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Using Mindfulness Techniques in Substance Abuse Treatment

Updated on September 29, 2017
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Kim is licensed in mental health and addiction counseling. Her education is in business, counseling, and health administration.

What is Mindfulness?

Mindfulness involves a keen awareness of the here and now, and a mindset that is open and receptive to new ideas, information and experiences. In substance abuse treatment, mindfulness skills can be used to cope with feelings, stress, triggers, cravings, and urges. Mindful awareness can be the difference between responding effectively to the trauma symptoms that often co-occur with substance abuse, and a relapse to substance use to escape the unpleasant symptoms.

If practiced regularly, mindfulness can be a positive, substitute addiction with one distinction that separates it from a self-destructive addiction. It is not an escape or an act of avoidance. It is a way of staying present with rather than fleeing from pain and discomfort. Instead of staying compulsively busy to avoid an urge, running from an urge, or giving in to an urge by using, a person observes and accepts the urge, and rides it like a wave—knowing that every urge has a beginning, middle, and end, and that this one too will pass.

The practices provide a way of engaging the rational mind in response to the fight-or-flight response of the primitive, addictive brain. They help a person recognize strong urges or feelings as invitations to accept or decline after careful consideration, rather than commands to act immediately. Consistent practice allows a person to remain calm under fire, and choose a rational response to a stimulus that is in his/her long-term best interest.

Mindfulness Skills

Mindfulness skills need to be learned and practiced. If practiced routinely, twice a day when calm, it will be easier to call upon the skills in a crisis and to apply them when needed. Practice does not necessarily require sitting in a certain position or closing the eyes. The skills can be practiced throughout the day during activities and as part of the activities. Some essential skills are:

Awareness: Awareness involves focusing attention on one thing at a time, while at the same time recognizing that there are many things going on. Some of these things are external such as sounds, odors, touch, and sights, while some of these things are internal, such as our feelings, thoughts, urges, impulses, etc.

Non-judgmental: The emphasis is on observing without judging or labeling things as “good” or “bad.” The idea is to observe my angry feelings without judging them as bad or feeling a need to get rid of them or do something about them. It’s like holding my anger at arm’s length and just noticing that this is anger. Then understanding that not only is it anger but that it’s ok that it is anger and even understandable that anger would be there.

Present Moment: A present moment focus or being in the present moment means fully participating in the present without being distracted by guilt from the past or worry and anxiety about the future. It means engaging in activities that are meaningful today, not just mindlessly doing what I have always done or "going through the motions" without paying attention to what I am experiencing.

Open Mind (or Beginner’s Mind): An open mind, or beginner’s mind, is childlike (not childish). It is being open to new experiences and seeing them as they are; not how you have judged them to be or think they should be. If I attend an event with the mindset that “this is going to be a waste of time,” I have a preconceived notion about the event that prevents me from experiencing the event as it is. Likewise, if I already know it all, I’m not open to learning anything new or experiencing the joy and bliss of learning. A beginner's mind is what a child has who experiences something for the first time.

Drug Addiction and Mindfulness Part I

Drug Addiction and Mindfulness Part II

Mindfulness Exercises

Mindful of Breathing: Mindful breathing involves focused attention on breathing. Notice how you are breathing. Notice slower breathing and fuller breaths. Notice your belly rise and fall as you breathe in and out. When your mind drifts away from your breathing, and it will, simply notice what caught your attention and gently shift your attention back to your breathing.

Mindful of Sounds: Following mindful breathing, focus your attention on sounds—soft sounds, loud sounds, nearby sounds, distant sounds. Notice your response to sounds. Notice if you are annoyed by a sound or judging a sound—then gently redirect yourself to listening to sounds without judging. When your attention drifts away to a thought, notice what thoughts you were distracted by, and gently return your attention to sounds.

Meditation: The purpose of mindfulness meditation is to become more aware and accepting of internal processes—thoughts, feelings, urges, sensations, cravings, triggers, etc. Meditation is not intended for relaxation. People who are extremely anxious about internal processes or have difficulty sitting still may need to work up to a full session of 20 minutes, beginning with only 2-3 minutes at a time and working on other exercises more at first. The goal is 20 minutes of meditation two times a day. During meditation, if your mind drifts to thoughts about the past or worries about the future, gently redirect your attention to the present moment. Mindfulness meditation is about staying in the present, not about achieving a heightened state of awareness or bliss.

Mindful Eating: When eating mindfully, choose a place that is quiet and free of distractions. Before beginning to eat, look at the food. Notice what it looks like—its shape and size and color, and how it smells. Notice any internal sensations—salivation, hunger, urges before you taste the food. Now take a bite. Notice the taste, texture, and sensations in your mouth. Notice your chewing. Notice urges to swallow. Notice your swallowing. Notice your stomach as you swallow. Continue eating mindfully, noticing sensations in your stomach—feelings of hunger and fullness. Decide when you are finished eating based on when you are no longer hungry. Avoid eating while engaged in other activities, such as watching television, reading, or working. Notice feelings and thoughts associated with eating and urges to eat between meals.

Beginner’s Mind: Pick an object in the room that is familiar to you, and examine it with your beginner’s mind—that is, as if you have never seen the object before. Some people imagine they are an alien from another planet or an alien on another planet and are seeing the object for the first time. Notice the shape, weight, texture, and color of the object. Try to imagine what the object could be used for. As you continue to examine the object, do you notice anything about it that you may not have noticed before? When you put the object away, reflect on what you learned about the object that you didn’t already know. Consider what would happen if you approached other areas of your life with a beginner’s mind—people, places, objects, situations. How would these other areas of your life be the same or different if you approached them with beginner’s mind? What expectations do you now have that you would not have if you saw them for the first time?

Mindful of Thoughts: Once you are comfortable and have become mindful of your breathing, shift your attention to your thoughts. Become aware of whatever enters your mind. Remember that your purpose is simply to observe the thoughts that are in your mind without judging them. Observe thoughts as they come and go in and out of your awareness without trying to engage them, continue them, stop them or change them. Simply notice them. If you find yourself getting caught up in a thought, notice what caught your attention, then gently redirect yourself to observing your thoughts. It is normal to get caught up in thoughts. When this happens, return to observing thoughts.

Mindful of Emotions: Begin by getting comfortable and becoming mindful of breathing. Think of an event in the past in which you experienced a particular feeling that you want to get in touch with—happy, sad, glad, scared, upset, angry, proud, embarrassed, etc. Remember the situation and imagine you are in the situation now. What do you see, hear, taste, smell, and touch? Notice what thoughts, feelings, and sensations come up as you remember the situation. Pay particular attention to your feelings. Is there one feeling or more than one? Notice any urges to hold onto or push away your feelings. Respond to these urges with understanding. Notice how your body responds to the feelings. Is there tension anywhere? Sweaty palms? Racing heartbeat? Urge to cry? Urge to run or hide? Urge to fix it or make it go away? Simply be aware of your emotions without judging or trying to get rid of them. Redirect your attention to just observing your emotions. Notice any changes in your emotions during this exercise. Do they change or stay the same? Get stronger or weaker? Return to mindful breathing before ending this exercise, as it can be a difficult one. This exercise can be done with moderate, less intense feelings at first.

Mindful of Physical Sensations: Physical sensations can be urges, pain, tension, hunger and racing heart. Begin to focus on sensations involved in your body as your body contacts the surface you are sitting or laying on. Notice the parts of your body that are not in contact with the surface. Notice the sensation of air on the skin or a sheet touching the skin. Notice the air temperature. Notice any body sensations: urges, cravings, hunger, pain, muscle tension, racing heart, stiffness, cramps, body temperature, etc. Notice any thoughts or judgments you are making about your physical sensations—then, gently redirect your attention to your body sensations. After 5-10 minutes, shift your attention back to the sensations you feel as your body contacts the surface of your chair or bed, then focus on breathing.

Mindfulness in All Activities: We can apply mindfulness to any activity at any time during the day. We can drive mindfully and do household chores mindfully—meaning we are keenly focused on what we are doing at the moment. We can practice mindfulness in the shower, during a walk, in a park, at work, during exercise, in a store, in the doctor’s office, in the waiting room, while dressing, while playing or drawing, etc. When we find feelings of guilt about the past or anxiety about the future creep in or unwanted thoughts, memories or cravings, we gently redirect our focus to the here and now.

This video is really long, but if you prefer listening to reading, it's an option!

References

Marianne T. Marcus EdD, RN, FAAN, Aleksandra Zgierska MD, PhD. (2009) Mindfulness-Based Therapies for Substance Use Disorders: Part 1. Substance Abuse 30:4, pages 263-265.

Smalley, S. and Winston, D. (2010). Fully Present: The Science, Art, and Practice of Mindfulness. Da Capo Press. Philadelphia, PA.

UCLA Mindful Awareness Research Center. Retrieved from http://marc.ucla.edu/default.cfm

© 2011 Kim Harris

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    • kimh039 profile image
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      Kim Harris 2 weeks ago

      Thank you for reading and commenting livetech. I agree. There are many ways to live well.

    • livetech profile image

      livetech 2 weeks ago from United Kingdom

      Fantastic article! It seems more and more people are waking up to the many fabulous uses of mindfulness practice. I for one encourage it in unison with active living, having a sense of purpose, self forgiveness, knocking bad habits on the head and eating well. All told a real transformative process!

    • kimh039 profile image
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      Kim Harris 5 years ago

      Thanks barranca. Your students are gaining knowledge and a whole lot more. I learned TM when I was 18 and took some eastern and western religion classes in college. Eastern religious influences were not as widely accepted then as they are now. I believe the knowledge and practice of meditation has profoundly influenced the way I have responded to life events. I hope your students appreciate the value!

    • barranca profile image

      barranca 5 years ago

      Very well done hub. I teach meditation to my World Religion students and follow a very similar set of mindful techniques such as you describe above.

    • kimh039 profile image
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      Kim Harris 6 years ago

      Thanks Thoughts Become:) I appreciate your taking the time to read and comment. Cheers!

    • Thoughts Become profile image

      Thoughts Become 6 years ago from Louisiana

      "The best way to cheer yourself up is to cheer someone else up." ~Mark Twain Thank you for the wonderful insight and info.

    • kimh039 profile image
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      Kim Harris 6 years ago

      Thank you for your loyal support, Gail. I really appreciate it. Hmmm. My pseudonym, kimh039, is getting the professional recognition. I can still be incognito. Good night, and thanks again.

    • Happyboomernurse profile image

      Gail Sobotkin 6 years ago from South Carolina

      Don't know how I missed this hub when it first came out, but I saw the announcement that it was cited in ATTC Network and stopped by to check it out.

      Great hub! I learned a lot and particularly liked this quote because it is very empowering:

      "Mindfulness helps a person recognize strong urges or feelings as invitations to accept or decline after careful consideration, rather than commands to act immediately."

      Thanks for sharing this information and congratulations for being cited in ATTC network.

      The hubs you write here reach many and it's nice to see one of them receiving professional recognition.

      Voted up, useful, awesome and interesting.

    • kimh039 profile image
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      Kim Harris 6 years ago

      Thanks for reading and commenting Dr Bill Tollefson.... and for doing so with a "beginner's mind!" I appreciate your taking the time to read and comment.

    • Dr Bill Tollefson profile image

      Bill Tollefson 6 years ago from Southwest Florida

      Excellent!! Well done HUB. I learned a lot even though I have worked with addiction throughout my career. I know this will help a lot of individual seeking recovery from an addiction. Thanks for your mindful thoughts!

    • kimh039 profile image
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      Kim Harris 6 years ago

      lambservant, first of all, my apologies for taking 6 days to realize you had commented:( I only happened on your comment and a couple others by accident. I'm not liking some of the changes here on HP.

      I'm glad you found your way to some mindfulness training, and that you are finding safety in God's care. Sounds like the therapist in your story might have benefitted from some advanced mindfulness training! That's funny, though. Thanks for reading, voting and commenting....6 days ago!

    • lambservant profile image

      Lori Colbo 6 years ago from Pacific Northwest

      I learned about mindfullness a couple of years ago in a support group for mental illnes. It is a hard discipline, but when I do it, my life, my moments are richer.

      I have a funny story. My therapist, who was the facilitator of our support group told us that she had just an attended a continuing ed class or workshop. The focus of the class was on mindfulness. At the end of the morning session, the speaker/teacher asked everyone would not speak to each other during lunch, and practice mindfullness while they ate. So my therapist sat down to lunch with hordes of ladies and just couldn't stand being silent. She is very relational and friendly and without realizing it she started to talking to the few women who surrounded her. This went of for quite a while when one of the women turned to her and said, "You sure like to talk a lot don't you." Hence this woman was rather annoyed because she could not practice mindfulness with my therapist blabbing away. At our next support group she shared the incident with us and we all had a good laugh. It isn't always easy, but I think the times it has been most helpful to me is when my emotions become very powerful and I am overwhelmed or even suicidal. I on a couple of occasions allowed myself to feel the feelings and remind myself they are just feelings, they will not harm me.

      In addition to mindfulness, I am prayerful, giving God thanks for the moments I am experiencing and that I am safe in his care. Thanks for a wonderful hub. I voted up, useful awesome and interesting.

    • kimh039 profile image
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      Kim Harris 6 years ago

      Thanks so much for the kind comment, goyakla. I hope you have a great week end!

    • Goyakla profile image

      Goyakla 6 years ago from United Kingdom

      This is a great hub. You have done your research well and presented the topic expertly. Well done.

    • kimh039 profile image
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      Kim Harris 6 years ago

      You mentioned Cool Water..." once before, and when I was putting together the amazon store (link above) I came across it and added it to the store. I haven't had an opportunity to check it out. "Wherever you go" is good too. Glad you're enjoying your meetings, and really experiencing them. The car is still purring, but I don't think it's supposed to! It is getting older, and my body makes noises it didn't used to make, so maybe my car is supposed to purr. It's exactly as it should be! Have a great day vern. you and your group are in my thoughts!

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      Vernon Bradley 6 years ago from Yucaipa, California

      Wow! Well done, Kim. Lot's of easy to follow detail and wonder ful descriptions of the process. Are you familiar with the book, "Cool Water: Alcoholism, Mindflness, and Ordinary Recovery" by William Alexander? A good read.

      I also like Zinn's "Wherever You Go There You Are."

      I am enjoying my recovery immensely and my morning meetings could not be richer. A combination of humor, insight, sharing, of course, an awesome group of folks who come almost every morning. It is early and for whatever reason, that time of day, my mind is perhaps more mindful than ever, and the hour seems to have no duration to it.

      Thanks for giving us another hub on recovery.

      Hope you car is still purring.

      Vern

    • kimh039 profile image
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      Kim Harris 6 years ago

      Thanks Susan. LOL. a reminder to be mindful! I am amazed at how mindful I am of mindfulness since I wrote this! I appreciate your feedback....and remember, stay mindful!

    • susanmarion profile image

      susanmarion 6 years ago from Bunnell

      Wow, Kim, I really needed this reminder. Your hub was well written and appreciated.

    • kimh039 profile image
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      Kim Harris 6 years ago

      Hi BAD! and thanks. It doesn't make the same claims to inner bliss as transcendental meditation, but it serves a useful purpose. There has been so much mindlessness in the news lately, that mindfulness sounds like a refreshing alternative!

    • billyaustindillon profile image

      billyaustindillon 6 years ago

      Excellent article Kim - have read much of Budha's mindfulness readings and so apt to all faiths - mediation through mindfulness is a fantastic cleansing and awareness tool.

    • kimh039 profile image
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      Kim Harris 6 years ago

      LOL mentalist acer:) Mindfulness does kind of seem like just an all 'round good thing. I'm not sure I understand the first part of your comment, but I do try to be mindful of what I publish on here and how others might be influenced. Thanks for reading and commenting!

    • Mentalist acer profile image

      Mentalist acer 6 years ago from A Voice in your Mind!

      To be mindful of another's ability to influence your judgement in a mindful or non-mindful way...your hub is worthy of an all-around technique for all situations,kimh039.;)

    • kimh039 profile image
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      Kim Harris 6 years ago

      Hi alekhouse. I think mindfulness is generally a quality way of living - the opposite of unmindful living. Thanks for your comment:)

    • alekhouse profile image

      Nancy Hinchliff 6 years ago from Essex Junction, Vermont

      I'm a big fan of "mindfulness"...that's the way I live my life. I've never had a problem with substance abuse and don't know much about it, but I surmize that this technique would help.