If you’ll remember, we began our review of substance abuse treatments by breaking them down according to their stance on abstinence. Next, we noted that the moderation-based programs fall under the umbrella term harm reduction. The division between abstinent and non-abstinent addiction theories, we explained, is highly partisan.
But the fact that substance abuse treatments are so contrarian puzzles. What’s at the heart of this division? Dr. Tom Horvath, who has been working in the field of addiction for over twenty years, addresses that question: “The fundamental split is between self-empowerment and the powerlessness approach…these both hinge on…’locus of control.’” If your locus of control is internal, then you have agency. If it’s external, you are powerless over your drug of choice.
Smart Recovery is one alternative to Marijuana Anonymous
Horvath runs a couple of rehabs that teach that the locus of control is internal, existing within the individual. These facilities teach something called Smart Recovery, a method that is examined in this article on thefix.com. The Smart Recovery philosophy doesn’t require abstinence, and it is becoming the most popular alternative to twelve step programs. The twelve steps teaches that an individual’s locus of control is external. Here’s step numero uno: “We admitted we were powerless over alcohol.” Moderation-based methodologies work for people who can’t get past step number one, and many people can’t.
Different Addiction Treatments Evolved From Different Models Of Addiction
In the last article, we explained that there are many models of addiction and that most treatments have evolved from an emphasis on one or another of these models. However, as we’ve already mentioned, the common ingredient in all recognized substance-abuse treatments is mindfulness. That holds true whether your goal is kicking overnight, tapering down slowly, or permanently moderating your consumption. No matter which model you adhere to, which methodology you apply to get there, or what your ultimate goal is, mindfulness is going to be involved.
Drug Addiction and Mindfulness Part 1 of 2
Drug Addiction and Mindfulness, Part 2 of 2
In her article, “The Practice of Mindfulness in Addiction Therapy,” Dr. Jenifer Talley says that mindfulness comes first when it comes to treating addicts: “With substance users, I often introduce mindfulness before we have fully determined a treatment plan or goal (for example, abstinence or moderation). Mindfulness can provide both the client and me with valuable information about what is unfolding inside…More ‘data’ can help promote greater understanding and healthier decision-making.” Instead of telling her client how to deal with his or her addiction, Talley uses the information gathered from a client’s mindfulness practice in order to determine which type of substance-abuse therapy would be most helpful to that client.
Mindfulness Based Relapse Prevention
Mindfulness is also helpful in preventing relapse. There’s even a type of therapy called Mindfulness Based Relapse Prevention (MBRP) that’s been developed at the University of Washington’s Addictive Behaviors Research Center. In her article “Secrets of Effective Meditation,” Jenna Hollenstein explains that “MBRP incorporates meditation and mindful awareness into the recovery process, seeking to free individuals of habitual actions—like reaching for a drink—by developing the ability to pause, observe and bring awareness to the moment.” Through non-judgment and self-compassion, MBRP “seeks to change how people relate to and respond to discomfort.”
I hope we’ve made it clear that we’re understating it when we say most substance abuse treatments are gung ho on mindfulness. But what about you? If you’re not quite convinced, we’ve got another example for you. In her article “Learning to Sit Still,” award-winning writer Chloe Caldwell credits Dialectical Behavioral Therapy (DBT) for keeping her addiction to heroin at bay. “DBT,” Caldwell explains, “is a form of therapy using four modules: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.” About the mindfulness component, Caldwell has the following to say: “Training myself to be in the present moment is saving my life.” Caldwell uses DBT “tricks” all day long to come by the sense of well-being that she previously sought out through heroin use. Mindfulness is kind of a big deal.
How again does one become mindful? Easily. We cultivate it through meditation, which we’ll talk a little bit more about in the next article.