Middlesex University Research Repository An open access repository of Middlesex University research http://eprints.mdx.ac.uk Bjørnå, Saphira (2016) An investigation of the dynamics of the personal will versus a higher power in Alcoholics Anonymous 12-step treatment of Substance Use Disorder. Other thesis, Middlesex University. [Thesis] Final accepted version (with author’s formatting) This version is available at: https://eprints.mdx.ac.uk/21502/ Copyright: Middlesex University Research Repository makes the University’s research available electronically. Copyright and moral rights to this work are retained by the author and/or other copyright owners unless otherwise stated. The work is supplied on the understanding that any use for commercial gain is strictly forbidden. A copy may be downloaded for personal, non-commercial, research or study without prior permission and without charge. 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See also repository copyright: re-use policy: http://eprints.mdx.ac.uk/policies.html#copy Final Project DPY 5360 – 360 Credit in partial fulfilment of Doctorate in Psychotherapy by Professional Studies An investigation of the dynamics of the personal will versus a Higher Power in Alcoholics Anonymous 12-step treatment of Substance Use Disorder Saphira Bjørnå Candidate Number: D12205/21170 Academic Advisor – Dr. Nigel Copsey Academic Consultant – Dr. Piero Ferrucci Summary Plan Name: Saphira Bjørnå Post Currently Held: Psychotherapist in private practice Title of Final Programme: Doctorate in Psychotherapy by Professional Studies Title of Final Project: “An investigation of the dynamics of the personal will versus a Higher Power in Alcoholics Anonymous 12-step treatment of Substance Use Disorder” Composition of proposed programme of study Completed/ Module Module Credit Level To Be completed Passed Title Semester Year DPY Review 20 4 (7) Second 2011 Yes 4421 (RPPL) DPY Research 40 4 (7) Second 2011 Yes 4442 Challenges Practice DPS Project 40 N/A N/A N/A 4443 (PEP) RAL at 40 4 (7) Second 2011 Yes L4 DPY Programme 40 4 (7) Third 2013 Yes 4444 Planning Major RAL at project 120/180 N/A N/A N/A L5 capability DPY Professional 40 5 (8) Fourth 2015 Yes 5547 Knowledge* DPY5360 Final Project 360 5 (8) Fourth 2015 Yes * Four professional knowledge seminars, one Masterclass and one international conference have been attended: Dr.Paola Valerio, Dr.Darren Langdridge, Dr.Maria Gilbert, Dr.David Mair & Dr.Denise Meyer, International Society for Addiction Medicine Conference, Dr.Beverly Costa, Dr.D’Ombraine Hewitt 2 Abstract This Final Project is an exploration of the lived experience of dynamics of the personal will of substance-abusing individuals going through the process of recovery in AA 12-Step self- help groups. The study also investigates the dynamic of the personal will interfacing with the will of a perceived higher power. The research context is within the paradigm of Alcoholics Anonymous self-help groups and their 12-step program. Most research in this field is related to predicting or measuring outcome of treatment in 12-step facilities and understanding the motivation for treatment among individuals with Substance Use Disorder. Few studies are found on the subject of the lived experience of the personal will prior to recovery, during recovery and into late recovery in the context of AA and the 12-step program. Twelve-step groups are available worldwide, in some countries it is the only type of free self-help group available within which recovery processes take place. There is a need for an enhanced understanding of the psychological mechanisms involved with the dynamics of the personal will in the process of recovery in the field of 12-step facilitation and in the field of addiction treatment generally. I chose qualitative research methods and the data were collected through semi-structured interviews. The participants were eight active members of AA with a sobriety time range of 2-17 years, with a mean length of 7.4 years. The analysis and description of the data were conducted using Interpretative Phenomenological Analysis. The results reveal the Will Complex in Substance Dependence (WCSD) of the addicted personality as multilayered, compensatory selves of destructive intents that correspond to the undifferentiated term ‘self-will’ in the AA literature. In the continuum of recovery, the participants unanimously name the appearance of a qualitatively different and constructive aspect of the personal will emerging into conscious awareness at the point of ‘hitting bottom’, as an authentic intent or Core Will. These aspects of the personal will are described in all eight cases to exist in parallel, constituting internal conflict negotiated until the point of surrender to a perceived higher power. From the point of surrender, the core 3 will is described to be in correspondence with the experienced higher will, whilst the aspects of the will WCSD recede or withdraw. The dynamics of the will are concomitant with a shift in belief system and consequently in intents. These paradoxical findings are discussed and interpreted through the theoretical lens of transpersonal psychology. Building on existing knowledge, this study can contribute to deciphering the psychological mechanisms behind the fluctuations of the personal will of substance-dependent individuals in treatment, which in turn can be used to enhance therapeutic interventions in the treatment of Substance Use Disorder. Suggestions for future research include a focus on further exploration into the proposed dynamic and the therapeutic effect of increased consciousness of one’s internal dynamics and their effect on choice alternatives. The conditions leading to the emergence of the ‘core will’ might also be explored to understand how we can facilitate the development of this will aspect to achieve constructive intentionality. The clinical significance of the study is potentially broad as the underlying psychological dynamic of the will of the substance-addicted individual can be incorporated into a variety of treatment approaches from different philosophical standings. This study is also significant and a helpful tool for psychotherapists working in rehabilitation facilities or in private practice with substance-dependent clients. For transpersonal psychotherapists this investigation will offer new knowledge, theory and competence to the complex field of Substance Use Disorder treatment. 4 List of tables and figures Table 1 – The 12-steps Table 2 – Will references in the Big Book Table 3 - Will connotations in the 12-steps Table 4 – Example of emerging themes in transcript Table 5 – Findings table Table 6 – Pilot project and participants feedback Table 7 – Pilot project and co-therapists feedback Figure 1 – Will Diagram Keywords Interpretative Phenomenological Analysis, Alcoholics Anonymous, Addiction, Subjective Will, Will Dynamics, Surrender, Higher Power, Recovery 5 Table of Contents Summary Plan ....................................................................................................................... 2 Abstract ................................................................................................................................... 3 List of tables and figures ...................................................................................................... 5 Introduction ........................................................................................................................... 10 Chapter 1 Literature Review .............................................................................................. 13 1.1 Literature Review – introduction ................................................................................. 13 1.2 Alcoholics Anonymous ................................................................................................. 15 1.2.1 AA background and function................................................................................ 15 1.2.2 Research on AA 12-step attendance and outcome .............................................. 16 1.2.3 Spirituality versus religiousness ............................................................................ 19 1.2.4 Spiritual emphasis in AA ....................................................................................... 20 1.2.5 Change mechanisms in AA .................................................................................... 23 1.3 Surrender ..................................................................................................................... 27 1.3.1 The phenomenon of surrender ............................................................................