ANN ARBOR, Mich. -- For decades, recovering alcoholics and those who treat them have incorporated spirituality into the recovery process -- whether or not it's religious in nature. But few research studies have documented if and how spirituality changes during recovery, nor how those changes might influence a person's chance of succeeding in the quest for sobriety.
Now, a new study from researchers at the University of Michigan Addiction Research Center sheds light on this phenomenon. In the March issue of the Journal of Studies on Alcohol and Drugs, they show that many measures of spirituality tend to increase during alcohol recovery. They also demonstrate that those who experience increases in day-to-day spiritual experiences and their sense of purpose in life are most likely to be free of heavy drinking episodes six months later.
"While people's actual beliefs don't seem to change during recovery, the extent they have spiritual experiences, and are open to spirituality in their lives, does change," says lead researcher Elizabeth A.R. Robinson, Ph.D., a research assistant professor in the U-M Medical School's Department of Psychiatry and member of UMARC.. "This effect was also independent of their participation in Alcoholics Anonymous which has a strong spiritual aspect."
The researchers report data from 154 adults with a diagnosis of alcohol dependence or alcohol abuse who entered an outpatient treatment program.
At the beginning of the study, and again six months later, the researchers assessed 10 different measures of the participants' spirituality and religiousness using standard research questionnaires. These included their views of God, religious practices such as prayer or church attendance, forgiveness, spiritual experiences, using religion or spirituality to cope, and existential meaning. The researchers also assessed participants' alcohol use, and problems related to their alcohol use, before the study began and after six months. All of these responses were combined with information about gender and AA participation, and analyzed using statistical techniques.
In all, the study shows, half of the measures of spirituality changed significantly in the six month period, including daily spiritual experiences, the use of religious practices, forgiveness, positive use of religion for coping, and feelings of purpose in life. But the measures that assessed individuals' core beliefs and values about God or religion didn't change. At the same time, use of alcohol decreased significantly, and 72 percent of participants did not relapse to heavy drinking.
The researchers then looked at how changes in spirituality related to the likelihood that a person had relapsed to heavy drinking. Those who had experienced an increase in their daily spiritual experiences were less likely to participate in any heavy drinking, as were those who had experienced an increase in their feeling that there was a purpose to their lives. Changes in the other measures of spirituality were not statistically associated with the likelihood of sobriety.
Robinson and her colleagues write that their results suggest that "proactive and experiential" dimensions of spirituality, rather than cognitive ones, were contributing to the recovery and decrease in drinking in the first six months.
They note that this pattern is consistent with two AA slogans: "Bring your body, your mind will follow," and "Fake it 'til you make it."
In other words, changes in core beliefs and values don't have to occur in order for someone to be more open to spiritual experiences or to take part in more spiritual activities.
These findings suggest that including spirituality of all kinds into the delivery of recovery services for alcoholism may indeed help. Many individual faiths or religious institutions have offered recovery services, and some advocates have suggested that faith-based recovery is most effective for all. But Robinson notes that the spirituality seen in the study was not necessarily a matter of believing in one interpretation of God, or even belief in a God of any kind.
Each individual's own spirituality, and the ability to experience growth in that spirituality, appears to be paramount, the authors suggest. So, each individual alcoholic might do best by searching for a recovery program that best matches his or her existing belief system.
One program that has been shown conclusively to aid alcoholics in achieving and maintaining sobriety is AA, which has spiritual components including invocation of a higher power. The new study, however, shows that the relationship between spirituality and likelihood of recovery was unrelated to whether a person took part in AA or not.
Some alcoholics may derive help from the spiritual aspects of AA, but others may not, says Robinson. "There's more than one way to feed your spiritual self," she notes.
The U-M research team has begun a new phase of research involving people who are taking part in three different alcohol treatment programs, and alcoholics not currently in treatment. This study will follow more than 360 people over three years.
They are also analyzing the data from this 154-person group more in-depth, including looking at how the individuals defined and described their own religious and spiritual preferences and practices.
The study was funded by the Fetzer Institute, which sponsored the initial workshop on spirituality and alcoholism that led to the current study, and by the National Institute on Alcohol Abuse and Alcoholism. In addition to Robinson, the study's authors are Kirk Brower, M.D., an associate professor of psychiatry and executive director of U-M Addiction Treatment Services; James Cranford, Ph.D., of UMARC and the U-M Substance Abuse Research Center; and Jon Webb, Ph.D., formerly of UMARC and now of East Tennessee State University.
Reference: Journal of Studies on Alcohol and Drugs (formerly the Journal of Studies on Alcohol), March 2007, Vo. 68, No. 2, pp. 282-290.