1. Vourakis, Christine PhD, RN

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As the guest editors for this issue put forth, a clear definition and description of the concept of spirituality in relation to addictions has been somewhat elusive in the scientific literature. Furthermore, there is a tendency for lay and other writers to provide recipes or prescriptions for achieving a spiritual state or for embarking on a spiritual path without ever defining or clearly describing the term. Perhaps, it is not definable in the way we have typically defined concepts. It may be best understood by taking note of the subjective reports of those who claim to have had a "spiritual experience" or who describe a "spiritual state of being." Clear examples of this are in the writings and activities associated with the program of Alcoholics Anonymous (AA). The concept is most apparent in AA's 12-Steps, 12-Traditions and in the AA principles and personal stories found within the pages of Alcoholics Anonymous (more generally called the "Big Book" of AA).

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Gregory Bateson in his essay on "The Cybernetics of 'Self': A Theory of Alcoholism" identifies the first two steps of the 12 steps in AA as the first "spiritual experience" in recovery for the alcoholic. He purports that to be conquered by alcohol and to realize this defeat is the essence of this first spiritual experience (Bateson, 2000/1972).


The AA program is uncomplicated by design. To be successful, the program simply suggests that individuals join with a desire to quit drinking, attend regularly, and follow the 12 steps. If the new member does this with sincerity, humility, and an openness to discovery, the potential for a spiritually based recovery path is greatly enhanced. The 12 steps along with the concept of "anonymity" (discussed in the 12 traditions) and the opportunities to learn and practice humility all embody suggestions for following a spiritual path.


Individuals learn to be humble in AA by practicing humility in and outside of meetings. It involves "working" the 12 steps over and over throughout the process of a lifetime of recovery, but it is also evident in other aspects of the program. For example, the concept of anonymity in AA, when consciously applied, propels the member at any given moment to shed the pitfalls of "personality," self-importance, and one's unique status as apart from others. Volunteering in meetings to set up chairs, make the coffee, and share one's experiences and struggles with recovery; reaching out to others; and avoiding being drawn into situations that fan the ego or highlight our outside status are examples of behaviors that reinforce humility and anonymity.


The dedicated AA member is slowly transformed in the program from an individual whose comportment signifies a person who operates (not necessarily consciously) as if he or she was the center of the universe (a nonsystem sense of being separate from the environment) to an individual who views the self as part of a larger whole or as an integral part of the environment. This transformation, in some sense, is perceived as the essence of spirituality, a humbling experience, if you will, which some view as an ecological transformation (Bateson, 2000).


It is my pleasure to introduce our guest editors for this special topic issue of the journal on "Addiction and Spirituality," Dr. P. Ann Solari-Twadell and Dr. Joan Kub. They have collectively spent the last 25-30 years studying, publishing, and speaking on the topics of addiction and spirituality.


P. Ann Solari-Twadell, RN, PhD, MPA, FAAN, is an associate professor at Loyola University Chicago in the Marcella Niehoff School of Nursing where she recently stepped down from the position as Director of the Accelerated Nursing Program. Before her faculty position, she was employed for 25 years at Advocate Health Care (AHC) in Park Ridge, Illinois. For 10 of those years, she worked in addictions treatment. In the last 6 of those 10, she held the position of Director of Nursing Services for Parkside Lutheran Hospital, a specialty hospital for addicted patients within AHC. From 1984 to 1988, she was President of the National Nurses Society on Addictions (since renamed as the International Nurses Society on Addictions). For the last 15 of the 25 years with AHC, Dr. Solari-Twadell held the title, Director of the International Parish Nurse Resource Center. In that capacity, she was the editor of "Perspectives on Parish Nursing Practice," a regular publication of the International Parish Nurse Resource Center. She also coordinated 15 Annual Granger Westberg Symposium's on Parish Nursing and the development of a standardized core curriculum for parish nurses in collaboration with Marcella Niehoff School of Nursing, Loyola University, and Marquette University School of Nursing. This included the preparation of over 65 faculty to offer the standardized core curriculum in over 70 sites in the United States, Canada, and Australia. She is the coeditor of two landmark books on parish nursing: Parish Nursing: Promoting Whole Person Health within Faith Communities and Parish Nursing: Development, Education and Administration.


Joan Kub, PhD, MA, APRN, BC, is an associate professor at Johns Hopkins University School of Nursing with joint appointments in the School of Medicine and Bloomberg School of Public Health. She is a public health nurse and behavioral scientist, with a strong interest in ethics and the relationship of spirituality to health. She obtained an MA in Theology in 2007. Her current clinical practice is focused on classroom prevention programs for youth, with an emphasis on violence, social emotional learning, and substance abuse prevention. She has been a co-investigator on numerous studies examining behavioral health, violence prevention in youth, end-of-life decision making and spirituality, and the impact of substance abuse on violence. She is currently involved with secondary analyses of a prospective study focused on examining spirituality and intravenous drug users. She is active in promoting the integration of spirituality and health through membership on the Johns Hopkins Clinical Pastoral Education Professional Advisory Group and the Bayview Operations Group for Healthy Community Partnership, a community-based effort in promoting health through partnerships with faith-based organizations. In light of their experience and scholarship in the area of spirituality, we are most fortunate to have Dr. Solari-Twadell and Dr. Kub leading this special issue on "Addiction and Spirituality."


We have some changes commencing with this issue of the journal. First of all, we have eliminated the Web Watch and the Resource Watch columns. That content is now combined in a new column entitled Media Watch and edited by Carolyn Baird. Dr. Baird was the Editor of the Web Watch column, and we thank her for keeping us so well informed on relevant material from the World Wide Web. We also extend a special thank you to Dr. Merry Armstrong for her years of service as the Resource Watch Editor. We are pleased to announce that Dr. Armstrong will remain on the Editorial Board.


We also have changes to our Editorial Board. We are grateful and thankful for the many contributions and years of service to those going off the Board: Bettye J. Beatty-Wilson, Mary Haack, Sandra Jaffe Colvett, G. Hussein Rassool, and Sharon K. Schmidt. Their dedication and advisement over the years has helped shape the Journal, and we sincerely thank them for their support. We are pleased to announce and welcome the participation of our new Board members: Nancy Campbell-Heider, Christien Loth, and Steven Strobbe. As the Journal continues to grow and expand, we look forward to the ongoing contributions of the continuing Board and the expertise and advisement of our new members.




Bateson G. (2000/1972). The cybernetics of "self": A theory of alcoholism. In Bateson G. (Ed.), Steps to an Ecology of Mind: Collected Essays in Anthropology, Psychiatry, Evolution, and Epistemology. Chicago, IL: University of Chicago Press. [Context Link]