Mindfulness for the Management of Addictive Behavior

By Jaime Carlo-Casellas, Ph.D.

Mindfulness is an intentional, nonjudgmental, present-moment awareness of the full gamut of ongoing experiences-thoughts, emotions, sensations and events. It is simply observing and accepting life as it is in the present moment.

Interest in mindfulness as an adjunct intervention in the treatment of addictive behavior was sparked by the finding that mindfulness interrupts the craving for the sought-after bliss induced by a substance and/or a behavior. This is so because mindfulness heightens an awareness and acceptance of the initial cues and triggers without judging, analyzing, or reacting to urges and temptations.

Empirical evidence supports the hypothesis that this awareness is attributable to the neuroplasticity (change in the structure and function of the brain) and the secretion of neurotransmitters associated with feelings of pleasure induced by mindfulness. The result of these neurobiological phenomena is an enhancement of mental acuity, information processing, and attentional control-alternatives to the mindless, autopilot thinking that propels the obsessive and compulsive addictive behavior.

One approach to develop and cultivate mindfulness is to practice Vipassana meditation. (Vipassana is a Sanskrit word that means: "seeing things the way they are.") From the vantage point of Western psychology, Vipassana Meditation enhances an awareness of ongoing behavior and cognitions. This allows the individual to modulate the inescapable, chronic stress associated with addiction.

The classical mindfulness-based addiction management program is modeled on the Mindfulness-Based Stress Reduction Program established by Jon Kabat-Zinn, Ph.D., at the University of Massachusetts Medical School and is rooted in the findings of G. Alan Marlatt, Ph.D., et al. It also encompasses the precepts of the mindfulness-based cognitive therapy of Zindel V. Segal, Ph.D., et al. Taken together, the work and findings of these investigators validate the effectiveness of mindfulness in the treatment and management of addictive behaviors, including addiction to alcohol, gambling, drugs, food and sex.

The intent of such programs is to offer a potpourri of Vipassana modalities-giving the individual a variety of modalities from which to choose, depending on his or her particular life style and preferences. The modalities include introspective breathing, compassion meditation, body scan meditation, walking meditation, Mindfulness Yoga, Reiki (healing touch), progressive muscle relaxation, mindful listening, mindful eating, and autogenics (a form of self-hypnosis that induces relaxation). As to a common denominator, all practices focus on awareness of present-moment ongoing thoughts, emotions and the physical sensations perceived through the five senses.

More recently, Pratyaahvaya Yoga (the Yoga of Resonance) has been introduced into the repertoire of Vipassana practices. The raison d'être of Pratyaahvaya Yoga is the recognition of our sameness as human beings. Pratyaahvaya faces squarely on the canons of Yoga that comprise the immeasurable virtue of love toward one another. In that vein, Pratyaahvaya is more cosmocentric than most styles of Yoga, which tend to be egocentric practices that endeavor to improve the sense of self.

Benefits of Mindfulness

Those coping with addiction who have woven mindfulness into the fabric of their daily lives report a better understanding of the factors that lead to "acting out," the ability to recognize and manage craving, an increased ability to cope with stress, decreases in the physical and psychological symptoms of addiction, greater energy and enthusiasm for life, and improved self-esteem. Other reported benefits included an increased ability to relax, lasting decreases in physical and psychological symptoms, the ability to manage residual pain and stabilized respiratory and cardiac activity.

Given these benefits, it is clear that mindfulness can be a valuable adjunct intervention to traditional relapse-prevention strategies, such as twelve-step programs, biofeedback, hypnosis, psychotherapy and psycho-pharmacotherapy. Notwithstanding, it is important to emphasize that mindfulness meditation is not intended to replace the services of healing arts professionals.

Summary

By definition, mindfulness is an intentional, nonjudgmental, awareness of the full range of present-moment experiences-thoughts, emotions, sensations and events.

Mindfulness can be honed through the practice of Vipassana modalities, which include different forms of meditation, Mindfulness Yoga, Reiki, progressive muscle relaxation, mindful listening, mindful eating, autogenics and the recently innovated Pratyaahvaya Yoga.

The release of neurotransmitters associated with feelings of pleasure, as well as the enduring physical changes in the brain induced by these practices support the hypothesis that mindfulness lets the addict modulate the obsessive and compulsive behavior associated with a craving brain.

Putatively, the cultivation of mindfulness enhances an awareness of ongoing behavior and cognitions, giving the addict a greater capacity to think clearly. In time, the addict begins to perceive and accept life as it is, without any judgment, and sets in motion the process of replacing thrill-provoking behaviors with healthier, more authentic coping mechanisms.