variables para medir la influencia de lo religioso en los procesos de curación, esta parado desde una visión

teocéntrica, da muchas cosas por sentadas.

Drug and Alcohol Review (r99o) 9, ~59-266

Spirituality: the silent dimension in

addiction research.
The I99o Leonard Ball oration
WILLIAM R. MILLER
University of New Mexico, Albuquerque, New Mexico, United States of
America

Abstract
Researchers currently recognize and incorporate psychological, biomedical, and social determinants in the
study of addictive behaviors. Yet spiritual aspects of addiction and recovery remain virtually unstudied, despite
the fact that spirituality is given central importance in Aleoholics Anonymous and in the lives of many
individuals. Traditional spiritual eoncepts have been relabelled to remove their transcendent dimension, and
addiction researchers have acted as though spirituality plays no role in the lives of those they study.
Consequently an entire elass of potentially important variables is being overlooked. A majority of variance in
addictive behaviors and treatment outcomes remains unexplained, a portion of which might be accounted for
through the study of spiritual dependent, moderator, and independent variables. Behavioural scientists have
begun to aeknowledge the role of complex spiritual, moral, and decisional processes in the addictive
behaviours. Though uncomfortable in some ways for both believers and unbelievers, the seientlfle study of
spiritual processes may improve our understanding of the addictive behaviours, and our ability to prevent and
treat these enduring problems.

To the psychologist the religious propensities of man
must be at least as interesting as any other of the facts
pertaining to his mental constitution.
William James
Introduction
The study and treatment of addictive behaviours have
entered the 'multi' age. We employ multivariate
statistics to analyze multiple measures assessing multi-
modal treatments delivered by multidisciplinary teams.
Territorial chauvinism is giving way to a view of
a d d i c t i v e behaviours as multifaceted problems, influ-
enced by multiple determinants, expressed in a multipli-
city of types rather than a single uniform condition. Any
model worth its salt today has to be 'biopsychosocial'.
This insight is not exactly new. Jellinek's r960
treatise on The Disease Concept of Alcoholism discussed
biological, psychological, and social determinants, and
proposed a typology to distinguish among different
types of alcoholism [i]. The r939 edition of.,41coholics
Anonymous described alcoholism as a disease with
"medical, psychiatric, social, and religious" dimensions
[2, p. I9].
Religious? Whatever happened to this fourth dimen-
sion? Biological, psychological, and social factors are all
well represented in modern scientific theory and
research on addictions, but the spiritual dimension has
been curiously ignored. The degree of researchers'
inattention to spiritual aspects is remarkable and, I
think, unlikely to have occurred by chance (p <0.05).
Modern studies have explored alcohol's effects on the
permeability of cell membranes, addicts' responses to
specific items of personality questionnaires, and the
influence of country music tempo on drinking rate. We
research expectancies, self-image, and defence mecha-
nisms, DNA, enzymes, neurochemicals, and immune
functions, the influence of gender, culture, and advertis-
ing. A few recent voices have called for acknowledg-
ment and exploration of the moral side of addictive

William Miller, PhD, Professor of Psychologyand Psychiatry, Universityof New Mexico,Albuquerque;New Mexico87x3i, United States of
America. Correspondenceand requestsfor reprints to ProfessorMiller.

259
260 I~illiara R. Miller
behaviours [3-5], but serious scientific research on the
spiritual side of addictions is rare indeed. Why have we
maintained such a peculiar research silence on this
topic?
The divorce of body, mind, and spirit
In part, our fragmentation of people and their problems
may have arisen from the increasing specialization of
professionals. We have spent four decades, for example,
debating whether the addictions are primarily biomedi-
cal or psychosocial phenomena, when it is abundantly
clear that both classes of determinants are important.
This polemic is one reflection of the dualistic isolation
of professionals treating 'physical' problems (e.g. physi-
cians and nurses) from those addressing 'mental'
disorders (e.g. psychologists and counsellors).
Whilst biomedical and psychosocial knights have
been jousting, few have championed spiritual factors as
predominant, or even significant determinants of addic-
tive behaviours. The spiritual domain has been further
isolated and separated from both biomedical and
psychosocial professions. As Mansell Pattison observed,
all of these healing functions were once integrated
within a single social role, and are still so united in some
cultures and subcultures [6]. The holistic approach is
not a new, but a very old tradition. It is rather recently
that the domain of spiritual guidance has been socially
and economically isolated from the practice of healing.
Many people, in fact, still seek first the counsel of their
clergy when encountering life problems.
Intersection
The disciplines of psychology and psychiatry are
themselves developmentally intertwined with philos-
ophy and theology. William James, Karl Menninger,
Carl Jung, Gordon Allport, Erik Eriksen, Viktor
Frankl, Lois Barclay Murphy, Lawrence Kohlberg, and
Erich Fromm were all much interested in and con-
cerned with the role of spiritual and religious processes
in human life. Other pioneers of the field were
significantly influenced by religion and seminary educa-
tion, including Carl Rogers, Rollo May, and O. Hobart
Mowrer. More recently, these ties have been explored in
the writings of Scott Peck [7], Allen Bergin [8], Alan
Watts [9], Herbert Benson [xo], and Norman Cousins
[ix], among others.
In pursuit of hegemony, however, the psychological
and medical professions have established a certain
territorial imperative in the healing field, marking their
boundaries not only with licensing statutes but also with
vocabularies. Longstanding spiritual concepts remain in
use, but are recast in new jargon. 'Sin' is rejected in
favor of concepts such as 'alienation' and 'rebellion'.
'Faith' and 'hope' are discussed in terms of 'expectancy'
and 'placebo effects' [i2]. The old Methodist concern
with 'backsliding' has been born again as 'relapsed
prevention' [i3]. The healing power of 'grace' and
'forgiveness' is encapsulated in 'acceptance'. Modern
professionals are concerned with 'personality', not
'character', though a few character constructs such as
'self-control' have escaped renaming [I4]. We live in a
post-Babel era, in which professionals speak in a
confusion of different tongues.
What is missing in these new biopsychosocial
definitions is a sense of transcendence. In every culture
through all of recorded history, at least large segments
of humankind have assumed the reality of a spiritual
dimension that transcends material existence. This
unseen domain is usually but not always personalized,
and the deities worshipped through the ages have varied
greatly in their form and nature. Many people have
described, and continue to describe, direct personal
experiences of God and of transcendence, a topic that
was of great interest to William James [i5] , hut such
experiences are seldom included in modern scientific
conceptions of human problems and their healing. A
key difference between spiritual constructs and their
psychological or biomedical counterparts is the removal
of this transcendent dimension. Modern grace has no
suprahuman source, and faith no transcendent object.
Character and sin must be redefined if there is no
absolute, external standard against which to judge
behaviour as virtuous or wanting.
And this, many may say, is exactly how it should be.
Science and religion do not mix. Since the persecution
of Galileo, scientists have recognized the wisdom of
separating themselves from religion. As Descartes
divorced the body from the soul, thereby clearing the
way for medical progress through the scientific study of
bodies living and dead, so--one might assert--the
behavioural sciences must separate themselves from
matters spiritual. In this way, scientists can proceed with
greater objectivity, unhindered by the blinders of belief
systems.
The fallacy of this perspective has been addressed
in detail elsewhere [8,I6-I7] , and is not a central
focus here. Suffice it to say that whatever the abstract
merits of this argument, scientists (and therapists) do
not and cannot proceed in a vacuum free of values
and beliefs. The canons of science require no suspen-
sion of one's belief system, only a willingness to
question and test it. The perception that one is
operating with total objectivity, unbiased by personal
beliefs, is a dangerous assumption, both in science
and in therapy. My purpose here, however, is not to
attack the rejection of spiritual factors in science, but
to commend their relevance in the study and treat-
ment of addictive behaviours.

Spiritual variables
Reasons for interest
My central thesis here is that an entire class of
potentially important variables is being overlooked in
current research and (to a lesser extent) practice in the
area of addictive behaviours. These are spiritual
variables. By 'spiritual', I refer to transcendent processes
that supercede ordinary, material existence. This in-
cludes, but is not limited to, systems of religion. The
easiest examples are those which involve relationship to
a God, deity, divine presence, or higher power. Certain
religious and existential questions [i8], however, also
involve this transcendent dimension without necessarily
assuming the existence of a personal deity (e.g. Why am
I here? What meaning or purpose is there to my life?
What happens to me after I die?). James discussed
spirituality in terms of this more general search for
discernment of meaning [i5]. It is important to note
that a scientist (or therapist) need not personally affirm
transcendent reality in order to consider the relevance of
spiritual variables in addictive behaviours and their
treatment. Neither does the measurement of such
variables assert transcendent reality. The scientific
concern is whether a person's disposition on such
variables can account for variance in behaviour.
Herein is one reason for openness to spiritual
variables in the study of addictions. At our present state
of understanding, we are accounting for only a minority
of variance in addictive behaviours and treatment
outcomes through psychological, biological, and social
variables combined. That is, most of the variability in the
onset, process, and outcome of addictions remains
unexplained at present, and we can ill afford to ignore
any class of variables with potential explanatory power.
Although we may yet identify that single elusive
psychological, biological, or social variable which drives
the preponderance of variance, our best minds and
measures have not yet unearthed it. In this light, the
existence of an entire measurement domain, largely
untapped in prior research, should at least evoke
curiosity. In the quotation opening this paper, William
James argued that human spiritual processes should be
"at least as interesting" to psychologists as other
determinants of behaviour [i5].
A second reason for interest is that both our clients
and our colleagues have pointed to the importance of
spiritual processes in addictions. The essence of Alco-
holics Anonymous (AA) is unambiguously spiritual [2].
Alcoholism is described in AA as a fundamentally
spiritual problem (e.g. self-centeredness and resent-
ment), which is also influenced by psychological and
physical factors. The official account of 'how it works',
manifested in the familiar 'twelve steps', emphasizes
acts such as turning to God, taking a personal moral
inventory, confessing and making amends for past
Spirituality 26x
wrongs, praying, living by spiritual precepts, and
reaching out to others. That is, spiritual variables are
described as lying at the core of addiction and recovery,
within a movement that boasts more than a million
members in tens of thousands of groups spread over a
hundred countries. It seems, in fact, that the question in
the minds of the founders of AA was not whether
spiritual factors are important in recovery, but rather
whether it is ever possible for alcoholics to recover on a
non-spiritual basis, without the help of a higher power
[2]. Despite the current lack of objective scientific proof
for AA's efficacy [i9] , one cannot discount its social
success and influence. The tenets of this major
movement clearly assign central importance to spiritual
processes, and could yield testable hypotheses in this
regard.
Interest in essentially spiritual processes within
addictions has not been limited to believers and
proselytizers, but has extended to distinguished behav-
ioural scientists of the field. Orford has called for "a
consideration of the role of higher-order attitudes and
values, and hence of 'spiritual' factors in behaviour
change," and asserted that, "The moral aspects of the
appetitive behaviour change process have been insuffici-
ently acknowledged" [-20, p. 29i j. In discussing addic-
tions, David Premack asserted "that the individual has a
conscience--a set of beliefs that prohibit certain
acts--and further, that the discovery that one is
engaged in behaviour that makes one a member of a
prohibited class can be acutely humuliating" [2I, p.
Izz]. Hunt & Matarazzo similarly discussed the role in
addictive behaviours of volitional and wilful decisions,
impacted by larger value systems. "The phenomena are
there. We would rather avoid the issues involved, but we
will accept the risk rather than brush the behavioural
phenomena under the rug" [22, p. 84]. The constructs
being discussed by these scientists are moral processes,
which may or may not involve a transcendent dimen-
sion. Morality, in this sense, involves a higher-order
value system of right and wrong, which guides behav-
iour and affects social contingencies. Spiritual perspec-
tives typically include such a system of morality, and
may further perceive a higher transcendent source or
authority behind these values.
The expressed views of these behavioural scientists
point to yet a third reason for interest in processes that
are usually regarded as 'spiritual'. The kinds of change
sometimes reported by members of Alcoholics Anony-
mous do not resemble the familiar successive approxi-
mations of learning theory. The experience of Bill
Wilson, co-founder of AA, was sudden, dramatic, and
life-changing. In his personal account he reported that
he was "catapaulted into what I like to call the fourth
dimension of existence. I was to know happiness, peace,
and usefulness, in a way of life that is incredibly more
wonderful as time passes [2, p. 8]. Dr Silkworth, a key
262 lP'illiam R. Miller
physician in the early history of AA, described similar
"vital spiritual experiences" in the lives of other
alcoholics before the founding of AA: "To me these
occurrences are phenomena. They appear to be in the
nature of huge emotional displacements and rearrange-
ments. Ideas, emotions, and attitudes which were once
the guiding forces of the lives of these men are suddenly
cast to one side, and a completely new set of
conceptions and motives begin to dominate them" [2, p.
ZT]. Such stories are common, though not the experi-
ence of a majority, among the members of Alcoholics
Anonymous. They stand in sharp contrast to the gradual
change model that typically guides psychological theory
and practice.
One could, of course, discount such stories as
anomalies or fabrications, though there is no scientific
reason for doing so. An alternative is to consider the
possibility that there is another type of transformation
that can occur in the lives of addicted persons, which
does not seem to obey the ordinary rules of behaviour
change as we understand them. Such change looks more
like an abrupt about-face than a learning curve. It seems
more decisional than habitual, relatively sudden and
discrete, and it often (though not always) is manifested
in an apparent and broad reorganization of behaviours,
attitudes, and values. Such changes are not unknown in
behavioural science. They have been described by
psychologists [2o-221, and occasionally documented in
considerable detail [23]. Indeed, current theory and
research are consistent with a view that there are at least
two systems of behavioural control that are relatively,
though not wholly separable [I43. At present, we seem
to have a good understanding of some of the determi-
nants of the more gradual, habitual, automatic control
system. Some advances have been made in describing a
separate memory system that is more controlled,
effortful, and intentional. But in comprehending the
kind of abrupt behaviour change described earlier, we
are kindergarteners.
In the spiritual domain, by contrast, such about-face
change models are familiar and ancient. The Greek
word epistrepho was an everyday word meaning to turn
around, and metanoia conveyed a more cognitive
shift--to change one's mind. Early Christian writers
appropriated these terms for a new purpose, not
captured in their original Greek usage, to describe a
total, dramatic turnabout in a person's life, usually based
on a wilful personal decision [241. The resemblance of
this construct of conversion or repentance to the kind of
transformational change described earlier is noteworthy.
Perhaps in spiritual processes we can find better models
and hypotheses for understanding transformational
change [251"
The study of spiritual variables, then, may reveal
important determinants of addictive behaviors, and shed
light on change processes by which people escape from
them. A better understanding of spiritual influences in
etiology and remission could be helpful in conceptualiz-
ing approaches for both prevention and treatment. If
religious commitment, for example, is related to lower
risk for addictive behaviors or more stable remission,
what are the factors that mediate this relationship? How
do these dramatic transformations happen, and what
affects their occurrence and endurance? How are clients'
spiritual understandings (e.g. conceptions of God) and
religious practices (e.g. personal prayer) related to the
course of their problems? To answer such questions,
researchers must venture into the realm of spiritual
variables.
One hypothesis is that there is a reciprocal relation-
ship between spiritual vitality and drug dependence, so
that each inhibits the other. This idea was expressed by
the early Christian writer, Paul [261, and 19 centuries
later by Dr Carl Jung, in a letter to Bill Wilson [27].
Jung wrote, "You see, alcohol in Latin is spiritus and
you use the same word for the highest religious
experience... The helpful formula therefore is: spiritus
contra spiritum" (p. 625). This view suggests that
spiritual variables are not only correlates, but causal
agents of the addictive behaviours.
Types of spiritual variables
Spiritual processes could be incorporated into current
addictions research as three different classes of variables:
(i) dependent variables, (2) moderator or predictor
variables, and (3) independent variables. In each case,
testable hypotheses could be generated regarding these
variables.
Spiritual dependent variables are behaviours that
covary with other conditions or responses. It might be
predicted, for example, that successful treatment of
addictions would be associated with improvement in
spiritual functioning as well as medical status and
psychological adjustment. This might be reflected in
measures of perceived purpose or meaning in life
[I8,28], changes in the structure of values and beliefs
[291, or shifts in religious practices and involvement. A
further hypothesis would be that status or change on
such measures would predict stability of sobriety.
The inclusion of a transcendent dimension might also
require some rethinking of traditional dependent mea-
sures of constructs such as attribution, locus of control,
and self-esteem. Attribution of change to God, for
example--a common view in AA--is neither internal
(self-generated) nor purely external (beyond one's
influence), and depends upon one's conception of God
(e.g. as alo0f versus within the person). Individuals with
strong spiritual and religious belief systems sometimes
have difficulty responding to questionnaires that do not
take the spiritual dimension into account. Consider a

classic Christian conception of God as responsive to
human concerns and actions, and as residing partially
within each person. How does a person with this belief
system respond to questions about self-efficacy, or to
forced-choice items describing the future as either self-
controlled or beyond personal control? The point I wish
to make here is that consideration of clients' spiritual
perspectives may improve our understanding of indivi-
dual differences, and reduce the noise in measuring
other constructs.
This is relevant to a second class of variables where
spiritual constructs could be considered: moderator or
predictor variables. In experimental design, a moderator
variable is one on which the client's status alters the
rdationship between dependent and independent vari-
ables. In addictions research, this is now discussed in
terms of client/treatment matching [30]. The relative
effectiveness of two different treatments for alcoholism,
for example, may depend upon where a client stands
along a predictor dimension. Those with severe alcohol
dependence may respond better to treatment X than to
treatment Y, whereas for those with little or no
dependence the opposite may be true. This yields a
statistical interaction effect on outcome measures
between treatment and predictor variables. This is a
more sophisticated way to study treatment outcome
than the comparative 'horse race' design, pitting
treatments against each other on overall effectiveness
with heterogeneous populations. New emphasis is being
given to such matching effects in addictions treatment
research [3i].
In this light, spiritual moderator variables may be of
value in predicting differential courses of outcome from
alternative treatment approaches. It has been predicted,
for example, that individuals who are more familiar and
comfortable with spirituality would be more likely to
affiliate (and succeed) with AA [32]. Ninety years ago,
William James postulated individual difference charac-
teristics that would mark a person's susceptibility to
rapid, transformational change as opposed to gradual
adjustment [i5]. Clients' religious value systems and
practices may affect the acceptance of particular
treatment goals and strategies.
Spiritually relevant variables may also be simple
predictors of outcome, without regard to treatment
type. The course of change may be affected by a
person's value hierarchy, such as the priority given to
personal pleasure and freedom relative to other values
[29]. Religious adherence has often been found to be
related to lower levels of addictive behaviours, and those
with no religious affiliation have been reported to be
overrepresented in treatment [33,34]. Religious involve-
ment, then, might be expected to be predictive of better
post-treatment adjustment. The opposite hypothesis has
been proposed by Albert Ellis, who asserted that "the
less religious [people] are, the more emotionally healthy
Spirituality 263
they will tend to be" [35, P. 637]. Such rival hypotheses
are testable [8].
Independent variables are those which can be experi-
mentally manipulated to study their effect on measur-
able outcomes. Spiritual independent variables, then,
represent a third way in which the role of spiritual
processes in addictions could be conceptualized and
investigated. The hypothesis to be tested in this case is
that a particular spiritual process itself impacts the
course of addictive behaviours and their treatment.
Intentional interventions impacting these spiritual pro-
cesses, then, would be expected to alter outcomes.
Both behavioural and biomedical scientists have been
chary of investigating the impact of the spiritual
interventions. Such interventions may lie beyond the
expertise and comfort zone of many researchers, but
clearly they are not beyond investigation. Byrd reported
a medical trial of one of the oldest forms of healing
intervention, Judeo-Christian intercessory prayer [36].
Coronary care patients were randomized to receive or
not receive intensive intercession, in a double-blind
design wherein neither patient nor physician knew
group assignment. Though the groups were identical in
medical status before the experiment, those in the
prayed-for group showed significantly better recovery in
hospital, had fewer complications, and required less
medical support in the form of antibiotics, diuretics, and
ventilation.
Rebecca Propst studied the impact of incorporating
clients' spiritual imagery into cognitive-behaviour
therapy for depression [37]. Clients in her study were
religiously-oriented individuals, who were randomly
assigned to receive cognitive therapy with or without
spiritual imagery. She found that therapy was signifi-
cantly more effective when it incorporated spiritual
content. Interestingly, the religious orientation of the
therapist had no effect~ non-religious therapists were
equally successful in incorporating the client's own
spiritual imagery. Apparently it is not only possible, but
can be advantageous to include clients' spiritual per-
spectives in behaviour therapy [38].
These experimental studies indicate that spiritually-
oriented interventions can impact treatment outcomes.
Neither was analyzed for matching effects, and it may
be possible to identify subpopulations who are particu-
larly responsive to such interventions. Spiritual ap-
proaches have a long history in the addictions field,
through the efforts of Alcoholics Anonymous and the
Salvation Army. It is puzzling that these approaches,
which represent some of the oldest and most prevalent
forms of intervention for addictive behaviours, have
been the subject of so little empirical study. In a report
recommending US priorities for alcohol treatment
research in the i99os , the Institute of Medicine of the
National Academy of Sciences has called for studies of
the long-term impact of AA [39] and of the mecha-
264 tFilliam R. Miller
nisms underlying effective change for those involved in
such groups.
It would be possible to test spiritual approaches as a
'black box', examining their overall efficacy relative to
alternative interventions. More informative results
would likely result from studies examining the processes
of change within such approaches, and their interaction
with individual difference characteristics. One reason-
able approach would be to test the importance of
variables that are assumed within the approach to be
crucial to recovery. Within AA, these are largely
spiritual constructs, which could be operationally de-
fined. To my knowledge, it has never been empirically
verified, for example, that recovery within A A is
dependent upon or promoted by the specific processes
prescribed in the twelve steps. A wealth of testable
hypotheses could be derived from this source alone. One
could predict, from the twelve steps, that recovery would
be enhanced by admitting powerlessness over alcohol
(step ~), believing in and committing to a higher power
(steps 2 and 3), making a moral inventory (steps 4 and
to), confessing past wrongs (step 5), making amends
(steps 8 and 9), praying (steps 7 and ~x), and reaching
out to other alcoholics (step i2).
The big book of A A also points to certain character-
istics of individuals that promote recovery [2]. These
are, interestingly, constructs of character. While psy-
chologists have myriads of measures for personality
traits, we have no established methods for assessing
character constructs such as honesty, humility, patience,
forgiveness, or unselfishness. Such concepts are recog-
nized and employed in everyday human discourse, and
represent key components of recovery within the
framework of AA. At present, behavioural scientists are
ill-prepared to study the spiritual processes, character
shifts, and transformational changes that are regarded as
normative in AA.
Yet nowhere is there a field more ready for harvest, if
one wishes to understand the relationship between
spirituality and addictive behaviours. A A is a mature
and ubiquitous organization. It was founded and
continues to focus on spiritual precepts, which are
specified and empirically verifiable. T h e personal ac-
counts of some members bespeak a type and magnitude
of change uncommon in many treatment settings.
Membership is open and free of charge. There are
substantial obstacles of design and practicality, to be
sure, but the time has come for such research.
Belief and unbelief
Studies of this kind pose different challenges and threats
depending upon one's personal belief or unbelief.
Although a majority of clients profess religions belief,
many therapists and researchers do not [8]. Propst's
findings suggest that at least some therapists can
integrate clients' spiritual imagery regardless of their
own belief system [37], and the same is likely true of
researchers. Yet extremes of belief or unbelief may
involve a dogmatism that precludes either good therapy
or good research where spiritual issues are concerned.
For unbelievers, there is the question of why one
should bother with immaterial constructs. But though
they are immaterial in one sense (i.e. spiritual), it is an
empirical question whether they are immaterial in the
other sense (i.e. of no consequence). Most clients who
present for treatment have some history of religious
belief [8,34], and spiritual concerns and practices
remain important for many. A t present, we lack
adequate knowledge of whether and how spiritual
variables impact the onset, course, and treatment of
addictive behaviours. There is, I believe, more than
enough evidence to warrant curiosity and investigation,
regardless of one's personal beliefs.
For believers, rather the opposite question emerges:
Why bother to try to prove, through relatively weak and
time-consuming methods, what we already know to be
true? This obstacle can be a substantial one, whether the
belief be in a particular religious system or in a specific
treatment approach. A response here is that human
belief is always fallible, and none of us is beyond error or
new learning. T h e advance of medicine through
scientific investigation has been a progressive unfolding
of mysteries, a discovery of elements that contribute to
illness and of processes that promote healing. If we
believe that spiritual processes are crucial and powerful,
we should lift them up confidently and gratefully to the
kind of scientific study that will permit them to be
shared more widely.
At a deeper level, both believers and unbelievers may
fear the consequences of such research. One cannot
contemplate studies of spiritual processes without asking
oneself, 'What would it mean to me if I did find an
effect?' or 'What would it mean if I did not?" Anxiety
over such questions may be one reason for the apparent
consensus between believers and unbelievers that spiri-
tual processes are best left unexamined. Yet can it be
best not to know? Unbelievers may protest that we are
trying to measure the immeasurable, while believers may
liken such investigations to a testing of God, a biting of
the forbidden fruit. Similar obstacles once impeded
scientific progress in many scientific fields, including
astronomy, medicine, and aerodynamics. Bill Wilson
observed that: "Some of the contemporaries of Colum-
bus thought a round earth preposterous. Others came
near putting Galileo to death for his astronomical
heresies... Are not some of us just as biased and
unreasonable about the realm of the spirit as were the
ancients about the realm of the material?" [2, p. 5x].
For me, this seems a field that is fitting, fascinating,
and likely to be fruitful. It is impossible to say, at the
outset, what the harvest will yield. I suspect, on

reflection, that like many couples, psychology and
religion have been divorced because they are so alike.
Psychological researchers and spiritual seekers are both
on quests for understanding and change. Both infer
unseen dimensions. Both realize that there are processes
well beyond our present comprehension, and both push
forward in the hunger to know more. To me, it is a
natural confluence, to bring together our rational
faculties and our spiritual yearnings. In the words of
William James, "We and God have business with each
other; and in opening ourselves to his influence our
deepest destiny is fulfilled" [i5, p. 4o6]. Perhaps, in the
process, we will also discover important new pieces of
the puzzle of addictive behaviours, and new tools to help
those who look to us for healing.
Acknowledgments
The author wishes to express his gratitude to Professor
Nick Heather and the staff of the National Drug and
Alcohol Research Centre (NDARC) in Sydney,
Australia, where this paper was prepared during
sabbatical leave, and also to Mr Malcolm Edwards and
Essington Ltd, for their generous grant to N D A R C
which made his Visiting Professorship possible.
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