Spirituality is an important concept for many people. This is particularly true for people struggling to recover from severe or fatal disorders such as addiction.

In Western Judeo-Christian cultures such as the United States, spiritual models typically presume a God with supernatural powers. This God is seen as one who governs, guides, directs, or intervenes on behalf of human beings. Spiritual models assume addiction occurs because of a separation from God. Moral causes of addiction presume there is a "correct" morality based on a particular set of values. Deviation from those values results in addiction. It is important to note that moral codes reflect the value system of a particular culture.

Therefore, the "correct" moral code will vary from one culture to the next. According to the spiritual model, a disconnection from God or a Higher Power causes addiction. This separation causes people's suffering because they fail to live according to God's will or direction. Therefore, recovery consists of establishing or re-establishing a connection with God or a Higher Power. The most prominent example of the spiritual approach is Alcoholics Anonymous (AA) and other 12-step groups. Participants practice 12-steps. These 12-steps help people restore their spiritual connection with a higher power. There are also "faith-based" approaches that arise from specific religious orientations.

Prayer, meditation, and counseling with spiritual advisors are techniques associated with this model. Questions for personal reflection from the spiritual model:

How do I evaluate my life in terms of my relationship with God or a Higher Power?

How do I evaluate my life in terms of my own ultimate values and beliefs?

Am I living in accordance with what I believe is important?

Do I devote enough time reflecting upon my values and believes?

According to the Moral model, a moral failure- a failure to do what is right causes addiction. Therefore, recovery consists of strengthening one's will or motivation to behave in an upright manner. The moral model is prominent in traditional approaches to recovery. "He just needs to strengthen his willpower to resist temptation and get on with his life." The criminal justice system also approaches addiction from this perspective.

Punishments for addiction related crimes (e.g., DUI, public intoxication) are intended to motivate people to behave better. Trying to persuade someone to behave better is also a technique associated with this model. Moral Reconation Therapy (MRT) is an evidence-based addiction treatment aligned with this model, but MRT is not well known. Conation is an archaic psychological term referring to our capacity for conscious and deliberate decision-making.

Moral Reconation Therapy works to raise the moral level of decision-making. Questions for personal reflection from the moral model:

Aren't there times when I need to exert more effort and willpower to stay on track?

Should I use willpower to behave better make wiser choices?

Are there times when I need to exert more effort to do the things, I know will help me in my recovery efforts? I know if I make the extra effort to exercise every day, I feel better. This improved my mood. It also reduced my cravings and made it easier for me to resist them.

Psycho-analytic Theory of Addiction

Psychoanalysis is considered as a theory, a treatment, and a way of thinking about human motivation. A psychoanalytic perspective includes conscious and repressed, unconscious motives and desires. Psychoanalysis is traditionally conceived as an opportunity for a motivated person to reflect deeply about everything he or she is feeling and thinking without editing or censoring.

Addiction is described as a defensive strategy to avoid feeling of helplessness or powerlessness. Drug abuse is a futile attempt to compensate for inner emptiness without success. The addict tries to compensate via addictive behavior for painful subjective states of low self-esteem, doubts, and anxiety. The use of drugs supplies a feeling of acceptance and temporary self-confidence. An addict substitutes an imaginary world, where he is in complete control, for the real world, where he feels useless and out of control. Repeated use of drugs to gain relief becomes a way of life. Relief is momentary, but in the long-term, drug use becomes an end in itself. The addiction problem prevents the user from understanding her distress, as well as the development of an emotional capacity to self-soothe.

The psychoanalytic view suggests addiction is basically a disorder of self-regulation. For instance, individuals with histories of exposure to adverse childhood environments like physical and sexual abuse tend to have a diminished capacity to regulate negative emotions and cope effectively with stress. These individuals may be self-medicating anxiety and mood disorders.

It is instructive to note that many individuals experiment with drugs but few become addicted. The success of therapy and the lasting change require the patients come into contact with previously inaccessible aspects of their inner feelings. Helping patients increase their ability to engage in self-reflection and identify alternative ways to manage difficult emotions are part of the psychodynamic approach to addiction treatment.