Discussing Trauma, and Spirituality

Peter Bray

Abstract The following chapter outlines a series of discussions held over a twelve month period with a group of New Zealand professionals. The clinicians are associated with a residential unit and they work with clients who have alcohol and substance . As most of the participants work as counsellors in settings that are influenced by the medical model, they wanted to discover how far their utilisation of, and interest in, spiritual orientations of professional practice might be recognised and developed as an aid to . Naturally they were concerned to explore how they might work in this way in a perceived atmosphere of institutional judgement. As the group freely explored their own spirituality in the context of their professional relationships with clients and the institution, it highlighted the positive benefits of their own non-denominational spirit-led practices. As they discussed addiction as originating in an act of self-medicating survival that supports the individual to overcome behaviours which originate in trauma, they began to consider recovery as a spiritually inspired self-actualising process. Although the initial aim of the group was to explore the significance of spirituality in clients’ presentations and to identify similar principles and beliefs that might underpin their own professional practice, a central theme began to emerge that resonated deeply with the group’s participants. It suggested that the experience of trauma significantly disrupts, or wounds, human beings’ tendencies to actualise, forcing them down less effective pathways to achieving or recovering the capacity to reach higher levels of consciousness. Addiction was therefore conceived not only as a false or unwelcome outcome of the struggle to meaning, a detour in the human journey into actualisation, but also as an adaptive process of recovery. In this context, counsellors saw themselves working with clients in a spiritual quest to reconnect their clients with their lost potential.

Key Words: Addiction, counselling, co-existing problems, competence, growth, mental health, recovery, self-actualisation, spirituality, trauma.

*****

1. Introduction There is an undeniable link between trauma and addiction.1 It has been estimated that there is a higher incidence of alcohol and substance addiction in individuals who have been impacted by stressful life events, such as histories of physical and/or sexual trauma, than those in the general population who have not.2 There is also strong evidence to suggest that individuals with co-existing mental health problems (CEP) use drugs and alcohol to avoid and/or to suppress the

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access 138 Discussing Trauma, Addiction and Spirituality ______distressing effects of trauma and that a substance abusing lifestyle may predispose them to experience further traumatic events.3 As a result, many clients seeking treatment for substance addiction require trauma treatment services and vice versa. Research also suggests that certain types of trauma can cause existential and spiritual crises and that addressing them can improve psychological and behavioural health.4 Spirituality also has a significant part to play both in the prediction of recovery and in improving addiction treatment outcomes. In cases where individuals have recovered successfully and positively maintained their changes, increases in the levels of spirituality between treatment entry and graduation have been noted.5 It also appears that a significant aspect of recovery from addiction, arguably a parallel to post-traumatic processes, is that over time individuals manage behaviour changes that depend upon successfully addressing struggles with existential meaning and the construction of durable narratives that incorporate new beliefs and goals. Thus, interventions that utilise personal spiritual resources can provide support to manage or resolve addiction, traumatic responses and other CEPs.6 Although interventions that involve spiritual beliefs are difficult to evaluate those that incorporate non-denominational approaches are effective at reducing trauma symptoms.7 The following presents the context and points of view of nine therapists at an addictions centre in New Zealand.8 A series of ten ninety minute conversations was facilitated with the group in which they discussed their experiences of trauma and spirituality work with clients affected by alcohol and substance addictions. This chapter incorporates some of their reflections on spirituality and its relevance to their practice.

2. A Special Interest Discussion Group on Spirituality A. The Group

How do we identify spirituality in the medical model? Name it as part of our practice . . . normalise it amongst our peers? We’ve talked about our own spirituality and the client’s and how that comes together in a collaborative therapeutic partnership. Now we are talking about what we do in addictions and how spirituality fits into that. How our spiritual journey has led us to this moment and how we can become a vehicle for our clients’ spiritualties and raise their awareness.9

Coming from an eclectic practice base the discussion group all agree that ‘addiction is a chronic relapsing brain disease characterized by compulsive behaviour’10 that causes psychological and physical harm to individuals, their families and communities. They also recognise that in the process of recovery,

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access Peter Bray 139 ______forms of spiritual rehabilitation are useful in penetrating their clients’ complex psychological defences.11 Almost all of their clients have mental health CEPs, particularly post-traumatic stress, ‘PTSD and Axis II disorders,’12 many derived from traumatic wounding in childhood. Their clients present with active mood, anxiety, personality, and eating disorders, and PTSD characterized by persistent maladaptive symptoms related to the trauma, including blunted emotional responses, hyper-arousal, and flashbacks.13 As our conversations ranged around spirituality, addictions, and trauma it was clear that the group members wanted to examine the impact of their spiritual experiences on professional practice. Their concern to address these issues corresponds to a developing trend in mental health and addictions recovery literature.14 Consequently, discussions involved a good deal of self-reflection that recognised the importance of spirituality in client work.15 The group’s comfort with their own spirituality and enthusiasm for examining spirituality in action was deeply encouraging and contradicted studies where health professionals have been ‘lukewarm’ about spiritual interventions and regarded them as ‘pertaining more to the private than to the public dimension of their own approach to the treatment of “addictions.”’16 Correspondingly, the group was anxious not to be identified or regarded as psychologically similar to their clients in case they might be seen to be contradicting the professional and clinical expectations of their funders. As one group participant put it, ‘How much of ourselves, the person and the clinician, are we to acknowledge and accommodate in our future discussions? I fear disclosing my spiritual side to the institution, to judgement.’ Whilst recognising that using spirituality as an intervention works in their therapeutic practices, ‘It is still an uncomfortable fit with the medical model’ and not an accepted or demonstrable part of their practice with clients.17

B. The Mental Health and Addictions Treatment Centre Over an eight week residential programme the centre works with clients who meet the Diagnostic and Statistical Manual of Mental Disorders definition for substance dependence: ‘a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behaviour.’18 Acknowledging the relationship between substance use and trauma-related mental health problems, clients are those that have committed to being substance-free, and ‘who don’t have healthy environments to grow up in, are unable to make healthy choices, or are afflicted by external traumatic events which have disempowered them.’19

What we are really trying to get to are the behaviours that guide clients’ addictive behaviours. Looking at the cause as well as the effect . . . We don’t often talk about drugs and alcohol but we do

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access 140 Discussing Trauma, Addiction and Spirituality ______talk about behaviour and the things that led to substance use - these are just as much a part of the addictive behaviours as using the substances.

C. Pathways to Recovery Looking for a pathway that both respects the intangible nature of clients’ experiential styles and responds to the expectations and constructions of the medical institution is a genuine challenge. ‘Either we are accused of being too cautious or unclear in our assessments or we only tick the boxes that enable us to be accountable.’ In such cases the difficulties entailed in using value-laden vocabulary like ‘faith’ or having a ‘Higher Power’ are clearly challenging when it comes to completing conventional medical assessment documentation. Counsellors provide a number of structured activities which include regular individual and group counselling, psycho-educational training, skills development, and recovery reviews. Currently, ‘Spiritual and Cultural’20 is a designated reporting area in their clients’ Recovery Action Plan, and the group were particularly interested about how they might tackle this in a more pro-active manner. Previously counsellors had interpreted this quite narrowly with clients and our discussions permitted them to step outside their clinical remit and reinterpret their clients’ ‘church and religious activities in broader spiritual terms.’ Strongly influenced by the medical model of practice they suggested that the only areas where it seemed acceptable to deal with a client’s spirituality were when discussing formal Christian values and Mäori culture, which meant that they had to ‘work covertly with one eye watching our backs.’21 The discussion group provided safe, ‘nurturing and self-care to support each other to safely articulate spirituality within the medical model.’ In conventional 12-step groups the connection between spirituality, substance misuse, and intoxication are well established.22 Likewise whilst these helpers informally accept the inherent wisdom of using spirituality as a tool for recovery, the centre only minimally refers to it by name in documentation.23 Anecdotally, there is resistance here to the 12-step doctrine suggesting that the fellowship’s rigid one-size-fits-all approach does not align with the unique requirements of their clients.24 However, frequently borrowed elements like ‘making amends,’ ‘surrendering,’ and being ‘powerless to your addiction’ are successfully included in the therapists’ work.25

3. Talking About Trauma and Spirituality A. What is Spirituality in Counselling and Addictions Work? The literature suggests a beneficial relationship between spirituality, religion, and recovery from substance use disorders. Also coming to this conclusion the group defined ‘spirituality’ as a relationship or consciousness nested in a larger context of meaning, and through their discussions began to bring together a

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access Peter Bray 141 ______number of concepts previously captured by the American Counseling Associations’ Summit on Spirituality. They described spirituality as an actualising tendency, one that directs an individual ‘towards knowledge, love, meaning, hope, transcendence, connectedness, and compassion . . . creativity, growth, and the development of a values system.’26 However, acknowledging the difficulty, bias, and ambiguity generated by distinctions, and rather than seeking specific definitions, the group chose to surrender personal definitions and to work within those existing traditions already formed by professionals working in an addictions and mental health service roles. Arguably this is a limitation but it also reveals in some measure the participants’ hesitancy in offering a hitherto private aspect of themselves for scrutiny within the potentially judgemental shadow of the medical institution. Constrained by life experiences, knowledge and values, or the particular theories that underpin their practices, and the context and disposition of clients, counsellors and other health professionals generally find it difficult to consider integrating spirituality into their professional practices.27 Studies suggest that although individuals recovering from addictions frequently cite spirituality as a supportive influence, ‘clinicians’ perceptions of their clients’ spiritual needs have sometimes appeared alarmingly inaccurate.28 Similarly in addictions work, clients and their counsellors who bring spiritual, religious, or mystical experiences and beliefs to their work are not always sympathetically received or understood when they coexist with symptoms of substance misuse. Arguably, the language of ‘transformation from addiction to recovery is best explained by recovering addicts themselves.’29

B. Spirituality and Addictions Work Nearly half the discussion group professionals were recovered addicts, and/or had experienced difficult life events or trauma. Although nervous about disclosing the spiritual dimensions of their private and professional lives or being judged severely by their peers, the group agreed that increasing their personal awareness must enhance their capacity to work competently with their client’s spiritual experiences. The group made two overarching assumptions: clients and counsellors bring a level of spirituality to their work; spirituality is a positive resource for clients managing the trauma of addiction.30 Subsequently, the group aimed to explore the ways that they positively admit spirituality into their clinical settings, therapeutic relationships, and practices. They also identified how it impacts upon their work in the institution and conceptualised how their approaches to practice might be integrated into a working model. The ten sessions proved to be a journey of self-discovery; members took spiritual inventories, sought intra-psychic connection, considered spirit-centred interventions, and generously shared spiritual experiences that deepened their

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access 142 Discussing Trauma, Addiction and Spirituality ______working relationships. Alongside deeply moving disclosures, models and interventions that placed trauma and spirituality at their centre, either as mutual or singular outcomes of addiction, as triggers, or as processes of psychological development and personal growth were carefully discussed.31 Raising the point that some trauma or crises leave unexplained and ‘consciously withheld’ experiences, one group member disclosed that she is aware of a permanent parallel dream-like thread of consciousness that accompanies and informs her day-to-day living and her practice like a continuous sense of déjà vu. ‘I am not mad but I have these experiences.’32 This opportunity to bring these ‘aspects of ourselves as professional people’ was warmly welcomed. It was agreed that clients want their counsellors to see them as whole people with resources that inform their wellbeing and provide healing.33 Spirituality as a core component of a client’s life experience, may either be viewed as a positive resource for coping or one that has the capacity to negatively contribute to mental , making it important for the group to ‘to know who we are before we help others to address their spiritual natures.’34 Here a significant point emerged concerning professional training. One of the group stated that she had been traumatically ‘dismembered’ by counselling training had ‘been in recovery ever since . . . Being so fragmented comes with a price but allows us to also be more fully exposed and known.’ Whilst another explained how she ‘knew’ that she couldn’t be a counsellor unless she undertook her own journey. Discussing suicide and other traumatising aspects of her life, she explained that she had ‘had just walked on from . . . I hadn’t done my grieving,’ emphasising there were things that had to be done if she was going to be of use to others. As drug use and spirituality are not antithetical, the group regard their work as a sensitive balancing act that holds quite contradictory notions for both counsellors and clients. For example, in order to fulfil a desire for wholeness, a relationship with Creation, human beings seek sacred and spiritual experiences, and for many spirituality and drug use are not incompatible.35 Spiritual experience may be quickly achieved through the use of substances or through deliberate training. However, personally traumatic and alienating experiences do disrupt these meaningful attachments and subsequently become the drivers for behaviours that support addictions and create further isolation. In short, there is a significant link between the temporary fulfilment of addiction and the desirability of surrendering to spiritual wholeness. Although it was agreed that counsellors do not generally indulge in delusory ‘“benefit-finding” or looking for “silver-linings” where there are none,’ they were wary about ‘rationalising suffering and pain by positively projecting upon client experiences spiritual explanations.’

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access Peter Bray 143 ______C. Admitting Spirituality into Practice The group agreed that as clients and counsellors do not have two dimensional existences a key factor in therapy is how to effectively identify and align spiritual orientation within the therapeutic relationship. It was suggested that spirituality is a relational connection. One counsellor recounted her experience of being with a suicidal client who ‘had lost the ability to carry on,’ and identified her client’s spirituality as a ‘thread that might help her to survive.’ In this case the counsellor’s role was to hold and nurture that fragile ‘piece . . . Until they [clients] are ready to pick it up again.’ Considering the Jungian collective unconscious, another clinician discussed possessing psychological radar that, using intuition or a higher level of consciousness, taps into the ‘energy that permeates everything and everywhere.’36 Another described her intimate ability to receive client data in terms of graphic impressions; ‘I get things [pictures] in my head that don’t belong to me.’ Another counsellor suggested that the spiritual experience of counselling was derived from empathic awareness, whilst another freely introduced the notion of determinism by suggesting that the encounter could be regarded as pre-designed.37 It was agreed that spirituality permeates all practice either as it is introduced by the therapist or provided by the experiences of the client.38 ‘Positioning with our client’s consciousness is about awareness and accommodation’ and ‘expanding our consciousness.’ To regard spirituality as a private area even to counselling would be to ignore or diminish the significance of client belief and the power of their spiritual capacity.39 Reflecting on the group’s carefulness around disclosing spiritual experience, it was assumed that the same reluctance and resistance might be experienced by clients. Although spiritually-sensitive or spirit-centred approaches to counselling allowed group participants to put their ‘spiritual eyes on’ and to ‘feel genuinely more connected’ they confessed to not having had any formal training in working in this way with clients.40 Relying on their own convictions to guide their work, they were critical of ‘linear, clinical, and cold’ training programmes that by omission deny a spiritual dimension of existence.41 In addition they noted with some caution that the influence of addiction , originating in the Kraeplinian model of mental disorders with its bias toward bio-organic causes, holds little regard for spiritual experiences and those that espouse them.42 Participants seemed to have quite independently experienced the restrictions caused by the institutional requirements of a medical framework, being undervalued and feeling vulnerable to professional misinterpretation. An example given of a local psychologist’s removal because of his unconventional beliefs about spiritual guardians was particularly telling and emphasised the impediments to communication caused by a zealously policed and sanitised bicultural and ethical practice. They suggested rather, that the counsellor’s role is to include the spiritual material that clients present, appreciate its positive contribution to healthy mental and social functioning, and learn to recognize when it begins to activate and

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access 144 Discussing Trauma, Addiction and Spirituality ______shape pathology rather than resolving it.43 The group identified their trauma survivors as engaged in an actualising process that develops resilience and includes a growing familiarity with a spiritual component.

They have more experience of distressing circumstances – developed spiritual muscles - and therefore have pushed to the line between the natural and the supernatural . . . they have gone to places that have prepared their psyches to connect with the numinous.

4. Conceptualising Trauma and Spirituality One of the group’s initial aims was to consider a common-sense model of spirit-led practice that corresponds to the clinicians’ experiences of spirituality in trauma and addiction recovery work.44 They began by conceptualising recovery as a survival process that equips the individual to overcome behaviours, in this case addictions, which originate in trauma. Later they incorporated self-actualisation in the survival process and suggested that it is fuelled by spirit and facilitated in a spiritual dimension. Their ideas suggest that trauma significantly disrupts or wounds the human organism’s natural tendency to actualise and creates less effective pathways to achieving or recovering the capacity to reach, higher states of consciousness. Thus the group conceived of addiction as the false or unwelcome outcome of a struggle to meaning in a disrupted journey, and the process of recovery as a spiritual quest to recover and reconnect the client with their lost potential. It was also agreed that even though the identification of spiritual resourcing may be difficult it seems to have a place in the process of recovery likened to a ‘shamanic’ journey beyond trauma.

You have come through the pain. You have come through the experience and you have come back with the word and the knowledge and you know that there is a door – you know that there is a way out. You know the route.

The clinician’s role as a guide is to assist the client in this integrative process of reattachment and realignment ‘so that the journey can continue.’ This rupture is used as a ‘space where informed choices are being made and actions are tentatively taken, disruptions are being challenged, and meaning and learning is happening.’ The group agreed that for some this space was more complicated than for others, ‘I experience the clients here as the more sensitive souls in the world.’ Subsequently, less vulnerable and in recovery, clients find it easier to look back upon their experiences as necessary and valuable, ‘Clients are grateful for their addiction journeys because they can’t hide from the insights they provide about themselves, who they once were, and how to relate again to the world.’ For the client,

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access Peter Bray 145 ______. . . the real struggle is to accept that they will need to be abstinent for the rest of their lives . . . That they can never use substance again as a coping mechanism - is the real trauma.

These counsellors hold the tense space between the institutions of our society and their clinical obligations to honour and work with their client’s experiences. They recognise that the ‘addict’ is not the totality of the client, or merely a broken part searching to fulfil its seemingly insatiable appetites. They understand that there is something greater going on. Human beings have the need to be whole, to be all that they can be and this is only finally resolved in nurturing relationship with others in their communities and through life affirming and meaningful activities. Unfortunately, many recovering addicts return to the places where their traumas began and where their greatest challenge is to continue with their abusers and those they have abused who may need as much help as they do. Nevertheless, in spite of the deficits of our society counsellors and their clients continue to do their work to reintegrate the needy and vulnerable parts of the clients’ with the whole. Together they engage in meaningful relational processes that draw upon profound personal resources to facilitate recovery and transformation. ‘That is spiritual . . . that’s a miracle!’

Notes

1 Center for Substance Abuse Treatment, ‘Anxiety Disorders’, Assessment and Treatment of Patients With Coexisting Mental Illness and Alcohol and Other Drug Abuse. Treatment Improvement Protocol [TIP] Series 9, DHHS Publication No. SMA 95-3061 (Rockville: Substance Abuse and Mental Health Services, 1994), viewed on 6 August, 2014. http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=hssamhsatip&part=A30236; Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA), ‘Mental Health Screenings and Trauma-Related Counseling in Substance Abuse Treatment Facilities,’ The N-SSATS Report, September 30, 2010; Center for Substance Abuse Treatment, Trauma-Informed Care in Behavioral Health Service: Treatment Improvement Protocol (TIP) Series, No. 57 (Rockville: Substance Abuse and Mental Health Services Administration, 2014). 2 Louise Langman and Man Cheung Chung suggest that the incidence falls within a range of 15-55% higher than the general population. Louise Langman and Man Cheung Chung, ‘The Relationship between Forgiveness, Spirituality, Traumatic Guilt and Posttraumatic Stress Disorder (PTSD) among People with Addiction,’ Psychiatry Q 84 (2013): 11-26; Lori Keyser-Marcus, et al., ‘Trauma, Gender, and Mental Health Symptoms in Individuals with Substance Use Disorders,’ Journal of Interpersonal Violence nv (2014), viewed, 29 July, 2014.

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access 146 Discussing Trauma, Addiction and Spirituality ______http://jiv.sagepub.com/content/early/2014/05/06/0886260514532523. 3 Martina Reynolds, Gillian Mezey, Murray Chapman, Mike Wheeler, Colin Drummond, and Alex Baldacchino, ‘Co-Morbid Post-Traumatic Stress Disorder in a Substance Misusing Clinical Population,’ Drug and Alcohol Dependence 77 (2005): 251. 4 Alan N. Baroody, ‘Spirituality and Trauma During a Time of War: A Systemic Approach to Pastoral Care and Counseling,’ Families Under Fire: Systemic Therapy With Military Families, eds. R. Blaine Everson, and Charles R. Figley (New York: Routledge, 2010), 165-190; Peter Bray, ‘A Broader Framework for Exploring the Influence of Spiritual Experience in the Wake of Stressful Life Events: Examining Connections Between Posttraumatic Growth and Psycho- Spiritual Transformation,’ Mental Health, Religion and Culture 13 (2010): 293-30. 5 Adrienne J. Heinz, Elizabeth R. Disney, David H. Epstein, Louise A. Glezen, Pamela I. Clark, and Kenzie L. Preston, ‘A Focus-Group Study on Spirituality and Substance-Abuse Treatment,’ Substance Use Misuse 451/2 (2010): 134-153. 6 Langman and Chung, ‘The Relationship between Forgiveness,’ 12; Lawrence Calhoun and Richard Tedeschi Calhoun, eds., Handbook of Posttraumatic Growth: Research and Practice (London: Lawrence Erlbaum Associates, 2006). 7 Center for Substance Abuse Treatment, Trauma-Informed Care, 104-105. 8 Stanislav Grof, and Christina Grof, eds., Spiritual Emergency: When Personal Transformation Becomes a Crisis (New York: G. P. Putnam’s Sons, 1989). 9 It was agreed that a recording might be made for future/further discussion and dissemination. In the following group notes, extracts, and commentary have been included where appropriate but not specifically referenced throughout the rest of the chapter. 10 Benita Walton-Moss, Ellen M. Ray, and Kathleen Woodruff, ‘Relationship of Spirituality or Religion to Recovery from Substance Abuse,’ Journal of Addictions 24.4 (2013): 224-225. 11 Harold E. Doweiko, ‘Substance Use Disorders as Symptoms of Spiritual Disease’ Addiction and Spirituality a Multidisciplinary Approach, eds. Oliver J. Morgan and Merle Jordan (St. Louis: Chalice Press, 1999), 51. 12 Information confirmed by a local unpublished report, ‘2014 Matua Raki Workforce Innovation Award’:10; Ingo Schafer, et al., ‘Childhood Trauma and Dissociation in Patients with Alcohol Dependence and Drug Dependence, or Both: A Multi-Centre Study,’ Drug and Alcohol Dependence 109 (2010): 87-88. 13 Marian L. Logrip, Eric P. Zorrilla, and George F. Koob, ‘Stress Modulation of Drug Self-Administration: Implications for Addiction Comorbidity with Post- Traumatic Stress Disorder,’ Neuropharmacology 62 (2012): 552-564. 14 Since 2009 the American Counseling Association, the ACA has required its members to satisfy nine ‘Competencies for Addressing Spiritual and Religious Issues in Counseling’ that assist them to develop a practice framework that allows

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access Peter Bray 147 ______them to understand and work effectively with clients’ spiritual and religious lives; J. Scott Young, Marsha Wiggins-Frame, and Craig S. Cashwell, ‘Spirituality and Counsellor Competence: A National Survey of American Counselling Association Members,’ Journal of Counseling & Development 85 (2007): 47–52; The competencies address four domains of counselling practice: knowledge of spiritual phenomena; awareness of one’s own spiritual perspective; understanding clients’ spiritual perspectives, and spiritually related interventions and strategies; Currently, the American Spiritual Ethical and Religious Values in Counseling (ASERVIC) has 6 areas of spiritual concern with 14 competencies. Viewed on 17 May 2014. http://www.aservic.org/resources/spiritual-competencies/; For a British perspective read John McLeod, The Counsellor’s Workbook: Developing a Personal Approach (Maidenhead: Open University Press, 2010); William West, and Spirituality (London: SAGE Publications, 2001), 17-18. 15 Julie Savage and Sarah Armstrong, ‘Developing Competence in Spiritual and Religious Aspects of Counseling,’ Handbook of Multicultural Counseling Competencies, eds. Jennifer A. Erickson Cornish, Barry A. Schreier, Lavita I.Nadkarni, Lynett Henderson Metzger, and Emil R. Rodolfa (Hoboken: John Wiley, 2010), 379-413. 16 Valeria Zavan and Patrizia Scuderi, ‘Perception of the Role of Spirituality and Religiosity in the Addiction Treatment Program among Italian Health Professionals: A Pilot Study,’ Substance Use & Misuse 48 (2013): 1157-1160. 17 The ‘medical materialism,’ articulated by William James as psychology’s inability to fully explain religious experiences, nearly a century later has the capacity to influence therapeutic practice at a grass-roots level. William James, The Varieties of Religious Experience (New York: Modern Library,1929). 18 American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. (Washington: American Psychiatric Association, 2000), 192. 19 Center for Substance Abuse Treatment, ‘Anxiety Disorders.’ 20 Mental Health and Addictions Service, ‘Recovery Action Plan,’ (Unpublished document): 1-5. 21 A majority of the centre’s clients are drawn from Mäori, Aotearoa/New Zealand’s indigenous population. Mäori recognise the physical realm as immersed in the spiritual realm, so wairua/spirituality significantly influences people’s relationships with the living, the dead, and the environment. Fraser C. Todd, Te Ariari o te Oranga: The Assessment and Management of People with Co-existing Mental Health and Substance Use Problems (Ministry of Health: Wellington, 2010); read also, Rangimarie Pere, Te Wheke: A Celebration of Infinite Wisdom (Gisborne, New Zealand: Ao Ako Global Learning New Zealand, 1997); Mason Durie, Whaiora: Mäori Health Development (Auckland: Oxford University Press, 1994).

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22 Herbert Spencer, Appendix II ‘Spiritual Experience,’ : The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism (New York: A. A. World Services Inc., 2001), 568; Ralph L. Piedmont, ‘Spiritual Transcendence and the Scientific Study of Spirituality,’ Journal of Rehabilitation 67 (2001): 4-14. 23 The following may provide a useful context for further discussion on this point: Marc Galanter, Helen Dermatis, Stephen Post, and Cristal Sampson, ‘Spirituality- Based Recovery from Drug Addiction in the Twelve-Step Fellowship of ,’ Journal of Addiction nv (2013): 1-8; Robert Walker, Thodore M. Godlaski, and Michele Staton-Tindall, ‘Spirituality, Drugs, and Alcohol: A Philosophical Analysis,’ Substance Use & Misuse 48 (2013): 1233- 1245. 24 Robert Walker and colleagues analysed four problems that they believe required satisfactory resolution before the applicability of spiritual practices in the 12-step method could be accepted. Walker, Godlaski, and Staton-Tindall, ‘Spirituality, Drugs, and Alcohol.’ 25 The American Psychological Association summarise the steps as a six phase process: 1. Admitting that one cannot control one’s addiction or compulsion; 2. Recognizing a higher power that can give strength; 3. Examining past errors with the help of a sponsor (experienced member); 4. Making amends for these errors; 5. Learning to live a new life with a new code of behaviour; 6. Helping others who suffer from the same addictions or compulsions. Gary R. VandenBos, APA Dictionary of Psychology, 1st ed. (Washington, DC: American Psychological Association, 2007). 26 Geri Miller, ‘The Development of the Spiritual Focus in Counseling and Counselor Education,’ Journal of Counseling and Development 77 (1999): 498- 501. 27 For a more detailed discussion read; Peter Bray, ‘Naming Spirituality in Counsellor Education: A Modest Proposal.’ Special Issue on ‘Counsellor Education in Aotearoa New Zealand,’ New Zealand Journal of Counselling, (2011): 76-97. 28 Atheistic denial of sacred realities, and a defensiveness in their presence and usage, a determined rejection of all but one’s own authentic spiritual path without recognising or appreciating the diversity of others, or an inability to accept that individuals may construct their own spiritual meanings might lead to a view that spirituality is beyond the purview of the counselling professional; read, Brian J. Zinnbauer and Kenneth I. Pargament, ‘Working with the Sacred: Four Approaches to Religious and Spiritual issues in Counselling,’ Journal of Counseling and

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Development 78.2 (2000): 162-171; Heinz, et al., ‘A Focus-Group Study on Spirituality,’ 134-153. 29 Mary Hansen, Barbara Ganley, and Chris Carlucci, ‘Journeys from Addiction to Recovery,’ Research and Theory for Nursing Practice: An International Journal, 22.4 (2008): 256-272. 30 West, Psychotherapy and Spirituality; Bray, ‘Naming Spirituality,’ 76-97. 31 Developed from a model of post-traumatic growth proposed by Lawrence Calhoun and Richard Tedeschi and combined with Stanislav and Christina Grof’s Holotropic framework of psycho-spiritual growth. Bray, ‘A Broader Framework,’ 293-30. 32 Ideas that corresponded perfectly with Ronnie Janoff-Bulman’s work on shattered assumptions, Ronnie Janoff-Bulman, Shattered Assumptions: Towards a New Psychology of Trauma (New York: Free Press, 1992). 33 Eugene W. Kelly, ‘The Role of Religion and Spirituality in Counselor Education: A National Survey,’ Counselor Education & Supervision 33.4 (1994): 227-237. 34 James M. Nelson, Psychology, Religion, and Spirituality (New York, NY: Springer 2009); Harold G. Koenig, ‘Research on Religion, Spirituality, and Mental Health: A Review,’ Canadian Journal of Psychiatry 54.4 (2009): 283; Johanna Leseho, ‘Spirituality in Counsellor Education: A New Course,’ British Journal of Guidance & Counselling 35.4 (2007): 441-454. 35 Christina Grof, The for Wholeness: Attachment, Addiction, and the Spiritual Path (New York: HarperOne, 1993). 36 Pavel Rican and Pavlina Janosova, ‘Spirituality as a Basic Aspect of Personality: A Cross-cultural Verification of Piedmont’s Model,’ International Journal for the Psychology of Religion 20.2 (2009): 2-13. 37 Spirituality is at the centre of Carl Rogers’ conceptualisation of the empathic relationship and his core counselling conditions permit the counsellor to respond to the client’s deep need for universal attachment and tendency to actualise; Carl R. Rogers, A Way of Being (New York: Houghton Mifflin, 1995), 134. 38 West, Psychotherapy and Spirituality. 39 Carl Rogers, confesses that he had ‘underestimated the importance of this mystical, spiritual dimension.’; Rogers, A Way of Being, 130. 40 Keith Morgen, Oliver J. Morgan, Craig Cashwell, and Geri Miller, ‘Strategies for the Competent Integration of Spirituality into Addictions Counseling Training and Supervision’, Counseling Outfitters, (2010); 1-10. Viewed on 12 August 2014 from http://counselingoutfitters.com/vistas/vistas10/Article_84.pdf. 41 West, Psychotherapy and Spirituality. 42 Galanter, ‘Spirituality and Addiction,’ 287-288. 43 Koenig, ‘Research on Religion,’ 289.

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44 The group were presented with a draft process pathway to recovery that originates in trauma and continues into developing post-addiction opportunities. Linear in presentation the pathway is a complex synthesises drawn from the author’s earlier work; Peter Bray, ‘A Broader Framework.’

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Acknowledgements

I would especially like to thank my colleagues whose permission, support, transparency, and enthusiastic participation in our Spirituality Special Interest Group has made this chapter possible. You do more than you know, and your knowing is rich with common-sense and caring.

Peter Bray is a Senior Lecturer in Counselling in the Faculty of Education and Social Work at the University of Auckland in New Zealand. He has been widely published in scholarly peer-reviewed journals and has recently edited a number of books that seek to positively reframe the institutional position and treatment of individuals exposed to crises and to trauma. His current research considers the

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access 152 Discussing Trauma, Addiction and Spirituality ______relational and spiritual dimensions of experience in counselling for both the practitioner and the client.

Peter Bray - 9781848883727 Downloaded from Brill.com09/26/2021 05:10:45AM via free access