While there has been a long history of incorporating spiritual principles in recovery and faith-based organisations are common-place, with many of them doing a fine job, if they are simply offering spiritual solutions to addiction they are not offering addiction treatment, and may, in fact, be doing more harm than good. Any place that purports to be a rehabilitation centre should be recovery based, not faith based.
One of the pastors who volunteer time at the non-profit organisation where I head up the addiction program came to me and said: “Shaun, I have a problem. I no longer feel comfortable with many of the rehabs I have been helping out at. What is going on there is wrong, and I can no longer be part of it.” Hallelujah.
For a long time recovery and “spirituality” have been inexorably linked. This is understandable considering that AA, and by association 12-step programs, were influenced by the teachings of the Christian Oxford Group. Jung, whose ideas also influenced the thinking of Bill W, the founder of AA, coined the phrase “Spritus contra spiritum” and described alcoholism in one patient as “the equivalent, on a low level, of the spiritual thirst of our being for wholeness, expressed in medieval language: the union with God.” The adoption of the 12-Step program into the professional treatment setting in the form of the Minnesota Model has seen the “spiritual” program becoming the de facto “cure” for addictions.
Even this, however, is too much recovery for some of the faith-based addiction programs we have in my local setting. Many organisations purporting to offer a cure for addiction believe that there is a pill that will solve your problems: The Gos-PILL. For me, this is a bitter pill to swallow.
Let me state clearly that it is my position that this thing we call addiction cannot be fully explained without taking a spiritual component into account. It is, in my and many other’s opinions, a bio-psycho-social-spiritual disorder. I also state for the record that I am a Christian working for an organisation that has a Christian ethos. I also believe that religion and spiritual awakening can be powerful motivators and agents of change, but to present this as a “cure” for addiction is morally wrong.
The Value of Religion in Recovery
Recently I attended an academic forum where a clinical psychologist was presenting on the psycho-dynamic theories of addiction. After the talk one of the attendees, a pure scientist with a PhD who is currently studying changes in brain activity amongst Methamphetamine users, made the comment “we should send them all to church.” While this comment was made a little tongue in cheek, there is some truth in the concept that many addicts benefit from religious involvement. The cynical amongst us may even describe the 12-step meetings as a form of religious gathering.
In their paper Religion, Self-Regulation, and Self-Control: Associations, Explanations, and Implications, McCullough and Willoughby conclude that there is strong evidence that religion is positively related to self-control and influences goal selection, pursuit, and management; there is reasonable support for the idea that religious rituals such as prayer and meditation can promote self-regulation, and there is mixed support for the idea that religion promotes self-monitoring.
Religion can, therefore, have a duel role: (a) It prescribes what people should strive for and (b) it prescribes the path people should take to reach these goals (Pargament, 1996). In other words, it can help the individual find meaning. In terms of social support, by joining a religious organisation, the recovering addict can form new bonds and receive the social integration and support that was often lacking during the periods of addiction (Loewenthal, 1995).
I have also found that the Christian concepts of being “reborn”, forgiveness and repentance greatly facilitate the addict turned Christian to heal the damage of their past as well as catalyze the behavioural, cognitive and psychodynamic changes essential to the recovery process.
Without labouring the point further, I merely want to point out that spiritual enlightenment/conversion can be key to a person’s recovery, or can, to a lesser degree, certainly help an individual attain their recovery goals.
Where it Goes Wrong
While there are a number of faith-based recovery resources that successfully blend religion and recovery, we have all heard the horror stories that stem from faith-based programs gone wrong. In the local (South African) context we have heard reports of Islamic Rehabilitation Centres kidnapping people off the street at the request of their family, holding these people captive and beating the soles of their feet (or should that be souls).
One of the largest “Christian” facilities guarantees a cure for addiction. I quote: “Last night I heard, the word came to me, about a miracle cure for addiction……100% cure, guaranteed…..How desperate are you for this cure?……. John Chapter 8 verse 36. “Therefore if the Son makes you free you shall be free indeed”. This particular centre also offers “correctional Intervention” where “The level of discipline will be stricter than the centre (e.g. military-style inspections and parades) in order to build team spirit, respect, and self-control.” This Centre was investigated in early 2001 for the deaths of two patients, or would that be “inmates”.
These “miraculous” cures and false promises all come with an override: “You must join, and stay in, our program” – at a fee. Yes, this fee is often a lot less than other treatment options, but then “other treatment options” have to do things such as employ professionals, and are trying to pay salaries for a multi-disciplinary staff, rather than support the owner’s lifestyle. This is manipulation. It is taking advantage of desperate families who would do anything to save their children and it is morally reprehensible.
Recently I have had to deal with some of the fall-outs of an organisation that was started by an ex-addict who had had a Damascus Road experience and was “called by God” to open a secondary care facility. This individual recently relapsed causing significant therapeutic damage to many of those living in the house and expecting his subordinates to assist him in converting items in the facility to cash so he could continue to fund his habit. When the money ran out, he simply “rededicated himself” and it’s back to business, and this is where it all goes wrong: there is no accountability.
Accountability and Training
Speaking from the Christian perspective, there has to be accountability. Many of these faith-based facilities have no accountability. They use various loop-holes that are designed to protect freedom of religion so as to be able to deliver various services without accountability. We see drug rehabs call themselves all manner of things to avoid providing professional services and avoid registration as treatment centres and thus circumvent the corresponding compliance criteria. In so doing they also avoid being accountable to professional bodies. And because it is a “ministry” and “calling from God” many are simply too trusting to ask the difficult questions, so they cleverly avoid accountability to the very people that pay them to provide recovery services.
Most of the program leaders that I have encountered in such facilities have no personal accountability either. They are usually recovering addicts who use their personal “recovery” experience as the sum total of their research. People, surviving cancer does not qualify you as an Oncologist! If God has called you to turn your tribulation into triumph and help others, then walk the walk. If helping people recover is your true purpose and calling then you won’t mind working under those who are more experienced and qualified. You won’t mind studying for a few years and working for a pittance. You won’t mind living in the real world before teaching others how to. And you won’t mind being accountable to a professional body, the standards set for evidence-based treatment, your church, your peers, and most importantly, those in your care.
More Harm than Go(o)d
Addicts and their families are a vulnerable population. They are desperate for a recovery. Often they have tried many things that haven’t, for various reasons, worked. That is why we see the proliferation of expensive and untested “cures”. Think Ibogaine. The particular harm done by these fundamentalist religious approaches is that they may laden the addict with an undue sense of shame. Shame has been shown to increase the incidences and severity of relapse as well as have implications on health (Tracy & Randles, 2013). The typically confrontational approach is also in direct opposition to evidence-based techniques such as motivational interviewing. This all goes to making valid treatment approaches less attractive to the addict and their family.
Another factor is that these programs tend to advocate long-term treatment, and are often only effective while the individual is in the program. They have nothing to “carry home” and self-efficacy is not what the program is designed to foster. There is often the on-going financial and emotional abuse that the leader exerts on his converts, fuelled by the inappropriate one-sided relationship that has been fostered. In these facilities, it is certainly “Personality before Principles”. I find it amazing that the self-appointed experts would often not begin to measure up to the standards they expect from their followers/clients and yet they hold themselves up as the standard.
These cultish organisations give religion and recovery a bad name and make it even more difficult for those suffering from addictive orders to find true recovery after exposure to these damaging environments. These facilities begin to look a lot like churches with captive congregations and 7-day a week services.
What should Legitimate Faith-Based Facilities be Offering?
We all have a right to religious freedom. As I have stated, I believe that a spiritual awakening is a key to many people’s recovery, but it is not the only way to finding recovery from addiction disorders. In his useful book The Biblical Link to Addiction, Colin Garnett views addiction from a Christian Biblical understanding, and even from this point of view he suggests that “Alcoholism needs Christianity like the Church needs therapy” and continues “Therefore the danger is that even if we assume the best of Christian ministers to be fully conversant with counseling people through the theological themes highlighted, their best theology is still going to leave people wanting.” Addiction is an exceedingly difficult disorder to treat. Rule number one of effective addiction treatment is that there is no “one size fits all” cure. Because of the complex interactions of mind, body, soul, and environment that lead to addiction, addicts require an equally complex mix of treatment interventions. While there are some who will benefit from a purely religious or spiritual experience, this should not be the focus of a professional treatment setting – this type of spiritual awakening, as is the 12-step program – is free to anyone who joins a church, and those who commercialise this should be approached with caution. Any good treatment program, even if it is faith-based, should include qualified professionals who are using research-based therapies or interventions that stand the test of science. In fact, I would go so far as to say that before being faith-based, any addiction treatment centre needs to be recovery based.
Hope House Counselling Centre
Garnett, C. (2011). The Biblical Link to Addictions. AuthorHouse.
Loewenthal, K. (1995). Mental Health and Religion. London: Chapman&Hall.
Mc Cullough, M., & Willoughby, B. (2009). Religion, Self Regulation andSelf-Control: Associations, Explanations and Implications. Psychological Bulletin , 1:69-93.
Mental Health Foundation of UK. (2006). The Impact of Spirituality on Mental Health: A Review of the Literature. London: Mental Health Foundation.
Pardini, D., Plante, T., Sherman, A., & Stump, J. (2000). Religious faith and spirituality in substance abuse recovery: determining the mental health benefits. Journal of Sustance Abuse Treatment , 19(4):347-54.
Pargament, K. (1996). Religious Methods of Coping: Resources for the Conservation and Transformation of Significance. In E. Shafranske, Religion and the Clinical Practice of Psychology (pp. 215-234). Washington DC: APA.
Sremac, S. (2010). Addiction, Narrative and Spirituality: Theoretical-Methodological Approaches and Overview. Academia.edu, 255-273.
Tracy, J., & Randles, D. (2013). Nonverbal Displays of Shame Predict Relapse and Declining Health in Recovering Alcoholics.Clinical Psychological Science .