Cult Culture and the 12 Steps

By Maia Szalavitz 08/27/12

A small but significant number of 12-step groups—from AA to addiction treatment centers—turn into dangerous cults. How can working the program take a wrong turn?

KIDS's Virgil Miller Newton photo via

12-step programs—with their clichéd language, frequent meetings and religious mien—are cults. So say many critics. But in fact, the traditions of AA, NA and the other As are intentionally structured to prevent their members from crossing that line. Nonetheless, there is a reliable way to use the steps to create a full-fledged destructive cult.

Cults are not simply weird or dangerous religious groups, according to those who study groups that have had disastrous outcomes, like Jim Jones’ People’s Temple, which ended in mass member suicide, and the Branch Davidians, which ended in a fiery siege by federal agents. Instead, cults are self-enclosed organizations that use a well-defined set of coercive persuasion tactics.

These typically include isolating people physically and emotionally from friends and family, breaking them down emotionally and taking total control over their environment, movement and finances. Because these procedures can also characterize rehab, residential treatment itself without proper oversight carries a risk for creating cultlike behavior.

However, since 12-step programs in the community aren’t residential, can’t physically isolate people or take their life savings—and because they are formally leaderless—they have little risk of becoming the next Jonestown, Guyana, or Waco, Texas.

But the repeated development of cults or near-cults—from Synanon to Straight Inc. to today’s Washington, DC, Midtown Group—based on the steps is not coincidental. The reason is a toxic compound created when AA’s voluntary steps are twisted so that they can be imposed by force, especially in settings where people cannot escape. Chuck Dederich, the founder of Synanon, was the first to recognize the power of this recipe for subjugating people and creating followers. Indeed, Synanon was the model for every “therapeutic community” (TC) in the US, including mainstream leaders like Phoenix House and Daytop.

Originally hailed in the 1950s as a tough, peer-pressure-based cure for heroin addiction, by the late 1970s it was stockpiling weapons, forcing couples to get sterilized and swap partners and, perhaps most notoriously, had placed a de-rattled rattlesnake in the mailbox of a lawyer who had begun winning cases against it on behalf of former members who had been abducted and abused. When Dederich was arrested for conspiracy to commit murder in the snake incident in 1980, the charismatic leader was dead drunk.

A toxic compound is created when AA’s voluntary steps are imposed by force.

By then, however, the Synanon model had already spread across America and around the world. In addition to Phoenix House and Daytop, the best known include Delancey Street, Walden House, Gaudenzia, Gateway House, Marathon House, Odyssey House, Samaritan Village, Amity, CEDU, the Seed and Straight Inc.

Following Synanon, these TC programs are or were residential, typically lasting from 90 days to 18 months. Originally, the idea was to break initiates through strict rules and daily humiliation and confrontation, and then rebuild them as they work their way up a structured hierarchy.

To rise through the levels toward graduation, participants have to demonstrate compliance by imposing the rules on others and emotionally attacking their fellows to help break them. These days, many TCs have abandoned the marathon attack therapy sessions and tried to reduce or eliminate the use of humiliation—but they retain the strict rules and hierarchical systems.

So how do the use of attack therapy and forcing the steps on people inspire cult formation?

Step 1: It starts with the first step. Voluntarily admitting you are powerless is relatively harmless (although there’s some evidence that this belief as part of the disease model of addiction is linked with worsening relapse).  By contrast, however, being forced into a position of absolute powerlessness is what defines a traumatic experience, and so it can cause post-traumatic stress disorder (PTSD) and related psychological problems, like depression. And traumatizing people is an excellent way to break their will and turn them into compliant followers.

Research into PTSD repeatedly confirms that at the heart of all trauma is the feeling of being completely vulnerable and out-of-control in a frightening situation, in a word, powerless. Whether well-intentioned or not, any program with the capacity to disempower participants by blocking their contact with the outside world and controlling their access to food, sleep and social support is potentially dangerous. This dynamic—in connection with the way power itself corrupts staff—explains why institutions ranging from orphanages to hospitals to prisons, where vulnerable people are subject to total control by others, constantly have abuse scandals and why they need to be subject to intense oversight.

Steps 2 and 3: When imposed coercively, these principles make matters worse. Again, voluntarily surrendering to a “higher power” can feel healing for many—but being forced to submit to human beings who make themselves and their program into your higher power is far less benign. Believing that surrendering your will and even your life to the leadership is the only path to recovery results in overwhelming vulnerability.

Not only is this dangerous for the victims, but it is also risky for leaders who are convinced that they “know best” and their program is so effective that they are justified in using any means necessary to “help” people. Once staff embrace the belief that breaking people to fix them is acceptable, once they “know” that they are absolutely righteous even when being emotionally cruel, the corrupting nature of this total power is intensified.

This elevation of staff and dehumanization of patients is the opposite of treating people with dignity and respect: the word of the “healers” is law and those in need of healing are powerless.

At rehabs, for example, when staff believe that they have all the answers, including which patients are “in denial” or “faking” or lying or, for that matter, telling the truth, there is a great potential for serious health and psychiatric complaints to be ignored. This can have—and has had, in dozens of cases—fatal consequences for those who are physically detained in programs. It also allows power to run amuck.

Steps 4, 5 and 10: Now, add in the demands for the confession of sins and for an ongoing moral inventory and you have an additional method of controlling people. Most religious cults focus on confession because knowing members’ darkest desires and most shameful secrets increases the power of the leaders. Not only can frequent confessions enable the blackmail dissenters, but they can also train participants to focus so relentlessly on their own failings that they have no energy left for criticism or resistance of the group itself.

Please read our comment policy. - The Fix
Maia Szalavitz.jpg

Maia Szalavitz is an author and journalist working at the intersection of brain, culture and behavior.  She has reported for Time magazine online, and is the co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered, and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids. You can find her on Linkedin and  Twitter.