In defense of spiritual solutions to addiction and protecting recovery
By Jeremiah Gardner
NOTE: This was originally published for the Hazelden Betty Ford Foundation’s monthly Recovery Advocacy Update. If you’d like to receive our advocacy emails, subscribe today.
It happens every year, sometimes a couple times a year — a media piece takes aim at addiction treatment or the Twelve Steps, or the relationship between the two. Some colleagues invariably send these to me, encouraging a spirited public response. Others send to me with a shrug, resigned to the idea that some people “just don’t get it.” Still others take what they like in such articles — there are often helpful critiques that over time drive meaningful change — and leave the rest.
This week, two such commentaries came across my desk — one in the New York Times and another in a digital publication called KevinMD. I’m generally inclined to let critiques such as these fade quickly into the next 24-hour news cycle— there’s too much to unpack time and time again.
This time, however, I was inspired to share a reaction.
One common thread in the two stories is the idea that medical care and psychological care should be separated from spiritual care in addiction treatment — that there’s no place for spiritual journeys in health care at all.
This perspective caught my attention because it’s against the grain of what feels like a cultural movement toward more spiritual seeking and holistic healing, and growing recognition that spirituality is correlated with longevity and general health. It certainly stands in stark contrast to the feedback we hear from healthcare professionals and medical students who participate in Hazelden Betty Ford’s experiential education programs. After a week immersed in our residential addiction treatment programs, most invariably share that all of health care — and especially care for chronic conditions — would benefit from our more holistic approach, addressing the biological, psychological, social and spiritual aspects of healing.
Of course, medical care is paramount, along with evidence-based therapy and peer support — all key aspects of the comprehensive care we provide. But the health care professionals immersed in our treatment also see for themselves that discovering hope, developing the motivation to change, finding one’s true self and aligning with one’s innermost values and goals are spiritual journeys, and equally key to healing. They see the power of providing care that is rooted in principles such as humility, love, empathy and grace — prioritizing human connection. They feel spirituality in the way Harvard University’s Dr. George Vaillant described it in his 2008 book Spiritual Evolution: “the amalgam of the positive emotions that bind us to other human beings.” Rarely, if ever, do we hear, “we need less of this in addiction care.” To the contrary, it’s usually: “we need more of this throughout health care.”
The KevinMD writer says, “the idea of a primary care physician sending their patient to a quasi-medical facility for treatment of their type 2 diabetes seems absurd to us.” Not to me. I’ve wondered for years why someone doesn’t pursue that very idea. If there were an option for comprehensive, holistic diabetes care — designed to facilitate healing in all realms of health (physical, psychological, social and spiritual), to inspire hope, and to empower a transformation in lifestyle — I imagine we’d see pretty good results among those who chose it.
Medical care alone — for any chronic condition — may reduce mortality (priority one, to be sure) but many individuals and their families also seek a more holistic recovery — the kind of transformative rebirth, renewal and freedom that millions in recovery from addiction have experienced. And we should have more of those options available, not less.
The primary assertion made by the New York Times writer is that people should not be forced by courts to participate in any particular kind of treatment or recovery support. On that point, we agree. Care is better when people get to choose.
It’s puzzling, though, why such an argument so often hinges on selective scrutiny, highlighting how the perceived status quo falls short without exploring how alternatives do as well — failing to credibly acknowledge the complexity of a chronic condition that has no cure and is notoriously difficult to treat.
It’s also puzzling why anyone would overlook the very practical reasons that Twelve-Step programs are part of addiction care. First, when people participate in such programs and fellowships — they work! Not perfectly — again, there is no cure. But according to both research and almost 90 years of results that keep people coming back, Twelve Step programs are effective. Secondly, they’re free. And third, they’re available everywhere.
Knowing that addiction is a chronic condition, we want people to engage in long-term, community-based support because it improves outcomes. By introducing the benefits of a free, effective and widely available fellowship and the wisdom of Twelve Step principles to people while they are participating in addiction care, we increase the odds they will find and engage in a supportive, nourishing fellowship after treatment and achieve their recovery goals.
This sort of assertive linkage between addiction care and community-based recovery support — as part of a robust, holistic approach — is the kind that I’d once again argue should be more common in health care, not less.
Jeremiah Gardner is director of communications and public affairs for the nonprofit Hazelden Betty Ford Foundation.
