Mindfulness for Substance Abuse Recovery
By Bhante Ethkandawaka Saddhajeewa (PhD)
At present, mindfulness meditation is one of the most important practices in clinical psychology, utilized by therapists in administering mindfulness-based interventions to their patients. The method is not a straightforward way as it requires necessary techniques for practitioners to achieve their objective. One needs to become aware of the process, the ultimate goal of which is being mindful of one’s physical, mental, psychological and social surroundings. Mindfulness meditation has been practiced in countries where Buddhism is the dominant religion and also as a means of maintaining healthy, sound and holistic living. It is a core practice among those who adhere to Buddhism.
What is Mindfulness Meditation?
Meditation in Buddhist practice is regarded as the vehicle through which human beings continue to live in the present moment and experience awareness of what is happening. Meditation is therefore a continual process and when the mind wanders off to other things, meditation helps bring the person back to attending to the present moment. (Olendzki, 2003). Bhante Gunaratana (2011) describes mindfulness as the actual awareness of something; a state of being watchful over actions, thoughts, and emotions that pass through our minds each and every day. These fundamental activities of mindfulness enable one to know what he or she is supposed to do at the moment, seeing things as they appear and really are, and acquiring a deeper understanding of a phenomenon. Paradoxically, mindfulness refers both to paying attention to an object at a given time and reminding us to pay attention if we have forgotten. He emphasizes that only mindfulness can teach individuals the three most profound truths of existence according to Buddhism: impermanence (anicca) — all condition things are just aspects in transition; unsatisfactoriness (dukkha) — every worldly thing is in the end unsatisfyingly; selflessness (anatta).
In explaining the reasons why, we meditate, Bhante Gunartana points out that meditation is the way in which we are able to achieve total happiness as peace. As human beings, we can’t get all the things that we want in life; with meditation, however, we are able to control our mind, keeping it focused on a new viewpoint. He avers that the main purpose of meditation is to purify our minds. Practicing mindfulness helps to cleanse an individual from psychic irritants, which include hatred, cravings for drugs and other intoxicants, jealousy and other things that keep an individual in a state of emotional bondage. By engaging in mindfulness, an individual is able to create a sense of tranquility and awareness of the present moment. Thus, the main purpose of mindfulness meditation is to create the possibility for personal transformation. The state of mind in which a person enters meditation is not the same as that when emerging from meditation. Meditation thus has the ability to transform an individual into a different person.
Mindfulness in Western Psychology
The most used definition of mindfulness in the literature of psychology was first coined by Jon Kabat-Zinn (1990) and supported by Ruth Baer (2003) as the working definition of the word mindfulness: “the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment.” This is the most often used definition of mindfulness found in the psychological literature reviewed during the development of the present study. However, Davis and Hayes (2011) point out that it is paramount to note that this definition implies that mindfulness is just a state rather than a certain trait that people should possess. It also implies that mindfulness is promoted by certain practices or activities such as meditation whereas in the real sense, mindfulness is not connected to this practice. In contrast, Carmody and Baer (2008) define what mindfulness attempts to cultivate rather than giving a description. She defines mindfulness as “intentionally paying attention to present-moment experience (physical sensations, perceptions, affective states, thoughts and images) in a nonjudgmental way and thereby cultivating a stable and nonreactive awareness”. Another commonly used definition of the term mindfulness was coined by Brown and Ryan (2003), but later simplified by Germer, Siegel, and Fulton (2005) to mean moment-to-moment awareness. And Martin’s (1997) definition of mindfulness suggests a connection with the Buddhist concept of attachment: “a state of psychological freedom that occurs when attention remains quiet and limber, without attachment to any particular point of view.”
Buddhist Mindfulness and Western Psychology
For us to be able to understand how Western psychology has developed definitions of mindfulness, it is necessary to look at the relationship that the term mindfulness has within Buddhist psychology. It is important to note that within Buddhism itself, there exists various schools of thoughts regarding mindfulness. We find Theravada, Mahayana, Vajrayana, as well as Zen, Ch’an, and Korean understandings of mindfulness. Whereas all of these schools of Buddhism share the same doctrine and principles, they differ in practices. In his valuable study, Olendzki (2003) conceptualizes Buddhist psychology as represented in the Theravada tradition, that which reflects the earliest formulation of Buddhism. The Theravadin branch of Buddhism is chronologically connected to the life of the historical Buddha, Siddhartha Gautama Shakyamuni and this school of thought arose in India in the 6th century B.C.E.
First, it is important to understand the ethical and philosophical foundations upon which Buddhist culture is built. Buddhist psychology rests on the premise that the human mind is best understood by paying attention to each moment of our lives and assessing each experience in meditation. This approach used in Buddhism is quite similar to the Western practice of using a scientific method to know and understand human consciousness. In Western psychological theoretical studies, one often finds reference to an individual’s ability to infer mental states that happen at the moment, such as beliefs, desires, emotions, which cause someone to reflect on what goes on in their mind as well as the minds of those around them. This theory doesn’t perfectly fit into the Buddhist concept and approach to mindfulness, however. In the Buddhist context, one examines and accesses personal experience with the further acknowledgement that other people’s experiences are different because everyone is subject to their individual personalities and perception. Thus, from the perspective of a Buddhist, consciousness is not the act of stringing together moments of knowledge and experiences that have accrued over time but is simply moment-to-moment awareness or knowing. This moment-to-moment awareness of the human mind is the reason why Buddhists have invested so much in the practice of meditation. Meditation is regarded as the vehicle through which human beings continue to live in the present moment and experience awareness of what is happening. Meditation is therefore a continual process and when the mind wanders off to other things, meditation helps bring the person back to attending to the present moment. (Olendzki, 2003)
The Problem of Substance Abuse Today
According to social historians, substance abuse has been a pervasive social and psychological problem for a very long time. The reasons why individuals develop substance abuse disorders are often complicated and solving the problem is also complicated. Vernig (2011) notes that the rate of substance abuse and addiction is relatively high. Approximately 7% of the U.S. population experiences some form of substance abuse each year. And Bayles (2014) points out that the psychological, social and interpersonal costs that are incurred dealing with the problem of addiction cannot be quantified, but are quite high. Over 1 million visits to emergency rooms per year are trauma-related and are also linked with substance abuse. When this group of individuals have no effective treatment to help them alleviate their situation, they often experience emotional pain, such as a feeling of worthlessness, which contributes significantly to relapse. Zgierska et al. (2009) make the important observation that substance abuse and dependence causes a significant psychological, social, and financial burden not only for the users but also for the families and communities within which they live. While there exists no intervention and therapy that has been proven to work effectively in the treatment of substance dependency, therapeutic communities and use of Cognitive Behavioral Therapy (CBT) have been used in the past with some level of success on relapse prevention. Despite this, there exists a need to incorporate other techniques that can be used to improve and foster prevention and intervention for the individuals that are susceptible to substance dependence. (Hendershot et al., 2011)
Mindfulness Meditation as a Path to Freedom
Buddhists have the goal to achieve enlightenment or liberation. The Buddha outlined the Noble Eightfold Path one needs to follow in order to attain this goal. The Path is divided into three categories: Sila (morality), Samadhi (concentration), and Panna (wisdom). Morality and concentration are the base upon which to build wisdom; and through wisdom we can attain enlightenment, or Nibbana in Pali. Nibbana is explained as the extinction of the fire of lust (lobha), hatred (dosa), and delusion (moha), which are the roots of all mental defilements. One who has a clean and clear mind is free from stress or mental obstacles. And meditation can help one achieve this.
Bhante Gunaratana points out that the main purpose of Buddhist meditation is not to achieve psychic capabilities, but rather to develop awareness. Learning to read human minds and levitation is not the goal of meditation; instead, the purpose of meditation is to liberate an individual. Buddhist meditation is a practice that anyone can engage in. It is a fundamental process that helps the practitioner develop awareness and involves three integral factors: morality, concentration, and wisdom. As one continues to meditate, these three factors continue to grow and deepen. These three components go hand in hand. With wisdom, one comes to understand situations that might arise, and one is then able to restrain thoughts, words, and deeds that might be able to harm others. An individual’s behavior would thus be automatically moral.
According to the Buddhist explanation, the mind is the leader, the mind is the forerunner, and we are living in the mind. If one’s mind is polluted, one’s actions and words will be unwholesome, and cause suffering. But if one’s words and actions are pure and wholesome, the mind is full of peace, and this will be a cause for happiness. Thus, as a human being we have to think about keeping our minds free of unwholesome thoughts.
Mindfulness, a practice central to Buddhist meditation, is now used for substance abuse treatment. Buddha himself gave special importance to mindfulness by including it within the Noble Eightfold Path of the Four Noble Truths. Psychologists have confirmed through scientific evidence that the Buddhist practice of mindfulness has a very positive effect on health. At the same time, mindfulness has been shown to have a very beneficial impact on our social-relational and professional environment, because it makes people more aware of their sensations, emotions, thoughts and the impact of their environment.
Buddhist methods of mindfulness meditation have not had a significant influence in the field of substance abuse recovery. Nevertheless, modern psychologists who are involved in recovery programs use the word “mindfulness.” What I intend to propose is a recovery program according to Buddhism. It is evident that by following the Buddha’s teaching, people can change their habits and behavior. While some modern psychologists talk about “awareness of the present,” and assert that being aware could help people recover from their addictions, according to Buddhism, awareness itself is not sufficient. In the Noble Eight-Fold path, mindfulness, concentration and wisdom are three components that go together hand in hand. Thus, in the Buddhist system, mindfulness is directly connected to wisdom; and to develop concentration, we need to obtain wisdom.