Spirituality and Substance Abuse Treatment
Bound to Drink: The Heavy Drinker & their Boundaries in Spiritual Approaches to Alcohol Abuse & Dependence
Alcohol abuse and dependence are major problems in Australia. Current approaches to understanding and managing these... more Alcohol abuse and dependence are major problems in Australia. Current approaches to understanding and managing these issues are not curbing increasing costs and harms to society; while research across multiple disciplines shows that the predominant biomedical model of treatment is outdated and reflects limited understandings. Research postulates that the incorporation of spiritual practice into treatment significantly improves outcomes for the heavy drinker. The ‘disease model of addiction’, however, continues to predominate as a treatment model. The twelve step programme developed by Alcoholics Anonymous (AA) incorporates spiritual practice, is widely acclaimed as the most successful treatment programme for alcoholism in the world and is often utilised in support of biomedical treatment. Critiques of AA, however, indicate that the Judeo-Christian foundations of the programme may limit its appeal, and gaps have been identified in addiction literature exploring alternative spiritual and religious approaches. In this research, semi-structured interviews were conducted with spiritual leaders from the Catholic, Jewish, Islamic, Pentecostal, Krishna Consciousness and Buddhist faiths. Generally, the heavy drinker was represented in terms of constriction and isolation, tightly bounded and separated from both their communities and their spirituality. Treatment and support options were presented with a focus on ‘softening’ the boundaries of the heavy drinker, encouraging them to reconnect with their community and with God or their Higher Understanding. The Catholic and Jewish interviewees represented alcohol dependence in terms akin to the disease model, requiring ongoing support from the spiritual and secular communities. The Islamic representation incorporated anomie, reflecting the belief that appropriate cultural and communal support would allow the heavy drinker to reintegrate the practice of abstinence which is integral to their faith. The remaining three prioritised a lived, embodied experience of God or Higher Understanding by the heavy drinker, positing that the eradication of boundaries between them can lead to cure for alcohol dependence. A focus on boundaries opens possibilities for future research on tailored individual programmes which may include induced spiritual experiences and incorporation of secular activities which encourage the experience of ‘flow’.
