Why mindfulness—or whatever you choose to call it—has become an established part of the treatment toolkit
By William WagnerSeptember 9, 2020
It almost reads like a mantra: Mindful meditation has gone mainstream.
Once viewed by the medical community as something fringy, meditation has been embraced as a viable tool in addiction recovery.
“As a healthy coping mechanism—especially in recovery—meditation has absolutely gained traction in recent years,” says Dave Kulsrud, supervisor of wellness and related services for the Hazelden Betty Ford Foundation. “At the Hazelden Betty Ford Foundation, meditation is a skill we help our patients develop. It is an integral part of the 12 steps, as the 11th step promotes regular spiritual, or meditative, activity.”
To varying degrees, treatment centers from coast to coast have incorporated meditation into their programs.
“Meditation—and other stress management coping skills similar to meditation, such as different relaxation strategies—are not uncommon,” Kulsrud says. “While there are varied forms of meditation, experientials are the most effective means of learning the skills. For example, we lead our patients through a guided meditation such as yoga, Tai Chi, walking, mindfulness and visual. We ask patients to participate in a variety of meditation ‘suggestions,’ but the ultimate goal is to find whatever technique works for them to practice daily.”
Concentration meditation teaches us to ignore our mind in times of cravings. This can be the key to preventing a relapse. The more you do mindfulness, the more you understand that everything is impermanent, including cravings.”—Noah Levine, author of Refuge Recovery: A Buddhist Path to Recovering from Addiction
The emergence of meditation as part of recovery has been a long time coming, but it’s arrival shouldn’t be surprising. For years, academic studies have been touting the benefits of meditation. And now the compatibility of “traditional” treatment methods and meditation is fairly well established.
Neuroscience and Meditation
“Contemporary advances in addiction neuroscience have paralleled increasing interest in the ancient mental training practice of mindfulness meditation as a potential therapy for addiction,” finds a 2018 article in Addiction Science & Clinical Practice by Eric L. Garland of the University of Utah and Matthew O. Howard of the University of North Carolina at Chapel Hill.
“In the past decade, mindfulness-based interventions (MBIs) have been studied as a treatment for an array of addictive behaviors, including drinking, smoking, opioid misuse, and use of illicit substances like cocaine and heroin. …Studies indicate that MBIs reduce substance misuse and craving by modulating cognitive, affective, and psychophysiological processes integral to self-regulation and reward processing.”
Part of the appeal of meditation is that it adds an element of specificity and actionability to addiction treatment. The 12 steps identify the need to surrender yourself to a higher power, but as Noah Levine says, “We show you how to do it.” Levine wrote the bestselling book Refuge Recovery: A Buddhist Path to Recovering from Addiction (2014), which sparked a far-flung program, Refuge Recovery, based on Buddhist principles.
The Source: Buddhist Mindfulness
“[The acceptance of meditation] is largely because of the secularization of Buddhist mindfulness,” Levine says. “There are millions of people using Buddhism and calling it mindfulness. When Refuge Recovery came out, there was already a mindfulness movement going on. Our program grew to 800 meetings, with guided meditation at every meeting.”
His style of guided meditation has served recovering addicts in many ways.
“For example, concentration meditation teaches us to ignore our mind in times of craving,” Levine says. “This can be the key to preventing a relapse. The more you do mindfulness, the more you understand that everything is impermanent, including cravings. One of the core [exercises] is forgiveness meditation. Resentment is the No. 1 cause of relapse. The more we train our minds on forgiveness, the [smaller the chance] of relapse.”
Levine says he could go on for hours about the different meditation techniques. Each has its own place, depending on the individual.
Regardless of the exact type of meditation a treatment center or program employs, Kulsrud has seen encouraging results, even beyond addiction recovery.
“Meditation helps on so many levels,” he says. “It increases the ability to focus and concentrate. It [helps you to be] present and mindful; reduces tension, anxiety and stress; increases clarity of thinking; reduces emotional turmoil; lowers blood pressure and cholesterol; increases self-understanding and acceptance; and helps develop a clarity or deepening of purpose and meaning.”
Exhibit A is someone we’ll call Jeff, a middle-aged Illinois dad recovering from alcoholism who credits meditation for saving his life.
The 12-step process didn’t work for me. …I was dealing with my actions more than my thoughts. If I hadn’t learned about meditation, I wouldn’t have made it.”—“Jeff,” a middle-aged man recovering from alcoholism
“I discovered meditation in rehab [in 2017],” Jeff says. “It was a relatively new part of the program there. I found it to be immediately helpful; it made sense to me. It was something tangible that I could do. Meditation has given me the space to observe my thoughts and not instantly react to them. The 12-step process didn’t work for me. I went through the whole 12 steps, and they did nothing for me. I was dealing with my actions more than my thoughts. If I hadn’t learned about meditation, I wouldn’t have made it. I’m sure of that.”
Photo: Katerina Jerabkova