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Spirituality as an Antidote to Addiction

Heal

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When you look at the evidence, spiritual practice may help us break free from the things we wish we didn’t want.

This article appeared in our October 2003 issue.

I remember vividly an advertisement I saw two decades ago. It depicted a Garden of Eden scene with a happy couple in harmony with creation. Filling the blue sky above them, beneath the sun and rainbow, was a gigantic bottle of liqueur, and underneath it all the words “Paradise Found.” Alcohol had literally been placed where God was supposed to be, promising fulfillment of the paradise that always somehow eludes us.

As in most ads for drinking, smoking, gambling, and other addictions, the truth is quite the opposite of the promise. Alcohol and tobacco do not render a person more sophisticated, affluent, healthy and fit, physically and sexually athletic, or socially skillful. The devilish reality of addiction is that the euphoria offers at best a compelling but temporary illusion of happiness and well-being, a euphoria that fades with time and tolerance until the person must use just to get back to neutral.

In the language of psychology, addiction is a progressive displacement of everything else in life. The addict spends increasing time with the addiction (acquiring the drug, using it, recovering from its effects), and less time doing other things once valued, pleasurable, or meaningful. The addict’s circle of friends and associates changes, and more time is spent with others similarly dependent, supporting the illusion that the behavior is normal.

Intentions and attempts to quit fail. After a period of abstinence, the immediate gratification value of the addictive behavior increases, and once resumed the addiction is often reinstated to full strength with surprising rapidity. Voluntary control erodes, and negative consequences accumulate. Yet in spite of it all, the addictive behavior persists.

A Spiritual Problem?

It would be difficult to find a clearer example than that alcohol ad of what Jewish scripture terms idolatry — giving to something ephemeral the reverence and priority that belong to God. The process of addiction is a reasonable model for the larger concept of sin and how it can enslave the human spirit. Carl Jung appropriated the ancient dictum spiritus contra spiritum to reflect the competition between spirituality and alcohol (spirits). One cannot serve two mutually exclusive masters — one drives out the other.

One of the most consistent findings in alcohol research, seldom mentioned in courses and textbooks, is that religious involvement significantly predicts lower current and future rates of substance use, problems, and dependency. There are many possible reasons for this correlation. Perhaps the spiritual practices of religion somehow protect adherents from using harmful substances. Conversely, heavy substance dependency diminishes religious practice.

Prayer and Meditation

The practices of prayer and meditation are clearly prescribed in the eleventh of Alcoholics Anonymous’ 12 steps as essential to maintaining sobriety: “[We have] sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.”

Research has shown that health benefits of prayer are particularly associated with the silent form known as contemplative or centering prayer, similar to transcendental meditation. Regular meditation has long been associated with lower levels of substance use and related problems. One small controlled trial of meditation to treat addiction showed significant reduction in alcohol use among heavy-drinking college students relative to an untrained control group.

Personal prayer and meditation are distinct from praying for another who is struggling with addiction. Following a growing body of research on the efficacy of what is called intercessory prayer, we designed the first clinical trial in which people entering treatment for substance use were randomly assigned to be prayed for or not by volunteers of various religions. Participants consented to be in the study and knew they might be prayed for, but did not know whether they actually were. We found that intercessory prayer had no effect on treatment outcome. If you want to help an addict, it appears that you would do better to teach the person to pray rather than pray for him.

Fasting

In ancient Jewish and Christian practice, prayer and fasting (temporary abstinence from a regular pleasure, usually food) were inextricably linked. Jesus did not need to instruct his followers to fast; he took it for granted that they regularly did so, and suggested refinements (“when you fast...”).

This ancient spiritual discipline is particularly interesting in relation to addiction, because it is a mirror opposite of indulgence. Presented with the possibility of eating, the person abstains for spiritual reasons. The latter motivation is important. Starving oneself to lose weight is not spiritual fasting.

Fasting may intensify other spiritual practices such as prayer. It may also strengthen one’s self control. As Roy Baumeister has found in studies, self-control — a virtue in many religions — is a depletable resource. Just as a muscle tires from use, controlling oneself decreases one’s ability to practice self-control in a subsequent task. Conversely, practicing self-control regularly appears to increase one’s ability to use it when needed, much as a muscle is strengthened by regular exercise.

Other Spiritual Disciplines

Though widely misunderstood, Alcoholics Anonymous is a spiritual approach for living. Spiritual discipline and character development, including humility, confession and amends, forgiveness, acceptance, submission to a Higher Power, ongoing personal moral inventory, and service to others are all emphasized. Presumably it is not just attending A.A. meetings that promotes recovery, but rather the practice of its precepts. “You can become a Christian by going to church,” Garrison Keillor once quipped, “about as easily as you can become a car by sleeping in your garage.” Indeed, recent research points to mental health benefits of practices such as forgiveness and acceptance.

Another program that takes spirituality seriously and incorporates it directly into treatment is the Na’nizhoozhi Center in Gallup, New Mexico. One of the largest addiction treatment programs in the United States, Na’nizhoozhi primarily serves the Dine, the Navajo people, and integrates Native American spiritual practices with modern treatment methods. The staff includes several traditional healers who are key members of the team.

Creating Spiritually-Based Treatments

What if an addiction treatment program drew directly upon Judeo-Christian traditions, for those whose cultural roots lie there? Even Christian treatment programs that rely on biblical preaching and doctrinal conversion often miss the opportunity to draw upon thousands of years’ experience in spiritual nurture and discipline. Many programs take clients off for wilderness survival or develop trust using ropes, yet few have followed the time-honored tradition of spiritual retreat.

The data suggest that such a program could be built around contemplative or centering prayer. Monastic retreats for meditation and contemplation have been common in Christian, Buddhist, and Hindu traditions. The experience of contemplative prayer can be intensified by silence, chanting, or fasting. All these practices involve the exercise of self-control: focusing attention, refraining from speech, abstaining from food. Spiritual direction can be interspersed with silence, prayer, and contemplation, offering clients experienced guidance in terrain that may be foreign at first.

Such programs would need testing, first as an adjunct to other forms of treatment. But we do know that in the largest clinical trial of any spiritually based treatment for addiction, Twelve-Step Facilitation Therapy compared favorably with two well-established methods, yielding a significantly higher rate of total alcohol abstinence during a year of follow-up.

Spiritual Awakenings

While spiritual facilitation may promote incremental change, there is a history of dramatic epiphanies. Release from addiction and craving is a frequent element of such transformation, stories of which are common in Alcoholics Anonymous. The last of the 12 Steps begins, “Having had a spiritual awakening as a result of these steps....” While most such awakenings are slow, the dramatic, mystical variety experienced by A.A.’s co-founder, Bill Wilson, is not uncommon. Indeed, Carl Jung once counseled a person beset by chronic alcohol dependence that his best hope might be such a spiritual experience.

Psychologist Jim Orford observed that reversing a condition as pervasive and persistent as drug dependence may require a sweeping “spiritual change” in attitude, values, and character. Jung described such escapes as “huge emotional displacements and rearrangements. Ideas, emotions, and attitudes which were once the guiding forces...are suddenly cast to one side, and a completely new set of conceptions and motives begin to dominate.”

Many factors, then, point to spirituality as an antidote to addiction: as a preventive, a treatment, and a path to transformation. Given the enormous suffering linked to addiction, we can scarcely afford to overlook this relatively untapped source of healing.

Where There’s No Past and No Future… And Everyone Is a Relative

In this place, there are no alcoholics, only people who may or may not choose to drink on any given day. There is no such thing as a pattern of addiction because the past and the future are alien concepts that don't apply here. In this place, there is no group therapy, only "talking circles"; there are no doctors or patients, only medicine men and women and their relatives, connected to each other by blood, clan, or spirit.

This place is the Na'nizhoozhi Center, Inc., in Gallup, New Mexico. It is one of the most successful treatment centers for people who, in conventional medical parlance, are substance abusers. Yet it relies little on conventional medicine. It is the largest alcohol addiction treatment center in the United States, since 1992 having served more than a quarter million people, most of whom are Hopi, Zuni, or Navajo.

NCI has been a laboratory of sorts for an alternative approach to treating alcohol abuse, emphasizing the spiritual dimension of healing embedded in Native American practices and teachings. All counselors at the center are traditional medicine men or women who have undergone rigorous traditional training since they were children or young adults.

They facilitate healing using a combination of sweat lodge ceremonies, prayers and blessings, herbal medicines, talking circles, drumming, singing, dancing, and extended periods of sitting, fasting, or physical exertion. They do not psychologize, philosophize, or pathologize, says psychologist Kevin Foley, Ph.D., director of clinical services.

"Focusing on the root of the problem is not a Native way to address healing," he explains. "Their cultural approach is to work on resiliency factors rather than uproot the problem. Native Americans are present-time-oriented and work toward healing by being who they are today rather than digging up the past and reliving the pain and emoting and catharsis. It's not good to reopen wounds unless they are right at the surface. Then we talk about it, but also work to move on. Mindfulness about life is really getting up in the morning and saying prayers to the sun, the wind, the animals, and the birds, and staying present to that which is really healing."

Of course, there is the matter of life's pain, loss, loneliness, and frustration, all of which trigger the urge to drink in the first place.Counselors work with relatives to identify those triggers so that they recognize when it is time to sing a song, not go out and get a drink. Counselors also provide teachings on how to contend with these challenges through traditional story and legend that "come from the heart, not something like Greek mythology," explains Lawrence Largo, a counselor at the center who has been a medicine man for 21 years. Teachings are designed to help people align themselves with their traditions, their clans, and their family responsibilities.

"We build up the trust," Largo explains. "We teach: Trust yourself, trust what your spirit is trying to say to your inner being, trust the purpose the great spirit has given you to fulfill here. You are the one who can work for you; it is you who need to feed that inner spirit. We might first give vomiting medicine [herbs in the sweat lodge] to get out the rottenness and decay and then we help them concentrate and open up and talk about... the isolation, frustration, depression, whatever they never talked about. But then we tell them, 'Now you leave it here, you don't talk about it again, and from here you are reborn from mother earth and her natural elements.'"

Outside the lodge, Largo says, relatives are taken through a cedar or tobacco-burning ceremony and given prayers to help them ward off the urge at moments of weakness or difficulty.

The backdrop for these teachings is Gallup, one of the poorest cities in America, with an unemployment rate over 70 percent. Not long ago, it was also one of the drunkest — in the eighties, the alcohol-related mortality rate was 19 times the national average. But Gallup has seen its intoxication, injury, and death rates fall dramatically since NCI opened its doors in 1992. Clearly, the center is doing something right. Some 60 percent of its clients stay dry after treatment, a rate far above the national average. Is that because the center treats addiction with a spiritual cure? "Western society calls it addiction. We don't," says Foley. "It may be a result of circumstance and life choice that a person lives his whole life drinking. But we have hope and faith that someday — any day, today, tomorrow — a person who has been drinking for 39 years can stop. We have more faith here in the potential of humans. We have faith in humanity."  — Louise Danielle Palmer


William R. Miller, Ph.D., distinguished professor of psychology and psychiatry at the University of New Mexico, has researched the psychology of change. He is the author of scores of articles and books, including, with Janet C ’de Baca, Quantum Change: When Epiphanies and Sudden Insights Transform Ordinary Lives (Guilford Press).


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