Conscientious Recovery: Towards Conscience Therapy for Addiction
Addiction science has advanced significantly but the challenges related to understanding addiction, and dealing with its treatment, are grounds for the continuing search for an effective holistic therapy – Yordan K. Zhekov explains
Complexities in Defining Addiction
Addiction is a multi-dimensional concept which requires a comprehensive analysis, an accurate understanding and effective treatment applications. The scope of this article is not to engage in scholarly debates but instead to draw on them in order to highlight tensions between the fundamental characteristics of the concept. One of the historical struggles with understanding addiction comes from the consideration of its nature as either illness or choice.
Illness or choice
Addiction as illness assumes that there is a genetic predisposition or some inherited physical impediment which, combined with suitable environment and lifestyle, lead to the dependence. The illness overtakes all dimensions of the individual’s life in spite of will, desire or choice. The latter is important to consider if addiction is treated as a matter of willful behaviour based on desire and lifestyle. According to this view the responsibility of undertaking this way of life rests upon the individual. If addiction is an illness it is beyond the will of the individual.
Conscious or automatic
Other approaches to addiction are related to its dynamics. The pattern of addictive behaviour being engaged is managed by the person’s conscious decisions or is a repetitive, automatic response to internal and external cues. The consequences of these two views may predict the possibility to interfere, or not, with the cycle of addiction.
Diagnostic criteria or unique disposition
Defining addiction is of crucial significance to the diagnostic criteria. The latter depends on precise guidance and characteristics. The importance of the criteria for understanding addiction is vital but when holistic treatment is in view tensions arise. The diversity of human character and personality exceeds any diagnosis and may diminish the latter to labelling.
All of the above
Finally, addiction is so complex that it may not do justice to its nature to define it only from a particular angle. A more holistic approach is to include all of the above aspects when considering the topic of addiction and its treatment. The latter is dependent on the definition of addiction and when a narrower approach is undertaken certain aspects of the treatment are over-emphasised. This leads further to lack of unity between different treatments.
Overemphasis and lack of unity in addiction treatments
There are various treatment approaches to addiction and it is beyond the scope of this article to attempt to deal with many of them. I will though attempt to highlight the diversity of some fundamental treatments and their over-emphasised characteristics.
Motivational interviewing – individual resourcefulness
One of the effective treatments of addiction is motivational interviewing. Its main presupposition is the internal resourcefulness of the individual. When this is engaged effectively through intervention the positive impact on recovery is imminent.
12 Step facilitation – powerlessness and spiritual empowerment
The long history of the 12 Step facilitation is a clear indicator of its effectiveness. Its main assumption is the powerlessness of the individual to overcome the addiction. This state is to be understood, acknowledged and resolved through an external empowerment based on spiritual enlightenment, by a higher power.
Cognitive behaviour therapy – emphasis on cognition and behaviour
Cognitive behaviour therapy stresses both cognition and consequent behaviour. It engages with the person’s biases, deals with inadequate beliefs and tackles behavioural responses. Modified beliefs lead to corresponding behavioural responses which formulate progressive recovery.
Mindfulness – emphasis on non-judgemental present experience
This spiritual construct of treatment is defined through comprehension of one’s present reality with a non-judgmental attitude. The absorption of the present through self-realisation shapes one’s internal change and develops recovery.
Diverse emphasis impacts holistic recovery
These treatment approaches highlight different aspects of recovery through their diverse emphases. However, the latter undermines unity and challenges the holistic treatment and recovery of the individual. I suggest that such a holistic approach may be achieved through understanding the concept of conscience and its role in addiction and recovery.
Conscience and its appeal to holistic recovery
Conscience is historically and theoretically a very rich concept which traditions derive from philosophy, psychology, biology, sociology and theology. Some may consider conscience to be a very elusive phenomenon and as such to be regarded as an inadequate contributor to the present discussion. I would attempt to prove that it is conscience which may adequately facilitate an understanding of addiction and its treatment.
Defining conscience – formation of a personal moral framework
Conscience is the capacity to manage a personal moral framework shaped through a belief system and engaging cognition, emotions, attitudes, behaviours and strivings. Morality is defined through the principle of reciprocity: to treat others as one expects to be treated. Hence conscience guides one’s moral behavioural responses and through reflexivity the emotions of guilt and shame provide an affective feedback to the failure of these responses. Conscience itself requires a balanced belief system in order to achieve an adequate moral framework and to be able to apply it and maintain it accordingly. Such a belief system may be considered in spirituality. Healthy spirituality in a nutshell is a relationship with the divine, God, which provides a loving environment of individual growth and as such depends on the divine characteristic of unconditional love.
Defining recovery – attitudinal – requires transformation of views, believes and habits
Recovery is difficult to define. If addiction is understood as a state of perpetuate entanglement resolving in degradation of self and life, recovery is to be viewed as a complete transformation of both self and life. This profound transformation is to begin from inside with the empowerment of one’s conscience.
Integrating conscience into recovery
Transformation from the state of addiction to the state of recovery is the goal of all treatment methods. Transformation requires a dramatic holistic change of cognition, emotions, behaviours and strivings. Conscience nature comprises all these four areas and if significant change is observed between conscience in addiction and recovery it may be considered that conscience plays a crucial role in transformation. Evidence is provided through a qualitative research of twelve personal narratives.
Studying conscience through personal narrative
The research I completed (Zhekov, Y. K. . Conscience in recovery from alcohol addiction. OR: Resource Publications.) provides evidence of the state of conscience in addiction and recovery. The narratives reveal that conscience during addiction is undesirable, suppressed and deadened. This state of conscience is underlined by character vice and entrenched addiction. The narratives reveal that a profound spiritual transformation revives and empowers conscience. The nature of this spiritual transformation in most of the narratives is described as a personal divine encounter highlighted by unconditional love and acceptance with profound nature and remarkable positive results. Conscience after the transformation leads to moral choice, virtuous character and robust recovery.
Empowering conscience through spirituality
The evidence shows that spirituality is an essential catalyst of conscience nature and functioning. The nature of this spirituality is relational. It facilitates a divine encounter which has a dramatic positive impact on the individual. The divine character is vital, revealing unconditional love and acceptance which lead to regeneration, reconciliation and forgiveness. The relationship resolves the guilt and shame derived from the failure to fulfil one’s moral framework. Hence it is through this spiritual relationship that conscience is to be maintained in a functional and balanced state.
Towards conscience therapy
Conscience provides a new dimension in understanding addiction and recovery. Its significance demonstrated earlier shows that its study and integration into treatment will be contributory. Potential novel therapeutic formats are considered historically and theoretically.
History of conscience therapy
The importance of conscience as an interventional tool emerges historically within a spiritual revival movement which stresses moral assessment, faith in Christ and a transformative relationship with God. Treating conscience occurs in a traditional psychoanalytic therapy targeting empathic modifications of its critical inputs. Finally, the key place of conscience is observed in more contemporary psychotherapeutic interventions where positive results are linked to practicing healthy spirituality. These examples highlight the significance of conscience in treatment and provide grounds for developing its modality.
Outlining conscience therapy
Maintaining healthy conscience is the goal of conscience therapy. This state of conscience is possible to achieve through spiritual empowerment. The character of the latter is to be relationally defined by unconditional love, acceptance, reconciliation, forgiveness and moral edification. Spiritual disciplines are to be explored as constructive tools for maintaining recovery and wellbeing. The therapy of conscience is to deal with cognition, emotion, behaviour, attitude and character. It is to facilitate the development of a moral framework which provides adequate decision-taking and leads to progressive recovery and personal growth.
Understanding conscience brings a new and profound outlook into the human psyche. The nature and functioning of conscience have an all-inclusive impact. This resolves the tensions and integrates the multi-dimensional understanding of addiction and the diverse treatments’ emphasis. Therefore, I propose the development of a new theoretical model for holistic addiction treatment – Conscience Therapy.