Welcome...
This is a list of questions for working the 12 Step program for
recovery from addictive behavior. You are invited to
pick those questions that seem most relevant to your recovery and answer them
to the best of your ability. In this way, you can
better keep track of truly working your 12 Step program. And in truly working the program, then you
can gain the benefits of 12 Step recovery.
Note that this does not claim to be a definitive list of questions
or replace a therapist, good friend or sponsor in any way. In
fact, this has started out from only one recovering addict’s attempt to help
you in your recovery process. It is hoped that this
questionnaire will help you gain more insight, strength, and sense of closure
as you work the program. You are invited to use it
only as it works well for you. If you have suggestions
for improvement or want to post updates or comments about these questions,
please email the webmaster@12step.org
so that this questionnaire can be as effective as possible.
Note also that the process of recovery can be a very delicate
process. It may be one of the most important and
difficult things that you ever do in your life, so you are admonished to be
gentle with yourself, get outside help when you need it and make time for
nurturing activities in this process. This is not to
say that you should not be diligent (that is the purpose of these questions, to
help you actually work the program). But
in finding the right balance between diligence and gentleness, you will
hopefully greatly enhance your process of recovery.
Step 1 - I admit that I am powerless over my addiction and that my
life has become unmanageable
·
Have
you seriously damaged your relationships with other people because of your
addictive behaviors? If so, list the relationships and
how you damaged them.
·
If
other people have told you how you how your have hurt them, then write down
what they said.
·
Describe
any missed appointments that resulted from your addictive behaviors.
·
Describe
any memory lapses where you cannot account for where you were.
·
Describe
any times that you cannot recall how you got home.
·
Describe
times and ways that you have significantly neglected or damaged relationships
with your loved ones in order to indulge in your addictive behaviors or because
you were recovering from your addictive behaviors.
·
Describe
any illnesses that have resulted from your addictive behaviors.
·
If
your addictive behavior contributed to excessive spending, describe the
situations and why you did it.
·
Describe
times that you have withdrawn from social interaction and isolated yourself to
an extreme degree and why.
·
Describe
incidents where you expressed inappropriate anger towards other people.
·
Describe
embarrassing or humiliating incidents in your life. Were
they related to your addictive behaviors? If so, how
were they related?
·
Describe
attempts that you have made in the past to control your addictive behaviors.How successful have they been? Do
these attempts show the powerlessness that you have over your addictive
behaviors?
·
Do
you feel any remorse from the ways that you have acted in your life? If so, explain that in detail.
·
Describe
any irrational or crazy set of events that have happened since you began you
addictive behavior. Did you rationalize this behavior? If so, in what way?
·
Have
you avoided people because they did not share in or approve of your addictive
behavior? If so, list these people and situations.
·
Describe
any dreams that you have had that exhibit the unmanageability or chaos of your
life.
·
Can
you pinpoint one time period in your life when your life began to become
extremely unmanageable? If so, describe that period of
time and what was happening.
·
Is
there one incident or insight that made you realize that your life was
unmanageable? If so, describe it in detail.
·
How
would you summarize the powerlessness and unmanageability of your life in the
face of your addiction?
Step 2 - I come to believe that a power greater than myself can
restore me to sanity
·
What
was the religion that your family of origin practiced or claimed to be a part
of?
·
List
the positive and negative aspects as you see it of your family’s religion.
·
Have
you made a break with your family's religion or have you stayed with it? Explain why you have taken your particular course of
action.
·
What
other people have helped you to see the unmanageability of your life? Do they believe in a Higher Power and if so describe their
belief as far as you know of it.
·
Recall
some of your best friends from childhood or adolescence. Describe
what you liked best about them and what they liked best about you? Do you think that these qualities have any relationship to
a Higher Power? Explain.
·
From
the following list of groups, write Yes or No according to whether you could
share in their values or not?
|
Group |
Share Values? |
|
Twelve Step
Group |
|
|
Conservative
Christian church |
|
|
Liberal
Christian church |
|
|
Synagogue |
|
|
Mosque |
|
|
Hindu
temple |
|
|
Buddhist
temple |
|
|
Unitarian
or non-Christian church |
|
|
Non-religious
ethical organization |
|
|
Activist
Humanitarian group (a.g. Amnesty Intl) |
|
|
Environmental
Organization (e.g., Sierra Club) |
|
·
Describe
events, situations or people who have helped you to
understand what a "Higher Power" or God is all about.
·
Describe
any dreams that you have had about a "Higher Power" or God, and what
they mean to you.
·
What
have been your previous experiences with religion? How
do think that this does or does not relate to your experience with God as you
understand God.
Step 3 - I make a decision to turn my will and my life over
to the care of God as I understand God
·
What
are your greatest fears about giving up control over your life to God as you
understand God?
·
What
things, people or circumstances have you tried to control in the past and how
has that turned out? Do you think that God will be
able to handle your life better than you have?
·
How
do you feel in general about turning your life over to God?
·
In
what ways will you keep up the process of turning your life over to God? Possibilities include going to religious services, 12 Step
meetings, meeting with others in recovery, writing a journal, service to
others, meditation, reading, physical exercise, contacting your sponsor or
engaging in therapy.
·
How
would you answer the question "Who am I"?
·
How
would you answer the question "Who is God"? In
other words, describe God as you understand God.
·
Describe
who or what you trust and to what degree.
·
In
what do you find meaning now or think that you can find meaning in the future?
·
How
do you think that you should live your life after giving your life over to the
care of God as you understand God? What changes do you
expect to make and how will this look in specific detail?
·
How
do you plan to celebrate or honor this step of turning your life over to the
care of God?
·
Describe
any celebration or honoring activity that you have actually made in turning
your life over to the care of God.
Step 4 - I make a searching and fearless moral inventory of
myself
·
Have
you had any broken relationships? If so, describe them
and how they hurt others or yourself. Describe any
grudges, anger or resentment that you have over these
relationships.
·
Have
you ever felt self-righteous? Explain when and the
circumstances. Was this justified? Elaborate.
·
What
events or triggers have caused you to begin your addictive behaviors in the
past? Describe situations, feelings, events, food or people that you seem to be a part of your life just
before or during your addictive behaviors.
·
Have
you ever held a grudge? Did you try to get revenge? If so, explain the situation and how it played out,
including whether or not someone else was hurt.
·
Describe
times that you have been oversensitive. Did this ever
damage your relationship with others, or were you just trying to keep your own
boundaries?
·
Describe
the faults that you most detest in others. Do you have
any of these traits yourself?
·
Put
a checkmark beside any of the following traits that you despise in others. Also check whether you see these traits in yourself.
|
Traits that I Despise in Others |
|||||
|
Trait |
In Others |
In Myself |
Trait |
In Others |
In Myself |
|
Selfishness |
|
|
Greedy |
|
|
|
Cowardice |
|
|
Snobbish |
|
|
|
Dishonesty |
|
|
Sarcastic |
|
|
|
Fearfulness |
|
|
Hypercritical |
|
|
|
Controlling |
|
|
Gossip |
|
|
|
Manipulative |
|
|
Tightwad |
|
|
|
Intimidating |
|
|
Harsh |
|
|
|
Power-hungry |
|
|
Unforgiving |
|
|
|
Possessive |
|
|
Verbally
abusive |
|
|
|
Prejudiced |
|
|
Physically
abusive |
|
|
|
Overly
dependent |
|
|
Sexually
abusive |
|
|
|
Procrastinating |
|
|
Impatient |
|
|
|
Judgmental |
|
|
Adulterous |
|
|
|
Preoccupied |
|
|
Sneakiness |
|
|
|
Lying |
|
|
Ungrateful |
|
|
|
Cheating |
|
|
Cynical |
|
|
|
Intolerant |
|
|
Bitter |
|
|
|
Self-Pitying |
|
|
Full of
Rage |
|
|
|
Jealous |
|
|
Envious |
|
|
|
Insecure |
|
|
|
|
|
·
Have
you failed to do things that you KNOW that you should have done? If so, then explain in detail.
·
What
are your fears? How have they caused you difficulty in
your life?
·
Describe
your relationship with your friends, co-workers or neighbors.
Is there something that you wish that you could do over again? If so, explain in detail.
·
Describe
your relationships with your family of origin. Do you
have conflicts with any siblings or with your parents? Are
you avoiding these matters in your family?
·
Describe
the earliest memories of your life. Did you share a
similar personality with those in your family or were they very different than
you? Do you think that these similarities o
differences caused problems in your life? If so,
explain.
·
If
you were to describe your family's major themes, what would they be?
·
Describe
your relationships with your nuclear family (spouse and children) if that is
different now from your family of origin. Is there
anything that you wish that you could erase from this part of your life?
·
Describe
in detail any major experiences in your life that you believe changed your life
forever afterwards (good or bad).
·
What
decisions have you made in your life that made a significant impact on your
life? How did you go about making those decisions?
·
How
much of your life have you used up already? If you
drew a time line of your life, where would you be now?
·
Put
your major experiences and major decisions on a timeline. Is
there a pattern of any kind?
·
What
are you most ashamed of in your life?
·
Do
you see any patterns in your addictive behaviors? If
so, explain them in detail.
·
What
have you done to cover and conceal your addictive behaviors? What
other deceptions did this lead to?
·
What
kind of personality do you exhibit at home? At school? At work? When no-one is around?
·
What
is so shameful in your life that you would not want to tell anyone? Who would you hurt if you told this?
·
Write
a summary of the highlights of your fourth step.
·
How
would you like to share your fourth step summary? What
details would you like to make sure that are known? Write
these details down in your summary and prepare the summary for presentation in
your fifth step.
·
Describe
anycelebrations or honoring activities that you hae done to honor the completion of your 4th
step.
Step 5 - I admit to God, to myself and to another human
being the exact nature of my wrongs
·
After
working through the fourth step questions, what do you realize about your
limitations and capabilities?
·
Describe
any person who has helped you to see yourself more clearly and objectively in
your process of recovery and of life.
·
What
qualities would you like to have in a sponsor? How do
the people in the list of possible sponsors measure up
to these criteria?
·
Write
down the names of the most trustworthy people that you know. Do
you think that they would be willing or interested in being a sponsor for you?
·
Describe
your feelings and expectations about sharing your fifth step with your sponsor.
·
List
people that you can think of that you might share your story with. Write whether you think that they are a safe, risky or a
bad choice to work your 5th step with.
|
Person |
Safe, Risky or Bad choice |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
·
Describe
who you have chosen to be your sponsor and how they reacted when you approached
them.
·
Describe
what it was like in sharing the fifth step. How did
you feel before, after and during the process? Are you
glad that you have done this?
·
Describe
any celebrations or activities that you have done in honor of completing the
fifth step.
Step 6 - I become entirely ready to have God remove all of
these defects of character
·
Do
you have any fairy tales or myths that you feel a special affinity with? Why?
·
Describe
situations and events where you have been full of pride. What
has this brought into your life that you like or enjoy? What
problems has it caused you?
·
Describe
the kind of activities do you really enjoy (of course, NOT your addictive
behavior).
·
What
are some healthy eating or exercise habits that you could start?
·
What
are some unhealthy eating habits that you could give up?
·
Describe
some secret GOOD deeds that you have done or would like to do.
·
Describe
situations and events where you have been greedy, oerly
needy or materialistic. What has this brought into your
life that you like or enjoy? What problems has it
caused you? Are you ready to give these attitudes over
to the care of God?
·
Describe
situations and events where you have given in to lust without regard for others
or any morality. What has this brought into your life
that you like or enjoy? What problems has it caused
you? Are you ready to give these lustful feelings over
to the power of God?
·
Describe
situations and events where you have been dishonest. What
has this brought into your life that you like or enjoy? What
problems has it caused you? Are you ready to depend
upon God to keep you from dishonesty?
·
Describe
situations and events where you have given into excessive eating, drinking,
shopping or covetousness. What has this brought into
your life that you like or enjoy? What problems has it
caused you? Are you ready to let God take control of
these behaviors and attitudes?
·
Describe
situations and events where you have been very envious or jealous of others. What has this brought into your life that you like or
enjoy? What problems has it caused you? Are your ready to turn these situations over to God?
·
Describe
situations and events where you have avoided responsibility for your actions or
lack of actions. What has this brought into your life
that you like or enjoy? What problems has it caused
you? Are you ready to allow God to help you take
responsibility for your actions?
·
List
your major defects of character.
·
What
do you plan to do when these major defects of character begin to become evident? List each defect individually along with the proposed
preventative behavior and how you will allow God to help you in your battle
against these defects.
Step 7 - I humbly ask God to remove my shortcomings
·
What
defects will be most difficult to give up? In what
order to you plan to give them up?
·
What
kind of situations, stressors or pressures cause you to regress back into your
defects of character? What can you do to lessen the
likelihood of that stress occurring?
·
Where
do you feel most supported and helped in your strivings for recovery?
·
What
makes you lose hope? Can you avoid such situations? If so, then how?
·
What
(person, situation, event, thought) restores your hope? Is
there a way to maximize those influences? If so, then
how?
·
What
would you like to recapture in your life?
·
Describe
in detail what you think that your life will be like with your defects of
character removed from you.
·
What
are you grateful for?
·
When
do you think that life has been especially good for you? When
did you have the greatest joy?
·
Describe
your typical day's activities in terms of how much time you spend on each type
of activity.
·
Describe
your typical day's activities if you knew that you had only one year to live.
·
Have
you made the correct decisions about how to spend time with loved ones, in
solitude and with your discretionary time? If not, how
would you like to change it?
·
What
would you do if you were granted three wishes?
·
What
do you think that you can do to leave the world a better place and accomplish
your mission in life?
Step 8 - I make a list of persons that I have harmed and
become willing to make amends to them all
·
How
have you hurt yourself by practicing your addiction?
·
What
important relationships did you destroy or damage because of your addictive
behaviors?
·
How
much time and energy have you lost from your addictive behaviors? What do you think you would have done or become had it not
been for your addictive behaviors?
·
Make
a list of all those that you have possibly harmed by your addictive behaviors. List the effect on them as individuals and on your
relationship.
·
Take
the list of people that you have harmed and make a list of possible amends for
each one of them.
·
From
the list of possible amends, choose the ones that seem most appropriate, and
mark them according to level of difficulty.
·
What
consequences do you fear in making amends? What is the
worst thing that can happen? What is the best thing
that can happen? What is likely to happen?
·
Do
you feel angry or resentful towards any people on your amends list? If so, write them a letter of anger, but don't send it to
them. Describe here any other ways that you have used
to get rid of the anger and resentment towards anyone on your list.
·
Describe
any dreams that relate to making amends to others.
Step 9 - I make direct amends to such people whenever
possible, except when to do so would injure them or others
·
What
amends do you think that you have already made? These
can include apologies already made, helpful tasks for those that you have hurt,
changed attitudes and so forth.
·
From
your list of amends, if there are apologies that you need to make, write them
down here first.
·
Read
your apologies to a friend or a sponsor and ask them if it sounds sincere or if
it sounds defensive or like an attack on the other person. Record
here what response they have about them.
·
Role
play with your sponsor or friends for anything that you are going to say when
making amends. Record here how these practice sessions
went and what you learned.
·
After
you have had your first encounter with making amends, record what happened here. How did you feel about it? How
did the other person respond? What have you learned
from this? What would you do differently next time?
·
After
you have done your first several encounters for making amends (for example,
after 5 times of making amends), record your overall impressions here. Is there anything common? Has
anything surprised you? Has anything disappointed you? How do you feel about the process and how has it affected
you?
·
What
amends do you have the most difficulty making? What do
you need to do to be able to make these amends?
·
How
has making amends affected your relationship with others?
·
How
are you dealing with the feedback from others after making amends? How are you feeling? How are you
dealing with the desire to defend yourself?
·
Write
down any other amends that you found that you needed to make after starting the
process of making amends.
·
How
can you celebrate or honor the completion of your making amends (step 9)?
·
Have
you had any dreams about making amends? If so,
describe them in detail.
·
Describe
any celebrations or activities that you have done to honor the completion of
your making amends.
Step 10 - I continue to take personal inventory and when I
am wrong I promptly admit it
·
What
is your plan to allow time for reflection each day?
·
What
new behaviors would you like to try to make your program more effective? How would you go about implementing these?
·
What
kind of behaviors and attitudes do you need to be most vigilant against to keep
from your addictive behaviors?
·
What
are your triggers for addictive behavior? How can you
guard against them or prepare for them?
·
What
are some amends or remedies that you should make when you find out that you are
wrong?
Step 11 - Through prayer and meditation I seek to improve
my conscious contact with God as I understand God, praying only for knowledge
of God's will for my life and the power to carry that out
·
Can
you recall anytime that your life was heading in the wrong direction? If so, what brought you back? Describe
this in detail.
·
How
would you describe your beliefs about God and a Higher Power to a child?
·
What
are your favorite sources of wisdom and knowledge abot
healthy values?
·
Has
anything you ever read convinced you to change in some fundamental or deep way?
·
If
you were stranded on a desert island with only one book, which book would you
take? Why?
·
If
you had only one week to live and unlimited resources, who would you gather
around you and how would you pass the time?
·
Write
out a complete form of what you would like your obituary to say.
·
What
do you believe will happen to you after you die?
Step 12 - Having had a spiritual awakening as the result of
these steps, I try to carry this message to others and to practice these
principles in all of my life
·
Have
you been able to reach out to another recovering addict? If
so, describe the situation and how it feels to you.
·
What
kind of approach would you like to have had when you first started the program? How can you implement that type of approach in your life
to others now?
·
What
you say if someone asked how the 12 Step program has worked for you?
·
How
do you usually handle conflict? Do you know of any way
to be more effective in conflict resolution? If so,
how would you become more effective? What would be the
steps?
·
How
much time do you want to and are able to allow for working with others on their
program? How will you go about setting that time
aside?
·
What
outside resources can you call on when you need help as a sponsor?
·
How
do you know if you are suited to helping another person work a 12 Step program?
http://www.12step.org/questionnaires.htm