Mindfulness in Recovery
The notion of mindfulness or being mindful is a relatively modern Western practice in psychology, counseling, and even philosophy that borrows from more ancient sources, such as Buddhism. The concept of mindfulness is all about attention to the moment, self-awareness, and awareness of what’s going on around oneself.
Mindfulness basically represents a state of being focused on one’s current experience. During this state of awareness, people accept their feelings, thoughts, and actions as they happen. The goal is not to be judgmental but to observe, experience, and learn.
- Anxiety disorders
- Chronic pain
- Stress reduction
- As adjunctive treatment to assist in recovery from cancer and cardiac disease (awareness and stress reduction)
Can Mindfulness Be Applied to Substance Abuse Treatment?
There are a number of interesting research studies that have looked at the utility of applying mindfulness techniques to the treatment of substance use disorders. The majority of this research is encouraging.
For instance, a recent meta-analysis published in the journal Substance Use and Abuse indicated that in the 24 studies used in the meta-analysis, there was sufficient evidence to suggest that
mindfulness-based interventions/techniques were effective at reducing use of alcohol, cocaine, marijuana, opiate drugs (e.g. Vicodin and OxyContin), and tobacco. In addition, mindfulness-based interventions were also found to significantly reduce cravings in individuals with substance use disorders and to increase self-awareness and reduce stress.
This type of study is important because a meta-analysis is a specific type of methodology that takes the results of many studies and determines whether the body of research investigated suggests that the specific technique in question is demonstrated to be effective. Thus, meta-analytic research offers a better quality of evidence than the results of single research studies.
The meta-analysis did report some areas of deficiency in research on the application of mindfulness-based interventions to substance use disorder treatment, which included the following:
- Many of the studies had small sample sizes and therefore had limited generalizability.
- Many of the studies had some issues with their methodology.
- More studies using randomized controlled trials should be performed to determine the strengths and weaknesses of mindfulness-based interventions/techniques in the treatment of substance use disorders.
A randomized controlled trial is the gold standard in clinical research that attempts to ascertain the treatment effectiveness of certain types of medications, intervention techniques, therapies, etc. The authors of the study noted that there were insufficient numbers of randomized controlled trials assessing mindfulness-based techniques compared to other types of interventions. Nonetheless, this particular meta-analytic study is encouraging. Other sourcesalso indicate that mindfulness techniques can be useful in the treatment of substance use disorders.
What Are Some Techniques of Mindfulness?
The first thing to understand is that mindfulness is a concept and not any specific type of treatment. The concept involves focusing on yourself and staying in the moment (in basic terms) as opposed to ruminating, getting caught up in worrying and thinking ahead, doing things without focusing on what is happening at the moment, etc. Practicing mindfulness techniques can be applied to many different types of therapeutic interventions.
A recent book by mindfulness practitioner Deborah Burdick lists many different techniques/interventions to enhance mindfulness and assist in a number of different treatment protocols. Some of the particular mindfulness techniques that appear to be particularly successful are:
- The R.A.I.N. acronym: This tool is used to deal with troubling feelings or emotions.
- R: Recognize when a strong emotion is present.
- A: Acknowledge it or allow it to be there.
- I: Investigate it and investigate feelings, thoughts, and behaviors associated with the emotion.
- N: “Non-identify” with it. This means recognize feelings and emotions as passing states and not defining moments. The process is just like watching a film. Observe emotion and recognize it, but do not let it define you or lead you into doing something you may later regret.
The R.A.I.N. practice is designed to help someone observe and understand what drives emotions like fear, sadness, anger, etc.
- S.T.O.P.: When an individual begins to feel stressed or overwhelmed, this technique has been used to help people pull themselves together.
- S: Stop what you are doing at the moment. Put things down. Focus inward.
- T: Take a deep breath. Breathe normally in and out through your nose.
- O: Observe all the current thoughts, sensations, emotions, and whatever else is going on. Take notice of your posture, any aches and pains, and any tension. Notice that they are not permanent, and they come and go. Naming one’s emotions can have a calming effect.
- P: Proceed and do something that will provide you support in the moment. Talk to someone, stretch, whatever it takes.
Mindfulness meditation or breathing exercises: There are many different meditation and breathing techniques to help individuals focus on themselves and the moment, and to acknowledge, but not be driven by, racing thoughts, feelings, etc. Many of these are based on various types of yoga and Buddhist practices.
Urge surfing: This technique was developed by addiction treatment psychologist Alan Marlatt to deal with cravings for drugs during recovery. Marlatt recognized that the most common approach that people in recovery have to deal with urges is to try to distract themselves, to rationalize why they shouldn’t given to them, or to talk about them. These strategies typically just feed the urges and create the illusion that cravings for drugs are invincible.Marlatt asks people to think of a time when they had the strong urges for their drug of choice but didn’t given in to them. Typically, the urges pass. This indicates that cravings are not undeniable or invincible but like many feelings, they are fleeting thoughts, time-limited, and come and go.Urge surfing allows one to acknowledge urges and make them less important. Eventually, they go away, and the individual begins to understand that they are just like other fleeting thoughts and feelings. Research on urge surfing indicates that it is an effective way to deal with cravings for drugs without using medication or giving into them.
There are a number of other techniques and strategies for using mindfulness to deal with issues surrounding substance abuse and addiction, depression, anxiety, and other psychological disorders. Various forms of established psychological therapeutic techniques incorporate aspects of mindfulness into their treatment programs as well.
Who Should Instruct People In Mindfulness Techniques?
The notion of mindfulness is not a specialized therapeutic technique that requires specific training under professional supervision. Anyone can read many of the books on mindfulness and immediately apply many of the techniques. Various forms of meditation and breathing can also be learned individually; however, it is often more productive to have an experienced teacher trained in these techniques to assist the person.
Anyone using mindfulness applied to various forms of psychotherapy should be a licensed psychologist or other licensed mental health professional who is certified to perform therapy. There are a number of different established therapeutic techniques, such as Cognitive Behavioral Therapy, Dialectic Behavior Therapy, and Motivational Interviewing, that will sometimes incorporate aspects of mindfulness into their paradigms. These techniques can only be practiced by licensed mental health professionals who have completed specific training in their use.