Summary: Yes, mindfulness can help addiction recovery in a variety of ways. Mindfulness skills derived from mindful meditation, mindful breathing, mindful relaxation, and mindful activities help people in addiction recovery identify and manage patterns of emotion, thought and behavior associated with addiction.
Key Points:
- The core concepts of mindfulness have been around for thousands of years.
- Meditative practices based in Buddhism and Hinduism have been adapted for secular, non-religious purposes.
- The skills of mindfulness are practical and can be applied in virtually any situation.
- Mindfulness techniques can be learned quickly, and once learned, can be effective over an entire lifetime.
What is Mindfulness?
Not long ago, most people considered mindfulness a relatively unscientific, new-age, alternative approach to health, well-being, and stress management. However, research and science-based applications of mindfulness have been in place since the 1970s.
One of the first researchers to validate the use of mindfulness in mental health treatment and stress reduction was Dr. Jon Kabat-Zinn, when he incorporated mindfulness concepts – based in traditional Buddhist meditative practices – into a system called mindfulness-based stress reduction (MBSR).
His research showed mindfulness is effective in the following areas:
- Improved executive function and decision-making
- Improved ability to tolerate stress
- Increased well-being
- Improved self-efficacy (belief/ability to change behavior to achieve a desired outcome)
Since the 1970s, mindfulness has grown in popularity thanks, in part, to the Vietnamese monk, Thich Nhat Hahn, who defined mindfulness as follows:
“Mindfulness is our ability to be aware of what is going on both inside us and around us. It is the continuous awareness of our bodies, emotions, and thoughts, without judgment or preconception, or the immediate urge to change or alter them.”
That definition provides a solid foundation for understanding what mindfulness is. In addition, mindfulness is about:
- Letting go, and not focusing on the past
- Allowing the past to be as it is, without dwelling on how things could’ve been different
- Not worrying about the future
When you look at mindfulness from these angles, it’s incredibly practical. In retrospect, it’s surprising it many people wrote it off as a woo-woo, unscientific novelty, because those points are totally common-sense. You can’t change the past, so there’s no reason to dwell on it. And since you can’t know how things will pan out, even if you have the best intentions, there’s really no reason to worry about what’s to come.
How Mindfulness Helps Mental Health Treatment, How Mindfulness Helps Addiction Recovery
In mental health treatment, providers often introduce mindfulness like this:
“The practice of mindfulness is meant to bring your focus to the present moment in order to reduce stress and anxiety, to help relax the mind.”
When patients in mental health treatment hear this, they most often say, “Yes, please, I want that. Teach me how to reduce stress and relax, please.”
But how does mindfulness help addiction recovery?
Here’s what providers say, most often:
“The practice of mindfulness teaches you to focus on the present moment in order to help you manage patterns of emotion and behavior that can lead to relapse. Mindfulness is a powerful tool for emotional awareness and relapse prevention”
When patients in addiction treatment hear this, they most often say, “Yes, please, I want that. Teach me how to manage my emotions and prevent relapse.”
As we mention above, research into mindfulness for stress reduction, mental health treatment, and addiction treatment has been ongoing since the 1970s. In 2016, a group of researchers from the U.K. published a study called “The Mechanisms of Mindfulness in the Treatment of Mental Illness and Addiction” that explore how mindfulness can help addiction recovery.
The research team identified the following ten mechanisms.
Brain and Body, Mind and Emotion: Ten Ways Mindfulness Helps Addiction Recovery
1. Changes in neuroanatomy.
Neuroimaging studies indicate mindfulness-based meditative states can promote changes in structure, connectivity, and generation in brain networks impaired by chronic drug and alcohol misuse, including:
- Anterior cingulate cortex: integrates cognitive and emotional input, and is associated with decision making, controlling impulses, and predicting reward.
- Insula: associated with physical functions like hunger and heart rate, emotional and cognitive regulation, empathy, and social behavior
- Default mode network: active in contrasting roles including imagination during daydreaming, details while completing tasks, future planning, and self-reflection
- Hippocampus: plays a critical role in short- and long-term memory, learning, and interpreting environmental cues
- Temporo-parietal junction: the location where brain systems associated with thought and sensation overlap and contribute to our concept of self, the world around us, and other people, essential for social interaction
- Fronto-limbic network: involved in the coordination and integration and regulation of thought and emotion, important in decision-making, memory, and social interactions.
To clarify, evidence shows the positive impact of mindfulness on learning, memory, regulation of emotion and regulation of behavior via its effect on these areas of the brain. In addition, evidence shows practicing mindfulness has a positive, restorative effect on cognition and self-awareness, both of which may be impaired by long-term exposure to substances of misuse.
2. Reduced responsiveness to cues and triggers.
Research shows mindfulness-based meditative states can reduce autonomic arousal, which means it increases the activity and output of the vagus nerve, which regulates our physical response to physical and emotional stress. Reduced autonomic arousal is associated with increased psychological and physical relaxation, both associated with two goals of mindfulness: physical and mental stillness. These paired states, in turn, promote emotional wellbeing and spiritual awareness.
3. Changes in perception.
Mindfulness-based meditative states can promote significant changes in the way we see, experience, and relate to the world. The experience of mindfulness can affect how we respond to not only the outside world, i.e. physical perceptions of sound, touch, sight, taste, odors, pain, but also to our own thoughts and emotions. Mindfulness can help create distance and objectivity related to our experience of the world and help us recognize our automatic, habituated responses to external and internal stimuli. For a person in recovery, learning to decouple specific environmental cues – i.e. triggers – from automatic, learned responses – i.e. using drugs – can reduce risk of relapse, and increase likelihood of sustained, long-term recovery.
4. Increase in spirituality.
While being religious or identifying as spiritual are not required to benefit from mindfulness, people who practice mindfulness report feeling and experiencing a connection to what many of us would consider the divine, or, to put it simply, they become connected to spirituality in a direct, experiential manner: they can feel it here and now. In addiction recovery, a connection to something outside of oneself, which people in AA call a higher power, can help on several levels, including fostering belief and hope that recovery is possible, and the belief that while in recovery, we are neither literally nor figuratively alone.
5. Improved practical awareness.
This is synonymous with the phrase situational awareness, most often associated with military or law enforcement training. Situational awareness means the ability to see and understand what’s really happening in the moment, assess options, predict the outcomes of those options, and make the most appropriate, logical decisions based on all the information available at the moment. For a person in addiction recovery, increased situational awareness refers to the ability to understand the big-picture consequences of decisions made in-the-moment, and improves the ability to predict outcomes accurately.
For instance, a person with improved situational awareness may be better able to predict outcomes related to situations where they’re given a choice to drink or say no, or use drugs or say no. In addition, person with a highly evolved situational awareness can use those skills to avoid circumstances where they’re faced with that decision.
6. Clarifying personal values.
In psychology, values clarification occurs when a person recognizes and defines what they value in life and how they find meaning in life. Evidence shows that mindfulness can promote value clarification, and this clarification, combined with a mindful approach to recovery, can improve symptoms of mental and/or behavioral disorders, including substance use disorder, a.k.a. addiction. Researchers propose that one element of values clarification is foregrounding the importance of recovery, overall: mindfulness can help a person define recovery as their primary goal, and mindfulness can also help them achieve that goal.
7. Improved self-awareness.
Research shows mindfulness-based meditative states help us develop an objectivity that allows us to recognize patterns of thinking and emotion associated with addiction and addictive behaviors. When we can recognize our internal physical, mental, and emotional states without being swept away or overwhelmed by them, we can respond to them rationally and consciously, rather than reactively and unconsciously defaulting to patterns habituated by years of impulsive behavior.
During the addiction treatment process, improved self-awareness can also help a person in recovery identify the tools and techniques that work best for them, align with their personality and personal values, and thereby increase the likelihood of sustained recovery.
8. Replacement/substitution.
One school of thought proposes that mindfulness works by replacing a negative or damaging addiction, i.e. to alcohol or drugs, with an addiction that promotes physical and mental wellness, i.e. mindful meditation. This proposal, however, limits the role of mindfulness to the practice of meditation, which is a discrete, time-limited activity, whereas mindfulness itself is more than that: it’s both a mind-view and way of moving through the world, and promotes a broad spectrum of awareness across time and activity.
Rather than providing temporary relief from the symptoms of addiction, mindfulness promotes the development of a durable, persistent perspective for managing the symptoms of addiction – i.e. cravings, fear, anxiety, depressive states – that does not require the use of alcohol, drugs, or any external mechanism: once you learn how to apply mindfulness to daily life, the skill is yours for life.
9. Surfing urges.
This concept appears in various mental health contexts. In dialectical behavior therapy (DBT), for instance, therapists help patients with extreme levels of emotional reactivity ride the waves of their emotion without fighting, resisting, or getting mad or sad that they’re happening. They observe I’m angry and upset but rather than trying to arrest, clamp down, or stifle the emotion, they let it play out, until its energy and momentum inevitably dissipate.
This technique is a direct adaptation of the mindfulness skill of objective nonjudgemental observation, which teaches meditators to identify thoughts and feelings without judging them or trying to change them. Mindfulness teaches people to see, identify, wait, and allow emotion to move through and past, without attaching themselves to it.
In addiction treatment, patients learn to apply this skill to triggers and cravings. Rather than fight urges, cravings, or negative emotions that can lead to relapse, mindfulness skills allow a person in recovery to identify, wait, observe, and allow the emotion to pass without engaging with it or acting on it, which can prevent a relapse to addictive behavior.
10. Letting things go.
Surfing urges in the moment is similar to letting go of big things over the course of life. When we get attached to tussling with our urges and emotions, it gives them strength. But when we disengage, we can move past them. This works for managing triggers and cravings, and it also works when people in recovery apply mindfulness to aspects of their lives they need to move past in order to grow and heal. In addiction treatment, patients can use mindfulness to let go of what no longer serves them, including the people, places, and things associated with addiction. Perhaps most importantly, though, mindfulness in addiction treatment can help people let go of the idea that they need alcohol and drugs to manage their emotions, and replace that idea with the belief that they can develop the tools and skills they need to live a full and fulfilling life.
Mindfulness-Based Approaches to Addiction Recovery
The validation of mindfulness for mental health treatment and addiction recovery through extensive peer-reviewed research has led to the development of several systematic, operationalized techniques that leverage the beneficial effects mindfulness.
These include, but aren’t limited to:
- Mindfulness Oriented Recovery Enhancement (MORE).
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- Developed by Eric Garland, PhD, MORE is the most complete and fully integrated application of mindfulness in addiction treatment. Evidence shows that MORE is effective for people with tobacco, alcohol, and opioid addiction.
- Mindfulness-Based Interventions (MBIs).
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- A large-scale meta-analysis exploring the impact of mindfulness and recovery showed that compared to standard treatment, MBIs were more effective in reducing overall use of opioids, tobacco, marijuana, amphetamines, cocaine, and alcohol.
- Mindfulness-based Relapse Prevention (MBRP).
- An early study comparing mindfulness for addiction recovery, in the form of MBRP, with standard treatment and cognitive behavioral therapy (CBT), showed that mindfulness helped prevent relapse by teaching patients to “monitor and cope with discomfort associate with craving” and negative mood.
The takeaway from all the information above – i.e. the mechanisms of action for mindfulness and the systematized approaches for mindfulness in addiction treatment – is that mindfulness pairs seamlessly with psychotherapy and addiction counseling to improve outcomes for people seeking long-term, sustainable recovery.
To learn more about mindfulness at Honu House, please read the information on this page:
Meditation – Honu House Hawaii
