Living in a woodland in deepest, darkest Somerset, our guests certainly get their fill of nature. We don’t deliberately give them demeaning jobs, but being knee-deep in pig shit, or building a compost loo, puts you in direct contact with the earthy realities of life. And reality, as the actress Lily Tomlin once quipped, ‘is a crutch for people who can’t cope with drugs’.
A corollary of that earthy reality is that, instead of being, in the old-fashioned phrase, ‘opium-eaters’, some of our guests eat a healthy dose of humble pie. And humility, as in 12-step AA orthodoxy, is the first step of the cure. Addicts often have a paradoxical combination of low self-esteem and massive ego, so recognising that they are ‘powerless’ over a substance is a vital reminder that they’re not super beings, just precious, weak humans, along with the rest of us.
AA is, of course, a much-debated institution. Founded in Ohio in 1935, it now has more than 2 million adherents and has been the model for dozens of other ‘Anonymous’ movements. Based on mutuality, it has no organisational structure to speak of, and yet it’s often accused of being cultish and controlling. Inspired by the ‘Oxford Group’ of Christians, it has always maintained that addiction is a ‘spiritual malady’ for which the only cure is conversion. Step three explicitly describes handing over responsibility for your recovery ‘to the care of God’. The AA’s ‘big book’ deliberately looks like a Bible, with its blue ribbon to mark a favourite passage. Those in recovery can invariably quote chapter and verse, and at the core of the book is that image of two evangelists — Dr Bob and Bill W — who went out into a darkness to spread the good news.
Research into the effectiveness of AA is notoriously unreliable (partly because of the anonymity that it promises). Recent studies suggest that it is no more or less successful than other behaviour treatments. But because AA was the first, and most famous, treatment programme, its influence on the wider recovery movement has been immense.
Most notably, AA’s notion that alcoholism is a disease — ‘a cunning, baffling and powerful disease’, as the big book puts it — has meant that for decades addiction has been seen in medical terms. This is something addicts yearn to hear, because seeing addiction as a disease allows a degree of self-forgiveness. It suits the medical profession too, because, in the scathing words of the psychiatrist Theodore Dalrymple in Junk Medicine (2007), it creates ‘employment opportunities’ for the ‘therapeutic juggernaut’. It’s easier, he writes with sadness, ‘to give people a dose of medicine than to give them a reason for living’. So heroin-users are prescribed methadone, a heroin substitute famously invented by Nazis, and potentially as addictive and often fatal as the thing it’s supposed to replace. But the medicalisation of addiction also suits politicians. The Nixon administration in the US was the first to flood the market with methadone in 1970 and, ever since then, it’s been seen as a politically expedient substance: not because it reduces addiction, but because it reduces crime.
There are now, however, stirrings of a backlash against the consensus. (...)
To my mind the great drawback of medicalising addiction is that it actually obscures AA’s subtler diagnosis of a ‘spiritual malady’. It’s not, perhaps, surprising that in our secular age the spiritual tag is touted less often than the ‘disease’ one. And yet the degree to which recovery is considered a spiritual experience is evident when reading some of the best books on the subject: Bruce Alexander’s The Globalisation of Addiction (2008), subtitle: ‘A Study in Poverty of the Spirit’; Richard Rohr’s Breathing Underwater (1989), subtitle: ‘Spirituality and the 12 Steps’; or Gerald G May’s Addiction and Grace(2007), subtitle: ‘Love and Spirituality in the Healing of Addictions’.
Even a cynic such as Russell Brand, in his maverick and moving BBC3 documentary From Addiction to Recovery said that rehab ushered in a ‘profound spiritual change’ and that he rediscovered ‘love and compassion’. Abraham Twerski, the American psychiatrist and rabbi, has worked with addicts all his life and he, too, insists on the immaterial, or metaphysical, nature of recovery. ‘I know without doubt that the source of addiction is spiritual deficiency,’ he has written. ‘Irrespective of whether we are religious or atheist, all human beings are spiritual by nature, and spirituality is the cornerstone of our recovery.’
The theory, broadly, is that addiction isn’t merely a physical craving for a substance, but a means by which damaged souls, severed from family, tribal, cultural and spiritual ties, address their sense of being dislocated, isolated and atomised in an atmosphere of superspeed capitalism and acute consumer competitiveness. We’re obsessed with ourselves and what we’ve got. We don’t talk about vocations and callings, but about careers and pay-packets. Being responsible implies a response to something, but we struggle because, in a cultural and spiritual vacuum, we’ve got nothing to which we can respond.
Fixing addiction, then, is much more complicated than weaning someone off a needle or bottle. Treatment needs to be holistic, dealing with an individual in the round. It’s not just about repairing a brain, or a vein, but about repairing relationships and the spirit. It sounds very highfalutin’ and, since we’re not professionals, we don’t really know how to do it. But then, nobody does. There’s no textbook about how to repair the spirit.
by Tobias Jones, Aeon | Read more:
Photo: Kate Keara Pelen
