A Hands-On Mindfulness Guide to Relapse Prevention

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A Hands-On Mindfulness Guide to Relapse Prevention

The topic at a glance

Why You Might Need Mindfulness

If you have ever gone through the following scenario, there is a good chance that mindfulness will be of benefit to you.

Picture this. You start the day full of shame and regret due to your latest misadventure with drugs. You solemnly swear to yourself, your loved ones, and anyone else who will listen (including God, minor deities, angels, and Mother Nature) that you will never, ever, ever use drugs again. This time you mean it.

Yet… in just a few hours, you are perched on a barstool or on the phone to your drug dealer.

What the hell happened?

I’m sure that when you made your solemn vow to never take drugs again you were being sincere. I’ve been there. Near the end of my own drinking career, nobody else was interested in my promises to change, so the only person I was making this vow to was myself. Why would I lie?

This swift personality change from the ‘new sober me’ back to the ‘drunk me’ in just a few hours used to baffle me like I’m sure it has baffled you. I would put it down to being weak-willed, but this lack of will-power certainly didn’t apply when it came to getting my hands on some booze (I once got cut to bits climbing over two barbed-wire fences because I wanted to get to a bar faster!).

Relapse is a State of Mindlessness

It is not a lack of will-power that causes us to use drugs again after promising ourselves to change. It happens due to mindlessness. This is where our addicted mind can trick us because we lack the ability to see things clearly. The cravings are just too powerful for a clouded-mind, so we keep returning to drug use despite our good intentions.

Mindfulness offers us the clarity we need to overcome mindlessness. It gives us some tools so that next time when we decide to quit, we can follow-through with it. With long-term practice, this mindfulness can lead to sufficient insight so that cravings stop being a threat (we understand the trick, so we stop being fooled by it), but here we will mostly be focusing on tools that allow us to deal with cravings as they arise.

Isn’t Relapse a ‘Normal’ Part of Recovery?

Before we look at the mindfulness tools that can help you stop returning to drugs, we need to agree that relapse is best avoided. This might seem like an obvious point to those who have never known addiction, but the craving minds can make a return to drugs seem not only justifiable but even beneficial. An example of this would be the argument that our cravings are a sign that we are not yet ready to quit for good, so we need to take more drugs to be ready.

My addicted mind used to twist facts like relapse statistics to justify continued indulgence – ‘of course I’m drinking again, I’m an alcoholic!’. So, while it is true that most of us will have multiple failed attempts before we are able to manage long-term recovery, we need to be careful not to use this as a justification. In other words, the relapse statistics are a description rather than an instruction!

Craving is a Pattern of Thinking

Craving can have a physical and emotional component, but it is primarily a pattern of thinking. One of the things we discover when we look closely at our experience is that we don’t get to choose which thoughts pop into our heads. Hard to believe? Well consider this, why would you choose to think about scoring drugs right after your recent solemn vow to quit?

We don’t get to choose our thoughts, but we do get to choose where we put our attention. Thankfully, thinking isn’t the only show in town, and one of the ways we can avoid being swept along by craving is to ground ourselves.

Grounding Yourself Means Not Being Carried Along by Craving

If you are caught in the middle of a fast-flowing river, there is not much you can do other than allow yourself to be carried along by the current. It is only when you catch sight of a rock or overhanging branch that you have any hope of escaping the flow. It’s the same with craving. It is only by having something else to grab onto that you can prevent yourself from being carried along.

Grounding yourself means moving your attention away from thinking to one of the five senses. This is something we intuitively do if we pace up and down as a response to anxiety (here we are moving our focus to physical sensation to get a break from the worry). Your attention can only be on one thing at a time, so if you deliberately direct your focus towards touch, taste, sound, smell, or sight, you have found your overhanging branch in the fast-flowing river of craving.

Mindfulness Tool 1 – Grounding Yourself

Physical sensation is probably the easiest of the five senses to use when trying to ground yourself. This could include the sensation of the rising and falling of the breath in the stomach or the physical sensations associated with walking. Here at Hope, we teach the clients to use the sense of touch while holding mala beads (I call this ‘lazy-person’s pacing’). You need to find a way to ground yourself that you feel comfortable with, and most importantly that you will remember to do.

The next time you experience a craving, try moving your focus to physical sensation. Don’t be surprised when the craving tries to win back your attention, just keep grounding yourself until the desire to drink or use drugs passes.

Grounding Yourself Is Not the Same as Using Distraction to Avoid Craving

Most of the traditional ways of dealing with cravings involve some type of distraction (e.g. keep yourself busy). This approach does work, but it means reinforcing the idea that we are unable to manage craving – and what happens if there is a time when we can’t distract ourselves?

Using the mindfulness grounding technique is not the same as distraction. All we are doing is moving our attention elsewhere, so we can clearly see that we are not choosing these thoughts. The fact that these cravings keep trying to win our attention helps us develop insight into their real nature. We start to see how these thoughts completely depend on our identification with them, and the only reason we identify with them is the mistaken belief that we are choosing them.

How Seeing Impermanence (aka Urge Surfing) Helps You Survive a Craving

I once relapsed after two years away from alcohol. I’d put so much effort into building a new life, including a year living in a second-stage rehab, but I threw it all away because of my inability to resist one craving. The crazy thing was that there was a two-hour gap between my decision to drink and actually doing it. By the time I got to a bar, the craving was gone, but I felt the decision was already made.

The relief we get from giving into a craving is from the craving no longer being there. What we often fail to appreciate though, is that the craving will disappear even if we don’t give into it. These thoughts are just temporary visitors in our mind, and if we wait for them to pass, we get the exact same relief as if we had given into them. The only difference is we miss out on all the additional misery caused by giving into craving.

Mindfulness Tool 2 – Using Knowledge of the Impermanence of Craving to Avoid Relapse

One of the things that makes cravings so hard to deal with is it feels as if they are going to be around forever. This is what makes them so intolerable that we are willing to throw away all our good work just to get rid of them. Our brain is lying to us because cravings are only temporary. If we can just be patient, the craving will pass, and we will have the uplifting experience of no longer being a slave.

You will need to practice if you want to use knowledge of impermanence as a relapse prevention tool. It is best to start with cravings that involve less serious consequences if you give into them. Try this – if you smoke cigarettes, drink coffee, or have a sweet-tooth, you could practice by not giving into these cravings. It means you can see for yourself that cravings will pass within a relatively short period of time (sometimes within a few minutes). This will give you the confidence to use your knowledge of impermanence to navigate more serious cravings.

Knowledge of the impermanence of cravings works best when combined with grounding yourself (mindfulness tool 1).

Compassionate Acceptance Gives You the Strength to Survive Cravings

Cravings are usually not as straightforward as the thought, ‘let’s go get a drink’. The addictive part of our thinking knows our weaknesses and it exploits these to control our behavior. One of the most effective ways it has of doing this is by filling our minds with doubt and negativity. This weakens our resolve until a return to drugs feels like a rational choice.

Compassionate acceptance gives us the resilience to meet the challenges created by craving. It means deciding that even though the addicted part of our thinking is getting desperate, and is willing to use every trick in the book, we are determined to support ourselves through this process of change. By refusing to allow these cravings to regain control over our lives, we pay the cost of admission to a better life.

Mindfulness Tool 3 – Compassionate Acceptance

Compassionate acceptance means fully supporting ourselves as we face the challenges of early recovery. The addicted part of our mind is unlikely to give up easily, but it can only succeed if we allow ourselves to be overwhelmed by doubt and negativity.

Compassionate acceptance is easier to do than it is to describe. I like to think of it as the feeling of being held by a loving-parent. Even if our real-life parents weren’t perfect, we now can be the parent to ourselves that we always wanted. This feeling of being supported gives us the strength to face whatever comes our way.

The Value of Mindfulness in the Long-Term

The three mindfulness tools presented here can be used right away by anyone. You don’t have to have meditated for hundreds of hours to benefit from them. If you are prepared to commit to long-term practice, your ability to deal with cravings will greatly increase. Eventually, you can gain so much insight into cravings that you will never again be a slave to them, but this is a topic for another day.

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