Mindfulness Therapy as an Addiction Treatment

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Mindfulness is a state of mental awareness and focuses that have been traditionally used in meditation practices, and has recently become popular as an element of certain types of cognitive behavioral therapy, such as Mindfulness-Based Cognitive Therapy, Acceptance and Commitment Therapy, and Dialectic Behavior Therapy.

In understanding what mindfulness is, it helps to practice mindfulness yourself. When you are mindful, you are aware of both your external surroundings and your inner experience, including your own responses to what is going on around you, in the present moment. The goal of mindfulness is to become aware without becoming attached to anything you are experiencing.

Although mindfulness is not difficult in itself, it requires a certain amount of self-discipline to focus only on the present moment, and not to get caught up in thoughts about the past and the future. For this reason, exercises in mindfulness can be helpful in giving a focus to mindfulness. Examples of mindfulness exercises are the raisin exercise, in which you take your time looking at, smelling, listening to, and eventually eating a raisin, and the body scan, in which you work through your entire body, just feeling the sensations of each body part.

How Mindfulness Helps With Addiction

You may be wondering how mindfulness can help therapeutically. You are not alone — the reaction of many people, when introduced to mindfulness, is "Is that it? How is that going to help me quit or make me feel better?"

One of the most basic ways it makes people feel better is by slowing things down, so you aren't rushing from one activity to another, or even one thought to another. By quieting the mental chatter, you can achieve a sense of tranquility that is often the reason people choose to use drugs such as alcohol, marijuana, and opiates.

Another way that mindfulness can make you feel better is by allowing you to start to notice many wonderful sensory experiences that occur in everyday life, that we often don't notice. When you allow the beauty of the world around you to fill your consciousness, the world doesn't seem like such a bad place to be.

Yu are less likely to seek out pleasure through addictive behaviors when you are enjoying life for its own sake.

A third way that mindfulness can make you feel better is that it tends to help you understand your own reactions to things. By understanding your reactions without getting attached to them, you find that you can often let things go that might have provoked you in the past. People often come to new realizations about themselves and the things that trigger them to drink, use drugs, or engage in other addictive behaviors, which can make it easier to respond differently in the future.

Mindfulness has been applied effectively to the treatment of addictions. One of the pioneers of the use of mindfulness in cognitive behavioral therapy, Marsha Linehan, developed a new approach to treating Borderline Personality Disorder first with women with chronic substance misuse problems.

What Does Mindfulness Involve?

Skills taught in mindfulness include:

  • Observation: Paying close attention to what is going on around you
  • Description: Being able to say what happened and how you felt in words
  • Participation: Becoming involved in an activity without being self-conscious about it
  • Taking a Non-Judgmental Stance: Accepting things as they are rather than judging them
  • Focusing on One Thing in the Moment: Without distraction from other ideas or events
  • Effectiveness: Doing what works rather than second-guessing yourself

Mindfulness also involves recognizing when you are running on "automatic pilot" — acting without thinking about what you are doing, as well as developing an attitude of "loving kindness" — a friendly, uncritical attitude towards yourself and others.

Mindfulness-Based Relapse Prevention

A program of Mindfulness-Based Relapse Prevention has recently been developed, which combines cognitive-behavioral therapy approaches to preventing relapse with mindfulness practice and relapse prevention. Mindfulness-Based Relapse Prevention includes the following elements:

  • Automatic pilot and relapse
  • Awareness of triggers and cravings
  • Mindfulness in daily life and in high-risk situations
  • Acceptance of whatever is happening and acting skillfully
  • The role of thoughts in relapse
  • Taking care of yourself as part of a healthy lifestyle
  • Social support and keeping your mindfulness practice going
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  • Bowen, S., Chawla, H. & Marlatt, G. Mindfulness-Based Relapse Prevention for Addictive Behaviors: A Clinician's Guide. New York: Guilford. 2011.
  • Kabat-Zinn, J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Random House. 1990.
  • Langer, E. Mindfulness: Choice and Control in Everyday Life. Addison-Wesley. 1989.
  • Linehan, M. Cognitive Behavioral Treatment of Borderline Personality Disorder. New York: Guilford. 1993.
  • Siegel, R. The Mindfulness Solution: Everyday Practices for Everyday Problems. New York: Guilford. 2010.

By Elizabeth Hartney, BSc, MSc, MA, PhD
Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada.