When  substance abusing group members complain about any aspect of their life, I tell them that nothing will change, in their lives, unless and until they stop drinking, drugging, gambling, sexual acting out or whatever compulsive behavior, or behaviors,  that they are ‘hooked on’. One such group member was alarmed that he had gained more than 20 pounds since he began drinking heavily in the past year. The group too was alarmed because in other parts of his life as well, he was out of control. I recommended AA, 90 meetings in 90 days.   There was no point analyzing his behavior until he stopped drinking. He challenged my suggestion. He objected to the religious overtone to the AA meetings. I told him that he is not obliged to accept the whole package. It’s the music not the words that matter. By that I mean,  listening to AA members ‘testify’  breaks through the denial. Even if he goes to meetings and sits silently, he cannot help but being consciously, and unconsciously stirred by what he hears, people publicly acknowledging that they are helpless to control their addiction.  This is known as ‘identifying’ and while a primitive mode of relating it is the first step in the process of recovery. Group therapy and 12 Step Programs are not mutually exclusive; they complement each other.  AA is a Self Help Group; people share experiences but they don’t relate to each other on an emotional level.  In group therapy, the focus is on interaction.  In my groups, the contract is;” Say how you feel toward the other members in the room and why  you feel that way”. In my professional experience, the combination of group therapy and AA works, if the person allows it to work. Sometimes, it takes desperation to serve as the motivation, even if the member is skeptical.  In AA, they say: ” Bring the body and the mind will follow”.