But mindfulness can also help the virtually 24 million Americans struggling with drug and alcohol addiction to find lasting recovery, according to some experts.
Research on mindfulness-based relapse prevention, an eight-week program developed at the University of Washington, offers hope even for cravings with the lowest recovery rates, such as opiate and crack cocaine addiction.
Modeled after mindfulness-based cognitive therapy for depression and mindfulness-based stress reduction, MBRP tackles the very roots of addictive behavior by targeting two of the main predictors of relapse: negative feelings and cravings. Treatment centers, prisons and Veterans Affairs centres across the country have implemented the program.
While the treatment is still relatively young and more research is needed to determine its long-term efficacy for various types of substance abuse, the results so far looking promising. Compared to people in traditional 12 -step relapse prevention programs, those in MBRP programs for substance use and heavy drinking experienced a significantly lower risk of relapse, a 2014 survey published in JAMA Psychiatry detected. Even people who did relapse reported significantly fewer days of substance use and heavy drinking at six-month and one-year follow-ups.
There’s reason to believe that these benefits can be seen on the neurological level, too, as research has shown that mindfulness educate affects areas of the brain associated with craving, negative affect, and relapse.
HuffPost Science chatted with one of MBRP’s inventors, Dr. Sarah Bowen, a clinical psychologist at Pacific University in Oregon, about how mindfulness works to short-circuit addictive behaviours and why researchers are optimistic about MBRP’s potential to change the landscape of craving recovery. Here’s what we learned.
What is an MBRP program like for patients?
In developing the program, we used Zindel Segal’s work on mindfulness-based cognitive therapy for depression as an exemplar, so MBRP has elements of both cognitive behavioral therapy and meditation.
In each conference, there’s a meditation practise as well as a practice with different cognitive and behavioral abilities — for example , noticing what kind of problematic believes might arise, and actually writing them down and becoming familiar with them. It’s about practising very applied skills for day-to-day living.
MBRP is group-based, with 8-15 people meeting for two hours weekly over the course of eight weeks. Originally, it was created as an aftercare therapy for those in recovery. Patients have gone through some kind of initial therapy so that their system is clear of drugs. They’ve been through that detox and stabilization — and now what? Well , now they have the rest of their lives to try to live differently. That’s where this program be coming back.
How does the program borrow from the protocol of MBCT?
It borrows from MBCT in the eight-week structure, and also in the way that it’s secularized mindfulness to make it more accessible. It’s not about becoming a Buddhist, it’s about learning these ways of training our mind and changing processes the hell is problematic.
But the processes that we’re targeting are different. In MBCT, there’s a lot of focus on the ruminative suppose patterns and cycles that can lead to depression relapse. In MBRP, we work much more on reactive, impulsive sorts of behaviours. We’re paying attention to the experiences of craving and how, for so many people, that can automatically lead to an impulsive behaviour. There’s also more of a focus on the physical aspects of craving.
How does mindfulness get to the roots of craving?
There’s a shift in the individual’s relationship to discomfort. Let’s say someone is feeling depressed, or sad, lonely or bored — something that tends to trigger craving and then substance employ. These practises are teaching people to notice that developing, and to relate to that differently.
So, there seems to be a change between the experience of emotional discomfort and having that almost automatically lead to substance utilize. We’re insuring a reduction in craving, and also a reduction in the tendency to reach for something in order to feel better.
Additionally, from what I ensure and experience, it’s helping people become really well informed what’s happening in their minds. Once they see that, they have a option and they have some liberty. We’re trying to teach people to become experts on themselves so they can see these processes unfolding and how they lead to places they don’t want to go. Then, they consider the places where they can intervene. How do we become aware of how we feel, and practise sitting with things that are uncomfortable — things we feel like we can’t tolerate? In fact, we can tolerate them. We only need to practice.
Do you think this program is able to help people in such a way that previous treatments haven’t?
I do. I hear that from both the clients and the clinicians who are burned out from old routes and old models of craving.
There’s a tremendous amount of trust and respect in this program. I suppose where it’s actually different is that we’re looking at the human condition and what it means to be human, much more than simply asking, “How are you going to not use drugs again? ” That’s where it’s a radical switching. We’re all sitting in the same circle, we’re all swimming around in the same human mess, and we’re all struggling with things — whether or not we’re junkies. Maybe one person has particular propensities that are showing in addiction, and another person can have the same basic makeup but their problem is different. It could be working too much or eating too much.
So the approach is, “Hey, we’re all human, it’s really hard to be human, and we’re doing our very best . ” Sometimes we don’t know how to attain ourselves happy, but we’re all trying. It’s coming from a very positive place — as Jon Kabat-Zinn says, “There’s much more right with you than wrong with you.”
It’s not really about not doing medications — it’s about what it means to be human and how we can live our lives a little more skillfully.
Taking on that perspective seems like a nice way to help lessened the stigma of addiction, too.
Yes. And on that note, we’ve really started working with kindness practices, being kind with ourselves and forgiving ourselves. It’s so important for everyone, but especially for people with addiction — there’s so much shame and resentment and guilt.
A huge piece of this work is acknowledging that we’re truly doing our very best, and we need to be kind to ourselves to get through it all.
Is there a patient who is particularly well-suited to a mindfulness therapy?
Anecdotally, it seems that this is particularly helpful for people who have been through these cycles repeatedly — someone who’s maybe gone through AA a number of times and continues to relapse, and requires something different and maybe a little radical in terms of how they experience themselves and their life.
Those people seem to be really ready for something different, because what they’ve done over and over isn’t working, and they seem to be very ripe for this kind of intervention. The people who seem to do really well with this and are actually open to it are folks who are now various kinds of on their knees, they’ve been through these cycles, they’ve been through treatment and they need something different.
I appreciate that you use the word “radical, ” because I think a lot of people will see meditation as being perhaps not radical enough for something as intense as an opiate craving. Why do you think this approach is radical?
What I appreciate about this approach is that I’m not trying to come in and tell someone what their experiences are and what the truth is. It’s much more, here’s a way for you to look at your own experience and tell me what you notice.
We’re learning how to be aware of what’s happening for us and to have a little flexible and selection and liberty. Once people see that, they get that it’s not about meditating per se — it’s about learning more about myself and being on my own side.
This interview has been edited for duration and clarity. Visit mindfulrp.com to learns more or to find a trained clinician in your area.
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