Steve Martorano 
The Behavioral Corner is produced in partnership with Retreat Behavioral Health -- where healing happens.

The Behavioral Corner 
Hi, and welcome. I'm Steve Martorano. And this is the Behavioral Corner; you're invited to hang with us, as we've discussed the ways we live today, the choices we make, the things we do, and how they affect our health and wellbeing. So you're on the corner, the Behavioral Corner, please hang around a while. 

Steve Martorano 
Hey, everybody, welcome to the Behavioral Corner. It's me again, Steve Martorano, right, where you left me hanging on the Behavioral Corner. You know, I hope you do -- what we do here. We have a big canvas and a broad brush. We talk about behavioral health. That's just about everything. Today, we're going to go to a topic that has fascinated me for a very long time, as I've been talking about substance abuse and mental health issues, then that is the role of spirituality, religion, or more broadly, put faith -- faith in a substance abuse treatment will probably go a little beyond that as well. That's gonna be the topic today on the Corner. It's a fascinating one. So I figure who am I going to talk to you about this, but my go-to guy, Tom Longnecker. Tom, thanks for joining us again, here on the Behavioral Corner. Incidentally, this is your "3pete" on the show. I don't think we've called on anybody as often, as we've called upon you,

Tom Longenecker 
I'm always glad to be with you, Steve. You're always curious and creative and I'm always eager to hear the things you're thinking about and putting out there. So thank you.

Steve Martorano 
Oh, you're the guy. You're the guy on this one. Because those of you who do not know from Tom from other programs, he is by experience and training -- many years of experience...of experience -- in lots of training, a certified counselor, clinician, in the field of both substance abuse and mental health issues. In addition to having a background and extensive background in theology, and a degree in divinity. Tom is also an ordained pastor. So that's the intersection I'm looking for. We're talking about faith and its role in substance abuse. You know, Tom, I'd like to begin as you know, kind of defining our terms. So we're all on the same page. And I got to thinking about faith, and I'm going to do something here I very rarely do and, quote, Scripture: Faith, according to the Bible, "The substance of things hoped for. And the evidence of things not seen." The "evidence of things not seen" may be one of the great phrases I've ever read in my life. So let's begin there with faith. When we talk about faith, in what? Faith cannot stand alone, it must be in conjunction with something. So when we talk about faith, what are we talking about?

Tom Longenecker 
Well, I think one of the key things that you bring up in that passage that relates very specifically to substance use and treating substance use is actually where it starts, which is hope. Because when we were working with people who are struggling in addiction, by the time they get to us, hope is usually replaced by despair. And so one of the key aspects and I think we can lead this over as well to mental health is, is the sense of being stuck in something that I can't control. And the sense of this is my destiny, or whatever, get out of this. And so one of the key parts of faith is the ability to hope as opposed to despair. So that's a key thing. Now you...your question also led to like "hope in..." that and then we have kind of, there's three ellipses, those three dots, okay, what is that going to be in? Because, you know, so much of the issue at hand, the exact existential reality is, despite my, my successes in other areas of my life, despite my intelligence, or power, capacity, my talents, my intelligence, here's an area of my life, which I have not been able to overcome by myself. So that faith in and that's the, what you said, the evidence of things not seen. I suspect a lot of faith, a lot of hope requires being able to see something you still need some kind of vision. You know, when we talk about change, oftentimes, there are drivers of change why am I ever going to change things about my life? Okay? Well, pain is a good driver, and pain can come up that can look in terms of relationships, employment, that can just look at, I look in the mirror, and I see what I don't want to see. So pain can look at a lot of different ways, but that's a pretty good driver. The problem is we can get really stuck in pain, and assume this is just what I'm going to be living with. So the other side of what draws people into change is I need to be drawn to change. So I need to see some things I need to have some kind of vision that replaces the despair -- you know, when I kind of get stuck in that quicksand of despair -- I need to be able to envision something that might be feasible. You know, that might be something you don't necessarily see. That's one of the benefits, I think have the rooms, the fellowship of AA where people are able -- or NA -- people are able to see people who I was on the street with you and I see this life that you're getting.

Steve Martorano 
But let's talk about the rooms for a minute, because a lot of what we accept as a given with regard to the role of faith, in substance abuse issues, really comes out of the AA experience. I mean, a was inspired directly by a religious movement. The objects are, you know, you know all about this. They very clearly in AA, in the beginning, and I guess up to today, talk about in religious terms, they use overtly religious words, they used God, at the very beginning, they've now replaced that or morphed over into whatever that means to you a higher power. The origins of helping someone in despair, who, as you say, has no control, cannot figure out why they're behaving this way, is a religious movement. So let's begin there and talk about the difference between religion and spirituality. Are they the same thing?

Tom Longenecker 
I suspect that you know, sometimes we're dealing with semantics, there are certainly big periods of places overlap. And I think there are places where we can separate that out a little bit. Religion religiosity, for better or for worse is, you know, religious traditions are often the places that have been a haven or places that have passed on certain kinds of spiritual practices, both for good and for ill. When we talk about spirituality, particularly coming out of the 12 step movement, really what we're talking about in a lot of ways is conscious attention - an awareness. An awareness of self and awareness of others, and the ability to look at yourself have some distance from yourself - the ability to look inside yourself. And so that for better for worse, those are often called spiritual practices. I suspect we could call them existential practices, or I'm sure we have other words that would probably fit their connection with religion is that you know, people can be religious and not engage in those practices hardly at all. But those religious traditions or wisdom traditions have often been the carriers of those very practices that are attentive to the inner self, to the inner life and relationships with others, both relationship with myself, relationship with others, and then a kind of relationship with the greater world. And in some ways people talk about the "Great Other" the self, that is not me. And that's where we talk about things like God higher power, oftentimes,

Steve Martorano 
I'm going to be sort of I hate to use this phrase in the context of our discussion, but I may have to be the devil's advocate here. But to understand this a little bit better. Basically, as I understand this -- my experienced -- these stories about the world outside of us, and something bigger than me, and have faith in that idea, our stories we tell ourselves. We've been telling stories since we could imagine. And the stories have great, great power. And the question is when you're in a substance abuse situation, are they on some level, these stories and a belief in the stories of faith in these stories? Absolutely essential? To get better?

Tom Longenecker 
Hmm. Yeah, I mean, I think..

Steve Martorano 
Have you treated atheists? 

Tom Longenecker 
Oh, certainly. 

Steve Martorano 
Okay. 

Tom Longenecker 
Yes, cer...certainly and actually, I think, the, I don't know what the percentage would be. But I think a large number of our people are at the very least ambivalent about the idea of, of existence outside of what I see. 

Steve Martorano 
They see so bad and so immediate. they don't see anything else going on? Right?

Tom Longenecker 
Sure. Sure. You know, so in our context, when I'm not necessarily drawing on, you know, scriptural texts from any of the religious traditions, necessarily, I mean, doesn't mean that we necessarily ignore them. But we're not necessarily prioritizing them either. Partly because I think it can be very confusing and religious traditions have done so much wounding that some...that's not necessarily going to be a healing path at this point in a person's life.

Steve Martorano 
Yeah, one of the often overlooked when you talk about the religious, for instance, the religious origins or something like AA, is that -- you're right -- religious...religious traditions and beliefs also have gone a long way towards demonizing and...and stigmatizing people with these problems. You know, your sic...you know, we've fortunately moved away from the notion that you're sinful if you're an alcoholic. You're sick, you have a problem. But the idea of sin, I guess is counterproductive in this whole discussion, right?

Tom Longenecker 
But I think part of the is kind of deconstructing some of the words that people have because that word is really packed, it just carries a lot of weight. In some ways, we do an awful lot of actually naming sin, which is just brokenness. I missed the mark here. I mean, in terms of like, kind of a more literal interpretation of that word, at least in the biblical context. But one of the things you know, we don't want it gives a sense that my struggle was substance use is something that is itself a -- that dams me as a person as my essential worth,

Steve Martorano 
I understand that completely what I need, in my mind for me anyway, because I've gotten kind of stupid here -- is how do you reconcile -- why would you think that faith is important, in something, whatever. But to think of your behavior as circumstances being sinful, is counterproductive? How can you rely upon safe to help you if you're sick? Or instance, how much faith is necessary for somebody who has diabetes or cancer? Where there's no stigma or moral problems?

Tom Longenecker 
Certainly. And, you know, the thing is, like, when we talk about addiction, we talk an awful lot about spirituality in some form, often very vague. But if I have cancer, and I go to the doctor, they're not necessarily going to prescribe me to pray.

Steve Martorano 
Right. Well, if they want to keep you as a patient.

Tom Longenecker 
Correct. Correct. Now, there is another kind of research that suggests there are certain benefits of spiritual practices and relating to a community and that kind of thing that gives people greater power and agency, when they're working through when they're living with cancer. But, I think we also need to make kind of a distinction between what it is to be healed, and what it is to be cured. Okay, and that maybe this can kind of bring us back a little bit. If I am cured of cancer, I get a clean bill of health, no more metastasizing, it's cleared out. That doesn't necessarily heal me. My body might be cured. But my relationship in my family, my ability to be available to my community, my kind of investing in life. That might not, that might lag behind, that might not happen.

Steve Martorano 
Yeah, your relationship to mortality would be would be shattered for sure.

Tom Longenecker 
I'm sure. But it is possible, actually not to be cured of cancer and actually heal. And you know, there's all these kinds of stories where, because of cancer, it because it's facing into mortality, I look at these things very differently, and relationships get restored and so healing happens. Okay. And I think we need to kind of bring that back also to the issue of substance use, again, it's unlikely somebody is cured. There's a chronic, you know, the chronicity, there's an ongoing kind of tendency that always looks around the corner with addiction. But great healing is possible. So believing and trusting in the process, and this is the thing we actually talked about, probably much more than sin or faith is trust the process. Can you trust the process? You come in, at this level of care, and the world is falling apart. I have a pretty dim view of myself, and maybe others, there's a lot of shame. And I don't see that I'm going to stick around here. And we say, you know, trust the process. Trust the process. Be part of the process. And there's a level of faith with that, which, okay, I don't see this. I don't know, I don't know why this works. But if I put myself into the process of I come to these places, I start to talk about myself, I start to put into practice some of these steps or some of these other projects, I start to do find this kind of grounding skills or centering skills. And then you start to see and then after a while, okay, I trust the process. I'm actually putting some faith, some trust.

Tom Longenecker 
In one sense, I think, a stronger connective word, then faith, which can put some people off, you know, I know you've talked to many, many people -- who there whose first experience with AA was off-putting for that, because they found it to be too, a little too "faith-based." Put your faith in this. So it sounds like what's going on here is a -- a worldly turn --away from this notion of a superpower somewhere off in the skies. And as you said, a process that you should have faith in because it's worked for many people. That's where the faith comes in, that you're trusting the process, as we say here in Philadelphia. 

Tom Longenecker 
Sure. I'm trusting some accumulated wisdom.

Steve Martorano 
Right.

Tom Longenecker 
And people kind of pass it on except this or reject it. But if I can try a little bit of it, I'm actually venturing out in some trust. Okay, why would you trust me, I'm trusting this person, I'm trusting this person's story, I'm trusting what I'm starting to see a trusting what I want to believe. 

Steve Martorano 
Yeah.

Tom Longenecker 
...something different. 

Steve Martorano 
And all of those words, trust, faith, and all of that are, I guess, in a way, what AA refers to as a higher power. In other words, what you've been doing, has gotten you in this spot. There are ways you should be behaving now that you have to have faith will work. And that's outside you. So is that what they mean when they say a higher power something? 

Tom Longenecker 
Well, I think...I think since we're talking about the 12 steps, I'm just thinking about how they really are built around power. So the first step is we admitted that we were powerless, over, in this case, alcohol, let's say that our lives have become unmanageable. And so at that point, people are actually identifying a power greater than myself. I've not been able to mend this, I've not been able to kick this, I've not been able to really work with this, it is greater than me by myself. So we're already talking about a higher power at that point, that's just one that's going to kill you. And then the second step they talked about is coming to believe a power greater than myself, could restore me to sanity. So again, we're the 12 steps really do work about...work around the idea of power. And at that point, they're only talking you know, very vaguely about power. And then they become much more overt. They made a decision to turn their lives over to the care of God. So again, the care of God would be the trust of God -- trust of a power greater than me, that can tilt the scales towards healing, and life as opposed to death.

Steve Martorano 
Yeah, here's, here's how the cynical mind works. And one that's trapped disease of addiction. Well, wait a minute, that higher power you talked about, must have had something to do with me being in the shape I'm in? Why take all the blame, and then turn to this higher power for help? Where was the higher power when I was abusing drugs?

Tom Longenecker 
Certainly, certainly. And if you look, in the early 12, step literature, it was even much more overt. They actually started to kind of weed out wanting to refer to things like higher power, because, you know, some of just all the -- all the ills that people have around that language, because language around God-language around spirit language around that kind of thing, tends to have a lot of weight. You know you look at all the sexual abuse that occurs in a church context. That occurs in all kinds of other places too in families and elsewhere. But it has an additional weight, because of the trust because of the just kind of the role that those institutions play. Because they really do reach a people's kind of wholeness in their inner parts in their outer parts. And so, so there's a lot of baggage, there's a lot of stuff around that. So the AA movement back in the early days started to try to move away from some of that God language, but it's still very, very overt. 

Steve Martorano 
Yeah.

Tom Longenecker 
So part of that is, you know, people say, what is a higher power to you that can be -- give you life? So some people can say, "Look, it's my group, I look around these people, and I find myself leaning towards life. I think that you know, this helps me get out of some of the thoughts in my head." So that can function. People can believe in, you know, some kind of god figure, and not even claim that as their higher power,

Steve Martorano 
Or have no belief in any supernatural...

Tom Longenecker 
Or have no belief, so no belief...

Steve Martorano 
The thing about the strength of community, which is the bedrock of AA is that there is, you know, we talk about evidence of things not seeing well, this is a situation, it seems to be where evidence is clearly seen, the group, the community, the substance abuser was in while abusing was reinforcing the bad behavior, progressing it making it worse. And so the idea is to find yourself in a different community, where they value and support positive behavior, and you gain strength from that, I get that completely.

Tom Longenecker 
I think I think part of the, you know, people can go a long way in recovery and work at the issues that have driven addiction, that has driven substance use and abuse and move a long way into recovery before they really actually never ever actually have to kind of deal with kind of theological kinds of issues about the existence of God in whatever way people are going to determine them. And again, I think a lot of you know some of the early AA when they talk about God as you understand God. I think a lot of that -- they were responding to we were taught these creeds, we were taught these statements about God, and we don't have to accept those. The other part of that is I don't know that we ever move beyond believing in God beyond..that is beyond our own understanding. 

Steve Martorano 
Yeah...

Tom Longenecker 
That's always...that's always the God that we believe in. The God that we...even the God I don't believe in is still the God of my understanding.

Steve Martorano 
Exactly right. Tom Longenecker is our guest. Tom is a clinical supervisor at Retreat Behavioral Health. They, of course, are underwriting partners. He is also as I mentioned earlier, an ordained minister and he has a degree in divinity, theological background. So he's the perfect guy to talk to about faith in the role of substance abuse. So it's...it's...it's an interesting concept. You're right about the weightiness of the religious notions of God as a loaded word. Higher power is just another way of, I guess, taking some of the load off...off of that term. Let's talk about a couple of practical things. For instance, in your role as a clinician, have you ever prayed with someone over the issue of their substance abuse?

Tom Longenecker 
Certainly, but only when they've requested it? 

Steve Martorano 
They request? 

Tom Longenecker 
Yeah. Now, the other part is... Oh, actually, when we lead a lot of meetings, we end with the Serenity Prayer. So I guess I would say that...

Steve Martorano 
Every...every meeting.

Tom Longenecker 
There are lots of meetings where I've been part of where we've closed with prayer. 

Steve Martorano 
Yeah, you know, the Serenity Prayer is -- I should memorize it by heart now -- but I, it does mention God immediately. But I think the essence of it is, just let me be wise enough, strong enough to know the difference between things I can change and things I can't change. And that doesn't necessarily have to be a divine inter intervention. You know, you just want to be able to go well, that's not good. And this is good.

Tom Longenecker 
Yeah. Yeah. Well, you know, and, the most likely composer of that prayer was a man named Reinhold Niebuhr.

Steve Martorano 
Yes. 

Tom Longenecker 
I forget if he taught at Yale, or he taught at Union in New York. His brother taught at one and he taught it the other night, I don't remember which one.

Steve Martorano 
He taught at Yale.

Tom Longenecker 
Okay. But, you know, there, he's just to kind of layout what are the parameters of freedom.

Steve Martorano 
Exactly. 

Tom Longenecker 
Yeah. You know, and the limitation and freedom need, you know, to understand freedom, we need to understand limitation as well.

Steve Martorano 
Right. When the past diverges, I would hope that I can be in a position to choose the right path.

Tom Longenecker 
And so, and that speaks so directly to the struggle with substance use, which is the kind of the self decrying, self-loathing, egomaniac, okay? In my addiction, I both carry the weight of the world, I see myself as both, you know, degraded and...and so some of this is simply just kind of working with a load of ego. What is the...what is the constraint? What is the right relationship of ego in my own life, the right relationship of my ego, in social relationships, and the broader world? And so I think that's part of why that has really caught on because so much of...so much of the workaround addiction is really coming to terms with myself.

Steve Martorano 
Yes. Is that the strongest role that faith plays in this process? Because I've heard people say, stopping the use of whatever it is you're abusing, is just the beginning of solving the problem. The other problem is all the things you just described. And those things have to be addressed on a more personal and I guess, faith-based idea. Is that where faith is strongest? Because look, you can't pray your way out of heroin (addiction). You know you're going to want herion. You're gonna want to drink. Once you stop doing that, then you need faith that you can keep stopping, right?

Tom Longenecker 
Well, and again, I think this leads us back to these practices that religious or wisdom traditions have carried to us. You know, I would -- I always make the distinction that one person is abstinent. Abstinence is not the same as sobriety. You know, some people can drink, some people can use pot, and it does not make them irrational. Okay. They're able to live their lives, they're able to be grounded. Some people do not so much. Okay. And so I usually kind of try to phrase it that abstinence is the prerequisite for sobriety. But sobriety is a whole different thing. So once we stop using and, you know, I work in a, in a medical facility that has meant to you know, assist people medically, to get through a lot of the physical and to some degree, some of the emotional and mental issues that kind of surround withdrawal. But beyond that, there's a whole other world that is opened up and I think this is the thing where we can really kind of make a strong connection between a secular approach and one that values against some of those spiritual practices or existential practices because one of the things we've worked through an awful lot around is slowing the brain down. Oka. So we do a lot of work around meditation. Contemplative prayer. We also will work around just a kind of grounding skills. And because one of the key things is we want to oftentimes -- a traumatized brain is a brain that really is being driven by the limbic system. And what we want to do is slow things down so that the limbic system, which is something that saves us much of the time, by reacting, but when we live our lives out of reactivity, we're not that's not serving us, well, we want to slow the brain down so that it can then use the higher functions of the brain, where we are able to get into things like are the great values that drive us are longer-term goals. That's where we're able to conceive of things like beauty, imagination, that's where we're able to conceive of things like God, or my sister's finance, who I think is probably about the same, my daughter's father. But, but part of what we do is, those are the practices that slow that down. And when the other thing is, through time, as we do those certain kinds of practices, it actually changes the brain. So there's the neuroplasticity part of the brain...

Steve Martorano 
Yes

Tom Longenecker 
...that these practices are essential and key, in allowing us to think differently, and by thinking differently, to be different. And to be able to -- to be able to then sustain our lives without jumping to other ways to save us.

Steve Martorano 
Yeah, as you know, in the world of substance abusers and clinicians. The aphorism is fake it till you make it. And you're just another way of saying, behave the way you wish you could to behave. And then soon enough, you will be that person. So let me ask you very specifically, though, about a couple of these other things. I read a lot, and now see advertisements for faith-based treatment. You've talked a little bit about the difference between treating somebody in a secular fashion and in a faith-based fashion. You have a problem with an organization that says they have a faith-based system for treating substance abuse -- a, specifically, a Christian, safe-based -- faith-based program. Is that problematic in your mind?

Tom Longenecker 
I think it raises questions that programs like that need to be aware of. I think that they can...they can be and I'm aware of some that are strong and have good track records. I think it raises some of the questions, which go to the core, which is: What is my essential worth and value? And one of the problems with religiously driven programs is they can feed the idea that if I do this, right, if I get all this right, and I believe the right things, then I will be saved. And I'm using the word saved in...well, actually, no, I'm using the word save, and all the many ways that you used. It comes from the Latin word salvare, which is like, again, healing. Sav, right? And the problem with that is it's the problem that we see also in the 12 steps, and in anywhere, which is, if I do all this, right. And I maintain this, this facade of maybe not perfection, but rightness. But that's just one more means of escape from myself. And so I think that's one of the problems that those programs have to deal with. Because they...they can easily play into that idea. Whereas the truth is, so much of recovery is about recognizing my brokenness and accepting it for what it is. And it doesn't define me. And I keep moving on honestly and speaking my, the truth that I'm learning about myself.

Steve Martorano 
In your experience, do people who have strong beliefs, whether they be religious or spiritual, have a better chance of healing themselves than people who, you know, don't...don't understand the notion of a higher power or much, much less a god. Do people who have something like that in them, to begin with, do they have a better chance of getting well?

Tom Longenecker 
That's a great question and I think the issue is, there are just so many complex things that come along. I think for many people if they can find resources in their religious tradition, that can be one more buffer. And that can be prayer, that can be served that can be a connection to their congregation or synagogue, or mosque. It can be part of their sense of a gracious God and a greater merciful universe that is abundant that wants to receive them and welcome them into a life that they have not yet even imagined for themselves. So that's always a possibility. It doesn't always play out that way. For people who are just rejecting and have more of a reductionistic approach, I think one of the key things to always develop is this idea that I am moving through a process. I don't I can't necessarily control the ends. Whether...whether we're talking...because people can still use God-talk and be very invested in controlling the ends. It doesn't...that kind of language doesn't necessarily -- doesn't necessarily make you more akin -- I mean religion can both provide a really strong community. It can provide all these practices and resources that have a very lot of strength and provide stability and insight. But they can also just be more tribalistic and this is just a place where I go to reaffirm my...my sense of my own rightness or the world as I see it. So the God-talk by itself is not enough. But people who don't have that kind of God-talk, certainly but part of what we have to work with is some kind of sense of ethic comes back to the very first question you asked, Can I believe in something that I don't see, can I trust that there's good that comes to me outside of myself?

Steve Martorano 
Yeah. It's a great insight. And you know, your first people I've noticed and said, that made that distinction about the means and the ends, let me the expression is the ends justify the means, in this case, are you can say what you like about the ends. Usually, it's God or religion. But as long as you're in control of the means, what you're doing, how you're doing it, you'll get to that positive outcome. If you're very, very lucky. Boy, this is a great topic, Tom, and you are the perfect guy to talk about this. Finally, to anybody who might be listening, who is hesitant to get help, because they think this is I don't know, cultish or, or to God-centered. What would you say to them? To sort of nudging them along

Tom Longenecker 
I guess part of the question is, do you like where you're at? Would you like something different? Can you believe in something...can you believe that something is possible? That's not what I've known. At some level, maybe that's a little bit a summarization of just what you and I've been talking about because that really does talk about trust and faith at some level. 

Steve Martorano 
Well, that's the ultimate faith question. Right? Know what I know how you feel about God and all that but why don't you come and sit down and we'll talk about this. If you have enough faith for that you're on...you're on the road anyway. At least you take the first step, Tom Longenecker, a clinical supervisor Retreat Behavioral Health. Very busy guy. I appreciate his time. Let's do this again. This topic is fascinating.

Tom Longenecker 
Gladly. You know how to get a hold of me. I'm always glad to hear what you're talking about what you're curious about. Steve, thanks for the good work you do. 

Steve Martorano 
Thank you, Tom, and thank you guys for hanging with us. Don't forget, follow us on Facebook, Instagram, and all those other places you follow us and we'll see you next time on the Behavioral Corner.

Retreat Behavioral Health 
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