paths through addiction and recovery: the impact of spirituality and religion
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Substance Use & Misuse, 48:12601261, 2013Copyright C 2013 Informa Healthcare USA, Inc.ISSN: 1082-6084 print / 1532-2491 onlineDOI: 10.3109/10826084.2013.808475
Paths Through Addiction and Recovery: The Impact of Spiritualityand Religion
Carlo C. DiClemente
Department of Psychology, University of Maryland, Baltimore County, College Park, Maryland, USA
The path into addiction and from addiction into recov-ery is a complicated one filled with personal strengthsand weaknesses, motivational and behavioral tasks,significant support, and intrinsic and extrinsic influencesthat become part of a cyclical, seemingly chaotic processthat leads to sustained, often radical change in the life ofthe addicted individual (DiClemente, 2003). Spiritualityand more formal religious affiliation and practice oftenplay an important role in this journey (Fletcher, 2001).Science, especially the science of psychology and psychi-atry, has had a difficult time exploring and understandingthe role that spirituality and religion play in addictionand recovery. Recently there has been renewed interestin exploring how spirituality and religious traditions caninfluence health (Thoresen, Oman, & Harris, 2004) aswell as in the study of human nature, motivation andbehavior change (Miller & Delaney, 2004). The articlesin this special issue highlight important interactions be-tween spirituality or religion and the process of addictionand change. These interactions can influence motivationand readiness to change, values and decision making,commitment, support for drug use or for recovery, stressproduction or reduction, sustaining change, and creatingthe foundation for a new lifestyle (DiClemente 2003;Humphreys & Gifford, 2006).
It is interesting that religion and spirituality can actboth as risk and as protective factors in initiation of andrecovery from addiction. Initiation of the use of drugs canbe fueled both by disenchantment with or rebellion againstoverly restrictive religious regulation as well as a searchfor spiritual enlightenment. Spiritual crises, epiphanies,and values embodied in various religious traditions suchas forgiveness, a merciful god, humility, and redemptioncan also serve as important motivators that can spur readi-ness and strengthen commitment to move into recovery.The challenge for prevention and treatment is to under-stand whether and how spirituality and religious practiceand values operate in the population of individuals thatwe are attempting to influence. Bringing in religion canbe a two-edged sword that must be used carefully. Many
Address correspondence to Carlo C. DiClemente, Ph.D.; E-mail: firstname.lastname@example.org.
individuals have strongly positive, strongly negative, ormixed feelings about religious messages, traditions, orpractices. Some have had problematic experiences withreligious ministers and congregations. Introducing reli-gion can arouse a range of reactions and interfere withor promote engagement and openness to interventions aswell as contribute to ambivalence. Using motivational en-hancing strategies to uncover how this important factorplays out in the life of this individual or group of indi-viduals would be an important first step. Clearly label-ing spirituality as always helpful or always harmful repre-sents a gross simplification of the complex relationshipsdescribed in these articles.
Addictions by definition involve some loss of controland impaired self-regulation. I have been intrigued bythe notion of self-regulation and self-control described byRoy Baumeister and colleagues (Muraven & Baumeister,2000). If stress, addictions, and struggling with mentalhealth and addiction exhaust self-control strength, thenreligious practices such as mindfulness, meditation, andprayer can offer some respite and can provide the scaf-folding needed to support compromised self-regulation.Spirituality can serve as a source of strength as well asmotivation for recovery. It is not a coincidence that the no-tion of hitting bottom and the finding of a higher powerin Alcoholics Anonymous are linked. This connection wassupported by the notion particularly in some AmericanProtestant traditions that success in business and life wasa reward for living a righteous life and turning to god wasthe only way to turn failure into recovery or righteousness.
I think that we will find from both neuroscience inves-tigations and recovery practices that there are importantconnections between spiritual practices and recovery es-pecially for individuals with the most devastating conse-quences related to addictions.
Finally, I think that the role of religion as a culturalbelief system, a community of believers, and a set ofspiritual practices can provide important support for theaction phase of the process of change. For individualsmoving into or out of addiction, religious affiliation can
PATHS THROUGH ADDICTION AND RECOVERY 1261
offer alternative settings, helpful significant others, andsupport communities that can allow the individual toretreat from beginning involvement with drug use or toenter into sustained recovery. There is also, however, thedanger of stigma and judgment that can interfere with thepositive potential. I have had addicted individuals reporta sense of being unwelcome in some religious commu-nities and some examples of unhelpful practices, such asbeing forced to pray to get housing or being labeled andisolated, that happen to individuals entering into addic-tions or struggling with recovery. Religion is not a drugthat stops addictions. Nor is it the answer for all individ-uals. We must not assume that all efforts that are labeledreligious or spiritual will be helpful, and we have someresponsibility respectfully to help religious organizationsand institutions learn about the journey into and out ofaddictions so that they can figure out how they can offersignificant assistance and minimize potential harm.
Support for recovery includes healthful and helpfulpeople, places, and activities. Recovery is not the absenceof substances but the return to wholeness and health. Thecontributions in this special issue offer a view of the poten-tial impact of religion and spirituality in promoting free-dom from addiction. The power and potential is not some-thing we can control since individuals come to addictionprofessionals with a variety of beliefs, practices, and reli-gious affiliations. Our task as researchers, clinicians, andprevention specialists is to understand, respect, explore,educate, and offer some guidance as to how to best incor-porate spirituality and religion into our work to assist ourclients to avoid the journey into addiction and to find thecourage to make the journey into recovery.
THE AUTHORCarlo C. DiClemente, Ph.D., isthe current UMBC PresidentialResearch Professor, Departmentof Psychology, University ofMaryland, who received hisdoctorate in psychology at theUniversity of Rhode Island.For the past 30 years, he hasconducted funded research inhealth and addictive behaviorsand been engaged in clinicalservices and research. Dr.DiClemente is the codeveloper
of the Transtheoretical Model of behavior change, and the authorof numerous scientific publications on motivation and behaviorchange with a variety of health and addictive behaviors. For hiswork in the addictions, he was given the Innovators CombatingSubstance Abuse Award by the Robert Wood Johnson Foundation,as well as the McGovern Award from the American Society
on Addiction Medicine (ASAM). Director, MDQuit TobaccoResource Center; Director, Center for Community Collaboration.
Addiction: Describes habitual patterns of intentional, ap-petitive behaviors that have interrelated physiologi-cal and psychological components creating significantself-regulation problems and a durable and stable pat-tern of substance use over time that is difficult tomodify.
Recovery: A process of ridding oneself of problematic pat-terns of behavior and developing new, healthier, morefunctional behavior patterns that are sustained overtime and replace the prior problematic patterns.
Self-Control Strength: A limited resource like a musclethat is needed to perform acts of volition and control(producing or inhibiting behaviors) and that enablescoping and executive functioning.
Self-Regulation: The ability to manage both internal andexternal demands in a way that is responsive to feed-back and available information, flexible in seeking so-lutions, and that does not overtax the system. It involvesexecutive cognitive functioning and affects regulation.
Declaration of Interest
The author declares no conflict of interest. The authoralone is responsible for the content and writing of thepaper.
DiClemente, C. C. (2003). Addiction and change: How addictionsdevelop and addicted people recover.NewYork: Guilford Press.
Fletcher, A. M. (2001). Sober for good: New solutions for drinkingproblemsAdvice from those who have succeeded. New York:Houghton Mifflin.
Humphreys, K., & Gifford, E. (2006). Religion, spirituality and thetroublesome use of substances. In W. R. Miller & K. M. Carroll(Eds.), Rethinking substance abuse: What the science shows andwhat we should do about it (pp. 257274). New York: GuilfordPress.
Miller,W. R., &Delaney, H. D. (Eds.). (2004). Judeo-Christian per-spectives on psychology: Human nature, motivation and change.Washington, DC: American Psychological Association.
Muraven, M., & Baumeister, R. F. (2000). Se