*This is an article from the Spring 2024 issue of Contentment Magazine.

By Don Middleton, DO 

The new guy in our 12-step support group was named John. He would barely make eye contact or say anything more than “Hi.” I did see him listening intently as others shared their struggles and possible remedies, and when we read from the book we were working through, I noticed a great deal of highlighting, making me think he had been studying between meetings. John continued to stay to himself and even turned down an invitation from several others to get dessert after the meeting one night. On perhaps his fifth meeting, he volunteered to share, and when he took the podium, we expected, “Hi, I’m John, and I’m an alcoholic.” Instead, we got, “Hi, I’m an alcoholic and a liar; my real name is Lawerence.” 

Lawrence went on to share that his life had been absolute chaos over the last few years, with time in jail, divorce court, and the unemployment line. He was drenched in shame, and his voice broke, and tears fell down his cheek when he ended with, “I am just so tired of hiding. I don’t know what to do.” Now, I have been around the rooms a while, and I know surrender when I see it – and this was it. This guy was done. 

After the meeting, I asked Lawrence if he had a sponsor yet and offered to meet with him, but he said he did not. We started getting to know each other at a local coffee shop and began walking through the steps. He tiptoed around his childhood but finally admitted that he had been “hurt” by his uncle when he was young. While I work as a medical provider at a well-known rehab/trauma hospital, I am not a therapist, and I know when I am over my head as a sponsor. I recommended a licensed Christian Counselor since we shared that worldview. While we continuchurch and Lawrence attended several weekly group meetings, took on a minor volunteer position at his church, and worked with his counselor. 

Six months later, Lawrence was unrecognizable, and “John” was gone for good. He was still attending groups and getting counseling. He had also reconnected with a church and was even plugged into a men’s Bible study for guys enjoying recovery from various drugs of choice. We had worked through the first nine steps, and he was learning to incorporate the steps into a life with a strong possibility of long-lasting and holistic health. One day, while checking in over coffee, he told me he was going to tap into his GI benefits to get a degree in addiction counseling. This was definitely not the same guy who had come to his first meeting just a half year ago with his tail between his legs and head down, lying about his name. 

When celebrating his progress, I asked him what made the biggest impact on his recovery. Lawrence felt all the pieces were necessary, but if he were forced to narrow it down, he said, “Being accepted into the groups and finding a new relationship with God.” For almost 90 years, the 12-step community has intrinsically known the value of community and connection to a power greater than themselves. Their literature called addiction a brain disease 20 years before the AMA issued a similar statement, but they also knew the answer was not just human or medical. A person could get physically abstinent on their own, but to be fully emotionally and spiritually sober was the secret sauce to a full and transformed life free from compulsive thinking.1

Everywhere you look in 2024, there is mention of PTSD and the monumental push to understand it better to help relieve sufferers from their pain. A great body of literature is being devoted to the difference between post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG). While resilience and grit are popular tag words in popular culture, PTG is much more. Bouncing back from being passed over for a promotion and recovering from years of childhood trauma really does not deserve to be in the same conversation. Many people trying to recover from compulsive disorders uncover trauma in their past that will not be ignored. Yet, it is clear that addiction recovery is another area where PTG is often recognized.2 Franciscan Priest and prolific author Fr. Richard Rohr is fond of describing trauma that is not transformed will be transmitted. The priesthood has been on the frontline of addressing many people’s trauma for millennia.  

The desperate folks in the rooms of the twelve-step communities have long known that alcohol and drugs are not the problem for guys like Lawrence; they are their misguided answer. In the 1930’s AA boldly proclaimed that addiction was a brain disease as a result of a spiritual malady, and the answer for those willing to surrender is spiritual as well. Reconnecting with God and clearing up the wreckage of the past with other people paved a path to a new way of living, free from the control of compulsive chemical or behavioral use. Truly a transformation in millions of lives through the years. Interestingly enough, early success rates of these groups were in the 70-80% range, but as the groups (and society in general) have become more secularized, their estimated success rates have recently hovered at the 5-15% rate. 

The utility of spirituality in the desire for PTG is well-known in scientific literature. While PTSD has Intrusive Rumination (IR) as a common symptom, PTG frequently occurs in the setting of utilizing Deliberate Rumination (DR). Meditative mantras, contemplative prayers, or even positive affirmations can all potentially help lead to growth after trauma. Indeed, the members of AA recite “The Serenity Prayer” at every meeting throughout the world. Regardless of their religious beliefs or lack thereof, there is universal acceptance of this little prayer and a commonly held belief in its ability to offer consolation and inner peace. 

Of the five most commonly recognized domains of post-traumatic growth, Spiritual Change occupies a strong space in many people’s walk away from addiction. Search for deeper life meaning, seeking to forgive and be forgiven, and exploring meaningful purpose in future endeavors all conspire to bring significance to post-addiction life. Without religious and spiritual growth, the question of “Why did this happen to me?” often goes unanswered. Entering into community with people with whom you share a worldview is a wonderful way to get understanding and advice consistent with one’s moral and ethical values. The Spiritual Change domain of PTG is fascinating to many observers. While there are tools to attempt to measure it, there also remain supernatural and unquantifiable components specific to the individual. 

What we have begun to understand, however, is that there can be both medical and psychological needs that are beyond lay people, and so layering in professional counseling or medical treatment, when appropriate, increases the success rate tremendously.3 Without them, at times, the individual is left to white knuckle their emotional pain and set themselves up for endless relapse with newfound and often terrifying “rock bottoms.” In our addiction treatment program, we understand recovery to be a process, not a final destination. When a computer crashes and data is recovered, it returns to the last place it left off. When taking an all-hands-on-deck approach to the struggle of addiction, people do not come back to where they started. They are often transformed into a life far beyond their wildest dreams. 

When medical personnel, experienced counselors, and faith communities band together with a common worldview and goal, the results can be miraculous. In these groups of people with a common struggle, it is common to hear teary-eyed testimony of horrific trauma being transformed from PTSD to PTG. This holistic approach moves the goalposts from surviving to thriving and can have lasting effects on unborn generations. Lawrence can shed “John” permanently as he moves into a transformed life of possibility. 


  1. Alcoholics Anonymous Big Book. 4th ed. New York, NY: Alcoholics Anonymous World Services. 2002. 
  2. Haroosh E, Freedman S, Posttraumatic growth and recovery from addiction: Eur J Psychotraumatol. 13;8(1), 2017. 
  3. Kelly J, Abry, A et all, Alcoholics Anonymous and 12-Step Facilitation Treatments for Alcohol Use Disorder: A Distillation of a 2020 Cochrane Review for Clinicians and Policy Makers. Alcohol, 55(6):641-651, 2020. 


Don Middleton, DO, is a board-certified Family Practice and Addiction Medicine physician at internationally renowned Meadows Behavioral Health in Arizona and director of The Dunamis Initiative, a Christian 12-step program encouraging churches to become more involved in an addiction recovery team effort. He is enjoying long-term sobriety, and that, along with his medical experience and deep faith, has uniquely qualified him to educate, equip, and encourage churches to address addiction as a significant cultural problem. His passion is to care for, disciple, and mobilize those most affected by addiction. Don is the author of The Dunamis Effect, taking the decades-old 12-step Program and bringing it up to date with advances in addiction medicine. 

Contentment Magazine

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