Addiction and Pastoral Care

Reddit icon
e-mail icon
Twitter icon
Facebook icon
Google icon
LinkedIn icon
Sonia E. Waters
  • Grand Rapids, MI: 
    Wm. B. Eerdmans Publishing Co.
    , February
     232 pages.
     For other formats: Link to Publisher's Website.


Those of us who provide pastoral care in congregations of varying size and location know well the reality of how addiction is affecting those we minister to daily. A glance at social media and various news sources provides an alarming narrative of an epidemic that is growing each day, as more and more people die from overdoses, suicides, and other ways related to chronic abuse of substances in the United States and globally.

Caring for those experiencing addiction and their loved ones is undoubtedly the most significant pastoral care need of our generation, a need which will continue for generations to come. Such a great need, like addiction itself, requires thoughtful, sustained, and substantive treatment, which Sonia E. Waters provides in Addiction and Pastoral Care.

For decades many of our churches have been welcoming spaces for those struggling with alcoholism and addiction, hosting meetings of twelve-step fellowships and other programs. Throughout Addiction and Pastoral Care, pastoral caregivers will find not only a compelling theoretical argument for why such minimal engagement is no longer sufficient amid an ongoing crisis affecting the people of God, but also concrete and tested ways to provide care to those who are suffering.

Waters reminds us repeatedly that addictions are complex with no easy answers for church leaders and pastoral caregivers. “Addictions are a pastoral challenge because we don’t really know how to relate to an addict who is in that process of healing. If addictions are so multivalent, then easy solutions evade us” (2). Such a reality, according to Waters, requires individualized care from pastoral caregivers, in addition to a mix of other care and support necessary for recovery—including residential and outpatient treatment programs, medically supervised detox, community-based support, and social services. Every addict we encounter in the context of pastoral ministry will be at varying stages in the process, and thus will require different levels and types of support, not all of which we are qualified or equipped to provide.

To provide such spiritual care, a greater understanding of the nature of addiction is crucial, Waters contends, noting that both the “medical” and “moral” models fall short of truly understanding what the addict is experiencing and going through. The medical model views addiction as a disease, the result of genetics, brain chemistry, and similar realities. The moral model views addiction as the result of sin, a lack of willpower, or an individual’s lack of relationship and connection to God. While not discounting these and other arguments altogether—she helpfully walks the reader through brain science research and theological understandings of sin and grace—Waters presents a fresh perspective, calling addiction a “soul-sickness.” Further, Waters counters the common belief that the addict remains active in their use to seek pleasure, arguing that the addict is seeking instead to manage pain.

“A soul-sickness arises from many interacting vulnerabilities and progresses into one all-encompassing condition of pain. . . . Addictive behavior self-organizes into an active evil that sticks to, corrupts, and entwines with a person’s state of being. Addiction is not a sin. Rather, it is spiritual bondage. It is not free-will action. It is a condition of the soul in distress” (16).

In offering such a significant and substantive reorientation regarding the nature of addiction, Waters offers hope—not only to pastoral caregivers who will likely find here the inspiration to reimagine their ministry to addicts and those who love them, but also to addicts themselves. Thus, this book will be of help to a wide-ranging audience.

A priest, pastor, and gifted homilist, Waters grounds this volume in a fresh and compelling exegesis of Mark’s gospel, particularly the narrative of the Gerasene and the legion which possesses him. Those of us who have worked in recovery ministry for some time are used to applying several scripture narratives to help inspire those we minister to, from Job to parables such as the Prodigal Son/Child/Parent and “Good” Samaritan. However, those stories and others, while helpful, don’t capture the complexity of the reality experienced by the addict. “The Gerasene’s possession helps us to better imagine the suffering of the addict’s soul in distress. In this soul-sickness the addict is possessed by his behavior. His actions are not completely his own. He can no longer access the beauty of God’s creation or his own belovedness as a child of God” (106).

Waters closes with two chapters which provide pastoral caregivers with tools to put theory and research into practice. With an overview of motivational interviewing techniques and change theory, readers who seek to help provide care to addicts in varying stages of change will find a tested path forward. As is true throughout, Waters reminds ministers of the importance of our role of being a listening presence, not seeking to treat or heal, but to journey prayerfully with the individual and providing resources and referrals along the way. As a result, this volume is a gift to the church in its varied forms, to the academy, and to everyone who seeks a life free from the bondage of the soul-sickness of addiction.

About the Reviewer(s): 

Eric S. Fought serves as Director of Care, Support, and Justice Ministries at Lumen Christi Catholic Community in Saint Paul, Minnesota, and is a doctoral student at Aquinas Institute of Theology in St. Louis.


Date of Review: 
December 19, 2019
About the Author(s)/Editor(s)/Translator(s): 

Sonia E. Waters is Assistant Professor of Pastoral Theology at Princeton Theological Seminary and an Episcopal priest. She has served as a volunteer chaplain at a local treatment center and is involved in recovery activities in the Princeton area.


Reading Religion welcomes comments from AAR members, and you may leave a comment below by logging in with your AAR Member ID and password. Please read our policy on commenting.