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​Sickness Not Sin: Healing vs. Repentance

A recent Chapel Service at Caron Pennsylvania gave me the opportunity to reflect in a spiritual way on the “disease model,” a key notion in the recovery and treatment worlds. Medicine, psychiatry, and the law – as well as our family systems – all have been challenged to wrestle with the basic question: “Is the person with addiction at fault?” Something very profound changes for each of these perspectives when the neurobiology and other evidence is taken deeply to heart and our doctors, counselors, judges, and loved ones come to believe that our “free will” was in fact taken away.

As a spiritual care professional, I am interested in this question as well. I have a lay person’s understanding of the “wiring” of addiction in the limbic brain. I also have a lot of experience meeting people who are “strong-willed” and have been extremely competent, effective, and successful in very challenging areas of life – law, medicine, business, politics, and research, etc. I am persuaded by this and by my own experience, that choice was taken away from me when my substance use disorder was active. I also have come to believe that a similar incapacitation is present for those struggling with addiction interaction, people who have mixed stories of gambling, or shopping, or over-work, or food-related disorders, for example, in addition to a substance use component. Addictions rarely work in a vacuum; they not only coexist, but interact, reinforce, and fuse to become part of a package.

I had already begun my journey of recovery when I first began my formal theological training. When the stories of my tradition were presented to me, I saw them through the lens of my own experience and that of others who had also suffered in this particular way. What I found, now more than 20 years ago, was that my theological perspective was somewhat different than many of my seminary peers. I was more oriented to view the hope of theology and the project of ministry as therapeutic, rather than merely behavioral. I interpreted things like “salvation” more in terms of healing than “sin.” Metaphors of rescue and new birth spoke to me, and my own sense of calling was linked to these ideas of love and service.

Since then, I have come to see the belief that addiction is a disease as somewhat of a spiritual watershed, a continuum in which people and institutions often can be said to tip to one or the other side. The result is not totally either-or. I am not averse to looking at my behavior, finding fault, or feeling shame. I am not without deep convictions. I believe profoundly in my need to study and grow, in understanding and behavior.

No, it’s not one thing or the other; rather, the differences involve emphasis and action. I find myself focused on the suffering, brokenness, and disconnection of people, and do not use language of “disobedience” or “sin.” I find myself moved to offer compassion and invite healing, rather than urging persons to greater self-control.

This preference has pulled me away from the theological academy and out into the “real world”. I am constantly reminded by my recovery peers to “keep it real” and to “keep it simple.” One of the lines that seems to stay with people from my lecture on “The Question of G-d” is this: “If our recovery depends on the right answer to a question that has been debated for centuries, we are in trouble!”

At Caron, I am privileged to work with so many who are oriented in a similar way, deeply convinced of the reality of addiction as illness, and deeply committed to extending hospitality, compassion, and love in the quest for renewal and the restoration of our connectedness with self, others, the universe, and that which we view as our higher power.