http://www.thefix.com/content/12-steps-rehabs-cults-abuse8851?page=all
Cult Culture and the 12 Steps
A small but significant number of 12-step groups�from AA to addiction
treatment centers�turn into dangerous cults. How can working the program
take a wrong turn?
By Maia Szalavitz
08/27/12
12-step programs�with their clich�d language, frequent meetings and
religious mien�are cults. So say many critics. But in fact, the
traditions of AA, NA and the other As are intentionally structured to
prevent their members from crossing that line. Nonetheless, there is a
reliable way to use the steps to create a full-fledged destructive cult.
Cults are not simply weird or dangerous religious groups, according to
those who study groups that have had disastrous outcomes, like Jim
Jones� People�s Temple, which ended in mass member suicide, and the
Branch Davidians, which ended in a fiery siege by federal agents.
Instead, cults are self-enclosed organizations that use a well-defined
set of coercive persuasion tactics.
These typically include isolating people physically and emotionally from
friends and family, breaking them down emotionally and taking total
control over their environment, movement and finances. Because these
procedures can also characterize rehab, residential treatment itself
without proper oversight carries a risk for creating cultlike behavior.
However, since 12-step programs in the community aren�t residential,
can�t physically isolate people or take their life savings�and because
they are formally leaderless�they have little risk of becoming the next
Jonestown, Guyana, or Waco, Texas.
But the repeated development of cults or near-cults�from Synanon to
Straight Inc. to today�s Washington, DC, Midtown Group�based on the
steps is not coincidental. The reason is a toxic compound created when
AA�s voluntary steps are twisted so that they can be imposed by force,
especially in settings where people cannot escape. Chuck Dederich, the
founder of Synanon, was the first to recognize the power of this recipe
for subjugating people and creating followers. Indeed, Synanon was the
model for every �therapeutic community� (TC) in the US, including
mainstream leaders like Phoenix House and Daytop.
Originally hailed in the 1950s as a tough, peer-pressure-based cure for
heroin addiction, by the late 1970s it was stockpiling weapons, forcing
couples to get sterilized and swap partners and, perhaps most
notoriously, had placed a de-rattled rattlesnake in the mailbox of a
lawyer who had begun winning cases against it on behalf of former
members who had been abducted and abused. When Dederich was arrested for
conspiracy to commit murder in the snake incident in 1980, the
charismatic leader was dead drunk.
A toxic compound is created when AA�s voluntary steps are imposed by
force.
By then, however, the Synanon model had already spread across America
and around the world. In addition to Phoenix House and Daytop, the best
known include Delancey Street, Walden House, Gaudenzia, Gateway House,
Marathon House, Odyssey House, Samaritan Village, Amity, CEDU, the Seed
and Straight Inc.
Following Synanon, these TC programs are or were residential, typically
lasting from 90 days to 18 months. Originally, the idea was to break
initiates through strict rules and daily humiliation and confrontation,
and then rebuild them as they work their way up a structured hierarchy.
To rise through the levels toward graduation, participants have to
demonstrate compliance by imposing the rules on others and emotionally
attacking their fellows to help break them. These days, many TCs have
abandoned the marathon attack therapy sessions and tried to reduce or
eliminate the use of humiliation�but they retain the strict rules and
hierarchical systems.
So how do the use of attack therapy and forcing the steps on people
inspire cult formation?
Step 1: It starts with the first step. Voluntarily admitting you are
powerless is relatively harmless (although there�s some evidence that
this belief as part of the disease model of addiction is linked with
worsening relapse). By contrast, however, being forced into a position
of absolute powerlessness is what defines a traumatic experience, and so
it can cause post-traumatic stress disorder (PTSD) and related
psychological problems, like depression. And traumatizing people is an
excellent way to break their will and turn them into compliant
followers.
Research into PTSD repeatedly confirms that at the heart of all trauma
is the feeling of being completely vulnerable and out-of-control in a
frightening situation, in a word, powerless. Whether well-intentioned or
not, any program with the capacity to disempower participants by
blocking their contact with the outside world and controlling their
access to food, sleep and social support is potentially dangerous. This
dynamic�in connection with the way power itself corrupts staff�explains
why institutions ranging from orphanages to hospitals to prisons, where
vulnerable people are subject to total control by others, constantly
have abuse scandals and why they need to be subject to intense
oversight.
Steps 2 and 3: When imposed coercively, these principles make matters
worse. Again, voluntarily surrendering to a �higher power� can feel
healing for many�but being forced to submit to human beings who make
themselves and their program into your higher power is far less benign.
Believing that surrendering your will and even your life to the
leadership is the only path to recovery results in overwhelming
vulnerability.
Not only is this dangerous for the victims, but it is also risky for
leaders who are convinced that they �know best� and their program is so
effective that they are justified in using any means necessary to �help�
people. Once staff embrace the belief that breaking people to fix them
is acceptable, once they �know� that they are absolutely righteous even
when being emotionally cruel, the corrupting nature of this total power
is intensified.
This elevation of staff and dehumanization of patients is the opposite
of treating people with dignity and respect: the word of the �healers�
is law and those in need of healing are powerless.
At rehabs, for example, when staff believe that they have all the
answers, including which patients are �in denial� or �faking� or lying
or, for that matter, telling the truth, there is a great potential for
serious health and psychiatric complaints to be ignored. This can
have�and has had, in dozens of cases�fatal consequences for those who
are physically detained in programs. It also allows power to run amuck.
Steps 4, 5 and 10: Now, add in the demands for the confession of sins
and for an ongoing moral inventory and you have an additional method of
controlling people. Most religious cults focus on confession because
knowing members� darkest desires and most shameful secrets increases the
power of the leaders. Not only can frequent confessions enable the
blackmail dissenters, but they can also train participants to focus so
relentlessly on their own failings that they have no energy left for
criticism or resistance of the group itself.
Steps 6 and 7: And these principles add an even more poisonous element:
when imposed by force, humility becomes humiliation and defects of
character become weak spots to attack. Public humiliation and emotional
barrages aimed at humbling people can be traumatizing. When employed
explicitly to break someone, such attempts to �remove� a person�s
�shortcomings� makes him or her even more vulnerable to the leaders�
influence.
Step 11: While they may seem utterly harmless, prayer and meditation
sadly further aid this type of coercion: For one, forced meditation can
exacerbate conditions like depression. While voluntary meditation is
liberating, coercive isolation in imposed silence is known to quite
literally drive people crazy. The repetition of prayer can also be used
to create trancelike states.
Step 12: Topping off the process is the demand to �carry the message� to
others. Social psychology research shows that trying to convert other
people to your perspective is only rarely successful in attracting
followers� but it is incredibly good at convincing the person doing the
proselytizing that their own cause is correct. Even when people are made
to argue a side with which they disagree, studies show that with enough
repetition they often come to believe what they�re saying.
One further ingredient makes this stew even more toxic. It is an
inconvenient truth that in the addicted population, people with
antisocial personality disorder (ASPD) and outright psychopathy are
over-represented. These people enjoy wielding power over others and
quickly learn to use the hierarchy and the emotional attacks to their
advantage. The most charismatic rise to the top and become the
leadership, often being assigned to run new branches of the program or
leaving to open dangerous programs of their own.
This problem even occurred in the US government's Lexington, Kentucky,
narcotics farm, which was the first federal attempt to provide addiction
treatment. When it modeled one of its programs on Synanon in the 1970s,
the "inmates running the asylum" who were made staffers got so
out-of-control in their abuses of power�including sexual abuse�that the
administration had to call in the FBI and abandon the program.
This destructive pattern has recurred with grim frequency. The Elan
School�notorious for its violence, such as putting teen residents who
disagreed with the leaders in a simulated boxing ring with fresh
opponents until they surrendered�was founded by a graduate of Daytop in
its early days of intensive confrontation.
Elan was open from 1970 to 2011 and, in cult-like fashion, created true
believers who attacked critics relentlessly and tried to hide dangerous
practices rather than improving them as a legitimate healthcare facility
would.
The steps provide an unfortunate guide for unethical people who want
to control others via coercive tactics.
Florida-based Straight Inc., which operated from 1976 to 1993, forced
youths to restrain one another on the floor without bathroom breaks
until they wet or soiled themselves, gagged them with Kotex and
practiced other intense humiliation. The chain of rehabs repeatedly
ignored attempts by regulators to reform its practices and tried to
conceal them from authorities. It claims to have �treated� 50,000 teens
and also left behind many supporters who are so fervent in their belief
that the program was right that they cut family members who disagreed
out of their lives forever.
Straight led to New Jersey�s KIDS, which was founded in 1984 by its
national clinical director, Virgil Miller Newton. It was at least as
brutal. When KIDS finally lost its Medicaid funding in 1998, staff
actually went underground and secretly continued the �treatment�
(including beatings, restraint, sleep and food deprivation) without a
license until at least 2001. Following its leader in seeing itself as
above the law, it met every criteria necessary to define a cult.
Uncovering a pattern of 12-step therapeutic communities that evolved
into cults and caused grave damage to participants is in no way to imply
that 12-step programs themselves�or every rehab that requires working
the steps�are cults. But the evidence shows that the steps provide an
unfortunate guide for unethical people who want to control others via
coercive tactics.
Forcing these spiritual principles that were designed to be voluntary on
unwilling people in recovery always carries the risk of descending into
cultish behavior. Research demonstrates that such coercion can backfire,
worsening addiction and that kinder, gentler methods that respect
self-determination are more effective.
If someone chooses to climb Mount Everest and face dauntingly cold
temperatures, sleep and food limitations, isolation and painful levels
of exertion under low oxygen conditions, the challenge�although
dangerous�can be an occasion for personal growth. Forcing someone to
endure that situation, in contrast, is not only a form of torture but as
likely to produce trauma as to lead to enlightenment.
That some people find meaning in triumphing over great suffering does
not mean that deliberately causing pain is therapeutic or acceptable.
The addiction field needs some humility of its own. It must recognize
that voluntary actions and forced ones have an entirely different
psychology. Even the physiology of being out of control is different
from that of being on top: studies show that the same degree and kind of
stress can either damage your immune system or have no effect at all,
depending on whether you feel in control.
The 12 steps truly are for people who want them, not for those who we
limited humans (who are assuredly not higher powers) believe need
them�unless your goal is to start a cult. In that case, study up!