Twelve Step Groups and Learning
Dr. Robert Smith, Ph.D. 429 E. Vermont St., Suite 11.
drbobtherapy.com Indianapolis IN, 46202
TWELVE STEP GROUPS AND LEARNING
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
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
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