Buddhism and Addiction Series

(This series was originally written in the Spring 2013 by the Site Administrator in partial fulfillment of the requirements for the Bachelor of Integrated Studies Degree at Murray State University.  The paper was originally entitled Integrating Buddhist Philosophy and Meditation Practice into the 12-Steps: A Spiritual Antidote to Narcissism and Addiction in Gay Men).

The 12-step model of recovery, which began with the formation of Alcoholics Anonymous (AA) in 1935, is one of the oldest and most widely used approaches to treat substance use disorders.  Alcoholics Anonymous is unique in that it claims to offer a spiritual solution for those who suffer from addiction.  However, describing what is meant by spirituality is a tremendously difficult task.  It is a term that carries with it numerous conceptual components and it can take on different meanings depending on a wide variety of internal and external variables.  In the context of AA, due to both historical and cultural factors, spirituality is often expressed in Judeo-Christian terms.  For this reason, AA has been rightly criticized as being far more religious than many of its members are willing to admit.  Though they claim to offer a broad and roomy spirituality, many AA members label as atheists those who hold reservations, doubts, or even disbelief regarding theistic conceptions of God.  According to them, the non-believer must either come to believe, or suffer an alcoholic death.  Though this sort of narrow mindedness is more often born of ignorance than hatred, it nevertheless leaves many who are referred to AA feeling alienated from the fellowship and at high risk for relapse.  Gay men are one such population that could stand to benefit from the AA treatment approach, but for whom the conflation of the religious and the spiritual can create significant barriers to recovery.

According to AA principles, addiction is a spiritual malady which often arises from an underlying narcissistic personality structure that must first be altered for recovery to begin.  As it turns out, gay men are more narcissistic than their heterosexual counterparts, and they are more than three times as likely to develop a substance use disorder as other members of the general population.  The increased risk for addiction and personality disorders in gay men arises as a result of mistreatment and outright hostility directed at them by caregivers, relatives, and peers beginning in early childhood.  Sexual minorities are victimized by gay-bashing on a variety of social and developmental fronts throughout their lives and homophobic mainstream religious institutions are the source of the most vitriolic anti-homosexual rhetoric.  The result is that gay men often suffer serious psychological damage, or narcissistic injury, characterized by internalization of homophobia and high incidence of substance abuse.  However, absent a frighteningly hostile socialization process, homosexuality is a non-pathological, normal human difference.

Nevertheless, given the risk factors at play, it would seem that gay men who suffer from substance use disorder would be ideally matched to AA which addresses both addiction and the narcissistic personality structure from which it springs.  Unfortunately, this is often not the case because AA cannot be divorced from the culture in which it was born and continues to function.  As a practical matter AA has assumed, in many respects, a Judeo-Christian identity which many gay men associate with oppression, hatred, and other forms of homophobia.  And yet, as a theoretical matter, the philosophical approach endorsed by the AA program could be of great benefit to gay men who are often lost in an existential void and in desperate need of spiritual help.  For the purpose of this research, the efficacy of AA’s general spiritual approach to treating addiction is presupposed; while at the same time there will be an effort to realistically assess how the program operates in practice to alienate many in the gay male population who suffer from addiction.  Thus, the objective herein will not be to offer an alternative to the AA program of recovery, but to investigate how and why gay men might incorporate a non-threatening, alternative spiritual system into the 12-step model.

As such, in Part I, Spirituality, Addiction and Recovery, a working definition of the term spirituality will be derived from its conceptual components.  The role that spirituality has historically played in addiction recovery will be explored with particular emphasis on its influence in the foundation and evolution of AA and the 12-steps.  The efficacy of the spiritual approach to addiction recovery will be evaluated and framed as a philosophical design for living.  The conceptual components of spirituality and religion will be examined for the purpose of determining whether these variables may be differentially operationalized.

In Part II, Narcissism, Addiction and Sexuality, the dimensions of the narcissistic personality structure will be described from multiple theoretical perspectives.  The relationships between narcissism, addiction, and sexuality will be explored for the purpose of investigating the interplay between these phenomena – specifically how the socialization of gay men leads to the development of a narcissistic personality structure; how narcissism gives rise to addiction; and how addiction operates to compound narcissism.

In Part III, Religious Dilemmas and Spiritual Solutions, the religious elements of the AA program are examined from a historical perspective with emphasis on the Judeo-Christian culture in which the early recovery movement began.  Examples of overt religiosity in AA literature, current practice, and doctrine are identified as specific barriers to recovery for some gay men – particularly those who have experienced trauma in the process of socialization and religious abuse resulting in internalized homophobia.  To overcome these obstacles, it will be argued that gay men could incorporate Buddhist philosophy and meditation practice into the 12-steps as a non-threatening alternative to traditional theism.  Buddhism is less threatening to gay men in part because there are no Supreme Deities to be worshipped; nor does it, in its Western manifestations, take a stance that is proscriptive towards homosexuality.  Furthermore, insight into the Buddhist concepts of anatta, anicca, and karma enhance the primary purpose of the 12-steps which is to collapse the ego by deconstructing the narcissistic personality.  As such, Buddhism and AA philosophy may be integrated in a way that could benefit gay men who are amenable to a spiritual approach to addiction recovery, but averse to Western religion.

Finally, a number of remaining open questions are presented as points for possible future research and study.  Implications for treatment are considered.