by Micki Fine, M.Ed., L.P.C.

“Giving up smoking is the easiest thing in the world. I know because I’ve done it thousands of times.” Mark Twain indicates the difficulty in staying abstinent even while he pokes a little fun at quitting any addictive behavior. He might add that finding skillful ways to help foster abstinence is an important aspect of addiction treatment.

In recent years, Dr. Alan Marlatt and his colleagues have proposed a Relapse Prevention model (RP) and combined it with the practice of mindfulness meditation. Known as Mindfulness-Based Relapse Prevention (MBRP), it has become recognized as a potentially powerful tool to aid in the prevention of relapse. Results from pilot studies show feasibility and the initial efficacy of MBRP as an aftercare approach for individuals who have recently completed an intensive treatment for substance use disorders.

Mindfulness is the practice of bringing open-hearted, non-judgmental attention to our moment-to-moment experience and setting time aside to practice mindfulness meditation. Mindfulness is a foundational aspect of Buddhism, though one can profess any faith tradition and incorporate the practice of mindfulness. In the past thirty years mindfulness meditation has been the subject of research that shows significant decreases in anxiety, depression, and numerous physical symptoms. Today, mindfulness is regarded as a science of the mind.

In the RP model there are recommended strategies to help prevent relapse:

• identifying specific high-risk situations
• enhancing one’s skills for coping with those situations,
• increasing one’s self-efficacy,
• eliminating myths regarding alcohol’s effects,
• managing lapses, and
• restructuring the client’s perceptions of the relapse process.

Mindfulness provides the foundation of non-judgmental awareness necessary to employ the above RP strategies. Awareness and openness to change are key abilities needed to identify one’s own high-risk situations and foster appropriate recovery related perceptions. Mindfulness meditation fosters awareness very directly . . . it’s about paying attention. When we are mindful, we begin to know our own thoughts and feelings more intimately. The open-hearted, non-judgmental quality of mindfulness can help us to be willing to see our misperceptions and be open to change. We come to understand that we don’t have to hold on to our old beliefs so tightly.

The highest-risk of lapse or relapse comes during times of difficult emotions. The ability to stay present and clear during a difficult emotion can allow us to befriend and then tend to our emotions instead of pushing them away. Mindfulness meditation provides a way to stop running from emotional pain and cultivate awareness and compassion right in the midst of the pain. We feel more able to face the emotion fully and not get swept away by it. We can comfort ourselves and find the freedom needed to calmly resolve the upset. Mindfulness helps us develop the skill of living fully. Most of us spend the majority of our time not really living our own lives. We live on auto-pilot, the mind hops the train of association to the past or to the future or to a daydream, sometimes ending up in difficult memories or anxious stories about the future. As the mind goes, so the emotions follow. Often we realize we’ve been thinking and wonder how we ended up in the emotional state we are presently in. When we choose to be present we can notice when the mind leaves the moment we then have the choice about where we place our attention.

In addition to tuning in to our thoughts and feelings, living fully means tuning in to other aspects of our lives. By slowing down a bit and being in the present moment, we begin to value ordinary life and recognize the beauty in it. Even in the midst of disturbance in life, we can find things for which to be grateful. For example, while showering we may notice the warmth of the water, the smell of the soap, and the calming nature of the experience instead of having our minds racing elsewhere, even if we are getting ready for a big job interview.

A key skill learned through mindfulness meditation is the ability to relate to our thoughts differently. In a well-established practice of mindfulness meditation we anchor ourselves in the breath and observe our thoughts as if the mind is as big as the big blue sky and our thoughts are clouds passing by. Through this observation we see thoughts as events in the mind that are impermanent and not even necessarily true. We then may have more freedom to choose our response to the situation instead of reacting reflexively and causing more difficult emotion, more tension, and other difficulties.

In addition to relating to thoughts differently, we can relate to the entirety of our experience in a radically different way. When we experience something pleasant or unpleasant we often tend to struggle with it in some way. With unpleasant events, we become tense or brace ourselves against the unpleasantness. We struggle to deny it or change it. With pleasant experience we struggle to hold on to it or make it even better. We experience struggle in both situations.

In mindfulness practice we experiment with allowing things to be as they are without trying to deny, change, fix, or make them different in the moment. We begin to notice that most of our suffering is caused by our aversion to or grasping at that which is already present. When we let go of the struggle we can see things more clearly and suffer less. This clearer perception of things helps us to make more skillful choices about living our lives. Mindfulness meditation can help us to know these lessons deeply each time we consciously let go and allow our experience to be just as it is.

This allowing and letting go is not a passivity or concession. It is a conscious and brave response aimed at seeing things clearly before we do anything about a particular circumstance. Through this wise use of our energy, we can avoid compounding the situation by fostering additional struggle, getting hi-jacked by our emotions and then reacting out of our limited perception.

From a mindfulness perspective, addiction is thought to be a disease of aversion and grasping. Managing the strong grasping of an urge to use can help prevent lapses. In MBRP there is a technique called “urge surfing”. An urge to engage in an addictive behavior can be imagined as an ocean wave that starts small, gets bigger, crests, and finally subsides. Urge surfing teaches us to use our breath as a “surfboard” to ride the wave of uncomfortable thoughts, feelings, and sensations rather than struggling or giving in to it. Mindfulness practice includes setting time aside to practice meditation and also intentionally getting off auto-pilot and being present to our experience. Classes in mindfulness are offered at Mindful Living. You can read more about mindfulness and class offerings at www.livingmindfully.org or by calling Micki Fine, M.Ed., L.P.C. at 713 522 7032.