“Recovery takes time to practice and develop.” – Dustin Kessler
Addiction Therapy: Mindfulness Finally Coming into Its Own
Mindfulness practice is derived from age-old meditational traditions, and beginning in the 1980s with the studies of Jon Kabat-Zinn, contemporary research has begun to look toward mindfulness practices for many benefits in the areas of wellness and healing, such as stress reduction.
In his talks, Kabat-Zinn frequently defines mindfulness as, “the awareness that arises from paying attention, on purpose, in the present moment, non-judgmentally.”
Most of us, as we experience our daily lives, are carrying on a constant narrative about those experiences. As someone approaches us, we are narrating, “Here comes so-and-so, who is such-and-such, and she looks to be in X mood and that means thus-and-so.”
Or if we deem the person approaching is inconsequential, we may run an internal script of self-interest: “I love the sandwiches at thus-and-so; I haven’t ordered out in – let’s see, is it three days? I think I’ll order lunch there today – wait, how close is pay day?” These conversations gong on in our heads are constantly mediating our life. Much of it is judgmental. “She’s in a bad mood, this could be bad for me…”
What mindfulness practice tries to do – and there are countless methods, exercises, and theories under this heading – is to disentangle the experience from both thoughts and judgments.
Mindfulness is a set of instructions that lead you to experience things directly rather than to think about or think during the experience.
Meet a Simple Mindfulness Practice
A common mindfulness exercise starts with observing the breath. Because breathing is an autonomic function, it is something we can observe without thinking. It arises in a recurring pattern and we can experience it as both an internal and external experience. We can feel lungs expand or air against the nostrils and moving through the nasal canal, and so forth.
A simple mindfulness experiment may ask you just to observe your breath. Be mindful of the many sensations. Do not “count” breaths or “narrate” them – just observe them. You can bring any senses to bear – for example, sense of smell or taste. Can you hear your breathing?
In therapeutic practice, mindfulness has been used successfully with anxiety disorder and binge eating disorder.
“Instead of trying to replace anxious ‘negative’ thoughts with less-anxious ‘positive’ thoughts, you’ll learn how to watch your thoughts, all of them, with gentle, dispassionate interest and without entanglement.” – The Mindfulness & Acceptance Workbook for Anxiety, John P Forsyth, Ph.D, Georg H. Eifert, Ph.D.
In working with eating disorders, one practices eating mindfully. The practice takes the eater through a full experience of the food, from touch, sight, and smell to taste and texture. In this setting, mindful eating is typically aligned with slow eating. The idea is to lead into a richer food experience while gaining more awareness of how eating is connected, for the individual, to other issues.
An additional stage to the practice, a preparation stage, can commonly be found in historical or spiritual mindfulness practices that might begin with meditation, ritual, or prayer. This preparation stage can, and has been, integrated into 12-Step work. As such, the preparation stage might be translated as showing gratitude for the food, thanking a higher power, and so forth.
Two aspects of mindfulness transfer very well to those working with addiction, especially for trying to strengthen and lengthen recovery. The first, in which mindfulness seeks to deepen our everyday experience, helps burned out neural pathways re-orient to ordinary (rather than chemically induced) stimuli. The second, non-judgmental thinking, can support the fragile psyche of many who are fresh out of rehab.
For example, if you are in a mindfulness practice and you feel shame, you can let it go. Even if you are practicing mindfulness, and suddenly you feel you are not being very mindful, you can let that go as well. Mindfulness is experience without assessment. So not only do you not judge your life and actions, but you don’t judge anything about the state you are in.
For those tormented by the hurtful or desperate acts they may have committed under the influence of substances, non-judgment is a very useful tool to cultivate.
Using Mindfulness for Addiction Recovery – Dustin Kessler
For American Addictions Centers’ therapist Dustin Kessler, mindfulness practice provides a tool for working with clients planning their recovery.
Someone who has just come off drugs is in a sensitive state. If they were using drugs to self-medicate, they could have the sense of being “unprotected” or “vulnerable” to a wide range of issues from boredom to self-loathing to trauma. Feelings of guilt, of shame, of failure may have moved in where there was once a pleasant buzz. If not vulnerable, they may be feeling shut down, or feeling that daily experiences seem insipid, lacking the intensity of a drug-induced high. Memories of those highs can be still fresh.
Kessler adds, there can be a huge gap between how people want to see themselves, or how they saw themselves when in a cycle of addiction, and how they begin to see themselves in the cold light of sobriety. This daunting disparity can lay seeds for self-judgment and shame, or exacerbate negative emotions already churning. The internal struggle around shame and self-judgment can potentially drive a person to relapse. But practicing mindfulness can, over time, become a strong tool against judgment – keeping it from blowing to dangerous proportions. It’s not that shame begins when clients become sober, says Kessler.
“All these things are going on with them but they’re blocking it out with the drugs. It’s the first time they’ve begun to see themselves for what they’ve become. So when I ask them to take a deep breath and be in the moment, something might come up that they haven’t experienced in days, weeks months.” – Dustin Kessler, Addiction Treatment Counselor, Forterus Treatment Center
These early sober realizations open a door for Kessler and clients to work with self-acceptance. He can forward the conversation about mindfulness.
“So something could come up like a negative. That’s totally normal. That’s when someone would be introduced to ‘just pay attention to that.’ Take that negativity and see it for what it is, learn about how it can just exist, it doesn’t have to dictate my behavior, it doesn’t have to dictate who I am, my next move. Because I recognize, ‘I feel really bad about who I am right now’… that doesn’t mean I need to go get high right now.”
Kessler uses three different approaches to help clients access a recovery-prone mindfulness practice:
“I work with the intention of mindful acceptance, to where whatever’s happening, just accepting it.
And then there’s an approach where I practice attention.
What’s more common to people is guided visual imagery, which is one of my least practiced ones.”
According to Kessler, the principles of guided visual imagery bring mindfulness practice too close to “escape” for his comfort.
“I’m in recovery myself and that’s what drugs do for me, they help me escape. I don’t want to escape anymore, I want to be as full in the moment as I possibly can be.”
With that, Kessler clarifies the two-fold value of mindfulness practice, both remaining in the moment – feeling it fully, through as many senses as possible – and accepting that moment without judgment.
Science and clients – Kessler’s challenge
Kessler himself became interested in using mindfulness as a treatment through a study.
“I was involved [as a blind researcher] in a research study, recently, on mindfulness’ effects on pain and distress tolerance.” Ten to fifteen minutes, just once – there were significant effects.”
Even a single session of just 10 – 15 minutes was able to produce “significant effects,” according to Kessler. Because that study involved managing stress and pain – both gateways through which individuals self-medicate their way to addiction – Kessler immediately saw the practice’s value for mental health and addiction, especially in preparing for aftercare.
“It’s a difficult concept, so I just show them how to do it – how to breathe. It’s just a way to get together to be on the same page. “ – Dustin Kessler
For Kessler, walking people through the new breathing exercises takes the group to a place where they can share experiences freely.
“When someone shares about it being not useful, I like to point out how it’s a practice…and it’s not going to work right away. But drugs, they worked right away. Recovery and learning to live a healthy lifestyle takes time to practice and develop. I encourage you to do so and see if you don’t see some results.” – Dustin Kessler
Since mindfulness is a practice, an ongoing process, some people will drift away before they “get it” or before they see benefits. But Kessler is hopeful that by teaching mindfulness he is providing a tool people in recovery can turn to.
“Unfortunately the shame cycle keeps a lot of addicts using: ‘I feel bad about my use, and the only thing I can do about it is to go use again…’ Take that negativity and see it for what it is, learn about how it can just exist – it doesn’t have to dictate my behavior; it doesn’t have to dictate who I am, my next move – be mindful when we get caught in that circle, and to be able to stop it and like, ‘Hey, this is where I’m at.’” – Dustin Kessler