469
Pr egledni	znans tv eni	članek/ Article	(1.02)
Bogoslovni vestnik/Theological Quarterly	82	(2022)	2,	469—483
Besedilo	pr eje t o/R eceiv ed:05/2021;	spr eje t o/ Accep t ed:09/2021
UDK/UDC:	613.81:2-184.3
DOI:	10.34291/B V2022/02/Simonic
©	2022	Poljak	Lukek	et	al.,	CC	BY	4.0
Saša Poljak Lukek and Barbara Simonič
Spiritual and Religious Factors  
of Recovery from Alcoholism
1
Duhovni in verski dejavniki okrevanja po alkoholizmu
Abstract : R ec o v er y	 fr om	 alc oholism	 is	 a	 c omple x,	 dynamic,	 per sonal	 and	 social 	
pr ocess	 aimed	 not	 only	 a t	 ab s t aining	 fr om	 alc ohol	 but	 also	 a t	 impr o ving	 the 	
quality	 of	 v arious	 ar eas	 of	 lif e.	 In	 this	 pr ocess,	 individuals	 r ely	 on	 a	 v arie ty	 of 	
in t ernal	 and	 e x t ernal	 r esour ces.	 One	 of	 these	 is	 spirituality/r eligiosity ,	 which 	
c on tribut es	 t o	 the	 r esults	 of	 alc oholism	 tr ea tmen t	 in	 v arious 	 w a y s.	 In	 this	 pa-
per ,	 wher e	 w e	 used	 the	 s y s t ema tic	 lit er a tur e	 r e vie w	 me thod	 t o	 analy z e	 28	 dif -
f er en t	 s tudies	 in	 the	 field	 of	 spirituality/r eligiosity	 in	 the	 r ec o v er y	 pr ocess	 fr om 	
al c oh ol i sm,	 w e	 pr esen t	 fin di ngs	 tha t	 i nd i c a t e	 the	 r ol e	 of	 sp i ri tual i ty	 as	 one	 of	
the	 c omponen ts	 in	 this	 pr ocess.	 W e	 shed	 ligh t	 on	 se v er al	 spiritual	 and	 r eligious 	
f act or s	 tha t	 ar e ,	 each	 in	 its	 specific	 w a y ,	 import an t	 support	 t o	 the	 individual	 in	
the	pr ocess	of	r ec o v er y	fr om	alc oholism.
Keywords :	 addiction,	 alc oholism,	 ab s tinence,	 r ela tionship	 with	 God,	 r eligion,	 spi -
rituality
Povzetek : Okr e v anje	 po	 alk oholizmu	 je	 k omplek sen,	 dinamičen,	 oseben	 in	 socialen 	
pr oces,	 k a t er eg a	 cilj	 ni	 samo	 ab s tinenc a,	 ampak	 izboljšanje	 kv alit e t e	 življenja	
na	 r azličnih 	 življenjskih	 podr očjih. 	 V	 t em	 pr ocesu 	 se	 ljudje	 naslonijo 	 na	 r azlične 	
notr anje	 in	 z unanje	 vir e.	 Med	 njimi	 je	 tudi	 duhovnos t/r eligio znos t,	 ki	 na	 r azlične 	
načine	 prispe v a	 k	 r e z ult a t om	 z dr a vljenja	 odvisnos ti	 od	 alk ohola.	 V	 prispe vk u, 	 v 	
k a t er em	 smo	 z	 me t odo	 sis t ema tičneg a	 pr egleda	 lit er a tur e	 analizir ali	 28	 r azličnih 	
r azisk a v	 s	 podr očja	 duho vnos ti/r eligio znos ti	 v	 pr ocesu	 okr e v anja	 od	 odvisnos -
ti od alkohola, predsta vljamo	 ugotovitve,	 ki	 nak azujejo ,	 k akšna	 je	 vlog a 	
duho vnos ti	 k ot	 ene	 izmed	 k omponen t	 v	 pr ocesu	 okr e v anja	 od	 posledic	 odvis -
nos ti	 od	 alk ohola.	 Izpos t a vljeni	 so	 r azlični	 duho vno-r eligio zni	 deja vniki,	 ki	 na 	
r aznolik e	 načine	 pr eds t a vljajo	 pomembno	 podpor o	 posame znik u	 v	 pr ocesu 	
okr e v anja	od	odvisnos ti	od	alk ohola.	
Ključne besede :	 odvisnos t,	 alk oholiz em,	 ab s tinenc a, 	 odnos	 z	 Bog om,	 r eligija,	 duho v -
nost
1	
The	 r esults	 w er e	 partly	 obt ained	 within	 the	 pr oject	 No.	 J5-2570,	 financed	by	 the	 Public	 Ag ency	 f or 	
R esear ch	of	the	R epublic	of	Slo v enia.

470 Bogoslovni vestnik 82 (2022) • 2
1. A Modern Understanding of Alcoholism
R ecen t	 r esear ch	 in	 the	 field 	 of	 addiction 	 c onfirms	 tha t	 alc oholism	 is	 not	 jus t	 a 	
men t al	 disor der	 of	 addiction	 but	 also	 a	 chr onic	 ph y sic al	 disease	 tha t	 damag es	 the 	
biologic al	 balance	 in	 the	 br ain	 (Ur schel	 2009,	 5).	 Fr om	 the	 poin t	 of	 vie w	 of	 men t al 	
health,	 alc oholism	 is	 diagnosed	 as	 a	 pa tt ern	 of	 harm ful 	 c onsump tion	 of	 a	 p s y cho-
activ e	 sub s t ance	 (alc ohol)	 tha t	 c auses	 health	 pr oblems	 and	 addiction	 s yndr ome.	
The	 la tt er	 is	 char act eriz ed	 b y	 a	 s tr ong	 desir e	 t o	 drink	 alc oholi c	 be v er ag es,	 per sis -
t e n t	 c onsum p tion	 of	 alc ohol	 de spit e 	 har m ful	 c onse que nce s, 	 hig he r 	 c om mitme n t	
t o	 alc ohol	 c onsump tion	 than	 other	 activities	 and	 oblig a tions, 	 incr eased	 t oler ance 	
and	 in	 some	 c ases	 ph y sic al	 disor der s	 due	 t o	 sub s t ance	 withdr a w al	 (W orld	 Health	
Or g a niz a tion	 2 0 1 6 , 	 2 8 9 – 2 9 1 ).	 A lc ohol	 a ddic tion	 is	 t hus	 m a nif e s t e d	 in	 t he 	 spe c ific	
beha viour ,	 thinking	 and	 emotions	 of	 an	 individual	 and	 a t	 the	 same	 time	 c auses 	
permanen t	 chang es	 in	 br ain	 function, 	 especially	 in	 impair ed	 fr on t al	 lobe	 function	
and	in	the	damag ed	neur otr ansmitt er	s y s t em.
Although	 alc oholism	 is	 oft en	 described	 as	 an	 addictiv e 	 beha viour	 driv en	 by	 either 	
the	pur suit	of	pleasur e	or	self -des tructiv e	 motiv es,	e xperts	find	 tha t	behind	addic-
tiv e	 beha viour	 ther e	 is	 deep	 and	 s tr ong	 p s y chologic al	 pain	 (Gos t ečnik	 e t	 al.	 2010, 	
364–365;	 Khan tzian	 2014,	 33).	 In	 under s t anding	 and	 dealing	 with	 alc oholism,	 it	 is 	
thus	 incr easingly	 import an t	 t o	 under s t and	 men t al	 de v elopmen t	 and,	 abov e	 all,	 the 	
f act or s	 tha t	 c ause	 and	 main t ain	 ps y chologic al	 s tr ess	 and	 pain	 in	 an	 individual	 during 	
de v elopmen t.	The	disor der	of	self -r egula tion	bec ause	of	tr auma tic	e xperience	(De 	
Bellis	 2002,	 164;	 W righ t	 2014,	 27)	 or	 insecur e	 a tt achmen t	 (Khan tzian	 2014,	 36)	 and 	
s y s t e m ic 	 adjus tm e n t	 of	 r e la tionship s	 t o	 non- func tional	 be ha v iour al	 pa tt e r ns	 ar e	
r ec ogniz ed	 as	 risk	 f act or s	 f or	 the	 dev elopmen t	 of	 alc oholism	 (V et er e	 2014,	 62).	 Ina-
ppr opria t ely	 r egula t ed	 ps y chologic al	 c on t en ts	 associa t ed	 with	 v arious	 f orms	 of	 (r e -
la tional)	 tr auma	 ar e	 thus	 in	 the	 backgr ound	 of	 the	 dynamics	 of	 alc oholism,	 and	
addiction	is	a	w a y	of	inappr opria t e	r egula tion	of	these	in t ernal	s t a t es. 	
2. The Process of Recovery from Alcoholism
Coping	 with	 alc oholism	 c an	 be	 aimed	 a t	 r educing	 the	 harm ful	 e ff ects	 of	 addiction 	
or	 a t	 main t aining	 abs tinence	 (W righ t	 2014,	 12).	 The	 r ec ov ery	 pr ocess	 c an	 be	 based 	
on	 the	 principles	 of	 non-spiritual	 appr oaches,	 non-r eligious	 spiritual	 appr oaches,	 or 	
r eligious	 appr oaches	 (Br own	 e t	 al.	 2006,	 655–656).	 All	 of	 these	 appr oaches	 should 	
include	 medical,	 ps y chother apeutic,	 and	 supportiv e	 int erv entions. 	 Because	 alcoholi -
sm	 is	 under s t ood	 as	 a	 disease,	 the	 fir s t	 s t ep	 in	 r ec ov ery	 mus t	 be	 a	 medic al	 appr oach 	
(especially	 f or	 pa tien ts	 with	 withdr a w al	 s ympt oms	 and	 c omorbid	 men t al	 disor der s, 	
f or	 e x ample,	 se v er e	 depr ession).	 With	 medic amen ts,	 w e	 enable	 the	 br ain	 t o	 r eg ain 	
the	 ability	 of	 pa ying	 a tt en tion, 	 lis t ening	 and	 memorizing ,	 thus	 meeting 	 basic	 c onditi-
ons	 f or	 further	 ps y chother apeutic	 and	 supportiv e	 tr ea tmen t	 (Ur schel	 2009,	 23,	 27).
When	 w e	 t alk	 about	 p s y chother apeutic	 support	 in	 the	 r ec o v er y	 pr ocess,	 the 	
import ance	of	r e-es t ablishing	r ela tionship s	is	incr easingly	emphasiz ed	(Khan tzian 	

471 Saša Poljak Lukek et al.  - Spiritual and Religious Factors of Recovery... 
2014, 	 53; 	 V e t e r e 	 2014, 	 63).	 In	 this	 phase ,	 the 	 r e c o v e r y 	 pr oce ss	 should	 the r e f or e 	
be	 f ocused	 primarily	 on	 building	 a tt achmen t,	 f orming	 r eliable	 in t erper sonal	 r ela-
tionships	 and	 r eor g anizing	 tr auma tic	 r ela tional	 e xperiences	 (W righ t	 2014,	 17).	 New 	
e xperiences	 in	 r ela tionship s	 enable	 ne w	 mechanisms	 of	 self -r egula tion	 (Khan tzian 	
2014,	 63)	 and	 thus	 one’ s	 aut onom y 	 and	 fr ee 	 and	 secur e 	 a tt achmen t	 t o	 another 	
per son.	 Thr ough	 in t erpr e t a tion,	 under s t anding ,	 and	 e xplana tion,	 c onscious,	 v erbal 	
in f orma tion	 is	 r eor g aniz ed,	 and	 thr ough	 the	 e xperience	 of	 this	 subjectiv e	 en vir o-
nmen t	 the	 implicit	 r ela tional	 kno wing	 chang es	 (St ern	 e t	 al.	 2010,	 14).	 In	 the	 r ela-
tional 	 c on t e xt,	 r ec ov ery	 fr om	 addiction	 is	 supposed	 t o	 r epr esen t	 a	 new	 sa tis f action 	
of	 basic	 r ela tional	 needs,	 wher e	 the	 w a y	 of	 c onnecting	 and	 es t ablishing	 the	 basic 	
elemen ts	 of	 a tt achmen t	 in	 r ela tionship s	 is	 k e y .	 The	 sa tis fied	 need	 f or	 signific ance 	
and	 r ec ognition	 is	 especially	 import an t	 since	 it	 is	 supposed	 t o	 help	 the	 r ec o v ering 	
individual 	 t o	 r eg ain	 a	 sense	 of	 trus t	 in	 r ela tionship s	 and	 the	 ability	 t o	 r e-a tt ach	 t o 	
a	per son	(which	r eplaces	a tt achmen t	t o	the 	sub s t ance)	(Khan tzian	2014,	63). 	
3. The Importance of Spirituality in Recovery after 
Alcoholism
When	 w e	 t alk	 about	 the	 spiritual	 or	 r eligious	 appr oach	 in	 the	 tr ea tmen t	 of	 addicti-
on,	 w e	 ha v e	 in	 mind	 v arious	 support	 in t er v en tions	 tha t	 include	 these	 tw o	 dimensi-
ons	 (Br own	 e t	 al.	 2006,	 656).	 These	 ar e	 tw o	 diff er en t, 	 but	 ine vit ably	 c onnect ed	 and 	
ov erlapping	 c ons tructs.	 Spirituality	 is	 usually	 under s t ood	 mor e	 br oadly	 than	 r eligio-
sity	 and	 de fines	 a	 per sonal	 and	 in t ernaliz ed	 sense	 of	 the	 tr anscenden t,	 the	 sacr ed, 	
wher e	 the	 individual	 es t ablishes	 a	 deep	 and	 per sonal	 r ela tionship	 with	 God	 or	 the 	
tr anscenden t	 being.	 R eligiosity ,	 on	 the	 other	 hand,	 is	 seen	 as	 a	 mor e	 e x t ernal	 and 	
or g aniz ed	 e xpr ession	 of	 spirituality ,	 also	 including	 an	 ins titutional	 and	 c ommunity 	
dimension,	 spiritual	 lif e	 acc or ding	 t o	 ins titutional	 rules	 and	 belie f	 acc or ding	 t o	 the 	
v alue	 s y s t em	 of	 a	 particular	 r eligion	 (Ben t -Goodle y	 and	 F o wler	 2006,	 283).	 R eligi-
osity	 c an	 thus	 be	 under s t ood	 as	 an	 e xpr ession	 of	 a	 spiritual	 r ela tionship	 in	 cert ain 	
f orms,	 w a y s,	 belie f s,	 and	 pr actices	 tha t	 de v elop	 within	 a	 c ommunity	 with	 other s 	
who	 shar e 	 the 	 same 	 e xpe r ie nce s	 with	 tr ansce nde n t	 r e ality 	 (Hodg e 	 2011, 	 22).	 In	
principle,	 w e	 c an	 sa y	 tha t	 spirituality	c an	 e xis t	 without	r eligiosity ,	 while	 r eligiosity 	
is	emp ty	if	it	does	not	include	spirituality	(Br o wn	e t	al.	2006,	654). 	
Ther e	 ar e 	 v arious	 w a y s	 in	 which	 spirituality	 and	 r eligiosity	 ar e 	 link ed	 t o	 alc ohol 	
abuse	 and	 the	 r ec ov ery	 pr ocess.	 Spirituality	 and	 r eligiosity	 c an	 help	 deal	 with 	
s tr ess	 (P ar g amen t	 e t	 al.	 2001,	 64),	 as	 r eligious	 c oping	 c an	 r educe	 or	 acceler a t e 	
the	 e ff ects	 of	 s tr ess ful	 e v en ts, 	 depending	 on	 ho w	 it	 is	 in v olv ed	 in	 the	 pr ocess.	 Se-
c ondly ,	 spir ituality 	 and	 r e lig iosity 	 c an	 pr omot e 	 he alth y 	 be ha v iour s	 and	 e motions, 	
e. g.	 higher	 le v els	 of	 spirituality	 and	 r eligiosity	 ar e	 associa t ed	 with	 lo w er	 indic a t or s 	
of	 de pr e ssion	 (Cha tt er s	 e t	 al.	 2008, 	 958).	 Some	 r e ligions	 e xplicitly	 f orbid	 the	 c on-
sump tion	 of	 alc ohol,	 and	 almos t	 all	 of	 them	 claim	 tha t	 alc ohol	 abuse	 is	 a	 mis t ak e	
(sin).	 Activ e 	 and	 spiritually	 mark ed	 beha viour s	 appear	 t o	 pr omot e	 self -es t eem 	
an d 	 cr ea t e	 p o si ti v e	 emo ti o n s 	 su ch 	 as 	 b ei n g	 l o v ed	 an d 	 f o r gi v en 	 ( 2000,	 335) . 	 F i n al -

472 Bogoslovni vestnik 82 (2022) • 2
ly ,	 spiritual	 and	 r eligious	 beha viour	 typic ally	 in v olv es	 r a ther	 in t ense	 f ormal	 and 	
i n f ormal 	 soci al 	 activi ties	 (e. g. ,	 i n cl usi on	 i n 	 v ari ous	 gr oup s)	 tha t	 ar e	 kn o wn 	 t o	 r e-
duce	 s tr ess	 and	 ha v e	 a	 positiv e	 e ff ect	 on	 p s y chologic al	 health	 (Miller	 and	 Saunder s 	
2011,	 2–3).	 Fr om	 this	 poin t	 of	 vie w ,	 spirituality	 is	 an	 import an t	 f act or	 in	 the	 pr o-
cess	of	r ec o v er y	fr om	alc oholism	(Jer ebic	and	Jer ebic	2012,	307).	
Support	 gr oup s	 f or	 the	 tr ea tmen t	 of	 alc oholism	 (e. g.	 Alc oholics	 Anon ymous	 -	
AA) 	 h i gh l i gh t	 th e	 b asi c	 p ri n ci p l es	 o f 	 sel f -h el p 	 wi th 	 wh i ch 	 a	 p er so n 	 c an 	 fi n d 	 w a y s	
t o	 main t ain	 ab s tinence	 and	 off er	 a	 ne w	 social	 ne tw ork	 in	 which	 individuals	 c an 	
tr y	 ne w	 w a y s	 t o	 mee t	 their	 r ela tional	 needs	 (Ur schel	 2009,	 110).	 In	 support	 gr o-
up s	 with	 a	 spiritual	 or	 r eligious	 c omponen t,	 a	 per son	 sa tis fies	 the	 need	 f or	 r ec o-
gnition	 and	 the	 need	 t o	 be	 with	 people	 the y	 per ceiv e	 as	 similar	 and	 sharing	 the	
same	 e xperience	 (Er skine	 1998 ,	 239).	 In	 addition,	 eng aging	 in	 r eligious	 rit es	 and	
cultiv a ting	 a	 g enuine	 spiritual	 r ela tionship	 with	 God	 or	 anoth er	 tr anscenden t	 be-
ing	 during	 r ec ov ery	 c an	 also	 alt er	 a tt achmen t	 pa tt erns	 (K erlin	 2017,	 405)	 as	 a 	
per son	 in	 their	 vulner ability	 r eg ains	 the	 e xperience	 of	 sa f e	 shelt er	 and	 dis tr ess 	
r e gula tion	 whe n	 the 	 c on t act	 is	 br ok e n.	 Expr e ssing	 gr a titude 	 thr ough	 pr a y e r 	 and 	
a ff ection	 thr ough	 r eligious	 rituals	 enables	 the	 individual	 in	 the	 r ec o v er y	 pr ocess	
t o	 a w ak e n	 spiritually	 and	 t o	 r each	 a	 ne w	 s t a t e	 of	 c onsciousne ss, 	 char act e riz e d	 b y 	
f aith	 in	 the	 tr anscenden t	 and	 jo y	 of	 lif e	 (Derma tis	 and	 Galan t er	 2016,	 511).	 Spiri -
tuality	 thus	 pla y s	 an	 import an t	 r ole	 in	 r ec o v er y	 fr om	 addictio n,	 as	 it	 is	 associa t ed	
with	 a	 mor e	 optimis tic	 vie w	 of	 the	 w orld	 and	 s tr ong er	 social	 support,	 which	 allow s 	
f or	healing	and	changing	one’ s	beha viour al	pa tt erns	(P ar dini	e t	al.	2000,	352).	
In	 a	 per sonal	 r ela tionship	 with	 God,	 a	 per son	 in	 the	 pr ocess	 of	 r ec o v er y	 c an 	
e xperience	 ne w	 dimensions	 of	 under s t anding	 themselv es,	 r ela tionship s, 	 and	 the 	
w orld.	 The	 spiritual	 iden tity	 of	 the	 individual,	 as	 an	 e xplicit	 and	 implicit	 e xpr ession 	
of	 the	 r ela tionship	 t o	 God	 (Da vis,	 Gr anqvis t	 and	 Sharp	 2018,	 8),	 is	 import an t	 in	 the 	
r ec ov er y	 pr ocess	 as	 it	 giv es	 the	 individual	 a	 sense	 of	 c on fidence,	 e fficiency ,	 c on tr ol 	
and 	 v al u e.	 A	 r el a tion sh i p 	 wi th	 a	 God 	 wh o	 d oes	 n ot	 ju dg e	 or	 d i sgr ace	 and 	 wh er e	
ther e	 is	 alw a y s	 a	 place	 f or	 human	 vulner ability	 c an	 off er 	 a	 ne w	 e xperience	 of	 se -
curity	 (Kirkpa trick	 2005,	 61)	 tha t	 r eplaces	 mee ting	 security	 needs	 with	 addictiv e 	
beha viour .	 Thus,	 b y	 changing 	 the	 a ttitude 	 t o w ar d	 God,	 when	 in	 momen ts	 of	 vul-
ner ability	 a	per son	 e xperiences	 its	 import ance	 f or	 living ,	the y	 f orm	or	chang e	the 	
e xplicit	 per ception	 of	 spirituality	 as	 w ell	 as	 the	 inner	 implicit	 a ttitude	 t ow ar ds	 God, 	
thus	cr ea ting	support	in	c oping	with	challeng es	in	the 	pr ocess	of	r ec o v er y . 	
4. The Purpose of the Study
Mos t	 s tudies	 on	 alc oholism,	 f ocusing	 on	 its	 aetiology	 and	 tr ea tmen t,	 r ely	 mainly	 on 	
the	 medic al	 model	 of	 under s t anding.	 Ther e f or e,	 little 	 r esear ch	 w ould	 f ocus	 on	 the 	
qualities	 of	 alc oholics	 who	 ha v e	 op t ed	 f or	 sobrie ty .	 The	 r ec o v er y	 pr ocess	 is	 based 	
not	 so	 much	 on	 medic al	 or	 biologic al	 pr edispositions, 	 but	 on	 ho w	 an	 individual 	
seek s	 meaning	 and	 purpose,	 the	 ability	 t o	 mak e	 mor al	 decisions,	 the	 decision	 t o	
kno w	 and	 w ork 	 on	 oneself ,	 and	 the	 ability	 t o	 be	 cr ea tiv e.	 R ec o v er y	 fr om	 alc ohol -
ism	 is	 an	 in t ernal 	 phenomenon, 	 it	 is	 a	,success	 s t or y ‘	 tha t	 c an	 only	 be	 t old	 fr om	

473 Saša Poljak Lukek et al.  - Spiritual and Religious Factors of Recovery... 
within.	 Of	 c our se,	 alc oholics	 oft en 	 op t	 f or	 ab s tinence	 due	 t o	 e x t ernal	 pr essur es 	
fr om	 f amily	 or	 socie ty .	 This	 decision,	 ho w e v er ,	 mus t	 also	 bec ome	 in t ernal;	 a	 tr ans-
f orma tiv e 	 pr ocess 	 mus t	 e v olv e 	 in	 which	 the 	 alc oholic 	 disc o v er s	 the 	 in t ernal	 f ac -
t or s,	 including	 spirituality ,	 tha t	 lead	 t o	 chang e	 (Wismer	 Bo w den	 1998,	 337–338).	
In	 this	 r eg ar d,	 the	 purpose	 of	 this	 paper	 is	 t o	 pr esen t	 a	 s y s t ema tic	 o v er vie w	 of	 the 	
findings	 of	 r ece n t	 scien tific	 s tudies	 tha t	 ha v e	 e x amined	 the	 r ole	 of	 spirituality	 in	
the 	 pr oce ss	 of	 r e c o v e r y 	 fr om 	 alc oholism .	 Base d	 on	 the 	 analy sis, 	 w e 	 w an t	 t o	 pr e s-
en t	the	r ole	of	spirituality	as	one	of	the	c omponen ts	in	the	pr ocess	of	r ec o v er y .	
5. Method
5.1 Systematic Literature Review
F or	the	r esear ch	method,	we	used	the	s ys t ematic	lit er atur e	r eview	method,	which	is 	
similar	 to	 met a-analysis.	 It	 can	 be	 described	 as	 a	 method	 that	 compar es	 the	 r esults	 of 	
qualit ativ e	and	 quantit ativ e 	 s tudies,	 using	 a	 qualit ativ e	appr oach	 (Sn y der	 2019,	 335). 	
It	 pr ovides	 an	 objectiv e 	 and	 s y s t ema tic	 ov er view	 of	 the	 field	 and	 off er s	 a	 good	 insi-
ght	 into	a	particular	scientific	 field	by	 identifying ,	critically	ev aluating	and	int egr ating 	
findings	of	 import ant	 qualit ativ e	s tudies	 addr essing	 a	 specific	r esear ch	 topic	 (Cooper 	
2003,	 5).	 The	 method	 needs	 t o	 be	 based	 on	 the	 pr epar a tion 	 of	 a	 det ailed	 analy sis 	
pr otocol,	 and	 the	 r esear ch	 mat erial	 consis ts	 of	 r elev ant	 s tudies	 that	 comply	 with	 pr e-
defined	crit eria	 f or	 inclusion	 in	 and	 e x clusion	 fr om	 the	 analysis	 (R essing ,	 Blettner	 and 	
Klug	 2009,	 457).	 The	 r esult	 is	 a	 compr ehensiv e	 and	 s y s t ema tic	 r eview	 of	 the	 r esults 	
of	 a	 lar ge	 number	 of	 alr eady	 published	 quantit ativ e 	 and	 qualit ativ e	r esear ch	 in	 a	 par -
ticular	 field.	 B y	 in t egr a ting	 the	 findings	 and	 per spectiv es	 deriv ed	 fr om	 the	 v arious 	
empirical	 findings	of	 these	 s tudies,	 we	 obt ain	 answer s	 t o	 r esear ch	 ques tions	in	 a	 w a y 	
that	 no	 single	 study	 can	 (Sn y der	 2019,	 333).	 In	 our	 study ,	 by	 a	 s ystematic	liter atur e	 r e-
view	 we	 identified, 	 summariz ed,	 and	 s ynthesiz ed	 achiev able	 r esear ch	 that	 addr essed 	
v arious	 aspects	 and	 the	 r ole	 of	 spirituality	 in	 the	 pr ocess	 of	 r ecovery	 fr om	 alcoholism. 	
5.2 Procedure
F or	 this	 s tudy ,	 w e	 sear ched	 f or	 scien tific	articles	 of	 qualit a tiv e	 and	 quan tit a tiv e	s tud -
ies	 on	 tw o	 online	 bases	 of	 articles,	 Sc opus	 and	 W eb	 of	 Science.	 T o	 c aptur e	 the	 ar -
ticles,	w e	select ed	the	period	fr om	January	2000	t o	December	2021.	W e	sear ched 	
the	 dat abases	 f or	 r esults	 under	 the	 sear ch	 t erms	 ‚alcoholism ‘, ‚ r ecovery ‘, ‚ spirituality ‘ 
and ‚religion ‘ ,	 which	 w er e	 f ound	 in	 the	 title,	 summar y	 or	 k e yw or ds.	 The	 f ollowing 	
crit eria	w er e	c onsider ed	in	iden tif ying	r ele v an t	s tudies: 	
 – The	 full	 article	 pr esen t ed	 an	 original	 s tudy	 (quan tit a tiv e	 or	 qualit a tiv e)	 in	 En-
glish	 and	 w as	 published	 in	 a	 peer -r eview ed	 scien tific 	 journal	 betw een	 January 	
2000	and	December	2021.
 – The	 c on t en t	 of	 the	 article	 r e f err ed	 (also)	 t o	 aspects	 of	 spirituality/r eligiosity	 in 	
the	 pr ocess	 of	 r ec ov ery	 fr om	 alc oholism	 (ev en	 if	 the	 article	 dealt	 with	 the	 pr o-
cess	 of	 r ec ov ery	 fr om	 abuse	 of	 other	 subs t ances	 and	 addictions,	 w e	 f ocused 	
only	on	the	part	tha t	w as	r ela t ed	t o	r ec ov ery	fr om	alc oholism).

474 Bogoslovni vestnik 82 (2022) • 2
 – The	 r esear ch	 sample	 c onsis t ed	 (also)	 of	 individuals	 with	 the	 e xperience	 of	 al-
c ohol	 addiction	 and	 w er e	 curr en tly	 or	 in	 the	 pas t	 in v olv ed	 in	 the	 pr ocess	 of 	
r ec ov ery	fr om	alc oholism.
Articles	 w er e	 fir s t	 e v alua t ed	 based	 on	 their	 title	 and	 ab s tr act. 	 In	 articles	 tha t 	
w er e	 not	 e x cluded	 w e	 then	 look ed	 a t	 the	 full	 t e x t	 tha t	 seemed	 r ele v an t.	 B y	 the 	
se t	 crit eria,	 w e	 designed	 the	 final	 selection	 of	 articles, 	 which	 w e	 analy z ed	 in	 de t ail 	
in	 acc or dance	 with	 the	 purpose 	 of	 our	 r esear ch.	 The	 en tir e 	 pr ocess	 of	 finding 	 and 	
selecting	articles	is	sho wn	in	Figur e	1.	
Figure 1: Process of obtaining and selecting studies.
6. Results
T able	 1	 pr esen ts	 the	 main	 f ea tur es	 of	 the	 included	 s tudies.	 Of	 the	 28	 s tudies	 in -
cluded,	21	w er e	quan tit a tiv e	and	7	used	qualit a tiv e	r esear ch	appr oaches.	
Sur v e y	(author s,	y ear)	 
and	type	of	sur v e y
Sample
R esear ch	appr oach	 
and	me thod	of	da t a	c ollection
Andó	e t	al.	(2016)	
Quan tit a tiv e	r esear ch
Adults	in v olv ed	in	addiction	
tr ea tmen t	pr ogr ams	(N=169)
St a tis tic al	analy sis	 
(ques tionnair es)
A tkins	and	Ha w don	(2007)
Quan tit a tiv e	r esear ch
P articipan ts	in	addiction	tr ea t -
men t	support	gr oup s	(N=924)
St a tis tic al	analy sis	 
(ques tionnair es)
Blak ene y ,	Blak ene y	and	Helmut	
(2005)
Qualit a tiv e	r esear ch
Chr onic	addicts	who	ha v e	en t er ed	
the	r ec o v er y	pr ocess	in	the	Je wi-
sh	c ommunity	(N=29)
Phenomenological  
c on t en t	analy sis	 
(semi-s tructur ed	in t er vie w s)
Br o wn	e t	al.	(2007)
Quan tit a tiv e	r esear ch
P articipan ts	in	the	pr ogr am	of	
r ec o v er y	fr om	alc oholism	(N=26)
St a tis tic al	analy sis	 
(ques tionnair es)
Br o wn	e t	al.	(2013)
Quan tit a tiv e	r esear ch
Adults	cur ed	of	addiction	(N=91)
St a tis tic al	analy sis	 
(ques tionnair es)
Doty -S w ee tnam	and	Morrisse tt e	
(2018)
Qualit a tiv e	r esear ch
W omen	in	the	pr ocess	of	r ec o v e-
ring	fr om	alc oholism	with	a t	leas t	
5	y ear s	of	ab s tinence	(N=7)
The	phenomenologic al	me-
thod	with	c on t en t	analy sis	
(in t er vie w s)
Galanter ,	Dermatis	and	Santucci	(2012)
Quantitative	r esear ch
Y oung	participan ts	of	AA	gr oup s	
(N=266)
St a tis tic al	analy sis	 
(ques tionnair es)
Galan t er	e t	al.	(2013)
Quan tit a tiv e	r esear ch
Adult	participan ts	(ph y sicians)	
who	w er e	AA	member s	(N=144)
St a tis tic al	analy sis	 
(ques tionnair es)
Galan t er	e t	al.	(2020)
Quan tit a tiv e	r esear ch
P articipan ts	of	the	Nar c otic	
Anon ymus	pr ogr am	(N=450)	
St a tis tic al	analy sis	 
(ques tionnair es)
Jack son	and	Cook	(2005)
Qualit a tiv e	r esear ch
Members	of	a	spiritual	group	in	the 	
community	recovery	progr am	f or 	
people	with	alcohol	problems	(N	=	5)
Con t en t	thema tic	analy sis	
(analy sis	of	t opics	tha t	emer -
g ed	a t	the	mee tings)
127 potentially important  
scientific articles with access to the 
full text in the Web of Science and 
Scopus databases
73 articles were excluded based 
on a review of the title and abstract
A more detailed review 
of 54 articles
26 excluded articles
28 articles for 
final analysis

475 Saša Poljak Lukek et al.  - Spiritual and Religious Factors of Recovery... 
Sur v e y	(author s,	y ear)	 
and	type	of	sur v e y
Sample
R esear ch	appr oach	 
and	me thod	of	da t a	c ollection
K elly	and	E ddie	(2020)	
Quan tit a tiv e	r esear ch
Adults	(US A	na tional	sample)	
(N=2002)
St a tis tic al	analy sis	 
(ques tionnair es)
K erlin	(2017)
Quan tit a tiv e	r esear ch
W omen	in v olv ed	in	in t egr a tiv e	
ins titutional	tr ea tmen t	of	addicti -
on	(N=95)
St a tis tic al	analy sis	 
(ques tionnair es)
Le wis	and	Allen	(2017)
Qualit a tiv e	r esear ch
50+	y ear s	old	Alask an	na tiv es	
in v olv ed	in	the	P eople	Aw ak ening	
pr oject	(N=10)
Thema tic	analy sis	 
(in t er vie w s)
Mason	e t	al.	(2009)
Quan tit a tiv e	r esear ch
Men	in v olv ed	in	a	sub s t ance	
abuse	r ehabilit a tion	pr ogr am	
(N=77)
St a tis tic al	analy sis	 
(ques tionnair es)
Medlock	e t	al.	(2017)
Quan tit a tiv e	r esear ch
Adults	diagnosed	with	a	serious	
addiction	disor der	(N=131)
St a tis tic al	analy sis	 
(ques tionnair es)
Miller	and	Saunder s	(2011)
Quan tit a tiv e	r esear ch
P er sons	in	the	pr ocess	of	gr oup	
and	individual	ther ap y	(N=55)
St a tis tic al	analy sis	 
(ques tionnair es)
Murr a y ,	Gog gin	and	Malc arne	(2006)
Quan tit a tiv e	r esear ch
Member s	of	AA	(N=144)
St a tis tic al	analy sis	 
(ques tionnair es)
Necula,	Baciu	and	Pung a	(2019)
Qualit a tiv e	r esear ch
P articipan ts	in	the	alc oholism	
tr ea tmen t	pr ogr am	or g aniz ed	b y	
the	Blue	Cr oss	Associa tion	fr om	
R omania	(N=o v er	700)
T riangulation	of	methods	(dir ect 	
observ ation, 	analysis	of	daily 	
r eports	and	int erviews	with 	
user s	of	the	r ecov ery	pr ogr am)
P ana ti	e t	al.	(2020)
Quan tit a tiv e	r esear ch	
Adults	diagnosed	with	alc ohol	
addiction	s yndr ome	(N=50)
St a tis tic al	analy sis	 
(ques tionnair es)
P ar dini	e t	al.	(2000)
Quan tit a tiv e	r esear ch	
Adults	cur ed	of	alc ohol	and/ or	
other	drug	addiction	(N=236)
St a tis tic al	analy sis	 
(ques tionnair es)
Piderman	e t	al.	(2007)
Quan tit a tiv e	r esear ch
Adults	in	the	pr ocess	of	tr ea ting	
alc ohol	addiction	(N=74)
St a tis tic al	analy sis	 
(ques tionnair es)
Piderman	e t	al.	(2008)
Quan tit a tiv e	r esear ch
Adults	who	ha v e	c omple t ed	an	
alc ohol	addiction	tr ea tmen t	
pr ogr am	(N=74)
St a tis tic al	analy sis	 
(ques tionnair es)
P olcin	and	Z emor e	(2004)
Quan tit a tiv e	r esear ch	
P articipan ts	in	AA	gr oup s	and	
other	tr ea tmen t	pr ogr ams	
(N=200)
St a tis tic al	analy sis	 
(ques tionnair es)
R obinson	e t	al.	(2007)
Quan tit a tiv e	r esear ch
Adults	cur ed	of	alc ohol	addiction	
(N=123)
St a tis tic al	analy sis	 
(descrip tiv e	longitudinal	s tudy)	
(ques tionnair es)
Selv am	(2015)
Qualit a tiv e	r esear ch
P articipan ts	(a	man	and	a	w oman) 	
with	e xperience	of	alc ohol	abuse 	
included	in	a	pr ogr am	wher e 	
elemen ts	of	Chris tian	c on t empla-
tion	w er e	pr actised	(N=2)
Case	s tudy	 
(in t er vie w	and	ques tionnair es)
W ade	(2013)
Qualit a tiv e	r esear ch
Alc oholics	in	the	pr ocess	of	r ec o-
v er y	in	AA	(N=12)
Phenomenological method  
(in t er vie w s)
W ebb	e t	al.	(2006)
Quan tit a tiv e	r esear ch
Adults	with	alc ohol	addiction	
included	in	a	c ommunity	tr ea t -
men t	pr ogr am	(N=157)
St a tis tic al	analy sis	 
(ques tionnair es)
Y e t erian,	Bur sik	and	K elly	(2015)
Quan tit a tiv e	r esear ch
Adolescen ts	one	y ear	a ft er	the	
end of treatment
(N	=	127)
St a tis tic al	analy sis	 
(ques tionnair es)
Not es:	AA	-	Alc oholics	Anon ymous.	In	articles	tha t	included	diff er en t	types	of	addiction	in	
the	r esear ch,	w e	analy z ed	only	da t a	r ela t ed	t o	alc ohol	addiction.
Table 1: Included studies and their characteristics.

476 Bogoslovni vestnik 82 (2022) • 2
R esear ch	 mos tly	 emphasiz es	 tha t	 v arious	 spiritual	 v ariables	 de v elop	 and	 func -
tion	 in	 the	 r ec o v er y	 pr ocess	 and	 tha t	 this	 spiritual	 de v elopmen t	 is	 associa t ed	 with 	
achie ving	 be tt er	 r esults	 in	 the	 pr ocess	 of	 r ec o v er y	 fr om	 alc oholism.	 With	 the	 e x -
cep tion	 of	 tw o	 s tudies	 (A tkins	 and	 Ha w don	 2007;	 Y e t erian, 	 Bur sik 	 and	 K elly	 2015) 	
tha t	 did	 not	 c on firm	 tha t	 the	 spiritual/r eligious	 dimensions	 incr ease	 an	 individu -
al’ s	 ability	 t o	 main t ain	 ab s tinence, 	 s tudies	 highligh t	 some	 import an t	 aspects	 of 	
spi ri tual i ty . 	 These	 ar e	 r el a t ed 	 t o	 l o w er	 l e v el s	 of	 cr a vi ng	 f or	 al c ohol ,	 one	 r emai ns	
sober	 mor e	 easily	 and	 with	 hig her	 cert ain ty ,	 and	 be tt er	 r ec o v er s	 p s y chologic ally .	
The	 findings	 of	 r esear ch	 on	 the	 r ole	 of	 spirituality	 as	 one	 of	 the	 c omponen ts	 in 	
the 	 pr oce ss	 of	 r e c o v e r y 	 fr om	 alc oholism	 c an	 be 	 summar iz e d	 in	 the 	 f ollo wing	 t op-
ics:	 the	 le v el	 of	 spirituality ,	 spiritual	 pr actice,	 r eligious	 c oping ,	 spiritual	 gr o wth	 and 	
per sonal	r ela tionship	with	God.	
6.1 Level of Spirituality/Religiosity
The	 r esear ch	 r esults	 sho w	 a	 positiv e 	 c orr ela tion	 be tw een	 higher	 le v els	 of	 spiritua-
lity/r eligiosity 	 and	 positiv e 	 aspects	 in	 the	 r ec o v er y	 pr ocess, 	 which	 also	 c on tribut e 	
t o	 a	 higher	 abili ty	 t o	 main t ain	 ab s tinence.	 A	 higher	 le v el	 of	 spirituality	 is	 associa -
t ed	 with	 a	 higher	 le v el	 of	 self -c on fiden t	 decisiv eness	 t o	 main t ain	 sobrie ty	 (Br o wn 	
e t	 al.	 2013).	 Spirituality	 and	 r e ligiosity	 ar e	 associa t ed	 with	 a	 mor e	 op timis tic	 lif e	
orien t a tion, 	 gr ea t er	 per cep tion	 of	 social	 support, 	 higher	 r esilience	 t o	 s tr ess	 and	
lo w er	 le v els	 of	 an xie ty , 	 which	 c on tribut es	 t o	 a	 mor e 	 success ful	 c oping	 with	 addic -
tion	 (P ar dini	 e t	 al.	 2000).	 When	 a	 higher	 le v el	 of	 spirituality	 in	 the	 r ec o v er y	 pr o-
cess	 is	 also	 associa t ed	 with	 a	 per son’ s	 self -e ffic acy , 	 i.e.	 a	 pr oactiv e 	 a ttitude 	 tha t 	
leads	 t o	 chang e,	 the	 desir e	 f or	 alc ohol	 decr eases	 (Mason	 e t	 al.	 2009; 	 Piderman	 e t 	
al.	 2007 ).	 A	 high er	 le v el	 of	 spir ituality	 is	 also	 associa t ed	 with	 less	 neg a tiv e	 a ff ect,	
mor e	 social	 and	positiv e	 beha viour ,	 and	mor e	 appr opria t e	 self -c ar e	 (P ana ti	e t	 al.	
2020),	ther eb y	incr easing	the	po w er	t o	ab s t ain	fr om	alc ohol.	
In	 g ener al,	 spiritually/r eligiously -orien t ed	 individuals	 ar e	 e xpect ed	 t o	 ha v e	 a 	
lo w er	 pr opensity	 t o	 c onsume	 alc ohol	 and	 other	 sub s t ances,	 and	 s tr eng thening 	
spirituality/r eligiosity	 pr o vides	 a	 s tr ong er	 c ommitmen t	 t o	 main t aining	 ab s tinence	
during	 r ec o v er y .	 De v eloping	 spiritual 	 and	 r eligious	 belie f s	 in	 the	 r ec o v er y	 pr ocess 	
in	 addicts	 is	 also	 ther apeutic	 and	 incr eases	 the	 chances	 of	 tr ea tmen t	 success	 (Ne-
cula,	 Baciu	 and	 Pung ă	 2019).	 R esear ch	 c on firms	 tha t	 in	 r ec o v er y	 pr ogr ams	 tha t 	
include	 spiritua l	 gr o w th,	 the	 le v el	 of	 spirituality	 and	 f aith	 inc r eases,	 which	 help s	
t o	 main t ain	 sob rie ty	 (Br o wn	 e t	 al.	 2007),	 as	 the	 s ymp t oms	 of	 an xie ty	 decr ease	 in	
r ela tion	 t o	 a	 higher	 le v el	 of	 spirituality	 (Andó	 e t	 al.	 2016).	 Spirituality	 is	 said	 t o	 be	
mor e	 import an t	 in	 the	 r ec o v er y	 pr ocess	 f or	 individuals	 who	 ha v e	 c omple t ed	 f or -
mal	 tr ea tmen t	 than	f or	 those	who	ha v e	 r ec o v er ed	 without	it.	In	 addition,	 higher	
lev els	 of	 spirituality/r eligiosity	 ar e	 e xpect ed	 t o	 c on tribut e	 diff er en tly	 t o	 major 	
chang es	 acc or ding	 t o	 cert ain	 char act eris tics	 (e. g.	 the y	 ha v e	 sho wn	 mor e	 signifi-
c ance	 in 	 Afric an	 Americ ans	 than	 Cauc asians	 and	 in	 w omen	 c ompar ed	 t o	 men	 in	
the	r ec o v er y	pr ocess)	(K elly	and	E ddie	2020).

477 Saša Poljak Lukek et al.  - Spiritual and Religious Factors of Recovery... 
6.2 Spiritual Practice
Some	 r esear ch	 has	 f ocused	 on	 g ener al	 or	 specific	 aspects	 of	 spiritual/r eligious 	
p r actice	 asso ci a t ed 	 wi th 	 th e	 r ec o v er y	 p r o cess. 	 In 	 g en er al ,	 p er so n al 	 sp i ri tu al 	 p r ac-
tices	incr ease	 the	 possibility	 of	 main t aining	 abs tinence 	 (Piderman	 e t	 al.	 2007; 	
2008).	 Pr omoting	 spirituality	 thr ough	 r eading	 spiritual	 t e x ts, 	 discussions, 	 lis t en-
ing	 t o	 other s,	 and	 participa ting	 in	 c on v er sa tions	 about	 spirituality	 is	 an	 import an t 	
f act or 	 in	 achie ving	 sobrie ty	 (Br o wn	 e t	 al.	 2007).	 Chris tian	 c on t empla tiv e 	 pr actice,	
which	 pr omot e s	 spiritual	 gr o w th	 thr ough	 s tr e ng the ning	 se lf -a w ar e ne ss, 	 se lf -r eg-
ula tion, 	 humility , 	 f or giv eness, 	 social	 r esponsibility 	 and	 in t ellig ence,	 also	 has	 the 	
pot en tial	 t o	 low er	 cr a vings	 f or	 alc ohol	 (Selv am	 2015).	 Pr a y er	 and	 a tt ending	 chur ch/
Mass,	 which	 enable	a	per sona l	r ela tionship	 with	God	while	also	pr o viding	 a	sup -
port	 ne tw ork	outside	 the	,drinking	 c ompan y ‘	 (non-drinking	 social	 en vir onmen t),	
ar e	 import an t	 f act or s	 in	 motiv a ting	 sobrie ty	 (Le wis	 and	 Allen	 2017).	 A tt ending 	
M ass	 (and	 sa c r a m e n t a l	 pr a c tic e )	 c an	 pr om ot e 	 t he 	 c om ple x	 r e c o v e r y 	 pr oc e ss, 	 as	
ther e	 one	 c an	 lis t en	 t o	 God’ s	 w or d	 and	 pr a y	 with	 other s,	 thus	 es t ablishing	 a	 sense 	
of	 c ommunity ,	 which	 also	 pr omot es	 r ec o v er y	 b y	 lo w ering	 the	 f eelings	 of	 loneli-
ness	and	aliena tion	(W ade	2013).	
6.3 Spirituality as a Way of Coping with Stress (Religious Coping)
Some	 s tudies	 ha v e	 f ocused	 on	 e x amining	 the	 r ela tionship	 be tw een	 the	 r ole	 of 	
spirituality/r eligiosity	 as	 a	 mechanism	 f or	 c oping	 with	 s tr ess	 and	 the	 aspects	 of 	
the	 r ec o v er y	 pr ocess.	 The y	 find	 tha t	 v arious	 in t er v en tions	 in	 the	 r ec o v er y	 pr ocess 	
deepen	 man y 	 positiv e 	 dimensions	 of	 spirituality 	 and	 r eligiosity ,	 including	 positiv e 	
r eligious	 c oping	 (R obinson	 e t	 al.	 2007).	 The y	 c on firm	 tha t	 positiv e	 r eligious	 c o-
ping	 (inc orpor a ting	 spiritual/r eligious	aspects	 of	 c oping	 with	 s tr ess,	 which	 s t ems	
fr om	 a	 sense	 of	 positiv e	 c onnection	 and	 c ollabor a tiv e	 r ela tionship	 with	 God,	 fr om 	
which	 one	 dr a w s	 s tr eng th	 t o	 f ace 	 one ’ s	 trials)	 is	 associa t ed	 with	 higher	 success	 in 	
the	 r ec o v er y	 pr ocess	 (P olcin	 and	 Z emor e	 2004).	 F or	 e x ample,	 this	 w a y	 of	 r eligious 	
c oping	 is	 associa t ed	 with	 a	 lo w er	 le v el	 of	 alc ohol	 c onsump tion	 be f or e	 en t ering 	
the	 r ec o v er y	 pr ocess	 and	 a	 t endency	 t o	 s tr ong er	 mutual	 support	 of	 participan ts	
in	 the	 r ec o v er y	 pr ocess,	 which	 is	 r e flect ed	 in	 a	 lo w er	 desir e	 f or	 sub s t ance	 and	 ab-
s tinence	tha t	is	mor e	r eliable	a ft er	dismissal	(Medlock	e t	al.	2017).
6.4 Spiritual Growth
R esear ch	 tha t	 has	 e x amined	 the	 pr ogr ess	 of	 per sons	 in	 the	 ar ea	 of	 spirituality	 in	
the	 r ec o v er y	 pr ocess,	 without	 e x cep tion	 poin ts	 t o	 the	 f act	 tha t	 the	 dimensions 	
of	 spirit uality	 and	 r eligiosity	 in 	 people	 in	 the	 r ec o v er y	 pr ocess	 ar e	 s tr eng thened.	
Higher	 le v els	 of	 spirituality	 ar e	 also	 associa t ed	 with	 gr ea t er	 success	 in	 main t aining 	
sobr ie t y .	 Spir it ua l	 g r o w t h	 in	 t he 	 r e c o v e r y 	 pr oc e ss	 is	 oft e n	 t he 	 r e sult 	 of	 in t e r v e n ti-
ons	 tha t	 spe cific	 r ec o v e r y	 pr ogr ams	 include 	 in	 the	 r ec o v e r y 	 pr ocess	 (e . g.	 spiritual 	
c on t en t	 in	 discussion	 gr oup s,	 discussions,	 r eading	 t e xts	 with	 spiritual/r eligious 	
c on t en t)	 (Br o wn	 e t	 al.	 2007),	 as	 w ell	 as	 r ela tionship s	 with	 oth er	 per sons	 (friends,	
r ela tiv es)	 tha t	 enc our ag e	 spiritual	 gr owth	 (Doty -S w ee tnam	 and	 Morrisse tt e	 2018). 	

478 Bogoslovni vestnik 82 (2022) • 2
Thus,	 in	 the	 pr ocess	 of	 r ec o v er y ,	 a	 kind	 of	 spiritual 	 a w ak ening	 occur s	 (Galan t er , 	
Derma tis	 and 	 San tucci 	 2012). 	 P articipan ts	 e xperience	 God’ s	 pr esence	 on	 a	 per so -
nal	 le v el	 and	 as	 a	 r esult, 	 their	 sense 	 of	 c onnection	 with	 God	 deepens	 (Galan t er 	 e t 	
al.	 2013),	 their	 daily	 spiritual	 e xperience	 incr eases,	 the y	 e xperience	 a	 deeper	 me -
aning	 of	 lif e	 (R obinson	 e t	 al.	 2007)	 and	 f eel	 higher	 e xis t en tial	 w ell-being	 in	 g ener al 	
(Miller	 and	 Sau nder s	 2011).	 In	 r ec o v er ed	 participan ts,	 w e	 ma y	 find	 tha t	 spiritual	
gr o w th	 the y	 e xperi ence	 i n	 the	 r ec o v er y	 pr ocess	 i ncr eases	 thei r	 op timi s tic	 l if e	 ori -
en t a tion	 and	 op enness	 t o	 socia l	 c on t acts	 and	 r esilience	 t o	 s tr ess,	 while	 it	 lo w er s	
an xie ty	 (P ar dini 	 e t	 al.	 2000)	 and	 depr ession	 (Galan t er	 e t	 al.	 2020).	 An	 import an t	
dimension	 of	 spiritual	 gr o w th	 in	 the	 r ec o v er y	 pr ocess	 is	 also	 the	 achie v emen t	 of	
f or giv eness	 (t o	 self	 and	 other s),	 which	 is	 a	 not e w orth y	 c omponen t	 of	 success ful	
r ec o v er y ,	 as	 i t	 al l o w s	 o n e	 t o 	 o v er c ome	 u n r eso l v ed 	 asp ects	 th a t	 ma y	 d ri v e	 al c o h o l 	
abuse	 (W ebb	 e t	 al.	 2006).	 All	 of	 the	 lis t ed	 dimensions	 of	 spiritual	 gr o w th	 in	 the 	
r ec o v er y	pr ocess	ar e	associa t ed	with	a	lo w er	cr a ving	f or	alc ohol.
6.5 Personal Relationship with God
The	 dimension	 tha t	 emer g es	 fr om	 r esear ch	 and	 e xplains	 ho w	 spirituality	 and	 r eli -
giosity	 help	 in	 the	 r ec o v er y	 pr ocess	 and	 support	 the	 main t enance	 of	 ab s tinence,	
is	 an	 aspect	 of	 e xperiencing	 a	 r ela tionship	 with	 God	 on	 a	 deeper ,	 per sonal	 le v el.	
It	 is	 import an t	 t o	 e xperience	 God’ s	 g enuine	 pr esence,	 also 	 r e flect ed 	 in 	 a	 secur e 	
a tt achmen t 	 t o	 God,	 which	 is	 associa t ed	 with	 less	 cr a ving	 f or	 alc ohol	 and	 main-
t aining	 sobrie ty	 (Galan t er	 e t	 al.	 2013;	 K erlin	 2017).	 P er sons	 in	 the	 healing	 pr ocess 	
deepen	 their	 per sonal	 r ela tionship	 with	 God,	 wher e	 the y	 e xperience	 God	 as	 a	 per -
sonal	 sa viour	 who	 has	 helped	 them	 sur viv e	 all	 the	 dang er s	 of	 addiction	 and	 s t op	
d ri n ki n g. 	 F o r	 th em,	 th e	 d eci si o n 	 t o 	 s t o p 	 d ri n ki n g	 an d 	 t o 	 r ec o v er	 eq u al s	 a	 cru ci al	
momen t	 of	 chang e	 in	 their	 liv e s,	 and	 the y	 belie v e	 tha t	 the y	 w ould	 not	 be	 able	 t o	
per se v er e	 on	 this	 pa th	 and	 w ould	 s t art	 drinking	 ag ain	 if	 the y	 did	 not	 e xperience	
support	 and	 salv a tion	 fr om	 God	 (Le wis	 and	 Allen	 2017).	 This	 per sonal	 and	 sa v -
ing	 r ela tionship 	 with	 God	 is	 also	 the	 r esult	 of	 spiritual	 a w ak ening	 (Galan t er	 e t	 al.	
2013),	 and	 the y	 e xperience	 it	 as	 men t ally	 ‚hearing ‘	 ho w	 God	 speak s	 inside	 them	
(2020).	 Man y	 e xperience	 their	 addiction 	 t o	 alc ohol	 as	 some thing	 the y	 ha v e	 r e-
placed	 God	 with,	 and	 f eel	 tha t	 in t ense	 hung er	and	 thir s t	 f or	 God	 lie	 behind	 their	
addiction.	 Bec ause	 of	 drinking ,	 the y	 f aced	 in f eriority	 and	 f eelings	 of	 loneliness	 and 	
aliena tion,	 which,	 ho w e v er ,	 diminished	 in	 their	 per sonal	 r ela tionship	 with	 Jesus	 in 	
the	 Euch aris t,	 wher e	 the y	 f elt	 accep t ed	 b y	 Jesus	 e v en	 though	the y	 w er e	 sinner s.	
T h e y	 e xp eri en ced 	 h i s	 mer cy	 an d 	 f o r gi v en ess	 -	 an d 	 wi th o u t	 a	 sen se	 th a t	 o n e	 h as	
been	 f or giv en,	 ther e	 is	 no	 r ec o v er y .	 The	 Eucharis t	 ensur es	 the	 true	 pr esence	 of 	
Jesus	 and	 thus	 a	 r ela tionship	 in	 which	 one	 c an	 be	 f elt,	 r es tructur e	 one’ s	 e xis ting	 lif e 	
and	 ob ser v e	 ne w	 things	 in	 r eal	 lif e,	 as	 w ell	 as	 t o	 c on tinue	 sob rie ty .	 The	 Eucharis t	
m e ans	 t o	 unit e 	 w it h	 Chr is t , 	 w ho	 is	 lif e , 	 a nd	 t o	 g o	 w it h	 him 	 t hr oug h	 t he 	 pr oc e ss	 of	
r e c o v e r y , 	 which	 is	 de a th	 and	 r e sur r e ction.	 Dur ing 	 the se 	 e xpe rie nce s, 	 as	 w e ll	 as	 in 	
belonging	 t o	the	Chur ch	and	 c ommunity ,	the y	f elt	sa f e,	 and	 abo v e	all,	 the y	w er e	
inspir ed	 b y	 the	 vie w	 of	 dea th	 and	 r esurr ection,	 which	 is	 an	 import an t	 par allel	 t o	
the	 r ec o v er y	 pr ocess	 (W ade	 2013).	 F or	 per sons	 in	 the	 pr ocess	 of	 r ec o v er y ,	 a	 per -

479 Saša Poljak Lukek et al.  - Spiritual and Religious Factors of Recovery... 
sonal	 r e la tionsh ip	 with	 God	 thu s	 r epr esen ts	 an	 in t ernal	 poin t	 fr om	 which	 c on tr ol	
o v er	 alc ohol	 abuse	 c an	 t ak e	 pla ce	 (a	 decision	 t o	 quit,	 a	 decisi on	 t o	 r emain	 sober)	
(Murr a y ,	Gog gin	and	Malc arne	2006).
7. Discussion 
Using	 the	 me thod	 of	 a	 s y s t ema tic	 lit er a tur e	 r e vie w ,	 w e	 iden tified	 fiv e	 ar eas	 tha t	
c o v er	 the	 r esults	 of	 r esear ch	 in 	 the	 field	 of	 spirituality	 and	 r ec o v er y	 fr om	 alc oho -
lism.	 These	 ar e:	 le v el	 of	 spirituality ,	 spiritual	 pr actice,	 r eligious	 c oping ,	 spiritual 	
gr o w th	 and	 pe r sonal	 r e la tionship	 with	 God.	 It	 tur ne d	 out	 tha t	 these 	 ar e	 the 	 main 	
ar eas	 thr ough	 which	 w e	 c an	 e xplain	 the 	 import ance 	 of	 spirituality 	 f or	 the 	 pr ocess 	
of	r ec o v er y	fr om	alc oholism.	
Spirituality	 or	 r e ligious	 pr actices,	 which	 an	 individual	 de v elop s	 as	 part	 of	 their	
e xperience	 and 	 beha viour ,	 c on tribut e	 t o	 a	 mor e	 success ful	 c oping	 in	 the	 pr ocess	
of	 r e c o v e r y	 fr om	 addiction	 and	 also	 fr om	 the	 c onse que nces	 of	 addiction.	 Spiritu-
ality	 and	 r eligiosity	 oft en 	 help	 people	 find 	 meaning	 and	 purpose	 in	 their	 liv es, 	
especially	 in	 s tr ess ful	 and	 tr auma tic	 situa tions	 (Hill	 and	 P ar g amen t	 2003,	 64–65;	
P er es	 e t	 al.	 200 7,	 346),	 and	 als o	 c on tribut e	 t o	 f as t er	 pos t -tr auma tic	 gr o w th	 a ft er	
difficult	 e xperiences	 (Calhoun	 e t	 al.	 2000, 	 522), 	 as	 w ell	 as	 in	 r ec o v er y	 fr om	 addic-
tion	 (K e r lin	 2 0 1 7 , 	 3 9 8 ).	 In	 c oping 	 w it h	 diffi c ultie s, 	 the 	 spir itual	 dim e nsion	 is	 oft e n	
one	 tha t	 help s	 t o	 under s t and	 the	 seemingly	 inc ompr ehensible	 and	 achie v e	 c on tr ol 	
o v er	 some thing	 tha t	 is	 difficult	 t o	 manag e 	 a t	 fir s t	 glance 	 (Erz ar 	 2021, 	 928–929), 	
which	 also	 seems	 challenging	 in	 the	 pr ocess	 of	 r ec o v er y	 fr om	 alc oholism.	 Based	
on	 the	 r esults	 of	 the	 r esear ch,	 w e	 c an	 c onclude	 tha t	 aspects	 of	 spirituality	 and 	
r eligiosity	 enable	 an	 individual	 t o	 div ert	 a tt en tion	 fr om	 addiction, 	 learn	 ne w	 s tr a t -
egies	 f or	 sa tis f ying	 basic	 r ela tional 	 needs,	 ne w	 s tr a t egies	 f or	 c oping	 with	 s tr ess 	
and	finding	ne w	meaning	in	lif e.	
Wha t	 is	 import an t	 her e	 is	 tha t	 spiritual	 or	 r eligious	 c oping	 with	 s tr ess	 is	 based	
on	 a	 s tr ong	 and 	 secur e	 r ela tionship	 with	 God	 (or	 other	 tr anscenden t	 being)	 fr om	
which	 a	 per son	 dr a w s	 a	 sense	 of	 cert ain ty	 and	 trus t.	 R esear ch,	 t oo ,	 sho w s	 tha t	 a	
per sonal	 r ela tionship 	 with	 God	 is	 an	 import an t	 f act or	 in	 success ful	 c oping	 with 	
addiction, 	 especially	 in	 main t aining	 ab s tinence.	 F or	 man y 	 r eligious	 people,	 God 	
(or	 other	 tr anscenden t	 being)	 is	 not	 an	 ab s tr act	 or	 dis t an t	 being ,	 but	 an	 import an t 	
per son	 who	 has	 an	 import an t	 place	 in	 their	 in tima t e 	 w orld.	 Man y	 theoris ts	 and	
r esear cher s	 of	 the	 r ela tional	 p s y chology	 of	 r eligion	 find	 tha t	 the 	 in tr ap s y chic 	 ima-
g e	 of	 God	 has	 the	 p s y chic	 ener gy	 and	 dynamics	 of	 a	 living	 per son.	 God	 is	 a	 p s y chic 	
r eality	 whom	 one	 f eels	 as	 r eal,	 aliv e,	 someone	 it	 is	 possible	 t o	 be	 in	 a	 r eal	 and 	
living	r ela tionship	 with.	(Belf or d	 Ulano v	 2001,	 17–22)	 E v en	 in 	 momen ts	 of	s tr ess	
and	 v ulne r ability , 	 it	 is	 a	 r e la tionship	 tha t	 c alms, 	 off e r s	 r e fug e 	 and	 c om f or t	 (Be ck 	
and	 McDonald	 2004,	 93).	 Namely ,	 when	 w e	 f ace	 emotional	 turmoil,	 f eelings	 of 	
loneliness, 	 guilt,	 and	 an xie ty , 	 and	 w e	 ar e	 vulner able, 	 secur e	 and	 trus ting 	 r ela tion-
ship s	 ar e	 of	 par amoun t 	 import ance	 (Johnson, 	 Makinen	 and	 Millikin	 2001,	 146). 	
P r o v iding 	 a	 se nse 	 of	 se c ur it y 	 w he n	 w e 	 a r e 	 v ulne r a ble 	 is	 a lso	 sa id	 t o	 be 	 one 	 of	 t he	

480 Bogoslovni vestnik 82 (2022) • 2
main	 functions	 of	 r eligion	 (Durkheim	 1965,	 419–421).	 It	 is	 in	 times	 of	 tr ouble	 and 	
c r isis	 t ha t 	 pe ople 	 f e e l	 v ulne r able 	 a nd	 fr a g ile , 	 w hic h	 is	 a w a k e ne d	 in	 t he 	 pr oc e ss	 of	
r e c o v e r y 	 fr om	 alc oholism, 	 tha t	 the y	 tur n	 t o	 God	 (or	 anothe r 	 tr ansce nde n t	 be ing )	
and	 seek	 pr ot ection,	 security	 and	 c om f ort	 (R o w a t	 and	 Kirkpa trick	 2002,	 638–639). 	
Such	 a	 r ela tions hip	 with	 a	 tr anscenden t	 being	 pr o vides	 peop le	 with	 security	 and	
c on fidence	 t o	 fu nction	 mor e	 easily	 in	 daily	 lif e	 and	 help s	 them	 c ope	 mor e	 easily	
with	trials	and	tribula tions.
In	 this	 ligh t,	 spi rituality	 also	 opens	 up	 the	 possibility	of	 pos t -tr auma tic	 gr o w th	
a ft er 	 c oping	 with	 the	 c onsequences	 of	 addiction.	 Due	 t o	 the	 dis tr ess	 c aused	 b y 	
f acing	 addiction	 and	 its	 c onsequences,	 people	 in	 their	 vulner ability 	 find	 and	 es-
t ablish	 c on t act	 with	 God	 in	 a	 ne w	 w a y .	 The y	 oft en	 e xperience	 a	 spiritual	 a w ak en-
ing ,	 which	 pr omot es	 the	 pr ocess	 of	 r ec ov ery	 fr om	 alc oholism,	 by	 es t ablishing 	
c on t act	 with 	 a	 higher	 po w er	 thr ough 	 pr a y er	 and 	 medit a tion,	 which 	 ar e	 the	 c or -
ner s t ones	of	r ec o v er y	support	pr ogr ams	(K erlin	2017,	405–406).	
The	 pr esen t ed	 s tudy	 is	 thus	 a	 s t arting	 poin t	 f or	 further	 r esear ch	 in t o	 the	 im-
port ance	 of	 spirituality	 in	 the	 pr ocess	 of	 r ec o v er y	 fr om	 alc oholism. 	 Abo v e	 all,	 it 	
f ocuses	 on	 the	 import ance	 of	 an	 individual’ s	 spirituality	 as	 a	 signific an t	 aspect	 of	
c oping	 with	 addiction.	 Her e	 w e	 r ec ogniz e	 the	 need	 f or	 further	 r esear ch	 tha t	 w ould 	
shed	 e v en	 mor e	 ligh t	 on	 aspects	 of	 the	 e xperience	 of	 those	 r ec o v ering	 fr om	 alc o-
holism.	 Ther e	 is	 especially	 a	 need	 f or	 additional	 qualit a tiv e 	 r esear ch,	 which	 w ould 	
pr o vide	 in-dep th	 insigh t	 in t o	 ho w	 spiritual	 dimensions	en t er	 this	 s tructur e	 of	 e x -
perience	 and	 wha t	 is	 their	 r ole	 and	 c on tribution	 in	 the	 pr ocess	 of	 r ec o v er y	 fr om	
alcoholism. 
8. Conclusion 
The	 na tur e	 of	 the	 pr ocess	 of	 r ec o v er y	 fr om	 alc oholism	 is	 e x tr emely	 c omple x:	 it 	
is	 a	 c on tinuous	 and	 multif ace t ed	 lif e	 chang e	 tha t	 allo w s	 a	 per son	 t o	 fir s t	 r ec o v er	
and	 then	 e v en tually	 main t ain	 sobrie ty	 (P ouille	 e t	 al.	 2020,	 2;	 W ade	 2013,	 1138).	
It	 is	 a	 dis tinctly	 per sonal 	 pr ocess,	 and 	 ab s tinence	 being	 only	 one	 aspect	 of	 it;	 in 	
t his	 pr oc e ss, 	 t he 	 indiv idual	 e m ba r k s	 on	 a	 pa t h	 of	 de e pe r 	 t r a ns f or m a tion	 a nd	 pe r -
sonal	 gr o w th, 	 par t	 of	 which	 is	 spir itual	 gr o w th.	 Spir ituality 	 in	 r e c o v e r y 	 c an	 be	 un-
der s t ood	 as	 a	 r ela tionship	 with	 someone/ some thing	 with	 meaning	 tr anscending	
the	 individual.	 The	 findings	 sug g es t	 tha t	 sub s t ances	 ar e	 of	 particular	 import ance	
t o	 the	 addict	 (McCaule y	 and	 R eich	 2008,	 25).	 Addicts	 de v elop	 a	 deep	 emotional	
a tt achmen t	 t o	 a	 sub s t ance	 and	 c an	 giv e	 it	 v er y	 per sonal	 meaning.	 It,	 ther e f or e, 	
seems	 r easonable	 t o	 think	 tha t	 only	 some thing	 with	 similar	 dep th	 and	 gr ea t er 	
per sonal	 signific ance,	 both	 spiritual	 and	 emotional,	 c an	 tr anscend	 and	 chang e	 this 	
a tt achmen t.	 Fr om	 this	 per spectiv e,	 addicts	 mus t	 fir s t	 r ec ogniz e	 and	 ackno wledg e 	
the	 depth	 of	 their	 emotional 	 a tt achmen t	 t o	 the	 subs t ance	 and	 then	 accept	 guidan -
ce	 t o w ar ds	 find ing	 higher	 mea ning	 and	 signific ance	 in	 some	 other	 aspect	 of	 lif e.	
Spirituality	 and 	 gr o w th	 in	 this	 ar ea	 c an	 ther e f or e	 be	 of	 par amoun t	 import ance	 in	
the	pr ocess	of	r ec o v er y	fr om	alc oholism.	

481 Saša Poljak Lukek et al.  - Spiritual and Religious Factors of Recovery... 
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