12 PASOS ALCOHOLICOS ANONIMOS PDF
Página de inicio Lea el Libro Grande y Doce Pasos y Doce Tradiciones Twelve en audio de los Doce Pasos y Doce Tradiciones de Alcohólicos Anónimos. Search for a meeting by name; or Find a meeting by selecting the day of the week to see a map and list of the AA Meetings for that day, or view pdf directories. Un mecanismo de acción propuesto para los Doce pasos de Alcohólicos Anónimos. Luis A. Giuffra 1, a,b,c. 1 Washington University. St Louis, USA. a Professor.
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Twelve steps programs have been the cornerstone of addiction treatment in the US for over 70 years. Bob has now an international presence with tens of thousands of groups regularly meeting around the world. It has been criticized and misunderstood, yet voices against AA have failed to slow down its progress and success.
Patients can easily understand why an antibiotic is needed to treat an infection, or why surgery is needed to remove a tumor. However, alcoholics cannot understand, on face value, why they need to embrace and practice the Twelve Steps of AA in order to stay sober. This represents an obstacle for prospective members since it is not intuitive or straightforward to understand why following the steps can help maintain sobriety.
We can easily understand why an antibiotic works when we treat bacterial pneumonia or why radiation therapy treats cancer. In the case of the Steps, however, there is no coherence between our understanding of how addiction affects the brain and why the Steps could help.
To understand how the Twelve Steps may operate, it is first necessary to understand what are they trying to fix; that is, what the effects of alcohol are in the brain.
Knowing what alcohol does to the brain makes it easier to understand how the Steps might counteract these effects. Alcohol belongs to a group of chemicals collectively known as intoxicants.
12 PASOS DE ALCOHOLICOS ANONIMOS PDF
Members of this group are able to generate abuse and dependence among users. There are about 30 million chemical compounds known to man, yet only about of them are intoxicants such as alcohol, opioids, benzodiazepines, barbiturates, cocaine, hallucinogens, solvents, etc.
What do the intoxicants have in common, and how do they affect the brain? What mechanisms of action drive their ability to generate abuse and dependence?
Through different biochemical pathways, intoxicants share a common final mechanism of action in the brain: they increase dopamine release in the nucleus accumbens NAc and the ventral tegmental area VTA 1. The NAc and the VTA are the core components of the reward system of the brain, and dopamine is the neurotransmitter that, when elevated in these nuclei, gives animals a positive, rewarding effect 2,3.
This positive effect is salient, recognized and remembered by the brain, and the animal is eager to repeat the behavior that produces it.
Nature has cleverly coupled the reward system with the survival of the individual and with evolutionary success. Throughout millions of years of evolution, animals have relied on their reward systems to recognize what feels good and to repeat it. This prompts the animal to eat regularly, guaranteeing their survival. During sex, dopamine levels in the reward system double, making the animal eager to repeat intercourse and ensure the survival of the species.
In the case of the intoxicants known to man, the amount of released dopamine is typically much higher than the amount released by common pleasurable behaviors such as eating or sexual activity.
Intoxicants therefore usurp and hijack the reward system of the brain, giving the organism powerful reasons to repeat using them despite negative consequences. Over millions of years of evolutionary history, repeating what feels good is synonymous with success. Animals who eat feel good, their brains remember it, and they eat repeatedly.
Repeated sexual activity feels good and, by engaging in intercourse, animals pass on their genes and promote the survival of the species. When the nuclei composing the reward system unaware of any negative evolutionary consequences of dopamine surges sense a dramatic increase of dopamine above and beyond what food or sex produce they immediately equate it with survival and evolutionary success.
For the addict, the drug is survival. Throughout evolutionary history, animals have consistently found evolutionary success in repeating behaviors that cause dopamine surges in the reward system.
Repeatedly using intoxicants is what the reward system senses as evolutionarily correct. In the case of humans, the quest of the reward system to make addicts repeatedly use intoxicants results in the development of maladaptive behaviors lying, cheating, stealing, being selfish, etc.
These maladaptive behaviors are symptoms of the illness and not life-long character defects.
Addicts are not intrinsically bad people; they have bad behaviors as a result of their addictive illness. In a way, these maladaptive behaviors serve well the evolutionary goal to repeat what feels good.
Addicted animals are doomed to use intoxicants repeatedly even if this repetition leads to death by causing animals to neglect real survival needs such as food or water. DiClemente and Gabhainn have noted that the practice of the steps has fundamental implications in reaching and maintaining abstinence, especially for those who practice them on a regular way.
However, available evidence about the benefits that each step brings to the alcoholics is still limited and sometimes controversial. There are very few investigations in Mexico about the role of spirituality in the alcoholic recovery process.
AA have not been sufficiently studied and there is a lot unknown about their treatment strategies. The objective of this study is to know if the effectiveness of the practice of the 12 steps, the frequency of their practice, and the experience of the "spiritual awakening" that AA consider as a consequence of practicing the steps influence on the maintenance of abstinence in members of AA. The sample was non probabilistic and included AA members from traditional groups or "an hour and a half" groups, named after the time meetings last from southern Mexico City area.
Individuals were divided in two groups: relapsed and not relapsed. The second group included subjects 86 percent of males, 14 percent of females who have not relapsed since they entered AA or for a ten year period or longer. To determine the influence of the spiritual principles of the 12 steps program, a question was designed to measure the practice of each one of them, as well as a scale to explore the frequency of such practice.
Also, since AA considers the "spiritual awakening" as a result of working with the steps, a question about its occurrence was included. Results also showed that frequency in the practice of: thinking about events that led to alcoholism steps 4 and 5 , humbleness to accept help from a Higher Power steps 6, 7, and 11 , acceptance of responsibility to reduce the consequences of addiction steps 8, and 9 , and helping other alcoholics step 12 , is significantly different between both groups; not relapsed individuals had a more frequent practice of these steps.
LOS DOCE PASOS DE AA PDF
Since AA assumes that working the steps leads to experience a spiritual conversion or "spiritual awakening" it implies a change in the self-concept, in the view of the world, and stop being self-centered , a regression analysis was performed to test this assumption.
No statistical differences were found in the practice of steps 13, but this does not mean that they are not important, for these are the most practiced steps in both groups. However, the fact that relapsed alcoholics put great value upon these steps, points out their willingness to stop consuming apparently they have accepted being powerless before alcohol, and to surrender their will and life to a Higher Power , but it also underlines their difficulty in attaching to some of the beliefs and activities that AA consider as base to complete the practice the steps and to develop spirituality.
Several of these activities are related to elements in the program that mean more action and certain degree of confusion and discouragement for those who focus in staying sober only based on a vague idea of what constitutes the Higher Power.
AA recognizes the first three steps as the facilitators of abstinence and as the beginning of the path to "spiritual awakening" through an aid that transcends the individual Higher Power , but they also emphasize that many times this is not enough for the recovery. Paradoxically, they state that this condition could lead to a feeling of false security that could invite the alcoholic to flirt with the idea of having "just one drink".
Therefore, it is not casual that relapsed individuals in the sample of this study focus on practicing the first three steps, though more research is needed to further confirmation.
These results allow concluding that spacing out the practice of the 12 steps or not practicing them at all, produces low levels of spirituality, which could be the cause of a relapse. Results also showed that a higher level of spirituality linked to the practice of more steps has an important influence on the recovery of alcoholics, particularly for those whose practice of the steps is more regular.
The sample of this study showed that its particular way to develop spirituality spiritual awakening and therefore maintain abstinence requires of a process that involves cognitive, emotional, and behavioral activity steps , and not only to embrace the conviction of alcoholism as a disease susceptible of being cured steps Finally it is important to indicate that the 12 steps program represent a particular way of expressing spirituality, and that they are limited to specific cognitions and practices; thus, more research is required to replicate these results with other measures of spirituality.
Psychol Addict Behav, , Alcoholics Anonymous and Research. Research on Alcoholics Anonymous: Opportunities and Alternatives. J Substance Abuse, , J Addictive Diseases, J Clin Psychol, , J Substance Use, , J Social Issues, , None survived the passage of time. Nature has cleverly linked pleasure with survival, and it is exactly this link that is usurped and hijacked by intoxicants like alcohol. Were entirely ready to have God remove all these defects of character.
This Behavioral Compensation is therefore a form of behavioral rehabilitation that disarms the reward system of the tools maladaptive behaviors necessary to promote the use of intoxicants. A given species is likely to disappear if its members neglect sexual behaviors in favor of using drugs, since drugs produce a more pleasurable effect.
When the nuclei composing the reward system unaware of any negative evolutionary consequences of dopamine surges sense a dramatic increase of dopamine above and beyond what food or sex produce they immediately equate it with survival and evolutionary success.