Mindfulness/Harm Reduction for Substance Use

What is addiction? There are several theories about this question. For our purposes here, we’re defining addiction as behaviors that are meant to get us out of emotional/psychological pain and, over time, become so automatic that we convince ourselves we need them as much as we need automatic processes like breathing or the heart beating. Eventually, these behaviors become a source of pain in themselves. Addiction also carries stigma. There is a long tradition of viewing reliance on substances as weakness or bad character. Living with this stigma can become another source of pain from which to attempt to escape through the very behaviors that are stigmatized, resulting in a vicious cycle. This group, meeting for eight weeks, will present addictive behaviors as the result of the relationship between the person and the substance. This is the essence of the Harm Reduction philosophy, to meet someone where they are in their current use, to assess harm or potential harm of use, and to identify what actions that individual is ready to take to reduce harm. This means that the group is open to anyone who is ready to make changes around their use, from reducing active use to maintaining abstinence. There will be no judgment allowed in either direction. This will be a safe space for everyone.
 
I will teach mindfulness skills that will allow participants to slow down and observe what is happening without automatically reacting. There will be short discussions after each practice in which participants can share their thoughts and feelings while supporting each other and building camaraderie. Homework between meetings will give participants the chance to practice and apply these skills in real-life situations.
 
Session 1 will include a lesson about “automatic pilot” behaviors, as well as the foundational mindfulness practices of mindful eating and a body scan meditation.
 
I require a commitment to attend all eight meetings. The cost is $40 per meeting, payable in two installments of $160 on August 24 and September 21.
 
I ask that interested participants contact me before attending.

Overview of Sessions

SESSION 1: AUTOMATIC PILOT AND RELAPSE

In this first session, we discuss “automatic pilot,” or the tendency to behave mechanically or unconsciously without full awareness of what we’re doing. We discuss this specifically in relation to alcohol or drug use (acting upon cravings and urges “automatically” without awareness). We begin this exploration with an exercise called the body scan to practice purposely bringing attention to the body.

SESSION 2: AWARNESS OF TRIGGERS AND CRAVING

This session focuses on learning to experience triggers, cravings, and thoughts of using without automatically reacting. We focus on recognizing triggers and what the reaction feels like in the body, specifically the sensations, thoughts, and emotions that often accompany craving. We begin to use mindfulness to bring greater awareness to this typically automatic process, learning to experience craving and urges in a way that increases our choices in how we respond.

SESSION 3: MINDFULNESS IN DAILY LIFE

We learn the “SOBER space” as a way to expand the quality of mindfulness from formal sitting or lying down practice to the daily situations we encounter. This may help us learn to “be with” various physical sensations and emotions that arise, including those associated with cravings and urges without reacting in harmful ways. In this session, we also begin the practice of formal sitting meditation.

SESSION 4: MIINDFULNESS IN HIGH-RISH SITUATIONS

We focus on being present in situations or with people that have previously been associated with substance use, using mindfulness to learn to experience pressures or urges to use without automatically reaching for a substance. We identify individual relapse risks and explore ways to cope with the intensity of feelings that come up in high-risk situations.

SESSION 5: ACCEPTANCE AND SKILLFUL ACTION

It can often feel like a paradox to accept unwanted thoughts, feelings, and sensations. However, this may be the first step in moving toward change. Acceptance of present experience is an important foundation for truly taking care of oneself and seeing more clearly the best action to take. We practice techniques such as the breathing space and focus on sing these in challenging situations. This session moves from noticing warning signs and learning to pause to taking skillful action in both high-risk situations and in daily life.

SESSION 6: SEEING THOUGHTS AS THOUGHTS

We further explore awareness of and relationship to thinking, with a focus on experiencing thoughts as merely thoughts (even when they feel like the truth). We look at what role thoughts play in the addiction cycle, specific thoughts that seem especially problematic, and ways to work more skillfully with these.

SESSION 7: SELF-CARE AND LIFESTYLE BALANCE

This session focuses on personal warning signs for addictive behaviors and how to best respond when these warning signs arise. This includes discussion of broader lifestyle choices, balance, self-compassion, and the importance of including nourishing activities as part of a full, healthy life.

SESSION 8: SOCIAL SUPPORT AND CONTINUING PRACTICE

In this final session, we review skills and practices learned in this course and discuss the importance of building a support system. We reflect on what we learned from the course and share our individual plans for incorporating mindfulness practice into daily life.

Mindfulness-Based Relapse Prevention/Harm Reduction

Mindfulness-Based Relapse Prevention is a structured approach for managing behaviors related to alcohol and drug abuse. I use it in its pure form to meet the goal of preventing relapse to substance use. For clients whose goal is to reduce harmful behaviors with or without the possibility of abstaining from them, I combine MBRP with a harm reduction philosophy. This includes viewing human behaviors on a continuum of harm, from out-of-control to abstinence (very harmful to no harm). Success is defined as moving along the continuum toward reduced harm from behaviors. The client decides how far to move along the continuum and which harmful aspects of the behavior to target.

Learn more about Mindfulness-Based Relapse Prevention