Mindfulness & Addictions Seminar - Sept 2013 (DONE)

8/11/2019 Mindfulness & Addictions Seminar - Sept 2013 (DONE)

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Mindfulness & Addiction

Strategies for Clients and Professionals

September 20, 2013

Marcello Spinella, Ph.D.

Professor of Psychology

Richard Stockton College of New Jersey


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Brief History of Mindfulness

History

Direct origins in Buddhism

o Similar/identical practices in allmajor religions

o Universal, human psychological skills

Completely Secularized Clinical Programs

o Mindfulness-Based Stress Reduction(MBSR) 1979

o >17,000 people completed the course

o >500 have been trained as teachers

o Other clinical offshoots

Mindfulness-Based Relapse Prevention (MBRP) for addiction

Research basiso

Benefits supported by published scientific studies (


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What is Mindfulness?

"Man will become better when you show him what he is like." --Anton Chekhov

Three Components of Mindfulness Meditation:

1. Concentration

a. What is it?

1. Sustained attention- awareness-extending tool (microscope analogy)

2. Trainable (muscle analogy)

b. Why do it?

1. Short-term: Mind alert & Body relaxed

2. Long-term: Benefits every aspectof life

c. How is it done?

1. Focusing & re-focusing

2. Some chosen object

a. Sensations, emotion, thoughts passing

b. Focus may be narrow or broad

"The faculty of voluntarily bringing back a wandering attention, over

and over again, is the very root of judgment, character, and will

An education which should improve this faculty would be the education

par excellence. But it is easier to define this ideal than to give practicaldirections for bringing it about."

- William James, Principles of Psychology


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2. Clarity

a. What is it?

1. Observing perspective of current experience (e.g. thoughts, emotions, sensations)

2. Observing theprocess notcontent. Example:a. Content Whatyou are thinking about

b. Process Observing the fact that thinking is occurring

b. Why do it?

1. Divide & conquerstrategy

a. See componentsof experience (seeing, hearing, feeling, thinking, etc.)

b. Disentangled - more tolerable, manageable

2. Disidentifying/Decentering

a. You are not your thoughts (or emotions, sensations, etc.)

b. Observing awareness perspective (meta-cognitive awareness)

c. Passing events

d. Reacting becomes a choice, rather than a compulsion(e.g. cravings)

Although meditation isnot thinking, nevertheless it can be clear

awareness of thinking

--Joseph Goldstein

We shift our focus from clinging to thecontentof our suffering

to observing theprocess. Already, in that shift, we have ceased

to suffer.

--Cheri Huber


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c. How is it done?

1. Focus on one component at a time (and/or in combination; apple analogy)

2. Optionally facilitated by mental labeling(feeling, thinking, etc.)

3. Equanimity

a. What is it?1. Changing the relationship to experiences

2. Attitude of non-interferencewith the natural flow of experiences

3. Synonyms: Allowing, Non-judgmental attitude, Acceptance

b. Why do it?

1. Suffering = Pain x Resistance (Shinzen Young)

c. How is it done?

1. Practicing a shift in attitude

a.Radical permissionto experience whatever comes up

b. Attitude of allowing, moment by moment

Serenity Prayer:

God grant me the serenity

to accept the things I cannot change; Equanimity

courage to change the things I can;and wisdom to know the difference.

Freedomis not freedom from having

emotions; it is freedom from complicating

them."

--Gil Fronsdal


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2. Equanimity isnot apathy:

a. Not trying to control internalexperience

b. May or may not involve external action

Motivating Factors

1. Changes aresubtle&gradual, butcumulative

a. Short-term: seems like nothing is happening, but it is.

b. Rewiring your brains response to experiences

2. Rewardinstead of punish

a. Dont judge/punish

1. Wandering mind is inevitable- unrealistic to expect the mind to stay blank2. We haveno controlover when the mind wanders

3. Punishment not helpful, counter productive

b. Rewardinstead of punish

1. Wandering Failure

2. Re-focus = success (every single time)

a. Feel good about it!

b. Tell yourself Good! every time you refocus (can drop it later)

c. Most important motivating factor!

Frustrated,

Stressed

Graceful,

Efficient

Restless,Helpless/depressed

Peaceful

Frustrated,

Stressed

Graceful,

Efficient

Restless,Helpless/depressed

Peaceful

Equanimity Resistance

No action

Action


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3. Benefit happens no matter what

a. Peaceful experience notice it

b. Confusion, chaos notice it

c. Both are equally good

d. Have equanimity with the lack of equanimity(accept the lack of acceptance)

4. Attitude of self-compassion, kindness Cannot emphasize enough

5. Attitude of curiosity

Payoffs- When a Meditation Technique "Works": (reasonable time frame)

1. Cognitive

a. Increased mental focus/clarity

b. Insight - deeper self-knowledge, understanding

2. Emotional:

a. Reduced suffering from pain (physical/emotional)

b. Increased satisfaction from pleasure (physical/emotional)

3. Behavioral: Adaptive changes in behavior


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Five Ways to Meditate(Shinzen Young)

Overview:

1. Focus In Internal experience (See In, Hear In, Feel In)

2. Focus Out External experience (See Out, Hear Out, Feel Out)

3. Focus on Rest Restful states4. Focus on Change Change in any experience

5. Focus on Positive Positive feel, image, and/or talk

The "Five Ways" (in depth):

1.Focus In

a. Observing internal emotions and/or thoughts:

1. Mental images

2. Mental talk/sounds

3. Emotional feelings in the body

(one by itself or any combination)

2. Focus Out

a. Anchor in the present moment (external sensations)

1. External vision, hearing, & touch

b. Examples:

1. Raking sand gardens

2. Everyday tasks (e.g. dishes, laundry, walking)

3. Looking at an object (candle)

4. Whole visual field while driving

5. Breath (touch around the nostrils, abdomen)


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3. Focus on Rest

a. Relative restful experience

1. Relative lack of activity

2. Gaps between thoughts, sounds, etc.

3. Happen spontaneously, but we can learn to detectthem better

b. Examples:

1. Focus on blank- Blank seen with eyes closed

2. Focus on silence Gaps between sounds, silence beneath the sounds

3. Focus on muscle relaxation

4. Focus on Change

a. Noticing change in any internal/external experience (as above 1,2,3)b. Focusing on the flow of activity aspect

c. Increased tolerance for challenging experience (e.g. stress, cravings)

5. Focus on Positive

a. Ways #1-4 involvejustobserving

b. #5 involves creatinga state & focusing on it

c. Methods:a. Image Positive mentalimagery, visualization (or looking at a picture)

b.Talk- Mentally repeating positive word/statements

c. Feel - Focus on positive feeling

d. Numerous examples (religious and secular)

1. Loving-kindness meditation

2. Hindu or Buddhist mantra

3. Tibetan Deity Yoga

4. Catholic Rosary

5. Islam (repeating Shabadah)6. Other Christian forms

a. Christian Centering Prayer- Choose word/phrase from scripture (mantra)

b. Eastern Orthodox Jesus Prayer (mantra)

7. Secular: Word expressing positive quality (peace, grateful, love)


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Research on Mindfulness & Meditation

Concentration

1. Develops Executive Attentional Network(Chan & Woollacott, 2007)

2. Physiology of Concentration - Lowered metabolism (Anderson, Liu, & Kryscio, 2008; Benson; 1976)

a. Oxygen consumption d. Blood pressure

b. Respiration e. Muscle tension

c. Heart rate f. Stress response

3. Brain Physiology of Meditation

Electroencephalogram(EEG)

Rihs et al., 2007; Kelly et al., 2006; Herbert et al., 2005)1. Increased alphaand thetawaves

a. Different from sleep

2. Increased gammawaves

3. Synchronize/links brain areas


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4. Brain blood flow (fMRI)

a. Frontal lobenetworks (**underactive in addiction)

b. Insula Awareness of internal body states

5. Thicker brain structure (MRI) (Lazar et al., 2005)

Mindfulness is Metacognitive Awareness

1. Self-awareness

2. Thinking

a. Less compulsively drawn in by thoughts

1. Self-judgment, criticism

2. Rumination pointless, repetitive thinking

3. Intolerance of uncertainty paralyzed by not having certainty/answers

"Meditation helped me see that my expectations were just stories that I was telling

myself about life. I became free of what life was supposed to be and able to enjoy life

as it was."

--Lee Lipsenthal

We are not stopping thoughts as much as overcoming any preoccupation we have with

them Mindfulness practice won't stop the thinking, but it will help prevent us from

compulsively following thoughts that have appeared.--Gil Fronsdal

Anything you cannot relinquish when it has outlived its usefulness

possesses you

--Peace Pilgrim

There is a difference between watchingthe mind and

controllingthe mind.

--Henepola Gunaratana


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3. Mindfulness of Emotions

a. Reduces

o

Stress(Grossman et al., 2004)

o

Anxiety, panic& OCDsymptoms

o Depression& relapse

o

Coping with many medical illnesseso ReducedPain

b. Increases

o

Positive emotion

Mindfulness in Addiction Treatment

1. Correlation: more mindfulness, less addiction symptoms (alcohol, sex, gambling, & spending)

2. Prison study (Bowen et al., 2006; Bowen et al., 2007)

a. 10-day retreat vs. treatment-as-usual

b. Reduced cravings - Urge surfing(wave analogy) (i.e. Feel In)

c. Less drug use post-release (alcohol, cannabis, and crack)

3. Smoking:

a. More tobacco cessation(Brewer, et al.)

b. Less cravings

4. Eating Disorders

a. Reduces binge eating (Kristeller & Hallett, 1999)

b. Less dysfunctional eating attitudes (Masuda, 2010)

c. Less body dissatisfaction (Lavender, 2012)

Emotionceases to be suffering as soon as we form a clear

and precise picture of it.

--Baruch Spinoza (1677)


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Mindfulness & Addictions Seminar - Sept 2013 (DONE)

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