By: Kevin Wilson
The first article in this series, “Stages of Change,” explored the transtheoretical model, which posits six stages through which people go when they change. At any given time, only about 20 percent of people who are seeking to change are at the action stage, and most people are in one of the three earlier stages: precontemplation, contemplation, and preparation. The previous article also highlighted the concept of social liberation, a process of change that helps people move through these early stages on their way to taking action. The current article explores a theology of addiction that will help the church formulate ways to bring about social liberation for people with addictions. The idea of a theology of addiction may seem rather strange. After all, theology in its limited sense refers to statements about God. While it would be possible to address the question of why God allows addiction, that is not what it meant by the term here.1 In the broader sense of the term, however, theology also involves an understanding of humanity and its relationship to God. This includes formulating a description of the human condition. A theology of addiction, in this sense, would involve a definition of addiction and how it fits into our understanding of what it means to be human. Historically, the excessive use of alcohol and other substances has been seen as a behavioral issue and categorized as a sin. The natural response to addiction, therefore, has been to preach against its abuse. This approach is characteristic of organizations such as the early days of the Salvation Army, for whom ministry to addicts has always formed a central part of their identity. Many biblical passages lend themselves to this approach, with stern warnings about the dangers of alcohol (e.g., Prov 20:1; Isa 5:11; 1 Cor 5:11; Eph 5:18). In contrast, most mental health and medical professionals refer to addiction as a disease. As such, it is not something against which preaching would be effective. No one preaches against pneumonia or cancer, for instance. As a disease, the treatment of addiction is to be approached through psychological and medical means. It is a problem over which the addict has no control, and therefore assertions that drinking or drug use is a sin are considered counterproductive. Some Christian counselors—particularly evangelicals—have resisted the idea of categorizing addiction as a disease. Edward T. Welch, for example, has argued that the disease model is a useful metaphor for understanding addiction but that we misunderstand its true nature when we take the metaphor literally. He points to the elements of choice that can lead someone toward addiction as evidence that the disease model is insufficient for explaining addiction. He offers the competing metaphors of idolatry and adultery as other ways to understand the problem, and sees sin as the root cause of addiction.2 The question of addiction as disease or sin is to a certain extent a false dichotomy. Welch and others who advocate the sin model usually talk about sin as actions that are morally wrong. Although they acknowledge that sin is something that affects the entirety of our existence, their primary focus is on individual actions and the choices that the addict makes. In their view, humans are sinners because we sin. Although the Bible certainly speaks of sin in this way, it also views sin in a much broader context of the human condition. Sin in this view is the brokenness that affects all of us and all of creation. This is often expressed through the metaphor of the fall (Gen 3; Rom 5) or St. Augustine’s concept of original sin. According to this view, we are not sinners because we sin; we sin because we are sinners. We commit sins because we are living as broken people. We were created to be one way, but we find the reality of our existence to be different than what we were intended to be.3 Just as a car with its steering out of alignment can sometimes be driven straight but will frequently pull to the side, so we, who are sometimes able to live correctly, are always being pulled off course. Paul expresses this in Romans when he says: I have the desire to do what is right, but not the ability to carry it out. For I do not do the good I want, but the evil I do not want is what I keep on doing. Now if I do what I do not want, it is no longer I who do it, but sin that dwells within me. (Rom 7:18b–20)4 As the condition that affects all of humanity, sin is the explanation for most of the problems—both personal and societal—that we experience. Our sin nature causes us to do things that are wrong, but it also accounts for physical illness and limitations. Even our relationship with nature is broken, as symbolized by God cursing the ground after the Fall (Gen 3:17–19). Sin is the disease; the evil we do and experience is merely a symptom of that disease. With this understanding of sin, it is easy to reconcile the two competing models of addiction. Addiction is sin, but it is sin in the sense that we are susceptible to it because of our broken condition. This does not mean that individual actions don’t play a role in the development of addictions, but they are only a secondary cause, in much the same way that failure to wash your hands can lead to the catching of an infectious disease. The idea of brokenness can encompasses the disease model as well, as addiction is understood as one of many diseases that we experience in this broken world. The fact that the addict’s condition is the result of the brokenness in which all of humanity finds itself means the church should resist seeing addicts as suffering from a problem that the rest of us don’t have. True, not everyone is dealing with addiction in their own life, but we are all wrestling with the consequences of living in a sinful world. Poverty, injustice, marital problems, cancer, and a host of other issues should be viewed as manifestations of the brokenness of the human condition. Addiction is just one more result of this same condition. 1 Such an endeavor would more properly fall into the larger question of why a loving God allows evil to exist, which is the subject of theodicy. 2 Welch lays out his position in Addictions, A Banquet in the Grave: Finding Hope in the Power of the Gospel, Resources for Changing Lives, Susan Lutz, ed. (Phillipsburg, NJ: P&R Publishing, 2001). For a shorter statement of his argument against the disease model, see “Sin or Sickness? Biblical Counseling and the Medical Model,” Journal of Pastoral Practice 10.2 (1990): 28–39. 3 In modern theological terms, this is what Paul Tillich called existential estrangement. 4 All quotations from the Bible are taken from the English Standard Version (Wheaton, IL: Crossway, 2001).