Spirituality and recovery – do they go together? Hang on a second; what is spirituality and why are scientific articles on the place of spirituality in recovery falling into my inbox on a regular basis? Yes, I’m calling them scientific articles because they appear in peer-reviewed journals.
I was at a graduate art show last night and got talking to a hospital chaplain about the nature of spirituality. I don’t come across hospital chaplains too much in my day-to-day life, but oddly enough, I’d been listening to one on Radio 4’s ‘Thought for the day’ slot only a day or two before. I was quite surprised by the lack of religious content to the job. The minister on the radio was much more focused on supporting people as they faced challenges, on helping them get through and on finding meaning in the difficulties they were experiencing.
Last night’s chaplain explained that in the ‘old days’ the hospital chaplain was expected to be ‘a witness for Christ’. Now the focus was on helping ill people and their families find spiritual health and address social and practical need too. It’s about holistic health. I talked about the growing evidence of the link between spirituality and recovery and began to realise as we talked that spirituality can be part of building recovery capital.
I was musing on this just a couple of weeks back too. There are tools to measure spirituality. Fancy that!
In the recovery world, spirituality is most closely, though not exclusively, associated with the AA programme. Over a decade ago, researchers found that those reporting a ‘spiritual awakening’ were four times more likely to be abstinent.
But it’s not all plain sailing. Suspicion around spirituality and its linkage to religiosity or cult-like practice provoke criticism of the 12-step programme. My observation is that this is more marked in our more secular society in the UK, than in the USA. It is interesting though that the very thing that is criticised and found to be contentious is being linked with better outcomes.
A couple of years back researchers took a look at the topic of spirituality in the Project Match sample. This was a massive randomised trial of different treatments. Data from Project Match have been beaten to within an inch of their lives as researchers have mined the study’s rich seams of information. Yet still they yield nuggets of interest.
The paper opens with a quote from a hospital administrator in 1937:
“Three years ago when my head doctor, Silkworth, began to tell me of the idea of helping drunks by spirituality, I thought it was crackpot stuff, but I’ve changed my mind. One day this bunch of ex-drunks of yours is going to fill Madison Square Garden…” (AA, 1952, p. 136).
The study examined the links between spirituality in AA and alcohol use and asked whether the relationship between AA and better alcohol outcomes could be explained by spiritual change. They checked this out in over 1,700 adults with alcohol use disorder using a tool to measure religiousness/spirituality as well as attendance at AA.
What did they conclude?
Findings suggest that AA leads to better alcohol use outcomes, in part, by enhancing individuals’ spiritual practices and provides support for AA’s own emphasis on increasing spiritual practices to facilitate recovery from alcohol use disorder.
But there are other routes to recovery. I wonder how spiritual SMART members are. SMART Recovery UK posted on a previous blog:
In the USA, 60% of SMART Recovery attendees believe in God or a higher power (I think that is right, but haven’t gone back and checked) and I think a majority go to Church. So certainly religious belief is no barrier to participation.
This is the UK and that figure will be much lower, but I wonder if religious belief is not only no barrier, but could actually be a benefit. Yet belief in God is not necessarily a fundamental component of spirituality and not only are there plenty of atheists in AA, but those who believe in some sort of higher power will often argue strongly that they are not religious. Indeed The Fix reports that in November, an AA convention for atheists and agnostics will be held in Santa Monica. It does appear that religiousness and spirituality were mashed up to some extent in this study and I wonder if that allows for nuanced views and a variety of experiences of spirituality.
I have another paper sitting in my inbox on spirituality in doctors who are in long term recovery and if all goes well, I’m going to take a look at that over the weekend. As I have posted before, doctors get different treatment and much better outcomes than their patients. I wonder if spirituality plays a part in that.