1. The Historical and Spiritual Foundations of
the Twelve Steps: Personal Significance
and a Pathway for Development
Jeffrey Rediger, MD, MDiv
Medical and Clinical Director
McLean Hospital SE and Community Programs
Harvard Medical School
Consultant
Good Samaritan Medical Center
Founder
Center for Psychological and Spiritual Development

2. Spirituality
Spirituality is the “eternal flame of life and love that
burns in the heart;” the realization that there is
something magnificent within us; an expansive “YES”
to life and oneself and others
Religion is an effort to box that flame
Is about becoming human rather than “godly”
Transcendence comes through attaining the
universally human
Whatever increases our capacity to know and
experience love

3. Spirituality
One’s “ultimate concern” (Paul Tillich)
Whatever it is that opens the heart and helps one feel
more alive and connected
Whatever it is that is genuinely restorative of life and
energy: nature, self-care, time with good
friends, activities that promote self-
knowledge, awaken hope and awareness of latent
potentials within oneself and others

4. Historical and Spiritual Foundations of
the Twelve Steps
• Letter from Bill W. to Dr. Carl Jung on January 23,
1961
• Letter from Dr. Carl Jung to Bill W. on January 30,
1961
• Carl Jung
• Oxford Group
• William James
• Belief in the goodness and magnificence of the
individual

5. “Hi, my name is Barry and I check my email two to three
hundred times per day”

6. Alcoholics Anonymous
• Began in 1935 with a conversation between Bill W., a
stockbroker, and Dr. Bob, a physician who also
suffered from alcoholism
• Today: AA is in over 200 countries, with 114,070
groups
• 2 million members in the United States alone
• NA numbers over 58,000 meetings in 131 countries
• Alcoholics Anonymous has sold over 30 million copies
and has been translated into 67 languages

7. Carl Jung and the Twelve Steps
• Spiritus contra spiritum: Addiction is ultimately about
a search for something higher
• One of the early forces distinguishing spirituality from
religion
• Explored the deeper relationship of psychology and
spirituality in the psyche

8. Individuation in Carl Jung
• Individuation: the process by which the individual Self
develops out of an undifferentiated matrix such as the
family or peer group, etc.
• For example, instead of not being genuinely happy
until the loved one has stopped drinking, individuation
suggests that each individual should develop his or
her own capacities and follow his or her own highest
aspirations. This is best for the person and also best
for the addict.

9. The Oxford Group
• Founded in 1921 by Frank Buchman
• Not a religion or a denomination; was also one of the
early efforts to distinguish religion from spirituality
• Represents a step away from organized religion and
the belief that the individual must be taught, guided or
controlled
• People helping people: one of the first successful
examples of a mutual-help group

10. The Oxford Group
• “…one man talking to another or one woman
discussing her problems with another woman was the
order of the day”
• Good Housekeeping (1936): described the Group as
having no membership, no dues, no paid leaders, no
new theological creed, nor regular meetings. “A
fellowship of people who desire to follow a way of life,
a determination, not a denomination.”

11. The Oxford Group’s Four Spiritual
Practices
1. The sharing of errors and temptations with another
person
2. Surrender of one’s life - past, present and future - to
God, as one understands God to be
3. Restitution to all whom one has wronged directly or
indirectly
4. The use of an early morning “quiet time”, where the
person reads spiritual literature and then with pen and
paper seeks direction for the day ahead.

12. Bill W. on the Oxford Group
• "The early AA got its ideas of self-examination,
acknowledgment of character defects, restitution for
harm done, and working with others straight from the
Oxford Group…and from nowhere else.”

13. Carl Jung on the Oxford Group
“…when a member of the Oxford Group comes to me in
order to get treatment, I say, "You are in the Oxford
Group; so long as you are there, you settle your affair
with the Oxford Group. I can't do it better...."

14. Dr. Silkworth
• Was Bill W.’s physician
• Advised Bill W. to change his approach and tell the
alcoholics they suffered from a disease - that could
kill them - and then apply the Oxford Practices
• Alcoholism as a disease and not a moral failing was
different from the Oxford concept that drinking was a
sin
• This is what Bill W. brought to Dr. Bob on their first
meeting
• Dr. Bob was the first alcoholic Bill W. helped to
sobriety.

15. Addiction as Moral Failing vs. Disease
• Western Christianity evolved away from its original roots
when it adopted Roman legal concepts
• Sin became condemnation, rather than an error or “missing
the mark”
• Law became more important than the person; no more did
law exist only in order to nurture individual life and well-being
• Basic goodness was lost; guilt, shame and “not measuring
up” permeated the western psyche (but not in Eastern
Christianity)
• Disease concept: an effort to off-set condemnation of self
and others, and to bring addiction into the fold of common

16. “Our psychopharmacologist is a genius!”
„

17. William James and the Twelve
Steps
The Varieties of Religious Experience “…indicates a
multitude of ways in which men have discovered God.
We have no desire to convince anyone that there is only
one way by which faith can be acquired….all of us,
whatever our race, creed, or color are the children of a
living Creator with whom we may form a relationship
upon simple and understandable terms as soon as we
are willing and honest enough to try. Those having
religious affiliations will find here nothing disturbing to
their beliefs or ceremonies…. “
The
Big Book

18. William James and the Twelve
Steps
• “…the sway of alcohol over mankind is
unquestionably due to its powers to stimulate the
mystical faculties of human nature, usually crushed to
the earth by the cold facts and dry criticisms of the
sober hour. Sobriety diminishes, discriminates, and
says no; drunkenness expands, unites, and says
yes.””
• “The drunken consciousness is one bit of the mystic
consciousness, and our total opinion of it must find its
place in our opinion of that larger whole.”

19. The Mystic Consciousness of the Addict

20. Two World-views
Ancient Spiritualities Disease Model
Person is perfect Person is flawed
Whole and complete; Needs external
possesses all that is needed knowledge or technology
to be added
Asleep
Deficit
Treatment is to awaken
Treatment is external:
medicine, procedure, or
external knowledge

21. Two World-views
Ancient Spiritualities Western Thought
Divinity is within (both Divinity is external or non-
immanent and beyond) existent
Emphasis is on connection Emphasis is on individual
and wholeness expression
Illness begins in the Soul Illness begins in the Body
Whole is greater than the Emphasis is on the parts
sum of the parts and the individual

22. Two World-views
Ancient Spiritualities Western Thought
Underlying perfection Original sin is primary
Immortal Emphasizes this life
Indestructible Destructible
Power with others Power over others
Invisible world is primary Visible world is primary

23. Reflection: Two World-views
Ancient Spiritualities Disease Model
Person is perfect Person is flawed
Whole and complete; Needs external
possesses all that is needed knowledge or technology
to be added
Asleep
Deficit
Treatment is to awaken
Treatment is external:
medicine, procedure, or
external knowledge

24. Thought Experiment
Given that spontaneous remissions may follow
discernible principles, the place of consciousness in
modern science and the better spiritual writings, what
helps people heal? What most motivates people to
help themselves and help each other?
It has taken hundreds of years to define the physical
laws of the universe
Is it possible that there are laws or principles of the
mind and heart that are more powerful than we
realize?

25. Ambulances vs. Guideposts

26. Mask vs. the Person
Examples of masks:
degrees, jobs, incomes, illnesses, age, appearances,
roles we play
Masks are roles that we play:
daughters, sons, lovers, spouses, employees, therapi
sts, patients, clients, etc.
Masks are also illnesses and diagnoses:
addictions, medical and psychological illnesses

27. Parts vs. the Whole
In the West, we focus on parts to the exclusion of the
whole:
a psychological problem is sent to the therapist
a medical problem is sent to the physician
a spiritual problem is sent to the priest, rabbi or
minister

28. New Model of the Person
So far:
The person is not his or her diagnosis or
addiction
The person is more than the sum of
biological, psychological and spiritual “parts”
It is a person who stands behind and orders all
the “parts” and “masks” into a coherent whole

29. Personhood
Our concept of personhood is evolving over the centuries.
A new conception was the basis for the Declaration of
Independence
Benjamin Franklin suggested the use of “self-evident” as a
way to base the new political system on common rationality
rather than sectarian religion
“We hold these truths to be self-evident, that all men are
created equal, that they are endowed by their Creator with
certain inalienable Rights, that among these are Life, Liberty
and the pursuit of Happiness...”

30. The Evolution of Culture
Religion: People are fundamentally sinful, even evil
creatures
Medicine: The disease model reifies disease
Psychology: Problems are reduced to deficits from
childhood
Psychiatry: Problems are reduced to neuro-chemical
defects

31. Deficit Models in Religion
Religion sometimes seeks to celebrate personhood in
theory
But too often:
teaches a negative view of human life
restricts personhood to a select few
teaches the opposite in practice
seeks to control rather than liberate

32. Deficit Models in Psychology
and Psychiatry
Reduce conflicts to deficits from childhood or neuro-
chemical defects
Assume that the deficits and defects reflect something
real about the person
This creates treatment resistance

33. “Before Prozac, she loathed company”

34. The Evolution of Culture
A slow movement away from negative and deficit-
based models towards a positive vision of the human
experience
Democracy, human rights, increased emphasis on the
self-evident dignity and inborn capacities and
possibilities of all human beings
A flowering of the inner life and capacities for self-
knowledge and self-determination

35. The Evolution of Culture
The theories of William James were a proto-type
Third-force psychology (Carl Rogers, Abraham
Maslow) heralded a new direction
Alcoholics Anonymous, Meditation, Self-Help, Positive
Psychology and Alternative Medicine represent a
flowering
Flowering of consciousness and renaissance closely
related to the meeting of East and West

36. Principles of Healing
We matter more than we have a clue about
We are more connected to others than we realize
We become what we focus on

37. The Primacy and Dignity of
Personhood
Each person brings something unrepeatable and
magnificent into the world
We suffer to the exact degree that we fail to
understand the dignity and magnificence of our
individual life and being
At the bottom of much of illness and disease lies a
longing to be seen, loved and valued unconditionally,
as one asleep but with potential

38. The Primacy and Dignity of
Personhood
Can be described in both “spiritual” and “non-spiritual”
language
Is described in the best of spiritual writing: Imago Dei, the
light within, divine spark, inner light, child of God, etc.

39. PII
Perfect, Immortal, Indestructible
From a higher perspective, the evidence of the five
senses gives rise to an illusion: we are not our masks
or who we appear to be
The perfection of imperfection: liberation comes from
the growing experience that we are both perfect and
imperfect human beings - “good enough”

40. PII
brings out the depth and genius of ourselves and
each other
helps us be present to the possibilities and the beauty
within our clients, and also within ourselves
revives hope and faith, which are vital forces for
healing
emphasizes the unrepeatable, unique gift that each
individual is; and that nothing can take this basic
reality away

41. PII
In spiritual language, the goal is to see the client, and
ourselves, not with our physical eyes, but with the
“eyes of the heart”
Seeing in this way liberates people and relationships
for gratitude rather than fear
This offsets the human tendency to judge rather than
seek to understand
The ubiquitous presence of judgment - of self and
others - in human relationships is one of the main
impediments to recovery for the addict

42. PII
“Here is my secret. It is very simple: It is only with
the heart that one can see rightly; what is essential is
invisible to the eye.”
“Well, I should tolerate the closeness of two or three
caterpillars, if I want to get to know butterflies.”
-Antoine de Saint-
Exupéry, The Little Prince

43. Principles of Healing
We matter more than we have a clue about
We are more connected to others than we realize
We become what we focus on

44. Connection
One of the great sources of suffering and illness is the
feeling or belief that one is alone
Healing often has to do with helping people feel less
alone
This is one of the great strengths of AA

45. Principles of Healing
We matter more than we have a clue about
We are more connected to others than we realize
We become what we focus on

46. The Focus
We become what we focus on: projection creates
perception; and perception creates experience
Focus on the illness more illness
Focus on what’s right and healthy more of what’s
right and healthy
We become what we cultivate and feed

47. Spiritual Principles
Build on what is right and good within the person
Fill life with love and gratitude
Look for the positive roots of negative traits and re-
orient the choices and behaviors into something
positive
See the addiction as an opportunity to learn

48. Summary
Next steps in the evolution of human life and culture
will involve:
Flowering of the inner life and its capacities
More positive view of human life and the capacity
for self-determination
Elucidation of the higher, less material laws of
human life and culture
This will transform our models of health and illness

49. In Conclusion
AA represents an important step forward in regards to
treatment models, brings together both spirituality and
the disease model, and is a model of the future
People helping people: we can only give to the souls
of another what we have given to our own souls
• “Your vision will become clear only when you can look
into your own heart. Who looks outside, dreams; who
looks inside, awakes.”
Carl Jung

50. The Magnificence Within You, by Akin Salawu