Researchers review existing paradigms in mindfulness research and how it has helped tackle addiction. They also discuss the future of this approach.
Bio-behavioural science continues to give us new insights into the mechanisms underlying addiction. However, most findings in this area of research have been focused on novel treatments in pharmacotherapies and there is a need for more alternative solutions.
Developments in addiction neuroscience have been focusing on mindfulness meditation to potentially treat addiction. Mindfulness-based interventions focus on reducing emotional distress. A recent review published by American scientists in the Addiction Science and Clinical Practice journal summarizes existing paradigms and discusses the future path in using mindfulness to tackle addiction.
Mindfulness-based interventions address the mechanisms underlying addiction. Research suggests that the benefits of frequent and regular practice of mindfulness occur through neuro-cognitive plasticity. An example of two existing mindfulness-based interventions are Mindfulness-Based Relapse Prevention (MBRP) and Mindfulness-Oriented Recovery Enhancement (MORE).
The most common mindfulness-based interventions are multi-week interventions, running for eight weeks. The participants are guided through various mindful practices, including mindful breathing and body scan meditations. The patients are also given homework on mindfulness principles and assignments, to monitor cravings and negative effects.
Different mindfulness-based interventions use different practices. MBRP is an open non-directive inquiry while MORE uses a more direct approach with high levels of positive reinforcement. For example, MORE participants are guided to participate in a “chocolate exercise” which is meant to increase the awareness of cravings and automaticity. The participants are instructed during the exercise to hold a chocolate close to the nose and lips and notice consciously how craving arises and they refrain from eating the chocolate. The participants are then guided through a meta-cognitive approach to their experiences that deconstructs the craving into its constituent affective, sensory, and cognitive components. This allows the participants to also perceive how the craving subsides over time.
The exercise of savouring
The exercise of savouring involves a comparison between the urge to swallow chocolate and the cravings experienced during addiction. Thus mindfulness-based interventions essentially exercise and train neurocognitive processes that are dysregulated during addiction.
Another novel hypothesis in a mindfulness-based treatment of addiction involves restructuring the reward hypothesis, although this is not explicitly the aim of most mindfulness treatments. The process of applying mindfulness as a practise wherein appreciating and focussing on natural rewards is called savouring. Increasing natural reward processing through mindfulness reduces cravings and addictive behaviour.
There have been extensive studies over the past 30 years evaluating mindfulness as a treatment for stress and chronic pain. However, it has only been in the last ten years that mindfulness as a means for tackling addiction has come to the forefront. As a young scientific field, more research is necessary to validate the findings and devise new treatments.
Research in mindfulness has increased with advances in neuroscience. While the original purpose of mindfulness was to diminish cravings with a middle path between attachment, pain, and pleasure, it is a skilful path to liberate individuals from the push and pull experienced during addiction and pleasure dysregulation.
Written by Sonia Leslie Fernandez, Medical News Writer
Reference: Garland, E. L., & Howard, M. O. (2018). Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research. Addiction science & clinical practice, 13(1), 14.