Mindfulness-Based Relapse Prevention

Presented by KJ Foster

March 31, 2015

Largely inspired by and based on the work of Jon Kabat-Zinn

Based on Buddhist principles of psychology

Integrates:

Cognitive Behavioral Therapy Relapse Prevention Skills Mindfulness Meditation Practice

Method of coping with urges and cravings that might be triggers for relapse across a variety of addictive behaviors.

(Bowen, Chawla & Marlatt, 2010)

MBRP

What is Mindfulness?

Mindfulness means paying attention

in a particular way:

on purpose,

in the present moment

and nonjudgmentally.

- Jon Kabat-Zinn

EXERCISE #1

What is Buddhist Psychology?

Emphasizes acknowledging, feeling, and accepting discomfort when it arises, and understanding the experience intimately, rather than endlessly attempting to run away from it.

This is a compassionate approach, emphasizing acceptance and openness rather than guilt, blame, and shame about one’s behavior.

Mindfulness can provide a skillful means of coping with urges and craving that involves observing them, without being wiped out or consumed by them.

Meta-cognition = big picture instead of giving in to one’s usual conditioned, habitual behavior.

Four Noble Truths First Truth – Life is fraught with suffering, and this

suffering is caused by attachment or craving.

Second Truth – This craving can take several forms and is a form of aversion or struggling against “what is.”

Third Truth – The good news! There is a way out of suffering!!

Fourth Truth – The “eight-fold path” is the way out of suffering.

The Noble Eightfold Path A list of eight desirable behaviors (or what are termed in

Buddhism as “right” behaviors) as the way to the end suffering:

Right view (understanding)

Right intention

Right speech

Right action

Right livelihood

Right effort

Right mindfulness

Right concentration

Awareness

“Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and freedom”

- Victor Frankel

Awareness Mindfulness practices increase awareness of this space and

create the opportunity to respond skillfully rather than react automatically and habitually (e.g. Impulse control). Thus, when faced with trigger for substance use, one can make a mindful choice that decreases the likelihood of relapse.

Mindfulness approach also helps reduce the tendency of the mind to exacerbate negative emotional states, lowering the stigma, shame, blame, and guilt commonly experienced by people who struggle with addictive behaviors.

EXERCISE #2

PARADOX

It is a paradox that we encounter so much internal noise when we first try to sit in silence.

It is a paradox that experiencing pain releases pain.

It is a paradox that keeping still can lead us to fully into life and being.

Our minds do not like paradoxes. We want things to be clear, so we can maintain our illusions of safety.Certainty breeds tremendous smugness.

We each possess a deeper level of being, howeverwhich loves paradox. It knows that summer is alreadyGrowing like a seed in the depth of winter. It knowsthat the moment we are born, we begin to die. It knowsthat all of life shimmers, in shades of becoming –that shadow and light are always together,the visible mingled with the invisible.

When we sit in stillness we are profoundly activeKeeping silent, we can hear the roar of existence.Through our willingness to be the one we are,We become one with everything.

Relapse Prevention (RP)

RP was developed by Marlatt & Gordan in 1985.

MBRRP integrates mindfulness meditation practices and traditional Relapse Prevention

The most salient factor that serves to decrease the risk of relapse in an otherwise high-risk situation, and which is at the core of the RP Model, is access to alternative coping response.

RP focuses on identifying high-risk situations and teaching coping skills so as to increase self-efficacy and decrease the likelihood of relapse.

Results overall show that although RP does not result in higher abstinence rates following treatment, it does significantly reduce the frequency and intensity of relapse episodes, helping people get “back on track” more quickly if they do fall off the wagon.

MBRP in Practice Consists of 8 weekly sessions conducted in a group

therapy format integrating cognitive-behavioral RP skills with mindfulness practices.

MeditationRelaxation TrainingExercise

The purpose of these practices is to increase awareness of triggers and habitual reactions, to develop a new relationship with these experiences, and to learn concrete skills to use in high-risk situations.

ADDICTION as DICTATION

The words addiction and dictation have the same Latin stem: dicere (“to impose or give orders with or as with authority”).

MBRP teaches the client that we do not have to be dictated to by our thoughts. I accept them and I let them pass.

By moving from aversion to acceptance as a means of coping with craving, recovery is facilitated on the basis of a new compassionate approach.

G. Alan Marlatt

Questions & Discussion

CLOSING EXERCISE

References

Bowen, S. W., Chawla, N. and Marlatt, A. G. (2010) Mindfulness-Based Relapse Prevention for Addictive Behaviors: A Clinician’s Guide. New York: Guilford Publications, Inc.