Spirituality and addiction

Instructions Read The Dark Night of Recovery on pages 222-224 in the textbook. Based on the reading, write a paper of 1,000-1,250 words addressing addiction as a spiritual crisis.
In your paper, address the following:
1. How a spiritual crisis can be part of the recovery process.
2. Explain May’s concept of a “dark night” in recovery, during which the recovering individual enters a stage of confusion and emerges with a deeper spiritual relationship.
3. Describe the difference between religion and spirituality.
Include at least four scholarly sources in addition to the textbook in your paper. Some, but not all, of these references can be taken from the assigned GCU Library articles for this topic.
Prepare this assignment according to the guidelines in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Topic 1 DQ1
Based on the assigned readings for this week, consider the roles of spirituality and religion in the treatment of addiction. How does spirituality differ from religion?
Topic 1 DQ2
Consider May’s personal experiences with his own spiritual crises as he describes them in the textbook. In particular, reflect upon May’s realization of his own limitations as a medical doctor when attempting to help addicts in their recovery. How might the frustrations that he experienced apply to you in the future if you were to work in the field of chemical dependency treatment?

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Study Material

PCN 373 Topic 1
Chapter 1 Text Book
1. Desire: Addiction and Human FreedomWhere your treasure is, there will your heart be also.the gospel according to matthewAfter twenty years of listening to the yearnings of people’s hearts, I am convinced that all human beings have an inborn desire for God. Whether we are consciously religious or not, this desire is our deepest longing and our most precious treasure. It gives us meaning. Some of us have repressed this desire, bury-ing it beneath so many other interests that we are completely unaware of it. Or we may experience it in different ways—as a longing for wholeness, completion, or fulfillment. Regardlessof how we describe it, it is a longing for love. It is a hunger to love, to be loved, and to move closer to the Source of love. This yearning is the essence of the human spirit; it is the origin of our highest hopes and most noble dreams.Modern theology describes this desire as God given. In an outpouring of love, God creates us and plants the seeds of this desire within us. Then, throughout our lives, God nourishes this desire, drawing us toward fulfillment of the two greatcommandments: “Thou shalt love thy God with all thy heart, and thy neighbor as thyself.” If we could claim our longing for love as the true treasure of our hearts, we would, with God’s grace, be able to live these commandments.1But something gets in the way. Not only are we unable to fulfill the commandments; we often even ignore our desireto do so. The longing at the center of our hearts repeatedly disappears from our awareness, and its energy is usurped by forces that are not at all loving. Our desires are captured, and Addiction_Grace_9780061122439.indd 13/9/12 10:24 AM 2 / ADDICTION AND GRACEwe give ourselves over to things that, in our deepest honesty, we really do not want. There are times when each of us can easily identify with the words of the apostle Paul: “I do not understand my own behavior; I do not act as I mean to, but I do the things that I hate. Though the will to do what is good is in me, the power to do it is not; the good thing I want to do, I never do; the evil thing which I do not want—that is what I do.”2In writing these words, Paul was talking about sin. Theologi-cally, sin is what turns us away from love—away from love for ourselves, away from love for one another, and away from love for God. When I look at this problem psychologically, I see two forces that are responsible: repression and addiction. We all suffer from both repression and addiction. Of the two, repression is by far the milder one.RepressionWe frequently repress our desire for love because love makes us vulnerable to being hurt. The word passion, which is used to express strong loving desire, comes from the Latin root passus, which means “suffered.” All of us know that, along with bringing joy, love can make us suffer. Often we repress our desire for love to minimize this suffering. This happens after someone spurns our love; we stifle our desire, and it maytake us a long time before we are ready to love again. It is a normal human response; we repress our longings when they hurt us too much. Perhaps it is not surprising, then, that we do the same with our deepest longings for God. God does not always come to us in the pleasant ways we might expect, and so we repress our desire for God.When we repress a desire, we try to keep it out of our aware-ness. We try to keep our focus on other things—safer things. Psychology calls this displacement. But something that has been repressed does not really go away; it remains within us, skirt-ing the edges of our consciousness. Every now and then it Addiction_Grace_9780061122439.indd 2 DESIRE / 3reminds us of its presence, as if to say, “Remember me?” And, when we are ready to tackle the thing again, we can. We may repress our longing for God, but, like the hound of heaven that it is, it haunts us. And it is there for us to deal with whenever we are ready. Repression, then, in spite of its sinister reputa-tion, is relatively flexible. It is workable. Addiction, the otherforce that turns us away from love, is much more vicious.The Paradoxes of AddictionFor generations, psychologists thought that virtually all self-defeating behavior was caused by repression. I have now come to believe that addiction is a separate and even more self-defeating force that abuses our freedom and makes us do things we really do not want to do. While repression stiflesdesire, addiction attaches desire, bonds and enslaves the en-ergy of desire to certain specific behaviors, things, or people.These objects of attachment then become preoccupations and obsessions; they come to rule our lives.The word attachment has long been used by spiritual tradi-tions to describe this process. It comes from the old French atache, meaning “nailed to.” Attachment “nails” our desire to specific objects and creates addiction. In this light, we can seewhy traditional psychotherapy, which is based on the release of repression, has proven ineffective with addictions. It also shows why addiction is the most powerful psychic enemy of humanity’s desire for God.I am not being flippant when I say that all of us suffer fromaddiction. Nor am I reducing the meaning of addiction. I mean in all truth that the psychological, neurological, and spiritual dynamics of full-fledged addiction are actively at work withinevery human being. The same processes that are responsible for addiction to alcohol and narcotics are also responsible for addiction to ideas, work, relationships, power, moods, fanta-sies, and an endless variety of other things. We are all addicts in every sense of the word. Moreover, our addictions are our Addiction_Grace_9780061122439.indd 3 4 / ADDICTION AND GRACEown worst enemies. They enslave us with chains that are of our own making and yet that, paradoxically, are virtually beyond our control. Addiction also makes idolators of us all, because it forces us to worship these objects of attachment, thereby preventing us from truly, freely loving God and one another. Addiction breeds willfulness within us, yet, again paradoxi-cally, it erodes our free will and eats away at our dignity. Ad-diction, then, is at once an inherent part of our nature and an antagonist of our nature. It is the absolute enemy of human freedom, the antipathy of love. Yet, in still another paradox, our addictions can lead us to a deep appreciation of grace. They can bring us to our knees.The paradoxes of addiction raise many questions. What really is addiction? What is its spiritual significance, its truerelationship to grace? What is the difference between addiction and deeply, passionately caring about something or someone? Are there some good addictions? And if traditional psychology does not help addiction, what does? I think I can shed some light on these questions, but many of the answers will not be pleasant to hear. Addiction is not something we can simply take care of by applying the proper remedy, for it is in the very nature of addiction to feed on our attempts to master it.At the outset, I must confess that I have by no means achieved victory over my own addictions. I am riddled with them, and I further confess that I enjoy some of them immensely. Al-though deep in my heart I would prefer to be free of them, the larger part of myself simply does not want to give them up. It is characteristic for addiction to mix one’s motives. But although I often feel impotent before my addictions, I do have some understanding of them, and that is what I hope to share with you. Understanding will not deliver us from addiction, but it will, I hope, help us appreciate grace. Grace is the most powerful force in the universe. It can transcend repression, addiction, and every other internal or external power that seeks to oppress the freedom of the human heart. Grace is where our hope lies.Addiction_Grace_9780061122439.indd 4 DESIRE / 5Journey Toward UnderstandingIt was in working with some of the most tragically addicted people—those enslaved to narcotics and alcohol—that I began wondering about addiction and grace. It was there also that I began to recognize my own addictedness. Most importantly, it was in the course of that work that I reclaimed my own spiritual hunger, a desire for God and for love that for many years I had tried to repress.As nearly as I can recall, the repression of my spiritual de-sire began shortly after my father died. I was nine at the time. Prior to that, I had had a comfortable relationship with God. As with all children, the earliest years of my life were “simply religious.” In the innocent wonder and awe of early childhood awareness, everything just is spiritual. My religious education had given me a name for God, but I hardly needed it. I prayed easily; God was a friend.3In a reaction typical for a nine year old, I expected God to somehow keep me in touch with my father after his death. I prayed for this, but of course it did not happen. As a result, something hurt and angry in me, something deeper than my consciousness, chose to dispense with God. I would take care of myself; I would go it alone. My wanting—my love—had caused me to be hurt, and something in me decided not to want so much. I repressed my longing. Just as my father faded from my awareness, so did God, and so did my desire for God.During college, I fell in love with literature and philosophy. In retrospect, I think this was my desire for God surfacing again, as a search for beauty and truth. I even tried to go to church on occasion, but I wasn’t consciously looking for God. By then I was searching for something that I could use to de-velop a sense of mastery over my life, something that would help me go it alone. In medical school and psychiatric training, I tried to make a god out of science; science seemed learnable, masterable, and controllable. Throughout, I resisted prayer and rebelled at religiosity in others. Such things seemed immature; Addiction_Grace_9780061122439.indd 5 6 / ADDICTION AND GRACEthey were signs of weakness. I wanted to be autonomous, al-though I wasn’t completely sure what the word meant.I was in the Air Force during the Vietnam War. Much in the Vietnam experience I had to repress. But much of it I could not repress. In a way, the tragedy of Vietnam woke me up a little. Afterward, I took a position as director of a community drug abuse clinic. With all the energy that might be expected of a young doctor, I applied my best psychiatric methods to the treatment of addictions. None of them worked. I was able to help people with their emotional and social problems, but they remained addicted to chemicals. Since so much of my desire for meaning and wholeness had become attached to professional success, and I was not being successful, I started to become depressed. A colleague called it a “normal profes-sional depression.” He went on to say, “All decent psychiatrists experience such depressions when they can’t cure the people they treat. If you didn’t feel depressed, it would mean you didn’t care enough.” It was some consolation. But not much.Then one day in the middle of this depression, I was casu-ally introduced to a faith healer at a conference in a nearby town. I did not believe in faith healers. As we shook hands, she paused, holding my hand, and told me she thought I was meant to be a healer too, but “I wouldn’t take my dog to you, because you think you are the one that has to do the heal-ing.” These are not the words one might expect to be helpful for a depressed person. But they struck me deep and well. In my search for self-determination, I had also been trying to command the very process of healing. It was obvious that some change in attitude was called for. I still wasn’t certain, however, what form that change should take.At about the same time, I embarked on a little informal re-search. I identified a few people who seemed to have overcomeserious addictions to alcohol and other drugs, and I asked them what had helped them turn their lives around so dra-matically. All of them described some sort of spiritual expe-rience. They kindly acknowledged their appreciation for the Addiction_Grace_9780061122439.indd 6 DESIRE / 7professional help they had received, but they also made it clear that this help had not been the source of their healing. What had healed them was something spiritual. They didn’t all use religious terms, but there was no doubt in my mind that what they spoke of was spiritual. Something about what they said reminded me of home. It had something to do with turning to God.As a result, I relaxed a little. I honestly considered there might be some power greater than myself involved in healing, and that I might be better off cooperating with that power in-stead of trying to usurp it. I also set about trying to understand more of what constituted “spiritual experience,” and why it had been so helpful to these addicted people. Secretly, I wanted to learn how to “do it” to people as part of their therapy. Even more secretly, I wanted to have those kinds of experiences once again myself.I described these spiritual experiences to some clergy friends. Most of them didn’t seem to understand what I was talking about. The least helpful friends tried to give me Freud-ian explanations of oceanic experiences: “Why, it’s simply a narcissistic regression of the ego to a state of infantile dis-sociation in order to avoid reality issues that have stimulated unacceptable libidinous impulses.” They said such things as if I should have known them already. But that was the problem; I did know them already, and knowing them didn’t help. But two of my clergy colleagues did offer some help. They said, in effect, “We don’t know for sure what it is either, but we agree it’s spiritual, and we’d like to help you explore it.” Interestingly, these two knew more psychological theory than the others; they knew enough to realize that psychology was not going to answer everything.With their companionship, I explored a multitude of spiri-tual ways and means. The 1960s were turning into the 1970s, and Freud and white-knuckled social activism were beginning to give way to something fresh afoot in America, something a little more spiritual. I studied Eastern religions, psychic phe-Addiction_Grace_9780061122439.indd 7 8 / ADDICTION AND GRACEnomena, psychedelic drugs, biofeedback, all the great stew of psychospiritual pop and pap that was percolating across the nation at the time. I read Alan Watts and Baba Ram Dass. I meditated every day. From a comfortable distance, I watched the rise of the charismatic renewal in Christian churches, and, from an equal distance, I sensed something powerful I couldn’t understand in Alcoholics Anonymous.One evening, about six months after my quest began, I was diligently practicing a form of yoga meditation that encour-ages the free coming and going of all thoughts. It is a method that might be described as the opposite of repression. In the freedom I gave to my mind, one of the thoughts that came was prayer. It was, in the beginning, the prayer of a nine year old, embarrassingly immature. “Dear Jesus, help me.” I would have stifled it immediately had I not been dutifully allowingall my thoughts to come and go. It was a sad and painful thing just to let that prayer happen, but I did. As months and years passed, the prayer grew, and with it, my awareness of my desire for God.I realized my exploration was less a professional research project and more a personal spiritual journey. I was not in control of my life; I needed as much of God’s grace as any of my patients did. With that growing realization, my spiritual desire seemed to pick up where it had left off some twenty years earlier. Now it was out in the light again, and I gradu-ally became able to reclaim it as my true heart’s desire and the most precious thing in my life.My more scientific observations continued, and for the mostpart they seemed to nourish and be nourished by the spiritual desire within me. The first, most striking, observation wasthat people could become addicted to chemicals that weren’t supposed to be addictive. In those days (and even until re-cently) drugs such as LSD, marijuana, and cocaine were not considered addictive. According to the experts, one might de-velop psychological dependency and overdo these drugs, but the drugs themselves were not supposed to be physically ad-Addiction_Grace_9780061122439.indd 8 DESIRE / 9dictive. Evidence for physical addiction required withdrawal symptoms and tolerance (the need for increasing amounts). Yet in my clinical practice I saw many people who in fact did have such symptoms with these drugs, and with a host of other substances as well. Someone walked in who was addicted to propoxyphene, a common painkiller that was supposed to be no more addictive than aspirin. Then someone came in addicted to aspirin! Then nose drops. Antidepressants. Tran-quilizers. The patients showed true addictions, complete with withdrawal symptoms and tolerance. It occurred to me that if a substance could alter your mind in any way whatsoever, it was possible to become addicted to it.I realized that I myself was addicted to a variety of sub-stances: nicotine, caffeine, sugar, and chocolate, to name a few. Was this “physical addiction” or just “psychological depen-dency”? Surely my tolerance and withdrawal symptoms were not as severe as I had observed in people addicted to alcohol or pure heroin, but the differences seemed only in degree. If I didn’t pay attention to my intake of these substances, I would increase my use of them. I would want more. That is a mild form of tolerance. And if I tried to cut down or quit completely I would experience distress, a distress that was in no way as dramatic as that of my patients, but neither was it just in my mind. The distress was a kind of tension; my muscles would be tighter than normal and a little tremulous, and there might be a headache and irritability, or even a slightly queasy stom-ach. From a physiologic standpoint, I was experiencing mild reflections of the same symptoms my patients experienced inwithdrawal from narcotics.Finally, I realized that for both myself and other people, addictions are not limited to substances. I was also addicted to work, performance, responsibility, intimacy, being liked, helping others, and an almost endless list of other behaviors. At the time, it seemed just fine to be addicted to some of thesethings, but others I would have much preferred to be free of. I had to admit that I had not freely chosen these things; my Addiction_Grace_9780061122439.indd 9 10 / ADDICTION AND GRACEconcern for them was not something I could control. They were compulsions.Tolerance and withdrawal were definite. However muchachievement, intimacy, or approval I had, it was never quite enough. I always wanted more. And if I had to do without one of them, I would experience not only a craving for it, but also some degree of anxiety and even actual physical discomfort. It occurred to me that my original “professional depression” had happened because I had been addicted to success and control. It was, in fact, a withdrawal; it happened when I couldn’t get my fix of professional successEven my littlest bad habits and secret fantasies had the quali-ties of addiction. I tried to take comfort in saying, “Yes, but my bad habits are inconsequential compared to alcoholism or drug addiction.” That statement was certainly true, but it also felt like a self-justification, a rationalization for keeping myhabits going. It sounded too much like alcoholics I had heard saying, “Well, at least we’re not junkies,” while on the other side of the same hospital ward narcotic addicts were saying, “Well, at least we’re not winos.”I can honestly say, then, that it was my my work with ad-dicted people, and the consequent realization of my own addictive behavior, that brought me to my knees. I am glad. Grace was there. If my attachments had not caused me to fail miserably at controlling my life and work, I doubt I ever would have recovered the spiritual desire and the sense of God that had been so precious to me as a child. Compared to what happens to people who suffer from alcoholism or narcotic addiction, what happened to me may not seem much of a “rock bottom.” But it had the same grace-full effect. To state it quite simply, I had tried to run my life on the basis of my own willpower alone. When my supply of success at this egotistic autonomy ran out, I became depressed. And with the depres-sion, by means of grace, came a chance for spiritual openness.I never did learn how to make spiritual experiences hap-pen to chemically addicted people so their lives would be Addiction_Grace_9780061122439.indd 10 DESIRE / 11transformed. I didn’t learn much of anything that helped me treat addictions, or for that matter any other form of illness. But I did become slightly more humble, through a growing appreciation of what I could and could not do to help myself or anyone else. I also learned that all people are addicts, and that addictions to alcohol and other drugs are simply more obvious and tragic addictions than others have. To be alive is to be addicted, and to be alive and addicted is to stand in need of grace.GenesisThe journey I have just described eventually led me to full-time work in exploring the interfaces of psychology and spiri-tuality. I wrote five books on the subject. This is the sixth. Afew years ago, I was given the opportunity to review current neurological research to see how it might inform our apprecia-tion of spiritual growth. In this exploration I discovered that neurology was on the brink of understanding how addiction takes place in the brain. To me, these neurological insights harmonized beautifully with what spiritual authorities have been saying for thousands of years. This book is the integra-tion of these themes. The themes themselves began long ago, with the biblical story of creation.The book of Genesis says that God made Adam and Eve out of earth and breath on the sixth day of creation and gave them an earthly paradise, a garden, to live in. It is said that this garden was near a place called Eden, which means “delight.” God looked on these two human beings and saw that they were very good and blessed them. God told Eve and Adam that they could eat fruit from all the trees in the garden except for two: the tree of immortality and the tree of the knowledge of good and evil. But a snake told Eve that God was lying, that she could indeed eat the fruit from the tree of knowledge, and that she would become like a god if she did. Seeing how enticing the forbidden fruit looked, she tried some. Then she Addiction_Grace_9780061122439.indd 11 12 / ADDICTION AND GRACEgave some to Adam as well. When God confronted the two human beings with what they had done, Adam blamed Eve. And Eve blamed the snake.Adam and Eve’s behavior is usually interpreted as symbol-izing humanity’s ongoing willful rebelliousness against God. God creates us with free will, and we respond by trying to be gods. We want to be the masters of our own destiny. We keep trying to substitute our own will for God’s will, but our pride always brings us to a fall and thrusts us even further away from an Eden we had hoped to recapture on our own terms. I certainly think this portrayal of human willfulness is accurate.4But when I read the Genesis story carefully, I respond sym-pathetically toward Eve and Adam. Surely they are respon-sible for what they do, but they do not really seem like hostile rebels; instead they seem innocent and gullible, almost like little children. As the Scripture relates it, they ate the fruit not because it was forbidden, but because it was “enticing to look at and good to eat” and because the serpent told them they could become like gods if they ate it. It seems to me their real problem was not rebelliousness but foolishness. Their lack of wisdom made them exceedingly vulnerable to temptation. Once they gave in to that temptation, their freedom was in-vaded by attachment. They experienced the need for more. God knew that then they would not—could not—stop with just the one tree. “They must not be allowed to stretch out their hands and pick from the tree of life also.” So God made a set of clothes for each of them and sent them out of the garden.5In this powerful story, the basic elements of addiction and grace are distilled: freedom, willfulness, desire, temptation, attachment, and, of course, the fall. It seems to me that each of our addictions reenacts Eve and Adam’s story. The story of Eden is not over, yet neither is it simply repeating itself end-lessly through history. Instead, it is going somewhere. I believe that humankind’s ongoing struggle with addiction is prepar-ing the ground of perfect love.Addiction_Grace_9780061122439.indd 12 Addiction and FreedomGod creates us out of love, or perhaps, as the fourteenth-century German mystic Meister Eckhart is supposed to have said, out of the laughter of the Trinity, which is the same thing.6 Scripture proclaims that this love, from which and for which we are created, is perfect. I do not presume to fully under-stand what this perfect love means, but I am certain that it draws us toward itself by means of our own deepest desires. I am also certain that this love wants us to have free will. We are intended to make free choices. Psychologically, we are not completely determined by our conditioning; we are not puppets or automatons. Spiritually, our freedom allows us to choose as we wish for or against God, life, and love. The love that creates us may be haunting, but it is not enslaving; it is eternally present, yet endlessly open.7It seems to me that free will is given to us for a purpose: so that we may choose freely, without coercion or manipulation, to love God in return, and to love one another in a similarly perfect way. This is the deepest desire of our hearts. In other words, our creation is by love, in love, and for love. It is both our birthright and our authentic destiny to participate fully in this creative loving, and freedom of will is essential for our participation to occur.8But our freedom is not complete. Working against it is the powerful force of addiction. Psychologically, addiction uses up desire. It is like a psychic malignancy, sucking our life energy into specific obsessions and compulsions, leaving less and lessenergy available for other people and other pursuits. Spiritu-ally, addiction is a deep-seated form of idolatry. The objects of our addictions become our false gods. These are what we wor-ship, what we attend to, where we give our time and energy, instead of love. Addiction, then, displaces and supplants God’s love as the source and object of our deepest true desire. It is, as one modern spiritual writer has called it, a “counterfeit of religious presence.”9Addiction_Grace_9780061122439.indd 13 14 / ADDICTION AND GRACEAttachment and DetachmentAddiction exists wherever persons are internally compelled to give energy to things that are not their true desires. To de-fine it directly, addiction is astate of compulsion, obsession, or preoccupation that enslaves a person’s will and desire. Addic-tion sidetracks and eclipses the energy of our deepest, truest desire for love and goodness. We succumb because the energy of our desire becomes attached, nailed, to specific behaviors,objects, or people. Attachment, then, is the process that enslaves desire and creates the state of addiction.The great spiritual traditions of the world have been talking about attachment for millennia. The Upanishads of ancient In-dia go back as early as ten centuries before Christ. One of these says, “When all desires that cling to the heart are surrendered, then a mortal becomes immortal.” In the sixth century b.c., the Greek Heraclitus said of attachment, “Whatever it wishes to get, it purchases at the cost of soul.” In the Hebrew tradition, the ancient preacher of Ecclesiastes moaned, “I denied my eyes nothing that they desired, refused my heart no pleasure. . . . What futility it all was, what chasing after the wind.” The core tenets of Buddhism are the Four Noble Truths: (1) suffering is a fact of life; (2) suffering is caused by attachment; (3) libera-tion from suffering and the reinstitution of human freedom can happen only through detachment; and (4) human effort toward detachment must involve all aspects of one’s life in a deeply spiritual way.10Detachment is the word used in spiritual traditions to de-scribe freedom of desire. Not freedom from desire, but freedom of desire. Of all the concepts we will be discussing, detach-ment is the most widely misunderstood. For centuries, people have distorted its meaning, mistakenly assuming that detach-ment devalues desire and denies the potential goodness of the things and people to which one can become attached. Thus detachment has come to be associated with coldness, auster-ity, and lack of passion. This is simply not true. An authentic Addiction_Grace_9780061122439.indd 14 spiritual understanding of detachment devalues neither desire nor the objects of desire. Instead, it “aims at correcting one’s own anxious grasping in order to free oneself for committed relationship to God.”11 According to Meister Eckhart, detach-ment “enkindles the heart, awakens the spirit, stimulates our longings, and shows us where God is. . . .”12Detachment uncovers our basic desire for God and sets it free. With freedom of desire comes the capacity to love, and love is the goal of the spiritual life. Jesus’ many words about detachment are set in the context of growing fullness of love.13 In Buddhism’s Metta Sutra, we find the following: “Letyour senses be controlled . . . and in this way become truly loving. . . . Even as a mother watches over and protects her child . . . so with a boundless mind should one cherish all be-ings, radiating friendliness over the entire world, above, below, and all around without limit.” The theme continues in Taoism: “The sage . . . is detached, thus at one with all. Love the world as your own self; then you can truly care for all things.” And it echoes in the Bhagavad Gita, the great Hindu Song of God: “Only by love can people see me, and know me, and come unto me. Those who work for me, who love me, whose End Supreme I am, free from attachment to all things, and with love for all creation, they in truth come to me.”14So instead of promoting a dry, uncaring state, detachment does just the opposite. It seeks a liberation of desire, an en-hancement of passion, the freedom to love with all one’s being, and the willingness to bear the pain such love can bring. In contemporary spiritual circles, some people wish to use the term nonattachment instead of detachment in order to temper some of these old misconceptions. The term may be useful in some settings. However, here we are speaking of attachment as the process through which desire becomes enslaved and ad-dictions are created. It is most accurate, then, to use detachment to describe the opposite process, the liberation of desire. The state that liberation leads to might legitimately be called a con-dition of nonattachment. I, however, prefer to call it freedom.Addiction_Grace_9780061122439.indd 15 16 / ADDICTION AND GRACEGraceThe first and greatest commandment for both Judaism andChristianity is, “You shall have no other gods before me.” Similarly, Islam’s basic creed begins with “There is no god but God.”15 It is no accident that these three great monotheistic religions share this fundamental assertion. “Nothing,” God says, “must be more important to you than I am. I am the Ultimate Value, by whom the value of all other things must be measured and in whom true love for all other things must be found.” We have already mentioned the two commandments that Jesus called the greatest: “You shall love the Lord your God with all your heart, with all your soul, and with all your strength, and you shall love your neighbor as yourself.” It is ad-diction that keeps our love for God and neighbor incomplete. It is addiction that creates other gods for us. Because of our addictions, we will always be storing up treasures somewhere other than heaven, and these treasures will kidnap our hearts and souls and strength.Because of our addictions, we simply cannot—on our own—keep the great commandments. Most of us have tried, again and again, and failed. Some of us have even recognized that these commandments are really our own deepest desires. We have tried to dedicate our lives to them, but still we fail. I think our failure is necessary, for it is in failure and helplessness that we can most honestly and completely turn to grace. Grace is our only hope for dealing with addiction, the only power that can truly vanquish its destructiveness. Grace is the invincible advocate of freedom and the absolute expression of perfect love.Some Christian spiritual authorities criticize other religions for denying the reality of grace. But in fact grace has its coun-terparts in all religions. The Torah of Judaism is suffused with cries for God’s loving salvation. Islam finds its very heart inAllah’s mercy. Even for Buddhists and Hindus, with all their emphasis on personal practice and effort, there could be no Addiction_Grace_9780061122439.indd 16 liberation without the grace of the Divine. Tibetan Buddhists, for example, pray for “gift waves” from deities and gurus. A Tibetan Buddhist hymn pleads simply, “Please bestow your compassionate grace upon us.” In the Bhagavad Gita, the Hindu God proclaims, “United with me, you shall overcome all difficulties, by my grace. Fear no longer, for I will save youfrom sin and from bondage.” And in the twentieth century, Mohandas Gandhi was very clear: “Without devotion and the consequent grace of God, humanity’s endeavor is vain.”16I do not wish to imply that all religions are basically the same; they certainly are not. But I do wish to demonstrate that in spite of widely varying emphases and radical differences in theology, all major religions deal centrally with the basic themes I have set forth here: we are created for love and free-dom, addiction hinders us, and grace is necessary for salvation.For Christians, grace is the dynamic outpouring of God’s loving nature that flows into and through creation in an endless self-offering of healing, love, illumination, and reconcili-ation. It is a gift that we are free to ignore, reject, ask for, or simply accept. And it is a gift that is often given in spite of our intentions and errors. At such times, when grace is so clearly given unrequested, uninvited, even undeserved, there can be no authentic response but gratitude and awe.It is possible to approach grace as if it were just another thing to be addicted to, something we could collect or hoard. But this kind of grasping can capture only an image of grace. Grace itself cannot be possessed; it is eternally free, and like the Spirit that gives it, it blows where it will. We can seek it and try to be open to it, but we cannot control it.17Similarly, grace seeks us but will not control us. Saint Augustine once said that God is always trying to give good things to us, but our hands are too full to receive them. If our hands are full, they are full of the things to which we are ad-dicted. And not only our hands, but also our hearts, minds, and attention are clogged with addiction. Our addictions fillup the spaces within us, spaces where grace might flowAddiction_Grace_9780061122439.indd 17 18 / ADDICTION AND GRACEIt is most important to remember, however, that it is not the objects of our addictions that are to blame for filling up ourhands and hearts; it is our clinging to these objects, grasp-ing for them, becoming obsessed with them. In the words of John of the Cross, “It is not the things of this world that either occupy the soul or cause it harm, since they enter it not, but rather the will and desire for them.” This will and desire, this clinging and grasping, is attachment.18HopeIt appears, then, that we are in a predicament. We are depen-dent upon grace for liberation from our addictions, but those very addictions impair our receptivity to grace. The message may not sound like good news. Yet God creates and cares for us in such a way that our addictions can never completely van-quish our freedom. Addiction may oppress our desire, erode our wills, confound our motivations, and contaminate our judgment, but its bondage is never absolute.Because of God’s continuing love, the human spirit can never be completely obliterated. No matter how oppressed we are, by other people and circumstances or by our own internal addic-tions, some small capacity for choice remains unvanquished. Poets have written beautifully about this indomitability of the human spirit, but its most eloquent advocates are men and women who have given their lives in the struggle against social oppression. Mohandas Gandhi used the term soul force to describe the internal undying ember of freedom, and he centered his doctrine of nonviolence upon it. Martin Luther King spoke of the same thing when he said, “I refuse to accept the idea that the ‘is-ness’ of our present nature makes us mor-ally incapable of reaching up for the ‘ought-ness’ that forever confronts us.” A young Jewish child of the holocaust must have felt the same thing when he wrote, “And every day, no matter how bitter it be, I will say: From tomorrow on, I shall be sad, Not today!” The bare edge of freedom is insured and Addiction_Grace_9780061122439.indd 18 preserved inside us by God, and no matter what forces oppress us from without or within, it is indestructible.19Because of our eternal possibility for freedom, it is no more hopeless to be defeated by our own interior addictions than by external oppression. Although we cannot rid ourselves of attachment through our own autonomous efforts, and our ad-dictions can indeed deaden our responsiveness to grace, there is always some level at which we can choose, freely, to turn to God or to turn away from God, to seek grace or avoid it, to be willing for our attachments to be lightened or to hold on to them.To return to Augustine’s metaphor, we may not be able to make our hands completely empty in order to receive the gifts of grace, but we can choose whether to relax our hands a little or to keep clenching them ever more tightly. In the face of significant addiction, our degree of choice may seem small;simply relaxing one’s hands may seem too passive. As we shall see, however, this simple choice may be the greatest kind of struggle any human being can face, and it may call forth the greatest courage and dedication. There is nothing passive about it. In the long run, it may prove far more assertive and powerful than any other possible action we could take. It is, after all, the pure, naked aspiration of the human soul toward freedom and, through freedom, to love.We may go through a great deal of humbling, if not outright humiliation, before we come to this simplicity of hope. We do not like admitting defeat, and we will struggle valiantly, even foolishly, to prove that we can master our destinies. God, in whose image we are made, instills in us the capacity for relent-less tenacity, an assertiveness that complements our yearning hunger for God. But most of us overdo it; our spirit of asser-tiveness quickly becomes a spirit of pride. We will never really turn to God in loving openness as long as we are handling things well enough by ourselves. And it is precisely our most powerful addictions that cause us to defeat ourselves, that bring us to the rock bottom realization that we cannot finallyAddiction_Grace_9780061122439.indd 19 20 / ADDICTION AND GRACEmaster everything. Thus, although in one sense addiction is the enemy of grace, it can also be a powerful channel for the flow of grace. Addiction can be, and often is, the thing thatbrings us to our knees. Again the words of Paul are relevant:I was given a painful wound to my pride, which came as Satan’s messenger to bruise me. Three times I begged God to rid me of it, but God’s answer was: “My grace is all you need; my power finds its fullstrength in weakness.” Therefore I shall prefer to find my joy and my pridein the things that are my weakness; and then the power of Christ will come and rest upon me. For this reason I am content, for the sake of Christ, with weakness, contempt, persecution, hardship, and frustration; for when I am weak, then I am strong.20Like Paul, it is possible that at some point on the journey with addiction and grace, we might even come to see addic-tion as a kind of gift. Some of the greatest spiritual authorities on addictions, the spiritual fathers and mothers of the Chris-tian desert tradition, were emphatic about this. “Whoever has not experienced temptation cannot enter into the Reign of Heaven,” said Abba Anthony. “Take away temptations and no one will be saved,” said Evagrius. Addiction teaches us not to be too proud. Sooner or later, addiction will prove to us that we are not gods.21Then we will realize that we are our own worst enemies; we cannot beat ourselves. At that point, when we have exhausted all the available false repositories for our hope, it is possible that we will turn to God with a true sense of who we are, with an integrity that is both humble and confident, with a dignitythat knows itself because it has met its limits.22Hope can sometimes be an elusive thing, and occasionally it must come to us with pain. But it is there, irrevocably. Like freedom, hope is a child of grace, and grace cannot be stopped. I refer once more to Saint Paul, a man who, I am convinced, un-derstood addiction: “Hope will not be denied, because God’s love has been poured into our hearts.”23 2. Experience: The Qualities of AddictionIt is the nature of desire not to be satisfied, and most human beings liveonly for the gratification of itaristotleI could tell many stories as examples of how people experience addiction. I think of Sam, addicted to alcohol. He is fifty-eightbut looks ninety because he has been drinking since he was a teenager. Once full of hope and dreams, he now languishes in a mental hospital. Doris, in contrast, leads an active and overtly successful life. She is socially popular and an effective businesswoman, but she is addicted to eating. Happy on the outside, she secretly hates herself because she cannot control her weight. Then there is Jim, a man of moderation in all things except his work. Addicted to his own sense of responsibility and the need to perform, he worries constantly about money and security. He is recovering from a heart attack, and his fam-ily hopes he will now slow down. He doubts that he can. I also think of Frank, a loving father and dedicated husband, who is completely entranced, compelled, by his infatuation with another woman. He was certain at first that the love he experienced was the purest he had ever known. Then, for a while, it seemed he was a slave of sexual desire. Now, as he longs for nothing other than freedom from both his wife and his lover, he has lost all understanding. He simply does not know what to do. And I remember Jean, a sweet and gracious homemaker. Jean is addicted to her relationship with her husband, who berates and belittles her at every opportunity. Friends who have witnessed this tell her to stand up to him, but the very thought of threatening the relationship fills her with panicThese people’s situations are not at all unusual, but they Addiction_Grace_9780061122439.indd 213/9/12 10:24 AM

Addiction and GraceTwo Articles by the AuthorLightness of Soul 210The Dark Night of Recovery 222Addiction_Grace_9780061122439.indd 2093/14/12 1:21 PM 210Lightness of Soul: From Addiction toward Love in John of the Crossby Gerald G. May(From the Fall 1991 issue of Spiritual Life magazine)For the most part, I have quit trying to figure outhow God’s grace works. But now and then, I can’t help myself; the old curiosity just explodes. Marveling at some miraculous transformation in a person’s heart I think: “I just have to know how God does this stuff!”It happens every time I think about myself in relation to John of the Cross. How could I, an optimistic Meth-odist psychiatrist from the rural Midwest, ever have come to seek spiritual and psychological guidance from an austere sixth century Spanish mystic who goes on endlessly about dark night and detachment?I have only one clue; it is his passion that hooked me. On the outside, John and I would bear no resemblance whatsoever. Interiorly, however, his longing speaks to mine in a language that transcends time, culture, and even faith tradition. His abyss calls to mine, and points my heart to the living Source of all true calling.It is that way for many people today. It happens especially for people like me who have exhausted the pop methods of prayer and the latest fads in typing personalities and integrating archetypes. It happens when our equivocations burn out, when we give up trying to achieve personal mastery and give ourselves to divine grace at the same time. Solely for some people, in a flash for others, John’s words begin to make sense:“a person likes to remain alone in loving awareness of God, without particular consideration, in interior peace and quiet and repose, and without . . . acts and exer-cises” (II Ascent 13, 4).1Addiction_Grace_9780061122439.indd 210 Contemplative PsychologyBut there is more to it. John speaks to my mind as well as my heart. His insights into human psychology are deeply challenging and rewarding. Western psycho-logical science did not even entertain the idea of the unconscious until Freud introduced it in the early twen-tieth century. Yet centuries earlier John, Teresa, Brother Lawrence, and other contemplatives were describing in fierce detail the inner life of the soul that goes onbeneath our surface awareness. They seemed to know all about what Freud would eventually call defense mechanisms—the tricks our minds play on us—and the subtle ways selfishness can masquerade as spiritualityOver the years I have come to understand that what the contemplatives call “self-knowledge” is a very spe-cial kind of psychological insight. It is something that both complements and transcends modern scientificpsychology. Psychology studies human behavior ob-jectively, from the outside; contemplative experience encounters the human mind directly, immediately, by being wakefully immersed in the mind itself. Thoughts, feelings, and images are all seen as they happen, from their inception as tiny bursts of psychic energy all the way through their differentiation into substantial men-tal events and, in some cases, to the point of becoming obsessions or preoccupations.John clearly gleaned his psychological insights from his own psychic immediacy, and his insights are breath-taking. It is obvious to me, for example, that his own interior watchfulness resulted in his certainty that no thought, no feeling, no image, no experience of any kind deserves the passion of a heart truly seeking God. He knew that any such things, and most often the best of such things, can easily become idols that capture hu-man desire, confine it, weigh it down, and restrict its capacity for love. “Since God is inaccessible, be careful not to concern yourself with all that your faculties can com-prehend and your senses feel, so that you do not become satisfied with less and lose the lightness of soul suitablefor going to God” (Sayings of Light and Love 52).Addiction_Grace_9780061122439.indd 211 212From his detailed and authoritative description, it is obvious this insight was not proclaimed merely on principle. Neither did it come from book-learning or a simplistic flesh-versus-spirit duality. It was instead anincarnate psychological truth cased on direct experi-ence. He knew the weighing-down that comes with overconcern for mental perceptions and events, because he had felt and seen it in himself. He also knew, in a manner unavailable to our best psychology, the light-ness of soul that is “suitable” for communion with God.Spiritual GrowthThe same kind of direct knowledge is evident in John’s descriptions of spiritual growth. Nowadays we are inundated with different models of the stages and phases of human spiritual development. They are helpful in understanding the psychosocial dynam-ics of maturation, but they are often so entranced by modern psychology that they fail utterly to address the transcendent activity of God in human life. Even in Carl Jung’s thinking—the most popular theory of psychospiritual integration in our time—there is no recognition of divine transcendent grace, or even of the transcendence of God’s self. God never rises above the status of an archetype. At best, the modern models are systems that speak of the immanence of God. This is in striking contrast with some ancient models that saw only God’s transcendence working upon an essentially powerless human soul, not inviting and empowering but propelling it through purgation and illumination to union.But in John, and Teresa as well, we find sketches ofthe process of human spiritual growth that embrace both the immanence and transcendence of God. It is clearest in Teresa’s Interior Castle and in John’s Ascent of Mount Carmel. With all the shiny modern systems that seek to describe spiritual growth, I find I must return to these two classic works to find something thatreally addresses the mystical relationship of human will and divine grace.Addiction_Grace_9780061122439.indd 212 As but one example, think of the differentiation John makes between the active and passive nights: the subtle distinctions between what the human will can do and where grace must intervene in obscure ways. Consider also how he draws the lines so faintly; at times it is unclear which is which. He allows distinction without hard separation, precision without compartments. It has to be this way because spiritual growth is growth in love, and love, while seeking truth, embraces every-thing.Love makes it all possible. God is in love with us; our hearts are in love with God. God invites; we respond. We reach out; God responds. We struggle and ache to-ward love; God aches with us and empowers our seek-ing. We trust in God’s lovingkindness and God opens our way for us, showing us miracles in everyday life. We choose God above all; God leads us where we never would go nor could go on our own—where we must confront the incompleteness of our choosing. It is all for love, in love, accomplished through love. Love is the at-mosphere in which unity and diversity, immanence and transcendence, will and grace are embraced.Freedom for DesireLove is the end, and love is the only way and means. In comparison to John’s sweeping vision of holy love, all psychological insights are of minor importance. Yet John’s insights can be profound revelations for our modern understanding of human behavior. In essence, John’s psychology speaks of human desire—what mod-ern psychologists call a motivational state. In a manner strikingly similar to but deeper than Freud’s, John sees this desire as energy, the love-thrust and love-opening of the human spirit. But without divine grace, love is possible for us only in small, restricted ways, because our desire is attached to countless objects within and around us.What John describes as attachment is precisely what modern psychology calls conditioning and ad-diction. The energy of our spirits is nailed to objects,
Addiction_Grace_9780061122439.indd 213 214relationships, and habits that we have adapted to and become dependent upon. We seek security and fulfillment through these objects of addiction, and we can be moved to violence by the threat of losing them.2Modern psychology is convinced that human mo-tivation must always be determined by some kind of conditioning. When a conditioning becomes severe and inflexible enough to cause trouble, it is called addictionor compulsion. In addressing addictions, psychology advocates the substitution of “better,” more efficientconditioning. John goes much deeper than this. He sees the objects of our attachment as good in themselves. He even distinguishes between more natural and more willful attachments. But no attachment, no condition-ing, no matter how noble or efficient, can really be seenas good. To the extent that anything binds the energy of desire, we are that much less free for the radical move-ments of love (see, e.g., Sayings of Light and Love 18).The radical point of John’s psychology for our time is his conviction that human beings are capable of growth beyond addiction, toward absolute freedom for love. Psychology has no real conception of such a possibility. Our brains function by means of conditioning, so our only choice is to condition ourselves more efficiently.John does not accept such a limited vision of human life. He maintains that there is another source of motivation: the radiance and power of God’s love. There is no rea-son to settle for less. “What do you ask, then, and seek, my soul? Yours is all of this, and all is for you. Do not engage yourself in something less” (“Prayer of a Soul Taken with Love,” Sayings of Light and Love 25).MotivationModern psychology is prone to see even love itself as the result of conditioning. We love what we are attached to. We are attached to what we love. John acknowledges the captivating nature of love, but refuses to accept that it means any kind of bondage. Instead, we are capti-vated by a love that offers more and more freedom. In this love we are drawn but not forced, impelled but not Addiction_Grace_9780061122439.indd 214 compelled, inspired but not controlled, impassioned but not driven.It is at such a point that my curiosity rises. I don’t know whether it is passion or compulsion, but I want to figure out at least a little of how this kind of motivationin love can be. How can we be captivated by freedom?It seems to be that human motivation takes three forms, in order of increasing freedom: reflex, conditioning, and desire. Reflexes are the inherent inbornresponses of our nervous system to stimuli. Touch a hot stove and your hand will jerk back. Caress a baby’s cheek and the baby’s face will turn toward the touch. Get a whiff of pepper and you will sneeze.Conditionings are similarly automatic responses, but they are learned instead of innate. You have certain habitual ways of dealing with conflict. In a group, youhave habits of how you feel about yourself and what you do to find your place. Even in prayer, we all have habitsof posture, interior attitude, form, and style. All these conditionings are based on experience and repetition. They exist because we have adapted to them.All conditioned habits are attachments of some de-gree. Some are minor; we could probably change them with only a little struggle if we recognized them and saw a good reason to change. They impair our freedom primarily because they happen so automatically. Other habits are full-blooded addictions; we experience great stress in trying to change or stop them. In fact we cannot stop them on our own.We also have conditioned habits of relationship. We adapt to relationships with other people, with pos-sessions, with groups, even with causes. Some of these relationships are also major addictions. They may be among the great loves of our life, but we must ask how free we are within them. Some, we find, are truly compelled.The third source of human motivation is desire. Orig-inally, desire draws us, orients us, gives us a direction for action. We feel desire for food when we are hungry, for warmth when we are cold. Because desire surfaces Addiction_Grace_9780061122439.indd 215 216in consciousness as an inner experience, it invites more freedom than the automatic motivations of reflex orconditioning. Desire wakens us up to what is going on. It gives us a chance to think about what to do. More im-portant, it helps us appreciate the wonder of our being alive, right here and now.3Unlike reflex or conditioning, desire is not a need initself. Instead, it is a feeling-state that represents need. It is not always conscious. Psychologists have discovered what John knew long ago; we keep many of our desires out of awareness because they are unpleasant or do not fit with our conditioned habits of life. Further, not allof our desires are simple reflections of basic needs forfood, warmth, and the like—what John called “natural appetites.” Many desires are expressions of our attach-ments and addictions. Even here, though, desire speaks of freedom. If I am addicted to alcohol, the beginning of hope for freedom is recognizing how much I want alco-hol, how much I feel I need it.Love and FearBut let us go a little deeper and be more precise. The au-thentic realization of addiction is found in recognizing not how much I want something, but in how much I fear being without it. Desire fundamentally takes two forms: attraction and repulsion, love and fear. Desire as love is experienced as drawing toward, reaching forward, opening up to, giving oneself into. Desire as fear is pull-ing away, avoiding, closing off, shutting out. Both are desire, but there is a great difference.Thus far we have been solidly on the ground of modern psychology. Now we must follow John a little further afield. Psychology makes no great distinctionsbetween love and fear when it comes to human motiva-tion. Who can say whether I love alcohol or fear being without it, whether I love companionship or fear loneli-ness, whether I love righteousness or fear sin? Psychol-ogy says it doesn’t matter much; what counts is what I do about my behavior. John also has a certain equa-nimity about fear, but for him what counts is only that Addiction_Grace_9780061122439.indd 216 love prevail; that the soul draw increasingly near the Holy Beloved.4We will not find God by fearing the devil, nor heavenby avoiding hell. The difference is freedom. Fear offers little more freedom than reflex or conditioning; its ownmethods of compelling us are awesome. Fear makes us do things we would never otherwise choose. You can tell your addictions not by their drawing power upon you but by the fear you experience at the thought of los-ing them.But most important, fear blocks our love. Why do we not love more? Because of fear. We fear what we love will ask of us. We fear the pain that comes with love. We fear opening ourselves and becoming vulnerable. It is fear that makes the two great commandments seem so far from the realm of possibility. It is fear, not addic-tion, that is the great enemy of love.Once again I must move a little deeper for precision. John makes clear that the problem is not so much fear itself, but what fear does to us or what we do with it. When fear prompts us to turn to God, it is as worthy as any other experience. When fear causes us to seek our own defenses and resources, it is as destructive as any-thing could be.What makes the difference? There is little we can do on our own to ease our fear. We can take certain risks of faith, extending ourselves a little bit here and there, and these do deepen our trust. But it is only grace, God’s loving guidance and empowerment of our desire, that makes love possible where fear was. For that, our only hopeful action is to try to draw near God in every moment of fear. And God’s grace is necessary even there, to enable our turning Godward instead of self-ward.This is at least part of what it means to me to be cap-tivated in freedom. God plants in my heart a deep love for God. In God’s own way and time, that love surfaces as attraction: a positive desire for love. Immediately I am afraid. My addictions are threatened, my safety is shaken, my security suddenly feels vulnerable. Left to Addiction_Grace_9780061122439.indd 217 218my own devices I would retreat—and often do—into self-protection. I continue to want, perhaps even desper-ately, but cannot move for fear. I cry out in longing, and God’s grace comes in God’s own way, somehow empow-ering a little more opening in faith, another liberation, and I am again afraid. All the while my yearning deep-ens. I am captivated in freedom; I could choose against this course of things if I so desired, but I know I will never so desire.There is learning in this: learning to distinguish be-tween authentic desire and driven compulsion, learning better how to align my behavior with my desire for love, learning to respond to fear by seeking God instead of self-defense. And learning helps. But it is never enough, for I will never fully know where my fear will arise; I will never fully discern where my nights must be.The Night of RecoveryI want to give just one very practical example of desire as love and fear in the process of recovery from addic-tion. It is something I consider very important in the spiritual direction of people in recovery. Many people have said that they found God through the struggles of their addictions. The “grateful alcoholic” is one who rec-ognizes that without suffering the addiction, he or she would never have come to realize the power and grace of God in life.Twelve-step programs are grounded in the recogni-tion of one’s powerlessness in the face of addiction and dependence on God for deliverance. There are twelve-step programs for everything now, but the old and good ones worked because people knew that recovery was a life-or-death matter. The truly recovering person knows that if recovery goes, there is no hope for a worthwhile life.This understanding is good because it works. But I sense that John of the Cross might have seen things a bit differently. Recovery from addiction was not the most important thing in John’s life; love for God was. The stripping away of attachment is neither an end in Addiction_Grace_9780061122439.indd 218 itself nor a means toward survival. It has value for John only as it frees human passion for love.People in twelve-step recovery normally meet God as savior. God is the one by whose grace freedom from addiction is made possible. There is a theological truth in seeing God as savior, but God is so much more than that. And there is no truth, I am afraid, in seeing God as a means to an end. The more important recovery becomes—and it must be important to work—the more difficult it is to see God as anything beyond the agent ofrecovery.I have worked with a number of people in twelve-step programs who want to deepen their spiritual life with God. They feel the desire for a more free, loving relationship with God and the world. God is deeply in their hearts, seeking to complete the sketch of God they bear inside (cf. Canticle 12, 6–8). But as they draw closer to these possibilities they feel increasing fear about jeopardizing their recovery. Many have so clung to the partial image of God as savior that even to think of God in a more complete way threatens their whole system of recovery.One person said, “I have dedicated so much of myself to abstinence that I am terrified to open to anythingelse. It seems like such abandon. I don’t trust myself; I’ll just make an excuse of it and start using again. Yet I know, I just know God wants something more.” These are not idle words; I have seen people relapse from their recovery just at the time when their hearts were being called to a more open, contemplative, intimate presence with God.This can be a full-fledged night of the senses forpeople in recovery. Many back off because of fear, and for years try to sit with their empty desire rather than risk their recovery for a greater love. Graced spiritual direction can be of tremendous importance here, as in any night. The surfacing desire has to be treated very gently. People should be encouraged not to project what it might be leading toward in the future; not to predict what God is going to do. Instead, the focus needs to be Addiction_Grace_9780061122439.indd 219 220here and now. “One day at a time” may need to move to the sacrament of the present moment: one instant at a time. The twelve-step KISS maxim—“Keep It Simple, Stupid”—needs to be reinforced. Most of all, the emerg-ing invitation calls for honest prayer: taking fears to God directly as they arise.And if it does become a night, the director’s unim-peding companionship can be most supportive. The night, we must always remember, is not something to be cured or even gotten through. It is not even our busi-ness. For director and directee alike, another twelve-step saying applies here more than anywhere else: “Let go and let God.”I hate to say it, but I think it is entirely possible that relapse may be necessary in this night. After all, if a person has made recovery more important than God and God wants to be more important than anything, what must happen? It is the same, finally, for all of us.We are all addicted, and we make our addictions more important than God. Usually, when we try to overcome an addiction, we make that attempt more important than God. To paraphrase John, neither indulgence in ad-diction nor the attempt to overcome it, neither sensory gratification nor righteous detachment, nothing, nothing, nothing (nada, nada, nada), and even on the Mount nothing. . . .5Notes1. All quotations from John of the Cross in this article are taken from The Collected Works of St. John of the Cross, trans. Kieran Kavanaugh & Otilo Rodriguez, 2d ed. (Washington, DC: ICS Publications, 1979), using the sys-tem of abbreviations described in the Editorial.2. The word “attachment” comes from the old French atache, meaning “nailed to.” See this book, pp. 3ff.3. In Chapter three of my book The Awakened Heart (San Francisco: HarperCollins 1991), I discuss the relationship between desire and wakefulness in more depth.Addiction_Grace_9780061122439.indd 220 4. John does not make the hard distinction I have between love and fear, but more accurately sees love as encom-passing fear. Fear is one of the passions. It can be natural, related to the frustration of the appetites. It can be holy, the classic fear of God. It can be demonic, instilled by devils to disrupt the soul’s calm. In all cases, however, what counts is that fear either causes no movement at all or prompts one to turn immediately toward God. See, for example, III Ascent 16, 2–6; Canticle 20 and 21, 9–15.5. From John’s “Sketch of Mount Carmel,” p. 67 of the Kavanaugh/Rodriguez translation.Addiction_Grace_9780061122439.indd 221

Addiction and spirituality.
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Authors:
Cook, Christopher C. H.1 (AUTHOR)
Source:
Addiction. May2004, Vol. 99 Issue 5, p539-551. 13p. 3 Charts.
Document Type:
Article
Subject Terms:
*SPIRITUALITY
*ADDICTIONS
*BOOKS
*PSYCHOLOGY
*MEDICINE
Geographic Terms:
NORTH America
Author-Supplied Keywords:
addiction
addiction.
Spirituality
NAICS/Industry Codes:
414420 Book, periodical and newspaper merchant wholesalers
424920 Book, Periodical, and Newspaper Merchant Wholesalers
451211 Book Stores
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Abstract:
Spirituality is a topic of increasing interest to clinicians and researchers interested in addiction. To clarify the way(s) in which the concept of spirituality is understood and employed in practice by clinicians and researchers who publish papers on addiction and spirituality, and to develop a definition or description of spirituality which might receive widespread assent within the field. A descriptive study of 265 published books and papers on spirituality and addiction. The study revealed a diversity and lack of clarity of understanding of the concept of spirituality. However, it was possible to identify 13 conceptual components of spirituality which recurred within the literature. Among these conceptual components of spirituality, ‘relatedness’ and ‘transcendence’ were encountered most frequently. ‘Meaning/purpose’, ‘wholeness (non-)religiousness’ and ‘consciousness’ were encountered less frequently in the papers on addiction and spirituality than in an unsystematically ascertained sample of papers concerned with spirituality in relation to other areas of psychology and medicine. However, biases in the literature are notable. For example, the great majority of publications are from North America and the field is dominated by interest in Twelve-Step and Christian spirituality. Spirituality, as understood within the addiction field, is currently poorly defined. Thirteen conceptual components of spirituality which are employed in this field are identified provisionally and a working definition is proposed as a basis for future research. [ABSTRACT FROM AUTHOR]

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Author Affiliations:
1St Chad’s College, Durham, UK
ISSN:
0965-2140
DOI:
10.1111/j.1360-0443.2004.00715.x
Accession Number:
12753848
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Addiction and spirituality.
Contents
METHODOLOGY
RESULTS
Authorship
Type of publication
Type of addiction
Scientific perspective
Perspectives on spirituality
Concepts of spirituality
Spirituality questionnaires
DISCUSSION
ACKNOWLEDGEMENTS
Footnotes
REFERENCES
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Background  Spirituality is a topic of increasing interest to clinicians and researchers interested in addiction. Aims  To clarify the way(s) in which the concept of spirituality is understood and employed in practice by clinicians and researchers who publish papers on addiction and spirituality, and to develop a definition or description of spirituality which might receive widespread assent within the field. Design  A descriptive study of 265 published books and papers on spirituality and addiction. Findings  The study revealed a diversity and lack of clarity of understanding of the concept of spirituality. However, it was possible to identify 13 conceptual components of spirituality which recurred within the literature. Among these conceptual components of spirituality, ‘relatedness’ and ‘transcendence’ were encountered most frequently. ‘Meaning/purpose’, ‘wholeness (non‐)religiousness’ and ‘consciousness’ were encountered less frequently in the papers on addiction and spirituality than in an unsystematically ascertained sample of papers concerned with spirituality in relation to other areas of psychology and medicine. However, biases in the literature are notable. For example, the great majority of publications are from North America and the field is dominated by interest in Twelve‐Step and Christian spirituality. Conclusion  Spirituality, as understood within the addiction field, is currently poorly defined. Thirteen conceptual components of spirituality which are employed in this field are identified provisionally and a working definition is proposed as a basis for future research.
Keywords: addiction; Spirituality
Spirituality is a concept which is encountered with increasing frequency in the contemporary addictions literature. It is understood by many writers and clinicians, and by more and more researchers, as being a key variable in understanding the aetiology of addictive disorders, and also a key aspect of the proper treatment of these disorders. But what is spirituality?
The Latin root of spirituality is spiritus, meaning breath. As early as the 5th century ce, the word spiritualitas was used with explicitly Christian reference to the influence of God, the Holy Spirit, in human lives. By the 12th century ce, the word had come to refer to what we might call the psychological aspect of human experience, in contrast to the material or corporeal, and in the 15th and 16th centuries it was used to refer to ecclesiastical people, properties or revenues ([29], pp. 361–363; [30], p. 5).
The first use of the word in its modern sense appears to be associated with ‘la nouvelle spiritualité’ of Madam Jeanne‐Marie Bouvier de la Motte Guyon in 17th‐century France ([29], pp. 184, 361–363). Madam Guyon was a controversial mystic whose teaching attracted criticism by the Catholic Church. Her simple contemplative approach to prayer and her goal of union with God were not dissimilar to those of the more widely accepted Rheno‐Flemish and Spanish mystical traditions within Christianity, but her approach to explaining and promoting her teachings appears to have invited hostile attention.
In the 20th century the word came into widespread usage in many languages, in relation to all religious traditions and unrelated to any religious tradition, but without satisfactory definition ([29], pp. 362–363; [10], p. 1532; [30]; p. 5). For example, a major encyclopaedic series of volumes on world spirituality has eschewed the attempt to provide a common agreed definition for use by all its contributors, but has instead employed the following ‘working hypothesis’ or description of spirituality:
The series focuses on that inner dimension of the person called by certain traditions ‘the spirit.’ This spiritual core is the deepest centre of the person. It is here that the person is open to the transcendent dimension; it is here that the person experiences ultimate reality. The series explores the discovery of this core, the dynamics of its development, and its journey to the ultimate goal. It deals with prayer, spiritual direction, the various maps of the spiritual journey, and the methods of advancement in the spiritual ascent (McGinn et al. 1996 ; p. xiii).
Over the last quarter of a century or more, the word ‘spirituality’ has been used increasingly in the literature of the medical and social sciences. However, the use of an undefined term in scientific research is highly problematic. Different authors and researchers faced with this problem have three options available to them. They can (a) avoid the problem and leave the term undefined; (b) offer their own working definition (which may be either empirically or theoretically based); or (c) define it according to the understanding of the research subjects under study. All these options have been employed (as will become clear later in this paper). However, studies in which option (c) is chosen reveal both a diversity and cultural specificity of understanding. For example, [30], p. 5) quotes findings of a 1995 national survey in Canada in which slightly more than half of respondents employed ‘conventional expressions’ and slightly less than half employed ‘less conventional’ responses to a request to explain what spirituality meant to them. The conventional responses included belief in God or Jesus, praying, church attendance and helping others. The less conventional responses included associations with the human spirit/soul, meditation/reflection, a sense of wholeness/oneness and inner/outer awareness.
In this context, the word spirituality is encountered with increasing frequency in the addictions literature. For example, empirical studies have looked at a possible role of spirituality as protective against alcohol and drug misuse ([31]). There has been interest in the role that spirituality plays in increasing purpose in life and length of sobriety following treatment ([ 8]). Increased spiritual practices have been associated with improved treatment outcome ([ 9]) and spirituality has been said to play a role in maintaining treatment gains ([18]). Recovering individuals apparently show more evidence of spirituality than those who relapse ([16]).
What are we to make of this? Is it a recently identified area of importance to addictions research and clinical practice, or is it simply a popular fashion of little significance? Is it a relabelling of concepts which are familiar, or is it something genuinely new? If it is an important concept, how may it best be defined within the addictions field? Would this definition be different in any way from definitions that might be preferred in other areas of science or in theology and religious studies?
The present study offers a systematic review of English language publications on addiction and spirituality which have appeared in the scientific and clinical literature over the last 25 years or more. It aims, as far as is possible, to be reasonably comprehensive. The primary intention was to identify the way in which the term ‘spirituality’ was employed and defined by different authors. It was hoped that this would provide an empirical basis for developing a theoretical and methodological framework for future research in the field of addiction and spirituality.
METHODOLOGY
MEDLINE and PsycINFO searches were undertaken in order to identify all papers on spirituality and addiction published during the period covered by each of these databases (i.e. since 1966 for MEDLINE and since 1872 for PsycINFO) until the end of the year 2001 [ 1]. Searches on spirituality alone were also undertaken in order to ascertain the total number of papers in each database containing reference to spirituality each year.
MEDLINE includes references from journals in the fields of medicine, nursing, dentistry, veterinary medicine, the health‐care system and the preclinical sciences. MEDLINE contains over 11 million citations. Spirituality became a MeSH subject heading in MEDLINE in 2002. The MEDLINE search was therefore conducted with spirituality as a keyword, which ensures that all articles are identified which show the word in the title, abstract or subject‐heading fields. Addiction‐related terms in MEDLINE are to be found mainly under the exploded MeSH heading of ‘Substance‐related disorders’, but ‘Alcoholics Anonymous’ was also included as an additional term in the search.
PsycINFO(R) includes references from journals, book chapters and books in the fields of psychology and related disciplines. More than 60 000 references are added annually through weekly updates. Spirituality became a main term in PsycINFO in 1988, but this database was also searched with spirituality as a keyword, in order to maximize ‘hits’. Because PsycINFO employs a different thesaurus to MEDLINE it was necessary to search for different addiction‐related terms than those used in the MEDLINE search. ‘Addiction’ and its cognates (drug‐addiction, heroin‐addiction and sexual‐addiction), ‘codependency’, ‘drug‐abstinence’, ‘drug‐abuse‐liability’, ‘drug‐abuse prevention’, ‘drug abuse’, ‘drug‐induced‐hallucinations’, ‘drug‐rehabilitation’, ‘drug‐withdrawal’, ‘drug‐dependency’ and ‘Twelve‐Step‐programs’ were all included as exploded search terms.
In addition to the MEDLINE and PsycINFO searches, further articles and books were identified by personal knowledge of the author, and by tracing references provided in the articles found by using these two databases. Some papers were also identified through discussion or correspondence with other experts ([21]). No paper was identified under this heading unless the word ‘spirituality’ was to be found somewhere specifically within the text of the paper and also that the paper included some aspect of addiction as a clear main focus, or at least as a significant secondary theme.
In addition to the systematically ascertained papers on addiction and spirituality, a selected reference group of papers was identified on spirituality related to other areas of psychology and medicine. These were chosen in order to identify a range of papers on different topics, with more emphasis being given to the recent literature. Again, no paper was identified under this heading unless the word ‘spirituality’ was to be found somewhere within the text of the paper. In fact, in these papers, spirituality was usually a main focus of interest.
Full‐text copies of all identified papers and books on addiction and spirituality were obtained through local libraries, the British Library, bookshops, the internet or direct from the author(s). In most cases, electronic copies of the texts were not available, and the searching and analysis of the texts which is described here was therefore conducted manually by the author.
For all papers and books included in the study, a search was made within the text in order to identify any description, definition or operationalization of the term ‘spirituality’. Definitions were restricted tightly to clearly specified attempts to define the topic. In all cases but one, this was by explicit use of the word ‘definition’ or cognate words. (The exception was a paper where, in reference to the word ‘spirituality’ it was stated ‘we use the term to refer to’. This was taken to be a definition for the purposes of this study.) All definitions and descriptions of spirituality and related terms were then analysed using a classification of conceptual content derived from the definitions of spirituality.
Conceptual content of the definitions was broken down into its component parts in such a way that no significant part of the field of meaning of a definition of the term should be excluded from the classification. In this way, all conceptual components of the definitions of spirituality employed in the study sample of papers and books were identified and classified. Conceptual components were drawn only from definitions derived from the study sample, and not from other sources.
In order to facilitate the subsequent data analysis and discussion, the author has given names to the conceptual components that were identified in this way. These names, and the brief descriptions of them offered below, represent the author’s own choice of words. However, the terms from which they are derived and upon which they are based were drawn only from the texts of the study sample of papers and books.
Where no definition or description of the term spirituality was included in the publication, definition or description of related terms was sought (e.g. ‘spiritual’, ‘spiritual thinking’, etc.). Other papers were classified according to whether or not the term was left undefined, deliberately not defined, specified as difficult to define, self‐defined by research subjects or defined by reference to another publication.
Where empirical research had been undertaken, attempts were made to obtain copies of the research instruments and any papers describing their validation or reliability.
Certain other key variables were also identified for each paper included in the study. In particular, number and gender of authors, year of publication, format and type of publication, number of references cited, content of the paper (according to type of addiction, scientific perspective and perspective on spirituality) and details of subjects and methodology (where the paper presented empirical research) were all recorded.
RESULTS
The earliest published paper identifiable in the PsycINFO database as including the keyword ‘spirituality’ is a journal article on the social psychology of religion, published in 1922. One other paper is identifiable in the same database from the same decade, three papers are identifiable from the 1930s, four from the 1940s, three from the 1960s and 14 from the 1970s. No papers referring explicitly to spirituality were identified in the MEDLINE database as being published prior to 1975. A graph showing the steady increase in publications since 1980 is provided in Fig. 1.
Graph: 1 Spirituality publications 1975–2001
In total, from 1922 to 2001, 3231 papers with spirituality as a keyword were identified on the PsycINFO database and 694 were identified on the MEDLINE database. Copies of 63 publications on spirituality were obtained, as described above, in which addiction was not a significant theme.
No publications on addiction and spirituality were identified by any means as being published prior to 1981. A total of 265 publications were identified from 1981 to 2001. Of these, 192 were found on the PsycINFO database, 44 on the MEDLINE database and 49 by other means (20 papers were on both databases). A graph showing the publications by year since 1981 is provided in Fig. 2. Copies of all 265 publications were obtained.
Graph: 2 Addiction and spirituality publications 1981–2001
Authorship
Eighty‐eight per cent of the papers on addiction and spirituality (n = 233) originated solely from authors and/or institutions in the United States. The next most frequently identifiable nation of origin was the United Kingdom (3%, n = 7 papers of sole UK authorship). Only four papers originated from authors in the developing world, and three of these were jointly published with American authors.
Type of publication
Seventy‐eight per cent of the papers (n = 206) were journal articles, 13% (n = 35) were chapters in books and 9% (n = 24) were books.
Twenty‐eight per cent (n = 74) of the papers were original articles, describing empirical research. A further 5% (n = 14) included case studies and 3% (n = 9) were descriptive of particular treatment programmes or approaches. Four per cent (n = 11) of the papers were presented specifically as being literature reviews. The majority (53%, n = 140) were best described as ‘articles’. These articles were more or less unsystematic reviews, and included varying proportions of speculation, opinion and comment. Only 2% (n = 5) of the papers were intended specifically as literature for patients. The remaining papers (n = 12) were commentaries, editorials, letters, interviews or of mixed type.
Type of addiction
Thirty‐six per cent (n = 95) of papers included in this study were concerned specifically with alcohol as the focus of addiction and 49% (n = 130) focused on polysubstance addiction. The focus of the remaining papers was on drugs other than alcohol (n = 11), dual diagnosis (n = 1), smoking (n = 2), behavioural addictions (n = 9), codependence and children of substance‐abusing parents (n = 5), or was unspecified (n = 8). No obvious trends were identifiable in regard to type of addiction focussed on by publications across the 20‐year study period.
Scientific perspective
Although it proved to be somewhat difficult to classify papers according to their scientific perspective (40%, n = 107, could not easily be classified), 14% (n = 37) were clearly written within a framework of counselling or psychotherapy, 9% (n = 24) appeared to be primarily from a psychological perspective, 11% (n = 30) were from a broad mental health perspective, 12% (n = 31) were from a sociological or anthropological perspective, 4% (n = 10) included feminist/women’s studies as a major theme and 3% (n = 8) were concerned with human sexuality.
Perspectives on spirituality
Most papers were concerned with a particular perspective on spirituality, either as the focus of study or else as the disclosed perspective of the authors, but 23% (n = 61) could not be classified easily. Forty‐eight per cent (n = 127) of papers were concerned almost exclusively with 12‐Step spirituality, 6% (n = 16) were concerned primarily with Christian spirituality and a further 7% (n = 18) were concerned with a combination of 12‐Step and Christian spirituality. Five per cent (n = 12) of the papers were concerned with 12‐Step spirituality in combination with other religions or spiritualities (including Judaism, Native‐American spirituality, religion in general and the spirituality of art). Five per cent (n = 13) of the total were concerned with Native‐American spirituality (with or without the 12 Steps), and 2% (n = 6) were concerned with African‐American spirituality. Three per cent of papers (n = 9) took the perspective of transpersonal psychology. There were no papers taking the perspective of the spiritualities associated with any of the other major world religions, although 6 were broadly from the perspective of religious studies, and one focused on Ayur‐Veda. (One very significant paper on Buddhism and addiction does not appear in this study, as the word ‘spirituality’ does not appear in its text; [14].) No obvious trends were identifiable in regard to perspective of publications on spirituality across the 20‐year study period.
Concepts of spirituality
In only 12% of papers (n = 30) was the term ‘spirituality’ found to be explicitly defined. In a further 32% of papers (n = 84) a description of the concept of spirituality was offered and in 11% (n = 30) a related concept was defined. [Related concepts were: the ‘spiritually healthy person’ (n = 1), the human or divine ‘spirit’ (n = 4), the ‘spiritual’ (used unqualified; n = 6) and various nouns [ 2] qualified by the adjective ‘spiritual’.] However, in 42% of papers (n = 110) spirituality was left undefined, and in only nine of these papers was it stated explicitly that spirituality was either too difficult to define or would be left deliberately undefined. In seven empirical studies, subjects were left to employ their own understanding of the term, and in five of these it was possible to analyse the subjects’ reported understanding of conceptual content.
Thirteen conceptual components of the definitions and descriptions of spirituality were identified. These were concerned with:
• 
Relatedness: interpersonal relationships
• 
Transcendence: recognition of a transcendent dimension to life
• 
Humanity: the distinctiveness of humanity
• 
Core/force/soul: the inner ‘core’, ‘force’ or ‘soul’ of a person
• 
Meaning/purpose: meaning and purpose in life
• 
Authenticity/truth: authenticity and truth
• 
Values: values, importance and worth
• 
Non‐materiality: opposition of the spiritual to the material
• 
(Non)religiousness: opposition of spirituality to, or identity with, religion
• 
Wholeness: holistic wellness, wholeness or health
• 
Self‐knowledge: self‐knowledge and self‐actualization
• 
Creativity: creativity of the human agent
• 
Consciousness: consciousness and awareness
Examples of definitions which together span all 13 conceptual components are shown in Table 1. Each of the conceptual components was found to be described in a variety of ways. The actual words/terms employed corresponding to each conceptual component of the various definitions/descriptions are shown in Table 2. Table 3 shows the relative frequency with which each of the most frequently encountered conceptual components appeared in the text of the combined sample of addictions papers (whether in an authorial definition or description of spirituality or a related term, or in definitions/descriptions of spirituality reported as given by study subjects).
1 Examples of definitions and descriptions of spirituality.
Classification as 
 definition/description Source Text of definition/description of spirituality/related concept
Definitions Booth (1987) ‘spirituality is defined as “being a positive and creative human being in all areas of our life” ’ (p. 271; from Booth 1987)
Hanna (1992) ‘Definitions of spirituality range from the non‐material to the sacred and are usually within the context of an association with a deity. This article will focus on the aspect of AA’s higher power and the implications of that association’ (p. 169)
Mercadante (1996) ‘spirituality by definition is supported or formed by conceptual and religious structure’ (p. 13)
Parker et al. (1997) ‘healthy spirituality or . . . functional faith [may be] defined as a sense of being “at home” in the universe; a capacity for unconditional trust (Buber 1970); a comprehensive will‐to‐meaning (Tillich 1955); or a receptivity to belief in intrinsic values such as beauty, goodness, or truth (Maslow 1964)’ (p. 43)
Descriptions Alpers (1995) ‘genuine spirituality touches our entire being and affects every dimension, principle, facet and action of our lives. It implies a constant and conscious process of expanding, deepening, and heightening our capacity to know, to love, and to create. Spirituality . . . is a journey toward integrity‐wholeness. It is the “fruit” of human evolution—it is maturity’ (p. 50)
Berenson (1990) ‘Spirituality, as opposed to religion, connotes a direct, personal experience of the sacred unmediated by particular belief systems prescribed by dogma or by hierarchical structures of priests, ministers, rabbis, or gurus’ (p. 59)
Dollard (1983) ‘spirituality . . . is concerned with our ability, through our attitudes and actions, to relate to others, to ourselves, and to God as we understand Him’ (p. 7)
Grof (1987) ‘True spirituality is experiential, universal, and mystical . . . It emerges when a person connects with certain levels of his or her unconscious and superconscious . . . [S]pirituality or numinosity thus appears to be an intrinsic quality or characteristic of the deeper dynamics of the human psyche’ (p12)
Johnson et al. (1987) ‘If spirit means either a positive or negative essence or energy, then spirituality is the presence of such energy. A person’s spirituality represents his state of being—either lively, hostile, or empty’ (p. 5)
Miller (1995) 
Rush, 2000 ‘In our spirituality, we reach for consciousness, awareness, and the highest value . . .’ (p. 142) ‘Spirituality is an ongoing quest for self‐knowledge that includes recognition of a transcendental dimension to life’ (p. 197)
Description of a related 
concept (humanity/spiritual existence) Shockley 1994 ‘To be human is to long for ultimate meaning and direction in life; it is to live a spiritual existence’ (p. 327)
2 Terms associated with the conceptual components of spirituality.
Relatedness
Relating
Relatedness
Relationship
Meaningful relationships
Positive relationships
Personal relationship
Quality of relationship
Connectedness
Connection
Interconnectedness
Identify with
Dependence
Interdependence
Intimacy
Direct communication
Community
Helping/serving
Trusting
Forgiveness
Love
Mercy
Compassion
Humility
Tolerance
Gratitude
Surrender
Prayer
Transcendence
Transcendent
Larger reality
Higher self (outside self)
Beyond the self
Higher Power
Higher Being
Supreme being
The Ground of Being
A power/force/something greater than oneself
Object of worship/reverence
Ultimate concern
Ultimate meaning
Ultimate reality
The ultimate
God/Goddess
God as we understood him
Divine presence
Divinity
Deity
‘Meta‐objective’ reality
Metaphysical
Spiritual world
Dimension of reality exceeding ordinary limits of human understanding/description
The eternal now
The sacred
The Divine
The Universe
The Cosmos/Cosmic
The Absolute
The Whole
Everything
The infinite
The mysterious ‘other’
Mystical
Spirit
Eternal spirit
Source (of nature)
Creator
Creative source
Craving for immortality
Afterlife
Humanity
Human being
Being human
Humanity
Uniquely human activities/features
Human characteristics
Human properties
[That which is exclusive to] the human animal
Something which every person has
Image & likeness of God
Core/force/soul
Core
Core quality
Core of all human experience
Core of our being
Core of the person
Internal source of wisdom
Inner feeling of strength
Inner state of being
Inner resource
Primordial power of Being
Deeper structure of being
Deepest ground
Soul
The Spirit
Immanent/pervading spirit
Life
Life energy/force
Living principle
Energy
Cosmic life energy
Central energy/principle
Vitality
Vital principle that gives life
Force
Liberating and sustaining force
Animating
Drive
Essence
Essential self
Fundamental nature
Fundamental part of existence
Source
Source of personal strength
Heart
Love
Higher self (within)
Meaning/purpose
Meaning or purpose
Meaning of our actions
Meaning making
Meaningful understanding of ourselves & the world about us
Meaning and purpose in life
Meaning of life, illness and death
Existential meaning
Will to meaning
Highest possible meaning
Purpose, meaningfulness, and mission in life
Purpose of our existence
Motive/Motivation
Divine design
Core beliefs
Who am I?
Authenticity/truth
Authenticity
Truth
Ultimate truth
Honesty
Good (v evil)
Right (v wrong)
Values
Values
Basic values
Powerful values
Ultimate values
Intrinsic values
Religious values
Spirit values
Value system
Most important in life
Highest value
Worth
Aspirations
Non‐materiality
Non‐material
Immaterial reality/realities
In contrast to the material/bodily
Material limits exceeded
Imperceptible to the senses
Spirit (v material/physical world)
Spirit (v the ‘worldly’)
Unknown (v manifest) reality
(Non‐)religiousness
Unmediated by particular/prescribed belief systems
Unmediated by belief systems/hierarchy/dogma
[Primary] (v secondary belief systems)
Belief systems may be an impediment
Possessed by all (v religion only possessed by some)
Quality that goes beyond specific religious affiliation
Supplanting the religious
Without respect to religious constructions
Not involving a common God
Not involving organisational structure/hierarchy
Not involving institutionalised attitudes/beliefs/practices
Not involving specific religious affiliation
Does not have standard prayers/rituals
More than religious principles
Broader construct definition
More encompassing
Wholeness
Wholeness
Wholeness of life, health and well‐being
Integrity‐wholeness
Integrating the spiritual, physical, emotional, & mental
Integrates the physical, socio‐cultural & emotional
Integration of body/mind/spirit
Total of . . . mental, emotional and physical well‐being
Holistic wellness
Healing
Health
Fulfilment in life
Maturity
Self‐knowledge
Self‐knowledge
View of one’s self
Orientation of self towards self
Transcending identification of self with partial realities
Self‐actualisation
Noetic dimension
Creativity
Creative in all areas of life
Creative values
Creative forces
Creative imagination
Creative source
To create
Consciousness
Connection with certain levels of the unconscious and superconscious
Receptive mode of consciousness
Consciousness
Personal consciousness
Awareness
3 Most frequently identified conceptual components of definitions and descriptions of spirituality.
Conceptual component 
 of spirituality Addictions papers Non‐addictions papers Questionnaires
n % n % n %
Relatedness  90 34 29 46 29 62
Transcendence 108 41 34 54 25 53
Core/force/soul  30 11  9 14  0  0
Meaning/purpose  29 11 25 40 18 38
A number of other conceptual components were considered and not included in the final list. In every case (except one description) these components were to be found alongside one or more of the 13 components listed above, and in no case (with one possible exception) did they appear to be central to the definition or description of spirituality that was offered, as follows.
• 
Suffering and pain appeared only three times, once in the context of spirituality as living with pain and twice in the context of spirituality as finding freedom from suffering
• 
At least seven papers included reference to spirituality as growth, change, process or journey. It was felt, however, that the process of developing spirituality should be distinguished here from the conceptual components which might represent the dimension or focus of change.
• 
One description referred to spirituality as a means of ‘coping with problems that cannot be solved’ and another to spirituality as resilience in the face of crisis/emergency.
• 
One description referred to spirituality as ‘being present in the moment and being fully alive. One description only stated that ‘the essence of Twelve‐Step spirituality . . . involves finding a way of living with incongruity, a way to embrace paradox’. Arguably this was central to this description of spirituality in this book, but the paradox described was primarily between that of a transcendent Higher Power and the immanent spiritual pervasion of all reality. It was judged for the purposes of this study that this was adequately encompassed by the dialectic of spirituality as transcendence versus spirituality as an inner core/force/soul.
• 
Four papers included direct or indirect reference to spirituality as including moral choice.
Careful study of the 63 non‐addictions papers did not reveal any other additional or different conceptual components employed in a total of 17 different definitions of spirituality. However, the frequency with which the different conceptual components were employed in definitions and descriptions of spirituality in this group of papers was different to that found in the addictions papers. In particular, the ‘meaning/purpose”(non‐)religiousness’, ‘wholeness’ and ‘consciousness’ components each occurred more frequently in the sample of non‐addictions papers than in the sample of addictions papers (40% versus 11%; 24% versus 9%, 11% versus 5%, 13% versus 3%, respectively).
No obvious trends were identifiable in regard to conceptual components included in definitions/descriptions of spirituality in publications across the 20 years study period. However, there was some evidence of differences in relative frequency of the conceptual components between papers in which spirituality was described or defined by authors, compared with those in which a related concept was defined, or in which it was defined by subjects. In most categories, trends were either not evident or not significant, and in many cells numbers were small. However, ‘relatedness’ was identified almost twice as frequently in authors’ definitions and descriptions of spirituality (63% and 68% of papers, respectively) compared with subjects’ reported understandings of spirituality (29%) or authors’ definitions and descriptions of related concepts (40%; χ2 = 10.1, 3 d.f., P < 0.02).
Spirituality questionnaires
The questionnaires/interview schedules employed as measures of spirituality or related concepts in the 50 empirical studies that clearly employed identifiable instruments of this kind were studied in order to establish whether or not each of the 13 concepts appeared in one or more questions. A total of 47 different questionnaires were employed in these studies. Copies of 34 of the questionnaires were obtained from publications or directly from the authors and were available for study. The proportion of these questionnaires in which each of the most frequently encountered conceptual components appeared is shown in Table 3. Several conceptual components appeared notably more frequently in questionnaires than in descriptions/definitions (e.g. 'meaning/purpose' 38% versus 11%, 'values' 19% versus 6% and 'self‐knowledge' 19% versus 3%, respectively). None of the questionnaires employed in these studies addressed the 'core/force/soul' or 'consciousness' components of spirituality. Only one addressed 'creativity' and only one addressed 'non‐materiality'.
The 50 empirical studies employing spirituality instruments were rather more likely to have provided a definition of spirituality as compared with the nonempirical studies (20% versus 9%, χ2 = 10.1, P < 0.05). Further study of 32 papers for which all spirituality instruments employed were available for study revealed some evidence of a mismatch between the conceptual components included in definitions/descriptions and those identifiable in the questionnaires. In only one paper was there a perfect match (between three conceptual components which occurred in both a description and questionnaire). In 19 papers questionnaires measured one or more conceptual components not included in the definitions/descriptions, and in eight papers one or more conceptual components included in definitions/descriptions were not identifiable in the content of the questionnaires. In two of these papers there was actually no overlap at all between concepts described and measured.
DISCUSSION
The concept of spirituality is proving to be of increasing interest to addictions researchers and practitioners alike. It is potentially important as both an independent variable and a dependent variable in treatment outcome studies. The lack of a clear definition of the concept is especially problematic for researchers who wish to measure spirituality as a dependent or independent variable. However, it could be argued that it is at least equally important that practitioners should be clear about what they mean when they employ the term in their writing or in their work with patients. It is therefore somewhat concerning that the authors of well over one‐third of the papers studied here felt no need to attempt to define or describe the concept or even to comment on the difficulty of definition. Furthermore, in over one‐fifth of the papers the authors did not appear to be writing from the perspective of any easily identifiable approach to spirituality. In many cases, there is thus considerable scope for ambiguity as to what exactly the authors do mean by the term 'spirituality'.
Within the literature which formed the primary focus of this study, that is the literature on addiction and spirituality, 13 conceptual components of spirituality were identified. In terms of frequency of occurrence, the 'relatedness' and 'transcendence' components would appear to be the most important. 'Core/force/soul' and 'meaning/purpose' were the next most commonly encountered, albeit three to four times less frequently. 'Meaning/purpose', however, appeared more frequently in the reference sample of papers on spirituality which were not concerned with addiction [as did also '(non‐)religiousness', 'wholeness' and 'consciousness']. This might be reflective of an unintentional selection bias affecting the latter sample, which was not ascertained systematically. However, it is interesting to note that 'meaning/purpose' also featured much more frequently as an item measured by questionnaires used in empirical research in the addiction and spirituality literature. Possibly this is an aspect of spirituality which is seen as important in other areas of psychological and medical care, and by researchers designing questionnaires, but not by authors publishing papers on addiction and spirituality.
Similarly, 'values' and 'self‐knowledge' appear much more frequently in questionnaires used in empirical research into addiction and spirituality than they do in definitions and descriptions of spirituality employed in the addiction and spirituality literature. Conversely, none of the questionnaires employed in the empirical studies measured the concepts of 'core/force/soul' or 'consciousness'. At the level of individual studies there was also evidence that the conceptual components built into descriptions and definitions of spirituality did not correlate well with those tapped into by questionnaires. It would appear, therefore, that there is a mismatch between the instruments employed to study spirituality and the concept as it is understood by addictions clinicians and researchers.
It is worth noting in passing that certain concepts (e.g. 'relatedness') may occur less frequently in authors' definitions and descriptions of related concepts (such as 'spirit' and 'spiritual') or in research subjects' understandings of spirituality, compared with authors' descriptions/definitions of spirituality. However, data available from this study provide too small a sample size to draw any firm conclusions concerning this possibility.
Given the diverse, confusing and conflicting conceptualizations identified in this study, as well as the poor correspondence between these conceptual components of spirituality and the research methodology used to study spirituality in practice, it is eminently arguable that the best way forward would be to dispense with the concept of spirituality altogether—at least so far as scientific work is concerned. Any of the 13 conceptual 'components' identified here might be suitable as substitute terms, or else perhaps the whole idea should be considered entirely redundant. At the very least it would appear that spirituality should now be approached from a multi‐dimensional perspective. If the supposed unitary concept is too diversely understood to be of scientific value, then perhaps its component parts should be specified and studied separately. The 13 conceptual components identified in this study offer one possible listing of the dimensions of spirituality that should be considered for further empirical study. It is argued here that such a multi‐dimensional approach might well be of value, but that it would be premature to dispense completely with the unitary concept.
It would certainly appear somewhat hasty to dispose of a concept which has so recently become of scientific interest to so many clinicians and researchers. Surely further empirical study is required to consider the relationship between its various components or dimensions? Furthermore, many semantic connections are discernible between the 13 components of spirituality identified in this study, and these components can be understood as being interrelated in various possible ways. For example, 'relatedness' could be understood as the pervading theme. 'Transcendence' might then be an extension of this concept to the wider universe and/or to a transcendent reality, and 'self‐knowledge' might be understood as concerned with relationship with oneself. On this basis, one might ask what is distinctive about the understanding of relationships inherent in spirituality as opposed to that of social psychology, psychotherapy or ordinary everyday social intercourse. Does the concept of spirituality add anything to our understanding of inter‐ (or intra)personal relationships? Perhaps the concern with 'meaning/purpose', 'authenticity/truth' and 'values' could all be understood as defining those aspects of relationships which are specifically 'spiritual'.
Alternatively, the humanist may wish to prioritize 'humanity' as central to spirituality. On this basis, 'transcendence' would have to be re‐understood in terms of those aspects of human nature which transcend the purely selfish or animal nature. Now, however, we are drawn to the question of how humankind differs from other forms of life, or from any other part of material reality. Does any such definition of spirituality offer a valuable contribution to this debate, or is every such definition simply a tautologous rewording of the question of what it means to be human? Perhaps again, 'meaning/purpose', 'authenticity/truth' and 'values' could all be understood as defining those aspects of human relationships which are both distinctively human and distinctively 'spiritual'.
In a similar way, the transcendentalist might prioritise 'transcendence' and 'non‐materiality' as the central themes of spirituality. Here, it would be these concepts which would determine what is 'spiritual' about 'relatedness', 'values', 'meaning/purpose', 'self‐knowledge' and 'humanity'. The definition of spirituality which would result from such an approach might be difficult to reconcile with the definition of spirituality preferred by the humanist. In other words, it may be easier to distinguish different understandings of spirituality than it is to distinguish spirituality itself from other concepts. However, in each case there would seem to be a certainly unity to the concept.
At this point it may be helpful also to consider the relationship between spirituality and religion. Just as some authors consider that spirituality and religion are closely related, so other authors see them as virtually antithetical. For example, Linda Mercadante states that 'spirituality by definition is supported or formed by conceptual and religious structure' ([22], p. 13). In contrast, Berenson has argued that:
Spirituality, as opposed to religion, connotes a direct, personal experience of the sacred unmediated by particular belief systems prescribed by dogma or by hierarchical structures of priests, ministers, rabbis, or gurus (Berenson 1990 , p. 59).
Of course, religion is itself also a concept which is elusive of definition ([ 7], pp. xv–xxiv). There is therefore great scope for defining both concepts in such a way as to see them as almost identical, or in such a way as to see them as virtually opposite. However, this does not necessarily deny the value of either concept, and perhaps behoves us even more to ensure that we distinguish particular definitions of spirituality from the overall definition of the concept itself. Spirituality defined as 'non‐religiousness' might be understood as very subjective and personal. Spirituality defined as 'religiousness' (or in other ways emphasising human 'relatedness') can in contrast be understood as a very social/cultural phenomenon. To insist, however, either that spirituality is on one hand necessarily limited or defined by religious belief and structure, or that on the other hand it cannot be mediated by religious structure, would seem equally unhelpful. In both cases, the unhelpfulness appears to arise from a concern to deny the spirituality of others, rather than to define positively what spirituality is all about. One denies the spirituality of others who are judged to be religious but not spiritual. The other denies the spirituality of those who claim to be spiritual but not religious.
Swinton ([28], pp. 20–24) suggests helpfully that we should recognize that spirituality includes a dimension of experience common to all humanity, aspects of experience and belief which we share with others (such as other religious groups), and aspects of experience and belief which are unique to the individual. Spirituality can thus, at one and the same time, be concerned with that which is unique to the individual, such as 'self‐knowledge', and that which is common to all 'humanity', as well as that which is shared by particular social groups and traditions such as Alcoholics Anonymous or Christianity.
The focus of this paper is more concerned with the specific than the general; with spirituality as understood in the context of the clinical and research arena of the addictions, rather than with spirituality in general. It is tempting, therefore, simply to leave spirituality as a broad concept as beyond definition, and to focus on the specific definitions relevant to the social groups and traditions of the addictions world. However, it is suggested here that this cannot be entirely adequate. First, it would allow the possibility of definitions that go beyond the bounds of what might generally be agreed to be spirituality. Secondly, it might be deficient in its understanding of the full breadth of spirituality. In either case, definitions of spirituality can easily become value judgements which deny the spirituality of other individuals or groups. In extreme cases, they might even become the basis for discrimination or prejudice.
On this basis, a definition is proposed as a 'working hypothesis' after the model of [20]), as cited above. This proposed definition is offered in recognition of its provisionality, vagueness and inherent limitations, and in particular the limitations of this paper with its specific and restricted focus on the addictions literature. However, it is in the nature of spirituality that it involves people in relationship with each other, and it is hoped that the relationships fostered by academic debate will one day be creative of a more complete and satisfactory definition.
The definition proposed here is thus:
Spirituality is a distinctive, potentially creative and universal dimension of human experience arising both within the inner subjective awareness of individuals and within communities, social groups and traditions. It may be experienced as relationship with that which is intimately 'inner', immanent and personal, within the self and others, and/or as relationship with that which is wholly 'other', transcendent and beyond the self. It is experienced as being of fundamental or ultimate importance and is thus concerned with matters of meaning and purpose in life, truth and values.
The word 'potentially' perhaps deserves further comment. On one hand, it enhances further the vagueness and non‐specificity of the definition. On the other hand, it recognizes that some people may find spirituality to be an uncreative dimension of their lives. However, it is not felt appropriate to extend this qualification to other aspects of the definition. Even a hermit exists in relationship with others—and perhaps by so doing makes an especially powerful statement about 'relatedness'. That which is experienced as fundamentally important cannot simultaneously be unimportant. To deny meaning, truth or value in life is to make a statement about 'meaning/purpose', 'authenticity/truth' or 'values', and thus is (according to this definition at least) a statement reflective of one's personal spirituality. It is therefore proposed here that spirituality is a truly universal aspect of human experience—as all human beings experience 'relatedness', and must reach at least implicit conclusions about 'meaning/purpose', 'authenticity/truth' and 'values' in life.
The spiritualities encountered most frequently in the addictions literature, those of the 12‐Step movement and Christianity, both conform to this definition of spirituality and may also be characterized accordingly using the 13 conceptual components of spirituality identified in this paper. For example, the doctrinal importance of 'transcendence' understood ontologically as Trinity in Christian spirituality contrasts with the subjective flexibility of the 'God as we understood him' of 12‐Step spirituality. The themes of 'relatedness' to God and other people, however, feature prominently in both spiritualities. Steps 3, 5, 6, 7 and 11 of AA are concerned with relationship with God; Steps 5, 8, 9 and 12 are concerned with relationships with people. In Christian spirituality, the synoptic gospels attribute to Christ an estimation of love for God and others as being the greatest commandments.
It is therefore proposed that the 13 conceptual components of spirituality identified in this paper, along with the proposed working definition, form a useful framework for future empirical and theoretical research in the field of spirituality and addiction. This framework helps to delimit the boundaries of spirituality (however broadly they may have been spread) and also offers a structure within which qualitative and quantitative comparisons may be made. However, it is important to recognize the provisionality of this framework.
First, there is a need for further research of this sort in areas of psychological and medical interest other than addiction. Of over 3000 papers identified on the PsycINFO database alone, less than 200 were concerned with addiction. A preliminary analysis of 63 papers on spirituality which were not concerned with addiction suggests that the 13 conceptual components identified here are also identified as being important in other areas of psychology and medicine. However, the preliminary analysis conducted here also suggests differences of relative emphasis in spirituality as understood in other fields, and there may be other conceptual components not identified here. A systematic search and analysis of papers on spirituality in other areas of medicine and psychology is indicated. The statistical analysis offered here is no more than preliminary, as a proper analysis would require a systematic approach to both samples.
Secondly, it is evident that this research, based primarily upon the use of electronic databases to ascertain papers from the addictions literature, may have neglected important aspects of spirituality as understood within both the unpublished working world of addiction treatment and also within the experience of the world's major faith traditions. For example, it is remarkable that so little reference was found to the theme of suffering and pain. Addiction is notably associated with suffering of both those who are addicted, and also their families and friends and others in society. The 12 Steps offer a practical response to this suffering. Christian spirituality is (or at least traditionally is) concerned centrally with the identification of God with human suffering in the person of Christ; and yet the theme of suffering was not at all prominent among the definitions and descriptions of spirituality identified from the 265 papers studied here. Furthermore, there appears to be a striking publication bias, such that almost all publications are by authors from the western world, and the vast majority of these are from the United States. Hardly any of the papers are written from the perspective of the world's major religions other than Christianity. However, it is clear that addictions treatment programmes are provided in Islamic ([ 1]; [ 2]), Buddhist ([ 4]) and other contexts. The present sample of publications would therefore appear to offer a very restricted perspective on addiction and spirituality.
Thirdly, this research is based upon observation of the way in which the term 'spirituality' is used in practice in the addictions literature. From some perspectives, such as those of the world's major spiritual and religious traditions, this empirical (and often secular) usage may be thought misguided or ill‐focused. For example, a treatise on a Christian spirituality of addiction, founded upon theological analysis, would be likely to produce very different conclusions. Such analyses would potentially be of great value to further inform an understanding of the concept of spirituality in this field but are currently, with some exceptions (e.g. [19]), largely absent from the literature.
Fourthly, this research has been undertaken by a single researcher with a professional training in psychiatry, ministerial training as an Anglican priest and academic interests in both addiction and theology. These life experiences, and the Christian spirituality to which they have contributed, will undoubtedly have influenced the way in which this research was undertaken and the conclusions which have been drawn from it. For this and other reasons, the possibility of involving one or more additional researchers in this project was considered. However, this was not undertaken, and the failure to do so is undoubtedly a methodological weakness. Clearly, future research would benefit from the involvement of researchers from diverse backgrounds and differing personal spiritualities. However, in respect of this project, it was considered that the individual perspective allows some greater clarity of interpretation. If additional researchers had been involved, how would their respective and differing contributions to the development and classification of conceptual components have been positively identified? How many such additional researchers should have been employed, and how would they have been chosen? How could any omission of perspective have been delineated and identified? Complete objectivity in research is always elusive, and the danger of a collective initial project could lay, arguably, in the more convincing illusion of apparent objectivity that it might convey. It is argued here that the limitations of perspective of a single researcher at least offer an advantage of simplicity in interpretation, and a more clearly defined reference point against which other perspectives can, in future, be compared.
Because it is argued here that spirituality is 'a distinctive, potentially creative and universal dimension of human experience', it is also argued that this is not necessarily a bad position from which to conduct such research. It is also suggested that in fact every researcher or author working in this field (including the atheist or agnostic) will necessarily have their own spirituality as a position from which they work. This may be implicit or explicit, acknowledged or unacknowledged, but in so far as publications in this field are concerned it is suggested here that it should be both acknowledged and described in such a way as to allow the reader to interpret the work of an author in context. This could be understood as a declaration of 'conflict of interest' as is required now by many scientific journals in relation to matters of potential ethical concern. However, in this case it is proposed that the declaration should be understood as both more positive and universally applicable.
The research reported here has potentially important implications for clinical practice and research. How frequently, and in what way, is spirituality adequately assessed by either clinicians or researchers? This study would suggest that new tools are required to assist in this work. Publications reporting on the use of more sophisticated multidimensional instruments to assess spirituality, such as those developed at the Fetzer Institute ([12]), are only now in preparation. It is currently difficult to know to what extent the core aspects of spirituality identified in this research are important in relation to treatment process and outcome. Further research is also required in order to consider the ways in which these aspects of spirituality are actually managed in the practice of treatment, and there are ethical issues to be addressed concerning the problems that arise when the spiritualities of therapist and patient/client are discordant ([24]).
ACKNOWLEDGEMENTS
I am grateful to Henry Smith's Charities for their funding which enabled many of the references to be obtained, and books purchased, in support of this research. I am also especially grateful to Joy Sharman and her staff at the postgraduate library at St Martin's Hospital, Canterbury. It was their great patience and tireless support which finally enabled me to track down all 265 publications identified in my literature search.
Footnotes
1 Papers continue to be added to the MEDLINE and PsycINFO databases for some months or years following the date of publication. The end of 2001, rather than the end of 2002, was therefore chosen as the limit for the study in order to ensure reasonable completeness of ascertainment. As the earliest relevant publication was found to be in 1981, this also conveniently defined a 20‐year period of study publications, from 1981 to 2001.
2 The qualified nouns were: actualization, arena, awakening, axioms/beliefs, component (of treatment), dimension(s) to health/treatment, domain, elements (of treatment), existence, events, experience(s), formation, growth, issues, journey, life, thinking, traditions.
REFERENCES
Abdel‐Mawgood, M., Fateem, L. & Al‐Sharif, A. I. (1995) Development of a comprehensive treatment program for chemical dependency at Al Amal Hospital. Damman Journal of Substance Abuse Treatment, 0, 369 – 376.
Abdel‐Mawgoud, M. & Al‐Haddad, M. K. (1996) Heroin addiction in Bahrain: 15 years experience. Addiction, 91, 1859 – 1864.
3 Alpers, R. R. (1995) Spiritual reading as bibliotherapy. In: Kus, R. J., ed. Spirituality and Chemical Dependency, pp. 49 – 63. New York: Haworth Press.
4 Barrett, M. E. (1997) Wat Thamkrabok: a Buddhist drug rehabilitation program in Thailand. Substance Use and Misuse, 32, 435 – 459.
5 Berenson, D. (1990) A systemic view of spirituality. Journal of Strategic Systemic Therapy, 9, 59 – 70.
6 Booth, L. (1987) Alcoholism and the fourth and fifth steps of Alcoholics Anonymous. Journal of Psychoactive Drugs, 19, 269 – 274.
7 Bowker, J., ed. (1999) The Oxford Dictionary of World Religions. Oxford: Oxford University Press.
8 Carroll, S. (1993) Spirituality and purpose in life in alcoholism recovery. Journal of Studies on Alcohol, 54, 297 – 301.
9 Carter, T. M. (1998) The effects of spiritual practices on recovery from substance abuse. Journal of Psychiaty and Mental Health Nursing, 5, 409 – 413.
Cross, F. L. & Livingstone, E. A., eds (1997) The Oxford Dictionary of the Christian Church, 3rd edn. Oxford: Oxford University Press.
Dollard, J. (1983) Toward Spirituality. Minnesota: Hazelden.
Fetzer Institute & National Institute on Aging Working Group (1999) Multidimensional Measurement of Religiousness/Spirituality for Use in Health Research. Kalamazoo: Fetzer Institute.
Grof, S. (1987) Spirituality, addiction and Western science. Revision, 10, 5 – 18.
Groves, P. & Farmer, R. (1994) Buddhism and addictions. Addiction Research, 2, 183 – 194.
Hanna, F. J. (1992) Reframing spirituality: AA, the 12 steps, and the mental health counsellor. Journal of Mental Health Counselling, 14, 166 – 179.
Jarusiewicz, B. (2000) Spirituality and addiction: relationship to recovery and relapse. Alcohol Treatment Quarterly, 18, 99 – 109.
Johnson, R. A., Sandler, K. R. & Griffin‐Shelley, E. (1987) Spirituality and the regulation of self‐esteem. Alcohol Treatment Quarterly, 4, 1 – 12.
Koski‐Jännes, A. & Turner, N. (1999) Factors influencing recovery from different addictions. Addiction Research, 7, 469 – 492.
May, G. G. (1988) Addiction and Grace. San Francisco: Harper Collins.
McGinn, B., Meyendorff, J. & Leclerq, J., eds (1996) Christian Spirituality: Origins to the Twelfth Century. London: SCM.
McManus, R. J., Wilson, S., Delaney, B. C., Fitzmaurice, D. A., Hyde, C. J., Tobias, R. S., Jowett, S. & Hobbs, F. D. R. (1998) Review of the usefulness of contacting other experts when conducting a literature search for systematic reviews. BMJ, 317, 1562 – 1563.
Mercadante, L. A. (1996) Victims and Sinners. Louisville: WJK.
Miller, M. A. (1995) Spirituality, art therapy, and the chemically dependent person. In: Kus, R. J., ed. Spirituality and Chemical Dependency, pp. 135 – 144. New York: Haworth Press.
Nethercott, D. R. (2003) Placebo or not—we may never know. BMJ, 326, 881.
Parker, R. J., Horton, H. S. & Watson, T. (1997) Sarah's story: using ritual therapy to address psychospiritual issues in treating survivors of childhood sexual abuse. Couselling and Values, 42, 41 – 54.
Rush, M. M. (2000) Power, spirituality, and time from a feminist perspective: correlates of sobriety in a study of sober female participants in Alcoholics Anonymous. Journal of the American Psychiatric Nurses Association, 6, 196 – 202.
Shockley, G. A. (1994) Overcoming the obstacles of co‐dependency: an interdisciplinary task. Journal of Spiritual Formation, 15, 103 – 108.
Swinton, J. (2001) Spirituality and Mental Health Care. London: Jessica Kingsley.
Wakefield, G. S., ed. (1988) A Dictionary of Christian Spirituality. London: SCM.
Wulff, D. M. (1997) Psychology of Religion: Classic and Contemporary, 2nd edn. New York: Wiley.
Zimmerman, M. A. & Maton, K. I. (1992) Life‐style and substance use among male African‐American urban adolescents: a cluster analytic approach. American Journal of Community Psychology, 20, 121 – 138.

Religion
from Bloomsbury Guide to Human Thought
Humankind, it seems, has always felt the need to search for God, whether to survive in a hostile environment at a time when good weather, good hunting and the safe delivery of healthy children were crucial, or to explain the sense of awe and wonder inspired by particular events or sacred places, or to assuage the anguish in the human soul. The etymology of the word ‘religion’ (Latin, religio) is disputed, but the most logical is that it is a combination of res, ‘a thing’, and ligare, ‘to bind’. Religion is thus what binds things together (such as families, societies, the world), and which enables humankind to live in harmony with the animal world and with the gods. In most societies it is the basis for morality and for all human relationships, especially where it is believed that there is a divine law controlling all things, and it gives meaning to life. Inequality and injustice in this life can be rectified by appeal to either divine intervention now, or to another dimension to which one can escape. Many religions promise personal transformation and/or that of society, in this life or the next, but essentially religion is concerned with this life.
To sociologists at least, one of the best ways of thinking about religion is in terms of what it is not. It is not necessarily the belief in one god (religions can involve many deities). It is not identifiable with moral prescriptions for human behaviour (the idea that gods are interested in behaviour on Earth is alien to many religions). It is not necessarily concerned with the origins of the world (some religions have myths of origin but many do not). It cannot be identified as intrinsically involving a belief in the supernatural (some beliefs and practices conventionally thought of as religious—Buddhism, for example—do not correspond to this definition).
What, then, is religion? The sociologist Émile Durkheim (1858 – 1917) defined religion as a system of beliefs and rituals which binds people together in terms of social groups. This certainly seems to include features that all religions have in common. Whether or not a religion involves a belief in god or the gods, there are virtually always objects which inspire awe. Religions practise diverse rituals and all religions involve ceremonials practised collectively by believers. Critics have pointed out, however, that such a definition is rather inclusive, since almost all public activity has an integrative effect on human groups. (Football matches are an example).
In Europe, after the wars of religion which followed the Reformation, the price for peace was the increasing secularization of society. The trend among monarchs in Roman Catholic countries was to keep the church at arm's length and drastically curtail its temporal power. In Protestant countries, this was paralleled by the demand that all denominations be treated equally. This coincided with the rise of modern science, and with the Evangelical revivals, with their heavy emphasis on personal piety. The result was that with the exception of events such as coronations, Remembrance Sunday, etc., religion became a private affair rather than a societal concern. In global terms, this was and is an aberration. In most countries outside the West, religion is viewed as embracing the whole of life (as Christianity does theoretically). In Islamic countries, for example, one sees clearly the effect of governing all life by religious practice; everything is done in response to the divine will. In India, there is no word for ‘religion’, only dharma, which could be translated as one's religious duties but also means the faith prescribed for each person, the duties one has to family, society and the gods, and above all the obligation to fulfil one's function in society to the best of one's ability. (This is the Latin concept of pietas, often misleadingly translated as ‘piety’.) Neglect by one person threatens the well-being of the whole of society.
In other words, religion is not just something believers do; it defines what they are. Many scholars hold that religion involves not only the performance of rites, but also inner experience of an extra-personal reality. For this reason there is debate as to whether Buddhism is a religion or a philosophy, since no such reality was acknowledged until Buddhism had absorbed elements of tribal religion. In Judaism the same tension is resolved by the saying ‘The fear of the Lord is the beginning of wisdom’, and the command (shared with Christianity) to love the Lord God with heart and mind, soul and strength.
There would seem to be no authoritative answer to the question of whether religion is an innate quality of the human personality, or whether it is implanted by society and experience. But there is no denying the quality of the lives of saints of every faith, or of the fine art, drama and literature religion has inspired. In some faiths the answers are that there is within every person an element of the divine, or that the believer can become infused with God's spirit. In an uncertain and unstable world, religion offers many people security, marks the transitions from one stage of life to another, and offers an assurance of continuing existence after death. DA RK EMJ KMcL

See also animism; charisma; church; Confucianism; Daoism; Hinduism; Islam; secularization; Shinto.
Further reading S.S. Acquaviva, The Decline of the Sacred in Industrial Society; , É. Durkheim, The Elementary Forms of Religious Life (1912); , Mircea Eliade, Patterns in Comparative Religions; A History of Religious Ideas 3 vols; , R. Robertson, The Sociological Interpretation of Religion; , B.S. Turner, Religion and Social Theory.
Bloomsbury Guide to Human Thought, © Bloomsbury 1993
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The Paradox of Powerlessness: Gender, sex, and power in 12-step groups
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Author: Sandra L. Herndon
Date: Fall 2001
From: Women and Language(Vol. 24, Issue 2)
Publisher: George Mason University
Document Type: Article
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Abstract: All 12-step groups rely on a version of Step One from Alcoholics Anonymous which states, "We admitted we were powerless over alcohol–that our lives had become unmanageable." The paradox inherent in this statement is the contradiction of asking group members to admit powerlessness in a group whose purpose is empowerment. This paper explorers the paradox of power and powerlessness in 12-step groups, especially in relation to gender and sex. Power in the western tradition is equated with control, authority, and masculinity while powerlessness suggests the opposite and is associated with femininity. This paper re-envisions the concepts of power and powerlessness from a broader perspective, avoiding a dichotomy and suggesting a framework based on mutuality, flexibility, and inherent strength through which mutually respectful relationships can be developed.
Introduction
The growth of twelve-step groups, part of the larger self-help recovery movement, is a response to personal and social problems in which individuals seek empowerment and transformation. Originating with Alcoholics Anonymous in the 1930s and now international in scope, twelve-step groups address a wide range of problems, including drug addiction (Narcotics Anonymous), gambling (Gamblers Anonymous), food addiction (Overeaters Anonymous), sex and relationship problems (Sex and Love Addicts Anonymous), emotional problems (Emotions Anonymous), families of alcoholics (Al-Anon), children of alcoholics (Alateen, Adult Children of Alcoholics), and families of drug addicts (Nar-Anon). Recovery from these problems into a "normal, useful way of life" is a primary goal of all these groups (AFGH, 1988, p. 233).
All twelve-step groups typically rely on an adaptation of Step One of Alcoholics Anonymous (AAWS, 1976): "We admitted we were powerless over alcohol–that our lives had become unmanageable" (p. 59). What exactly is the paradox here? Webster's Unabridged Dictionary identifies a paradox as a statement that seems contradictory, unbelievable, or even absurd, but that may indeed be true. In an earlier work (Herndon & Eastland, 1999), 1 described this paradox as one which asks group members to admit powerlessness in a group whose purpose is empowerment–a seemingly contradictory, if not absurd, idea. The purpose of this paper is to explore the paradox of power and its obverse, powerlessness, in twelve-step groups, especially in relation to gender. To accomplish this goal I will 1) identify some of the fundamental issues in twelve-step groups relating to the idea of powerlessness, 2) discuss briefly the philosophical basis of the paradox of power and powerlessness, 3) explore the gender implications of this paradox , and 4) identify alternative ways of addressing these issues in the context of twelve-step groups.
The paradox of powerlessness inherent in twelve-step groups has generated controversy and critique in part because of the connotations of the term 'power.' Power is defined by Webster's Unabridged Dictionary as vigor, force, strength, influence, or ability to control others, while powerlessness is defined as weakness or impotence, without force or energy. Why and how are members expected to admit their powerlessness? To the Western mind such an act is untenable. For members of self-help groups seeking direction and guidance in solving difficult problems to be told, first and foremost, to admit powerlessness appears tantamount to being told to admit defeat. In addition, the relationship between gender and powerlessness is significant. Webster's defines masculine as strong (therefore powerful) and feminine as weak (therefore powerless). Hence the meaning of admitting powerlessness must inevitably differ, depending on one's gender and/or sex role.
The matter of gender or sex is rarely acknowledged in twelve-step literature and then principally as a role (e.g., the wife of the alcoholic). However, gender and sex-role issues underlie the groups' histories. Alcoholics Anonymous (AA), the earliest and perhaps most recognizable of these groups, began as a group of white upper-middle-class Protestant alcoholic men in the 1930s (see AFGH, 1989; Rudy & Greil, 1988; AFGH, 1976) although many women now participate in AA. Al-Anon, begun by the wives of AA founders for families and friends of alcoholics, continues to consist predominantly of women. This paper will use Al-Anon as its primary example of a twelve-step group because it evidences issues clearly related to gender and defined sex roles, but many of the issues are similar in all groups modeled on AA.
Power and Powerlessness in Twelve-Step Groups
This section will identify some fundamental tenets related to power and powerlessness in twelve-step groups which are based on a set of twelve steps and twelve traditions (see Appendix A for a list of Al-Anon's twelve steps). The steps provide a guide for personal change and growth based on personal responsibility and a belief in a spiritual force or Higher Power while the twelve traditions guide group process and structure (Herndon, 1992).
Much of the current literature about alcoholism describes family roles, based frequently on the model of the alcoholic husband, codependent or enabling wife, and children who enact a variety of roles. The nature of these interpersonal interactions, regardless of who occupies which role, is addressed in Al-Anon, a program for families and friends of alcoholics. According to Al-Anon's Twelve Steps and Twelve Traditions (AFGH, 1981), the twelve steps are the "heart of the program in which the family of an alcoholic can find a new way of life in the fellowship" of the group (p. ix). Several of these steps are related directly to issues of power/powerlessness:
"Step 1: We admitted we were powerless over alcohol–that our lives had become unmanageable." In this and related steps, group members are encouraged to understand that by admitting powerlessness over the "facts of our situation and the other people involved," they will discover that they "are not helpless" (AFGH, 1990, p. 31). Following this step, it is advised, provides a feeling "of release, of yielding or letting go" when it becomes clear that "no change in others can be forced" (AFGH, 1989, p. 8). An Al-Anon member writes, "Many meetings later, I grasped the idea that the only person I have any power over is myself" (AFGH, 1990, pp. 40-41).
"Step 3: We made a decision to turn our will and our lives over to the care of God as we understood Him." AlAnon guidance suggests a reliance on and relationship with a "benign Power" in which "our part . . . was to learn to recognize, reach out, accept–and act, with the inner awareness of the spiritual presence whose direction we decided to follow when we made a decision to turn over our will and our lives" (AFGH, 1981, p. 21). Commonly referred to as "turning it over," this step acknowledges reliance on a Higher Power, however it is defined. Kasl (1992) calls this the "let go and let god" step, referring to one of the frequently used slogans in twelve-step groups (p. 312).
However, the official language always refers to "God" as "Him," thus reaffirming a patriarchal view of spiritual guidance. While individuals or local groups may be flexible in their own language use, nowhere has the issue of sexist language or its power implications been addressed in conference-approved twelve-step publications (those materials officially sanctioned by Al-Anon Family Group Headquarters, Alcoholics Anonymous World Services, or their counterparts). The equation of God with a male 'Higher Power' reinforces an inherent gender inequality.
Step 8: "We made a list of all persons we had harmed, and became willing to make amends to them all, and Step 10: "We continued to take personal inventory and when we were wrong promptly admitted it." In these and related steps, members are encouraged to confess their mistakes and strive to be more aware of the consequences of their actions in relation to other people. Al-Anon guidance suggests, "Taking Step Ten gave us the opportunity to spare ourselves the consequences of being stubbornly opinionated. It reminded us that we were not all-wise, that the philosophy of our Steps is based on humility, on acknowledging a Power greater than ourselves" (AFGH, 1981, p. 64). Admitting one's failings and making amends can certainly be cleansing and renewing; it may also be a source of shame and reconfirmation of one's worthlessness. Kasl (1992) identifies this problem as a "cultural double bind" where the "victim" may be taking responsibility not only for her own behavior but also for what has been done to her (p. 322). A feminist critique would ask why she should focus on her shortcomings at the expense of her achievements.
The Paradox
How can admitting powerlessness empower someone? How can yielding or surrendering produce strength? Although these ideas may seem contradictory to those of us schooled in the Western tradition, they have a long history in Eastern philosophy. In this section I want to demonstrate very briefly the philosophical roots of this paradox.
A description of the "working principles" of Al-Anon identifies them as the "concepts on which all spiritual philosophies are based," in the "Bible as well as the sacred literature of the Orient" (AFGH, 1988, p. 229). The AlAnon book of daily meditations, Courage to Change (AFGH, 1992), is punctuated with quotations from a variety of sources, including Lao Tzu, Confucius, Kagawa, Helen Keller, Kahlil Gibran, Carl Jung, Soren Kierkegaard, Antoine de Saint-Exupery, Langston Hughes, Meister Eckhart, The Bhagavad Gita, The Bible, The Talmud, and Persian poems, as well as Ojibway, Zen, Turkish, and American proverbs and sayings. The debt to the thinking of many of the world's great writers and traditions is evident.
Writing in the sixth century B.C., Lao Tzu penned Tao Te Ching (1972), the basis of Taoism which remains a central part of Chinese culture. The paradox of power and powerlessness is a prominent theme, as evidenced in these excerpts:
Yield and overcome;
Bend and be straight;
Empty and be full;
Wear out and be new;
Have little and gain;
Have much and be confused. (Twenty-Two)
The softest thing in the universe
Overcomes the hardest thing in the universe. (Forty-Three)
A man (sic) is born gentle and weak.
At his death he is hard and stiff.
Green plants are tender and filled with sap.
At their death they are withered and dry.
Therefore the stiff and unbending is the disciple of death.
The gentle and yielding is the disciple of life.
Thus an army without flexibility never wins a battle.
A tree that is unbending is easily broken.
The hard and strong will fall.
The soft and weak will overcome. (Seventy-Six)
The truth is often paradoxical. (Seventy-Eight)
Hassett (1996) writes in an article unrelated to twelve-step programs, "The many paradoxes of the Tao now make sense. When Lao Tzu says 'yield and overcome,' I know what he means because I've pushed against life, trying to make it obey my desires, and have learned that it doesn't work that way." Here we can begin to see how, ironically, admitting powerlessness may result in a sense of power-flexibility may provide strength, yielding may "get" us what we cannot get through force.
The Buddhist tradition also illustrates the paradox of having and turning loose. Mark Epstein (1995), a Western-trained psychiatrist and a practicing Buddhist, explores our Western confusion about the nature of happiness which he describes as "the ability to receive the pleasant without grasping and the unpleasant without condemning." Ultimately, he says, happiness is "release from the attachment to pleasant feelings." Ron Leifer (1997), a Buddhist as well as a psychiatrist, says that from the Buddhist perspective suffering results from our selfish pursuit of happiness. In describing the "way of the Lotus" associated with Buddhism, Herman (1997) suggests that "the Lotus way invites us to engage in action.., but to do it with unattachment," comparing this principle with the teachings of the Upanishads, Jesus of Nazareth, Islam, the Bhagavad Gita, and Taoism. This paradox is reflected in the Al-Anon principle of detachment: "We let go of our obsession with another's behavior and begin to lead happier and more manageable lives, lives with dignity and rights, lives guided by a Power greater than ourselves" (AFGH, 1992, p. 43).
For many of us steeped in the Western tradition, the idea of being powerless suggests losing, being dominated or defeated. These ideas are based on the assumption of a dichotomy (one wins and one loses) rather than complementarity or mutuality (Berenson, 1991). The paradox is that one may become empowered by accepting one's powerlessness. The gender implications of this paradox will be explored in the next section.
Gender Implications
I begin this section with a brief summary of the obvious. The dichotomous stereotypes of masculine as rational, objective, strong (and therefore powerful) and feminine as emotional, subjective, weak (and therefore less powerful or even powerless) continue with us. Being powerful connotes being successful, in control, in charge, in authority. Inevitably, in a patriarchy, power, being associated with masculinity, gets conflated with being male. Being powerless, however, suggests the opposite and therefore gets conflated with being female, a double-bind ("catch-22"), explicated by Kasl (1992), Jamieson (1995), and others.
It becomes evident that the twelve-step prescription to admit powerlessness carries an implicit challenge, albeit a paradoxical one, to normative expectations, especially of masculine behavior. While accepting powerlessness may be difficult for anyone in a culture which celebrates being in control, it is not surprising that females, having been socialized into expectations of femininity, may have less difficulty acknowledging powerlessness. According to Kasl (1992), AA founder Bill Wilson was "constantly concerned with the need to deflate a rigid, over-blown ego as a prerequisite to admitting one has a problem with alcohol" (p. 17) which worked well for the privileged white men with whom he worked. Kasl points out, however, that such an admission of powerlessness does not necessarily serve the same purpose for most women and many underprivileged people who may already be painfully aware of their powerlessness. Indeed, building up a healthy ego may need to be the goal for those who suffer from oppression as w ell as problems associated with addiction.
Furthermore, turning over one's will and life to a Higher Power, always referred to as masculine, is also paradoxical. On one hand, the process of letting go can be liberating, hence the slogan "Let Go and Let God" (AFGH, 1988, p. 248). On the other hand, it can increase one's sense of powerlessness. Kasl (1992) argues that the "last thing women and minorities need to do is hand their wills over to others to control. To do so is at the heart of oppression" (p. 313). A feminist critique would argue that people who have had their power and autonomy restricted or even stripped away (e.g., women, racial/ethnic minorities, gays and lesbians) are rightly wary of prescriptions to do anything that might further reduce their strength, power, dignity.
Another major gender implication inherent in Al-Anon practice is the reliance on stereotyped sex roles, perhaps best illustrated by a free pamphlet made available at meetings and identified as a helpful source of information especially for newcomers. using a theatrical metaphor, Alcoholism: A Merry-Go-Round Named Denial (Kellerman, 1969) identifies one of the major characters as the "provoker," a role described in other literature as codependent. This "key person" in the play is "usually the wife or mother," who is "hurt and upset by [the alcoholic's] repeated drinking episodes; but she holds the family together … she feeds back . .. her bitterness, resentment, fear and hurt, and so becomes the source of provocation. She controls, she tries to force the changes she wants; she sacrifices, adjusts, never gives up, never gives in, but never forgets" (pp. 5-6). Kellerman explains that "the customs of our society train and condition the wife to play this role" (p. 6). While this pamphlet is sympathetic to the w oman's position and its difficulties, it reveals the classic double-bind, or paradox of powerlessness. If she actively tries to change him, she is denying his autonomy; if she passively accepts the situation, she reinforces her own sense of powerlessness. Either way, she loses.
One criticism of Al-Anon is that by privatizing the problems of living with an alcoholic, it implicitly reinforces societal expectations of female passivity in the name of acceptance. The story of one such group member is detailed under the title "I Learned to Love" in Al-Anon Faces Alcoholism (AFGH, 1988, 134-139). The "wife of an active alcoholic" recounts that since she learned not to "hand over the money" to him, her husband now "manages to pay the bills." She has allayed her anxiety about his irresponsibility by recognizing her own flaws and determining not to "blame" him for his drinking. No mention is made of the consequences of unpaid bills or any alternatives she might have to this dependency. In describing a similarly unhealthy relationship, Kasl (1992) stated that the woman in this situation needed "some feminist consciousness-raising" (p. 265). Repressing anger, Kasl argues, results in loss of power.
Krestan and Bepko (1991) describe codependency, such as the behavior described above, as the "process of 'losing' one's identity to an overfocus on another person or relationship" (p. 50). Such behavior becomes even more problematic when it is described as a disease. While Al-Anon literature refers to alcoholism as a "family disease" (AFGH, 1988, p. 47), its members often speak of their own "disease" of codependency in meetings. Medicalizing social or political conditions only serves to perpetuate them because the underlying causes are not examined, as Western medicine customarily proceeds from a mechanistic model of the body independent of circumstance. The traditional medical model casts the doctor as a knowledgeable and powerful (usually masculine) authority, the patient as supplicant (usually female) having less power or knowledge. Gender inequality, hardly a medical condition, is certainly a major source of what is described as dysfunctional, codependent behavior (see Berenson, 1991; Krestan & Bepko, 19 91). Kasl (1992) reframes the idea of disease by redefining codependency as "a disease of inequality–a predictable set of behavior patterns that people in a subordinate role typically adopt to survive in the dominant culture. Codependency is a euphemism for internalized oppression and includes traits of passivity, compliance, lack of initiative, abandonment of self, and fear of showing power openly" (p. 279). She argues that this behavior is taught and reinforced through our primary cultural institutions in order to maintain patriarchy and capitalism.
Concern over issues relating to gender and powerlessness has spawned some critique and spurred the development of alternatives which will be identified in the next section.
Alternatives
Several authors have revised the twelve steps to address many of the issues described in this paper (see Berenson, 1991; Kasl, 1992). These revisions fall outside the boundary of "conference-approved literature" (AFGH, 1988, p. 258), a limitation which has resulted in material that does not challenge or critique gender inequality. First published in Ms., Kasl's (1990) original revision of the steps (see Appendix B) offers a provocative alternative addressing the fundamental issues of power/powerlessness and gender inequality. Following is her revised version of the steps analyzed earlier in this paper: Steps 1, 3, and 8-10 (pp. 30-31):
"Step 1: We acknowledge we were out of control with — but have the power to take charge of our lives and stop being dependent on others for our self-esteem and security." This formulation moves away from powerlessness as loss of control toward claiming power over one's own life.
"Step 3: I declared myself willing to tune into my inner wisdom, to listen and act based upon these truths." A radical departure from the original, this revision places the primary locus of spirituality inside the individual, rather than in a masculine deity.
"Step 8-9: We took steps to clear out all negative feelings between us and other people by sharing grievances in a respectful way and making amends when appropriate." This revision rights the imbalance of the original one-sided version by emphasizing respect and openness as opposed to an apologetic attitude.
"Step 10: Continued to trust my reality, and when I was right promptly admitted it and refused to back down; we do not take responsibility for, analyze, or cover up the shortcomings of others." A complete inversion of the original, this step now emphasizes the right to stand up for oneself and not to take responsibility for others, rather than focusing solely on one's mistakes.
Another interesting alternative is provided by "J" (1996) who has translated AA's primary text "from the gender-weighted English of the 1930s to an English that treats men and women equally" (p. vii). Arguing that the original version essentially ignored women except in the role of wife, "J," a self-identified sober alcoholic in AA, seeks to rectify this imbalance both by getting rid of the masculine pronouns and by changing the sex of the principals in several examples in the text. To date, this version has not been conference-approved.
In addition to alternatives focusing on changing language, Kasl (1992) identifies three twelve-step programs which have formed as alternatives to Alcoholics Anonymous: Women for Sobriety (WFS), Rational Recovery (RR), and Secular Organization for Sobriety or Save Our Selves (SOS), which were begun because of dissatisfaction with the treatment in AA of such issues as powerlessness, definition of God, and sexism.
At a fundamental level all these alternatives attempt to restore a balance of power. Berenson (1991) argues for a redefinition or "recovery" of power, to move from power as "technical will" or control toward power as "existential will" or willingness. He suggests that the "process of recovery from addiction is a process of recovering a different, more feminine, sense of power and will" (p. 74). Rather than power as domination over, we can think of power as autonomy, the ability to take responsibility for oneself and act in a caring and respectful way toward others, a conception of power that is mutual and balanced. The revised twelve steps reinforce this view. Autry and Mitchell (1998), in drawing lessons for business from the Tao, argue for just such a redefinition of power.
Conclusion
This paper has attempted to identify and explore a fundamental paradox at the heart of twelve-step programs-the paradox of powerlessness-and to explore its gender implications. It can be well argued that paradox is what makes the program work. However imperfectly, it reflects the wisdom of the ages. Yet equally valid is the need to rid twelve-step groups of destructive gender inequality. Perhaps the Serenity Prayer, written by theologian Reinhold Neibuhr and used in many twelve-step group meetings, reflects the balance needed to manage these paradoxical demands:
God grant me the serenity
To accept the things I cannot change,
Courage to change the things I can,
And the wisdom to know the difference.
(AFGH, 1988, p. 252)
Sandra L. Herndon is Professor and Chair of the Graduate Program in Communications at Ithaca College. She has published a volume on "Communication in Recovery: Perspectives on Twelve-Step Groups" and finds the intricacies of paradox to be intriguing.
Notes
(1.) An earlier version of this paper was presented at the annual conference of the Eastern Communication Association in Portland, ME, in April 2001.
(2.) Special thanks to Anita Taylor for helping me clarify the title of this paper.
References
Al-Anon Family Group Headquarters, Inc. (AFGH) (1988). Al-Anon faces alcoholism (2nd ed.). New York: Author.
Al-Anon Family Group Headquarters, Inc. (AFGH) (1981). Al-Anon's twelve steps and twelve traditions. New York: Author.
Al-Anon Family Group Headquarters, Inc. (AFGH) (1992). Courage to change: One day at a time in Al-Anon II. New York: Author.
Al-Anon Family Group Headquarters, Inc. (AFGH) (1990). In all our affairs: Making crises work for you. New York: Author.
Alcoholics Anonymous World Services, Inc. (AAWS) (1976). Alcoholics Anonymous. New York: Author.
Autry, J. A., & Mitchell, S. (1995). Real power: Business lessons from the Tai Te Ching. NY: Riverhead Books.
Berenson, D. (1991). Powerlessness–liberating or enslaving? Responding to the feminist critique of the twelve steps. In C. Bepko (Ed.), Feminism and addiction (pp. 67-84). New York: The Haworth Press.
Epstein, M. (1995). Opening up to happiness. Psychology today [Online], 28(4). Available: http://web.lexisnexis.com.lopes.idm.oclc.org/univers…5=f99b6e9824f2f89420d63e47b3a7980 e
Hassett, B. (1996, Sept. 22). Finding wisdom in ancient philosophy means letting analysis go. Sacramento Bee [On-line]. D5. Available: http://web.lexisnexis.com.lopes.idm.oclc.org/univers…5=acfd081cf283814e2450c883d214d86 a
Herman, A. L. (1997). The way of the lotus: Critical reflections on the ethics of the "Saddharmapundarika Sutra." Asian Philosophy [Online], 7(1). Available: http://web3.searchbank.com/infotra…on/411/306/20313689w3/7!xrn_11&b km
Herndon, S. L. (1992, May). The twelve traditions: A study in group process and organizational structure. A paper presented at the annual convention of the Eastern Communication Association, Portland, ME.
Herndon, S. L., & Eastland, L. S. (1999). Introduction. In L. S. Eastland, S. L. Herndon, & J. S. Barr (Eds.), Communication in recovery: Perspectives on twelve-step groups (pp. 1-10). Cresskill, NJ: Hampton Press.
"J" (1996). A simple program: A contemporary translation of the book "Alcoholics Anonymous. "New York: Hyperion.
Jamieson, K. H. (1995). Beyond the double bind: Women and leadership. NY: Oxford University Press.
Kasl, C. D. (1992). Many roads, one journey: Moving beyond the twelve steps. New York: Harper Perennial.
Kasl, C. D. (1990, Nov.-Dec.). The twelve-step controversy. Ms., 30-31.
Krestan, J. A., & Bepko, C. (1991). Codependency: The social reconstruction of female experience. In C. Bepko (Ed.), Feminism and addiction (pp. 49-66). New York: The Haworth Press, Inc.
Kellerman, J. L. (1969). A merry-go-round named denial. New York: Al-Anon Family Group Headquarters, Inc.
Lao, Tzu. (1972). Tao teaching [G. F. Feng & J. English, Trans.]. New York: Vintage Books.
Leifer, R. (1997). The happiness project. Ithaca, NY: Snow Lion Publications.
Rudy, D. R., & Greil, A. L. (1988). Is Alcoholics Anonymous a religious organization?: Meditations on marginality. Sociological Analysis, 50(1), 41-51.
Appendix A
Al-Anon's Twelve Steps (From Al-Anon Family Group Headquarters, Inc. [1981]. Al-Anon's twelve steps and twelve traditions. New York: Author.)
1. We admitted we were powerless over alcohol–that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him (emphasis in original).
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him (emphasis in original), praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these Steps, we tried to carry this message to others, and to practice these principles in all our affairs.
Appendix B
Revised Twelve Steps (Kasi, C. D. [1990, Nov.-Dec]. The twelve-step controversy. Ms., pp. 30-31.)
1. We acknowledge we were out of control with but have the power to take charge of our lives and stop being dependent on others for our self-esteem and security.
2. I came to believe that the Universe/Goddess/Great Spirit would awaken the healing wisdom within me if I opened myself to that power.
3. I declared myself willing to tune into my inner wisdom, to listen and act based upon these truths.
4. We examined our behavior and beliefs in the context of living in a hierarchal, male-dominated culture.
5. We shared with others the ways we have been harmed, harmed ourselves and others, striving to forgive ourselves and to change our behavior.
6. We admitted to our talents, strengths, and accomplishments, agreeing not to hide these qualities to protect others' egos.
7. We became willing to let go of our shame, guilt, and other behavior that prevents us from taking control of our lives and loving ourselves.
8-9. We took steps to clear out all negative feelings between us and other people by sharing grievances in a respectful way and making amends when appropriate.
10. Continued to trust my reality, and when I was right promptly admitted it and refused to back down. We do not take responsibility for, analyze, or cover up the shortcomings of others.
11. Sought through meditation and inner awareness the ability to listen to our inward calling and gain the will and wisdom to follow it.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to others, and to practice these principles in all our affairs.
Herndon, Sandra L.
Copyright: COPYRIGHT 2001 George Mason University
http://comm.gmu.edu/

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222The Dark Night of Recovery
byGerald G. May(First published in Radical Grace,
March–April 2005)The phrase “grateful alcoholic” occurs frequently at AA meetings. Some people are grateful simply to be in recovery, to have the resources and support that twelve-step programs provide. Others realize that their lives are more open and rich than they ever were before their struggles with addiction. For many, the gratitude is for a profound spiritual life that exists only because their addiction brought them to their knees.”I was a willful, self-driven person before I realized I was addicted,” said one man. “My addiction defeated my will and finally led me to admit my powerlessnessand to surrender to God. Without that defeat. . . . I’m just grateful because my addiction gave me the most im-portant thing in my life: my relationship with God.”People frequently discover or profoundly deepen their spiritual lives during recovery. Usually this is a gentle and consoling process. For some, however, there may come a time that is disconcerting, scary, and baf-fling to the recovering person as well as to their sponsoror spiritual director. It is a time I call the Dark Night of Recovery.It is important to understand that “dark night” does not necessarily imply a time of great pain, suffering, and loss. The term is a translation of “noche oscura,“ described by the sixteenth-century Carmelite Saint John of the Cross. Oscura, while accurately translated as “dark,” does not connote anything sinister, but rather that things are obscure; one cannot see clearly what is happening.John of the Cross says the dark night is a very special gift, signaling the advent of a deeper way of prayer and relationship with God. This deepening characterizes all authentic dark-night experiences, but because of the ob-Addiction_Grace_9780061122439.indd 2223/9/12 10:24 AM 223scurity of the process, it seems instead like something has gone wrong. This happened to a recovering woman who came to me for spiritual guidance.When she began her AA program, her spiritual life was, as she put it, “Pretty simple. I went to church on Sunday, and prayed the prayers in the prayer book. But I never felt much of a personal relationship with God.”She began the program with a heartfelt conviction that recovery was a life-or-death matter; she would die if she did not stop drinking. Her experience in the first steps led her to pray more personally, directly, andspontaneously than ever before. She began to have a sense of Divine Presence in her life, and started a rou-tine of evening prayer and meditation as well. It was about that time that her sponsor suggested she seek spiritual direction.She and I walked together for nearly two years, dur-ing which time she diligently worked the program as well as deepened her life of prayer. Then, gradually and for no obvious reason, she began to experience anxiety about her recovery. “I don’t know why, but I have this feeling that I’m going to fall off the wagon,” she said, “and that’s the scariest thing in the world for me. There’s something about my prayer that scares me too,” she said. “My heart just doesn’t seem to be in it anymore.”On looking more deeply, she was able to see that during her time in the program, her prayer had almost completely been about her recovery. It was, after all, a life-and-death matter, so her sense of relationship with her Higher Power was all about the grace that was enabling her recovery, giving thanks for what she had received and asking for it to continue.Now she was experiencing a lack of enthusiasm, even a heavy boredom as she tried to continue to pray in the usual way. I asked her what she thought she was really longing for in her prayer. She finally said, “I think I’d bedelighted to just sit and only feel that love for God.”“The reason I’m so scared,” she continued, “is that I really need to pray for my recovery, to acknowledge over and over my dependence on God, my absolute Addiction_Grace_9780061122439.indd 223 224need for God’s grace. If I stop doing that, and just hang out with God, I’m afraid I’ll start drinking again. God knows, I’ve certainly been tempted a lot recently.”This woman was being led into a deeper relationship with God, and this deeper relationship was requiring a change in her prayer. It came to her much later that although God was willing to be primarily a savior for this woman for a while, dispensing the grace necessary for her recovery, God also wanted more. God wanted to stop being a means to an end (recovery), but rather to be the beginning and the end of a profoundly loving relationship with her. Still another way to describe it is that she had made an idol of her recovery, and God had been a means to help her worship that idol. This is both common and understandable, especially when one real-izes that recovery is a life-or-death matter. Now though, God was calling for a change, in essence saying, “Thou shalt have no other gods before me.”In fact, this person did relapse briefly as she wentthrough this transition. It was a terrifying time for her, but many months later she reflected that, although shedid not understand why, perhaps the relapse might have been necessary.Obviously, not every rough spot on the road to recov-ery is a dark-night experience. Still, it is important for spiritual companions and sponsors to recognize that sometimes, when things seem to be going wrong, it’s possible that something very right is happening.Why does it have to remain so obscure? John of the Cross said that God “darkens” such deep experiences in order to keep us safe. When we think we know what is going on, we will inevitably take it into our own hands and try to manage it. That, John says, is where we are sure to fall. But if we know we don’t know what’s happen-ing, we are much more likely to let God lead us. Then, John says, we do not stumble. We are kept safe. Addiction_Grace_9780061122439.indd 2253/9/12 10:24 AM

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