"While people's actual beliefs don't seem to change during recovery, the extent [to which] they have spiritual experiences and are open to spirituality in their lives does change," said Elizabeth Robinson, Ph.D., a research assistant professor at the Addiction Research Center at the University of Michigan's Department of Psychiatry.

While anecdotal evidence indicates that spirituality plays a role in alcohol recovery, until recently there were few hard data to prove if and how it impacts sobriety.

Now a team of researchers at the University of Michigan Addiction Research Center (UMARC) headed by Robinson have found that many measures of spirituality increase during alcohol recovery. And increases in day-to-day spiritual experiences and sense of purpose in life were associated with fewer episodes of heavy drinking six months later, independent of involvement in Alcoholics Anonymous (AA).

Their report appears in the March Journal of Studies on Alcohol and Drugs.

"I was surprised that there was a relationship between spirituality and a change in drinking independent of AA involvement, because AA involvement certainly impacts spirituality," Robinson told Psychiatric News.

The researchers assessed the changes in spirituality and religiosity (S/R) of 123 adults (66 percent men; mean age 39; 83 percent white) with alcohol use disorders at entry into treatment and six months later. They also investigated whether those changes were associated with drinking outcome. The 10 S/R measures of the participants' spirituality and religiousness, measured with standard research questionnaires, included their views of God, religious practices such as prayer or church attendance, forgiveness, spiritual experiences, using religion or spirituality to cope, and existential meaning. Drinking behaviors were assessed with the Time-line Followback interview. AA participation and attendance were also measured.

In all, the study showed that during the six-month period there were statistically significant changes in half of the measures of spirituality, including daily spiritual experiences, use of religious practices, forgiveness, positive use of religion for coping, and feelings of purpose in life.

But the measures that assessed individuals' core beliefs and values about God or religion didn't change. At the same time there was a statistically significant decrease in alcohol use, and 72 percent of participants did not relapse to heavy drinking. Heavy drinking was defined as five or more drinks a day for men and four or more drinks a day for women. Increases in Daily Spiritual Experiences and Purpose in Life scores were associated with increased odds of no heavy drinking at six months, even after controlling for AA involvement and gender. Changes in the other measures of spirituality were not statistically associated with likelihood of sobriety.

Robinson and her colleagues said that because spiritual practices and experiences increased significantly over time while spiritual and religious beliefs did not, the results suggest that proactive and experiential dimensions of spirituality, rather than cognitive dimensions of spirituality, were contributing to recovery and less drinking during the first six months.

They noted that this pattern of differential changes in S/R experiences and behavior rather than beliefs is consistent with two AA slogans: "Bring your body, your mind will follow," and "Fake it 'til you make it." In other words, changes in core beliefs and values don't have to occur for someone to be more open to spiritual experiences or to take part in more spiritual activities.

Robinson said that including spirituality of all kinds into recovery programs for alcoholism may indeed provide benefit. Many individual faiths or religious institutions offer recovery services, and some advocates have suggested that faith-based recovery is effective for most people. But Robinson noted that the spirituality seen in the study was not necessarily a matter of believing in one interpretation of God, religions, or even belief in a God of any kind (see "Data Highlight Spirituality-Alcohol link").

Each individual's spirituality the ability to experience growth in that spirituality appear to be paramount, the authors suggested. Thus, each individual alcoholic might do best by searching for a recovery program that best matches his or her belief system.

While AA, which has spiritual components including invocation of a higher power, has been shown to aid alcoholics in achieving and maintaining sobriety, the new study shows that the relationship between spirituality and likelihood of recovery was unrelated to whether a person took part in AA. "Some alcoholics may derive help from the spiritual aspects of AA, but others may not," said Robinson. "There's more than one way to feed your spiritual self."

The UMARC research team is further analyzing the data from this 154-person group by looking at how the individuals defined and described their own religious and spiritual preferences and practices. In another study they will follow for three years more than 360 people who are taking part in three different alcohol treatment programs, as well as alcoholics who are not in treatment.

The study was sponsored by the National Institute on Alcohol Abuse and Alcoholism and the Fetzer Institute, whose mission is "to foster awareness of the power of love and forgiveness through research, education, and service programs."

An abstract of "Six-Month Changes in Spirituality, Religiousness, and Heavy Drinking in a Treatment-Seeking Sample" is posted at<www.jsad.com/jsad/article/SixMonth_Changes_in_Spirituality_Religiousness_and_Heavy_Drinking_in_a_T/2120.html>.▪