The television news one evening reported an April Fool's Day celebration in Moscow's financial district. The scene was a lot like a New Orleans Mardi Gras. The camera zoomed in on the front entrance of a tall building for a close-up on the large banner displayed there. It read, "Our elevators are broken. Please use the ones across the street."
Yogi Berra also offered similar counsel when he delivered his well-known advice that when you come to a fork in the road, take it.
Irony, like most good humor, reverses events and surprises us with the familiar. Yogi's quip sums up in a simple one-liner perhaps the most commonplace of all human experiences -- change and choice. It also sums up for me what addiction and spirituality are about. Perhaps one reason Reinhold Niebuhr's prayer [for the serenity to accept what cannot be changed, the courage to change what can be changed, and the wisdom to know the difference] remains so firmly rooted in the recovery experience is that it is precisely about change and choice and about how one lives a mature life [aka a spiritual life] in relation to both.
For working but certainly not exhaustive definitions of addiction and spirituality, the following have functioned very well for me. The psychiatrist Gerald May defines addiction as any compulsive, habitual behavior that limits the freedom of human desire. Addiction cripples choice. A healthy spirituality demands it. By spirituality, I mean not merely one more compartment along with mind and body and feelings, but rather the fundamental and essentially relational reality that distinguishes and motivates us as human beings. Call it what you will, but I think of it as a basic quality of life that is revealed through the processes of how we manage change and choice. Whenever or however we attempt to quantify that human spirit either religiously or pharmacologically -- and there's not a lot of difference -- we're in trouble. I cannot think of addiction and spirituality, however, apart from a good sense of humor.
Long ago, our forebears in the practice of medicine thought that humor was pretty much all that life was about. As you well know, they postulated four humors. Too much or too little of one or the other unseated a balanced life, and we got sick. Therefore, it was said that to be healthy was to have a good "sense of humor." Later on, the English playwrights used these theories of the humors to produce a whole literary corpus of what we might today call "sit coms." Dominance of one humor over another produced an eccentric character, hence, a more risible stage effect. So it was that humor, once specific to a medical state, came to mean, after all, something to laugh about.
A wholesome spirituality, a good sense of humor, and effective mental health are not all that far apart. Addiction is a marvelous way to dismantle the whole thing.
As medicine became more a science and less an art, it also distanced itself from these old nostrums. We suffered such a confusion about the relation between humor and health that many, especially the more straight-laced, came to see no connection at all. It took Norman Cousins and others with similar insights to start us back toward reality.
There's a widespread notion that something's wrong about being human, about having feelings, about making choices, and what is more or even worse, that nobody else has the problem. So, we think, the cure for all this must come from outside. We turn to others, to religion, to science, to work or to some other nostrum to medicate the turmoil in our souls. When we find what we think is the answer, we hang on for dear life. We want more and more, until more is never enough.
Little do we know that we've got something in reverse. We are not human beings whose goal is a spiritual experience, some euphoric panacea. Rather are we spiritual beings whose vocation is a human experience, that is, to awaken our spirits and become ourselves, and to assume the stewardship for which we are created.
May's definition of addiction as any compulsive, habitual behavior that limits the freedom of human spirit or desire strikes at the heart of what it means to be human, which is to be free to choose: to love, to create, to reason, and to live in harmony with all of creation and with the awesome mystery of why we are here in this life at all. The practice of addiction compromises that freedom. I've never met a human being who doesn't want that freedom by whatever name, and I've never met a practicing addict who has it.
It is important in the treatment of addiction that we not confuse it with the more common problem of repression. Addiction is primarily a disease of the will, not an act of the will. Nobody chooses to be an addict.
Addiction is a separate and even more destructive force that does not merely repress choice, but actually disables it. Repression stifles desire. According to May, addiction attaches desire, binds and enslaves the will, literally "nails" it to specific things, behaviors, and relationships. These objects of attachment become preoccupations and obsessions that take charge and rule our lives. It is precisely this energy of desire that must be released, this spirit that must be awakened, retrained, and put into the service of recovery.
Of course, addiction is no laughing matter, least of all for the practicing addict whose sense of tragedy is usually sufficient sustenance to avoid even the very happiest of times. A spiritual understanding of addiction suggests that like any other neurosis, it "has nothing to do with how one behaves or suffers; it has nothing to do with the fact that the psyche is infused with contradictions; it is primarily a failure of the capacity to attend to the truth about oneself, whatever it may be, with an awareness free of emotionalism, a capacity, by the way, that the great spiritual masters of early religions called sobriety." (from a review by Don Lattin in "Common Boundary" magazine, Mch/Apr 92, pp 46ff)
The capacity to attend to the truth about oneself is perhaps but another and better way to speak of a sense of humor or of spiritual well-being. I should think it is also a helpful way to describe the mental health and balance sought by any practitioner in the field of human relations, not only for one's client, but perhaps more importantly, also for oneself. This seems clearly what AA's 12th step means by "spiritual awakening," that is, to come upon the necessary chutzpah to confront maturely both change and choice. When we speak of "recovery," it seems that it is this wake-up call that we're reaching for, not only as the goal, but also as the evidence for extending that capacity to attend to the truth about life.
Gerald May's "in your face" definition of addiction avoids the risk of compromising the implications and meaning of the malady by limiting it only to chemicals and cautions us to remember or perhaps learn for the first time that addiction can include any number of disasters, both professional and personal, not the least of which is the religiosity so often found to be the culprit in our attempts to care for the addict.
I think we also risk compromising the meaning and, indeed, the maximum therapeutic potentials of spirituality as a resource when we shackle it to religion as nothing more than a mere synonym. Of course, few thoughtful people do that anymore, nevertheless, it is rare to find it introduced for consideration apart from some inevitable religious connection.
The Twelve Steps of AA, based as they are on widely held spiritual principles, are without question an effective guideline for recovery. Whatever other resources brought to bear in treatment of the addict consider well to take their lead from these simple insights, complementing and not assuming to replace them. Addiction is a malfunctioning of the whole person centered in the will. We who undertake to offer care and management profit by remembering and implementing the old adage that we are "shepherds, not veterinarians."
Many who truly desire to "do something" about their addiction become leery by what they sense rightly as the overtly religious language of the Steps. They've previously seen spirituality as nothing other than a synonym for religion and certainly not as a way of describing the very essence of what it means to be human. They've experienced religion if at all as anything but freeing, but as restrictive and judgmental. They've been held accountable not only for their behavior, but for their feelings. They've found their faith, such as it may be, held in question rather than respected and nourished, and they've been accused as sinful rather than recognized as sick. They're understandably confused by any notion that addiction is primarily an infirmity of the spirit.
Some thirty years ago when Dr Elliott Newman was director of the Clinical Research Center here in the Vanderbilt Medical Center that now bears his name, his philosophy of rounding was to include either a theologian or a reasonable facsimile on the rounding team. From time to time, I enjoyed the privilege of serving in that capacity, as a facsimile, of course.
This "consultant," as it were, was offered full and equal access to the patient. When the rounding was completed, the team met for the usual reflections and decisions, and then the visitor was asked to comment specifically on the teams relationship to the patient. Dr Newman was deeply concerned that his research not lose sight of the integrity of human being, and he believed, as well, that the process of healing was every bit as relational and the work of a community as was the process of research.
Once again, perhaps few practicing addicts have ever considered the possibility that we are not human beings whose vocation is to a spiritual experience, but spiritual beings whose vocation is to a human experience, and that this is what is meant by the twelfth step's assurance of a "spiritual awakening" as both the goal and the evidence of recovery. The test of that renewed spirit reveals a release and return to precisely what addiction has enslaved -- the ability to live an enhanced life, a heightened capacity for the truth about oneself, to love and accept love, and to experience the courage to be together with a sense of one's own humor and that of others, as well. We speak of "recovering" but don't often name what it is we're in the process of recovering. It should be clear by now that it is our humanity, our human being, that's what.