MOJ MOJAMT

Addiction Medicine & Therapy
Editorial
Volume 1 Issue 2 - 2015
The Role of Mindfulness in Addictions: Can It Be An Effective Treatment Option?
Ricardo Joao Teixeira1,2*
1University of Aveiro, Department of Education, Portugal
2Clinica Medico-Psiquiatrica da Ordem, Portugal
Received: May 28, 2015 | Published: July 23, 2015
*Corresponding author: Ricardo Joao Teixeira, Psychology Coordinator at Clinica Medico-Psiquiatrica da Ordem, Porto, Portugal, E-mail:
Citation: Teixeira RJ (2015) The Role of Mindfulness in Addictions: Can It Be An Effective Treatment Option?. MOJ Addict Med Ther 1(2): 00007. DOI: 10.15406/mojamt.2015.01.00007

Abstract

Mindfulness meditation has gradually been included into a variety of health care programs to address issues such as mental health problems, physical diseases and addictions. However, precisely how mindfulness works, for whom, and for how long are not exactly outlined. Recent studies have investigated the mechanisms of action of mindfulness-based interventions in the prevention of relapse for substance use disorders. Other line of research focused on the assessment of mechanisms of action (physiological, cognitive and psychological) to customize more effective treatments for addictions. The purpose of this review was to underline some of the most recent literature (mainly cross-sectional) on the effects of mindfulness-based interventions for different kinds of addictions, offering a reflection about some of the mechanisms and processes underlying such interventions. Even though some promising results, more researches are needed in order to entail large, longitudinal, well controlled studies that examine the intentions, psychological, behavioral, and physiological characteristics of addicts participating in mindfulness-based treatments, to define mechanisms of action and help further the capacity to design mindfulness interventions for most effective application.

Keywords: Mindfulness; Addictions; Treatment

Introduction

There is a growing interest of psychosocial research in mindfulness/meditation and its role in coping with day-to-day stressors [1], as well as a treatment for patients with mental health issues [2,3]. This mini review shows some empirical and clinical evidence, arguing that there may be applications for mindfulness approaches in the treatment of addictions. Penberthy [4] revised the mindfulness-based interventions for addictions, and focused on the mindfulness-based relapse prevention. The author argued that it seems to be an effective treatment for reducing substance use relapse.

The concept of mindfulness was originally inspired by old Buddhist meditation practices. Much of the recent interest in mindfulness and mindfulness-based treatments can be traced to Kabat-Zinn [1] mindfulness-based stress reduction program. Mindfulness techniques have been incorporated into several treatments associated with improved health outcomes [5]. It has enticed various domains, such as basic emotion research, clinical science, and neurosciences [6] with these proliferated findings, researchers have attempted to operationally define mindfulness, including two main components as follows: awareness and attitude [7]. However, Cardaciotto et al. [8] have conceptualized mindfulness as a general tendency towards greater awareness of one's experiences, bringing an attitude of acceptance and non-judgment to these experiences. In fact, an attitude of openness and non-judgment is perceived as a crucial mechanism of change in promoting the positive benefits associated with mindfulness [9]. Although “mindful” individuals may experience negative thoughts, they appear to exhibit a greater ability to “let go” of these thoughts and focus their attention on healthier ways of relating to their experiences [10,11]. The cultivation of mindfulness can create a significant change in the way individuals approach their experiences, allowing the development of greater stability, meaning, flexibility, and less reactivity [9].

Mindfulness-based interventions are commonly carried in an eight-week format, comprising the following:

  1. Weekly sessions of around 120 minute’s duration.
  2. A psycho-education constituent.
  3. Guided exercises.
  4. CD’s of guided meditations for daily practice.
  5. Varying themes for discussion-based intervention with the program facilitator.

Examples of mindfulness-based interventions used in addictions include Mindfulness-Based Relapse Prevention [12], Mindfulness-Based Stress Reduction [13], Meditation Awareness Training [14], Mindfulness-Based Cognitive Therapy [15], and Mindfulness-Enhanced Cognitive Behavior Therapy [16].

Studies about the role of mindfulness in addictions have mainly focused on the treatment of pathological gambling. Researchers discovered a negative association between dispositional mindfulness and gambling severity in problem gamblers [17], thought suppression [18], and psychological distress [19]. Several recent case studies have verified that mindfulness can lead to a clinically significant alteration in patients with gambling problems [16,19-22]. Beyond gambling addiction, a single case study conducted by Shonin et al. [14] have investigated workaholism, treated with a mindfulness approach, in which a patient was successfully treated using Meditation Awareness Training [23]. Important improvements after the training were also observed for relevant variables such as: psychological distress, sleep quality, work activities during free time, hours of work, and job performance.

According to Shonin et al. [24], empirical studies of the role of mindfulness in the treatment of addictions have exclusively focused on workaholism or gambling. Based on a review and assessment of the mechanisms underlying the enhancements enabled by the use of mindfulness in problem gamblers, the authors argued that mindfulness-based approaches are likely to have psychotherapeutic utility across a wider variety of addictions (e.g., sex, internet, video games, etc.). Main mindfulness-based treatment processes proposed for chemical addictions, include:

  1. A perceptual change in the approach of relating to sensations, cognitions an emotion, apprehending cognitive processes as transitory events.
  2. Use mindfulness to decrease relapse symptoms via relieving maladaptive coping related to addictive behaviors.
  3. Shifting the focus on stress from external conditions to internal resources (metacognitive and attentional processes).
  4. The change of negative mood states via the cultivation of self-compassion.
  5. decreases of focus on reward.
  6. Higher spiritual consciousness that encourages a re-evaluation of life primacies.
  7. Focus on adopting an non-reactive attentional-set, non-judgmental and observatory mental processing (‘urge surfing’).
  8. Reduced psycho physiological arousal through conscious induced breathing.
  9. Enlarged capacity to accept gratitude and improve patience.
  10. a higher competence on labeling and regulate mental ‘impulses’ and negative thinking patterns [24].

Conclusion

Recent findings in the treatment of addictions indicate that there might be important applications for mindfulness-based interventions in this field. However, further studies (with larger-sample controlled study designs) are undoubtedly needed, and should focus on addressing some of the questions that currently hamper the wide scale practice of mindfulness approaches in addiction treatments [25]. Moreover, it is still unclear what defines the mindfulness construct [7,26,27]. Finally, it is important to underline that there might be some risks, and adverse effects, of mindfulness-based interventions, that are aggravated due to a misunderstanding of what really constitutes an effective mindfulness training, routine, and teachings. Regardless of, recent empirical and clinical findings appear to assent that mindfulness meditation is a non-invasive, harmless and cost-effective approach for improving general psychological health, as well as for treating addictions [28].

References

  1. Kabat-Zinn J (1990) Full catastrophe living: using the wisdom of your mind to face stress, pain, and illness. New York: Dell Publishing.
  2. Baer RA (2003) Mindfulness training as a clinical intervention: a conceptual and empirical review Clinical Psychology: Science and Practice 10(2): 125-143.
  3. Segal ZV, Williams JM, Teasdale JD (2002) Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. Guilford, New York.
  4. Penberthy K (2012) Mindfulness -based interventions for addictions: What is next? J Addict Res Ther 3(5): 116.
  5. Grossman P, Niemann L, Schmidt S, Walach H (2004) Mindfulness-based stress reduction and health benefits. A meta-analysis. J Psychosom Res 57(1): 35-43.
  6. Goldin PR, Gross JJ (2010) Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder. Emotion 10(1): 83-91.
  7. Bishop S, Lau M, Shapiro S, CarlsonL, Anderson N, et al. (2004) Mindfulness: A Proposed Operational Definition. Clinical Psychology: Science and Practice 11(3): 230-241.
  8. Cardaciotto L, Herbert JD, Forman EM, Moitra E, Farrow V (2008) The assessment of present-moment awareness and acceptance: the Philadelphia mindfulness scale. Assessment 15(2): 204-223.
  9. Shapiro SL, Carlson LE, Astin JA, Freedman B (2006) Mechanisms of mindfulness. J Clin Psychol 62(3): 373-386.
  10. Frewen PA, Evans EM, Maraj N, Dozois DJ, Partridge K (2008) Letting go: Mindfulness and Negative Automatic Thinking. Cognitive Therapy and Research 32(6): 758-774.
  11. Shonin E, Van Gordon W,  Griffiths MD (2013) Cognitive Behavioral Therapy (CBT) and Meditation Awareness Training (MAT) for the Treatment of Co-occurring Schizophrenia and Pathological Gambling: A case study. International Journal of Mental Health and Addiction 12(2): 181-196.
  12. Bowen S, Chawla N, Collins S, Witkiewitz K, Hsu S, et al. (2009) Mindfulness-based relapse prevention for substance use disorders: a pilot efficacy trial. Substance Abuse 30(4): 205-305.
  13. Vallejo Z, Amaro H (2009) Adaptation of Mindfulness-Based Stress Reduction Program for Addiction Relapse Prevention. The Humanistic Psychologist 37(2): 192-206.
  14. Shonin, E, Van Gordon W, Griffiths MD (2014) The treatment of workaholism with meditation awareness training: a case study. Explore (NY) 10(3): 193-195.
  15. Hoppes K (2006) The application of mindfulness-based cognitive interventions in the treatment of co-occurring addictive and mood disorders. CNS Spectr 11(11): 829-851.
  16. Toneatto T, Pillai S, Courtice EL (2014) Mindfulness-enhanced Cognitive Behavior Therapy for Problem gambling: A controlled pilot study. International Journal of Mental Health and Addiction 12(2): 197-205.
  17. Lakey CE, Campbell WK, Brown KW, Goodie AS (2007) Dispositional Mindfulness as a Predictor of the Severity of Gambling Outcomes. Pers Individ Dif 43(7): 1698-1710.
  18. Riley B (2012) Experiential avoidance mediates the association between thought suppression and mindfulness with problem gambling. J Gambl Stud 30(1): 163-171.
  19. De Lisle SM, Dowling NA, Allen JS (2011) Mindfulness-based cognitive therapy for problem gambling. Clinical Case Studies 10(3): 210-228.
  20. Tony Toneatto, Lisa Vettese, and Linda Nguyen (2007) The role of mindfulness in the cognitive- behavioral treatment of problem gambling. Journal of Gambling Issues 19:91-101.
  21. Shonin E, Van Gordon W, Griffiths MD (2013) Meditation as medication: are attitudes changing? Br J Gen Pract 63(617): 654.
  22. Shonin E, Van Gordon W, Griffiths MD (2013a) Meditation as medication: are attitudes changing? British Journal of General Practice 63: 654.
  23. Andreassen CS, Griffiths, MD, Hetland J, Pallesen S (2012) Development of a work addiction scale. Scand J Psychol 53(3): 265-272.
  24. Shonin E, Van Gordon W, Griffiths MD(2013) Buddhist philosophy for the treatment of problem gambling. Journal of Behavioral Addictions (2)2: 63-71.
  25. Shonin E, Van Gordon W, Griffiths MD (2014) The emerging role of Buddhism in clinical psychology: Towards effective integration. Psychology of Religion and Spirituality 6(2): 123-137.
  26. Shapiro SL, Bootzin RR, Figueredo AJ, Lopez AM, Schwartz GE (2003) The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: An exploratory study. J Psychosom Res 54(1): 85-91.
  27. Van Gordon W, Shonin E, Sumich A, Sundin, Griffiths MD (2013) Meditation Awareness Training (MAT) for Psychological Well-Being in a Sub-Clinical Sample of University Students: A Controlled Pilot Study Mindfulness 5(4): 381-391.
  28. Shonin E, Van Gordon W, Griffiths MD (2015) Are there risks associated with using mindfulness for the treatment of psychopathology? Clinical Practice 11(4): 389-382.
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