Urge Surfing or Wiping Out: Urge Surfing or Wiping Out: Mindfulness for Change and Mindfulness for Change and Recovery Recovery Daniel Gutierrez, Ph.D., LPC, CSAC, NCC Daniel Gutierrez, Ph.D., LPC, CSAC, NCC Alex Hilert, M.Ed. William and Mary William and Mary William and Mary New Leaf Clinic & Department of New Leaf Clinic & Department of Doctoral Student Director, New Leaf Clinic Counselor Education Counselor Education
Agenda Agenda Discussing Addiction Discussing Addiction Types of Meditation Types of Meditation Introduction to Mindfulness Introduction to Mindfulness Mindfulness in Addiction Treatment Mindfulness in Addiction Treatment Implementing Mindfulness Strategies Implementing Mindfulness Strategies Demonstrations and Activities Demonstrations and Activities Clinical Considerations Clinical Considerations Questions Questions
“You cannot stop the waves, but you can “You cannot stop the waves, but you can learn to surf. learn to surf. - Jon Kabat-Zinn - Jon Kabat-Zinn
Introduction Introduction Substance use disorders have been described as a chronic relapsing Substance use disorders have been described as a chronic relapsing condition in which roughly 50% individuals participating in treatment condition in which roughly 50% individuals participating in treatment relapse within 6 months (McKay & Weiss, 2001), and up to 80% experience relapse within 6 months (McKay & Weiss, 2001), and up to 80% experience an ongoing cycle of treatment, relapse and problematic drug use an ongoing cycle of treatment, relapse and problematic drug use Including mindfulness practices into treatment may improve outcomes by Including mindfulness practices into treatment may improve outcomes by altering the craving-use relationship (Brewer et al., 2014; Witkiewitz et al., altering the craving-use relationship (Brewer et al., 2014; Witkiewitz et al., 2013) 2013)
The Biopsychosocial Model of Addiction The Biopsychosocial Model of Addiction Biological predisposition and neurobiological dysfunction: cravings and stress Biological predisposition and neurobiological dysfunction: cravings and stress responses responses Psychological Health: negative affect, perceived stress, comorbid Psychological Health: negative affect, perceived stress, comorbid psychopathology psychopathology Social-situational influences: peer pressure, lack of social support, and Social-situational influences: peer pressure, lack of social support, and environmental cues environmental cues Dynamic reciprocal interactions (i.e. feedback loop) Dynamic reciprocal interactions (i.e. feedback loop) negative affect substance use negative affect negative affect substance use negative affect
Mindfulness & Mindfulness & Meditation Meditation
Types of Meditation Types of Meditation There are many, many forms of meditation (Transcendental, There are many, many forms of meditation (Transcendental, Mindfulness, Yoga, Centering Prayer, ACEM, Zazen…etc.) Mindfulness, Yoga, Centering Prayer, ACEM, Zazen…etc.) Each approach has a rich spiritual and historical tradition Each approach has a rich spiritual and historical tradition The overlap creates a difficult in categorizing them The overlap creates a difficult in categorizing them For example: They all seem to influence Mindfulness in some For example: They all seem to influence Mindfulness in some capacity (Goleman, 1988) capacity (Goleman, 1988) Some approaches (LKM) might be considered more guided Some approaches (LKM) might be considered more guided imagery imagery
Types of Meditation Types of Meditation Two methods of categorization: Two methods of categorization: Concentrative and Awareness (Seidmeir, 2012, Walsh & Shapiro, Concentrative and Awareness (Seidmeir, 2012, Walsh & Shapiro, 2006) 2006) “Be Here Now” meditation and “Be There Now” meditation (Lou Ritz, “Be Here Now” meditation and “Be There Now” meditation (Lou Ritz, personal communication) personal communication) We need more research on various types of meditation: We need more research on various types of meditation: Culturally appropriate approaches are needed Culturally appropriate approaches are needed Research on other approaches might demonstrate some models are Research on other approaches might demonstrate some models are more effective more effective We need to understand what types are most effective for what We need to understand what types are most effective for what conditions and in what settings conditions and in what settings
Research? Research?
Meditation as Medication Meditation as Medication Beneficial effects on anxiety, depression, addiction, anger, chronic pain, Beneficial effects on anxiety, depression, addiction, anger, chronic pain, insomnia, eating disorders, stress related to chronic health conditions, insomnia, eating disorders, stress related to chronic health conditions, and hyper tension (Creswell, 2017) and hyper tension (Creswell, 2017) Positively impacts emotion regulation, emotional intelligence, attention, Positively impacts emotion regulation, emotional intelligence, attention, self-compassion, subjective happiness, empathic concern, and creativity self-compassion, subjective happiness, empathic concern, and creativity (Sedlmeier et al., 2017) (Sedlmeier et al., 2017) Reduced Blood Pressure and Stress; boosts immune system (Ospina, Reduced Blood Pressure and Stress; boosts immune system (Ospina, 2007; Creswell, 2017; Sedlmeier et al., 2017) 2007; Creswell, 2017; Sedlmeier et al., 2017)
Emotional Regulation Emotional Regulation There is more and more convincing proof that meditators have the ability There is more and more convincing proof that meditators have the ability to moderate the intensity of their emotional arousal (Aftanas & to moderate the intensity of their emotional arousal (Aftanas & Golosheykin, 2005; Seldmeier, 2017). Golosheykin, 2005; Seldmeier, 2017). Researchers suggest meditation improves emotional regulation through Researchers suggest meditation improves emotional regulation through increased meta-cognitive awareness, acceptance of thoughts, and increased meta-cognitive awareness, acceptance of thoughts, and executive control (Creswell, 2017) executive control (Creswell, 2017)
Effects on Mood Effects on Mood Lane, Seskevich and Piper, (2007) studied 200 healthy adults using a Lane, Seskevich and Piper, (2007) studied 200 healthy adults using a number of psychological instruments that focus on mood, anxiety and number of psychological instruments that focus on mood, anxiety and psychological distress. The clients were given a simple meditation psychological distress. The clients were given a simple meditation technique and asked to practice it. Those who practiced the technique technique and asked to practice it. Those who practiced the technique reduced negative mood and their perceived stress. Those who practiced reduced negative mood and their perceived stress. Those who practiced most frequently had the greatest effects. most frequently had the greatest effects.
Stress Recovery Stress Recovery Goleman (1976) showed meditation teachers Goleman (1976) showed meditation teachers and non-meditators films of industrial accidents and non-meditators films of industrial accidents & measured physiological reactions & measured physiological reactions Meditators showed a unique pattern of reaction: Meditators showed a unique pattern of reaction: They reacted immediately to the stress and They reacted immediately to the stress and showed the typical fight or flight reaction but showed the typical fight or flight reaction but then they rapidly recovered to the pre-film level. then they rapidly recovered to the pre-film level.
Goleman (cont.) Goleman (cont.) But the non-meditators reacted more slowly and continued to feel But the non-meditators reacted more slowly and continued to feel the stress both mentally and physiologically for a longer period of the stress both mentally and physiologically for a longer period of time. time.
Goleman (cont.) Goleman (cont.) Goleman concluded that quick stress Goleman concluded that quick stress recovery is a trait of meditators. This recovery is a trait of meditators. This is key in the full court press of life is key in the full court press of life where one must recover where one must recover
Meditation as Therapy Meditation as Therapy There has been a line of fairly consistent There has been a line of fairly consistent research on the effectiveness of research on the effectiveness of meditation for reducing anxiety, stress, meditation for reducing anxiety, stress, treating phobias, emotional regulation, treating phobias, emotional regulation, and excessive anger and excessive anger How do you think this could help How do you think this could help someone struggling with an addiction? someone struggling with an addiction?
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