What Imago Dei Means for Treatment of Addiction

By Dr. David Galbis-Reig, DFASAM

As an internal medicine physician with a subspecialty in addiction medicine, other colleagues, patients, and family members of patients have often asked me, “Why did you choose to become an ‘addiction doctor’?” My response is quite simple: I want to free people from the shackles that prevent them from experiencing a relationship with those who love them, and most importantly, with the God who created them. Spirituality is an important part of recovery from addiction, and while it does not always take the form of Catholicism, the journey to recovering must involve some form of spiritual awakening.

To understand addiction from a Catholic social perspective, it is important to recognize that we, as children of God who are made in the image of God, Imago Dei, were given one of the greatest gifts God could have ever bestowed on humanity: free will. In other words, by virtue of our birth into this world, God bestowed each of us with the gift of forging our own path in this life, which invariably involves making many moral decisions and choices. Enter Maslov’s Hierarchy of Needs, which stipulates that human beings are motivated first to take care of their basic needs (food, water, shelter, and clothing) before they can focus on higher order human needs that include family bonds, friendships, self-esteem, and at the pinnacle, spirituality (self-actualization – which in Catholic terms means a true connection with the Trinitarian Lord and Savior and participation in His Church here on earth). When basic needs are not able to be attained, the individual focuses all his/her energy on trying to meet these basic needs which are required for survival at the expense of higher order needs. It is only when the basic needs are at least minimally met that an individual can actualize higher order needs (including spirituality).

The disease of addiction creates a disordered “need” for something that is not truly required for life, but which becomes the dominant focal point of the individual’s motivation to the exclusion of all other basic human needs. Because an individual with addiction is compelled to seek out the substance of their addiction to the exclusion of other life-preserving activities and higher order needs, the patient becomes self-centered to the exclusion of other relationships. The focus of all the individual’s emotional and physical energy becomes the substance of their addiction. In this sense, the substance is like an idol that is worshipped. The substance becomes the chains that shackle the individual and often leads the individual to act in ways that may be contrary to their nature (sex for substances, thievery, lying, cheating, domestic violence). Most individuals, when abstinent, recognize the immorality inherent in their behaviors and feel guilt and shame, but because they have lost the connection to their spiritual self, self-loathing and hopelessness ensue, further separating them from the people that love them, and the God that created them. In essence, they have become a slave to their base instinct to avoid pain and seek pleasure at the expense of all else. They are no longer truly free, in the pure sense of the word, to make moral and ethical decisions. They are living in the shackles that were created by decisions made when they were young, and which will not let them go.

The principal of solidarity in Catholic Social Teaching (CST) recognizes that we are all members of the one body of Christ, and as such, when one of us suffers, the entire body suffers. It is by virtue of this solidarity that we must love our neighbor as we love ourselves and strive to demonstrate the compassion that we would want demonstrated towards ourselves. And while the disease of addiction affects the whole of society, the principle of subsidiarity recognizes that treating individuals is best accomplished at the most basic level through the therapeutic relationship that is established between the individual’s provider (be it a therapist, nurse, physician, counselor, teacher, pastor, etc.) and the suffering soul. It is these basic interactions that leave the most indelible mark, for ill or for good, on those who suffer the stranglehold of the disease of addiction.

With the above principles in mind, it is important to recognize that when these individuals present themselves to providers for treatment, whether voluntarily or involuntarily, they have often lost a sense of the human dignity that is inherent in all of us. They often hate what they have become and are living in profound despair, feeling unworthy of love from others. Often, because of their desire to obtain satisfaction of their base needs, they have alienated all the people in their life that could have been supportive in their recovery. CST tells us that as children of God, our worth is not dictated by our actions, but by the fact that we have been created in the image and likeness of God and preserve this quality even when we do not act accordingly. As health care providers, the initial interaction with such individuals is crucial in helping them trust that we truly believe that they maintain their human dignity irrespective of their past. When we approach these individuals with the love of Christ, who called all to Himself, even the greatest of sinners; when we recognize the inherent dignity of these broken individuals who are created in the image of God; when we recognize that these individuals are part of the human body of Christ and that their suffering is our own; when we recognize that our interactions with these individuals has the capacity to affect great change; and when we act in accordance to these realizations, only then can the shackle of addiction be weakened by the hope that we bring to the interaction with these suffering souls.

Dr. David Galbis-Reig is a member of CMA’s Catholic Social Teaching – Justice in Medicine Committee. He is board certified and involved in Maintenance of Certification in Internal Medicine by the American Board of Internal Medicine and in the subspecialty of Addiction Medicine by the American Board of Preventive Medicine. He is currently the Medical Director of Addiction Services at Ascension Wisconsin All Saints (where he has been employed for the past 20 years). He is a past President of the Wisconsin Society of Addiction Medicine and the Wisconsin Medical Society Foundation.

References:

United States Catholic Conference of Bishops. New Slavery, New Freedom: a pastoral message on substance abuse. 1990. Publication No. 404-X. Washington, D.C. ISBN 1-55586-404-X.

Grim BJ, Grim ME. Belief, Behavior, and Belonging: How Faith is Indispensable in Preventing and Recovering from Substance Abuse. J Relig Health. 2019 Oct;58(5):1713-1750. doi: 10.1007/s10943-019-00876-w. Erratum in: J Relig Health. 2019 Aug 21: PMID: 31359242; PMCID: PMC6759672.

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