There has been much skepticism regarding the effectiveness of AA, in large part because of the spiritual element of the 12-step recovery model. Many discount AA (and its brethren) because they cannot reconcile their religious/spiritual beliefs with the concept of a higher-power, and therefore give up before they really get started. This article seeks to explain the neuro-science behind 12-step recovery programs, both for the clinician wishing to guide the people in their care and for the skeptical newcomer struggling to “surrender”.
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Autonomic Nervous System (ANS)
The ANS controls body actions (breathing, heart beating, digestion, fighting expressing anger, feeling fear) without much conscious control. According to Stephen Porges, the ANS has three major components, the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PSNS). The PSNS has two parts, the Ventral Vagal Branch (VVB) and the Dorsal Vagal Branch (DVB).
The SNS is the nervous system which produces action. When activated by the perceived experience of fear, and danger it goes into a “let’s try to survive” stressed out mode of anger, fight or flee. This is somewhat destructive to our bodies. It is not a nice place to be in.
If however, the action of fighting or fleeing doesn’t work, then the body goes into a freeze state associated with activation of the DVB branch of the SNS.
We recover from the physical damage done to our bodies by going into the VVB branch of the PSNS system, which is associated with rest, digest, heal, reproduce, connection and all those nice, pleasant things to experience.
A suggestion for what might be happening in AA recovery
Research has shown that excess alcohol consumption damages the ANS and especially the PSNS. Research has shown that AA members with long term sobriety seem to have re-activated their PSNS. We suggest that this process happens when the recovering AA member takes humbling actions by working and living the AA program. We analyzed the Twelve steps and especially the Seventh step prayer and found that each suggested action is a humbling action. Each humbling action supports the recovering alcoholic to move from an ego-centered SNS active ANS to a more peaceful serene, sober-minded, connected state of an activated VVB branch of the PSNS. Science has shown that AA members with long term sobriety have increased Emotional Regulation (aka serenity) which is most probably a result of increased activity of the VVB branch of the PSNS activity. This work was done by the SCALAB of the University of Lille in France.
This shift most probably happens because of the “Fake it until you make it” methodology when the humbling actions fire neurons that, if the action are repeated often enough, the neurons will wire together. The recovering alcoholic will live more with an activated VVB branch of the PSNS. Experiencing less fear (more acceptance) in this state might reduce the alcoholics tendency to want to make the fear to go away by drinking alcohol with its devastating consequences.
Reactions from AA members
Most AA members don’t want to listen to or adopt this viewpoint . It contains implicit AA heresy in that it says a belief in God/HP is not necessary for recovery. Just taking actions that the ego finds humbling is enough!!
However a belief in HP is very useful as it encourages the believer to take the humbling actions necessary to shift from ego (Sympathetic Nervous System active , fear, anger, loneliness) into Serenity ( Parasympathetic Nervous System active ,connection, peace, acceptance ).
Things like prayer (especially the 7th Step prayer), Asking HP/God for help/direction, expressing gratitude to HP are humbling actions that will lead to the shift in activity in the Autonomic Nervous System. to the Serene State which AA members pray for often in the Serenity Prayer.
If the recovering alcoholic is willing to believe the above ideas, then the recommendation to retain sobriety is to continue to take the humbling actions suggested in the program such as living the steps, service, attend meetings, sponsor and being sponsored, pray to be granted sobriety etc. Just the stuff we all have been told to do many times before 🙂
There are lots of other ways of activating the VVB branch of the PSNS. My favorite is slow deep breathing (respiratory sinus arrythmia). But meditation, yoga and tai chi also work.
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