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Twelve Step Groups and Learning

Dr. Robert Smith, Ph.D. 429 E. Vermont St., Suite 11. Indianapolis IN, 46202

(317) 283-6360


Twelve step groups such as Alcoholics Anonymous have known to be effective with many alcohol and substance disorders. In this section, we will discuss factors that may help or hinder this therapeutic process. The processes of peer support interventions, 12-step groups and mentors or sponsors requires interactions that support learning. Specifically, what conditions

enable or limit the brain’s functions in learning? What does research suggest with regard to this

type of learning?

Some researchers have suggested that primitive biochemistry, neuroanatomy and reflexes in

human brain evolution work to enable the learning process in support groups such Alcoholics

Anonymous (A.A.)

1. Research suggests that learning and brain growth is best in the context of human

relationships. This would include the relationships that are formed and maintained in 12-step

groups such as A.A. *Secure relationships promote brain growth and learning.

2. Research suggests that learning is maximized in conditions of support (Peer Support,

Sponsor in A.A. or a 12 step group) encouragement and attachment to others enable

learning and brain growth (plasticity). In contrast, tension, stress and states of high arousal

limit learning, acceptance and neuroplasticity in the brain.

3. Research suggests that stress often occurs with alcoholism inhibits brain growth and


4. Some research also suggests that when we are too anxious or afraid the brain trigger certain

chemicals (norepinephrine and cortisol) that impedes the process of learning and brain

growth. It is safe to say that an interaction with peer support, beginning in a 12-step group or

being admitted into a rehabilitation facility often produces some anxiety in the problem user.

Peer Support specialists should be ready to address this anxiety. This can include staffing

the case with Employee Assistance (EAP) or Clinical Director.

5. Research suggests that the appropriate use of humor can result in chemical brain changes,

attachment (to caregivers), reduced anxiety needed in the learning process. Getting a

person into treatment involves learning and effective guidance (teaching and support). This

is also the brain neuroscience of peer support!

6. Research also suggests that an optimal learning (and support) environment requires

minimizing shame and emotional pain. In addition, the brain is quite resilient in healing

shame and emotional pain through the growth of new neuropathways (neuroplasticity).

This process can begin with peer support and supportive relationships (this is the essence of

the peer support interaction).

Alcohol Disorders Research

There have been some advances in brain science and research on alcohol addiction in the last

15 years. Research and scientific investigation have yielded some new insights in the field of

addiction. The following are excerpts from recent alcohol research.

One study suggests that dopamine (reward) systems are compromised in crucial phases of the

addiction cycle. The decrease in dopamine function is hypothesized to increase the sensitivity

of the drug (alcohol). Researchers theorize that the reward system is represented by the high

or euphoria derived from the initial usage (e.g., heavy drinking). The compromise of the

dopamine system eventually minimizes the reward.

The next phase leads to the motivation to drink that alleviates withdrawal symptoms

Alcohol diagnostic criteria for withdrawal symptoms include; irritability, nausea, vomiting, tremor,

anxiety, insomnia, hyperthermia, hyperventilation, tachycardia, convulsions, seizures,

hallucinations and delusions.

Research has suggested that 27 genes have been identified that were altered in alcoholics.

Research has also suggested that both neurobiological and environmental factors influence

motivation to drink. Biological variables (includes genetic) and environmental (includes learning

and drinking environment) factors along with social forces have strong influence. These

variables play a key role in expectations about the consequences of alcohol that shape

decisions (regarding drinking behavior).

Research has supported solid evidence in the association between chronic alcohol usage and

stress related symptoms. These symptoms include; anxiety, negative emotions, sleep difficulty,

changes in diet and aggressive behaviors. Alterations in attention, concentration, memory and

desire/craving are noted. Neuro-imaging (e.g., functional MRI) has also supported the chronic

alcohol usage stimulates the hypothalamic-pituitary-adrenal (HPA axis) that stimulates the

stress response.

Studies report that many people initially drink primarily to experience stimulation (high) and

accompanying positive affect. These people become dependent on alcohol when they switch to

drinking primarily to experience reduced anxiety associated with sedation.

A number of research reports suggest a strong association between alcohol misuse and

impulsivity. This includes a number of behaviors including risk-taking and novelty seeking


Adapted from; Summer, W. H. & Spanagle edts. Behavioral Neurobiology of Alcohol Addiction 2013

Copyright Robert Smith, Ph.D. 2019


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