Editing Twelve-step program (section)

==Process==
In the twelve-step program, the human structure is symbolically represented in three dimensions: physical, mental, and spiritual. The problems the groups deal with are understood to manifest themselves in each dimension. For addicts and alcoholics, the physical dimension is best described by the allergy-like bodily reaction resulting in the compulsion to continue using substances even when it's harmful or the addict wants to quit.<ref name="KURTZ1987"/><ref name="RONEL2000"/> The statement in the First Step that the individual is "powerless" over the substance-abuse related behavior at issue refers to the lack of control over this compulsion, which persists despite any negative consequences that may be endured as a result.<ref>{{cite book | last = Alcoholics Anonymous | title = Alcoholics Anonymous | publisher = Alcoholics Anonymous World Services | date=2001-06-01 | edition = 4th | isbn = 978-1-893007-16-1 | oclc = 32014950 | chapter = Chapter 2: There Is a Solution | chapter-url = http://www.aa.org/bigbookonline/en_bigbook_chapt2.pdf | page=21 |quote=At some stage of his drinking career, he begins to lose all control of his liquor consumption, once he starts to drink.}}</ref>

The mental obsession is described as the cognitive processes that cause the individual to repeat the compulsive behavior after some period of abstinence, either knowing that the result will be an inability to stop or operating under the delusion that the result will be different. The description in the First Step of the life of the alcoholic or addict as "unmanageable" refers to the lack of choice that the mind of the addict or alcoholic affords concerning whether to drink or use again.<ref>{{cite book | last = Alcoholics Anonymous | title = Alcoholics Anonymous | publisher = Alcoholics Anonymous World Services | date = 2001-06-01 | edition = 4th | isbn = 978-1-893007-16-1 | oclc = 32014950 | chapter = Chapter 2: There Is a Solution | chapter-url = http://www.aa.org/bigbookonline/en_bigbook_chapt2.pdf | page=21 |quote=These observations would be academic and pointless if [he] never took the first drink, thereby setting the terrible cycle in motion. Therefore, the main problem...centers in his mind....The fact is that most alcoholics...have lost the power of choice in drink...unable, at certain times, to bring into [his] consciousness with sufficient force the memory of the suffering and humiliation of a month or even a week ago. [He] is without defense against the first drink.}}</ref>
The illness of the spiritual dimension, or "spiritual malady," is considered in all twelve-step groups to be self-centeredness.<ref name="KURTZ1987">{{cite journal |author=Kurtz LF, Chambon A |title=Comparison of self-help groups for mental health |journal=Health & Social Work |volume=12 |issue=4 |pages=275–83 |year=1987 |pmid=3679015 |doi=10.1093/hsw/12.4.275}}</ref><ref name="RONEL2000">{{cite journal | last = Ronel | first = Natti| year = 2000 | title = From Self-Help to Professional Care: An Enhanced Application of the 12-Step Program | journal = The Journal of Applied Behavioral Science | volume = 36 | issue = 1 | pages = 108–122 | issn = 1552-6879 | oclc = 1783135 | doi = 10.1177/0021886300361006| s2cid = 144471066}}</ref> The process of working the steps is intended to replace self-centeredness with a growing moral consciousness and a willingness for self-sacrifice and unselfish constructive action.<ref name="RONEL2000"/> In twelve-step groups, this is known as a "spiritual awakening."<ref name="ROEHE2004">{{cite journal | last = Roehe | first = Marcelo V. | date = 2004 | title = Religious Experience in Self-Help Groups: the neurotics anonymous example | journal = Psicologia Em Estudo | volume = 9 | issue = 3 | pages = 399–407 | issn = 1413-7372 | language = pt | doi = 10.1590/S1413-73722004000300008| doi-access = free }}</ref> This should not be confused with [[abreaction]], which produces dramatic, but temporary, changes.<ref name="MARMOR1980">{{cite journal |author=Marmor J |title=Recent trends in psychotherapy |journal=The American Journal of Psychiatry |volume=137 |issue=4 |pages=409–16 |date=1980-04-01 |pmid=6987904 |doi=10.1176/ajp.137.4.409 }}</ref> As a rule, in twelve-step fellowships, spiritual awakening occurs slowly over a period of time, although there are exceptions where members experience a sudden spiritual awakening.<ref name="BIGBOOKAWAKENING">{{cite book | last = Alcoholics Anonymous | title = Alcoholics Anonymous | publisher = Alcoholics Anonymous World Services | date = 1976-06-01 | isbn = 0-916856-59-3 | oclc = 32014950 | chapter = Appendix II. Spiritual Experience | chapter-url = http://www.aa.org/bigbookonline/en_appendiceii.cfm | archive-url = https://web.archive.org/web/20081205154352/http://www.aa.org/bigbookonline/en_appendiceii.cfm | archive-date = 2008-12-05 | url-status = dead }}</ref>

In accordance with the First Step, twelve-step groups emphasize self-admission by members of the problem they are recovering from. It is in this spirit that members often identify themselves along with an admission of their problem, often as "Hi, I’m {{bracket|first name only}}, and I’m an alcoholic".<ref name="HAYES2000">{{cite journal |title=Stigmatizing Indebtedness: Implications for Labeling Theory |last=Hayes |first=Terrell |journal=Symbolic Interaction |volume=23 |issue=1 |date=February 2000 |pages=29–46 |doi=10.1525/si.2000.23.1.29 }}</ref>