Traditionally, addiction has been seen as a loss-of-control issue, marked by a subjective sense of powerlessness. However, a paradoxically positive perception of powerlessness exists, partly rooted in the 12-step program, though its scientific exploration and practical implications remain limited. This phenomenological study examined perceptions and experiences of powerlessness among individuals recovering from substance and behavioral addictions (n = 31), family members (n = 9), and therapists (n = 9). The findings revealed a dialectical process leading to a reframing of powerlessness, with two main themes: (a) negative attributions of powerlessness and (b) the powerlessness reframing process. This study enriches the addiction recovery literature by emphasizing the importance of understanding and leveraging the positive aspects of powerlessness through a Positive Criminology lens. It addresses criticisms of narrow understandings and a lack of awareness of the foundational role of powerlessness in recovery and recommends tailored therapeutic interventions.
Alcoholics Anonymous. (1981). Twelve steps and twelve traditions (3rd ed.). Alcoholics Anonymous World Services.
2.
Alcoholics Anonymous (AA). (2001). Alcoholics Anonymous: The story of how thousands of men and women have recovered from alcoholism (4th ed.). Alcoholics Anonymous World Services.
3.
AmitayG.Hawa-KamelD.RonelN. (2021). Sufi non-doing offender rehabilitation: Positive and peacemaking criminology in practice. International Journal of Offender Therapy and Comparative Criminology, 65(8), 916–936. https://doi.org/10.1177/0306624X21990782
4.
BattenS. V.DeVivaJ. C.SantanelloA. P.MorrisL. J.BensonP. R.MannM. A. (2009). Acceptance and commitment therapy for comorbid PTSD and substance use disorders. In BlackledgeJ. T.CiarrochiJ. V.DeaneF. P. (Eds.), Acceptance and commitment therapy. Contemporary theory, research and practice (pp. 311–328). Australian Acad. Press.
5.
BaughJ. R. (1988). Gaining control by giving up control: Strategies for coping with powerlessness. In Behavior therapy and religion: Integrating spiritual and behavioral approaches to change (pp. 125–138). Sage Publications.
6.
BensimonM.BaruchA.RonelN. (2013). The experience of gambling in an illegal casino: The gambling spin process. European Journal of Criminology, 10(1), 3–21. https://doi.org/10.1177/1477370812455124
7.
BensimonM.RonelN. (2012). The flywheel effect of intimate partner violence: A victim-perpetrator interactive spin. Aggression and Violent Behavior, 17(5), 423–429. https://doi.org/10.1016/j.avb.2012.05.004
BrezinaT. (2020). Freedom of action, freedom of choice, and desistance from crime: Pitfalls and opportunities in the study of human agency. Journal of Developmental and Life-Course Criminology, 6(2), 224–244. https://doi.org/10.1007/s40865-019-00111-w
11.
BrooksF.ArminioJ.Caballero-DennisK. A. (2013). A narrative synthesis of addictions, surrender, and relapse: Confirmation and application. Alcoholism Treatment Quarterly, 31(3), 375–395. https://doi.org/10.1080/07347324.2013.800427
12.
ButlerM. H.CallM. L.MeloyK. C.ZitzmanS. T. (2014). Deconstructing mechanisms of powerlessness for clients seeking recovery: Learning to be powerless over addiction. Sexual Addiction & Compulsivity, 21(2), 92–113. https://doi.org/10.1080/10720162.2014.895461
13.
ButlerM. H.MeloyK. C.CallM. L. (2015). Dismantling powerlessness in addiction: Empowering recovery through rehabilitating behavioral learning. Sexual Addiction & Compulsivity, 22(1), 26–58. https://doi.org/10.1080/10720162.2014.993778
ChenG. (2010). The meaning of suffering in drug addiction and recovery from the perspective of existentialism, Buddhism and the 12-step program. Journal of Psychoactive Drugs, 42(3), 363–375. https://doi.org/10.1080/02791072.2010.10400699
16.
ChenG. (2018). Building recovery capital: The role of “hitting bottom” in desistance and recovery from substance abuse and crime. Journal of Psychoactive Drugs, 50(5), 420–429. https://doi.org/10.1080/02791072.2018.1517909
17.
ChenG.GuetaK. (2015). Application of positive criminology in the 12-Step program. In RonelN.SegevD. (Eds.), Positive criminology (pp. 208–220). Routledge. https://doi.org/10.4324/9781315796536-15
18.
ChenG.GuetaK. (2019). Narrative review of the benefits, challenges, and dilemmas of conducting qualitative research in prison. Israeli Criminology. (Hebrew).
19.
ChenG.GuetaK.RonelN. (2020). Does self-change occur among severely dependent substance users?Journal of Psychoactive Drugs, 52(4), 357–365. https://doi.org/10.1080/02791072.2020.1767832
20.
ChiF. W.KaskutasL. A.SterlingS.CampbellC. I.WeisnerC. (2009). Twelve-Step affiliation and 3-year substance use outcomes among adolescents: Social support and religious service attendance as potential mediators. Addiction, 104(6), 927–939. https://doi.org/10.1111/j.1360-0443.2009.02524.x
21.
CohenS.RothbartM.PhillipsS. (1976). Locus of control and the generality of learned helplessness in humans. Journal of Personality and Social Psychology, 34(6), 1049–1056. https://doi.org/10.1037//0022-3514.34.6.1049
22.
CovingtonS. (1994). A women’s way through the twelve steps. Hazelden.
23.
CreswellJ. W.HansonW. E.Clark PlanoV. L.MoralesA. (2007). Qualitative research designs: Selection and implementation. The Counseling Psychologist, 35(2), 236–264. https://doi.org/10.1177/0011000006287390
24.
DanioniF.PaleariF. G.PelucchiS.LombranoM. R.LumeraD.RegaliaC. (2023). Gratitude, forgiveness, and anger: Resources and risk factors for Italian prison inmates. International Journal of Offender Therapy and Comparative Criminology, 67(2-3), 207–223. https://doi.org/10.1177/0306624X211049191
25.
DenzinN.LincolnY. (2000). Handbook of qualitative research (DenzinN.LincolnY. (Eds.), 2nd ed.). Sage.
26.
DuPontR. L.McGovernJ. P. (1992). Suffering in addiction: Alcoholism and drug dependence, (15-2461), (pp. 155–201). NLN publications.
27.
DyslinC. W. (2008). The power of powerlessness: The role of spiritual surrender and interpersonal confession in the treatment of addictions. Journal of Psychology and Christianity, 27(1), 41–55. https://doi.org/10.1016/j.jaci.2012.05.050
EfratiY.GolaM. (2018). Compulsive sexual behavior: A twelve-step therapeutic approach. Journal of Behavioral Addictions, 7(2), 445–453. https://doi.org/10.1556/2006.7.2018.26
30.
ElishaE.IdisisY.RonelN. (2013). Positive criminology and imprisoned sex offenders: Demonstration of a way out from a criminal spin through acceptance relationships. Journal of Sexual Aggression, 19(1), 66–80. https://doi.org/10.1080/13552600.2011.638145
31.
EytanS.FlintT. (2023). Between forcefully surrendering and willingly submitting: Implementing the 12-step programme in treating women suffering from sexual-related trauma and substance use disorder. In Women’s empowerment for a sustainable future (pp. 553–565). Springer. https://doi.org/10.1007/978-3-031-25924-1_34
32.
EytanS.RonelN. (2023). Learning a lesson: Spiritual attributions of sexual trauma and revictimization. International Journal of Offender Therapy and Comparative Criminology, 67(13-14), 1343–1361. https://doi.org/10.1177/0306624X231165423
33.
FlintT.EytanS. (2023). Transformative powerlessness: The role of powerlessness in recovery from interpersonal trauma. Submitted for Publication.
34.
GalanterM.DermatisH.PostS.SampsonC. (2013). Spirituality-based recovery from drug addiction in the Twelve-Step fellowship of Narcotics Anonymous. Journal of Addiction Medicine, 7(3), 189–195. https://doi.org/10.1097/ADM.0b013e31828a0265
35.
GambleJ.O’lawrenceH. (2016). An overview of the efficacy of the 12-step group therapy for substance abuse treatment. Journal of health and human services administration, 39(1), 141–159.
36.
GlassmanH. S.RhodesP.BuusN. (2020). A critical review of qualitative interview studies with alcoholics anonymous members. Substance Use & Misuse, 55(3), 387–398. https://doi.org/10.1080/10826084.2019.1681450
37.
GlassmanH. S.RhodesP.BuusN. (2022). Exiting alcoholics anonymous disappointed: A qualitative analysis of the experiences of ex-members of AA. Health. An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 26(4), 411–430. https://doi.org/10.1177/1363459320961438
GuetaK.AddadM. (2013). Moulding an emancipatory discourse: How mothers recovering from addiction build their own discourse. Addiction Research and Theory, 21(1), 33–42. https://doi.org/10.3109/16066359.2012.680080
40.
GuetaK.GamlielS.RonelN. (2021). “Weak is the new strong”: Gendered meanings of recovery from substance abuse among male prisoners participating in narcotic anonymous meetings. Men and Masculinities, 24(1), 104–126. https://doi.org/10.1177/1097184X19849449
HumphreysK.WingS.McCartyD.ChappelJ.GallantL.HaberleB.HorvathA. T.KaskutasL. A.KirkT.KivlahanD.LaudetA.McCradyB. S.McLellanA. T.MorgensternJ.TownsendM.WeissR. (2004). Self-help organizations for alcohol and drug problems: Toward evidence-based practice and policy. Journal of Substance Abuse Treatment, 26(3), 151–165. https://doi.org/10.1016/S0740-5472(03)00212-5
43.
IsbergE.NordgrenJ. (2023). Being a parent of a teenager with illicit drug use - a qualitative interview study. Drugs: Education, Prevention & Policy, 1–10. https://doi.org/10.1080/09687637.2023.2265545
44.
JacksonC.VaughanD. R.BrownL. (2018). Discovering lived experiences through descriptive phenomenology. International Journal of Contemporary Hospitality Management, 30(11), 3309–3325. https://doi.org/10.1108/IJCHM-10-2017-0707
45.
JacquesC. (2017). What is the nature of the recovery processes underlying twelve step fellowships? A constructivist grounded theory study[Unpublished Doctoral Thesis]. University of London. https://openaccess.city.ac.uk/1189/
46.
KaslC. D. (1990). The twelve-step controversy (pp. 30–31). Ms. Magazine.
47.
KellyJ. F.StoutR. L.SlaymakerV. (2013). Emerging adults’ treatment outcomes in relation to 12-step mutual-help attendance and active involvement. Drug and Alcohol Dependence, 129(1-2), 151–157. https://doi.org/10.1016/j.drugalcdep.2012.10.005
48.
KempR. (2009). Relating to the other: Truth and untruth in addiction. European Journal of Psychotherapy & Counselling, 11(4), 355–368. https://doi.org/10.1080/13642530903444787
49.
KingstonS.KnightE.WilliamsJ.GordonH. (2015). How do young adults view 12-step programs? A qualitative study. Journal of Addictive Diseases, 34(4), 311–322. https://doi.org/10.1080/10550887.2015.1074506
50.
KougialiZ. G.PytlikA.SoarK. (2021). Mechanisms and processes involved in women’s pathways into alcohol dependence and towards recovery: A qualitative meta-synthesis. Drugs: Education, Prevention & Policy, 28(5), 437–453. https://doi.org/10.1080/09687637.2021.1904836
51.
KurtzE. (2002). Alcoholics Anonymous and the disease concept of alcoholism. Alcoholism Treatment Quarterly, 20(3-4), 5–39. https://doi.org/10.1300/J020v20n03_02
52.
KurtzE.KetchamK. (1992). The spirituality of imperfection. Bantam.
LaudetA. B.WhiteW. L. (2005). An exploratory investigation of the association between clinicians’ attitudes toward twelve-step groups and referral rates. Alcoholism Treatment Quarterly, 23(1), 31–45. https://doi.org/10.1300/J020v23n01_04
55.
LincolnY. S.GubaE. G. (1985). Naturalistic inquiry (Vol. 75). Sage.
56.
MathesonJ. L.McCollumE. E. (2008). Using metaphors to explore the experiences of powerlessness among women in 12-step recovery. Substance Use & Misuse, 43(8-9), 1027–1044. https://doi.org/10.1080/10826080801914287
MedinaM. (2014). Research paper the paradox of self-surrender and self-empowerment: An investigation of the individual's understanding of the higher power in alcoholics anonymous. Counselling Psychology Review, 29(3), 28–42. https://doi.org/10.53841/bpscpr.2014.29.3.28
59.
MilbergA.StrangP. (2011). Protection against perceptions of powerlessness and helplessness during palliative care: The family members’ perspective. Palliative & Supportive Care, 9(3), 251–262. https://doi.org/10.1017/S1478951511000204
60.
MyllmakiL. (2011). Exploring recovery experiences of women in alcoholics anonymous (Vol. 7, pp. 73–80). Undergraduate Review.
61.
Narcotics Anonymous. (1996). Narcotics anonymous. World Service Office.
62.
Narcotics Anonymous. (2002). Just for today. World Service Office.
PattonM. Q. (2002). Two decades of developments in qualitative inquiry: A personal, experiential perspective. Qualitative Social Work, 1(3), 261–283. https://doi.org/10.1177/1473325002001003636
65.
PeeleS. (2004). 7 tools to beat addiction. Three Rivers Press.
66.
PeeleS. (2015). American addiction treatment is shame-based. Psychology Today.
67.
PiedmontR. L. (2004). Spiritual transcendence as a predictor of psychosocial outcome from an outpatient substance abuse program. Psychology of Addictive Behaviors, 18(3), 213–222. https://doi.org/10.1037/0893-164X.18.3.213
68.
PolkinghorneD. E. (1989). Phenomenological research methods BT - existential-phenomenological perspectives in psychology: Exploring the breadth of human experience (ValleR. S.HallingS. (eds.); pp. 41–60). Springer US. https://doi.org/10.1007/978-1-4615-6989-3_3
69.
RichertT.SvenssonB.JohnsonB. (2021). Experiences of Swedish parents seeking social services support for their adult children with drug addiction. Journal of the Society for Social Work and Research, 12(4), 677–704. https://doi.org/10.1086/712894
70.
RobertsA.JacksonM. S.Carlton-LaneyI. (2000). Revisiting the need for feminism and Afrocentric theory when treating African-American female substance abusers. Journal of Drug Issues, 30(4), 901–917. https://doi.org/10.1177/002204260003000413
71.
RødnerS. (2005). “I am not a drug abuser, I am a drug user”: A discourse analysis of 44 drug users’ construction of identity. Addiction Research and Theory, 13(4), 333–346. https://doi.org/10.1080/16066350500136276
72.
Rodríguez-MartínB. C.Gallego-ArjizB. (2018). Overeaters anonymous: A mutual-help fellowship for food addiction recovery. Frontiers in Psychology, 9, 1491–1495. https://doi.org/10.3389/fpsyg.2018.01491
73.
RogersJ.LandonJ.SharmanS.RobertsA. (2020). Anonymous women?International Journal of Mental Health and Addiction, 18(4), 1008–1024. https://doi.org/10.1007/s11469-019-00101-5
74.
RonelN. (2000). From self-help to professional care: An enhanced application of the 12-step program. The Journal of Applied Behavioral Science, 36(1), 108–122. https://doi.org/10.1177/0021886300361006
RonelN. (2011). Criminal behavior, criminal mind: Being caught in a “criminal spin.”International Journal of Offender Therapy and Comparative Criminology, 55(8), 1208–1233. https://doi.org/10.1177/0306624X11384946
77.
RonelN. (2012). Goes with the wind: Twelve-step program therapy. Bar-Ilan University(Hebrew).
78.
RonelN.ClaridgeH. (2003). The powerlessness of control: A unifying model for the treatment of male battering and substance addiction. Journal of Social Work Practice in the Addictions, 3(1), 57–76. https://doi.org/10.1300/J160v03n01_05
79.
RonelN.ElishaE. (2011). A different perspective: Introducing positive criminology. International Journal of Offender Therapy and Comparative Criminology, 55(2), 305–325. https://doi.org/10.1177/0306624X09357772
80.
RonelN.ElishaE. (2020). Positive criminology: Theory, research, and practice. Oxford Research Encyclopedia of Criminology and Criminal Justice. (Issue February). https://doi.org/10.1093/acrefore/9780190264079.013.554
81.
RonelN.FridN.TimorU. (2013). The practice of positive criminology: A Vipassana course in prison. International Journal of Offender Therapy and Comparative Criminology, 57(2), 133–153. https://doi.org/10.1177/0306624X11427664
82.
RonelN.HumphreysK. (2000). World view transformations of narcotics anonymous members in Israel. International Journal of Self Help and Self Care, 1(1), 107–121. https://doi.org/10.2190/bwh7-pt8l-jdm9-l53a
83.
RonelN.SegevD. (2014). Positive criminology in practice. International Journal of Offender Therapy and Comparative Criminology, 58(11), 1389–1407. https://doi.org/10.1177/0306624X13491933
84.
RoomR. (1993). Alcoholics anonymous as a social movement. In McCradyS. B.MillerW. R. (Eds.), Research on alcoholics anonymous: Opportunities and alternatives (pp. 167–187). Rutgers Center of Alcohol Studies. https://www.robinroom.net/alcoanon.pdf
SandersJ. M. (2006). Women and the twelve steps of alcoholics anonymous: A gendered narrative. Alcoholism Treatment Quarterly, 24(3), 3–29. https://doi.org/10.1300/J020v24n03_02
ShuppM.BrooksF.YostL. (2021). The interface of drug and alcohol addiction, suicide, and surrender: Implications for treatment and approaches. Alcoholism Treatment Quarterly, 39(2), 198–209. https://doi.org/10.1080/07347324.2020.1825146
89.
TeodorescuK.ErevI. (2014). Learned helplessness and learned prevalence: Exploring the causal relations among perceived controllability, reward prevalence, and exploration. Psychological Science, 25(10), 1861–1869. https://doi.org/10.1177/0956797614543022
90.
ThomasE.MagilvyJ. K. (2011). Qualitative rigor or research validity in qualitative research. Journal for Specialists in Pediatric Nursing, 16(2), 151–155. https://doi.org/10.1111/j.1744-6155.2011.00283.x
91.
ThompsonS. C.WiersonM. (2000). Enhancing perceived control in psychotherapy. In SnyderC. R.IngramR. E. (Eds.), Handbook of psychological change: Psychotherapy processes & practices for the 21st century (pp. 177–197). John Wiley & Sons Inc.
92.
TieboutH. M. (1953). Surrender versus compliance in therapy, with special reference to alcoholism. The Quarterly Journal of Social Affairs, 14(1), 58–68. https://doi.org/10.15288/qjsa.1953.14.058
93.
Tiebout& H. M. (1954). The ego factors in surrender in alcoholism. The Quarterly Journal of Social Affairs, 15(4), 610–621. https://doi.org/10.15288/qjsa.1954.15.610
94.
TwerskiA. J. (2009). Addictive thinking: Understanding self-deception. Simon & Schuster.
95.
Van der ToornJ.FeinbergM.JostJ. T.KayA. C.TylerT. R.WillerR.WilmuthC. (2015). A sense of powerlessness fosters system justification: Implications for the legitimation of authority, hierarchy, and government. Political Psychology, 36(1), 93–110. https://doi.org/10.1111/pops.12183
WhiteW. L. (1998). Slaying the dragon: The history of addiction treatment and recovery in America. Chestnut: Health Systems/Lighthouse Institute.
98.
WhiteW. L.KurtzE. (2006). The varieties of recovery experience: A primer for addiction treatment professionals and recovery advocates. International Journal of Self Help and Self Care, 3(1-2), 21–61. https://doi.org/10.2190/911r-mtq5-vj1h-75cu
99.
WilsonK. G.HayesS. C.ByrdM. R. (2000). Exploring compatibilities between acceptance and commitment therapy and 12-step treatment for substance abuse. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 18(4), 209–234. https://doi.org/10.1023/A:1007835106007
100.
WorleyM. J.TateS. R.BrownS. A. (2012). Mediational relations between 12-Step attendance, depression and substance use in patients with comorbid substance dependence and major depression. Addiction, 107(11), 1974–1983. https://doi.org/10.1111/j.1360-0443.2012.03943.x
