Mindfulness as an Intervention for Alcohol Addiction

Mindfulness can be defined as the a very particular mental state which is both wholesome and

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capable of clear and penetrating insight into the nature of reality (Cullen, 2011). Where the particular subset of mindfulness, mindfulness meditation originally derived from Buddhist Vipassana meditation is used to teach individuals with physical and mental ailments (Marcus, 2010). The ongoing practice of mindfulness has been shown to lead to significant increases in trait mindfulness which in turn enhance the effects of formal mindfulness practice on psychological symptom reduction (Carmody & Baer, 2008).  The process of combining the mindfulness meditation to address alcohol dependency involves understanding the underlying factors of addiction (Zgierska, 2014). Addiction is principally defined as three main factors, firstly compulsion to seek and take the substance, secondly loss of control in limiting intake and finally the emergence of a negative emotional state (Koob & Volkow, 2010). Alcohol addiction in particular is a prevalent problem in contemporary Australian society where daily 17.4% of adults aged 18 years and over exceed the lifetime risk guideline (Australian Bureau of Statistics, 2015).  This persistent issue that is situated in society brings forth a variety of problems that are placed onto healthcare professionals and alternate intervention methods are necessary (Breslin, 2002).

Differentiating mindfulness meditation from other intervention methods is that individuals are encouraged to self-regulate their own behaviour and control their own impulses (Murphy &  MacKillop, 2011). This essay will evaluate the importance of mindfulness meditation to cope with the multitude of issues that are a direct result of alcohol abuse, each section focussing on one element of the program.

Primarily, through acceptance based rational, mindfulness meditation enhances and individuals ability to cease implus thoughts (Vernig & Orsillo 2009). Where impulses are defined as  external stimuli that directly influence an individual’s action without any conscious deliberation (Strack & Deutsch, 2004). When situated in an environment with alcohol present this stimuli can lead to undesirable response causing a failure in a long term goal such as rehabilitation (Strack & Deutsch, 2004). However when placed into triggering environments mindfulness can donate perspective to an individual’s actions (Sherman, 2017). This involves paying sustained attention to one’s ongoing sensory, cognitive, and emotional experience, without giving in to our natural tendency to react, elaborate, or evaluate (Bishop et al., 2004). The practice includes observing craving, which is considered to be a transient cognitive and affective phenomenon, just like any other experience intending practice is to bring awareness to the experience of craving and to learn to observe it without reacting and judgment (Witkiewitz et al., 2012).

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Additionally, mindfulness aims to shifting from “reacting” to “skillful responding”, arming oneself to be equipped at the situation of anything negative occuring (Bowen et al., 2009). Furthermore, repeated exposure to triggering stimuli during which participants practice nonreactivity may, over time, result in habituation, thereby decreasing the intensity of the initial impulse reaction (Bowen et al., 2009). Concentration on the compulsion of addiction allows the impulsive drives or motivations, substance wanting, emotional states,  physical sensations and stress responses enables an individual to observe their own urges to gain perspective on their own craving (Witkiewitz et al., 2012).

Further research indicates that craving is rooted within the most basic neural processes: positive and negative reinforcement (Brewer, Van Dam & H.Davis, 2015). Such a neural process can create an “addictive loop” through the continual substance use, which has the potential to become a cue-induced unconscious experience leading to a further addiction  (Brewer, Van Dam & H.Davis, 2015). Previous interventions have failed to identify the cues associated with drug use producing more challenges for the treatment of individuals whereas mindfulness has the ability to deal with the omnipresence of cues and to ultimately detect and modify an individual’s relationship with the cue itself (Brewer, Van Dam & H.Davis, 2015).

An alternate proposal stated that conscious craving occurs when the automatic cognitive framework that drives and drives addictive behavior is activated by conditioned, substance related stimuli but then is stopped through situational demands or self-restraint. (Garland et al, 2014) Therefore, the conscious noting of these actions creates an adaptive behaviour to then act as the mediator for maladaptive behaviour.

Secondly, the present notion of mindfulness develops a sense of control within an individual’s mindset to therefore, enabling individuals to continue maintain an attitude of acceptance towards their experience (Bishop et al., 2004). Stemming from the Buddhist tradition, recognising that craving could be targeted by mindfulness meditation, this treatment could also be a possible deterrent for relapse (Witkiewitz et al., 2012). Relapse can be ignited by a variety of sources such as specific environments linked to the intake of alcohol, pre-existing physical and mental health issues and internal guilt from lapsing. But through the introduction of mindfulness these situations can be modified and ultimately an individual’s perception can be altered.  This can be achieved by bringing awareness to the germination of reactions that occur in response to stimuli presents that individuals can alter their own behavioural patterns (Witkiewitz et al., 2012). Shifting views to teach clients to assess their internal reactions to external triggers deescalates the process by not engaging in unconscious decisions that are triggered by these circumstances (Witkiewitz et al., 2012). This process leads to a decrease to a less problematic long-term outcomes and enhances self-motivation within the mindfulness practice (Witkiewitz et al., 2012).

Moreover, these skills of acceptance that mindfulness teaches enhances one’s ability to allow negative thoughts to be present without acting in accordance with them, and to alter these thought patterns to a more positive outlook (Lindsay & Creswell, 2017). This acceptance equips an individual’s ability to combat against the omnipresence of triggers in the environment.

Finally, mindfulness delivers an understanding of the third stage of addiction, viewing the addiction loop process to become more effective than other treatment forms (Brewer, Van Dam & H.Davis, 2015). Mindfulness offers insight into the substantiating factors in regards to the reason an individual consume alcohol, divided into four main categories of motivation to drink includes positive internal enhancement, positive social situation, coping and  external conformity (E. Kuntsche et al., 2005).

To conclude, the multifaceted nature of mindfulness meditation ensures that the stem causes addiction are addressed, ensuring for the continuation of the rehabilitation whilst keeping it within the minds of the individual. Mindfulness based rehabilitation programs address the three main factors of addiction whilst maintaining a treatment option that will ensure longevity with their rehabilitation. Extending meditation therapies can be used to alleviate distress and garner fundamental change in maladaptive behavior and thought patterns (Bowen et al., 2009). For the treatment of alcohol addiction mindfulness training is an essential element to perturb the seeking the substance then to the act as a barrier for the intake of alcohol and finally recognition of  the emergence of a negative emotional state. Mindfulness acts a holistic approach to an alcohol addiction to equip individuals with coping strategies to ensure that relapse does not occur.

References

https://depts.washington.edu/ccfwb/sites/default/files/Cullen%20on%20Mindfulness-based%20Interventions.pdf

https://www.ncbi.nlm.nih.gov/pubmed/17899351

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2818765/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106278/

https://www.nature.com/articles/npp2009110

https://onlinelibrary-wiley-com.ezproxy.lib.monash.edu.au/doi/full/10.1093/clipsy.9.3.275

https://link-springer-com.ezproxy.lib.monash.edu.au/content/pdf/10.1007%2Fs00213-011-2573-0.pdf

https://journals-sagepub-com.ezproxy.lib.monash.edu.au/doi/pdf/10.1177/1948550611419031

https://onlinelibrary.wiley.com/doi/abs/10.1093/clipsy.bph077

https://www.ncbi.nlm.nih.gov/pubmed/22534451

https://www-tandfonline-com.ezproxy.lib.monash.edu.au/doi/abs/10.1080/08897070903250084

https://link-springer-com.ezproxy.lib.monash.edu.au/chapter/10.1007/978-1-4939-2263-5_14

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5195874/

https://www-sciencedirect-com.ezproxy.lib.monash.edu.au/science/article/pii/S0272735805000759

https://www-sciencedirect-com.ezproxy.lib.monash.edu.au/science/article/pii/S0272735805000759

Eric L. Garland, Amelia Roberts-Lewis, Karen Kelley, Christine Tronnier & Adam Hanley (2014) Cognitive and Affective Mechanisms Linking Trait Mindfulness to Craving Among Individuals in Addiction Recovery, Substance Use & Misuse, 49:5, 525-535, DOI: 10.3109/10826084.2014.850309

Peter M. Vernig & Susan M. Orsillo (2009) Psychophysiological and Self-Reported Emotional Responding in Alcohol-Dependent College Students: The Impact of Brief Acceptance/Mindfulness Instruction, Cognitive Behaviour Therapy, 38:3, 174-183, DOI: 10.1080/16506070902767563

 

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