Getting Sober / Staying Sober


Spiritual Cleansing

Buried deep within the Mile End, an unassuming garage door on Marconi St. was wide open to the elements, yet what lay inside was still shrouded in mystery.

The hypnotic scent of Palo Santo incense overwhelmed my senses as soon as I stepped into the vacuous warehouse. The warm light coming from outside enveloped the visitors as I watched.

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Spirituality in a Rehab in Florida

Some people might be surprised when considering entering a rehab that there is any talk of spirituality, let alone the significant amount of time devoted to concepts associated with spirituality and religion, God, prayer and meditation – a spiritual life !

In truth, spirituality has been at the heart of recovery from alcoholism since the formation of Alcoholics Anonymous, and the subsequent development of all 12-step programs.

The debate about what spirituality is and isn’t, what God means and doesn’t mean has been at the heart of the recovery movement since it started.

Bill Wilson, one of the cofounders of Alcoholics Anonymous, wrote an article once in which he said something to the effect that the phrase he used in step three of the Alcoholics Anonymous programme, God as we understood him, was perhaps the most important thing he had ever written.

It is certainly true that it is key to everyone’s recovery from alcoholism or any other addiction that they have the freedom to choose for themselves what type of God or higher power they want to have in their lives.

Aside from being a very practical freedom, it does in theory avoid the debate about what God does and doesn’t mean and what spirituality does and doesn’t mean.

This is not an academic debate. Most people have a fair amount of baggage, for better or worse about religion, and it is an area that should be treated with enormous sensitivity. Unfortunately it often is not.

A rehab will, for many people, be the first time they are introduced to the concepts of recovery as laid out in the experience of 12-step fellowships such as Alcoholics Anonymous.

A rehab will most likely use an adaptation of the first five steps of Alcoholics Anonymous as the basis for its therapeutic approach to treatment.

There are some rehabs/treatment centres that are very specifically religiously orientated, and this will be made clear in their mandate and mission statement.

A rehab of this type will appeal to certain people, and that is fine for them.

Spirituality is a term that people will use in many different ways. In terms of recovery from alcoholism and other types of addiction, a rehab should use the time available and its therapeutic techniques to introduce the concept of spirituality as being a personal issue, and one that the individual should have a total freedom to explore for themselves.

There is a real danger with this whole issue, that individuals will get very excited about telling other people what they should and shouldn’t believe in and how this should affect their recovery.

This happens a lot in life generally, but in a rehab can be especially dangerous.

This is because the environment in a rehab should be one of safety, hopefully with an absence of pressure, where an individual can explore some of the underlying emotional drives that have fuelled their alcoholism/alcohol abuse.

A rehab does have a real responsibility in this area, as anyone admitted to a rehab will be in many ways be in a very vulnerable situation.

That vulnerability will of necessity be as a result of active alcoholism or other addiction, and a rehab needs to take special care that that vulnerability is respected, and people are given a space to explore their spirituality and what it means to them in their own way.

A rehab like any organisation, can sometimes exploit people for its own good. It will often do this by rationalising that what it is doing is for the good of its clients. In the area of spirituality and religion, a rehab has a special role in helping people understand the freedom that recovery can bring.

A major part of this freedom of recovery from alcoholism/alcohol addiction is the freedom for people to discover what spirituality/religion/meditation and prayer means or doesn’t mean to them.

People who work in a rehab, such as therapists nurses etc need to take special care that their own personal views do not cloud the work they do with clients who come into a rehab seeking recovery.

This is a special area of personal and professional development that these professionals need to beware of. A rehab should have special mentoring or line manager type processes to make sure that this is happening.



A Rehab and Hope

Being able to give someone a sense of hope that is based on reality is perhaps in many ways the greatest gift that you can give to someone. Someone entering a rehab, however grim their situation may be, is likely to have lost most, if not all hope about themselves and their lives.

A rehab, for most people is the end of the road, not the beginning of a new one. An alcoholic will at some point in their drinking probably come to believe that alcohol is the only thing that is really holding them together. Alcohol will give an alcoholic hope.

This may be hope based on an illusion, but to many an alcoholic it is better than their perceived reality. When alcohol gives an alcoholic hope, it becomes a need they cannot let go of. Hence their sense of denial, their need to protect alcohol, and their perceived loss of control of their life.

A rehab, if it is to do any good for either the alcoholic or their families must address two definitive issues. Firstly is to understand that alcohol gives an alcoholic hope. That the journey of progression of alcoholism is not simply about drinking, but is about the sense that at some level an alcoholic believes alcohol is the only thing that keeps them alive.

That is the importance of hope to an alcoholic. A rehab must realise, both at an institutional level and by the attitudes of its staff, that this is the core element or at least a core element of someone’s alcoholism.

The main thing a rehab must do is to allow an alcoholic to own or acknowledge that need or perceived hope that alcohol has given them. A rehab must give an alcoholic space both literally and figuratively to make a transition from the realisation that this is a false sense of hope, to a place where they can begin to rebuild their lives both internally and externally.

This sense of rebuilding is obviously a very long-term process, but one of the main things a rehab can do is to give an alcoholic a sense of hope based on reality. A large part of that depends on an alcoholic feeling safe enough in a rehab to begin to own the reality of their own life.

A rehab must be able to hold a place where an alcoholic can both look back and validate where they have come from, and realise there is a way out, a route to a future life that is better. This sense of a better life based on the reality of understanding, or beginning to understand their alcoholism, is what can genuinely give them a sense of hope.

It is always potentially a bit dangerous to talk about other people’s needs. A rehab needs to address a number of important issues in the recovery process for any alcoholic. What actually gives a person hope may differ hugely between people, but one important element is the realisation that an alcoholic can change their inner world. This realisation, either in a rehab or after someone has left a rehab, is absolutely key.

There are many reasons for this, but one of the major ones is that it will at some level connect them to their own inner voice, their own inner truth. This realisation may come after someone has left a rehab, but the time spent in a rehab can play a major part in contributing to this.

Hope is essential. Alcohol, for many an alcoholic has given them a sense of hope perhaps most of their lives. Many will see going into a rehab as being the final place where they lose hope.

Perhaps one of the most important things a rehab can do is to own that, acknowledge their sense of reality, and begin to point them in a direction that will allow them to own their past, whilst at the same time rebuilding for their future, both internally and externally.


Spiritual development

The idea of spiritual development in relation to recovery from alcoholism/alcohol abuse whether in a rehab or by directly going to Alcoholics Anonymous meetings is sometimes a difficult concept for many people to grasp.

This is because most people who have a fairly limited understanding or experience of alcoholism will see the problem as being that of alcohol, whereas people who work in a rehab, or have experience of having been in a rehab and worked with alcoholics will understand that the real process of recovery concerns a person in someway changing their inner world.

The original members and founders of Alcoholics Anonymous realised that the nature of recovery from alcoholism necessitated a profound spiritual change within the person. What became more difficult to define is what this actually meant.

When people enter a rehab, there is normally a fairly clear tipping point by way of external pressures or problems that may include alcohol and other life issues.

Once in a rehab the person will be confronted with the reality of life in some sense. It is probably fair to say at an alcoholic, through the progression of their illness, will have come to see alcohol as being the solution to their problem not the problem itself.

This is an attitude and approach that anyone who works in a rehab should understand and be sympathetic to.

Many people who work in a rehab in either a therapeutic or nursing or medical role are often recovering alcoholics themselves, as well as having been in a rehab at the beginning of their recovery process.

A person’s spiritual development will be unique to them both at the beginning of the process in a rehab or by directly attending meetings of Alcoholics Anonymous.

These meetings may be held in a rehab itself or outside premises.

When people talk about a spiritual development, they inevitably think that it means becoming a good or better person. In fact the real process around a spiritual development or growth has much more to do with a person’s authenticity than whether they have involved themselves in any type of character building.

The recovery process in a rehab will often focus more extensively on the alcohol than the therapeutic recovery process.

This does vary quite considerably within different types of rehabs, with some being exclusively focused on the early process of recovery, whilst many a rehab will work through an adaptation of the first five steps of Alcoholics Anonymous.

The time spent in a rehab will be seen as a precursor to living life in recovery outside a rehab, and hopefully the rehab will encourage meetings of Alcoholics Anonymous/Narcotics Anonymous.

Many a rehab will actually make it a condition of people spending time in a rehab/treatment center that they attend a specified number of AA/NA meetings a week.

This is something that people need to consider when deciding what type of rehab they want to enter.

It is important not to be frightened by the term spiritual development.

Of itself it is simply a process that will begin in a person once they enter a rehab, or make the decision to enter a rehab, which is of itself an admission that in some way they need help.

What happens when the person leaves a rehab can vary considerably, but time spent a rehab means that seeds will have been sown that hopefully over time will root the person in their own spiritual life.


What is trust in God?

The concept of trusting God begins for most people in childhood, with a sense that it adds a level of safety to the safety that a child hopefully feels within their family.

It is unlikely to be spelt out in detail what this means, but will most likely be a felt sense of trust that is more likely to be seen as an extension of a sense of trust or safety that already exists within the family.

The nation of trusting in God will be reinforced by the by such rituals as night-time prayers, going to church, Sunday school, Bible reading etc.

In other scenarios many families and many parents verge on somewhat of the religious neurotic, and use the notion of God as an image almost to escape their own lack of a sense of safety or the ability to provide an emotionally safe environment for their children. In this context the notion of trusting in God takes on a very different meaning, a more sinister one in affect.

When entering a rehab, as when first attending meetings of Alcoholics Anonymous or Narcotics Anonymous, many people are confronted with the word God, and the implications that this word brings up in them, normally as a legacy of their childhood experience.

A rehab will most likely promote the 12 step programme of Alcoholics Anonymous, which is by its very nature focuses on the world of the spirit and of God.

A rehab will have many different approaches to how it deals with people’s antagonism or outright hatred of religion, or any meaning of the word God.

This will be a huge part of a person’s recovery, not least because many people entering a rehab will feel they have lost their sense of choice about what they do.

If a rehab focuses on telling people that they are effectively need to disempower themselves even more by relying on some sense of God that does not work for them, they will merely deepen that sense of hopelessness that the alcoholic is likely to feel on entering a rehab.

A rehab is likely to focus on the first five steps of Alcoholics Anonymous, although the interpretation of what they mean is often significantly different to that which the AA program actually refers.

What will arise, is the question of what trusting in God actually means, and how an alcoholic can begin that process.

This will inevitably raise the question of what the word God means for the alcoholic, and hopefully a rehab will be sensitive to this and help a person explore the different meanings open to them.

The book Alcoholics Anonymous, on which the Fellowship of AA is based, makes continual references to God, spiritual experience, spiritual awakening etc.

At the same time the book does not try to define what these terms means, but makes it pretty clear that it should be a freedom for the individual to discover what these terms mean to them.

It should be a big part of the function of a rehab to reinforce this freedom, although sadly this is not always the case.

The other thing that the big book of Alcoholics Anonymous continually implies, is that a sense of God or of spirit is primarily to be found within the person themselves rather than externally.

This gets to the whole question of the nature of God etc which is much better left alone, in this context.

A big part of the function of a rehab is to provide a safe environment, where an alcoholic can begin the process of rebuilding their life and their inner world.

Learning to trust in God, primarily means learning to trust in themselves first, and using that as a freedom to discover what God means to them, and what trusting in that God actually means.

A rehab should encourage this freedom, even though it obviously brings a level of uncertainty with it, a position that a rehab might find uncomfortable given its very structured and focused environment.


Quality of life

Hugely important piece of research by Professor Ann Bowling into the measurement of disease specific quality of life scales

Abstract underneath

‘The aim of this volume is to introduce the key literature on the psychometric properties of measures of disease-specific quality of life, including the symptom scales often used alongside them. In addition to updating the reviews published in the first edition of this book, the opportunity has also been taken to include additional scales. These include the Living with Heart Failure Questionnaire; the Heart Failure Questionnaire; the Seattle Angina Questionnaire; the Camberwell Assessment of Need, Quality of Life Enjoyment and Satisfaction Questionnaire; the Quality of Life in DepressionScale; the London Handicap Scale; the Breathing Problems Questionnaire; the Medical OutcomesStudy HIV Health Survey; the McGill Quality of Life Questionnaire; the McGill Nausea Questionnaire; the Support Team Assessment Schedule; and the Kidney Disease Quality of Life Questionnaire.Individualized measures are also included. For example, the Schedule for the Evaluation of Individual Quality of Life and the Patient Generated Index. The final chapter on measurement issuesin the first edition of Measuring Disease has been removed from this edition, as these are coveredmore fully in the author’s Research Methods in Health (Open University Press 1997). ‘

Refernce :

Bowling, A. (1997). Research Methods in Health. (pp. 241–270). Buckingham: Open University  Press.

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Spirituality and Depression

Relationship Between Spirituality and Depressive Symptoms Among Inpatient Individuals Who Abuse Substances

Naelys Diaz

  1.  1. E. Gail Horton
  2.  2. Diane Green1
  3.  3. John McIlveen
  4.  4. Michael Weiner
  5.  5. Donald Mullaney

This study aims to examine the relationship between spirituality and believing in God’s presence and depressive symptoms among 160 inpatient individuals who abuse substances. Findings indicated that both spirituality and believing in God’s presence were significant predictors of depressive symptoms, whereby spirituality was inversely related to depressive symptoms and believing in God’s presence was positively related to depressive symptoms. These findings may have implications for mental health practitioners considering implementation of spiritually based interventions that can develop and strengthen clients’ spirituality.


Counseling and Values

Volume 56,Issue 1-2,pages 43–56,October 2011

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Spirituality and Alcoholism

Research – Spirituality and


This is a piece of research by Stephanie Carroll into the relationship between spirituality and a sense of life purpose as realised through recovery from alcoholism and by practising the 12 steps as outlined in the book Alcoholics Anonymous.T

he research focused on spirituality as realised through step 11 and 12 of the AA program, and drew its conclusions at such. The drawback with this approach, is that it ignores the remaining 10 steps of Alcoholics Anonymous.

The wording of step 12 indicates clearly that the person practising the 12 steps undergoes a spiritual awakening or spiritual experience as the result of practising the 12 steps. Focusing on only two of the steps gives a distorted impression of the recovery process.

The added sense of a life purpose expressing itself through working with other alcoholics could be seen as either a healthy process, in some ways a continuation of a coping mechanism that is inherent in the nature of alcoholism.

Below is a quote summarising the research piece followed by a full reference and link. The research was published in the Journal of Studies on Alcohol and Drugs.

“This study examines the relationship between spirituality and recovery from alcoholism. Spirituality was defined as the extent of practice of Alcoholics Anonymous Steps 11 and 12 and was measured by a Step Questionnaire developed by the researcher. Step 11 suggests prayer and meditation and Step 12 suggests assistance of other alcoholics. Expressed degree of purpose in life was also seen as a reflection of spirituality. It was postulated that the extent to which Steps 11 and 12 were practiced would be positively correlated with the extent of purpose in life reported by 100 Alcoholics Anonymous members. The major findings of this study are significant positive correlations between practice of Step 11 and purpose in life scores (r = .59, p < .001) and between Step 11 and length of sobriety (r = .25, p < .01). Number of Alcoholics Anonymous meetings attended was significantly correlated with purpose in life scores (r = .24, p < .01) and length of sobriety (r = .25, p < .01). These findings suggest that a sense of purpose in life increases with continuing sobriety and practice of the spiritual principles of Alcoholics Anonymous. (J. Stud. Alcohol 54: 297-301, 1993)”

Reference using the Harvard System

Carroll S (1993) “ Spirituality and Purpose in Life in Alcoholism Recovery ‘ Journal of Studies on Alcohol and Drugs, Vol 54, pp 297/301

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