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In Mindfulness for Addiction Problems, Dr. G. Alan Marlatt demonstrates his meditative technique for helping clients with substance addictions. Studies have shown that heavy drinkers who begin meditating show a decrease in the amount they drink.
In this session, Dr. Marlatt works with a 46-year-old woman with alcoholism who has recently relapsed into drinking. He talks with her about her compulsive behaviors, which include her alcoholism, and then walks her through a mindfulness technique for handling strong cravings.
Approach
Mindfulness has its origins in Eastern philosophy, and Dr. Marlatt's approach is based on Buddhist meditation practices. He considers this approach to be nonreligious, as he describes Buddhism more as a philosophy or science than a religion, the teachings of the Buddha being a "manual of how to deal with the behavior of your mind."
Dr. Marlatt's approach focuses on teaching clients breath-focused meditation as a way to manage substance cravings. This meditation technique involves monitoring thoughts, sensations, and emotions without judging them. Because there is no judgment of the addictive craving or impulse, but merely observation of it, this opens up more choice-points than are typically apparent to someone less mindful. This aspect of the practice allows the client with addictions to see the bigger picture and to act (or not act) accordingly.
Mindfulness and meditation also offer a substitute for the addictive substance or activity. Meditation can be described as a "positive addiction" in that it can—and should—become habit forming. It has some of the same general results that addictive substances may bring, but in a nonharmful form: Meditation is relaxing, it reduces stress, and it provides a sense of immediate gratification.
This program features an example of one mindfulness technique called "urge surfing." This involves focus on the breath and a guided meditation in which Dr. Marlatt shows the client how to "surf" the craving for substances: An urge to use alcohol or other substances may be seen as a wave in that it starts small, gets bigger, crests, and finally subsides. This mindfulness technique allows the client to use the focus on the breath as a "surfboard" for riding the wave of addictive craving rather than giving in to such urges.
About the Therapist
G. Alan Marlatt, PhD, is a professor of psychology and director of the Addictive Behaviors Research Center at the University of Washington, Seattle. He received his doctorate in clinical psychology from Indiana University in 1968. After serving on the faculties of the University of British Columbia (1968–1969) and the University of Wisconsin (1969–1972), he joined the University of Washington faculty in the fall of 1972.
His major focus in both research and clinical work is the field of addictive behaviors. In addition to over 200 journal articles and book chapters, he has published several books in the addictions field, including Relapse Prevention (1985), Assessment of Addictive Behaviors (1988), Harm Reduction (1998), and Brief Alcohol Screening and Intervention for College Students (BASICS): A Harm Reduction Approach (1999).
Over the past 30 years, he has received continuous funding for his research from a variety of agencies including the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, the Alcoholic Beverage Medical Research Foundation, and the Robert Wood Johnson Foundation.
Dr. Marlatt received the Jellinek Memorial Award for outstanding contributions to knowledge in the field of alcohol studies in 1990, the Innovators in Combating Substance Abuse Award by the Robert Wood Johnson Foundation in 2001, and the Distinguished Research Award from the Research Society on Alcoholism in 2004.
Suggested Readings
Marlatt, G. A. (2002). Buddhist philosophy and the treatment of addictive behavior. Cognitive and Behavioral Practice, 9, 44–49.
Marlatt, G. A., Witkiewitz, K., Dillworth, T. M., Bowen, S. W., Parks, G. A., Macpherson, L. M., et al. (2004). Vipassana meditation as a treatment for alcohol and drug use disorders. In S. C. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 261–287). New York: Guilford Press.
Parks, G. A., Marlatt, G. A., Bowen, S. H., Dillworth, T. M., Witkiewitz, K., Larimer, M., et al. (2003, July/August). The University of Washington Vipassana Meditation Research Project at the Northwest Rehabilitation Facility. American Jails, 17, 13–17.
Witkiewitz, K., Marlatt, G. A., & Walker, D. D. (2005). Mindfulness-based relapse prevention for alcohol use disorders: The meditative tortoise wins the race. Journal of Cognitive Psychotherapy, 19, 211–230.
