An Integral Approach to Substance Abuse: Body, Mind, and Spirit

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February 20, 2013 by Dr. Bob Weathers

I just had opportunity to read the following article:

“An Integral Approach to Substance Abuse” by a team of authors, led by Diana Amodia, M.D., from the University of California at San Francisco’s Center for Health and Aging. (Published in the “Journal of Psychoactive Drugs” in December, 2005; accessible for free at http://bit.ly/VwxB3d)

The authors make an articulate plea for more comprehensive approaches to treating substance abuse. Specifically, they posit the need for a model which not only addresses biological, psychological, and social needs; but also incorporates spiritual and cross-culturally valid resources.

Their suggested model draws directly on the seminal groundwork formed by decades of writing, research, and reflection by contemporary transpersonal psychologist and philosopher, Ken Wilber. Wilber titles his approach: integral theory.

As the authors summarize (helpfully providing a single-page diagram, applying Wilber to addiction treatment and recovery): every component of our lives may be usefully analyzed from four complementary perspectives, or quadrants. Just as we can examine ourselves from interior (experiential, or phenomenological) and exterior (scientific, or empirical) perspectives, so can we understand our experiences on both an individual level (our own lives and stories) and a collective level (from the vantage point of culture, society, political and economic realities, even group or cultural mythologies and religions).

Now how does all of this pertain to treating substance abuse?

The authors, rightly I believe, observe that most treatment programs focus on only one of Wilber’s quadrants. As but one example, they make mention of the 12 Step programs. Such programs provide great value in their integration of spirituality into the process of recovery (Wilber’s lower-left quadrant, the collective interior). Yet there often is an accompanying disregard, or even negative judgment, of psychodynamic exploration (Wilber’s upper-left quadrant, the individual interior); or also, addressing possible biochemical imbalances best dealt with by informed medical professionals (Wilber’s upper-right quadrant, the individual exterior).

Not only does the authors’ application of integral theory help with such distinctions as the above — pointing toward integrating, rather than excluding, multiple, overlapping perspectives on effective treatment — but they also make a strong argument for addressing political and economic variables which underpin treating vs. simply incarcerating the addict (the latter being neither effective nor necessarily humane).

Until our society embraces a comprehensive, or holistic, treatment orientation such as that suggested here, we can “just say no” till we’re blue in the face…