Spirituality and self-esteem are often neglected or misunderstood concepts in the treatment of alcoholics. One's spirit can either be malevolent or vital and alcoholics typically feel either cynical or lifeless. Self-esteem can, likewise, be positive or negative and alcoholics have generally abdicted their responsibility for this choice. The process of re-establishing a positive spirituality and a healthy self-esteem involve the following elements: separating spirituality from concepts of formal religion, defining spirituality, having the alcoholic recognize his negative, caustic view of himself and the world, and accepting the choice and responsibility of these aspects of treatment link self-esteem and spirituality in the recovery from alcoholism.
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Johnson et al. (1988) studied this question.