Are you able to focus on one activity at a time or are you a multi-tasker who juggles five things at once?
Modern life is not always conducive to staying in the present moment, but as we are learning in the addiction field, the practice of mindfulness can bring greater joy into daily life and also help recovering addicts guard against relapse.
Increasingly, the field is embracing Eastern practices, including mindfulness meditation, as an adjunct to traditional addiction treatments.
In the past two decades, mindfulness has been incorporated into a variety of therapies, including:
• Dialectical Behavior Therapy (DBT)
• Mindfulness-Based Cognitive Therapy (MBCT)
• Acceptance and Commitment Therapy (ACT)
• Mindfulness-Based Stress Reduction Program (MBSR)
• Mindfulness-Based Relapse Prevention (MBRP)
Mindfulness, which has its roots in Buddhism, involves a purposeful and nonjudgmental focus on one’s feelings, experiences, and internal and external processes in the present moment. Rather than escape from painful feelings, mindfulness meditation encourages addicts to sit quietly with themselves and pay close attention to their thoughts and feelings without taking action to judge or “fix” them.
It is not about apathy or suppression of feelings, but rather the freedom to experience the full range of feelings and strategically choose how to respond.
Like yoga, tai chi and related practices, mindfulness is a portable skill that can become a regular part of the recovering addict’s life, both during and after treatment. It takes only a few minutes and can be done by anyone anywhere, and its effects are long-lasting.
In many ways, mindfulness is the opposite of addiction:
• Addiction is an automatic behavior used to escape difficult feelings or situations, whereas mindfulness involves conscious and deliberate focus on difficult emotions as a way to disarm them and interrupt habitual patterns like drug or alcohol use.
• Addiction is the pursuit of what seems to be lacking but has really been there all along. Mindfulness is one way to connect with one’s inner resources and see the abundance in life while recognizing that reliance on drugs and alcohol is no longer a helpful coping mechanism.
• Key features of addiction are denial and lying to self and others, often without even realizing it. Through mindfulness, the recovering addict honestly evaluates their addictive behaviors and takes responsibility for their actions, which empowers them to make changes in their lives.
• Addicts experience a great deal of shame and self-blame. Through mindfulness, they can develop compassion for self and others.
After trying unsuccessfully to change unwanted behaviors or characteristics, many people conclude, “This is just who I am.” But cutting-edge neuroscience shows that temperament can change dramatically even in adulthood.
In just eight weeks of mindfulness practice, we can alter the neural pathways in the brain. For example, the mid-prefrontal cortex and the mid-insular region of the brain become thicker with greater mindfulness practice (Lazar et al. 2005), promoting a sense of well-being and creativity.
Other research suggests that mindfulness practice may increase grey-matter density in the hippocampus (the area associated with learning and memory) and decrease grey-matter density in the amygdala, which can help regulate stress and anxiety. As a result, recovering addicts can enjoy greater self-awareness and self-regulation.
Mindfulness skills complement (but do not replace) other aspects of addiction recovery, including self-help support groups, medication and psychotherapy. While mindfulness helps recovering addicts reconnect and cope with their emotions, other therapies such as cognitive-behavioral therapy help them change unhealthy patterns.
Dr. Alan Marlatt introduced mindfulness-based behavioral relapse prevention (MBRP) as a way to help recovering addicts recognize negative thoughts and feelings without judgment or a need to act on them. A central technique in MBRP is “urge surfing.”
In this approach, cravings and urges are not seen as some mystical, overpowering force but as a series of passing thoughts and feelings that peak and then disappear much like a wave. Using their breath as a surfboard and visualizing the craving as a wave, the recovering addict rides the wave to the shore. Other useful techniques include deep breathing and body scanning, which involves paying close attention to sensations in different parts of the body.
A growing body of research supports the use of mindfulness-based relapse prevention techniques as an adjunct to traditional approaches. In one study comparing MBRP and standard relapse prevention programs, recovering addicts who completed the MBRP program had significantly lower rates of substance use over the four-month follow-up period and reported fewer cravings as well as improvements in acceptance and awareness.
In a controlled study of incarcerated addicts, those who participated in a meditation program had significantly lower relapse rates and showed improvements in psychiatric and social measures compared to the standard treatment group.
Through self-awareness, recovering addicts can consistently check in with their thoughts and feelings and take preventive action before relapse is imminent. Practitioners of mindfulness meditation often report feeling greater self-acceptance and lower stress levels, putting them in a better position to prevent relapse.
Mindfulness-based therapy has been used for a variety of ailments, including anxiety, depression, chronic pain, physical illnesses and addiction, but its usefulness extends even further. Mindfulness can be applied to every area of life, including the most mundane daily tasks like house cleaning, taking a walk or eating a meal. Even decades into recovery, mindfulness is a way to stay fully invested in life.
David Sack, M.D. is board certified in Addiction Psychiatry and Addiction Medicine. As CEO of Elements Behavioral Health he oversees a network of addiction treatment centers in California, Florida, and Tennessee. You can follow Dr. Sack on Twitter.
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Last reviewed: 2 May 2012