Marron J T
Department of Family Medicine, SUNY Health Science Center, Syracuse.
Prim Care. 1993 Mar;20(1):107-19.
Alcoholics Anonymous and its 12 Steps and 12 Traditions have arisen out of the experiences of recovery of alcoholics. It offers an important treatment option to the clinician who sees destructive compulsive disease in his or her practice. Despite their nonscientific, nonrational approach, AA and other 12-step programs have evolved to offer a set of attitudes, beliefs, and behaviors that can facilitate change in this group of patients. AA is the forerunner of the others and offers as its most important characteristics an unconditional acceptance of the patient's alcoholism, an unshaken belief in the concept of alcoholism as a disease, and support to foster a healthy dependence in the alcoholic. The recovery of an alcoholic involves a fairly long initial stage in which denial about alcoholism is broken down with slow and halting identity change. This characteristic underscores the primitive level of ego development in the alcoholic and the need for much continuing support, nurturance, and tolerance. Clinicians can be an important part of this support network by working with AA and other 12-step groups to help break down denial in the patient and direct individuals to the appropriate program. By allying themselves with this method and groups, clinicians will be making powerful statements about their beliefs and attitudes toward these destructive illnesses.
戒酒互助会及其“十二步”和“十二传统”源自酗酒者的康复经历。它为在临床实践中遇到破坏性强迫性疾病的医生提供了一种重要的治疗选择。尽管戒酒互助会和其他“十二步”项目采用的是非科学、非理性的方法，但它们已经发展出了一套态度、信念和行为方式，能够促进这类患者的改变。戒酒互助会是其他项目的先驱，其最重要的特点包括无条件接纳患者的酗酒问题、坚定不移地相信酗酒是一种疾病的观念，以及支持酗酒者培养健康的依赖心理。酗酒者的康复包括一个相当长的初始阶段，在此阶段，对酗酒问题的否认会随着缓慢而断断续续的身份转变而被打破。这一特点凸显了酗酒者自我发展的原始水平以及对持续支持、培育和宽容的需求。临床医生可以通过与戒酒互助会及其他“十二步”团体合作，在这个支持网络中发挥重要作用，帮助患者打破否认心理，并引导他们加入合适的项目。通过与这种方法和团体结盟，临床医生将有力地表明他们对这些破坏性疾病的信念和态度。
