By Jamie Salsberg, LCSW, CAP, MPH, Assistant Clinical Director at Transformations
‘Alternative’ Therapy
When I first got to Transformations Treatment Center many years ago and proposed the inclusion of meditation and mindfulness groups, it was something of a joke among the clinical team. Therapists would tease me talking about my wanting to do ‘non-clinical’ groups with the clients. Then over the years, as more research and evidence has continued to surface about the use of meditation and mindfulness, not only in the field of addiction but among successful businessmen, athletes and others, suddenly the topic was not such a laughing matter anymore. I think it is important first to identify what addiction is, with respect to mind, in order to better understand what meditation and mindfulness can offer.
It is quite common for a client to come into treatment saying “I just use because I want to get high” and at first glance, this may appear to be true. Upon further investigation however, it typically becomes apparent that this is a lie that most alcoholics and addicts tell themselves and the reality is that what is really going on is ‘I use because I want to get relief.’ Ask almost any alcoholic or addict the question “If you could get the same relief from something that was not self-destructive and did not negatively impact the people who care about you, would you stop using?” and the answer will undoubtedly be ‘of course,’ only most individuals who have been using or drinking addictively do not believe there is another way. Herein lies the problem of addressing clinically the underlying issues without replacing the behaviors with healthy alternatives to coping. It leaves the person aware of their misguided attempts to manage life, without an effective solution.
On Meditation 
Typically when someone hears the word meditation their first thought is a monk or a yogi posed in lotus position, ohming or repeating a mantra. While transcendental and other classic forms of meditation are significant, this type of stillness can often be difficult for people, particularly those who were dependent on mood and mind altering substances are attempting abstinence. The common idea about meditation is that meditating is about thinking about nothing, and letting go; and while repeating mantras or letting go of your thoughts may come easy to some individuals, most have a hard time with this. In reality, the idea of thinking about nothing is nonsensical, because it requires thinking about something. To better understand meditation, it might be supportive to define it as redirecting your thoughts, or focusing your thoughts on something different. This is a much easier concept to grasp, and often a much easier task to master. One of the things I am proud of about TTC is the fact that we have integrated multiple kinds of meditation and mindfulness into our core curriculum to support clients in having healthy coping skills for life.
I once heard it said that meditation is like eating a Reese’s peanut butter cup…there is no wrong way to do it. In addition to traditional meditation, at TTC, we utilize guided meditations, in which clients can focus on the dialogue introduced in order to take the focus off of fears and anxiety or to process difficult emotions. We also utilize mindfulness techniques in which the clients are directed to be present to physical feelings or environmental stimuli, so that they are not focusing on the past of future. Another form of meditation utilized is a walking meditation where clients follow a labyrinth, a path marked out on the floor, and focus on their experience. Experiential exercises are often better received and understood by addicts and alcoholics as they have become accustomed to responding to concrete physical and experiential stimuli. For this reason we have also integrated breath work into our programming. Breath work is an experiential exercise in which clients breathe in a certain pattern and work through negative self-talk, guilt and shame, anxiety, resentment and other issues through being present to their breath. People often come into this exercise very cynical and skeptical, and typically leave being very surprised with the impact, largely because of the physical, emotional and mental experiences that occur with a simple change in breathing style. Clients are taught and shown that they can feel a variety of different things without needing to put a drink or a drug into their bodies.
We spend a lot of time focusing on the disease model of addiction in treatment these days, and often in the media as well. It is important to keep people educated about what addiction really is and the biological and physiological components of this disease. The goal is to help addicts and alcoholics and loved ones understand that this is not an issue that can be solved through will power or motivation. At the same time, however, this often pushes aside the reality that addiction is a disease of the brain, and therefore a disease of cognitive distortions, in which the person making the decisions is often thinking about things in an illogical or irrational framework. It is almost impossible to change the behaviors and surrounding decisions without changing the context from which they come.
Albert Einstein said, “We cannot solve our problems with the same level of thinking that created them.” It would stand to reason then, that exercises in thinking, presence of mind and understanding and changing perception would be essential to recovery. Meditation offers a healthy and effective way of letting go or shifting some of these distortions, in order to reduce stress, anxiety and anger while increasing concentration, focus and serenity. It offers a sense of control over the thoughts and internal chaos, in individuals who struggle largely with their inability to control the external world. I believe it is also important to point out the fact that 12 step recovery recognizes the importance of a regular meditation practice to support sustained recovery. Step 11 states, “Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of his will for us and the power to carry that out.” Many people often miss this idea, focusing on prayer alone; however the steps of AA and NA are specific in mentioning meditation as part of a recovery program.
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