Addiction is defined as a disease of the body, mind and spirit, but the spiritual aspects of recovery often take a backseat to treating the physical and psychological symptoms. Listen in as noted psychiatrist and addiction recovery expert Marvin D. Seppala, MD, talks with host William C. Moyers about spirituality and healing: practicing honesty, humility and compassion; leaning on others for help; experiencing positive emotions (joy, love, awe); and living with greater purpose and meaning.
0:00:14 William Moyers
Hello and welcome to Let's talk, a series of podcasts produced by the Hazelden Betty Ford Foundation on the issues that matter to us and the issues that matter to you, too. Issues related to prevention, research, addiction, treatment and recovery support. I'm your host, William Moyers, and today I'm joined by the Chief Medical Officer of the Hazelden Betty Ford Foundation, Dr. Marvin Seppala. Marv, welcome.
0:00:40 Dr. Marvin Seppala
0:00:42 William Moyers
Good to have you with us again today because our topic today is one that you know very closely from your own personal journey and also from your expertise as an addiction doc, a psychiatrist, and that's on the fact that addiction is an illness of the mind, and the body and the spirit. And today we wanna talk about spirit. So what does it mean when you talk about addiction as a spiritual malady?
0:01:08 Dr. Marvin Seppala
Yeah I think of it as a disease of the soul. You know, our lives are in the balance. We may die, we may not. And from a neurobiological basis, which we discussed in a neurobiology examination of addiction for a different podcast, we're being driven by a reward center that just wants that drug. And it's been re-prioritized to seek that drug and that high rather than attend to even life itself. It's survival based behaviors are not as important as continued use of the drug once addiction takes hold. And so, we're out of control. We're risking our life to continue drug use and we don't recognize it, we don't stop. And that to me is a soul disease. And the American Society of Addiction Medicine, ASAM, they define addiction as, you know, a disease with mind, body and spirit.
0:02:08 William Moyers
So you mean spirit has a place in medicine? And in science?
0:02:12 Dr. Marvin Seppala
It's one of the wonderful things about working in addiction is you know you can actually talk about that. And it does have a place. And I think in a real important place. Because of that loss of control. So, in the midst of my own use, you know, that loss of control drove me to do things I never had otherwise done in my life. You know, illegal activities and, you know, and all those things that I was so ashamed of that I couldn't even talk about it, so guilty over and so many of us have that, right, when we start to address our recovery. And that stuff keeps us using 'cause it's so painful. And it's getting over those things that allow us to start looking at life so much differently.
0:02:58 William Moyers
0:02:59 Dr. Marvin Seppala
If there was suddenly a magic pill or, you know, let's say that we figured out addiction from a neurobiologic perspective and you could give somebody this pill that would relieve their addiction and their craving and they wouldn't ever use again. Well they'd still have all this shame and guilt and all this stuff about their use and all the things they did, it wouldn't relieve that. And for some people maybe that'd be enough. For somebody like me that wasn't enough at all. That abstinence itself was almost like torture because I could actually think about all those things really frequently, those things that brought me to hate myself. And in recovery, I found means in my own journey through Twelve Step programs to address those issues and it was addressed with a spiritual focus.
0:03:51 William Moyers
So if addiction is an illness of the mind, and the body and the spirit, you eluded to the fact that recovery must address not just the mind and not just the body, but also must address the spirit.
0:04:06 Dr. Marvin Seppala
I believe so, and you know Twelve Step programs do that, Refuge recovery uses a Buddhist orientation to do that. You know a lot of different means of addressing life are spiritual in focus.
0:04:21 William Moyers
Creativity can do that. Exercise can do that. It's whatever you find that you can hold onto that gives you that sense of hope, that sense of purpose, that sense of wellness. That's all spirituality.
0:04:35 Dr. Marvin Seppala
It is all spirituality. And it drives people to change, you know, to try and improve upon their lives in all those spheres and all those areas. And in relationships especially because I think of addiction also as a disease of isolation.
0:04:51 William Moyers
0:04:52 Dr. Marvin Seppala
We don't wanna let anyone know what's really goin' on. I couldn't admit to what was really goin' on and certainly not admit to how I felt and how much I hated myself. And to be able to get past that, that doesn't improve, that sort of healing doesn't happen without interacting with other human beings.
0:05:10 William Moyers
0:05:11 Dr. Marvin Seppala
And addressing, you know, that void in a way that's positive, it starts to establish good relationships and integrity and honesty again. And love. Love itself.
0:05:26 William Moyers
I've often talked about it as it manifests itself in my mind, body and spirit, I always called it a hole in the soul.
0:05:33 Dr. Marvin Seppala
0:05:34 William Moyers
A sense that I wasn't good enough or I needed to be better than. And, what I've discovered in my long recovery journey as imperfect as it's been at times is that I best can fill that hole in the soul with that community of helping other people. Carrying that message and giving back in a way that fills this spiritual void.
0:05:55 Dr. Marvin Seppala
I think of that entering recovery. So I went to treatment at 17 as a high school dropout. And I didn't get sober 'til 19. And when I finally walked into a Twelve Step meeting, there were three guys there. All over 70, I was 18 at the time. And I don't know what they said. You know, I was there out of pure desperation. I had been through treatment, I knew I needed to stop using and I was afraid I was gonna die, I was afraid I was gonna lose this good job I had. I finally kinda got it that this was the crux of the issue. And desperation isn't lasting. And I went back a week later to the same meeting, the same three guys, and I kept goin' on that Sunday morning. And I think I went because of them and the connection they made with me and the hope they offered. And the relationships. I think, you know, that they loved me. They cared enough about me when I could not care for myself and in a lot of ways I think of that as absolute spiritual connection with another human being.
0:07:06 William Moyers
0:07:07 Dr. Marvin Seppala
That gave me something I couldn't see in myself.
0:07:11 William Moyers
And yet when we talk about spirituality, some people can rear back, they're aversed to the whole notion of it because they see it as a requirement that you believe in a Higher Power that starts with the letter G or that somehow you gotta be a church-going, you know, recovering person, or you gotta believe in that Higher Power stuff. It's not about that, is it?
0:07:36 Dr. Marvin Seppala
No, it's not. And it's, you know, the difficulty I think lies in the Twelve Step literature itself. Where they do actually use that capital G, God, and talk about a Higher Power. In a real Christian format. And yet even the founders at that time, and we published a book in regard to how the Big Book of AA called Alcoholics Anonymous was written. And they recognized that to address that program at its earliest sort of point from a religious standpoint would turn off a lot of people. And they wouldn't be able to get the healing that could occur in those programs. And they eliminated a lot of it but they didn't eliminate it entirely. And it was built, you know, it was written back in the thirties.
0:08:28 William Moyers
0:8:28 Dr. Marvin Seppala
So, they thought they'd done a great job. Well now we look at it and we say well there's still all this stuff that makes it look religious. And people that have had difficulties with religion or are agnostic, or atheist, or whatever but just don't want to involve themselves in religion still can be biased by that, and see it as something that eliminates their ability to involve themselves.
0:08:57 William Moyers
0:08:57 Dr. Marvin Seppala
Which is the exact opposite of what the founders intended. They tried to actually eliminate it to allow all those people in with any kind of belief. That something outside themselves could play a role in their lives. And that something could just be the group itself, the other people, you know, those relationships. A way of understanding the world that can, I'm not running the show, and when we talked about the neurobiology of alcohol, we're not running the show. You know this is a disease of the soul part of it's because, you know, we've done things in the course of addiction, driven by this part of the brain, and we've actually done them and carried them out, and can't explain why. Don't have a clue why. And yet now the neurobiology tells us well, of course you did that because you know dopamine's overriding the entire system and you were driven. Your brain was hijacked. And to be able to take that in and understand it in a way that says, yeah, it really wasn't me makin' those decisions and yet, I'm so frightened to go back there. To get involved with another group of people of a like mind that care enough about each other to say you know, hey, if you keep doing this, whatever this is, you may not have to keep using anymore. You know I did it, you can too. And I heard that over and over.
0:10:33 William Moyers
So, you're the Chief Medical Officer of the Hazelden Betty Ford Foundation, you're a psychiatrist, you're a member of the American Society of Addiction Medicine, you've got 42 plus years walking this walk a day at a time. How do you bring all of that together in helping that still suffering alcoholic or that new patient in treatment? How do you bring it all together to help them address their own spiritual bankruptcy or their own spiritual needs?
0:11:03 Dr. Marvin Seppala
That spiritual need I think of as a void and you speak to that. And we need to work to fill that void but we need to do it with a language that people can accept, first of all. And understand in some ways. And there's a new sub-group of psychologists that started a body of research and science associated with the positive emotions. The positive emotions are not positive thinking. It's about, you know, joy, love itself, you know, awe and wonder, those emotional experiences that are so positive in nature. And it looks as though the positive emotions themselves help us heal, they help us think broader, because you think of when you're angry, you know, usually just focused on whatever you're angry on and can hardly think of anything else. Just kinda, can't even get out of the argument with your spouse, right? You know or whatever [laughs heartily] because you're angry. You can't think clear enough to get out of it. And yet, when you're really in a loving interaction, it's like, things just open up. You know we're more creative under those circumstances. And those are two extremes but it kinda makes the point that the positive emotions drive really good things. And in fact brain scanning studies show that when two people are interacting with loving intent for the other person, their brains light up almost identically. And the benefits actually occur in both. Which means that it occurs exponentially as it goes out to all the people they're involved with. Which is a wonderful way of thinking about spirituality that it has to do with these positive emotions that are a result of interactions with other human beings that are really, you know, deep and meaningful.
0:13:03 William Moyers
Particularly relative as it relates to what you said earlier about addiction being an illness of isolation. And so the antidote to it is precisely that.
0:13:13 Dr. Marvin Seppala
Sure is. You know, I'm a little concerned about some of the online means of interacting. Because some of this love research that's being done actually shows that it doesn't work unless you're in proximity to the other person.
0:13:29 William Moyers
0:13:30 Dr. Marvin Seppala
So it doesn't work online, doesn't really work that well by phone, but it does work when you're face-to-face. And, I still think we should be doing online services no question about it, but there's a question I do have about it, you know.
0:13:43 William Moyers
0:13:44 Dr. Marvin Seppala
Is it enough? Is it enough for those people that are so isolated. And somehow we have to make sure that they get that piece, that they get out to meetings or do other things to interact with other human beings whatever that may mean. So that they get that piece. And don't miss out on that and maintain, you know, this isolated existence which I think would contribute to potential relapse.
0:14:07 William Moyers
We only have about a minute left but since we're on this subject and you've talked about your own experience, just close us out here by talking about the evolution of your spiritual journey and its relevance today like it was relevant back 42-43 years ago when you were 19 years old.
0:14:28 Dr. Marvin Seppala
Early on, I was attracted to people who expressed spirituality. And expressed it in a way that was really about how they interacted with other people. They cared about one another. And that's what I wanted. I didn't—only recognized it in retrospect. I knew I was attracted to those folks. I didn't know why until I looked back on it. And yet, there's research about Twelve Step programs actually and how they work. And it says that people will endorse spirituality as the most important part of their recovery, but when they do the research they don't find aspects of spirituality until a few years into recovery, right?
0:15:13 William Moyers
0:15:13 Dr. Marvin Seppala
So it's not like I was suddenly spiritual, it's more like I was attracted to spirituality, and in others, and that's what kept me going and kept me sober and kept me wanting to, you know, improve upon my life and do those things necessary to, you know, get honest and actually go to college, and start taking care of myself physically, and mentally and spiritually.
0:15:37 William Moyers
And today? And today you've done all those things over this time. And what of, and its relevance today, what is it today?
0:15:42 Dr. Marvin Seppala
You know I think what's happened that love itself has become even more important to me. And treating other people well has become even more important to me. And I recognized that all these lessons all along that I got out of Twelve Step programs can be gotten out of any of the perennial philosophies, right? Any kind of spiritual practice. I was able to build upon and use to develop a whole new life as a result of my addiction. And of course it goes up and down.
0:16:15 William Moyers
0:16:16 Dr. Marvin Seppala
You know sometimes I'm doing that and doing it well. I like one of the features of one of the steps in AA that talks about maintaining a constant contact. And to me that's like an ideal that can't be met, how can it be constant? And as a result, moving toward it, that's a wonderful thing. And the more I do it, the better off I live, and the better I feel and I think the better I serve mankind.
0:16:49 William Moyers
And you do serve mankind, and we are so grateful that you have the present that you have, to be able to talk about the science of the mind and the body, the science of the addiction. And also to talk about recovery with that spiritual piece that is as relevant as the science of the mind and the body are. So Dr. Seppala thank you for joining us today and for sharing your own experience in that journey, that one day at a time is added up to a remarkable career and a journey that's very inspiring to all of us. Thanks, Marv.
0:17:20 Dr. Marvin Seppala
0:17:21 William Moyers
And thanks to all of you for joining us for another edition of Let's Talk, a series of podcasts that talks about the issues that really matter to us as an organization and we know matter to you, too. Thank you very much.