There are several promising applications of mindfulness to enhance recovery from alcohol and drug dependence and other addictions. This article explores several new trends and ways that meditation and mindfulness can be used to complement and help with recovery.
The Buddhist teachings (dharma) focus on the healing power of compassion. To recover from an adversity (i.e., addiction) gives one an opportunity to be more compassionate toward others as well as toward oneself.
Using mindfulness in counseling
Mindfulness has gained wide acceptance from counselors in the mental health and addiction recovery fields. Over the last 15 years the psychology field has seen a resurgence of mindfulness being used for the treatment of stress, anxiety, depression and personality disorders. For instance, John Kabat-Zinn used mindfulness training and meditation to help clients with stress, pain and anxiety disorders Kabat-Zinn (1992); Marsha Linehan (1993) integrated mindfulness practices in her Dialectical Behavior Therapy (DBT) for the treatment of personality disorders; Steven Hayes (1999) developed Acceptance and Commitment Therapy (ACT) for the treatment of depression and anxiety; Zindel Siegal et. al. (2002) developed Mindfulness-Based Cognitive Therapy (MBCT) as a relapse prevention approach to depression.
Thus, it makes perfect sense that Buddhist teachings (dharma), meditation and mindfulness training would be an ideal tool to help in the treatment of addictions.
Buddhism and addiction
Buddhist teachings make several references to addictions. Addictions often prevent individuals from being present and aware, conscious of what is going on with others and themselves. People often fail to realize what is really important. They often forget that they are not in control, and are prone to self-deception.
“Buddhist literature offers considerable insight into the basic nature of addiction, how addictive behavior develops, and how meditation can be used as a method of transcending a wide variety of addiction problems,” said Dr. Alan Marlatt, director of the University of Washington Addictive Behavior Research Center and an expert on alcohol/drug relapse prevention (Marlatt, 2002).
Buddhism describes addiction as being “a false refuge” — a delusional place to try to hide and escape from being present in life. Buddhism also describes addiction in the context of grasping, resisting and delusions; the mindfulness counters are listed below.
The grasping is the craving, obsession and compulsion to use alcohol/drugs, and the accompanying addiction-related behaviors. Grasping is described in the three “Cs” in our functional definition of addiction — compulsion and obsession, inability to control and continued use despite negative consequences.
The resisting is the pushing away, the isolation, the shutting down of normal human pleasure and displeasures, the withdrawal from connection with others — the invoking of the “no talk, no feel, no trust” rule, and of course, “not asking for help.” The Alcoholics Anonymous proverb “Silence is the enemy of recovery,” describes this resistance. Resistance is demonstrated by denial, delusion and rejecting advice, help and direction from others.
Addiction — “Land of the Hungry Ghosts”
Dr. Thomas Bien and Dr. Beverly Bien, authors of Mindful Recovery (2002), and Finding the Center Within (2003), describe a strange and peculiar realm in Buddhist cosmology, called the “land of hungry ghosts.” People in this land are described as having huge appetites, but unable to satisfy them.
Addiction is viewed in Buddhist teachings as the inability to see the abundance in our lives, nor the joy that is there “in the now.” Bien and Bien describe the torture of addicts as “…. not lack, but the inability to open to the surrounding abundance …”
“We do not need to fill ourselves with new things — we need to experience more fully what is already there,” the authors state in their book, Finding the Center Within (Bien & Bien, 2003).
Meditation and Alcohol/Drug Recovery
Bien and Bien, in their book Mindful Recovery, describe meditation and mindfulness as helping the person develop a “quality of calm awareness.” The authors further describe this as a perfect antidote to the “addicted state of mind.”
In a study conducted by the authors, three groups of heavy alcohol users were given different treatments: one group received deep muscle massage sessions for six weeks; another group did silent reading for six weeks; and the final group had six weeks of meditation sessions. The meditation group decreased their alcohol consumption by 50 percent (the highest of all groups). The meditation group also chose to continue their meditations for longer than the other groups continued their respective practices.
Meditation, twice a day for 20 minutes per session, allows the recovering person to let thoughts and feelings (positive and negative, pleasurable and unpleasurable) to stream through consciousness without attaching to them, holding them at arms’ length, observing and reflecting, rather than reacting.
Delusion and Denial
Recovery from alcohol and drug addiction involves breaking through “denial” and admitting you are powerless over these substances. The old joke in the alcohol/drug recovery field was that denial is a river in Egypt (de-Nile). A more contemporary description of d-e-n-i-a-l stands for: I don’t even know I am lying.
Buddhism has a similar focus on denial, and frequently talks about “delusion” and how we deceive ourselves from accepting suffering as part of our lives. In Buddhism, the goal is to be more aware and present by overcoming our deceptions in our life.
Pema Chodron says it well: “The essence of bravery is being without self-deception” (Chodron, 2001).
The 12 Steps and the Eightfold Path
Mindfulness is very compatible with Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), and the 12-step principles. Kevin Griffin, author of One Breath at a Time, describes the many similarities and differences between the 12 steps and the Buddhist Eightfold path. One of the similar teachings of these two is Rigorous honesty and Right Speech.
A major problem in addiction is the addict’s deception, dishonesty and outright lying. The Big Book and AA emphasize rigorous honesty to counter the rationalized lies and deceptions that are often a part of the disease. In a similar way, the third path of the Buddhist Eightfold path talks about Right Speech, which is speech that is truthful, helpful, kind and appropriate. Lies are expanded to include exaggerations, half-truths, omissions, denials, rumors and gossiping. Right Speech goes even further in describing right speech as not harming others, being kind, melodious, aesthethic and compassionate, accepting and understanding of others.
There also are many common teachings, expressions and proverbs that are paralleled in the teachings of AA and Buddhist dharma, including:
The Eightfold Path includes the following: Right View; Right Intention; Right Speech; Right Action; Right Livelihood; Right Effort; Right Mindfulness; and Right Concentration. The term “right” is used not in the context of right or wrong, but instead as the preferred way or suggested way. “Right” also means wholeheartedness and goodness.
Compassion for self and others
Life is difficult enough without beating yourself up. Give yourself a break, lighten up, and “stay in the now.”
“All beings want to be happy, yet so very few know how. It is out of ignorance that any of us cause suffering for ourselves or for others,” said Sharon Salzberg, in her book, Loving Kindness. Buddhism teaches compassion for oneself and for others. Shame, self-blame, criticism, judgments, anger and isolation cause and contribute to problems with alcohol and drugs. They can be countered by developing compassion for oneself and for others. Buddhism is a different way of viewing oneself and others. It is the way of compassion, reflection and goodness. Compassion also involves forgiveness. Forgiveness can allow a person to open his or her heart and live with greater compassion and love.
In his book, The Wise Heart, Jack Kornfield said, “For most people, the work of forgiveness is a process. Practicing forgiveness, we may go through stages of grief, rage, sorrow, hurt, and confusion. As you let yourself feel the pain we still hold, forgiveness comes as a relief, a release for our heart in the end. Forgiveness acknowledges that no matter how much we may have suffered, we will not put another human being out of our heart.”
In my book, Awakening to Mindfulness, I’ve outlined 10 Steps of compassion:
1. Being sensitive to others’ suffering, as well as your own suffering
2. Being reflective (gentle) instead of reactive
3. Changing critical attitudes (greed, hatred, delusion) into caring attitudes (generosity, love and awareness)
4. Being truthful, helpful, kind and appropriate
5. Not blaming, taking responsibility
6. Not complaining or dramatizing
7. Invoking “right speech” and following the eightfold path
8. “Cherishing” others
9. Avoiding and reducing criticism, contempt, defensiveness and stonewalling in relationships
10. Having the grace to love and to be loved
Mindfulness-based behavioral relapse prevention (MBRP)
Dr. Alan Marlatt and his associates at the University of Washington have been exploring the application of mindfulness and meditation in preventing relapse to alcohol/drugs. He has found that “the heightened state of present-focused awareness that is encouraged by meditation may directly counteract the conditioned automatic response to use alcohol in response to cravings and urges” (Marlatt, 2007).
MBRP helps the recovering alcoholic/addict to recognize (not suppress) the negative emotional states, keeping them at arms’ length. Ironically, trying to suppress negative thoughts results in an increase, rather than a decrease, in negative thoughts (Bowen, 2007). The negative thoughts are identified as “normal thoughts” at various stages of recovery. These negative thoughts are accepted as thoughts that the individual does not have to choose to act on.
An example of a MBRP technique is “urge surfing,” which involves visualizing your “urge” to use (alcohol/drugs) as having a cycle much like a wave. The wave has a crest, it crashes and then rolls to shore and disappears. This technique involves using your breath as a surf board, as you ride out the wave to shore.
My own experience using MBRE
I have specialized in alcohol/drug counseling for more than 30 years, and I am very excited about the many ways meditation and mindfulness can be used as a recovery enhancement for alcohol/drug addiction. In the last two years I have been introducing meditation and mindfulness practices in my two outpatient (alcohol/drug recovery) therapy groups, and have seen firsthand the many benefits of meditation and mindfulness practices in helping my clients to be more aware, compassionate to others and themselves and enjoying life more. I have seen remarkable growth in my group members, especially in their ability to be less reactive and more reflective.
The benefits of meditation and mindfulness include helping the individual to: have a “quality of calm awareness”; be less reactive and more reflective; reduce stress; learn how to enjoy life “in the now”; see the “joy” and “abundance” in his or her own life; have a stronger spiritual well-being; be compassionate to self and others; make connections and have interdependence; feel worthwhile; and no longer need to be in the “land of hungry ghosts.”
Richard Fields, PhD is the author of the college textbook Drugs in Perspective, 7th edition, and Awakening to Mindfulness: 10 Steps for Positive Change. He is a national trainer and consultant in the field of alcohol/drug recovery and mindfulness-based recovery enhancement (MBRE), the owner/director of FACES Conferences (www.facesconferences.com) and has a private counseling practice in Bellevue, Wash.
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Bien, Thomas & Bien, Beverly (2003). Finding the Center Within — The Healing Way of Mindfulness meditation. Wiley, N.Y.
Bowen, Sarah, Witkiewitz, Katie, Dillworth, Tirara & Marlatt, G. Alan (2007) “The role of Thought suppression in the relationship between mindfulness, meditation, and alcohol use.” Addictive Behaviors 32, 2323-2328.
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Kornfield, Jack (2008). The Wise Heart — A Guide to the Universal Teachings of Buddhist Psychology. Bantam, New York.
Marlatt, G. Alan (2002) “Buddhist Psychology and the Treatment of Addictive Behavior.” Journal of Cognitive and Behavioral Practice 9(1) (2002): 44-49.
Marlatt, G. Alan & Chawla, Neharika (2007) “Meditation and Alcohol Use.” Southern Medical Journal. Vol. 100, no. 4.
Salzberg, Sharon (1990) Lovingkindness:The Revolutionary Art of Happiness. Shambhala, Boston.
This article is published in Counselor, The Magazine for Addiction Professionals, April 2009, v.10, n.2, pp.40-44.