, When Do The Good Things Start? and Waking Up Just In Time. In his dealings with Peanuts, he noted that Linus, a permanent character in the comic, is addicted to his blanket.
The 12 Steps are very widely accepted as a successful method of fighting addiction, and there are millions of people in hundreds of self-help organizations around the world that use them. Participants learn to admit that they cannot control their addictions or compulsions, and that being aware of this weakness can empower them. They study the mistakes of their past with the help of a veteran member of the organization; make amends for the mistakes; learn to adopt a new existence with a new code of behavior; and assist others who suffer from the same problems.
When as a professional he first attended AA meetings, he was touched by the altruistic behavior he saw among recovering and former addicts, who volunteered to help fellow sufferers at any time of the day or night. He also recognized the limitations of psychoanalysis: it emphasizes understanding where bad behavior came from instead of demanding patients abandon this behavior and change their lives.
In this, the religiously observant psychiatrist realized that the Torah’s “mussar,” ethics, moral conduct and discipline to penitence (Teshuvah), and the 12 Step approach have a lot in common – hence the new book.
Twerski wrote about the urge for instant gratification – leading to drug addiction in the American Jewish community four decades ago when few were willing to concede that alcohol and narcotics were problems there. Many Jews were among those rehabilitated at Gateway, which uses the 12 Step approach woven with Jewish concepts.
Today, even Orthodox synagogues have admitted the problem and agreed that 12 Steps programs could be held on the premises.
Twerski writes in the new book that Jewish penitence “is more than making amends and attaining forgiveness. If person A offended or injured person B, then apologized and made whatever restitution was necessary, thereby restoring their relationship to the status prior to the provocation, it is only logical that person B should forgive him. There was no need for a special creation of teshuvah for this to occur.
Teshuvah is more than erasing the negative.
It should bring about spiritual growth in the penitent. The Talmud says that ‘The place occupied by ba’alei teshuvah [penitents] cannot be occupied by tzaddikim [the righteous] who never sinned.’” While the Talmud praises sincere penitents, writes Twerski, many observant Jews refuse to accept this and might turn down a match for their children because the prospective mate’s parent used to violate Shabbat and eat non-kosher food.
He attended his first 12 Steps meeting in 1961 after feeling that his psychiatric training failed to teach anything about addiction.
“My experience with sincere recovering alcoholics and addicts is that they came to the realization that their behavior was destructive, and they could not continue living a worthless life. If they adopt Torah and [mitzvot], it is out of the sincere belief that this is the only thing that can give their lives true meaning. I have seen addicts make this radical change because bitter experience convinced them that their addiction robbed their lives of meaning.”
Working with the treatment of alcoholics, he writes, he has “gained some valuable knowledge. These are people whose behavior was self-destructive as well as harmful to others, but for years they adamantly denied it.
When they recognized their errant behavior and changed their lifestyle, they essentially did teshuvah. Having observed thousands of people who did this, I gained some knowledge into the difficulty of making lifestyle changes and attaining recovery and how to overcome the obstacles. This shed some light on the process of teshuvah.”
He added that at many AA meetings, the recovering person declares his offenses to the group. Alcohol distorts a person’s judgment, and one’s drinking has often resulted in harm to others. The recovery program requires open admission of the harm one has done, and requires making amends to those harmed.
The terms “teshuvah” and “recovery” share a common concept, says Twerski.
“Teshuvah is essentially a religious term, referring to one’s abandoning and atoning for sinful behavior. Recovery is a medical term, referring to being healed from disease.
Both focus on eliminating negativity in favor of positivity. Sin and addictive behavior have some similarities. Addictive acts are self-destructive, but the person indulges in them because they provide a pleasurable sensation or a ‘high.’ Sin is no different. The pleasure of the sinful act causes the person to continue to act self-destructively.”
He does not blame addicts.
“Addictions are not sins nor bad habits. Addictions are diseases. Furthermore, it is my opinion, shared by many specialists in addiction, that addiction is a primary disease and is not secondary to psychological problems. While we do not know the exact causes of addiction, I believe that addiction must be treated. Although an addict may also have psychological issues [that] can be helped by psychiatric/psychological treatment, I have not found the latter to be effective in overcoming the addiction. I have also found that while an addict may have some psychological issues, psychotherapy cannot be very effective until the addiction is arrested.”
He notes that “there is one marked difference between teshuvah and recovery. While there is a vast literature on teshuvah, it is essentially a private affair. Except for offenses against another person, where one must make amends and seek forgiveness from the offended person, teshuvah is between a person and [God]. We are not privy to the process of teshuvah, and we cannot see how a person does teshuvah. Most people do not share their innermost thoughts and feelings with others. Recovery from addiction is distinctly different, because it is often achieved openly, with the support and participation of other people. A person’s progress or lack of progress is visible.”
Recovery and teshuvah have something major in common, he says, and “that is the greater effectiveness of the group over the individual. Experience has demonstrated that one-to-one therapy for addiction, even with the most competent therapist, is not as effective as the group meetings. This has its counterpart in teshuvah, where the communal prayer for forgiveness is superior to individual prayer.” Using the 12 Steps concept, the group itself “exerts a force that an individual cannot achieve.” Halacha (Jewish law) states that prayer in public is far more effective than an individual prayer. “Even if a person feels that one’s concentration and meditation is much better in solitude than in a group, where there may be many distractions, Halacha states that the weakest communal prayer is superior to the finest individual prayer.”
IN AN intriguing chapter, Twerski writes that some Orthodox Jews “questioned the appropriateness and even the permissibility of joining a 12-step program” because it had its origin in a Christian group.
“This is not true. The laws of teshuvah and the ethics of mussar preceded the 12 Step program by many centuries. If a Christian group adopts Torah principles, that does not make them goyish. The Lord’s Prayer, which is part of the Christian liturgy, was taken from the kedusha of the Amida. That does not make the kedusha goyish.”
He then asks why Jewish sages did not invent the 12 Steps, leaving it to Bill Wilson to do so.
He explains that “Jews did not consider alcoholism to be a significant problem among them. When I began expounding to Jewish communities that alcoholism, drug addiction and gambling were prevalent among Jews, I was considered a rabble-rouser. It is only rather recently that Jews have grudgingly accepted this reality. The fact that the overwhelming majority of 12 Step meetings were held in church basements added to the concern that it was a Christian group. Some expressions, such as seeking the help of a Higher Power, ‘God as I understand Him,’ were considered alien to Yiddishkeit. Also, the fifth step, which is ‘we admitted to God, to ourselves and to another human being the exact nature of our wrongs’ was thought to be the Catholic confessional, and the 12 Step meetings generally close with the Lord’s Prayer.”
He concludes the volume with numerous pages of personal correspondence he has had (using only first names) with former addicts and others who needed his help.
They are enlightening.
Now that the book has been published, perhaps the time has come to end the debate on who first thought up the 12 Steps and to implement them even more widely to treat the huge populations around the world who suffer silently with addictions and compulsions.