Lance M. Dodes, M.D.

Is addiction a problem of the spirit?

In the United States, addiction is often described as a "spiritual, physical, and emotional" problem.  The use of all these terms together has been a way to please people of every point of view, but unfortunately has done nothing to aid understanding or treatment (for more on this, see the post in this blog, "Is addiction a biopsychosocial phenomenon?").   One consequence of the popularity of this vague description is that people believe that treating addiction should address all of these elements.  Before focusing on spirituality, let's quickly consider the other two pieces of this 3-part view.

First, is addiction an emotional problem?  Obviously, it is.  Readers of this blog or any of the numerous psychological writings on addiction (including my academic papers and books), know that addiction can be shown to be a psychological symptom, just one version of the common emotional symptoms we call compulsive behaviors.  Importantly, once addiction is understood psychologically, it can be far more effectively treated.

Second, is addiction a physical problem?  Physical addiction is a common result of some drug addictions, but that has very little to do with the repeated urge to return to addictive behavior days or even years after the last dose of a drug, when there is no more physical addiction.  The other physical notion, the "chronic disease hypothesis" of addiction, was developed from study of rats and has been shown to be completely invalid for humans. (For a description of the numerous fallacies of this view, see earlier posts in this blog including the most recent post, "Answers to Addiction Questions".  A fuller discussion can also be found in my books, "The Heart of Addiction," and "Breaking Addiction," or academic papers, especially "Addiction as a Psychological Symptom" in the journalPsychodynamic Practice (2009) 15: 381)).

This brings us to spirituality.  Is addiction a spiritual problem?  To think about this we first have to define the word, "spirituality." This turns out to be surprisingly hard to do.   A search reveals that up to about 70 years ago, the terms spirituality and religion were almost synonymous.  But since then, "spirituality" has also been used to refer to a feeling or belief in the oneness between an individual and the universe, being in touch with one's soul or inner self, and even simply a sense of personal well-being.  None of these newer meanings has a specific reference to a deity or  to religion.

So, is addiction a spiritual problem?  If "spiritual" is used in the original sense as "religious" then the answer is certainly no.  Addiction is not a failure of religious devotion.  There is also no reason to think of addiction as a disconnection between an individual and the universe, or any other New Age ideas such as working for social change or channeling contact with spirits.  Since addiction is a psychological symptom, it probably could be loosely described as being out of touch with one's inner self, in the sense that there areunconscious elements in every emotional symptom. But calling addiction a spiritual problem on this basis would mean saying that every aspect of emotional distress was a "spiritual" problem.  That would add nothing to our understanding or treatment and would actually interfere with trying to figure out the specific emotional factors within people that produce this behavior.

Of course, sometimes people, including people with addictions, feel less distressed when they feel "spiritually" at peace—comfortable with themselves and their place in the universe.  But plainly that doesn't mean that addiction is a spiritual problem, or that treatment of addiction has anything to do with becoming more spiritual.

In fact, we know from numerous studies that when people rely on a treatment which claims that addiction is a spiritual problem, they are at high risk of relapse (for a review of these scientific studies see my book, "The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry").

Addiction is not a spiritual problem.  Indeed, saying that it is has caused a great deal of pain to many.  Addiction is hard enough for people, without having to think they have shallow or tormented souls.