Abstract
Spirituality persists as a mechanism of behavior change for addiction recovery. The aim of this project was to carefully attend to how those in recovery construct meaning of their experience of addiction, regardless of the addiction treatment modality or ideological framework. Participant accounts reflected the increased public interest in and research funding based on the brain disease model of addiction (BDMA). The qualitative study used interpretive phenomenological analysis to investigate the experiences of six adults (age range from 24 to 72) with at least three years of sustained recovery from substance use disorders. In-depth key informant interviews tracked their construction of their experiences and their understanding of addiction. Participants who entered recovery after 2010 sought to integrate BDMA-related constructs into their understanding of addiction and recovery. Addiction recovery narratives featuring BDMA-related constructs integrated neuroscience-related ideas with spirituality-related constructs rather than completely replacing the latter. Notable innovations and paradoxical tensions were found within participant accounts. Such features echo the insights on secularity of Harvard philosopher Charles Taylor, particularly his notion of the “buffered self,” which offers a theoretical framework for understanding these shifts in meaning-making. For persons entering recovery in the twenty-first century, the brain disease model of addiction carries more explanatory authority than it does for previous generations, despite the lack of agreement across addiction-related neuroscientific findings. As a model, it engenders more mechanistic, agential, brain-centered (“buffered”) senses of self, ostensibly making it less compatible with spiritual understandings of addiction than other medical models of addiction. However, this study’s findings indicate that those in recovery are likely to devise complex narratives of the etiology of addiction that combine elements from various models.
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Notes
In this article, addiction serves as an umbrella term for the full range of substance use disorders (Miller 2016, p. 92).
References
Ashenberg Straussner, S. L., & Byrne, H. (2009). Alcoholics anonymous: Key research findings from 2002–2007. Alcoholism Treatment Quarterly, 27(4), 349–367. https://doi.org/10.1080/07347320903209665.
Blevins, J. (2009). We were powerless: Addiction, the will, and the Evangelical roots of the Twelve Steps. http://religiondispatches.org/we-were-powerless-addiction-the-will-and-the-evangelical-roots-of-the-twelve-steps/. Accessed 26 May 2015.
Bogren, A. (2017). “Alcohol short-circuits important part of the brain”: Swedish newspaper representations of biomedical alcohol research. Addiction Research and Theory, 25(3), 177–187. https://doi.org/10.1080/16066359.2016.1239720.
Bröer, C., & Heerings, M. (2013). Neurobiology in public and private discourse: The case of adults with ADHD. Sociology of Health and Illness, 35(1), 49–65. https://doi.org/10.1111/j.1467-9566.2012.01477.x.
Buchman, D. Z., Borgelt, E. L., Whiteley, L., & Illes, J. (2013). Neurobiological narratives: Experiences of mood disorder through the lens of neuroimaging. Sociology of Health and Illness, 35(1), 66–81. https://doi.org/10.1111/j.1467-9566.2012.01478.x.
Campbell, N. D. (2007). Discovering addiction: The science and politics of substance abuse research. Ann Arbor: University of Michigan Press.
Campbell, N. D. (2010). Toward a critical neuroscience of “addiction”. BioSocieties, 5(1), 89–104. https://doi.org/10.1057/biosoc.2009.2.
Campbell, N. D. (2011). The metapharmacology of the “addicted brain”. History of the Present, 1(2), 194–218.
Campbell, N. D. (2013). “Why can’t they stop?” a highly public misunderstanding of science. In E. A. Raikhel & W. C. Garriott (Eds.), Addiction trajectories (pp. 238–263). Durham: Duke University Press.
Clinebell, H. J. (1998). Understanding and counseling persons with alcohol, drug, and behavioral addictions: Counseling for recovery and prevention using psychology and religion (rev. and enlarged ed.). Nashville: Abingdon Press.
Cook, C. C. H. (2004). Addiction and spirituality. Addiction, 99(5), 539–551. https://doi.org/10.1111/j.1360-0443.2004.00715.x.
Cook, C. C. H. (2006). Alcohol, addiction and Christian ethics. Cambridge: Cambridge University Press.
Cook, C. C. H. (2010). Perspectives of beliefs and values are not conflicts of interest. Addiction, 105(4), 760–761. https://doi.org/10.1111/j.1360-0443.2010.02921.x.
Daniels, S. (2016). The white chip [live theatre performance]. Lowell: Merrimac Repertory Theatre.
DeAngelis, T. (2001). Substance abuse treatment: An untapped opportunity for practitioners. Monitor on Psychology, 32.
Dermatis, H., & Galanter, M. (2016). The role of twelve-step-related spirituality in addiction recovery. Journal of Religion and Health, 55(2), 510–521. https://doi.org/10.1007/s10943-015-0019-4.
Dodes, L. M., & Dodes, Z. (2014). The sober truth: Debunking the bad science behind 12-step programs and the rehab industry. Boston: Beacon Press.
Doehring, C. (2006). The practice of pastoral care: A postmodern approach. Louisville: Westminster John Knox Press.
Dossett, W. (2013). Addiction, spirituality and 12-step programmes. International Social Work, 56(3), 369–383. https://doi.org/10.1177/0020872813475689.
Dunbar, D., Kushner, H. I., & Vrecko, S. (2010). Drugs, addiction and society. BioSocieties, 5(1), 2–7. https://doi.org/10.1057/biosoc.2009.10.
Dunnington, K. (2011). Addiction and virtue: Beyond the models of disease and choice. Downers Grove: IVP Academic.
Earley, P. H. (2017). RecoveryMind training: A neuroscientific approach to treating addiction. Las Vegas: Central Recovery Press.
Field, M. (2015). Addiction is a brain disease. .. but does it matter? https://www.nationalelfservice.net/mental-health/substance-misuse/addiction-is-a-brain-diseasebut-does-it-matter/. Accessed 16 February 2017.
Flaherty, M. T., Kurtz, E., White, W. L., & Larson, A. (2014). An interpretive phenomenological analysis of secular, spiritual, and religious pathways of long-term addiction recovery. Alcoholism Treatment Quarterly, 32(4), 337–356. https://doi.org/10.1080/07347324.2014.949098.
Flanagan, O. (2011). What is it like to be an addict? In J. S. Poland & G. Graham (Eds.), Addiction and responsibility (pp. 269–272). Cambridge: MIT Press.
Geppert, C., Bogenschutz, M. P., & Miller, W. R. (2007). Development of a bibliography on religion, spirituality and addictions. Drug and Alcohol Review, 26(4), 389–395. https://doi.org/10.1080/09595230701373826.
Glaser, G. (2015). The false gospel of alcoholics anonymous. Atlantica, 315(3), 50–60.
Heinz, A. J., Disney, E. R., Epstein, D. H., Glezen, L. A., Clark, P. I., & Preston, K. L. (2010). A focus-group study on spirituality and substance-abuse treatment. Substance Use and Misuse, 45(1–2), 134–153. https://doi.org/10.3109/10826080903035130.
Humphreys, K., Blodgett, J. C., & Wagner, T. H. (2014). Estimating the efficacy of alcoholics anonymous without self-selection bias: An instrumental variables re-analysis of randomized clinical trials. Alcoholism: Clinical and Experimental Research, 38(11), 2688–2694. https://doi.org/10.1111/acer.12557.
Johnson, T. J. (2013). Addiction and the search for the sacred: Religion, spirituality, and the origins and treatment of substance use disorders. In K. I. Pargament, E. P. Shafranske, & A. Mahoney (Eds.), APA handbook of psychology, religion, and spirituality (Vol. 2). Washington, DC: American Psychological Association.
Katsogianni, I. V., & Kleftaras, G. (2015). Spirituality, meaning in life, and depressive symptomatology in drug addiction. International Journal of Religion and Spirituality in Society, 5(2), 11–24.
Keane, H. (2002). What’s wrong with addiction? New York: NYU Press.
Kelly, J. F. (2017). Is alcoholics anonymous religious, spiritual, neither? Findings from 25 years of mechanisms of behavior change research. Addiction, 112(6), 929–936. https://doi.org/10.1111/add.13590.
Kelly, J. F., & Greene, M. C. (2014). Toward an enhanced understanding of the psychological mechanisms by which spirituality aids recovery in alcoholics anonymous. Alcoholism Treatment Quarterly, 32(2/3), 299–318. https://doi.org/10.1080/07347324.2014.907015.
Khantzian, E. J. (2003). Understanding addictive vulnerability: An evolving psychodynamic perspective. Neuropsychoanalysis, 5, 5–21.
Kime, K. G. (2015a). A higher power: Thinking theologically about addiction, recovery and being not-God. Church Health Reader, (2015), 28–31.
Kime, K. G. (2015b). New neuro models for the interdisciplinary pursuit of understanding addiction. American Journal for Bioethics: The Neuroethics Blog http://www.theneuroethicsblog.com/2015/06/new-neuro-models-for-interdisciplinary.html.
Kime, K. G. (2017). Why addiction narratives matter. American Journal for Bioethics: The Neuroethics Blog http://www.theneuroethicsblog.com/2017/03/why-addiction-narratives-matter.html.
Klingemann, J. I. (2011). Lay and professional concepts of alcohol dependence in the process of recovery from addiction among treated and non-treated individuals in Poland: A qualitative study. Addiction Research and Theory, 19(3), 266–275. https://doi.org/10.3109/16066359.2010.520771.
Koob, G. F., & Moal, M. L. (2005). Neurobiology of addiction (1st ed.). San Diego: Academic Press.
Kurtz, E., & White, W. L. (2015). Recovery spirituality. Religions, 6(1), 58–81. https://doi.org/10.3390/rel6010058.
Lende, D. H. (2012). Addiction and neuroanthropology. In D. H. Lende & G. Downey (Eds.), The encultured brain: An introduction to neuroanthropology (pp. 339–362). Cambridge: MIT Press.
Leshner, A. I. (1997). Addiction is a brain disease, and it matters. Science, 278(5335), 45–47.
Lewis, M. (2016). The biology of desire: Why addiction is not a disease (Reprint ed.). New York: PublicAffairs.
Lund, P. (2016). Christianity in narratives of recovery from substance abuse. Pastoral Psychology, 65(3), 351–368. https://doi.org/10.1007/s11089-016-0687-3.
McDonough, W. C. (2012). Sin and addiction: Alcoholics anonymous and the soul of Christian sin-talk. Journal of the Society of Christian Ethics, 32(1), 39–55.
Mercadante, L. A. (1996). Victims and sinners: Spiritual roots of addiction and recovery. Louisville: Westminster John Knox Press.
Mercadante, L. A. (1998). Addiction and recovery. Christian Century, 115(9), 302–303.
Mercadante, L. A. (2009). Religious and theological roots of alcoholics anonymous. In A. Browne-Miller (Ed.), The Praeger international collection on addictions: Volume 1, faces of addiction, then and now (pp. 95–105). Westport: Praeger.
Mercadante, L. A. (2010). Helping addicts move beyond the spiritual wading pool: A new approach to religion and spirituality in the healing of addictions. International Journal of Existential Psychology and Psychotherapy, 3(1), 1708–1696.
Merriam, S. B. (2009). Qualitative research: A guide to design and implementation. San Francisco: Jossey-Bass.
Meurk, C., Carter, A., Hall, W., & Lucke, J. (2014). Public understandings of addiction: Where do neurobiological explanations fit? Neuroethics, 7(1), 51–62. https://doi.org/10.1007/s12152-013-9180-1.
Meurk, C., Morphett, K., Carter, A., & Weier, M. (2016). Scepticism and hope in a complex predicament: People with addictions deliberate about neuroscience. The International Journal on Drug Policy, 32, 34–43.
Miles, M. B., Huberman, A. M., & Saldana, J. (2014). Qualitative data analysis: A methods sourcebook (3rd ed.). Thousand Oaks: SAGE.
Miller, W. R. (2016). Sacred cows and greener pastures: Reflections from 40 years in addiction research. Alcoholism Treatment Quarterly, 34(1), 92–115. https://doi.org/10.1080/07347324.2015.1077637.
Miller, P. G., & Miller, W. R. (2009). What should we be aiming for in the treatment of addiction? Addiction, 104(5), 685–686. https://doi.org/10.1111/j.1360-0443.2008.02514.x.
Nadeau, L. (2014). All for one, one for all: Interdisciplinary collaboration in the treatment of addictions. Canadian Journal of Addiction Medicine, 5(3), 23–27.
Nelson, J. B. (2004). THIRST: God and the alcoholic experience (1st ed.). Louisville: Westminster John Knox Press.
O’Connor, R. (2015). Rewire: Change your brain to break bad habits, overcome addictions, conquer self-destructive behavior (Reprint ed.). New York: Plume.
O’Connor, C., & Joffe, H. (2013). How has neuroscience affected lay understandings of personhood? A review of the evidence. Public Understanding of Science, 22(3), 254–268.
Ortega, F. (2009). The cerebral subject and the challenge of neurodiversity. BioSocieties, 4(4), 425–445.
Pargament, K. I. (2007). Spiritually integrated psychotherapy: Understanding and addressing the sacred. New York: Guilford Press.
Racine, E., Waldman, S., Rosenberg, J., & Illes, J. (2010). Contemporary neuroscience in the media. Social Science and Medicine, 71(4), 725–733. https://doi.org/10.1016/j.socscimed.2010.05.017.
Robillard, J. M., & Illes, J. (2012). The diction of addiction at the intersection of law and neuroscience. In A. Carter, W. Hall, & J. Illes (Eds.), Addiction neuroethics: The ethics of addiction neuroscience research and treatment (pp. 215–230). London: Academic Press.
Robinson, E. A. R., Brower, K. J., & Kurtz, E. (2003). Life-changing experiences, spirituality and religiousness of persons entering treatment for alcohol problems. Alcoholism Treatment Quarterly, 21(4), 3–16.
Rohr, R. (2011). Breathing under water: Spirituality and the twelve steps. Cincinnati: St. Anthony Messenger Press.
Rose, N. (2007). The politics of life itself: Biomedicine, power, and subjectivity in the twenty-first century. Princeton: Princeton University Press.
Rose, N. S., & Abi-Rached, J. M. (2013). Neuro: The new brain sciences and the management of the mind. Princeton: Princeton University Press.
Satel, S. L., & Lilienfeld, S. O. (2013). Brainwashed: The seductive appeal of mindless neuroscience. New York: Basic Books http://proxy.library.emory.edu/login?url=http://www.emory.eblib.com/EBLWeb/patron/?target=patron&extendedid=P_1113965_0.
Smith, J. A. (2009). Interpretative phenomenological analysis: Theory, method and research. Los Angeles: SAGE.
Sørensen, T., Lien, L., Landheim, A., & Danbolt, L. J. (2015). Meaning-making, religiousness and spirituality in religiously founded substance misuse services—A qualitative study of staff and patients’ experiences. Religions, 6(1), 92–106. https://doi.org/10.3390/rel6010092.
Spiegelman, E. (2015). Rewired: A bold new approach to addiction and recovery. Hobart: Hatherleigh Press.
Sremac, S., & Ganzevoort, R. R. (2013). Addiction and spiritual transformation. An empirical study on narratives of recovering addicts’ conversion testimonies in Dutch and Serbian contexts. Archive for the Psychology of Religion, 35(3), 399–435. https://doi.org/10.1163/15736121-12341267.
Starks, H., & Trinidad, S. B. (2007). Choose your method: A comparison of phenomenology, discourse analysis, and grounded theory. Qualitative Health Research, 17(10), 1372–1380.
Stewart, C. (2004). An empirical exploration of spirituality and religiousness in addiction treatment. American Journal of Pastoral Counseling, 7(4), 71–83. https://doi.org/10.1300/J062v7n04_05.
Szalavitz, M. (2016a). Unbroken brain: A revolutionary new way of understanding addiction. New York: St. Martin’s Press.
Szalavitz, M. (2016b). Can you get over an addiction? The New York Times. http://www.nytimes.com/2016/06/26/opinion/sunday/can-you-get-over-an-addiction.html
Taylor, C. (2007). A secular age. Cambridge: Belknap Press of Harvard University Press.
Tonigan, J. S., Rynes, K. N., & McCrady, B. S. (2013). Spirituality as a change mechanism in 12-step programs: A replication, extension, and refinement. Substance Use and Misuse, 48(12), 1161–1173. https://doi.org/10.3109/10826084.2013.808540.
Vidal, F. (2009). Brainhood, anthropological figure of modernity. History of the Human Sciences, 22(1), 5–36. https://doi.org/10.1177/0952695108099133.
Vrecko, S. (2010). Birth of a brain disease: Science, the state and addiction neuropolitics. History of the Human Sciences, 23(4), 52–67.
Williamson, W. P., & Hood Jr., R. W. (2016). Psychology and spiritual transformation in a substance abuse program: The Lazarus project. Lanham: Lexington Books.
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Kime, K.G. Interpretive Phenomenological Analysis of the Spiritual Characteristics of Recovery Experiences in the Context of the Brain Disease Model of Addiction. Pastoral Psychol 67, 357–372 (2018). https://doi.org/10.1007/s11089-018-0816-2
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DOI: https://doi.org/10.1007/s11089-018-0816-2