Using the Power of Mindfulness in Alcohol Addiction Recovery

Mindfulness is one of the various types of meditation shown to help prevent relapse in alcohol addiction recovery. Mindfulness meditation has many benefits, and it is often used in formal addiction treatment.

What Is Mindfulness?

Meditation is an ancient practice that is part of many East and South Asian cultures. Seen as a way to seek mental, emotional, and spiritual health or insight, meditation is estimated to date back more than 3,000 years. Meditation includes a wide range of activities that foster relaxation, enhanced concentration, and an overall sense of wellbeing. The idea behind meditation is to be in control of distracting thoughts and distractions of the outside world to boost attention.1

Mindfulness is one specific type of meditation used to develop a conscious awareness of your immediate experiences. This means that you simply observe what you are thinking and feeling without judgment and without trying to change those thoughts or feelings.2 Doing so helps to bring awareness to any unhelpful thought patterns, which in turn can give you a greater sense of control over them.1

How Is Mindfulness Used in Alcohol Addiction Treatment?

Thinking obsessively about the past—such as when experiencing toxic shame—or future—such as by “future tripping”—can cause symptoms of depression, anxiety, or negative emotions that can be triggers for alcohol use. Training to spend more time in the present moment through mindfulness can reduce harmful thought patterns.3

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Therapists incorporate mindfulness into alcohol recovery treatment in a few different ways. Your therapist may teach mindfulness strategies regardless of their main therapy style to help you relax or cope with stress. Certain treatment programs also integrate mindfulness into the course of treatment through specific modalities, including the following.

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is a structured treatment that is delivered in individual or group therapy and consists of four main stages:4

  1. Development of the ability to handle emotions, enhance interpersonal communication, tolerate distress, and increase mindfulness
  2. Replacement of a sense of despair with a more regulated experience of positive and negative emotions
  3. Reduction of psychological symptoms
  4. Resolution of a sense of incompleteness to achieve a feeling of contentment in your life

DBT mindfulness is effective in helping people with alcohol use disorder and other substance use disorders. One study found that DBT-style mindfulness led to longer periods of abstinence and a stronger ability to manage emotions.5

Mindfulness-Based Intervention Programs

Mindfulness-based interventions (MBIs) train you in exercises that work to enhance your awareness of your thoughts and feelings in the present moment as opposed to the past or future.

MBIs are usually approximately eight-week programs that occur in a group therapy format. Each week, or each group session, a trained mental health clinician guides group members in various mindfulness practices. In a subsequent group meeting, the mindfulness practices used in the previous week are debriefed, after which new information is covered and discussed. Group members are also often given homework assignments, such as practicing mindfulness exercises and self-monitoring symptoms like cravings or negative emotions.6

What Are Some Mindfulness Exercises Used in Treatment?

Many mindfulness exercises and techniques may be utilized in alcohol addiction treatment.

Mindful Breathing

One example of a mindfulness exercise is mindful breathing, wherein the goal is to pay attention to the process of breathing in fully such that the abdomen expands, breathing out fully, and making note of the thoughts that enter your mind as you try to focus on your breathing. Not only can this exercise be calming, but the power of unhelpful thoughts can lessen.6

The “Chocolate Exercise”

Another example of a mindfulness practice that has been used in addiction treatment is what is known as the chocolate exercise.6 Patients hold a piece of chocolate near their nose and lips and, as they refrain from eating the chocolate, they notice how their craving increases and the similarity in the temptation to eat the chocolate to craving addictive substances.

Individuals are then guided in deconstructing the craving into different parts. You may notice how the chocolate smells and the feelings and thoughts it brings up. Through this exercise, you may notice that, through such deconstruction of the experience of the chocolate, the initial craving for the chocolate subsides over time.

The goal of the chocolate exercise is for individuals to learn to consciously respond to their urge to use substances with such a deconstruction rather a foregone conclusion. The more that such mindfulness exercises are practiced, the easier it becomes to employ them when cravings to use substances occur.6

What Are the Benefits of Mindfulness in Alcohol Addiction Recovery?

One study found that mindfulness-based intervention (MBI) treatment led to greater recovery from increased heart rate as a result of a stressful condition. In addition, there were significantly greater reductions in distress as a result of stress cues.6 Another study found that the more that participants in an MBI program did their therapy homework assignments, the lower their rate of alcohol use was after the treatment program ended.6

In another experimental study, the longer that participants had used mindfulness, the more they felt in control of their alcohol cravings, had fewer cravings, experienced lower stress levels, and consumed fewer drinks per day. They also had a lower tendency to pick up on alcohol cues—like advertisements or smells—in their environments.7

The observed benefits you could experience from using mindfulness regularly in alcohol addiction recovery include:6,7

  • Experiencing fewer cravings for alcohol
  • A greater sense of control over cravings for alcohol
  • Using less alcohol, through more effective harm reduction or longer periods of abstinence
  • Experiencing less overall stress
  • Lower emotional distress as a result of stressors
  • Quicker return to your regular heart rate after a stressor
  • Having less sensitivity to potentially triggering alcohol cues
  • Reduced risk of relapse

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What Are Some Mindfulness Exercises that I Can Start Using Now?

Fortunately, you do not have to wait to begin a mindfulness-informed addiction treatment program to learn and use mindfulness. Here are three mindfulness exercises that you can start doing on your own as a way to calm your mind and bring yourself into the present moment.8

1. Observe Your Environment

Simply paying attention to what your senses are taking in is a great way to bring yourself to the present moment. This exercise can also increase feelings of enjoyment, pleasure, and contentment by creating appreciation for what is around you.

Follow these steps to notice and appreciate your surroundings:8

  1. Sit—Choose a location you find comforting or peaceful, such as your backyard or your favorite living room chair. Take about 20 seconds to slow yourself down and focus on taking full breaths.
  2. See—Look around you and name five different objects you can see.
  3. See and feel—Look at, name, and touch five objects different than those you did in the previous step. Notice their texture, temperature, and weight as you do so.
  4. See, feel, and smell—Look at, name, touch, and smell three different objects, noticing their colors, textures, and aromas.
  5. Listen—Close your eyes and identify five different sounds.
  6. Taste—Focus and notice anything you might be tasting, such as gum you are chewing or the lingering flavor of food you just ate.

When you are caught up in worries or a busy schedule, it can be easy to overlook the vibrant colors of the beautiful flowers in your yard or how soft the fleece blanket feels to the touch. However, the sensations you focus on do not have to feel miraculous, life-affirming, or full of wonderment. Sensations that are ordinary or neutral—such as the feeling of your feet on the ground, the movement of a vehicle, or the daily sounds of your household—can also be grounding.

2. Be Mindful of Your Thoughts

You might have noticed that when you ruminate on worrisome or sad thoughts, they are often of things over which you have little control. Moreover, thinking about them over and over again often accomplishes very little. In addition, the more time you spend thinking about those things, the more the issues grow in your mind, and you might start to believe the thoughts to be fact.

There are many types of unhelpful thought patterns, or cognitive distortions. For example, after making a mistake, you might think “that was stupid.” The more you dwell on the situation, the more you might start to believe that, actually, you are stupid. This is a shame spiral. In reality, you are not stupid, but rather, the though, “I am stupid,” is a conditioned response as a result of a specific type of experience.8 This response may be part of a pattern of toxic shame or the cognitive distortion of labeling—where a person assigns moral values broadly to themselves or others with no nuance or distinction.

The goal of intentionally being mindful of your thoughts is to start getting you to simply notice your thoughts; you also do not judge them or judge yourself for having them:8

  1. Sit in a place and a way that is comfortable for you.
  2. Bring your attention to your breathing. Notice how your breath fills your lungs and expands your abdomen, and then how it leaves your body when you exhale.
  3. As thoughts come into your mind while doing this, which is normal, notice them.
  4. Do not judge your thoughts as being good, bad, or anything else, and do not judge yourself for having them. They are simply thoughts that have come to you, not facts. You can respond to your thoughts by saying to yourself something like, “Oh, I’ve been thinking about that a lot today” or “Huh, haven’t thought about that in a long time.”
  5. You might find yourself forgetting to stay an observer and find yourself engaging with your thoughts. For example, you may start to zoom in on the parts of a situation that make you feel embarrassed. This is normal. When you notice that you have zoomed in, bring yourself back to focusing on your breathing.

An analogy that might be helpful in understanding how to notice versus engage with your thoughts is thinking of the thoughts as clouds floating in the sky. Notice how clouds of thoughts come and go rather than following a specific cloud on its path. You might find that simply noticing your thoughts without judgment weakens them and you feel more in control of your feelings and reactions to them.

3. Engage in Walking Mindfulness

Walking mindfulness is a great exercise if you find that the previous exercises make you restless from sitting in one place.8 Find a park or walking path and comfortable walking shoes and:

  1. Walk slowly and concentrate on your steps as you look straight ahead. Be aware of how your body feels and moves, and how the ground feels beneath your feet.
  2. Slowly expand your focus and take in everything around you. Look at the trees and the people. Feel the breeze on your skin. Listen to the rustling of the leaves.
  3. If you notice your mind drifting off and engaging with thoughts, that’s okay. Let the thoughts come and go and bring your attention back to your steps.

Mindfulness is not something that you are either “good” or “bad” at, and an exercise is not a failure if you do find yourself engaging more with the thoughts that come up for you. Mindfulness is simply an exercise to help you bring yourself back to the present moment. The longer you do it, you may notice that it gets easier for you to not engage with your thoughts or to notice when you do.9

What Precautions Should I Take When Doing Mindfulness Exercises?

While mindfulness is not dangerous, sitting with your thoughts and surroundings affects each person differently. Things to be aware of before starting a mindfulness exercise are:9

  • Your thoughts and attitude toward mindfulness can affect how well it works for you. Skeptical and negative thoughts can distract from mindfulness exercises in a way that makes them less useful.
  • Many different thoughts and feelings may come up as you do a mindfulness exercise. They can range from happiness to comfort to stress to even panic.
  • For some people, being in the present moment may not feel safe. This is especially common for individuals with unprocessed trauma. Working with a mental health professional can help you stay emotionally and mentally regulated during mindfulness and other meditative activities.
  • You may feel discomfort in your body, including being increasingly aware of chronic or acute pain sensations. Some people learn to decrease or manage pain symptoms through mindfulness and other somatic therapies over time, but this increase in awareness can be intense initially.
  • Mindfulness exercises need to be repeated and continued to receive the full benefits. Many studies are based on daily mindfulness practices over the course of at least one year. It can be helpful to set aside time in your schedule to do them.
  • Mindfulness requires patience with yourself and with the process of improving in your ability to stay present during mindfulness exercises over time.

You do not have to be in an inpatient or outpatient addiction treatment program to learn mindfulness techniques from an instructor. You may consider taking a class on mindfulness before starting exercises on your own. This way you can get the support of other people and debrief on how things are going. Mindfulness classes are offered in private practices that provide holistic services such as massage therapy, in community centers and clinics, through special interest organizations, and at local schools and colleges.

You may also choose to use mindfulness guides like workbooks or journal prompts, such as the Alcoholics Anonymous Daily Reflections book.

Guidelines to use while doing a mindfulness exercise include:9

  • Allow yourself to adapt an exercise to meet your needs. For example, someone who has experienced physical trauma may not want to focus on the sense of touch on their own or even under the supervision of a mental health clinician. They may focus on the senses of sight, hearing, taste, and smell when doing a mindfulness exercise, especially when alone.
  • Use techniques that work best for you. While many individuals find mindful breathing to be a helpful starting place, others may use other foundations for mindfulness, such as a predictable noise like a fan.
  • Go back to the basics of mindfulness whenever you feel uneasy while doing an exercise. Go back to your “anchor” of being aware, present, and nonjudgmental.
  • Be patient with yourself and know that if you do find yourself engaging in thoughts while doing a mindfulness exercise, it is okay and that the point of the exercise is to bring yourself back to the present moment when you find yourself entertaining unhelpful thoughts.
  • Remind yourself that the longer you do mindfulness exercises, including evidence-based mindfulness exercises like taking an opposite action, the easier and more beneficial your practice will become.
  • Think of your mindfulness practice as one tool in your recovery toolbox. Mindfulness can complement many other skills you may learn in addiction treatment, peer support groups, or therapy.

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Resources

  1. Sampaio, C.V.S., Lima, M.G., & Ladeia, A.M. (2017). Meditation, health and scientific investigations: Review of the literature. Journal of Religious Health, 56, 411-427.
  2. Eberth, J., & Sedlmeier, P. (2012). The effects of mindfulness meditation: A meta-analysis. Mindfulness, 3, 174-189.
  3. National Center for Complementary and Integrative Health. (2016). Meditation: In-depth.
  4. Dimeff, L., & Linehan, M.M. (2001). Dialectical behavior therapy in a nutshell. The California Psychologist, 34, 10-13.
  5. Cavicchioli, M., Movalli, M., Vassena, G., Ramella, P., Prudenziati, F., & Maffei, C. (2019). The therapeutic role of emotion regulation and coping strategies during a stand-alone DBT Skills training program for alcohol use disorder and concurrent substance use disorders. Addictive Behaviors, 98.
  6. Garland, E.L., & Howard, M.O. (2018). Mindfulness-based treatment of addiction: Current state of the field and envisioning the next wave of research. Addiction Science & Clinical Practice, 13(14).
  7. Garland, E.L., Boettiger, C.A., Gaylord, S., Chanon, V.W., & Howard, M.O. (2012). Mindfulness is inversely associated with alcohol attentional bias among recovering alcohol-dependent adults. Cognitive Therapy Research, 36, 441—450.
  8. Pederson, C. S. & Pederson, L. (2012). Mindfulness Exercises. The Expanded DBT Skills Training Manual. PESI Publishing and Media.
  9. Veterans Health Administration. (2018, January 31). Precautions with using mindful awareness practices.

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