Mindfulness-based Relapse Prevention

The name Mindfulness Based Relapse Prevention (MBRP) comes from the Addictive Behaviors Research Center at the University of Washington, which supports individuals in recovery from addictive behaviors (Bowen, Chawla and Marlatt, 2010). The name is new, but the practice of vipassana meditation, the core practice in MBRP, is not. Mindfulness meditation originated approximately 2,500 B.C., when it was introduced by Indian spiritual figure Siddhartha Gotama.

Mindfulness Based Relapse Prevention for Sobriety

Mindfulness Based Relapse Prevention programs teach clients how to develop the mental skill of moment-to-moment awareness of their changing thoughts and feelings. By learning to identify and name individual thoughts and feelings as they move through the mind and body, substance abusers literally become “mindful” of how their minds and bodies trigger them to act out their addictions. One client of mine said it this way:

“Once I learned how to sit still and meditate, I saw that my mind was full of triggers I wasn’t really conscious of before. Now I see them and stop them before I start drinking.”

MBRP clients learn to use meditative skills that prevent blind reactivity to trigger thoughts and feelings. They pause, observe how they think and feel in each moment, and learn to see that they have a wide range of choices of how to respond to stresses. Therapists leading MBRP groups also teach a cognitive-behavioral component, which includes journaling, group discussion and individual therapy on how the thinking process changes in MBRP. Similar to Mindfulness-Based Cognitive Therapy (MBCT) for depression, MBRP is best suited to individuals who have undergone initial treatment and wish to develop a lifestyle that supports their recovery.

Mindfulness-based programs are a hot topic among psychological researchers. In 2010, the Journal of Consulting and Clinical Psychology, (Vol. 78(3), Jun 2010, 362-374), reported on depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention. According to the clinical abstract of the MBRP study by Witkiewitz and Bowen:

A strong relation between negative affect and craving has been demonstrated in laboratory and clinical studies, with depressive symptomatology showing particularly strong links to craving and substance abuse relapse. Mindfulness-based relapse prevention (MBRP), is shown to be efficacious for reduction of substance use, uses mindfulness-based practices to teach alternative responses to emotional discomfort and lessen the conditioned response of craving in the presence of depressive symptoms….MBRP appears to influence cognitive and behavioral responses to depressive symptoms, partially explaining reductions in post intervention substance use among the MBRP group. Although results are preliminary, the current study provides evidence for the value of incorporating mindfulness practice into substance abuse treatment and identifies a potential mechanism of change following MBRP. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

In summary, the goals of MBRP are:

1. 1. Become acutely aware of personal triggers and blind reactions.
2. 2. Learn to pause, think and feel before acting out.
3. 3. Develop the ability to experience discomfort without self-medicating.
4. 4. Become skillful at making non-addictive behavioral choices.
5. 5. Have non-judgmental compassion for yourself and others who struggle.
6. 6. Build a mindful lifestyle, including meditation, which supports abstinence.

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About the Author

Michael Hoffman is a Doctor of Addictive Disorders, a vipassana mindfulness meditation teacher, and a Certified Hypnotherapist. His books, available on Amazon, include Life After Rehab, Vol. 1: How to Stay Sober in the Outside World and The Thirsty Addict Papers: Spiritual Psychology for Counselors.