Initial studies with young adults show dramatic
drops in stress, cravings, impulsivity and risk of relapse after
practicing mindfulness.
Mindfulness might offer more than relief from daily stress. Research
now suggests it can boost recovery from addiction and trauma.
Investigators at USC believe the contemplative practice could
represent the next major breakthrough in the treatment of substance use
and major mental health issues.
“It’s a very different way of doing therapy and being in therapy,” said Jordan Davis,
an assistant professor at the USC Suzanne Dworak-Peck School of Social
Work. “But it’s like the Wild West right now. We just don’t know that
much yet.”
That is slowly changing, thanks in part to the work of Davis and other experts at USC. Results from their recent studies
are encouraging. In one project at an inpatient drug treatment program
for young adults, Davis found that completing just eight weeks of
mindfulness training led to drops in stress and cravings — and improved
chances of staying clean — even six months later.
Now he will put those initial findings to the test. Davis is
recruiting participants for a two-year study that will examine whether
mindfulness has benefits for young people who have experienced trauma
and are receiving outpatient treatment for drug use and mental health
challenges. His team expects it will help participants control their
urges and emotions.
What you get from mindfulness is the realization that you can deal with this, you can tolerate this.
Nicholas Barr
“So much of the internal narrative around cravings is not being able
to handle it,” said Nicholas Barr, the study’s head clinician and a
postdoctoral scholar at USC. “What you get from mindfulness is the
realization that you can deal with this, you can tolerate this.”
USC researchers envision mindfulness-based addiction recovery
The researchers are enrolling young adults between 18 and 26 years
old with posttraumatic stress disorder and current substance use —
placing them into either a control group or a mindfulness group.
Participants will complete neurocognitive tasks to assess their ability
to control their behaviors and emotions. They will also report their
PTSD symptoms and substance use, along with any feelings of shame, guilt
and stress.
For eight weeks, those in the mindfulness group will learn strategies
like recognizing painful or uncomfortable thoughts without trying to
immediately get rid of them.
“They will also learn skills such as loving kindness, which is a
different type of mediation practice that teaches skills of
self-compassion as well as compassion for others,” Davis said.
Participants will then repeat the neurocognitive exercises and other
measures for three months to assess the longer-term impact of
mindfulness relative to those in the control group, who will receive no
mindfulness training.
What is mindfulness-based addiction recovery?
Debate is robust regarding the definition of mindfulness. However,
many view it as an outcome of meditation, an umbrella term for exercises
designed to improve consciousness, enhance concentration and help
people notice their thoughts, feelings and physical sensations.
One aspect of mindfulness is attentional awareness — being focused on
feelings and thoughts in the present moment and accepting them without
judgment. Barr likened it to having an itch, but instead of scratching
right away, waiting for a second and studying the feeling.
“Then, without evaluating it as good or bad or wrong or illogical,
you figure out an effective way to manage what you are experiencing,” he
said.
Recognizing urges like drug cravings can help people develop new
coping strategies instead of repeating harmful behaviors. Davis noted
that mindfulness should complement — not replace — proven techniques
like cognitive behavioral therapy, which seeks to change behaviors by
challenging negative thoughts like anxiety and worry.
USC experts advance field of mindfulness research
Research has increasingly bolstered mindfulness’s place in the field of psychotherapy, and fewer experts view it with skepticism. Investigators have shown how the practice can change structures in the brain, including areas associated with self-awareness and coping with emotion.
The evidence now is pretty robust. People for the most part are confident that mindfulness can produce some of these brain changes and associated behavioral changes.
Nicholas Barr
“The evidence now is pretty robust,” said Barr, who studied
comparative religion as an undergrad before earning his PhD in social
work at USC. “People for the most part are confident that mindfulness
can produce some of these brain changes and associated behavioral
changes.”
To encourage even more acceptance of meditative practice, Davis helps lead the new USC Center for Mindfulness Science
as associate director of research. And his team of investigators aren’t
the only USC experts building science behind the potential benefits of
mindfulness.
Some researchers study the practice’s positive effects on sleep quality. Mindfulness also could address depression and thoughts of suicide. Others have recommended meditation and mindful awareness as a strategy to deal with the stress of living in a big city.
USC even has its own university initiative, Mindful USC,
that encourages students, professors and others on campus to practice
mindfulness. It offers the USC community free classes, training sessions
and a free mobile app with guided meditations and other resources.
Mindfulness-based addiction recovery is promising new strategy
Jon Kabat-Zinn is credited with developing the modern form of mindfulness
training in the late 1970s to help people with chronic pain and stress.
Similar approaches have been used in intervening decades to treat
depression and improve performance and happiness.
But research on applying mindfulness to substance use first emerged
less than a decade ago, Davis said. He encountered the practice in 2008
while working in a college counseling center as a master’s student at
Syracuse University. His clients seemed to benefit, so he tested
mindfulness during his research into treatments for substance abuse
problems — the focus of his PhD studies at the University of Illinois.
He was drawn to helping young people with drug or alcohol issues and
histories of trauma like child abuse and neglect. They often are the
hardest to treat and have the worst treatment outcomes of any age group,
he explained.
“It makes me angry and sad, to be honest,” Davis said. “I get very
emotionally invested in these projects, because we can’t seem to figure
out how to help kids who have experienced a lot of adversity.”
Initial studies suggest mindfulness can have powerful effects on substance use
Promising findings from the studies he began for his doctoral
dissertation energized him to keep hammering out grant proposals and
pushing his research forward. The numbers in the research results were
promising, Davis said, but he cared more about the dramatic changes he
saw in the people he treated.
Every day we went to that residential facility, we had people saying, ‘Are we going to meet today? I want to do this again. I’ve never been able to sleep like this before.’
Jordan Davis
“Every day we went to that residential facility, we had people
saying, ‘Are we going to meet today? I want to do this again. I’ve never
been able to sleep like this before,’” he said. “For me, having people
excited about mindfulness, that is the best possible outcome.”
One client stands out to Davis as a good example of the power of
mindfulness. He had experienced extreme abuse as child. By his early
20s, he was using upward of $500 of heroin a day and facing the loss of
his young child to protective services. He agreed to be in Davis’
mindfulness study but stated unequivocally that he didn’t believe in
therapy or meditation.
“Day 1, session 1, first six minutes — he broke down crying,” Davis
said. “He had never sat with a feeling or emotion like that before.”
The client began to understand that heroin may have been a way to
escape his uncomfortable memories and negative thought processes. Now he
was learning to develop new ways to cope. It paid off in just a few
weeks, when he encountered his old heroin dealer in a parking lot.
During a treatment session later, he described the familiar rush of heat to his skin as powerful cravings took hold.
“He said he didn’t know what to do, he started freaking out,” Davis
said. “He started to describe what happened and said he just kind of
stopped and thought, ‘This is just a feeling.’ His mindfulness training
kicked in, and that millisecond of procrastination gave him the time to
realize he could respond in a different way.”
USC researchers plan studies on mindfulness-based addiction recovery
Davis and Barr are just starting their two-year study, funded by $30,000 from USC’s James H. Zumberge Faculty Research and Innovation Fund. They envision using their findings to secure federal grants for a bigger trial of mindfulness and substance use recovery.
But they aren’t limiting themselves to working with young adults
struggling with alcohol or drugs. They believe many other groups could
benefit from learning the calming techniques of mindfulness.
They see opportunities to help military veterans who are wary about
seeking help for posttraumatic stress and substance problems. Other
populations with high rates of mental health challenges and drug abuse,
like homeless teens and young adults, might also benefit.
“Mindfulness is not a magic panacea, it’s not going to fix everyone’s
problems,” Barr said. “But if you talk to anyone who has practiced for
some time in a serious way, you just notice a difference.”
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