Today I found myself contemplating the role of the 12 steps in relation to the wider scope recovery from substance use disorders. I thought about the main premise of the 12 step model that "selfishness, self-centeredness ...is the root of our troubles." It seems to be a given in the treatment field that one must sober up before one can make mental health progress. Certainly, every person with a substance use disorder has a problem of the primary order with self-centered thinking. Perhaps then, while the substance user, abuser, or addict may have other primary level causes, they must be rid of this selfishness before they can make effect gains in other maladaptive disorders.This usually requires some external intervention first, then a self-examination and behavioral change process and some social reinforcement. Therefore, this is why the 12 step program is indispensable.