Trauma and the 12 Steps: An Interview with Jamie Marich

Aaron: I just finished your book, Trauma and the 12 Steps, and today is my 15-year sobriety date. I got sober in Alcoholics Anonymous, and I always say that everything good in my life comes from AA. The irony in this statement is that for the first time in my 15 years, I have stopped going to meetings. I think it’s been at least a month since I last went to a meeting, and before that, I was going once or twice a week since mid-April. I’m not exactly sure why I stopped going to meetings except that I stopped feeling safe there. And whenever I begin talking about safety, I’m also talking about my trauma.

This is a long way of saying your book landed in my life at just the right time. I appreciate the way you hold two systems in your head at once–trauma recovery and the 12 Steps. When my childhood trauma came roaring out of me two years ago, it was the first time the 12 steps didn’t work. It was terrifying and confusing, and I know I’m not alone. So thank you. And thank you for agreeing to do this interview.

I’ll jump right in. The central idea in Trauma and the 12 Steps is the tension between 12-step programs and trauma therapy. Can you talk a little bit about why you think that tension exists, and how the two communities can do better to work together?

Jamie: First of all, Aaron, congratulations on your 15 years… that is remarkable! I also strongly relate to your experience of owing so much of what is good in your life to AA while also reaching a certain place where meetings start to feel unsafe. For me that came when I was about 10-12 years into my recovery journey and I noticed that I was hiding a lot of who I really was and what I really wanted to express at meetings. I’m grateful that I’ve found other “rebel AAs” like myself–people who honor the 12 steps yet also see the problems with certain aspects of meeting culture, dogmatism, and “othering” certain members of a group. And most of these “rebel AAs” understand the impact of unhealed trauma, and the importance of addressing it as part of recovery at any stage.

My whole career, especially the Trauma and the 12 Steps projects (the first edition came out in 2012, and this revised and expanded edition takes it many steps further), has been a cry for us in recovery communities, especially those of us who work in addiction treatment to do better. We have to abandon the phrase that this is the way we’ve always done it. We can appreciate that Bill Wilson and Dr. Bob Smith (the co-founders of AA) did an amazing thing back in 1935, tapping into the healing power of human connection–specifically the healing power of one suffering person helping another. No small feat for men of their era. Yet we’ve learned a heck of a lot more about trauma since 1935, and we must interweave this knowledge into how we approach addiction if we are going to help people experience meaningful, lasting change.

There are so many myths and misconceptions about what it means to address trauma, both in professional treatment and in the rooms of recovery. I’ve seen 12-steppers and professionals alike shy away from working with trauma because they don’t want to make people worse or give them more excuses. Yet in my experience, this hesitancy usually stems from their own fear around addressing their own trauma and legacies of wounding. In reality, you can still validate a person’s traumatic experience while challenging them into meaningful action towards change. You can run initial interventions with people in a way that teaches them to sense into their bodies and emotions instead of just their rational brains. A major component of trauma work is trauma-informed stabilization, which involves education about trauma and dissociation while teaching people how to use skills and small lifestyles changes that are action and body-based. I’ve long seen that the body will tell us what is wrong long before our rational minds realize what is happening… that’s why slogans like “think the drink through,” or pure cognitive interventions are generally futile. Treatment has to start here, then once a person is sufficiently prepared and supported, we can take them deeper into the healing journey using a wide variety of interventions that are available. Healthy 12-step work and connection with members of fellowships who support this healing journey can be a crucial part of the process. So I am not and never will be about abandoning 12-step wisdom… it is imperative, however, to realize that there is so much more out there we can be harnessing to help people who suffer.

Aaron: I love what you wrote, how “the body will tell us what is wrong long before our rational minds realize what is happening.” Understanding how trauma lives in the body was the biggest personal revelation to me. It really clicked with me when I read The Body Keeps the Score, which you discuss in your book, and it clicked again when I read your book, Trauma and the 12 Steps. It’s impossible to unknow something, of course, but I try to think back to before, what is was like when my body began freaking out as the trauma presented itself decades after the traumatic event. Getting triggered left and right. Feeling like myself in one moment, and then feeling like someone else the next (turns out this was my five-year-old self). Not being able to regulate my emotions.

When you’ve been in AA as long as I have, and then something goes wrong at 12 years sober, as it did for me, it’s an existential crisis. I worked the steps again, and they didn’t work! Of course I needed outside help, and eventually I got it. Your book is one of the few I’ve ever seen to address this. Can you share a little bit about what prompted you to write Trauma and the 12 Steps? And the journey from publishing the first edition to this revised and expanded edition?

Jamie: Wow! There must be something about the number twelve… because I was also at 12 years when I had my crisis of identity as a recovering person. “Do I really belong in these meetings anymore? Am I getting anything out of this? Have I outgrown this?” Then I remember being in New York City on a teaching trip, on my twelfth anniversary (7/8/14), and checking out one of the LGBT+ meetings at a Midtown clubhouse. This was a year before I formally came out as bisexual in every aspect of my life (I was already out to friends and those close to me). The rainbow meetings had long been calling to me, yet after all of those years I never attended one. When I went to the meeting I felt like I came home to my fellow rebels and that I could be at a meeting where I could be the fullness of myself, not just in my sexual identity, but with everything else as well. That kept me “coming back,” so to speak. When I returned to Ohio I ended up making the LGBT meeting my home group and that’s where I met my current sponsor and primary recovery family. Finding the people you mesh with may ebb and flow the more that you heal and work on yourself, and that’s okay.

But I digress! To address your question, the idea for the first edition of Trauma and the 12 Steps came to me also when I was on a teaching trip, this one in 2010, teaching general courses for clinicians on trauma and addiction. I kept getting the feedback that I had a great way of not bashing the 12 steps while also calling them (and traditional treatment) “out” on where they need to be more trauma-informed. My response when I heard that was, “This is just the way that my first sponsor really taught me to think about the steps,” and it broke my heart that so many people had horrible, even re-traumatizing experiences, in meetings, and treatment and with sponsors. So it felt like I had the chops on the topic to write a book about it. I had a hell of a time finding a publisher the first go–my existing publisher on my first book didn’t like the 12-step focus, and another publisher liked the 12-step focus but felt it was too academic. The mainstream recovery publishers either thought it wasn’t original enough, OR they were not pleased with the dual-audience approach (e.g., for both professionals and the general recovery public, especially sponsors). What can I say? I’ve been a bridge builder from the word “go” and that’s what I wanted to do with this book. I still felt in my heart that there was an audience for the book, so I proceeded to self-publish, which ended up being a great decision at the time. The work has evolved, brought many people into my life who are now great friends and collaborators. And I am ever so grateful to North Atlantic Books, a long-time publisher of really innovative material on trauma, for seeing the value in the work in this revised and expanded form. I’ve grown a great deal in seven years since I wrote the first edition and I am pleased with how that growth reflects in the content and in my voice.

Aaron: I love how in Chapter 5 you take each of the 12 steps and view them through a trauma-informed perspective. I also love how you give suggestions to both therapists and sponsors throughout. The book has a nice balance between practice and theory. Is there anything you left out that you might add now based on feedback you’ve gotten from readers? What are you hearing from them?

Jamie: Thank you for the compliment on balancing practice and theory. This is who I am as a person and as an educator, so I am more than glad that it comes through. More of that Bridge Building 101! As for what I may have left out, I am certainly open to that feedback. The revised and expanded edition is still new so, as one of my readers, you tell me… what might you like to see addressed that isn’t?

What I can say is that this autumn my company is publishing two supplementary resources to go along with the core book: A daily recovery reader and a step workbook. This is in response to feedback and requests I’ve gotten from readers along the way to have this material broken down even more. I am excited for both. My collaborator and friend Dr. Steve Dansiger joined me on both projects; he is also a trauma educator in long-term 12-step recovery. I’ve wanted to produce the reader since the first edition was published. Being able to take in material on a day-by-day basis was critical for me in the early days, using the Twenty-Four Hours a Day book published by Hazelden. My first sponsor, Janet (the hero of Trauma and the 12 Steps) literally had me place it on my toilet seat so that I would have to pick it up each morning! So it means a great deal to me that we’re breaking down the Trauma 12 content even further into that form. As for the step workbook, Anna David put that idea into our head and we have run with it!!!!!!

Aaron: I didn’t mean to suggest that you’d left anything out! I guess I’m more interested in hearing about the feedback you’re getting on the book. What are readers telling you that they’re learning? How has the response grown from the first edition of the book to the most recent? What has the experience been like for you? (And by the way, shout out to Anna David! She does amazing work.) Another way into this question is the world has clearly shifted from the first edition to now. Your book foresaw a time when the trauma recovery world and the 12-step world would begin to talk to each other. What has it been like to watch that transformation?

Jamie: Such a great question that makes me quite emotional, actually. Being able to connect with readers from the first edition has been one of the most rewarding experiences of my personal journey and professional career. Above all, it’s beautiful to hear people feeling validated through reading the book. People that have gone through ugly experiences in treatment centers and in meetings feel that someone has validated their journey. People who are mental health professionals that often get chastised for still connecting with the 12-step path feel validated as well. For me, this validating quality is the most important aspect of the work, and if that validation can challenge people into action… to make a difference in their own sphere of influence, I know that there is hope for bringing about real change in recovery.

Transformation–wow, it’s really all about transformation, isn’t it? That is one of the ways that I describe meaningful recovery. And when we really break down the word it means to change shape, or form. That suggests to me that the essence of what we need for change, both personal and professional, is already with us. Now we need to learn a new way of being in the world. As I write in Trauma and the 12 Steps, an update for this revised edition that is also a commentary on our current times, we need to learn to build bridges instead of walls. For me, that is the ultimate transformation that will heal us personally, as a recovery community, and as a field of helping professionals.

Aaron: What would you say to someone who is at the beginning of this journey, someone living with addiction and untreated trauma? What would you say to the loved ones living with them?

Jamie: Although specific situations may vary, and I seek to get a sense of what those circumstances are from people, I usually approach it very similarly to how Janet approached me: “After everything you’ve been through, it’s no wonder that problems with addiction have resulted. So now that you know, let’s come up with a plan. What are the next steps?” I ask this not to pretend I have the instant answers to fix people, because very often, jumping into instant solution-mode without allowing people adequate time to grieve is not helpful. Yet I do feel that people need to realize that they can start taking small steps on a daily basis to take back their power as survivors and as people who struggle with addiction. For me, although a contradiction to some, admitting powerlessness over the addiction (not over myself), is literally the first step in that process, and it reminds me that I must take small actions every single day to stay well.

For families, I would offer much of the same direction with the caveat that it can be quite difficult to live with someone who is struggling. You are not a bad person for loving someone who is addicted. The important thing is that we find a way to help you take care of yourself too. And above all, do not take things personally, especially when your loved one is acting out or triggered. I know that directive is soooo much easier said than done, yet it can be possible to establish that boundary within by learning to care for yourself just as much as you may care for your loved one.

Aaron: What strikes me about all this is the intrinsic relationship between addiction and trauma, and what is so important about your book is the way you bring them together. Would it be fair to say that in many cases you can’t treat one without treating the other, AND you can’t treat trauma with the twelve steps, or addiction with trauma recovery tools? This, it seems, is the challenge before us, the challenge you take on in your book. Each needs its own approach and yet that those approaches need to talk to each other.

Jamie: I think you’ve hit the nail on the proverbial head with your summary, Aaron. And this speaks to the essence of the both/and approach that defines so much of my work anyway. I truly hope that the book highlights the importance of the art of dialectics. We stay stuck when we get dogmatic or exclusionary. I see staunch 12-steppers do this, and I see the staunch anti-12 steppers to this. I see so many of my trauma colleagues believe that if they just use their therapy of choice to treat the trauma, then the addiction problems will automatically clear up. And I see addiction colleagues afraid to touch trauma. All of this has to stop, and I hope that I’ve issues a reasonable call to action, together with actionable solutions, in the book.

Aaron: Yes! You said it so well, and I’d like to explore this a little more. What do you think is the fundamental misunderstanding about addiction from the trauma therapist’s perspective? Is it really true, do you suppose, that a non-addict can’t really understand addiction? Also, what can the addict/trauma sufferer do to best navigate this? Maybe more practically, how can that person find the best therapist?

Jamie: A marvelous series of questions. First of all, I do believe that we are all in recovery from something and that we are all “addicted” to something, if we are defining addiction as maladaptive attachments that can form to anything outside of ourselves… and yes, this often happens in response to trauma. So in the broadest sense, I really don’t think that there is such a thing as a “non-addict”… sure, not everyone may need to go to rehab, yet it we can appreciate that we all have issues to address with our attachments, this is a major way to squash the stigma. And it can help purely mental health or trauma clinicians who may not identify with those people better understand what those of us who identify as in recovery are going through on a daily basis. To me the solution must start with squashing stigma.

To be clear, I believe that many trauma clinicians’ hearts are in the right place. They want to help people who suffer heal the source of their addiction, which we are increasingly understanding is likely to be traumatic in nature. Yet such clinicians can be so focused on the past, they are not helping people work with daily lifestyle changes that need to happen in the present and leveraging motivation for the future (or work to build it if it doesn’t exist). A three-pronged approach like this is truly needed to heal addiction, and so many trauma clinicians can miss that. And, if I may be so bold, they often miss it because they are avoidant of their own issues with addiction and maladaptive attachments.

In searching for a therapist, I always recommend screening out who you select. Just because someone lists trauma or addiction as their speciality doesn’t mean they are a good fit for you. Make a call, ask your questions on email or schedule a trial phone consultation (many offer a free consultation). Look at the therapists website and online presence and see if you feel a connection or a vibe. Further, if you have the time to manage this, I also think it can be appropriate to make appointments with three different therapists to start with and do a session or two with each to see where you feel the best fit. The only caution here is to be careful that you’re not fishing for what you may want to hear that signs off, so to speak, on behaviors that may be keeping you stuck in suffering.

Aaron: I’m interested in this idea that everyone is an addict in some way, which suggests that addiction is more of a continuum of behavior. I love this because it erases the binary between addict/normie, and it also offers a more expansive view of human behavior and by extension, recovery/healthy living. This is also important because it begins to cut away at the stigma of being an addict. And it’s exciting to consider how far we’ve come in addiction/trauma studies. As you wrote: “To me the solution must start with squashing stigma.”

Stigma not only appears in human interactions but political policy as well. What are two to three changes at the social policy level that would improve our ability to address mental illness the most? Put another way, what are some obvious obstacles that have been standing in our way?

Jamie: The biggest obstacle has long been the us vs. them divide. We tend to see that when politicians or policymakers end up having significant influence in changing legislation and funding policies around treatment, it’s either because they’ve done their own work and know that this is a public health crisis that affects everyone. Sometimes it’s because people close to them have been significantly affected. There is so much I can delve into here about the politics of discrimination and “othering,” yet it really boils down to the us vs. them issue. When we can see that addiction is a problem that impacts all of us, no matter how it manifests, then we may have a prayer of making some shifts. The biggest change I would like to see is access to high-quality, trauma-focused addiction treatment across the board, regardless of the individual’s life status; and this taps into the great American debates around healthcare in general and whether it is a right or a privilege. Now I’m getting activated! Because as it relates to American politics, how many of our leaders wield power by playing into the “us vs. them” divide, tapping into the fear that their constituents have about the “other?” I can best summarize my feelings on this by referencing one of my favorite teachings that I cite in the book. Progressive pastor Nadia Bolz-Weber, herself a person in long-term recovery, said last year during a sermon I heard at a festival, “As a society, our biggest drug of choice is thinking that we’re better than other people.” And that, my friend, is the real problem.