So over the last few months I have been struggling with my health. I’ll spare you the details, but the gist of it is that I either have a permanent and chronic, but treatable, gastro-intestinal condition or I have something more serious. And while there are no doubt many spiritual lessons I can and will learn through my first real foray into physical illness—I am so far a terrible sick person, impatient and frustrated, a big Man-baby who needs to learn to grow up—that is not what I want to explore here. No, I want to talk about the difference between what the 12 Step Programs call “symptoms” on the one hand, and “causes and conditions” on the other, and to use this same analysis to apply to our spiritual life in Christ.
“Alcohol is but a symptom” says the Big Book of Alcoholics Anonymous. Now this comes as a surprise to most addicts and their families, who are sure that alcohol or other addiction is the problem, and that if they can just get the addict to stop drinking, or drugging, or gambling, for example, that all will be well. But the Book goes on to talk about the underlying “causes and conditions,” spiritual maladies that inhabit all addicts: deep and profound isolation, loneliness, and alienation and yet at the same time overlarge egoism, self-centeredness and an obsession with control. These spiritual and character defects, says the Program, are where we addicts must eventually focus if we are to stay sober and ever to be happy, joyous and free, and the Twelve Steps are designed to help the addict or alcoholic take these on, systematically and incrementally, but habitually, one day at a time.
This refusal to stay stuck in symptoms— to focus exclusively on the drinking, or drug use, or gambling, or compulsive sexuality—is the deepest spiritual genius of the 12 Step approach.
And yet, the wisdom and practicality of those who established AA and the other Programs was that, until the symptoms are arrested, no permanent spiritual healing or progress can be made. It is no good talking to a man about, say, a character defect of being overly controlling when he cannot go a day without drinking himself into oblivion. And so the early days of AA were filled with stories of helping the newcomer in early stage recovery, even detoxification—things often done these days in rehab or detox centers. But there was in the early days, and sometimes still is when we deal with those who go in and out of sobriety, a renewed realization of how totally debilitating are the “symptoms” of the disease of addiction, and thus a proper dedication to treating those symptoms, in order to get the newcomer to a place where he or she can focus on the underlying causes and conditions of his or her disease.
Here a quick note from my recent health struggles: while the doctors are rightly trying to figure out what is wrong with me in terms of pathology—they obviously want to find the “causes and conditions” of my malady—I on the other hand just want some relief from the symptoms: I just want to be out of pain, able to rest and to engage with my life. Like the practicing addict, I really am not so interested in the long term as in the short term. I just want to feel better. So that keeps me motivated and paying attention.
And here, I suggest, we Christians can learn from this distinction between symptoms on the one hand, and causes and conditions on the other. If the working thesis of this blog is accurate—that there are fundamental parallels between addiction and sin, that the recovering alcoholic and the practicing Christian are united in their recognition of brokenness and their need for healing—then we can surmise that, as Christians we must ever be conscious of the spiritual tension between symptoms and causes. We must realize that, even as we are committed to following Christ along the long road Home, even as it takes us over and over again through suffering and joy, pain and triumph, death and resurrection—even as we focus on our own spiritual sin, our “causes and conditions” as it were, yet we live in a world of symptoms, and we can rightly keep one eye on those symptoms at all times. Even Jesus often told his followers to focus on their behavior as well as their sin: “you have answered wisely, friend; now, go, sell all you have, give it to the poor, and come follow me.” After all, it does my friends no good to know that I am “working on” becoming more patient if their experience of me is as a hotheaded bully; it does not matter if I am clear on my pathology as a self-centered person and am “committed to working on it,” if my daily actions around my family and loved ones are utterly self-absorbed. And the fact that I still cause hurt and pain to those I love, like the symptoms of physical illness, should keep me motivated. For it is surely true that, just as alcohol is a symptom that must be arrested before I can make any lasting progress in recovery, so also my old and sinful behaviors must be addressed if I am to be in a closer and more intimate spiritual relationship with God in Christ.
As a physically sick man does not long lose awareness of his painful symptoms even as the doctors seek the long term answers, as those symptoms keep him motivated to find the long term answers, so also the alcoholic and the Christian cannot long afford to lose awareness of our everyday actions even as we remain committed to deepening our spiritual union with God. The symptoms are in this sense necessary reminders of our true condition, deeply motivating, and they rightly keep us focused and aware of our need to go deeper, even deeper, into the mysteries of the divine.