Above all, trust in the slow work of God.
Teilhard de Chardin
Early in my medical career, when I began recognizing the life-destroying consequences of addiction in my patients, I fell into magical thinking. I was sure addiction was a bad habit, one that could be fixed by a little will power and a motivating lecture from me.
After I learned that addiction was a disease with a well-established treatment plan, there were still elements of magical thinking. I accepted the standard thinking of the day that a thirty-day treatment program followed by AA and NA meetings was all anyone needed to start on the road to recovery—and stay there.
Today, we know that thirty days sober is often just long enough to create chaos in the brain of an addicted individual. We also know that the true benefits of 12-Step programs come not from mere attendance but from the deepening of spiritual practices to which these programs can lead, such as prayer, meditation, and careful working of the 12-Steps.
Working with my co-author James B., as well as homeless addicted men, I have come to believe that the process of recovery is a slow, long journey, with many stops and starts. The brokenness of body and spirit that James describes so well in The Craving Brain: Science, Spirituality and the Road to Recovery and in his blog posts on this site is neither easily nor quickly repaired.
Uncontrollable craving is a brain injury caused by frequent exposure to high levels of addicting chemicals. The addicted brain is focused on keeping the brain supplied with sufficient levels of alcohol or other drugs to avoid the unbearable agitation of withdrawal. It is never easy to manage an addiction on top of the demands of ordinary life, and addicted individuals develop compulsive strategies and behaviors that further impair the brain’s delicate wiring. In the process, they damage—sometimes irreparably—their personal and professional lives.
How is it possible then to recover from this terrible, circular disorder, with its comprehensive injury to the body, mind, and spirit? How can the rewired addicted brain be rewired again, this time in the service of a healthy and productive life?
The emerging partnership between medical science and spiritual practices provides some important answers. Although there is no magic bullet, researchers are discovering new drugs to help addicted individuals control their craving. These drugs include naltrexone for alcohol addiction and methadone for prescription pill and heroin addiction.
At the same time, medical researchers have documented the critical role that monitoring programs can play in recovery. These programs, which combine drug testing with positive rewards and a severe penalty for alcohol or other drug use (such as going to prison or losing a pilot’s license or medical license) have five-year sobriety rates which exceed ninety percent.
Simple abstinence, however, is never enough to repair the spiritual and relational damage caused by addiction. Like the rest of us, individuals in recovery need spiritual tools that will sustain them for the long-haul, including the difficult tasks of maturation, restoration, and reparation.
Chief among these spiritual tools is participation in a 12-step group that includes membership in a home group (a support group within a meeting), working with a sponsor, and developing spiritual practices such as prayer, meditation, and journaling through the 12-Steps.
In The Craving Brain: Science, Spirituality and the Road to Recovery, James describes in great detail his journey through the 12-Steps. Through a slow process of journal writing and getting feedback from his sponsor, he rewired his brain, this time not for addiction but for recovery. In the process, he experienced a spiritual awakening, a sense of surrender and letting go that enabled him to experience deepening levels of growth and transformation.
The critical role that the partnership between medical science and spirituality can play in recovery is still little understood. And to my dismay, the conversation about addiction—both at the academic and street level—often does not include the latest research about the effectiveness of monitoring programs, 12-Step programs, and spiritual practices. Along with my coauthors, my hope is that The Craving Brain: Science, Spirituality and Recovery will be a part of a true “recovery revolution.” The revolution will bring together science and spirituality to create effective recovery experiences for addicted individuals, and to bring hope to their family members, friends, and colleagues.
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