Trauma and the Twelve Steps: Clinical Keys to Recovery Enhancement

Trauma and the 12 Steps:
Clinical Keys For Enhancing
Recovery Services
Jamie Marich, Ph.D., LPCC-S, LICDC
Counselor, PsyCare, Inc.
Founder, The Ohio Center for Mindful Living (Mindful Ohio)
Author, Trauma and the Twelve Steps

What led you to
today’s workshop?

About the Presenter
Ohio: LPCC-S, LICDC
Member of the American Academy of Experts on
Traumatic Stress
Twelve years of experience working in social services
and counseling; includes three years of experience in
civilian humanitarian aid in Bosnia-Hercegovina
Specialist in addictions, trauma, abuse, dissociative
disorders, performance enhancement, grief/loss, and
pastoral counseling
Trained in several specialty interventions for trauma,
most extensively in EMDR
Author, qualitative researcher
Creator, Dancing Mindfulness & Founder of the Ohio
Center for Mindful Living

Objectives
O Describe how certain 12-step approaches, slogans, and customs
may be counterproductive when working with a traumatized client
O Define trauma in a biopsychosocial/spiritual manner and explain
how honoring this holistic conceptualization of trauma enhances
addiction treatment
O Explain how certain features of 12-step recovery are productive for
working with addicted survivors of trauma stress and identify how
these features can be implemented into treatment
O Develop a plan for working 12-step recovery strategies alongside
appropriate treatment for the traumatic stress issue(s)
O Apply at least three clinical techniques from various psycho-
therapeutic approaches to help clients attain addiction recovery in
a trauma-sensitive fashion

Dr. Marich’s Working Definition
O Addiction is continuing to do something
(e.g., drink alcohol, smoke cigarettes,
gamble, engage in sexual activity), even
when the activity causes repeated pain
and consequences.
SOURCE: GWC, Inc. (1993), Human Addiction

From Dr. Kevin McCauley
(2009):
O Organ Defect (Cause)  Symptoms

(2009):
O Organ Defect (Cause)  Symptoms
O Femur Fracture (e.g., skiing)  Pain
O Pancreas  No Insulin  Blindness,
Numbness, Wounds

(2009):
O ___________  __________ 
_____________

(2009):
O ___________  __________ 
_____________
O Midbrain  Various *  Biopsychosocial
Consequences
* Addiction (McCauley): defect in the brain’s ability to
perceive, process, and act upon pleasurable/painful
experiences

Models of Addiction
Rigid acceptance of the disease
model, or any alternative model,
is not optimally trauma-sensitive.

Once you’ve been bitten by a
snake, you’re afraid even of a
piece of rope.
-Chinese Proverb

PTSD: DSM-IV-TR
O Actual or perceived threat of injury or death- response
of hopelessness or horror (Criterion A)
O Re-experiencing of the trauma
O Avoidance of stimuli associated with the trauma
O Heightened arousal symptoms
O Duration of symptoms longer than 1 month
O Functional impairment due to disturbances

For the latest updates on DSM-5,
visit the official website at
www.dsm5.org

Trauma: small-t
• Although not life-threatening, definitely life-altering
• If it’s traumatic to the person, then it’s
traumatic
• Examples include grief/loss, divorce, verbal
abuse/bullying, and just about everything
else…

Etymological Origin
O Trauma comes from the Greek
word meaning wound
O What do we know about physical
wounds and how they heal?

A Client’s Perspective:
Lily Burana (2009)
“PTSD means, in ‘talking over beer’ terms, that you’ve
got some crossed wires in your brain due to the
traumatic event. The overload of stress makes your
panic button touchier than most people’s, so certain
things trigger a stress reaction- or more candidly- an
over-reaction. Sometimes, the panic button gets stuck
altogether and you’re in a state of constant alert,
buzzing and twitchy and aggressive.”

Lily Burana (2009)
““Your amygdala- the instinctive flight, fight, or freeze partYour amygdala- the instinctive flight, fight, or freeze part
of your brain- reacts to a trigger before your rationalof your brain- reacts to a trigger before your rational
mind can deter it. You can tell yourself, ‘it’s okay,’ butmind can deter it. You can tell yourself, ‘it’s okay,’ but
your wily brain is already ten steps ahead of the game,your wily brain is already ten steps ahead of the game,
registering danger and sounding the alarm. So youregistering danger and sounding the alarm. So you
might say once again, in a calm, reasoned cognitive-might say once again, in a calm, reasoned cognitive-
behavioral-therapy kind of way, ‘Brain, it’s okay…’behavioral-therapy kind of way, ‘Brain, it’s okay…’

Lily Burana (2009)
“But your brain yells back, ‘Bullshit kid, how dumb do you
think I am? I’m not falling for that one again.’ By then,
you’re hiding in the closet, hiding in a bottle, and/or
hiding from life, crying, raging, or ignoring the phone
and watching the counter on the answering machine go
up, up, up, and up. You can’t relax, and you can’t
concentrate because the demons are still pulling at
your strings.”

Lily Burana (2009)
“The long-range result is that the peace of mind you
deserve in the present is held hostage by the terror
of your past.”

from Marich (2010)
Fadalia (pseudonym), a recovering heroin addict with complex
trauma reflected on where she was at before receiving the
integrated treatment that led to her longest sobriety to date
(3 years):
“Before [treatment], my feelings,
thoughts and experiences were all
tangled like a ball of yarn. I needed
something to untangle them.”

Putting it Simply…
O Cognitive-behavioral therapies primarily target
the prefrontal regions of the brain (e.g.,
thinking, judgment, and willpower).
However, when a person gets activated or
triggered by traumatic memories or other
visceral experiences, the prefrontal cortex is
likely to shut down and the limbic brain (e.g.,
emotional brain) takes over.

Putting it Simply…
O Simply talking about the trauma can trigger this
volatile, limbic region, and if the client has no
skills to regulate these intense emotions, a
client can be re-traumatized.

Putting It Simply
O What does not seem to change with traditional talk
therapy is that uncomfortable experience of being
triggered at a visceral level, (bottom of the brain)
when the person is faced with reminiscent features of
the original trauma in the present (Brown, 2003)

Putting it Simply
O Thus, our therapeutic interventions must
address the entire brain.
O Another way to look at processing is to
think of these three brains “linking up”

How Significant is Trauma When it
Comes to Treating Addictions?
-High comorbidity between PTSD and substance use
disorders: 27.9% of those with PTSD meet criteria for
substance abuse, 34.5% meet criteria for dependence
(Kessler et al., 1995; (Peirce, Kindbom, Waesche,
Yuscavage, & Brooner, 2008)
-Of patients in substance disorder treatment, 12-34%
have PTSD; these numbers can be as high as 33-59% in
women (Najavits,2001; 2005).

How Significant is Trauma When it
Comes to Treating Addictions?
Comorbidity between PTSD and
addictions has been established, and
untreated PTSD has been identified as a
factor in relapse
(Miller & Guidry, 2001; Zweben & Yeary, 2006)

Ricci and Clayton (2008)
“Trauma may also disintegrate any sense of a
future, thus fostering a propensity for the
pursuit of instant gratification” (p. 42).

A Brief Primer on
12-Step Recovery
O Alcoholics Anonymous founded in 1935 by Bill Wilson
and Dr. Bob Smith in Akron, OH
O Both had been members of the Oxford Groups
O Decided to focus on reaching out just to the alcoholic
(a difference from the Oxford Groups), but kept many
of the same principles

A Brief Primer on
12-Step Recovery
• Six steps of the Oxford Groups:
1. Admitted hopelessness
2. Got honest with self
3. Got honest with another
4. Made amends
5. Help others
6. Prayed to God as you understand him

A Brief Primer on
12-Step Recovery
O The publication of the book Alcoholics Anonymous in
1939 gave the fellowship a name, saw the publication
of the first draft of the 12-steps, and gave the A.A.
fellowship some uniformity
O Although A.A. co-founder Bill Wilson is the primary
author of the first part of the “Big Book,” various edits
of the book were passed back and forth between the
New York and Akron groups.

Context: A Brief Primer on
12-Step Recovery
O Bill Wilson (who was the New Yorker) and the
Akron groups wanted to keep the focus on
spirituality.
O The New York groups wanted to keep the focus on
the physical aspects of alcoholism.
O What emerged was a combination of the two
approaches

A Brief Primer on
12-Step Recovery
• The groups hoped that the initial publication of the
book in April of 1939 would propel the message of
Alcoholics Anonymous into the mainstream
• To the dismay of the groups, orders for the book only
“trickled” in
• The Rockerfeller foundation assisted with getting the
4,000 non-purchased copies of the book out of
storage
• There was not a need for a second printing of the so-
called “Big Book” until 1941

A Brief Primer on
12-Step Recovery
• It was actually The Saturday Evening Post article in
March 1941 that caused the membership of
Alcoholics Anonymous to expand exponentially
throughout the United States.
• Noted writer Jack Alexander had set out to expose A.A.
as a fraud…what emerged was 6 pages of praise about
the A.A. fellowship, necessitating a second printing of
the Big Book.

A Brief Primer on
12-Step Recovery
Fruits of Alcoholics Anonymous (A.A.):
Acknowledgment of addiction as a disease by the
American Medical Association in 1952
Influenced the development and rise to popularity of
the Minnesota model of treatment in the 1950’s
Prompted the founding of hundreds of related
fellowships that also use the 12-steps

12 Steps of Alcoholics Anonymous (1939/2001)
 Step 1 - We admitted we were powerless over alcohol- that our lives had
become unmanageable
 Step 2 - Came to believe that a Power greater than ourselves could restore
us to sanity
 Step 3 - Made a decision to turn our will and our lives over to the care of God
as we understood God
 Step 4 - Made a searching and fearless moral inventory of ourselves
 Step 5 - Admitted to God, to ourselves and to another human being the exact
nature of our wrongs
 Step 6 - Were entirely ready to have God remove all these defects of
character
 Step 7 - Humbly asked God to remove our shortcomings
 Step 8 - Made a list of all persons we had harmed, and became willing to
make amends to them all
 Step 9 - Made direct amends to such people wherever possible, except when
to do so would injure them or others
 Step 10 - Continued to take personal inventory and when we were wrong
promptly admitted it
 Step 11 - Sought through prayer and meditation to improve our conscious
contact with God as we understood God, praying only for knowledge of God's
will for us and the power to carry that out
 Step 12 - Having had a spiritual awakening as the result of these steps, we
tried to carry this message to other addicts, and to practice these principles
in all our affairs

Let’s Discuss…
O What are your thoughts/feelings on 12-step recovery?
O What limitations have you encountered with 12-step
recovery in certain populations?
O What does it mean for an intervention, such as 12-step
recovery, to be trauma-sensitive?

Common Criticisms of
12-Step Recovery
O Too much emphasis on spirituality
O Too one-size fits all
O Emphasis on powerlessness and character defects is
counter-therapeutic
O Certain 12-step groups and treatment centers can get
too fanatic
O Disease model of addiction is not acceptable

Common Problems in
Treatment
O Rigid application of 12-step principles
without considering role of trauma
O “They’re just addicts”
O “You’re here to work on your addiction, not
the trauma”
O Tricky scenarios in group work

PROBLEM #1
Rigid application of 12-step
principles without
considering role of trauma

Potentially Problematic
12-Step Slogans
O Just For Today/One Day at a Time
O Take the Cotton Out of Your Ears and Put it
in Your Mouth
O Your Best Thinking Got You Here
O Think, Think, Think
O We Are Only as Sick as Our Secrets
O Any misplaced spirituality slogan…

And The Gauntlet…
4th
and 5th
Step Work
4. Made a searching and fearless moral
inventory of ourselves
5. Were entirely ready to have God remove
all these defects of character
What makes these steps nearly impossible
for someone with unresolved trauma
issues?

Case Study: Nancy (Marich, 2009)
You can’t put anything in the proper perspective. And you can’t
really get a heads up on what really happened because you were
so traumatized and you had such bad experiences and like in my
case, I had the trauma then I had the- I call it the after-effect of
my ex-husband- pounding over and over and over and over it for
like 14 years after that. I took so much responsibility for it. It
was almost like I victimized myself all over again in my mind.

PROBLEM #2
“They’re just addicts…”
-and/or-
“You’re here to work on your
addiction, not your trauma.”

Evans & Sullivan (1995):
Living in the Solution
1.) A large portion of clients presenting for treatment in
any setting have a history of childhood trauma.
Respecting this history enhances treatment.
2.) Successful treatment of the trauma must include
working through memories of the trauma in an
experiential way, after the clinician and client have
established a foundation of safety and coping skills

3.) Substance use disorders are a significant part of the
clinical picture for a substantial number of survivors of
childhood abuse, thus:
-Treatment of the abuse issues that does
not address the substance use issues will
be ineffective
- Treating only the addiction in those with
survivor issues will likely be ineffective

4.) The disease model of addiction and conventional 12-
step approaches to treatment are productive in treating
the addicted survivor of trauma
5.) Treatment models for addicted survivors of trauma
must be integrated, and must address the synergism
of trauma and addiction. A two-track approach is
generally ineffective.

Practical Tips for
12-Step Facilitation
O Get to know the local meetings in your area that
are known for tolerance
O Encourage gender-specific meetings
O Advise looking for a sponsor who has at least a
basic understanding of trauma and/or someone
who is not strictly “letter of the law”

Practical Tips for
O Encourage clients to bring their concerns about
what they see/hear at 12-step meetings to
counseling
O Work with clients to build a set of practical, body-
based coping skills (e.g., breath work, muscle
relaxation, exercise, music, journaling) especially
before 4th
and 5th
step work

Practical Tips for
O Consider using individual counseling to help clients
identify their roadblocks to successfully completing
4th
and 5th
steps (may also apply to 8th
and 9th
steps)
O Evaluate with a client whether or not the 5th
step will
be best completed with a trained professional…
remember, the step just says another human being

Practical Tips for
O Be prepared to process pejorative slogans or
insults to self that clients may hear in meetings or
from traditional counselors
O Name calling and hot seat strategies, even if done
in a spirit of “tough love” can be incredibly
damaging for the traumatized client

PROBLEM #3
Tricky scenarios in group
work…

Wrap-Up: Best Practices for
Interacting with Clients
O Do not re-traumatize!
O Do be genuine
O Do ask open-ended questions
O Do be non-judgmental
O Do make use of the stop sign when appropriate
O Do assure the client that they may not be alone
in their experiences (if appropriate)
O Have closure strategies ready
O Do consider the role of shame in addiction,
trauma, and grief

What is Shame?
Guilt is feeling bad about what
you’ve done,
Shame is feeling bad about who
you are.
“Shame is the lie that someone
told you about yourself.”
-Anais Nin

“When we honestly ask ourselves which
person in our lives means the most to us,
we often find that it is those who, instead
of giving advice, solutions, or cures, have
chosen rather to share our pain and
touch our wounds with a warm and
tender hand.”
-Henri Nouwen

From Dr. Bessel Van Der Kolk
“The purpose of trauma treatment
is to help a person feel safe in his
or her own body.”
-from a the new documentary
Trauma Treatment for the 21st
Century (Premier, 2012)

General Consensus Model of
Trauma Treatment
OPHASE I: Stabilization
OPHASE II: Processing of Trauma
OPHASE III: Reintegration

Incorporating into Addiction Treatment
O Research is continuing to demonstrate that any of
these past-oriented treatments can be
appropriately applied to an integrated addiction
treatment program when proper precautions are
taken (Marich, 2010)

Tying it All Together…
O Before any clinician can engage in past-
oriented trauma treatments focused on
resolution, a set of coping skills must be in
place.

Phase I Treatment Planning
-A set of coping skills must be in place
before heavier trauma resolution
therapies can take place.
-Initial treatment is a valuable time to
help with coping skills training and
installation.

What Types of Coping
Skills Work Best???
O Breath work
O Muscle relaxation/pressure points
O Yoga
O Imagery/multisensory soothing
O Resources & Recovery Capital
O Spiritual principles
O Anything that incorporates the body in a
positive, adaptive way!!!

Breathing Basics
“The mind controls the body, but the
breath controls the mind.”
B.K.S. Iyengar

Breathing Basics
"Practicing regular, mindful breathing can be
calming and energizing and can even help with
stress-related health problems ranging from panic
attacks to digestive disorders.“
Andrew Weil, M.D.

Breathing Basics
“Teaching breathing exercises to your client is like
teaching a teenager when to accelerate and when
to brake the car.”
Amy Weintraub

Strategy #1: Breathing Basics
ODiaphragmatic breathing
OComplete breathing
OUjjayi breathing

Breathing Basics
O Clients who are easily activated may not feel
comfortable closing their eyes during breath work..
O Start slowly…if a client is not used to breathing
deliberately, don’t overwhelm him. Starting with a
few simple breaths, and encouraging repetition as a
homework assignment, is fine.
O If a client has a history of medical difficulties, make
sure to obtain a release to speak with her medical
provider before proceeding.

Strategy #2:
Progressive Muscle Relaxation

Strategy #3: Pressure Points
Sea of Tranquility
Letting Go/Butterfly Hug
Gates of Consciousness
Third Eye (and variations)
Karate Chop/Inner Gate

Yoga: Hype or Hope?
O Dr. Bessel Van Der Kolk is a leading research
proponent of using yoga as a primary and
adjunctive treatment for PTSD
O Yoga, if integrated safely and appropriately, is at
very least, an ideal coping skill technique in
traumatized individuals
O Many addiction treatment centers throughout the
world offer yoga

Yoga (Union)
O Recommendation:

Yoga (Union)
O Recommendation:
Yoga and the 12-Step Path
By Kyczy Hawk

Strategy 4:
Body Cuing & Soothing
OImagery
OSound
OSmell
OTouch/Tactile
OTaste

Strategy #5: Mindfulness
Mindfulness means paying attention in a
particular way: on purpose, in the presence
of the moment, and non-judgmentally.
-Jon Kabat-Zinn (1994)

Strategy #6: Acceptance
- acceptance as Buddhist principle
- 12-step recovery (Alcoholics Anonymous, 2001;
p. 417)
-”radical acceptance” (from dialectical behavioral
therapy)
-acceptance and commitment therapy

Strategy #7: Empowerment
O Encourage that change is possible, no matter how
chronic the relapser… be sincere about it (Marich,
2010).
O Foster identification as a survivor, not a victim
(Hantman & Solomon, 2007)

Factors to Consider Before
Going Farther …
O Does the client have a reasonable amount of
coping skills to access?
O Is there a sufficient amount of positive material
(e.g., recovery capital) in the client’s life?
O Is the client willing (and ready) to look at past
issues? In 12-step terms, this is best done between
steps 1-3 and 4-5.
O Have you assessed for secondary gains and other
related issues?
O Have you considered number of sessions available?

Reprocessing Made Simple
OI am not good enough 
OI am good enough

The Common Factors
O Client and extratherapeutic factors
O Models and techniques that work to engage
and inspire the participants
O The therapeutic relationship/alliance
O Therapist factors
Source: Duncan, B.L., Miller, S.D., Wampold, B.E., Hubble,
M.E. (2009). The heart and soul of change: Delivering what
works in psychotherapy. (2nd
ed.) Washington, D.C.:
American Psychological Association.

Some Reprocessing
Approaches You May
Already Incorporate…
O Narrative Therapy
O Trauma-Focused CBT
O Gestalt Elements
O Mindfulness-Based Cognitive Therapy
O Somatic experiencing

Innovative & Specialty
Training Approaches
O Art/music/performance therapies
O EMDR
O Hypnotherapy
O EFT/NET/TFT

Intense Affect & Abreaction
O “The therapeutic process of bringing forgotten or
inhibited material (i.e., experiences, memories) from
the unconscious into consciousness, with
concurrent emotional release and discharge of
tension and anxiety.”
APA Dictionary of Psychology; VandenBos (2007)

For Continued Development
O What are my personal barriers with addiction and
trauma?
O How do I handle intense affect and abreaction?
O What factors may inhibit me from being effective
with a traumatized addict?
O When is the best time to use collaborative
referrals?

Why it Matters…
O The literature in general traumatic stress
studies suggests that the therapeutic alliance
between client and clinician is an important
mechanism in facilitating meaningful change
for clients with complex PTSD (Fosha, 2000;
Fosha & Slowiaczek, 1997; Courtois &
Pearlman, 2005)

Tips for Collaborative Referral
O Know your limits. If a client is triggering you too
much, don’t be afraid to refer.
O Network in your local community—get to know who
offers what and who seems to be most
knowledgeable in trauma and addiction.
O The Internet is a treasure trove of resources. Many
of the major websites in trauma therapies have
data bases listing clinicians around the country
who have gone through extra training.

Tips for Collaborative Referral
O In making psychiatric referral, get to know the doctors
(or nurse practitioners) in your area who have a
prudent, balanced approach to medication.
O It is not wise to send a client who struggles with
addiction and trauma issues to a psychiatrist who
relies heavily on benzodiazepine prescribing (or use
of other controlled substances)

RESOURCE
Medications and the Recovering Person (pdf)
Available at: www.glenbeigh.com
(Under “Resources”)

References
O Alcoholics Anonymous World Services. (2001). Alcoholics anonymous. (4th
ed.) New York: Author.
O American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders. (4th
ed.-text revision) Washington, D.C.: Author.
O Brown, S. (2003). The missing piece: The case for EMDR-based treatment for posttraumatic stress
disorder and co-occurring substance use disorder. LifeForce Trauma Solutions. Retrieved June 4,
2008, from http://www.lifeforceservices.com/ article_detail.php?recordid=5
O Burana, L. I love a man in uniform: A memoir of love, war, and other battles. New York: Weinstein
Books.
O Courtois, C.A., & Pearlman, L.A. (2005). Clinical applications of the attachment framework: Relational
treatment of complex trauma. Journal of Traumatic Stress, 18(5), 449-459.
O Cunningham, A. (2010). Healing addiction with yoga: A yoga program for people in 12-step recovery.
Forres, Scotland, UK: Findhorn Press.
O Duncan, B.L., Miller, S.D., Wampold, B.E., Hubble, M.E. (2009). The heart and soul of change:
Delivering what works in psychotherapy. (2nd
ed.) Washington, D.C.: American Psychological
Association.
O Evans, K., & Sullivan, J.M. (1995). Treating addicted survivors of trauma. New York: The Guilford
Press.
O Fosha, D. (2000). The transforming power of affect: A model for accelerated change. New York:
Basic Books.
O Fosha, D., & Slowiaczek, M.I. (1997). Techniques to accelerate dynamic psychotherapy. American
Journal of Psychotherapy, 51(2), 229-251.
O GWC, Inc. (1993). Human addiction [VHS Tape]. Cahokia, IL: Author.
O Hantman, S., & Solomon, Z. (2007). Recurrent trauma: Holocaust survivors cope with aging and
cancer. Social Psychiatry & Psychiatric Epidemiology, 42, 396-402.
O Kabat-Zinn, J. (1994). Full catastrophe living: Using the wisdom of your body and mind to face
stress, pain, and illness. New York: Dell Publishing.
O Kessler, R.C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C.B. (1995). Posttraumatic stress
disorder in the national comorbidity survey. Archives of General Psychiatry, 52, 1048-1060.

References
O Marich, J. (2009). EMDR in addiction continuing care: Case study of a cross-addicted female’s
treatment and recovery. Journal of EMDR Practice and Research, 3(2), 98-106.
O Marich, J. (2010). EMDR in addiction continuing care: A phenomenological study of women in early
recovery. Psychology of Addictive Behaviors, 24(3), 498-507. McCauley, K. (2009). Pleasure
unwoven. [DVD]. Salt Lake City, UT: Institute for Addiction Study.
O Miller, D. & Guidry, L. (2001). Addictions and trauma recovery: Healing the body, mind, and spirit.
New York: W.W. Norton.
O Najavits, L. (2001). Seeking safety: A treatment manual for PTSD and substance abuse. New York:
The Guilford Press.
O
O Najavits, L. (2005). Handouts for training on PTSD and Seeking Safety. ODADAS Women’s
Symposium, May 16-19, 2006.
O Peirce, J.M., Kindbom, K.A., Waesche, M.C., Yuscavage, A.S., & Brooner, R.K. (2008). Post-traumatic
stress disorder, gender and problem profiles in substance dependent patients. Substance Use and
Misuse, 43, 596-611.
O Premiere Education & Media. (2012). Trauma treatment: Psychotherapy for the 21st
century [DVD].
Eau Claire, WI: Author.
O Ricci, R.J., & Clayton, C.A. (2008). Trauma resolution treatment as an adjunct to standard treatment
for child molesters. Journal of EMDR Practice and Research, 2(1), 41-50.
O VandenBos, G.R. (Ed.) (2007). APA dictionary of psychology. Washington, DC: The American
Psychological Association.
O Weintraub, A. (2012). Yoga skills for therapists. New York: W.W. Norton.
O Zweben, J., & Yeary, J. (2006). EMDR in the treatment of addiction. Journal of Chemical Dependency
Treatment, 8(2), 115-127.

To contact today’s presenter:
Jamie Marich, Ph.D., LPCC-S, LICDC
The Ohio Center for Mindful Living
jamie@jamiemarich.com
www.jamiemarich.com
www.drjamiemarich.com
www.TraumaTwelve.com
www.DancingMindfulness.com
Phone: 330-881-2944

Trauma and the Twelve Steps: Clinical Keys to Recovery Enhancement

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