Bates Literature Review of 1 16

Christopher Bates
Interdisciplinary Capstone Project: Literature Review
IDS4934-14Summer CW01
Literature Review: An Investigation into Narrative and
Personal Myth-Making Within Alcohol and Drug
Addicted Recovery Communities

I. Overview
# Dene or identify the problem and/or controversy involved with your
focus, thus providing an appropriate context for reviewing the literature.

Stories of personal transformation are universal. They grab our attention and dont let go.
Interestingly, in recent years, personal transformation through the retelling of the protagonists
own story has become a major theme: characters dont change because of external events, but
because they come to see themselves in a new and different light; they retell their own stories
and in so doing, transform. This storytelling motif personal transformation as a direct result
of narrative recreation is a reection of post-modern philosophys fascination with
worldmaking and reication.

Among psychologists and mental health professionals, the idea of narrative therapy or narrative
reconstruction is gaining momentum; among addictions researchers, it is an old topic, but one
little understood; among philosophers, it is a post-modern thought, accepted by some, denied
by others; among sociologists, it is still in the emergent phase. This simple idea is central to my
research paper: how retelling stories can help people (in my example, men and women
suffering from chemical addiction) to know happiness.

# Justication of interdisciplinary approach. Not every problem or question

is an interdisciplinary one. Explain why this problem or controversy is
complex. Explain why no single discipline has been able to address it
comprehensively. Explain how each disciplines involved with the problem
or controversy understand it. Explain how this focus is an unresolved
societal need or issue.

Narrative is an intrinsically interdisciplinary term, used in multiple disciplines and in multiple

ways. It can refer to the self/societally-constructed world (sociology), as narrative therapy
(psychology), narrative medicine (addictions therapy), world-building formation and
transformation (philosophy), and spiritual narrative-making (religion) among many, many others.
No single discipline can hope to provide a complete understanding of the process or its
application, none can even provide a universally applicable denition or circumscribe the entire
scope of the research problem. While we accept that a generally accepted denition is
impossible, for consistency, this study adopts Floras interdisciplinary denition:

Bates Literature Review of 2 16

A narrative contains facts that connect to a particular theme, unfolds in time, and has a
certain plot. A story is presented as a chosen sequence of specic facts or circumstances
that are more important or realistic than others. As the story unfolds, the narrator is called on
to choose specic information that advances the story, as opposed to other information that
will not. (314 Flora)

Since post-modern philosophy has had a tremendous inuence on each of the elds considered
throughout this research, it is important to note how that philosophy has contributed and
changed the fundamental approach of various disciplines and scholars to the idea of narrative.

To wit: leading postmodern thinkers teach that humans are in a constant process of narrative-
creation and re-creation. Nelson Goldman and Ernest Becker are two of the most inuential of
these voices, arguably the co-grandfathers of narrative theory:

Much but by no means all worldmaking consists of taking apart and putting together,
often conjointly of composition and decomposition, of weighting, of ordering, of
deletion and supplementation, of deformation insofar as a version [of the new
world] is verbal and consists of statements, truth may be relevant. But truth cannot
be dened or tested by agreement with the world; for truths differ for different worlds
notoriously nebulous. (Goodman 12, 14,17)
Goodman, Nelson. Ways Of Worldmaking. n.p.: Hassocks [Eng.] : Harvester
Press, 1978.

The world of human aspiration is largely ctions, and if we do not understand this, we
understand nothing about man. It is largely symbolic creation by an ego-controlled
animal that permits action in a psychological world, a symbolic-behavioral world
separated from the present moment (Becker 33)
Becker, Ernest. The Birth And Death Of Meaning: An Interdisciplinary
Perspective On The Problem Of Man. (2nd Ed.). New York, NY, US: Free
Press, 1971. Print.

But an important idea of postmodern thought was to come slightly later. This theory states that
humans are in the process of world-building, true enough, but what makes the world-building,
narrative reconstruction so interesting is that they are intentionally unaware they are doing so.
Intriguingly, this theory notes that the inhabitants of the new world the new narrative
quickly forget the story now inhabited is one previously self-created. This concept known as
reication is one of the most important and relevant contributions of post-modern thought to
the question of narrative formation, especially within addicted communities.

Reication is the apprehension of human phenomenon as if they were things, that

is, in non-human or possibly supra-human terms. Another was of saying this is that
reication is the apprehension of the products of human activity as if they were
something else than human products Reication implies that man is capable of
forgetting his own authorship of the human woel, and further that the dialectic
between man, the producer and his products is lost to consciousness. (Berger and
Luckman 36-37)
Berger, Peter L, and Thomas Luckmann. The Social Construction Of Reality:
A Treatise In The Sociology Of Knowledge. New York: Doubleday, 1966.

Bates Literature Review of 3 16

Narrative formation has thus trickled down from philosophical ivory towers and inltrated
numerous elds across disciplinary boundaries.

The interdisciplinary foundation for this research paper is therefore the following: men and
women in our case, men and women in recovery from addiction are unaware that the
narrative structure imposed upon their lives has the power to create or deny potential for
happiness and fulllment, that the stories they tell themselves either contribute to or diminish
basic human ourishing. Nowhere is this relationship between narrative and outcome more
clearly seen than among those addicted to chemical substances, for a poorly formed narrative
can lead to jails, institutions, and even death.

Addiction is a subject studied by almost every major discipline: from biology to governmental
affairs, from criminology to sociology, from psychology to religion, it seems that everywhere one
looks there is yet another voice with a slightly different view, a new set of terms, a new set of
theories, a new set of, well everything. This research paper seeks to help those disciplinary
voices to sing in chorus, at least for a short while and perhaps only on a single topic.

But sing they shall.

# Point out overall trends in what has been published about the focus; or
conicts in theory, methodology, evidence, and conclusions; or gaps in
research and scholarship; or a single problem or new perspective of
immediate interest.

The major disciplines I consider in this paper are psychology, addiction therapy, sociology,
philosophy, and religion. Among these ve disciplines, there is no single understanding of
narrative formation, even among the disciplinary masters of each; in fact, there is rarely broad
agreement. Our pressing problem is, in part, because there is no consensus. For example,
within psychology, there is a broad understanding that some sort of spiritual experience is
necessary for recovery from addiction to have any lasting effect. Psychologists are happy to put
together measuring tools to quantify self-reports, but (strangely) are resolutely loathe to dene
this thing theyve determined absolutely necessary.

Hill, Peter C., And Kenneth I. Pargament. "Advances In The Conceptualization And
Measurement Of Religion And Spirituality: Implications For Physical And Mental
Health Research." Psychology Of Religion And Spirituality S.1 (2008): 3-17. Web.
Rowan, N. L., et al. "The Higher Power Relationship Scale: A Validation." Journal of
Social Work Practice in the Addictions 6.3 (2006): 81-95. Web.

Further, Gabriel Segal has does excellent work studying the disease model of alcoholism and
addiction and has unearthed major problems on both sides of the debate; such as the
challenges of quantication: some men and women t the diagnostic criteria for a lifelong mental
health disease, a progressive decline further down the slope towards insanity and death and
others people who had t the same criteria on a given date in their past later? They simply
dont.
Segal, Gabriel M. A. "Alcoholism, Disease, And Insanity." Philosophy, Psychiatry &
Psychology 20.4 (2013): 297-315. Academic Search Premier. Web. 1 July 2014.
Bates Literature Review of 4 16

Another example: within sociology, spirituality is discussed at length Spiritual but not
Religious groups are the fastest growing segment of the religious population and an area of
endless fascination to Sociologists of Religion but no one has been able to lay out a single
denition about which there can be consensus, no single denition others within the eld can
agree on.

Zinnbauer, BJ, et al. "Religion And Spirituality: Unfuzzying The Fuzzy." Journal For The
Scientic Study Of Religion 36.4 (n.d.): 549-564. Arts & Humanities Citation Index.
Web.
Chalfant, H. Paul. "Stepping To Redemption: Twelve Step Groups As Implicit Religion."
Free Inquiry In Creative Sociology 20.2 (1992): 115-20. Print.

Sociologists investigate the social dimensions of addiction and crime as well as the twelve step
groups that support the addicted, but as far as investigating the spiritual narrative of the
individual members of those groups? Not yet.

The disciplines this paper focuses on each have in common a post-modern fascination with
narrative and narrative creation as a discovery of meaning. I am investigating the relevant
issues, the interaction and potential integration of key theories, and the ways and means by
which narrative creation can promote both an initial adoption of a recovery lifestyle and the
sustaining of that lifestyle over an extended period of time.

# Establish the writer's reason (point of view) for reviewing the literature;
explain the criteria to be used in analyzing and comparing literature and
the organization of the review (sequence); and, when necessary, state why
certain literature is or is not included (scope).

As certain important contributing voices were considered, it became apparent that I did not
posses sufcient discipline mastery to consider their methods, concepts, etc, with anything like
comprehensiveness, though I did discover what issues they did not focus on. This lack of
attention is noted, though there may be discipline-specic reasons for the absence that I am
unaware of. This is especially true of two disciplines: sociology and psychology; their silence on
the question of narrative formation among the recovery community may be due to some
disciplinary assumption that I am unaware of or it may be simply an as-yet un-investigated
issue.

II. Categories and Organization

The literature review is split into disciplinary elds. When the authors were writing from an
interdisciplinary point of view, their work was put into the category that seemed closest to its
disciplinary relative. This approach seemed a more common sense system of organization than
attempting to categorize by historical analysis (narrative formation and addiction studies are
both relatively new elds), and there were so many conicting points of view an approach
Bates Literature Review of 5 16
organization would have been resulted in a one-view-per-category, hardly an efcient method of
delineating thought!

Many, many works were considered prior to writing this review. Only those of inherent value to
the nal paper, that were peer-reviewed, and with a solid authorial voice were noted on the
pages that follow.

III. Similarities and Differences

Psychology
Hammer, Rachel, et al. "The Experience Of Addiction As Told By The Addicted: Incorporating
Biological Understandings Into Self-Story." Culture, Medicine & Psychiatry 36.4 (2012): 712-734.
Academic Search Premier. Web. 14 July 2014.

Discipline: Psychiatry

Authority - Authors: R. R. Hammer Mayo Medical School,Seattle Pacic University; M. J.

Dingel, University of Minnesota,; J. E. Ostergren, and K. E. Nowakowski, Mayo Clinic
Biomedical Ethics Research Unit; J. E. Ostergren, School of Public Health, University of
Michigan; B. A. Koenig, Department of Social and Behavioral Sciences, Institute for Health
and Aging, University of California

Objectivity - The authors were aware that utilizing test subjects indoctrinated by their rehab
into a disease model would tilt their research that way so they were careful to utilize a
number of participants from a number of sources
The treatment sites varied in their approach to substance use. Most offered a
combination of group or individual therapy sessions and pharmacological treatments,
including methadone and drugs such as acamprosate and nicotine replacement therapy.
Several programs used audiovisual aids or treatment strategies that emphasized the
biological components of addiction. One used a brief educational lm that highlighted the
disease model of addiction; a second treatment site included a large display of living
zebra sh used to study the genetic basis of nicotine addiction.

Value: The authors focus on addictive use by describing it as an infrequent though recurring
event rather than as continual process comparing it to the stress-based theory of addiction:
The Punctuated Equilibrium theme has much in common with the stress-based theory
of addiction. This model assumes that people spend a signicant portion of life in
equilibrium with euthymia, solid relationships, and reliable employment. This steady
state is disrupted when their threshold for stress is surpassed, an adverse event takes
place, or some other anomaly occurs to punctuate that even ground with a change in
slope, causing their addictive habits to return. (720)

As such, they are more interested in the way patients buy into the disease model of addiction
and incorporate it into their self-understanding and personal narrative (rather than how they
form their own).

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Persuasive Contribution - while the treatment patients receive at a given treatment center
does highly contribute to the style of narrative that they assume, it is by no means the only
contributing factor, nor necessarily the most important:
Treatment centers employ their own dominant narratives in explaining addiction, and
clients frameworks for understanding addiction are shaped by the language and
ideology of their treatment milieu. Our participants who spoke of addiction with a genetic/
biological understanding were primarily, but not exclusively, under treatment in two
treatment centers that explicitly teach a biological model of addiction as part of
treatment.Or to the contrary, if focused inordinately on the psychosocial narrative, a
treatment center may overwork to re-author a personal narrative or improve the quality
of family dynamics as the solution for addictive behaviors, and possibly underestimate
the extent to which the substance use has re-authored the physiology of the
patient. (729)
and:
People bear templates of DNA and experiences alike whereupon the epiphenomena of
their unique biochemistries, cultures, and willful souls are entangled. Just as geneticists
and molecular biologists labor to witness the patterns and anomalies written in the
libraries of genomic testimony to being, so clinicians and therapists witness the motif and
novelty in their patients accounts of illnessaccounts told, imaged, and assayed. (730)

All of this leads the authors to suggest research and treatment professionals stop attempting to
nd a grand, unied theory of addiction and move towards narrative- based medicine, one in
which the patients OWN understanding of their condition is the basis for ongoing interaction.

Wallis, Jennifer, Jan Burns, and Rose Capdevila. "What Is Narrative Therapy And What Is It
Not? The Usefulness Of Q Methodology To Explore Accounts Of White And Epston's (1990)
Approach To Narrative Therapy." Clinical Psychology & Psychotherapy 18.6 (2011): 486-497.
CINAHL Plus with Full Text. Web. 14 July 2014.

Discipline- Psychology/ (Social Work)

Authority The authors are all psychologists and psychological researchers at respected
universities Jennifer Wallis, Berkshire Healthcare National Health Service Foundation Trust,
Berkshire, UK; Jan Burns Department of Applied Psychology, Salomons Campus, Canterbury
Christ Church University, Kent, Uk and Rose Capdevila, Faculty of Social Sciences, The Open
University, Milton Keynes, UK

Objectivity - The authors were merely attempting to discern the dominant models of
approach in a contested eld and were neither overtly pro- nor con-. They recognize
that:
Research into narrative therapy is at a comparatively embryonic stage. Few
studies exist that would be considered as good evidence for the effectiveness of
narrative therapy within the traditions of therapeutic outcome research. Some of
the reasons for this may relate to the type of research valued by narrative
therapists and problems with positivist evidence-based research. ( Wallis et al.
488)

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Value - I had hoped that this article would provide a base from which to understand
narrative therapies and narrative medicine. It did not. Evidently, even when good
researchers attempt to understand how psychologists understand narrative therapy,
they come up confused at best. This article demonstrated that within the discipline of
psychology, different researchers have come to a confused blend of conclusions.
Some are convinced that stable narratives are important and that narrative-based
therapy plays some part in effective treatment. While narrative therapy is dened in
textbooks and manuals as:
ways of understanding the stories of peoples lives, and ways of re-
authoring these stories in collaboration between the therapist / community
worker and the peoples whose lives are being discussed. It is a way of
working that is interested in history, the broader context that is affecting
peoples lives and the ethics or politics of this work. These are some of the
themes which make up what have come to be known as narrative
approaches. (Wallis et al. 488)
-these ideas are not universal nor are they common. Everyone who practices narrative
therapy has a slightly different way of doing so:
Narrative therapy and how it is carried out remain unclearly dened, which
limits studies of the efcacy of this approach (Wallis et al.486).This study also
illustrates a pluralism that has inuenced the debate around what is narrative
therapy for some time.(Wallis et al. 495)

Persuasiveness - The authors do little more than prove no one is entirely sure what
they are doing when they engage in narrative therapy. Therapists and social workers
have so many different ways of understanding their treatment modalities that
cohesiveness within the single sub-sub discipline is impossible.
If therapists are to demonstrate the effectiveness of models of therapy, specifying
what we do and how we do it is vital. The accounts identied in this study may
assist practitioners in identifying an approach to narrative therapy that reects
their values and practice. This study also illustrates a pluralism that has
inuenced the debate around what is narrative therapy for some time. (495)

Flora, K. "Recovery From Substance Abuse: A Narrative Approach To Understanding The

Motivation And Ambivalence About Change." Journal Of Social Work Practice In The Addictions
12.3 (2012): 302-315. Social Work Abstracts. Web. 14 July 2014.

Discipline: Psychology/ (Sociology)

Authority - Dr. Katerina Flora, Clinical Psychologist, Panteion University of Social and
Political Studies, Athens, Greece

Authority of evidence presented - The results are somewhat mixed as the participants were
all in treatment patients at a single rehab outside of Thessalonica, Greece; only a small
number could be sampled. Labovs structural analysis was utilized to understand how:
The primary function of narrative is to turn disorder into order. By telling a story, the
narrator tries to organize the narrative to convey a message; that is, the meaning of the
Bates Literature Review of 8 16
story. The actual process of putting things in order is completed through organizing a
series of events in a plot. (307)

Objectivity - The concern is that only two people analyzed the data, interpreting it
necessarily with a great deal of subjectivity. Potential bias was huge:
Analysis centered around the structure, plot, and main concept of the narrative, with
particular attention paid to tone, any pauses, the arguments developed, and the general
tenor with which the interview was conducted. (308)

Value - Flora shows how narratives grow and change. Her primary usefulness as a source is
in the evaluation of different narrative types; different stories lead to different recovery
outcomes/ how the types of stories we tell ourselves determine how well we live. Floras
research:
revealed seven types of narratives used by respondents following treatment: the
optimistic, the pessimistic, the overly pessimistic, the overly optimistic/enthusiastic, the
tough life, the troubled/confused, and lastly the balanced narrative. (308)

Persuasivene Contribution:
Flora though not focusing on narrative therapy or medicine does illuminate the central
role of narrative transformation in long-term, stable sobriety. This key nding provides a
consolidation of theory for other works.

narratives allow each individual to unfold one or more explanatory schemas

concerning his or her recovery, giving meaning to the painful recovery process and to
the forthcoming successful or unsuccessful therapeutic result. (313)

A narrative contains facts that connect to a particular theme, unfolds in time, and has a
certain plot. A story is presented as a chosen sequence of specic facts or
circumstances that are more important or realistic than others. As the story unfolds, the
narrator is called on to choose specic information that advances the story, as opposed
to other information that will not. Therapists interested in narrative ideas and practice
collaborate with clients to help them leave their past-connected stories of disappointment
behind and move toward the discovery of the untold story of their desired future life (new
goals, hopes, commitments, values, desires, and dreams). The main goal of the
narrative approach is not for therapists to solve their clients problems, but for the clients
to discover for themselves through conversation the hopes, desires, and so-far-
unidentied potential hidden in their past stories. It is what White and Epston (1990)
described as the process of revision of the stories and the lives of people. (314)

Addiction Research
Brooks, Ford, Jan Arminio, and Kadie-Ann Caballero-Dennis. "A Narrative Synthesis Of
Addictions, Surrender, And Relapse: Conrmation And Application." Alcoholism Treatment
Quarterly 31.3 (2013): 375-395. PsycINFO. Web. 1 June 2014.

Discipline: Addiction Therapy/ (Education)

Authority - The authors come from the disciplines of education (Brooks) and psychology
(Armino). Prior to their research, they conducted a thorough literature review of extant
Bates Literature Review of 9 16
material before embarking on their study, a standard narrative analysis with multiple levels of
double-checking for accuracy and agreement.

Disciplinary assumptions:
We elected to illuminate the experience of surrender via narrative research partly
because it assumes that people are always in the process of change. Surrender too
assumes change. Also, we selected this methodology as it is appropriate for listening to
previously silenced, oppressed, and ordinary voices that we believe people with
addictions are. Narrative researchers, make themselves as aware as possible of the
many, layered narratives at work in their inquiry space. They imagine narrative threads
emerging. Aspects of these layers include how speakers construct events through story
telling; they do not simply retell events. (379)

Objectivity: The authors did not present contrary positions or refute possible objections.
Instead they focused on one type of addiction narrative to the exclusion of all others. This
biased understanding of addiction resulted in only one kind of narrative being considered,
one the authors termed the grand narrative.
All but one participant told stories of early exposure and introduction to alcohol. Most
watched parents partake in alcohol abuse. Over time alcohol use progressed in quantity
drank and in substances used branching to other drugs. Subsequently, all participants
told stories of negative consequences that included violence, legal entanglements, lost
relationships and jobs, and most went to jail. Hopelessness and suicidal ideation
became a part of their addiction narrative. Feelings of rejection, loss, fear, and other pain
preceded frequent use and addiction. Use was a way of being or at least feeling
accepted. Use continued until participants feared death if they did not stop. Although
participants often knew that change was crucial for survival, they struggled with knowing
how to actually stop especially when friends and family encouraged continued
use. (383)

Value: The research proves that identity development and associated narrative
transformation are necessary ingredients in long-term recovery.
What is helpful for clinicians to realize is how powerful the cognitive distortions are and
the impact it has on identity and self-worth. (386)

Persuasive Contribution: The authors provide further proof that narratives are formed out
of an individual understanding/ construction of reality, not necessarily reality itself as
objectively understood.
Those participants interviewed in the hospital were in Gorskis (1989) second stage of
recovery, stabilization, and in the process of developing a structured recovery plan prior
to discharge. To a person, support in recovery was voiced as a very important aspect of
staying clean and sober, yet many of them shared how previously they did not attend AA
or Narcotics Anonymous (NA) meetings with any regularity and found themselves
relapsing.For those who chronically relapse, the narratives illustrated how the
unconscious aspect of denial returns so insidiously and surreptitiously so as to not be
detected by the addicted person. (387)

Forcehimes, Alyssa A. "De Profundis: Spiritual Transformations in Alcoholics Anonymous."

Journal of Clinical Psychology 60.5 (2004): 503-17. Web.

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Discipline Psychology/ (Psychiatry)

Authority - Forechimes is professor of Psychiatry at University of New Mexico and a

practicing psychologist with expertise in empirically supported clinical treatment. Her
research focuses on behavioral treatments for addiction including motivational
interviewing and other brief interventions; effective methods for disseminating and
teaching evidence-based behavioral treatments for addiction, mental health,
substance abuse, and health care providers.

Objectivity - Forechimes doesnt spend much energy or ink considering those who
deny the reality of the spiritual experience. It is enough that they believe, a key issue
in narrative analysis.

Value : Offers a grounding in AA theory and practice, and an introduction into how the
12 step model effects narrative formation:
Although Alcoholics Anonymous is not afliated with any religion, the roots of Alcohol-
ics Anonymous are in the Oxford Group, a nondenominational program begun as an
answer to antireligious response following World War I. (504)

and

Although it may seem counterintuitive, it is possible to make use of the descending path
toward hitting bottom as a way to the ascending quality of the spiritual transformation.
Similar to St. John of the Cross maxim, the soul must empty itself of self and experience
a passive purgation through deep trials from God. The freedom that stems from the
spiritual cleansing is repaid in the glory of a union with God. In a similar way, the AA
member who experiences the downward movement toward hitting bottom actually is
beginning an ascent. When the prior self has been exposed in its most raw and
unmanageable form, humility creates a fertile ground for the spiritual awakening. (512)

Persuasive evidence: Forechimes is not attempting to prove that the spiritual narrative
described in the De Profundis Sequence is necessarily objectively true, but rather it must be
believed to be true for the alcoholic in recovery to maintain anything like long-term sobriety. It
is in this narrative formation and acceptance that her contribution is clearly seen:

A.A. teachings acknowledge that alcohol recovery is not dened by abstinence;

recovery is dened by a transformed and sober life. Perhaps spiritual transformations
are the distinguishing factor between abstinence and sobriety.... These discrete, life-
changing spiritual-transformation experiences deserve to be understood more
completely because they seem to reveal the innermost workings of what makes A.A.
such a successful program. Sobriety is intertwined with spirituality in a way that
necessitates a spiritual transformation for successful recovery. In a profound realization,
one recovering alcoholic admitted, I came here to save my ass. And then I found out it
was attached to my soul. (516).

Philosophy/ Religioin
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Mitchell, Allison. "Taking Mentality Seriously: A Philosophical Inquiry Into The Language Of
Addiction And Recovery." Philosophy, Psychiatry, & Psychology 3 (2007): 211. Project MUSE.
Web. 14 July 2014.

Discipline: Philosophy/ (Addiction Therapy)

Authority - Allison Mitchell is a philosopher with a strong interest in Wittgenstein and

narrative formation. No other credentials are offered and her research paper shows a
lack of understanding about both the mechanism of addiction and the process of
addiction therapy. She is included to demonstrate the problems associated with a
mono-disciplinary approach.

Objectivity and Assumptions - The paper assumes a moral/ cognitive orientation of

full responsibility, writing that:
the thought and behavior involved in drug dependence is associated with a
certain pre-theoretic conception of the self that nds philosophical
expression as a grossly simplied form of materialism. Addicts tend not
to take mentality seriously: They do not understand themselves as
minded beings capable of self-awareness and development through
intentional action. Recognizing the practical implications of accepting this
philosophically unconvincing view, I argue, encourages a modication of
self-conception that is instrumental to the process of recovery from
addiction. (211)
This, of course, is a gross misunderstanding of addiction as a mental disorder.
Value- The primary value of this research is a demonstration of applying disciplinary
analysis without the benet of a broader understanding. Her bias against twelve step
programs becomes clear when she writes:
If the twelve-step programs are practically effective, one might doubt the
advisability or point of reconsidering, and perhaps revising, the rhetoric of these
programs. (220)

Why revise something that is practically effective? Because, she writes, that even if it
is unclear that such a thing would work, it is better that other, unproven, untested
opportunities are tried:
Consider the following reasons we may want to proceed with such modication:
First, revising the language of the twelve-step process will enable us to develop
an alternative picture of rehabilitation and thereby appreci- ate the multiplicity of
possible recovery routes. Second, twelve-step programs leave little space for
individual creativity in the modication of self-conception; they picture the
addicts nature and then attempt to persuade those individuals to accept the
aptness of that picture. (220)

Persuasiveness - As a means of gaining greater understanding of narrative through

Wittgensteinian analysis, much could be gained. Mitchells work could have been a
valuable source of insight were it not for her insistence that:
Bates Literature Review of 12 16
If we accept the same starting point as the twelve-step programs, we may
gesture toward an alternative picture of recovery that does not require the
renunciation of autonomy or agency and need not invoke the notion of a higher
being. (221)
Mitchell tells us more about herself and her own refusal to accept anothers narrative
than she does about either narrative therapy within addictions recovery or the
meaning-making power of narrative.

Ross, Patricia A. "The Truth Will Set You Free, Or How A Troubled Philosophical Theory May
Help To Understand How People Talk About Their Addiction." Philosophy, Psychiatry, And
Psychology 13.3 (2006): 227-231. Philosopher's Index. Web. 14 July 2014.

Discipline: Philosophy / (Addiction Therapy)

Authority - Patricia Ross is Clinical Pharmacy Specialist in Ambulatory Care and

Anticoagulation Management; Adjunct Assistant Professor, University of Maryland
School of Pharmacy

Objectivity and Assumptions - The author is critiquing a view commonly held: that a
story told indicates a story believed, commonly known as the Wittgensteinian Analysis,
such that:
every act of self-expression, whether it is verbal or written narrative, reveals
something about the conceptual framework with which the author is working.
Thus, one can learn about the author of a narrativeone can acquire a sense of
how that individual conceives of him- or herselfby looking at the language that
is employed to talk about and describe him- or herself. (228)

She challenges the view based on the fact that much of the language used in narrative
expression is assumed from culture and environment, and is used sub- and
unconsciously.

Value- Whereas some attempt to teach addicted individuals to see themselves (to tell
their story, their narrative) through the lens of strict material philosophy a view that
says the material world is the only real one, behavior is explainable in mentalistic
terms, etc Ross is interested in nding the stories addicted people are already
telling themselves.
The rst aspect relies on the belief that conceptual changebelieving the right
thingswill change ones behavior. But this is a problem that is considered in
great detail in moral philosophy, as well as being a well-studied aspect of human
psychology. In particular, empirical research has shown that beliefs (either
currently held beliefs or newly accepted beliefs) do not necessarily provide
motivation for action.Counseling intervention that relies entirely on altering the
prejudice individuals beliefs is ineffective. (230)

Persuasive Contribution - Ross agrees with Martin Weegman and Ewa Piwowoz-Hjort;
she believes that narratives are written backwards, not forwards. Powerful, life-changing
Bates Literature Review of 13 16
narrative structures are formed after the events: behavior comes before conception, not
conception before behavior:
It seems that only when the addiction is not in control of ones life that one can
begin to alter ones self-conception, especially in terms of autonomy. Thus, any
intervention that requires a conceptual change before a behavioral change
seems doomed to failure. Therapeutic intervention must rst stop the behavior,
and as a result of that begin to develop a different self-conception. (231)

Hollywood, Amy. "Spiritual but Not Religious: the Vital Interplay between Submission and
Freedom." Harvard Divinity Bulletin (Vol. 38, Nos. 1 & 2).Winter/Spring 2010 : 2/15/2013. Web.
2/15/2013

A series of common questions seem to underlie many people's conception of spiritual

experience. How am I to have my own experience of the divine? How can I experience
the divine personally, and isn't such a desire rendered impossible within the framework
of institutions that direct my understanding and experience of God? What happens to
that aspect of my experience that is irreducible to anyone else's? On the one hand,
many who consider themselves spiritual understand their spirituality in terms of an
attune-ment with nature or spiritsomething that is bigger than and lies beyond the
boundaries of themselves. Yet, on the other hand, there is a keen desire for this
experience to be one's own.

Eisenberg, Richard L. "Refuat Ha-Nefesh URefuat Ha-Guf: Spiritual Dimensions Of Addiction

Recovery." Conservative Judaism 1-2 (2009): 94. Project MUSE. Web. 14 July 2014.

Discipline - Religion (Judaism); (Addiction Treatment and Therapy)

Authority - Richard L Eisenberg was a rabbi for 25 years before switching careers
and devoting himself to drug and alcohol recovery counseling. His references include
works from Jewish religious thought and society, addiction treatment, the source texts
of AA and NA, and philosophy.

Objectivity - Eisenberg is somewhat biased (he recounts the story of how his
brothers addiction played a key role in his career change) he attempts to integrate
jewish religious thought with the philosophical tenants of AA, NA, and recovery
therapy and as such, his paper is intrinsically interdisciplinary.

Value - Eisenberg contrasts sharply with thinkers in the vein of Allison Mitchell, who
believe that the purpose of therapy with addicted persons is to correct their thinking
that they dont have control over use to a new model which says that they do. This is
basically a parallel to the moral model, which Eisenberg describes as:
The moral model of addiction can be understood as the belief that people abuse
alcohol [and other drugs] because they choose to do so.

This approach implies that
chemical dependents, by abusing drugs, are choosing an immoral path that causes
harm to themselves and the people within their familial, social, and professional
networks. The moral model causes negative and unproductive attitudes toward the
addict. A well-meaning family member or friend might say, Youd be sober if you only
Bates Literature Review of 14 16
tried harder. This type of statement reects an attitude that places blame and moral
judgments upon the addicted person. it is my view that our attitudes about addiction,
as long as they remain morally based, weaken our ability to be truly helpful to chemical
dependents. This holds true for family members, friends, and professionals alike. (95-96)

Persuasiveness - Eisenberg believes that: Understanding chemical dependency as

a biopsychosocial phenomenon also helps frame the way we apply Jewish concepts
and values to our discussion of addiction recovery (97). This is key. He uses four
important concepts from jewish religio-spiritual tradition to frame and understand
concepts from the twelve steps of recovery. It is in learning to tell the story of addiction
and recovery through this new language (using new words with altered and expanded
denitions) that integration and ultimately, greater health and success is found. The
last two paragraphs of his essay demonstrate how he accomplishes this herculean
task in his own interdisciplinary effort at seeking answers:

Finally, the deep humility that comes from ones feelings of powerlessnessover the
drug, over other people, over changing the pastis the emotional predisposition that
leads to enlightenment. Walking humbly with God is the way the person recovering from
addiction or co-dependency retains a hold on Eternity. This trust in turn engenders
faith, hope, and love. The person of faith enters the gates of Eternity, the light of spiritual
truth, through his disposition of humility.

It is no different for those of us who are in
recovery. As we are continually reminded of our powerlessness in Step 1, we develop
the need to fully trust in our Higher Power in Steps 2 and 3, a trust that keeps us
fastened in the Now and deters us from dwelling on a troublesome past and an
uncertain, possibly worrisome future. One day at a time, we nd that our faith, hope, and
love of God and one another keeps growing. As we journey along the road of recovery,
we know that the disease of addiction no longer has power over us; rather it is the power
of the Eternal that sustains us, strengthens us, bears us through our days of darkness
and lovingly carries us into light, faith, and serenity. (103-104)

Sociology

Weegmann, Martin, and Ewa Piwowoz-Hjort. "Naught But A Story: Narratives Of Successful AA
Recovery." Health Sociology Review 18.3 (2009): 273-283. Academic Search Premier. Web. 14
July 2014.

Discipline: Sociology/ (Psychology)

Authority/ Methodology - The authors base their research style and methodology from a
viewpoint an interdisciplinary space between three disciplines: Sociology, narrative
psychology, and addiction treatment and medicine. Martin Weegman, is an addictions
professional and psychologist at Queens Mary Hospital and Ewa Piwowoz-Hjort, is a
Sociologist at Sundbyberg in Stockholm, Sweden. They describe their process as:
Interpretive phenomenological analysis (IPA) was performed on nine transcribed
interviews of participants who were continually sober from alcohol/drugs for a minimum
of nine years (abstinence mean = 14 years). The method was used to discern themes
and identify the concepts of recovery participants had found helpful. (273)
Bates Literature Review of 15 16

Objectivity- The authors assume that all humans are meaning making, story making animals
and that those stories have the power to alter individual enjoyment of life:
Narrative psychology suggests that such appraisals are not merely cognitive re-
adjustments or epiphenomena, but help to make up people, so to speak, implicating
subjects in new forms of identity and trajectories. Narrative approaches can consider not
only the individual, idiosyncratic story but how stories deploy and incorporate pre-
existing discursive resources and traditions. Hence, such approaches are a potentially
strong analytic resource, allowing an in-depth understanding of both the idiosyncratic
and culturally constructed aspects of a persons story and self-account. (274)

Value for my paper: We write our stories backwards - the maps are formed after the events
that they describe:
Most participants spoke to a distinction between admitting problems around their
drinking and lives and an emotional, attitudinal shift which involved a deeper process of
acceptance. Paradoxically, for these people, it could be said that they were becoming
alcoholics in the act of stopping, which enabled them to re-appraise their pasts. In
describing a kind of gateway to recovery, one person re-construed her rock bottom from
a negative, cracking-up experience into the positive beginning of my
experience. (277)

Persuasive Contribution: AA stories and story formation, of narrative construction are

typically more extensive and elaborate than in the non addicted population and provide a
valuable glimpse into the myth making process:
Life stories express a sense of who we are, of identity in the making, the where we have
come from to the where we have got to (Lindy 1993). Life stories are revisable and tell
a great deal of our connections or group-self, to those sustaining others and networks
upon who we depend. Previous research has addressed the link between coherence
and recovery The stories thus suggest that in order to get going on the way to
recovery, people need to form a credible model of their problems, which can be used to
guide their attempts at recovery. Another useful, dynamic image is that of social and
personal identity projects (Koski-Jnnes 2002), in which previously addicted individuals
move from an initial disjunction and collapse in their view of themselves and envisage or
make themselves in new ways. (280)

IV. Conclusions
1. Important Contributing Articles:
Martin Weegman and Ewa Piwowoz-Hjorts work: Naught But A Story: Narratives Of
Successful AA Recovery; Patricia A. Ross work: "The Truth Will Set You Free, Or How A
Troubled Philosophical Theory May Help To Understand How People Talk About Their
Addiction; Katerina Floras work: "Recovery From Substance Abuse: A Narrative Approach To
Understanding The Motivation And Ambivalence About Change. Each of these were vital to the
interdisciplinary focus gained and allowed me to incorporate the themes of post-modern
worldbuilding, reication and narrative construction into the entire work.
2. Conclusions so far
Two things became clear during the research process:

Bates Literature Review of 16 16

While broad agreement exists that narrative reconstruction is important, the ways and means
people go about doing so is little understood and for this reason, any further research must
begin by looking to this vital issue. It is clear that all people (both within and without the
addiction community) are involved in retelling their stories; how do they go about doing so? The
disciplinary approaches of Narrative therapy, narrative medicine? These elds of inquiry are
sure to yield interesting results that could then be incorporated into a broader schemata.

Likewise, it is clear that twelve step programs in some unidentied way facilitate narrative
reconstruction. Here, an entire range of things are yet to be found and studied. How does the
twelve steps of AA or NA contribute to (or force) the reconstruction of narrative and thus,
identity? Is it the process or the community or some combination of both? Do rehabilitation
facilities support or interfere with the process and in what ways? These are areas of study that
would need to be explored for any signicant interdisciplinary contribution to be found.

What this paper has made apparent is that narrative reconstruction can lead to wholeness, can
lead to healthy lifestyles, can lead to human ourishing and successful relationships. For by
transforming our stories, we in some unknown way and by some unknown mechanism
transform ourselves.
3. My interdisciplinary question:
How does narrative formation and worldbuilding support and maintain healthy lifestyles?