Maybe he heard an old-timer say it at a meeting. Maybe his wife found the phrase underlined in his Big Book. Either way, the words spiritual malady can sound old-fashioned the first time a family hears them.
The idea behind them is simple and hopeful. A spiritual malady is the sickness of spirit that the Big Book of Alcoholics Anonymous places at the root of a drinking problem. The same book says that when the spirit heals, the rest of the man begins to heal with it. At SOZO, we keep that hope in view, because our program brings faith and clinical care into the same week.
What a spiritual malady means
The phrase comes from chapter five of the Big Book, the chapter called How It Works. That chapter sets out the honest inventory a man takes in the fourth step. In the middle of it, the book calls resentment the number one offender and says it destroys more alcoholics than anything else.
From resentment, the passage says, stem all forms of spiritual disease. It adds that alcoholics have been spiritually sick as well as physically ill. Then comes the line that holds the phrase itself: “When the spiritual malady is overcome, we straighten out mentally and physically.” You can read the full passage in chapter five of the Big Book on the AA website.
So a spiritual malady is more than a bad mood or a lapse in faith. It is the inner sickness that kept a man drinking, with resentment at its center. The Big Book treats it as the first thing to heal, because the other healing follows from it.
Signs of a spiritual malady in a man’s life
The Big Book keeps its description close to resentment, and that is the clearest place to look. If you love a man with a spiritual malady, you may see anger he cannot put down. The passage asks men to write those resentments down.
The same pattern can show up after the drinking stops. A sober man may still be restless and hard on himself. People in recovery sometimes call this the dry drunk stage, when the drink is gone and the old attitudes remain. Those attitudes point back to the same root the Big Book describes.
He is carrying something heavy that he was never meant to carry alone, and he can learn to set it down with help. The Big Book calls it a sickness, and a sickness responds to treatment. When a family understands that, it becomes easier to stop arguing with the symptoms and start helping with the cause.
How the 12 steps help a man heal it
The Big Book does not leave the spiritual malady as a diagnosis. Right after the line about straightening out, it tells men what to do next. They write each resentment down and ask themselves why they are angry.
If you are the man, that written list is where your own healing can start. It is the heart of the Step 4 inventory. On paper, a man can finally look at his anger in plain sight. Seeing it on paper takes away some of its power. He starts to look for his own part in the old conflicts, and the grip of resentment loosens. The Big Book asks him to put the wrongs others did out of his mind and look for his own mistakes. It also suggests that the people who wronged him were perhaps spiritually sick too. That view lets him take a kinder stance toward them, and it lets him stop rehearsing the old fight.
Prayer keeps the work going. A man in our program can lean on Step 11 and daily prayer to keep his spirit healthy after he finishes the inventory. Faith gives a man somewhere to bring the anger he no longer wants to carry. Families sometimes ask whether this means AA is a church, and we answer that question in plain words in our post on how faith and the 12 steps work together.
How we treat body and spirit together
The Big Book describes a sickness that reaches the spirit as well as the body. Our program treats both at the same time. We join Christian principles and the 12 steps with evidence-based practices, and every man gets a personalized treatment plan.
For many men, healing starts in residential treatment on our multi-acre campus in Jessieville, Arkansas. Residential care follows ASAM Level III with round-the-clock support. A man takes part in group therapy and one-on-one therapy. Art therapy and meditation fill out the week. He learns healthy ways to cope and how to avoid relationships that pull him back toward drinking. He leaves with a long-term support plan.
Prayer and scripture are part of the same days. A man can work his inventory and talk about it with a counselor in the same week. The spiritual work and the clinical work strengthen each other, because both aim at the same inner wound.
Some men also carry depression or anxiety. We treat co-occurring disorders at the same time as the addiction, so the mind gets care while the spirit heals. After residential care, a man can step down to partial hospitalization, which addresses the physical, psychological, emotional and spiritual sides of addiction. From there he can move through intensive outpatient care and outpatient services. Sober living waits after that, all inside our program. Our sober living homes give him daily routines and peer support, with staff access around the clock.
Each step down gives him more freedom and keeps the support close. His family can join that work as he goes, because our outpatient program includes family counseling. A wife or a parent who understands the spiritual side of his recovery can encourage the inventory and the prayer with confidence. Before he goes home, we help him make the inventory and prayer part of his daily life.
Questions families ask
What is a spiritual malady?
A spiritual malady is the sickness of spirit that the Big Book places at the root of alcoholism. Resentment is at its center. The Big Book says that when it heals, a man begins to straighten out in mind and body as well.
What are the signs of spiritual sickness?
The Big Book points first to resentment. That means the anger and the old grudges a man cannot let go. Restlessness and harsh self-blame can stay even after the drinking stops. A counselor can help a man see these patterns clearly.
Where does the Big Book talk about the spiritual malady?
It appears in chapter five, How It Works, in the part about the fourth step inventory. The passage moves straight from the spiritual malady to writing resentments down. That order shows how the program answers the problem.
Does a man have to be religious to heal a spiritual malady?
The 12 steps ask a man to be honest and willing. At SOZO, faith is part of every day, and we welcome men of faith and men open to a faith-based approach. If you are not sure he is ready, you can still call. Our admissions team can talk with you about whether our program fits him.
Take the next step with SOZO
A man whose spirit is healing can come home with a clear head and a lighter heart. We help men in Arkansas do that work with faith and clinical care, side by side with other men in recovery. The chair at the table can be his again.
Starting takes one phone call. Call our admissions team at 501-984-5317, or read about admissions at SOZO first. The admissions team checks your coverage on the first call and tells you which level of care fits. Our main office is at 505 W Grand Ave, Hot Springs, AR 71901. If a man is in danger right now, call 911.