Whoever coined the phrase, “there are no stupid questions”, probably never interacted with a Zen Master. I say this because I was recently involved in an interchange with a Zen teacher that, in retrospect, should have resulted in my receiving a hearty whack from him with an awakening stick. As usual, after his dharma talk, he opened the floor for questions, and I asked him about the purpose of the ego – specifically, “if it is so problematic, why is it the norm instead of enlightenment?”
From the Book of Serenity, koan 25, the theme of brokenness is explored:
One day Yanguan called to his assistant, “Bring me the rhinoceros fan.”
The assistant said, “It is broken.”
Yanguan said, “In that case, bring me the rhinoceros.”
I have come to view the years I spent in active addiction as my having been trapped in state of perpetual unconsciousness. That is not to say there was no mental or emotional activity. On the contrary, whether I was getting high or not, my mind raced incessantly and my emotions swung to extremes. I say that I was unconscious because all of this mental and emotional activity occurred without much if any apparent effort on my part as if it all were happening automatically. I have since learned that these reactive patterns were conditioned in me from a very young age and were likely reinforced by both genetic and other biological factors. Initially, alcohol and drugs soothed the perpetual state of anxiety (or, dissatisfaction, discontent, dis-ease, or dukkha, if you will) which pervaded my existence. However, these powerful chemicals ultimately turned on me as they acted upon vulnerable reward, memory, and motivation circuitry in my brain to ensure that I would fall into the vicious downward spiral of addiction. Thus the trap of addiction is complex and composed of myriad personal and environmental risk factors which conspire to form the trance of automaticity. And so, for me the process of recovery has essentially entailed an awakening to the causes and conditions of these automatic reactive patterns. More importantly, it has also been about learning to step out of and interrupt these patterns through cultivation of mindfulness.
Religious Dilemmas and Spiritual Solutions
At first glance, it would seem that gay men with substance use disorder would be ideally matched to AA for post-treatment recovery maintenance or aftercare. As previously noted, gay men are especially vulnerable to the development of a narcissistic personality structure. The philosophy of the AA program is that addiction is essentially a “disorder of the self” characterized by narcissistic traits. The AA program is unique in that it addresses both the underlying pathological personality structure, and the substance use disorder, by way of spiritual transformation. However, when spirituality gives way to overt religiosity – as it often does in AA – the program becomes inaccessible and exclusive, and more foreboding than welcoming.
Narcissism, Addiction and Sexuality
The Narcissistic Personality
Like spirituality, the concept of “narcissism” is one that defies simple reduction. Infused with different meanings by different theorists to explain both normal and pathological conditions, narcissism is one of the oldest and most enigmatic terms in all of psychology (Drescher, 2010; Brown & Bosson, 2001). Origins of the word may be traced to the Greek myth of Narcissus, a young man who was cursed by the goddess Nemesis, fell in love with his own reflection, and ultimately transformed into the flower which bears his name (Beck, Freeman, & Davis, 2003). As a psychological construct, the term first appeared in a footnote to a 1905 essay by Sigmund Freud entitled Three Essays on the Theory of Sexuality (Rubenstein, 2010). Use of the term, however, did not gain prominence in psychoanalytic circles until the late 1960’s and 1970’s at which time it was more fully explicated by object relations theorists. These theorists posited that primary narcissism arises from early childhood when all of the infant’s needs are met, and its self is undifferentiated from that of its caretaker (Beck et al., 2003; Epstein, 1986). In the absence of childhood trauma, the infant transitions from this state to one of a mature, normal self (Van Schoor, 1992). Psychological disturbances arise, however, when there is inadequate caregiving during childhood (Beck et al., 2003; Kernberg, 1982; Kohut, 1972). During this phase of development, called “rapprochement”, there is alternation between exploring moves into the environment and returning to the safekeeping of the caregiver, [but] the child sometimes receives inadequate support in these alternating efforts because caregivers are inconsistent, unavailable, or place self-centered demands upon the child. (Beck et al., 2003, p. 243)
Spirituality, Addiction and Recovery
Until recently, scientists have generally avoided the concept of spirituality in research and in clinical settings (Eliason, Amodia, & Cano, 2006). One explanation for this omission is that spirituality is often mistakenly conflated with religion – the latter being viewed as largely off-limits due to professional ethical considerations (Eliason et al., 2006). The rule of thumb has been that spiritual matters were best left to the realm of the clergy or mystics and kept outside of the boundaries of science.
Last December, when I learned that Clouds in Water Zen Center in St. Paul, Minnesota would host the 6th Annual Buddhism and 12-Step Retreat, I immediately began making plans to attend. It was with great anticipation that I boarded a plane on March 7 and flew to the Land of 10,000 Lakes for the 3-day retreat. What follows are my initial thoughts and reflections from this remarkable event; but first, some background information is in order…
Upon reaching the 8th Step last summer, I had made substantial progress in freeing myself of the closed-mindedness towards spiritual matters that had previously blocked my recovery. Leading up to that point, while working the 3rd Step, I had come across Lao Tzu’s Tao Te Ching and for the first time felt that I could honestly trust the process of recovery — an experience which I wrote about in an essay entitled An Appeal for Pantheism. However, as I moved forward with the work of Steps 4 through 7, further spiritual investigation was forestalled in favor of Albert Ellis’ rational approach to cognitive restructuring. Ellis’ techniques proved practical and effective. But as I began to consider the 8th Step, I was drawn back to the search for a spiritual underpinning from which I could make sense of the amends process which I was about to undertake. It was time for me to face, once and for all, the deep-seeded shame and resentment which had fueled my addiction. And so, the search for a spiritual antidote to these problems resurfaced.
Step 10: Continued to take personal inventory and when we were wrong promptly admitted it.
This award winning film takes viewers into India’s largest prison which also happens to be one of the toughest in the world. The film documents the dramatic change brought about in both inmates and prison guards under the visionary leadership of Inspector General, Karin Bedi who oversaw the introduction of Vipassana meditation into the prison.
Substance abuse prevention is generally thought to involve primary and secondary prevention strategies which target populations that have either not yet engaged in use of alcohol and drugs (though they may be at risk to do so), or those who are in the very early stages of alcohol and drug use (Wilson & Kolander, 2011). Though efforts to prevent the onset of addiction are important, of equal concern is substance use relapse prevention wherein the stabilization brought about during treatment is preserved, and long-term abstinence is promoted.
Unfortunately, it appears that relapse prevention is often viewed as an afterthought of treatment wherein patients are discharged with little meaningful guidance nor provision of resources to aid them moving forward in recovery (McClellan, Lewis, O’Brien, & Kleber, 2000). As experts in the field continue to acknowledge that addiction is a chronic rather than acute condition, the provision of continuing care for those who have completed treatment must likewise adapt to meet this emerging awareness. To this end, the following substance use relapse prevention project, Mindful Living, is proposed.