Religion and Spirituality in Psychiatry

Spirituality and Substance Use Disorders 117From this perspective, substance use representsan attempt to fill a spiritual vacuum. Thespiritual components of transcendence, relatedness,meaning and purpose, and core/force/soul are, using Jung’s aphorism s piritus contraspiritum , displaced by the use of psychoactivesubstances. In an attempt to take the easier pathto spiritual enlightenment, substance use movesthe individual toward attachment and isolationand farther away from what they actually seek:purpose in life and connection to others. In thisconceptualization, a path out of addiction is toincrease one’s spirituality as a way to find meaningand purpose.3.2. The Role of Spirituality in Recoveryfrom AddictionThe choice then, to continue to rely on self or toturn to something higher, is a risk of faith and is asource of ambivalence for many seeking treatmentfor substance use disorders. Recovery requiresgiving up the demand to control one’s experience.Within Alcoholics Anonymous, the term powerlessnessembodies the paradox of surrender: gainingmore control by giving up control to somethinggreater. Cole and Pargament (13) describe thisprocess as one in which “the individual begins tosee the self in relationship to a higher purpose ortranscendent reality rather than the center of theworld” (p. 185). In other words, “Our deep desirefor this is not simply a spineless need to be withoutresponsibility; rather it is a heartfelt longing togive ourselves, in love and honesty, to someone orsomething truly worthy” (p. 302).(14)May (14) describes willingness as a “surrenderingof one’s self-separateness, an enteringinto,an immersion in the deepest processes oflife itself ” (p. 6). The spiritual practices of prayer,meditation, and fasting are practices that requireincreased self-control and foster increased selfawareness.These practices require an acceptanceof mystery, powerlessness, and an increasein self-awareness. Willingness implies humilityand represents “spirituality’s concern to preservethe sense of awe in the presence of mysteryand an awareness of the strengths tapped byan admission of powerlessness” (p. 40).(15) Thereliance on a higher power is an act of willingness.The individual must exercise the willingnessto accept acceptance, which, in Tillich’s (9)terms is an act of faith. The acceptance of one’sfinitude represents a significant gain in spiritualmaturity.Hope is found in the discovery of a powergreater than one’s self and an openness to thatwhich is beyond the realm of human understanding.In the spiritual sense, hope emerges after oneturns toward meaningful existence with humility.Hope implies an effort to search for, find, and clingto something significant in living, and the willingnessto accept the mystery of life. As Frankl (16)wrote, “Existence falters unless there is a strongideal to hold on to” (p. 50). One way that hope iselicited is through the process of identifying one’spersonal values in a way that offers inner structure.(17)This increase in value-behavior consistencystems from an ability to see beyond andaccept one’s circumstance rather than dull one’sfeelings through the use of a substance. A hopefulattitude allows an individual to relate to oneselfand others with a new outlook.Frankl (16) highlighted humans’ most fundamentalsimilarities when he wrote, “There is nohuman being who may say that he has not failed,that he does not suffer, and that he will not die”(p. 73). Spirituality increases by focusing onsimilarities rather than differences and by openingone’s self in a trusting relationship. As oneshares personal experiences, trust and closenessinevitably develop, which enrich both individuals’appreciation of their humanity. It is a realizationthat allows an individual to feel cohesionand structure, knowing there is a transcendentcore to which everything is connected. Here, theself and others are viewed as ends in themselves,reflecting Buber’s I-Thou (12) relationship thatinvolves an open, sharing, and complete relationshipwith another. In the culmination of spiritualgain, an individual reestablishes a connection tolife and others.From the perspective of a spiritual model ofrecovery from addiction, individuals engage inthe process of moving toward increased meaning