Looking for ideas to help you deal with a drinking problem, or other problematic substance use? Have you stopped and are finding it’s a struggle to stay stopped? Are you seeking an alternative to AA? Or just searching for some additional tools? Let me tell you how mindfulness can help.
The definition of mindfulness I use is: “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.” It comes from Jon Kabat-Zinn, founder of the Mindfulness-based Stress Reduction programs that have been taught world-wide over the last 30-plus years.
Let’s examine this definition: “on purpose” means having the intention to step out of our usual autopilot mode, where we’re more likely to behave reactively. Then we bring our attention into “the present moment,” with an awareness of our breath and bodies – which always exist in the present – and working with our mind’s tendency to dwell in the past and worry about the future. Finally, we make this effort “non-judgmentally,” acknowledging the mind’s natural tendency to judge, as we try not to take ourselves, or our critical self-judgments, so seriously.
Can you begin to see how this approach might help? “Paying attention” leads to greater awareness – of both the things that can trigger addictive behaviors, as well as the impulses themselves – which interrupts automatic patterns of thinking and reacting. Being “in the present moment” means learning to accept what’s happening, whatever the experience may be, without using substances or behaviors to change it or escape from it. And doing so “non-judgmentally” helps to detach from the automatic thinking that often leads to a relapse after you’ve quit.
Mindfulness-based Relapse Prevention (MBRP) is an innovative approach that integrates evidence-based cognitive behavioral relapse prevention skills with mindfulness meditation practices. It is intended for adults in recovery from alcohol, drug, or other substance addiction – or who are simply concerned about problematic substance use. It offers an alternative to traditional aftercare and 12-Step programs, or an additional source of group support and tools to maintain sobriety. I’ve been using MBRP informally with my clients for a few years, and I’m now facilitating MBRP groups.
MBRP is similar to 12-Step groups and other relapse prevention programs in that it begins with an awareness that one’s substance use or other addictive behaviors are causing significant problems, and places responsibility for addressing these problems on the individual, while emphasizing the need for group support. It encourages developing “the wisdom to know the difference” between what we can and cannot control, as the Serenity Prayer says.
MBRP takes a slightly different approach to abstinence, treating it as a desired goal rather than a requirement for group participation, and de-pathologizes cravings, seeing them as based in normal human needs. MBRP group participants focus on their moment-by-moment experience, rather than processing their feelings or telling their stories. And they practice being mindful, using a series of guided meditation practices, each day of the week between group meetings.
One of the most valuable tools in MBRP is the SOBER Breathing Space. It’s a mini-meditation that can be done anywhere, any time you need to be able to pause, take a step back, and hit the reset button. You can try it for yourself, here:
Another really useful meditation practice we use is Urge Surfing. It’s based on the principle that any urge, craving, or strong emotion behaves like a wave in the ocean: it rises, crests, and then will eventually fade away. If we can learn to surf that wave, using our breath like a surfboard, we can ride the wave rather than succumbing to the urge and being wiped out by it.
A note of caution about this practice: some people find it to be an intense experience, so it isn’t advisable to try it when you’re already feeling triggered, or traumatized, or really stressed. But if you’re in a stable state, and have a way of managing any intensity that may arise – like going for a run, doing some meditative breathing, or calling a friend – then give it a try. One more word of caution: please don’t pick the most triggering situation for you when you first try this exercise, it’s best if you choose something that’s only a 2 or 3 on a scale of 1 -10.
The MBRP curriculum is designed to be presented in weekly 2-hour sessions over eight weeks. The initial sessions focus on learning and integrating basic mindfulness practices, then we move into how to apply these practices in daily life to deal with cravings, triggers, and stressful situations. The final sessions address self-care, support networks, and life balance.
Research studies have shown that MBRP leads to greater overall reduction in substance use, greater decreases in cravings, and greater self-acceptance than traditional treatment/aftercare approaches. My students have reported increased self-awareness – including better ability to identify automatic thoughts and recognize habitual thinking patterns that get them into trouble – as well as improved ability to deal with their feelings and strong emotional reactions, fewer cravings, improved overall mood, and better decision-making.