Religion and Spirituality in Psychiatry

118 Alyssa A. Forcehimes and J. Scott Toniganwith a different perspective toward others and self.Reconnection is established to others and individualsare no longer in need of a substance to fillthe innate desire for spiritual longing.4. EMPIRICAL FINDINGS4.1. Categorizing Research on Spiritualityand AddictionGeppert, Bogenschutz, and Miller (18) developeda comprehensive annotated bibliography on spiritualityand addictions. A total of 1,353 papers metsearch criteria and were subsequently classifiedinto ten categories, including spiritual practicesand development and recovery, measurement ofspirituality and addiction, and religious and spiritualinterventions. Inverse relationships betweenreligiousness and spiritual practices and substanceuse were consistently observed. Of the empiricalstudies reporting results of spiritual interventionsfor substance users, transcendental meditationand other forms of meditation were foundto produce significantly reduced substance use.Finally, although there appears to be a consistentlypositive relationship between twelve-step attendanceand involvement and various measures ofspirituality or religiosity, a causal role of spiritualor religious change resulting from twelve-stepparticipation has received mixed support, at best.The authors note that a majority of the research inspirituality and addiction has been concentratedin a few areas and point to a need for longitudinaland prospective studies that begin to explore themechanisms of action of spirituality.4.2. Twelve-Step Programs: A SpiritualApproach to Recovery from AddictionIn the recovery from substance use, researchersare beginning to address spirituality and religionas important factors, a long overdue realizationthe recovery program of Alcoholics Anonymoushas promoted since 1935.(19) In the words ofBill W., the co-founder of Alcoholics Anonymous,those with substance abuse problems “have beennot only mentally and physically ill, [they] havebeen spiritually sick” (p. 64).(5) In twelve-stepprograms such as Alcoholics Anonymous, membersengage in specific prescribed behaviors tofacilitate spiritual growth.From the perspective of twelve-step programs,individuals must embrace the simplicity and submissionof spiritual surrender and give up the needfor heroic mastery of their own life.(5) Submissionis apparent in the first step, as the process of surrenderrequires individuals to give up independencefor proper dependence on God. Confession is alsoa part of the twelve-step tradition, when a memberadmits to himself or herself and others that he orshe is an alcoholic. This theme is echoed again in thefifth step, when an individual admits to God, himselfor herself, and another human being the exactnature of his or her wrongs.(5) Brenda Miller (20)argued that spiritual modeling, which she definedas “observing other persons who are exemplary inmodeling spiritual practices,” is a mechanism forthe transmission of spirituality in AA (p. 233).(5) InAA, learning through modeling occurs as membersshare their experiences of “strength and hope” andwork with a sponsor who has an understanding ofthe spiritual nature of the program.4.3. Spiritual Transformations in Recoveryfrom AddictionEvidence of the importance of spirituality withinan addiction population was supported in a studyconducted by Robinson, Brower, and Kurtz.(21)Results of this study included the significant findingthat 54.4 percent of patients entering treatmentfor alcohol problems had, at some time intheir lives, had a life-changing spiritual or religiousexperience, compared to 39.1 percent in a largenational survey. Alcoholics Anonymous holds thatspiritual transformations are the mechanism forchange and therefore transformational experiencesare an important component of the AA program.The twelfth step assures “having [had] a spiritualawakening as a result of these steps” (p. 60).(5)Within Alcoholics Anonymous, the spiritual transformationis understood as the means to movefrom destructive independence to proper dependenceon God and others.(22) The experience of