Table Of ContentCharacter strengths as mediators
in a mindfulness based intervention
for recovery from addictive behaviour:
a study in psychology of religion and positive psychology
Sahaya Gnanaselvam Antony
Heythrop College, London
A dissertation submitted for the degree of Doctor of Philosophy
(in Psychology of Religion) at the University of London.
June 2012
Abstract
There is an increasing interest in studying the association between spirituality and
recovery from addiction. A few studies have already explored the mediators of the
association, but rarely have they attempted to elucidate the association within a viable
theoretical framework. The present study attempted to address this need. Beginning with
the conceptualization of religion and spirituality, the study considered the possibility of a
construct called ‘religious spirituality’. Working within an epistemology of hermeneutical
realism, this project in psychology of religion (PR) proposed positive psychology (PP) as a
multidimensional theory, and opted for a mixed method approach integrating quantitative
and qualitative data.
The literature review showed several parallels between the dimensions of
spirituality as explored within PR and the list of character strengths as developed by PP.
Therefore, the study set out to explore the association between spirituality and recovery
within the theoretical framework of character strengths, otherwise also known as ‘Values in
Action’ (VIA; Peterson & Seligman, 2004). A qualitative systematic literature review of
the spirituality-addiction literature yielded a list of salient character strengths. A holistic
conceptual framework was developed to understand addiction and recovery in the context of
PP, predicting that spirituality based interventions, such as mindfulness, enhance the salient
character strengths and thus facilitate recovery from addiction. The study went on to
examine the efficacy of a Christian version of mindfulness (Jesus Prayer, Labyrinth walking
and journaling) in enhancing character strengths and reducing addictive behaviour.
The empirical study was carried out in two phases in Nairobi, Kenya. The first part
was a survey (N=504) to examine the correlation between three addictive behaviours
(harmful use of alcohol, sex addiction and compulsive use of internet) and character
strengths. The second part was an intervention study that was designed as a controlled trial
(N=71). The regression tests on the data from the survey supported the conceptual
framework to some extent. The lack of prudence, integrity, spirituality and forgiveness
could predict addictive behaviours. Due to small sample size, the quantitative data from
the intervention study could not establish that the effect of mindfulness was significantly
different from the life skills or control conditions, nor was its effect on character strengths
quantitatively verifiable. Through the case studies, it was possible to explore the impact of
Christian mindfulness on the participants in the context of addiction recovery. An
interesting pattern emerged suggesting a three dimensional religious spirituality in
participants’ relationship to the self, others and God. Perspective, humility, self-control,
social intelligence, responsibility, forgiveness and spirituality were identified as being
active in the practice of Christian mindfulness. Limitations of the VIA-Inventory of
Strengths (VIA-IS) were observed, particularly for a cross-cultural situation. In general, the
results suggest that while character strengths are conceptually attractive to address the
mediators in a mindfulness based intervention for recovery from addictive behaviour, the
VIA-IS itself may not actually present the best measurement instrument in this domain.
The findings add support to the emerging understanding that addiction is a
multidimensional phenomenon. Character strengths offer a promising framework for further
exploring religious spirituality.
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Acknowledgments
One sultry afternoon in 2007, a young man walked into my office in the Don
Bosco Youth Centre in Dar es Salaam, Tanzania. His opening lines were, “I was in one
of your spiritual retreats. I just came back to tell you that in the past six months I have
not tasted ‘the garlic of Egypt’.” In my final reflection during the five-day silent retreat
for young people, I had made a Biblical reference to the people of Israel, who, on their
journey towards the Promised Land would often think of the fish, the cucumbers, and
garlic of Egypt (Num 11:5-6). They often expressed even a preference to run back into
slavery just to be able to enjoy the delicasies of Egypt. We might go through a similar
experience, I had said. As a result of spiritual experiences we begin to enjoy some fresh
air of freedom, but when the going gets tough we are tempted to backslide. The young
man went on to narrate a personal testimony of his struggles with some addictive sexual
behaviour in the past, and how he was able to manage it well and remain spiritually-
oriented after that retreat. What was particularly helpful for him, I went on to enquire.
He mentioned, Jesus Prayer and journaling! This was for me the proverbial Newtonian
apple! In the weeks and months that followed, as I facilitated more and more retreats
similar testimonies were repeated.
What is happening, I began to wonder. Apart from the increase in my own
spiritual fervour, given my previous academic background my intellectual curiosity
became even more pointed. By the middle of 2008, there was the promise of support to
me from my religious order to pursue a doctoral degree. What area of human enquiry
could offer the possibility for me to empirically examine the effect of spiritual
interventions on recovery from addictive behaviours? After some preliminary search, I
came into the psychological study of religion.
Many people have generously supported me in the completion of this PhD
project. I thank all my young African friends, whose distant smiles provided the
motivation for daily study in the past four years. My supervisor, Dr Joanna Collicutt
gently but firmly directed the development of the project. Dr David Ball, the secondary
supervisor, brought an empirical outlook to the project and an editorial quality to the
text of the dissertation. Dr James Au Yeung assisted me with his expertise in statistics
when I was lost in the forest of numbers. Several conversations with Dr Human
Unterrainer have also been helpful in the initial stages of the project. Barlet Jaji
facilitated with much ease the data collection process in Nairobi, Kenya. While Eddie
Kabue and Vivian Nyamwaya facilitated the Christian mindfulness intervention, Jane
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Cate Mbuti and Nancy Lisi were the trainers for the life-skills intervention. The Little
Way Association offered some financial assistance to carry out the interventions. Sean
Burns worked meticulously to improve the linguistic aspects of the text. The
participants in the intervention phase so generously availed themselves, and some of
them offered to be interviewed and others trusted me with their journals.
The Provincial Superiors of the Salesians of Don Bosco – Eastern Africa, Frs
Joseph Pulikkal and Gianni Rolandi, gave necessary permissions and facilitated in every
way the completion of this doctoral project. The Provincial Superiors of the Salesians
of Don Bosco – Great Britain, Frs Michael Winstanley and Martin Coyle, offered board
and lodging for the entire duration of my stay in London. Thanks is due also to the
Battersea community, and in a special way to the Rector, John Dickson. Fr Guillermo
Basanes stood by me when the going got tough. During the months of data collection, I
was kindly assisted by Sebastian Kol and the staff of DBYES, Nairobi. Several friends
in the U.K., East Africa, India and elsewhere have been supportive of my work. I am
grateful to them all.
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List of Contents
Abstract 2
Declarations 3
Acknowledgements 4
List of Contents 6
List of Tables 10
List of Figures 12
Chapter 1: General Introduction 13
1.1. Statement of the Problem 13
1.2. Objectives of the Study 17
1.3. Approach and Scope of the Study 18
1.3.1. Epistemological position: Hermeneutical Realism 18
1.3.2. An overview of the project 19
Chapter 2: Positive Psychology as a Theoretical Framework for
Psychology of Religion 23
2.1. Theoretical Framework: A Bird’s Eye View 23
2.2. Psychology of Religion (PR), and Constructs of Religion and 24
Spirituality
2.2.1. Psychology of religion: an introduction 24
2.2.2. A multidimensional matrix of religion and spirituality 26
2.3. Positive Psychology (PP) 38
2.3.1. Positive psychology: its sources and contents 38
2.3.2. Character strengths of Values in Action (VIA) 41
2.4. Psychology of Religion and Positive Psychology 54
2.4.1. PP as a theoretical framework for PR 54
2.4.2. Parallels between constructs of spirituality and
character strengths 59
2.4.3. Cultivating character strengths though mindfulness 65
Chapter 3: Addiction, Spirituality & Character Strengths:
Evolving a Conceptual Framework 69
3.1. Understanding Addiction 70
3.1.1. Definitions and characteristics of addiction 70
3.1.2. Understanding recovery and relapse 85
3.1.3. Varieties of addictive behaviour 88
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3.2. Character Strengths in Spirituality and Addiction: A
Systematic Literature Review 91
3.2.1. Description of procedure 91
3.2.2. Results of the literature search 96
3.2.3. Character strengths identified from addiction-
spirituality literature 101
3.2.4. Discussion on the identified character strengths 110
3.2.5. Towards a conceptual framework 113
3.3. From Addiction to Wellbeing through Character Strengths 115
3.3.1. A holistic understanding of addiction and recovery 115
3.3.2. The hypothetical framework: Character strengths as
mediators in recovery 122
3.4. Research Questions and Specific Hypotheses 129
Chapter 4: Method of Study 131
4.1. Research Design 131
4.2. Assessment Instruments 132
4.2.1. Values in Action - Inventory of Strengths (VIA-IS) 133
4.2.2. Multidimensional Inventory for Religious/Spiritual
Wellbeing (MI-RSWB 48) 134
4.2.3. The Alcohol Use Disorders Identification Test
(AUDIT) 136
4.2.4. The Sexual Addiction Screening Test (SAST) 137
4.2.5. Compulsive Internet Use Scale (CIUS): 138
4.2.6. BriefCope 139
4.2.7. The Hospital Anxiety and Depression Scale (HADS) 140
4.3. Participants 141
4.3.1. Demographic details of the participants in the survey 143
4.3.2. Profile of the participants in the intervention 144
4.3.3. Description of the participants in the case studies 145
4.4. Procedure of the Intervention Phase 145
4.5. Religious Spirituality Intervention: A Christian Mindfulness 146
4.5.1. Component 1: A Christian contemplative practice 148
4.5.2. Component 2: Labyrinth walking 155
4.5.3. Component 3: Mindfulness journaling 160
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Chapter 5: Results 165
5.1. Reliability of the Instruments Used 165
5.1.1. Internal reliability tests for instruments used 165
5.1.2. Test-retest reliability of the VIA-IS 166
5.1.3. Factor Analysis on the VIA-IS 168
5.1.4. Correlation between MI-RSWB and VIA-IS 171
5.2. Addictive Behaviour among the Sampled Population 172
5.2.1. Addiction prevalence 172
5.2.2. Inter-correlation between addictions 173
5.2.3. Religious spirituality and addictive behaviour 173
5.3. Character Strengths and Addictive Behaviours: Correlations
and Regressions 174
5.3.1. The effect of extraneous and latent variables on
addictive behaviours 174
5.3.2. Correlation between character strengths and addictive
behaviours 176
5.3.3. Regression: the effect of character strengths on
addictive behaviours 178
5.3.4. Dimensions of RSWB and their effect on Addictive
behaviours 181
5.4. Control Variables and Addictive Behaviours: Correlations
and Regressions 182
5.4.1. The interaction among control variables 182
5.4.2. Control variables (coping, anxiety and depression)
and character strengths 183
5.4.3. Control variables and addictive behaviours 184
5.4.4. Control variables as predictors of addictive
behaviours 186
5.5. Path Analysis: Character strengths as Predictors of Addictive
Behaviours 186
5.6. The Effect of Interventions on Character Strengths, Addictive
Behaviour, and Control Variables 190
5.6.1. Effect of interventions on character strengths 190
5.6.2. Effect of interventions on coping styles 190
5.6.3. Effect of interventions on depression and anxiety 193
5.6.4. Effect of interventions on addictive behaviours 194
5.7. The Dynamics of Christian Mindfulness Intervention: Two
Case Studies 197
5.7.1. Participants in the case studies: Before and after
intervention 199
5.7.2. Experiencing Christian mindfulness in terms of
character strengths 203
5.8. A Summary of Findings 207
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Chapter 6: Discussion 210
6.1. The Role of Character Strengths in Addictive Behaviour 210
6.2. On Understanding and Measuring Character Strengths 213
6.3. Character Strengths as Mediators in Mindfulness Facilitated
Recovery 219
6.4. Coping, Anxiety and Depression vis-à-vis Character Strengths
and Addiction 224
6.5. Points for Discussion Emerging from the Case Studies 226
Chapter 7: Conclusions 230
7.1. Recapping the Process 230
7.2. Insights on Addictive Behaviours Emerging from the Study 232
7.3. Limitations of the Study and Orientations for the Future 234
7.4. Contributions to Psychology Research in Africa 237
7.5. Summary of the Contributions of the Present Study 239
7.6. Researcher’s Voice: Reflexivity 242
References 245
Appendices
Appendix A: Systematic Literature Review: Sample of Coding 283
Appendix B: Mindfulness Intervention Protocol 285
Component 1: Christian contemplative practice 285
Component 2: Labyrinth walking 289
Component 3: Mindfulness journaling 298
Appendix C: Contents of Life Skills Training 302
Appendix D: Timetable for the Training Weekends 309
Appendix E: List of Sampled Locations for the Survey 310
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List of Tables
2.1. Values in Action 44
2.2. Parallels between character strengths (CS) and constructs of
spirituality 63
3.1. Characteristics of addiction 72
3.2. Correspondence between theories and characteristics of
addiction 84
3.3. List of studies included for review 97
3.4. Description of the studies included for review 98
3.5. Summary of nodes and their contents 99
3.6. The 12-steps and character strengths 112
4.1. Summary of instruments of measure 133
4.2. Summary of the items of MI-RSWB 48 135
4.3. Description of participants 143
4.4. Details of eligible participants who responded positively to the
invitation for the intervention 144
4.5. Participants in intervention conditions scoring above the cut-
off points 144
4.6. Rituals in the labyrinth with possible links to character
strengths 159
5.1. Reliability of measures used 166
5.2a. VIA test–retest reliability for CS based on Pearson’s r 167
5.2b. Test-retest reliability for addiction measures 168
5.3. Factor loadings and communalities based on a principal
components analysis with varimax rotation for 24 CS 169
5.4. Inter-correlation between character strengths 170
5.5. Correlation between MI-RSWB and VIA-IS 171
5.6. Prevalence of addictive behaviour among the sample 172
population
5.7. Inter-correlation between addiction scores 173
5.8. Correlation between religious spirituality and addictive 174
behaviour
5.9. Correlation between character strengths and addiction scores 177
5.10. Correlation between the scores of CS
and addiction measures above the cut-off points 178
5.11. Stepwise Multiple Linear Regression for character strengths
predicting CIUS 178
5.12. Stepwise Multiple Linear Regression for character strengths
predicting harmful use of alcohol 179
5.13. Stepwise Multiple Linear Regression for character strengths
predicting sexual addiction 180
5.14. Summary of Simple Multiple Linear Regression for character
strengths predicting addictive aehaviour 180
5.15. Stepwise Multiple Linear Regression on MI-RSWB 48
predicting CIUS 180
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Description:multidimensional theory, and opted for a mixed method approach the spirituality-addiction literature yielded a list of salient character strengths.
