An Integral Approach to Addiction

Dr Stirling suggests how it would be possible to apply integral philosophy to the context of addiction treatment and attempt to further reconcile the approaches to addiction sciences with the latest advances in humanist research.

Are You Operating at Your Optimum State of Being?

The Evolution of Man and Addiction

The twelve-step program is a well-established method for treating addiction, based upon a holistic philosophy of human growth. It seeks not just to repair sick people, but to rebuild them from the ground up. As such, it is comparable to the latest philosophical approaches to so-called “integrated” living, which draw connections between individual growth and the development of humanity as a whole.
Integral Theory
The world’s leading physicists are still engaged in the search for a viable system that can unify Einsteinian and Quantum physics - the so-called “theory of everything”. Philosophy, in recent decades, has already made great strides towards achieving a comparable feat: the unification of western models of human development with those propounded by the schools of eastern mysticism.
Since the communications revolution, philosophers have had to grapple not with a dearth of research, but with an infinitude of information. Everything that one could possibly wish to know about stages and states of consciousness can be known and, with self-study, verified. The problem lies in finding the unifying patterns and processes which underlie the entire human condition.
One of these patterns, or rather meta-patterns, is the fractal, crystalline property of reality; the alchemist’s assertion that “as above, so below”. That is to say that the same types of phenomena can be observed across scales of ontological depth. This principle is already greatly utilised in chaos theory and in the art of computer modelling.
Nature remembers, and if the laws of physics, chemistry, and biology are her habits, novelty is her hobby
Certain structures and patterns, such as the sphere, repeat themselves across fields due to their efficiency. Other novel developments, such as the eye, co-evolve in numerous, separate branches of the evolutionary tree once they have first come into effect. Nature remembers, and if the laws of physics, chemistry, and biology are her habits, novelty is her hobby.

Man as Microcosm

In biology, there is an adage stating that “ontogeny repeats phylogeny”. This refers to the process whereby an embryo recapitulates the entire process of evolution. In many insects, this continues to a remarkable extent long after they have hatched. A caterpillar’s genes are precisely the same as a butterfly’s, but during it’s post-natal life-cycle, it must still individually go through a process of metamorphosis to achieve it’s ultimate state. Let us keep this inspiring image in mind; considering the fractal nature of reality, it is more than just an apt metaphor for the process of human transformation.
Ontogeny repeats Phylogeny
Fittingly, human beings, as the most complex forms of life on earth, also go through one of the most complex processes of evolutionary recapitulation. We spend a long time in the womb proceeding from a single cell to a hominid, and then an even longer time outside of it recapitulating the epigenetic, cultural progression that led mankind from a state of natural subsistence to the complex, chaotic societies that we now (in most cases) inhabit. The major upheavals, quantum leaps, and revolutions that our forefathers went through on a macrocosmic scale are visited upon their descendants in microcosm, on the scale of their own lives.

Integral Recovery 

Once one understands this, one can begin to consider the ways in which addiction treatment can be most holistically approached. A hidden benefit of the chronic addict as a patient is that he is generally fairly welcoming to the idea that he must be psychologically reconstructed. As the twelve-steppers say to those who are still functioning, “come back when you’ve hit bottom”. The same thing could be said, and has been said, by spiritual teachers. The upshot is that somebody who doesn’t think they need help probably can’t be given it, and ethically almost certainly shouldn’t. However, if somebody is willing to admit the inadequacy of their psychological operating system as it currently exists, and to submit to our care and guidance, we ought for their sake know what we are doing, and figure out precisely how to take a psyche from rock bottom to the peak of human capacity.
If we set out on this venture, we will not at any rate be alone: we have the whole force of evolutionary momentum behind us. If the rapid acceleration of human development is to be taken as significant, then it seems as though nature is very keen on us making progress, perhaps because the sorts of pathology and retarded development that can affect societies as much as they can individuals are placing a great degree of unnecessary strain on the carrying capacity of our planet.

An Integral Model

This, then, is my sketch of what a model of integrated addiction treatment would look like, beginning at the very beginning. It is based upon a basic interpretation of the stages of human development whose analogies exist in almost all philosophical traditions. In Buddhist and Hindu mysticism, they are the chakras; in psychology they are the steps of Maslow’s Pyramid. As in Ken Wilbur’s integral system, each of the stages corresponds to a phase in the history of human society, beginning with the archaic and leading up to the cutting edge of the present age.
The theory underlying the model is that each stage can be associated with a belief system which is either successfully imprinted, allowing for development to the next stage, or left pathologically unintegrated. Psychotherapy is largely an attempt to fill in all the rungs in the ladder. If therapists are capable of leading patients through the imprinting of each of these systems, then they ought to carry their patient through the stages of human development and towards recovery.
The stages coalesce around an escalating series of belief systems to be fostered in the patient. These are entirely pragmatic, and can – and will be – discarded once they have fulfilled their purpose. Remember, this is not about what you believe; this is about what it is necessary to believe at a specific stage of development.

Stage 1 – The Archaic, Survival

At this stage, nothing is of relevance except the patient’s survival and that they come to identify with it as a purpose. If they are ideationally suicidal, do not necessarily attempt to change their mind. Only observe (when and if this is the case) that they continue to breathe, to eat, drink, rest, clothe themselves, and seek shelter. They may have no other priority other than staying alive, and ought to be rewarded for everything they do to achieve this goal. If the patient is willing to be treated – and it is the ethical stance of this particular model that if they are not then they ought not to be[1] – then merely attempt to foster the single belief that they will not survive if they do not kick the habit. Again, if this is not the case, then it would be better that they go back out into the world until it becomes so. If it doesn’t, then they are not at “rock bottom”, and are largely none of our business.

Stage 2 – The Magical, Tribal

Having covered basic survival needs, it would now be of benefit to begin to bring some sort of order into the patient’s life, some sort of system based around “if – then” statements. These need be by no means be rational, and would in fact be better if they are superstitious, and talismanic, as it is, for the most part, over-use of faulty reasoning that has caused the problem in the first place. If a patient has lucky socks, by all means encourage them to wear them. Attempt to introduce to the patient a generalised, non-distinct sense of a beneficent universe. This is the time for an acceptance of “a higher power”, certainly not a god in a monotheistic, rule-bound sense (such gods may well have been a source of the problem). The type of higher power best introduced is an all-loving, all-giving, Gaian mother-Goddess; if a patient cannot imprint the sense of a kindly, maternal world, then they will likely not be able to progress to further stages, just as a child is critically hampered by the lack of a loving mother. A source of love is what is needed; this may well manifest as the community of addicts itself, but shorn of any of the doctrines or baggage that the individuals involved may bring along with them to their meetings.

Stage 3 – The Mythic, Hierarchical

The patient having surrendered his will to a higher power, it would now be useful for that higher power to begin handing down some doctrines; let a father-figure emerge from the void. A patient may wish to begin adhering to the moral system of any of the traditional religions, or to the tenets of the 12-step program. Remember, this is not a time for theology; it is a time for rules and structures. The vengeful sky-god is the consort of the plentiful earth-mother. Both must exist for the sake of a healthy psychological balance. This would be a good time for an experienced guide or sponsor to enter the patient’s life - beforehand, they would only be considered a threat to be avoided or placated. Now, with some luck and judicious choice of appointment, they can become a worthy father figure. This stage is inherently group-centric, so let the patient feel the full force of the community of those in recovery. They are indeed a special, unique tribe. They do indeed have all the answers.

Stage 4 – The Rational, Modernist

This stage ought perhaps be most identified with “recovery” in general. If it can be attained, then the patient can begin to be considered – and to consider themselves – sane and healthy. It is characterised by a consideration of wider forces and the implications of one’s actions. One ought not to damage one’s self because one has a duty to be of use to society and avoid being a burden to others. Let the patient become a part of society outside the world of recovery. Let them re-enter employment, seek out new friends and relationships, volunteer in the community. Simultaneously, this is also a good time to begin to consider the twelfth step, as helping others will finally come to be of value to the patient. Naturally, one can only seek to do this if one is operating in a wider social environment which upholds rational values; luckily, in western Europe, this tends to be the baseline.

Stage 5 – The post-modern, Pluralist

If it were still the 1930s, it would be reasonable to have concluded with the above. However, the values of society have begun to progress away from a mere respect for science, and a belief in egalitarianism and conformity. This stage corresponds with the philosophical and societal revolutions that swept the western world in the 1960s, and can be encouraged through an introduction to the non-dual philosophies of eastern mysticism, such as Zen Buddhism or Ashtanga Yoga, as well as western post-modernism and existentialism.
The patient ought now to see just how many ideas are out there, and the possibilities that exist for formulating one’s own take on things, and for appreciating the underlying wholeness in everything. Now is a time not just for doing good, but for understanding why it is done. Now the patient is a moral and philosophical agent in their own right, and is free to reject the systems that have brought them to this point if they so wish. The great leap to make is from identifying with humanity as a whole to identifying with all things. This is a good time to engage in ecological thought, and to get as mushy and hippy-dippy as possible, so as not to colour existential liberty with gloom. Nothing is true, all is permitted – but this is a good thing.

Stage 6 – The Integral

The next step is the biggest leap so far. So far, each stage has been achieved through a conscious or semi-conscious rejection of those preceding it. At this point, it ought at last be possible for the patient to look back over his shoulder and see how the whole process has brought him to the state of illumination at which he now stands. All points of view have legitimacy; not just because they are all true, but because they are all of benefit. So long as babies continue to be born a blank slate, and so long as we continue to consider it necessary to socialise them, it will be necessary for society to contain structures built around the healthiest possible model of each stage, so as to permit every individual to develop as swiftly and as cleanly as possible towards their optimum state of being.
See also Sailing for Recovery by Dr Stirling

[1] *This is not discounting the efficacy of techniques, such as motivational interviewing, to elicit motivation to change, but simply observing that they can only effectively take place in contexts where the patient has consented to undergo treatment.