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Mindfulness Based Harm Reduction Resources

New York Times said:
Afterward, in the hallway, the doctor struggled to understand what she had witnessed. “I saw a patient with anxiety and stress who couldn’t control her pain,” she said, carefully. “And then someone spoke soothingly, and led her into deep breathing.

"So much of pain is tied up with fear,” Dr. LaPietra continued. “We can do more than we think, if we can just take the time to sit with patients and let them know we’re present for them.”

Then she smiled and shrugged. “And when we can get it right, why not, especially if we don’t have to use opioids?”
http://nyti.ms/1TZ7eO8
 
I find that I look forward to my time in the early morning. It is dark...the air is still...people have not started filling my ears with noise and meaningless words. It is my time.

It is important to find a time and make it your own. When I was using, I also worked around the clock day in and day out to try to keep my thoughts away from how badly I was hurting inside. It was not sustainable. Now I know that I need a time of the day that is for me. Even if it is just meditating on watering my garden.
 
Bumpity Bump ;)

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I find that I look forward to my time in the early morning. It is dark...the air is still...people have not started filling my ears with noise and meaningless words. It is my time.

It is important to find a time and make it your own. When I was using, I also worked around the clock day in and day out to try to keep my thoughts away from how badly I was hurting inside. It was not sustainable. Now I know that I need a time of the day that is for me. Even if it is just meditating on watering my garden.

Using sound as an anchor in meditation, such as the ticking of a clock, a metronome, the sound of a water fountain/waterfall, rainfall, pedestrian traffic, birds chirping and squirrels barking, etc. etc., make for a really great meditation.

I like your idea of mindful watering. That is so timely for me actually, given the SEVERE drought in CA.
 
From another thread that I felt was good enough to share here:

I suggest that, in truth, there are not more negative things in your life than positive, but rather that you have yet to find the skillful means to relate to the problems you're struggling with as challenges to be met and overcome and the opportunities they truly are.

You were once ignorant of just how bad it actually is to live life actively addicted to anything, as everyone is until they become an addict or is educated (which is pretty much impossible to do as a non-drug using lay person in America given the War on Drugs), to the horrors of addiction. As such you didn't work as hard to make choices and decisions that ensured you would not become an addict, such as smoking pot instead of taking Vicodin.

Eventually, if you had access to drugs, found their use enjoyable and attractive, even if for totally legitimate and justified reasons, you would begin to slide down the slippery slope towards away from healthy coping skills to maladaptive ones, a.k.a. addiction.

Given the darkness that is the stigma attached to being known as an "addict"* and treated as an addict, unless you do a heck of a lot of work educating yourself and are lucky in terms of your environment and genetic endowment, you will still have internalized and consciously or unconsciously recreated and incorporated at least some of the extremely negative, moralistic mythes about addiction and the addict as the scourge of mankind and evil incarnate, as bad as terrorists and even more evil than pedophiles.

Then one day, you wake up to your life in tatters and your living space a disgusting mess. It would just be any other day for you, by this point in your life, except for the fact that on this particular day, for whatever reason, you are lucky enough to more literally wake up to your circumstances. One day, sooner or later, I believe very strongly that every addict comes to realize that their life is shit. That they hate themselves.

I am not at all speaking of rock bottom here - your life could, if someone else saw you who had no idea about your harmful patterns of drug use or drug misuse, be the epitome of the ideal man or woman, someone they wish they could be - or at least think they do ;) No, I am speaking here of insight. One day you begin the process of gaining meaningful insight into your addiction. Something like, "Wow, now I understand why I hate New Years so much: I am always too hung over from Christmas to enjoy it!" And with such insights you can begin gather motivation and resources to move towards a lasting, meaningful, fulfilling recovery.

I have kind of gotten off track here, but back to the point I wanted to make earlier. I suggest that you would benefit immensely from the kind of paradigm shift that will occur when we change our relationship to the material bodies like drugs, your cravings, thoughts and your feeling states (what people refer to as "people, places and things" in the 12 step orthodoxy)(craving is a feeling state FYI) through the use of mindful awareness practice.

It is pretty darn hard if not impossible to do this without some form of mindfulness practice. For instance, many religions and orthodoxies employ aspects of what is now referred to as mindfulness (vipassana). While you can easily find mindful practices outside of Buddhism, the Theravada tradition in particular is recognized as the oldest most robust, secular type of mindfulness ever created and still practiced today.

You can do this though my friend! There are some super basic, easy mindful awareness (a.k.a. mindfulness) resources that are free and accessible to all online that you can use to start your own practice. Granted, this is no quick fix. It will take weeks, month and years to produce a real paradigm shift and sea change. However, it does on the one hand begin to free you from old thought patterns of thought and letting your mind run wild as well as impulsive and less than skillful patterns of behavior, while on the other hand allowing you to experience true joy, which is not what most people in the West know as joy, but rather the equanimity that is appreciative joy, a particular type of joy that allows you to bring compassion to any moment of life, even those considered by others as nothing but painful.

Check out the Mindfulness Based Stress Reduction Resource sticky. In particular scroll down until you find my post with the STOP exercise in it. That will be the most valuable practical mindfulness based tool you can start using right away. Go to the Mindful Awareness Research Center's website and download Diana Winston's guided meditations.

Start off with a short 3-10 minute meditation once or twice a day for a week that you do at the same times each day in the same environment (whatever you can manage, but start slow because, although challenging yourself is not a bad thing, there is no reason your practice should be particularly difficult - we are after decreasing the stress in our lives here after all, and some practice is always better than none at all). When you're ready do a ten or 15-25 minute meditation once or twice a day for twice as long as the short sit. If you're ready to move on to a 30-45 minute sit after one week, go for it!

Although the current research indicates that we need a minimum of about 30 minutes to really benefit from, you will benefit from longer sits more than you would from shorter ones (as long as you are sitting safely and other medical issues and social obligations are taken care of). The difference from going from 3 minutes of meditation to 30 minutes will be a lot more dramatic than the changes you'll notice in going from 30 minutes to an hour. This is all probably because it takes a while for you to settle into the meditation and because more challenging stuff comes up to work with and untangle during longer periods of sitting.

The Case for Making Mindfulness a Priority in Your Recovery:

For the most part modern addiction treatment and therapy in the West is founded on CBT and psychoanalysis. As such they are all about avoidance. Nothing wrong with that, but it does not address all the mass of jumbled underlying issues that made your addiction possible and really shaped what its development. Instead of training you to avoid or attempt to ignore your problems, mindfulness trains you to recognize, allow, investigate and then move beyond your problems.

It was a truly amazing day when I realized that I had genuinely begun to look at my problems and failures in a new light. Instead of just reeling against discomfort and trying to cling on to pleasure, through a mindful awareness (a.k.a. Insight Meditation a.k.a. Vipassana) practice we teach our minds to meet them head on skillfully instead of reactively as the challenges and opportunities our pains and pleasures were all along.


Obviously these issues need to be address to make any kind of meaningful progress in your recovery. Mindfulness fills this need. Look into Against the Stream and Refuge Recovery, the only two auxiliary organizations (similar to 12 step groups in that they are non-formal support to whatever treatment you've found works for you) that are focused if not explicitly certainly wholly on mindful awareness practice.
 
Anchors and Obstacles received a MUCH needed revision this morning. My previous edition was sooooo fucked up it was almost funny trying to make sense of it again. Such is trying to do life on drugs, for better or worse, huh?
 
I was easily able to spent many hours a day gathering resources to use, or using. It feels like some kind of success to spent a fraction of that time in meditation. after so many years, still have a hard time getting the body to follow the mind. The mind sometimes just follows what the body wants like a little puppy dog. with really sharp teeth. Thanks for the stuff on this page.
 
so funny that I found this web site when I was researching some cancer drug for work... I'm glad I did, though :)
 
I was easily able to spent many hours a day gathering resources to use, or using. It feels like some kind of success to spent a fraction of that time in meditation. after so many years, still have a hard time getting the body to follow the mind. The mind sometimes just follows what the body wants like a little puppy dog. with really sharp teeth. Thanks for the stuff on this page.

I had a hard time meditating for a while due to my anxiety problems. I had to learn that I needed to be busy weeding or watering and focus my mind on that to truly meditate. I was lucky that in rehab we had mindful meditation twice a week and one of our therapists either lead us on guided meditation, or taught us how to meditate more effectively. I've been very sick for a while, and he would guide me on meditation that would focus on my ailments and changing my mentality to a more positive force for my recovery. It is very helpful.
 
Wow, Toothpaste, this is amazing! The time you put into it is just astronomical! Plus defocused me for a good 30 minutes or more:). Ironically I just began a new thread about "all natural, drug free, feel good "highs" and listed reading as one of the very many ways I made my brain "high" (I hope that makes sense) before I began using.

I never thought of meditation. That would be perfect for me! And I feel yoga as well especially due to the anxiety issues (SEVERE panic disorder) that I developed when I was around 25.

Isn't it crazy how some of our brains "work"? No pun intended. Someone mentioned OCD. I have that as well but when using that flew right out the window. As in I used to HAVE to have things always exactly in order. My home. Vehicle. Sometimes it would take me 2 hours to "do" my hair because strands just felt out of place (yet I'm sure they weren't) plus I had body dysmorphic disorder. I've always been tiny yet I'd look in the mirror while being 5'7 and 100 pounds and see fat. Yet I never viewed others that way no matter what they're size was.

Another crazy thing. Did you ever hear of Mirror therapy? It's quite amazing and works for many. For me, a mirror was placed between my legs (affected by the rsd)...not a normal mirror though. I was not allowed to look at my legs but could only look at the "special mirror". I was to look at my left leg in the mirror (seeing it's normal) and then stare at my right leg (reddish/purple and extremely inflamed from the knee down) in the mirror but the mirror only allowed me to see the reflection when looking at the right side of it of my healthy leg. It was SO bizarre. But I was getting discouraged and disgusted with all my treatments that I basically laughed thinking; "What the hell good is this going to do me???" Yet scientifically it's been proven to work for many.

Blah, blah....that went off topic. Back to the meditation part of your thread. I woke at 6 am this morning and my heart was POUNDING. I was fidgety, shaking, back to thinking I was dying, took a Xanax (prescribed) but reading this made me think. Instead of taking sleeping meds (the 100 mgs of Seroquel I am prescribed for sleep does NOTHING for me and Nyquil and all that? I could go for a run after taking it if I was physically able to.

I have access to millions of apps on my phone (as we all do) and reading this I have to wonder if meditation may be my "key" for much of my anxiety and my lack of sleep. To relax my brain which is chronically in "overdrive".

Anyway, I'm going to have to go back and read all of this again because I mostly just was looking at the meditation parts. You're an AMAZING writer, Toothpaste and I feel honored to be one of your many friends <3
 
I will update the sticky with a special section just for you and your anxiety tomorrow morning :)

Take care of yourself my friend <3
 
I will update the sticky with a special section just for you and your anxiety tomorrow morning :)

Take care of yourself my friend <3
Thanks, as always....you should've added onto your "list" on my thread that you love being an amazing friend:). Because you are:). You've been more then therapeutic to me within the little time I've been a member on here and I'm 100% positive you are to others as well. You're an amazing person.

My OCD isn't back. Nor is my body dysmorphic disorder....just the anxiety. There was no sweating or a bad dream....nothing besides waking in pure panic mode. It also happened yesterday as a matter of fact yet oddly never when I'm out (it used to be BAD when I was 25 and my doctor tried nearly everything before lastly resorting to Xanax...I even had to flee from stores...."fight or flight" always kicking in hardcore not knowing when it'd hit...with a cart filled with items and FAST). Now when I talk to people (even those I don't know) I get an inner sense of well being when I go out oddly. You'd think it'd be the opposite. And not within my own home only.

I appreciate your time, your praise, your inputs....everything.

Lastly, I just thought of something. Your "name" is toothpastedog. I said recently I'm only going to call you "Toothpaste" because you're not a "dog". That being said though I would actually refer to you as "Tdog" but meaning it as "Top dog":). Cause that's what you are:)
 
I'll be your dog if you like ;)

Kink aside, "tad" is generally the shorthand version. I'm glad you are finding this helpful, that is truly the best possible reward!
 
Lovingkindness Exercise 1

Sit comfortably. Let your body relax and be at rest. As best you can, let your mind settle down, letting go of plans and preoccupations. Then begin reciting with your inner voice the following phrases directed at yourself.

May I be safe,
and protected from harm.​
May I be happy,
and content with what is.​
May I be healthy,
and thrive.​
May I be peaceful,
and live with ease.​

Do this for 5 to 45 minutes depending on your skill and familiarity. Remember, go easy on yourself. There is no rush, you have you whole life ahead of you.

At first the phrases may sound hollow and empty or forced. That is okay. As you practice working with them you will begin to find that you connect more with some phrases. You will work with the ones that make sense to you and can create your own. The phrases here are only suggested as a starting point.

Here is a longer version of the phrases:

May I be filled with lovingkindness.
May I be well.
May I be peaceful and at ease.
May I be happy.​

When you feel ready, you can expand the focus to include family and friends. Sense them in detail and recite the same phrases with your inner voice,

May they be filled with lovingkindness.
May they be well.
May they be peaceful and at ease.
May they be happy.​

When you’re ready, start to include people who are strangers to you, holding them close to your heart while reciting the same phrase, evoking a sense of lovingkindness for them.

May they be filled with lovingkindness.
May they be well.
May they be peaceful and at ease.
May they be happy.​

When you’re ready start to include all people, holding them close to your heart while reciting the same phrases, evoking a sense of lovingkindness for them.

May they be filled with lovingkindness.
May they be well.
May they be peaceful and at ease.
May they be happy.​

When you’re ready, include all people who are your enemy, holding them close to your heart while reciting the phrases evoking a sense of lovingkindness for them.

May they be filled with lovingkindness.
May they be well.
May they be peaceful and at ease.
May they be happy.​

When you’re ready, include all living beings, all thing living, sentient or not, rocks included, holding them close to your heart while reciting the phrases evoking a sense of lovingkindness for them.

May they be filled with lovingkindness.
May they be well.
May they be peaceful and at ease.
May they be happy.​
 
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Updated with

Enhanced Mindfulness Training for Treating Anxiety

:)

BTW Abdominal breathing is easiest to achieve right off the bat when laying down flat on your back. Try that first if you find it difficult in the chair or seated positions.
I unfortunately can't find the link:(

And you can be my dog if you'd like as long as you get along well with other dogs and don't bite:). Haha:)

Thanks for all your help always <3
 
Introduction to Lovingkindness:
Relational Mindfulness and Cultivation Practices​

Lovingkindness practice is a formal practice of relational mindfulness. It focuses on cultivating wholesome mind states that promote harmony in how we relate to ourselves, our fellows, the environment and the world. In many traditions, lovingkindness practice is taught using the following traditional phrasing:

"May [object of focus] be safe (protected from harm)/be happy (content)/be healthy (well)/live with ease (be peaceful)." As you silently repeat the phrases (may you be safe, may you be happy, etc), you visualize and focus your mind on the object of your meditation and move through the phrases with them in mind. Generally this also means visualizing their image or saying their name when you run through each phrase. In the traditional case of metta the objects of meditation are:

First, the benefactor. This is someone who's image lends itself and effortlessly cultivates feelings of love, kindness, friendliness and a general sense of peace:
  • May you be safe.
  • May you be happy.
  • May you be healthy.
  • May you live with ease.

Then you use yourself as the object:
  • May I be safe.
  • etc...

The next object is a friend or family member. Not just anyone though, it should be one who also lends themselves to and elicits these pleasant feelings:
  • May you be safe.
  • etc...

Then you bring yourself to a neutral person as the object. It should be someone for whom you don't have strong feelings, either positive or negative, someone who image is neither particularly pleasant nor unpleasant. Often this is someone you don't really know, a stranger perhaps:
  • May you be safe.
  • etc...

Moving on you shift to someone who tends to elicits more difficult or challenging, although not acutely uncomfortable, feelings as the object, rather than someone who carries a peaceful or neutral tone:
  • May you be safe.
  • etc...

You then shift to an enemy, someone you find very difficult and who elicits very challenging, often adversarial feelings, such as enmity:
  • May you be safe.
  • etc...

Finally, you expand the visual field to encompass those in the room/house/locality you find yourself, widening it further to include your entire geographic region (say, North America), outward, until it expand around the entire world, and further still until you encompass an entire universe (or even multiverse if that's, like me, your thing). This is all done with then intention for each object, eventually for all that is, to be safe, happy, healthy and at ease:
  • "May all beings be safe.
  • etc...

There are many ways to practice metta, this is just what is most often taught in most American Theravadan traditions I've encountered (the biggest Theravadan schools in American Buddhism, which the mindfulness movement seems centered around, are those taught at Spirit Rock and the Insight Meditation Society). According to these schools it is treated as the most basic approach to lovingkindness practice. Other schools of Buddhism use systems not dissimilar to the above.

A simplified metta practice is found in the Mahayana Burmese Buddhist tradition. You use the same objects of meditation, but the basic phrase is simply, "may you/I/all beings be peaceful." This is in many ways a very refined practice, lending itself to allowing the practitioner to get into highly concentrated states more difficult with more complex lovingkindness phrases.

Self compassion, compassion, forgiveness (or perhaps more accurately translated into English as patience), and gratitude practices also follow a similar logic as the two basic metta practices I've described. Like metta practice, these are cultivation practices. They are used intentionally to cultivate particular kinds of mindstates, ways of relating to the world primarily informed by kindness, love, friendliness, kinship, compassion, patience, gratitude, etc. Each practice has a particular usefulness specific to certain situations, serving specific ends distinct from one another: say I am feeling angry towards someone, I will engage in the first metta practice I've described, for instance.

At first metta and the other cultivation practice phrases may seem like a forced, rather fake and disingenuous activity. It often takes a diligent, creative practice for them to gather meaning. At first merely placing one foot after the other and running though the motions to familiarize yourself with the basics is enough.

As your metta practice develops, some phrases stand out and seem particularly meaningful. Latch on to these phrases that you are drawn to, they will foster a more fruitful, easier to develop practice. It isn't unusual to end up developing a personal interpretation of the traditional phrases. Treat the traditional phrases as a jumping off point, turn them into something meaningful to you.

For instance, my chosen interpretation of traditional metta in the Thai Forest tradition is:
  • May you be safe and protected from harm.
  • May you be happy and content with what is.
  • May you be healthy and thrive.
  • May you be peaceful and live with ease.

I am also very partial to self compassion practice. Junkies, people with histories of trauma and people with experiences of substance use or other behavioral disorders generally speaking all tend to live lives that are significantly ill-affected by self-hatred and self-loathing. It is fairly obvious how useful this could be. In fact, my metta practice really developed and took often once I developed a self compassion practice that was meaningful to me. Self compassion practice is not necessarily as accessible to everyone as it is for some. Especially in our culture, it can be particularly disquieting to think of one's self as essentially, inherently and inalienably good. However, learning to do so is well worth the effort.

The self compassion practice (adapted from Christina Neff's practice) I have developed follows the same objects of meditation and goes like:
  • May I open to my own goodness.
  • May I feel my own goodness.
  • May I trust in my own goodness.
  • May I love myself, forever and always.
 
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Seems like people have a hard time viewing past the NSFW tags on the mobile site? No matter, I made it a bit easier to use. Now there are links to the exercises instead of them being wrapped in NSFW tags. Here's the one I suggest you look into:

Enhanced Mindfulness Training for Treating Anxiety
I, personally, have alot of trouble viewing some things on here since I just use the app and less features are available to me. Not that it's a big deal, cause it'd probably be a pic of a woman with devil horns on her head if I chose one right now, but I can't even create an avatar. I just choose to not have Internet in my home cause I have a really great phone.

Anyway, thanks for sharing it this way. I didn't read it yet but rather just clicked on to see if it was there.

Much love to you, just not to myself at the moment:(
 
Just finished a lot of pruning, added some more accurate descriptions (more work on this later, I'm not nearly done) and updated and reorganized all the links. Still need to go through all the links and make sure none are broken, but this is what we have for now.

I'll update this again later today. Really coming together now!
 
Injecting Some Mindfulness into the Mindlessness of American Recovery Culture
Filling the Void Left by the Failure of Treatment Models Prioritizing Abstinence in Place of Harm Reduction

Addiction Treatment, Desire and Attachment

Wild Geese
by Mary Oliver

You do not have to be good.
You do not have to walk on your knees
For a hundred miles through the desert, repenting.
You only have to let the soft animal of your body
love what it loves.
Tell me about your despair, yours, and I will tell you mine.
Meanwhile the world goes on.
Meanwhile the sun and the clear pebbles of the rain
are moving across the landscapes,
over the prairies and the deep trees,
the mountains and the rivers.
Meanwhile the wild geese, high in the clean blue air,
are heading home again.
Whoever you are, no matter how lonely,
the world offers itself to your imagination,
calls to you like the wild geese, harsh and exciting --
over and over announcing your place
in the family of things.​

The Recovery Movement’s Selfish Ego

As practiced in America, modern addiction treatment attempts at best to teach and at worst to reprogram drug users. Addiction treatment in the US relies primarily on an abstinence based cognitive behavioral approach to managing addiction. It represents a narrow minded, one size fits all approach to treating behavioral issues related to drug use. Given the privatized and non-professional character of the treatment industry in America, significant client populations are placed in highly inappropriate levels of care. Exposing drug users to inappropriate treatment models causes drug users serious harms making recovery more difficult.

Despite its limitations and flaws, the “abstinence only” model maintains the status qua when it comes to American addiction treatment. Apparently we are too afraid to think outside the box imposed by our prudish Puritanical roots. Those in the recovery industry are complacent with the status qua because it worked for them and they assume it will thus work for everyone else challenged by their relationship to substance use.

Recovery zealots do not understand that their abstinence only approach to treatment does not work for the vast majority of substance user. They cling to their understanding of addiction because it has become a part of how they understand themselves, how they identify with their world, and are unwilling to try open their minds to the possibility that there might be something better when it comes to their understanding of addiction or the efficacy of their treatment model.

Normies and Addicts: A False Dichotomy

America is a nation of addicts. America is not a cesspool of junkie scum, but it is a nation of drug users. Who do you know who never drinks anything with caffeine or eats anything with sugar? These two drugs are the staple habit of America. What separates the intravenous drug user from your neighbor who enjoys a blueberry muffin with his coffee is merely a difference of degree.

When it comes to substance use, normal is only found on a spectrum, with deviance at one end and conformity the other. As one’s relationship to substances develop over time, one’s substance use will move from non-existent to either deviant or conformist. Within the realm of deviance and conformity there is also room for movement.

As with the bell curve, a narrow majority of people occupy a space of so-called normality, but as a location normality is only so definable. You might be able to place normality on a graph, but in life normal is dynamic not static. There is no fixed point or origin of normality. People are not definitively normal (conformity) or abnormal (deviant), they become. Like a dance, the actors are constantly moving, flexible, in flux.

The dynamics that go into substance use represents a form of experiential learning. This is good news because, as with any form of experiential learning, substantive change is possible. Experiential learning implies choice and relates the significance of decision making. Awareness of the causes and conditioning of our behaviors allows agency to develop from more reactive conditioning.

As with any set of behaviors, patterns will emerge when we engage in substance use. No one is born an addict in the literal sense. Just as one must learn how to use substances before meaningful self-medication is possible, addiction is learned. Addiction cannot be unlearned, but recovery can likewise be learned. By gaining an awareness of patterns of self-medication substance users gain insight. When these insights are put to good use and cultivated, patterns of behavior that cause harm invariably change for the better.

Insight into substance use creates a kind of forward momentum well into recovery. The catch is that the insight must be cultivated. The application of insight to decision making must be supported. Insight is cultivated simply by bringing awareness to present moment experience. It is nurtured by turning towards and leaning into one’s experience, not turning away from or avoiding it. Avoidance is antithetical to insight.

Avoidance: The Essence of Addiction and Hindrance to Recovery

Addiction is defined by craving and craving characterizes avoidance. Providing clients with the tools to regulate craving is the priority of the abstinence based treatment model. The most widely used modalities in addiction treatment emphasize the cultivation of avoidance based coping skills.

Even in medically assisted treatment programs like opioid replacement therapy, treatment models rooted in the philosophy of harm reduction, the goal and emphasis of treatment tends to fall on abstinence. When it comes to the classic treatment models in America, residential and outpatient treatment, the emphasis is solely on abstinence, despite the fact that other modalities and paradigms are often more appropriate for certain patient populations (such as opioid users) that are much more successful in their efficacy (such as medicine assisted treatment).

The poor efficacy of abstinence based treatment models can be traced back to their focus on substance user’s addiction instead of their relationship to substances. For treatment to facilitate recovery, the locus of control needs to be the addict’s process in recovery, not their process of addiction. Merely placing the addict in the limelight is not enough.

Little insight is gain in conditioning the addict to believe they are, first and foremost, an addict. The process by which the addict approaches and pursues must be the focus. It must respect and celebrate the multidimensional nature of the addict, empowering the addict with the understanding that they are more than merely the sum of their addiction.

When it comes to any process of recovery from addiction, the addict is the most important player. The struggle of the addict is characterized by challenges of unskillful desire, otherwise known as craving. The aim of any effective treatment model is training clients to regulate craving.

Successful treatment outcomes are defined by addicts developing the ability to self-regulate. Self-regulation is not the kind of conditioning used by the vast majority of treatment models. The more common abstinence based conditioning you see in treatment focuses on a kind of psychological tough love, on teaching the addict that they are, at their core, an addict.

Although things are shifting, there is still a nearly insurmountable stigma attached to lay understandings of addiction. Forcing addicts in early recovery to self-identify as addicts is like asking them to think of themselves as degenerate junkie scum. The tendency to cultivate self-hatred here should be obvious. Effectively educating addicts in early recovery as to the dynamics of addiction is therefore crucial.

Locating the problem of addiction in drug use itself is the mistake often made educating drug users on addiction. The harms associated with substance use should not be the sole focus of educating addicts. Its locus must be wider, on the nature of desire.

Craving affects the body’s neurobiology and serves to regulate the mood. Yet craving is nothing more than desire turned on its head. Craving also reinforces itself, a form of self-regulation. It is also entirely experiential. Drug users experience craving firsthand themselves, often many times each day. The intellectual experience of craving is not necessarily the same as one’s experience of it in the body. When it comes to the push and pull of powerful desires, craving can make things very confusing for the drug users. Craving can make very complex things seem simple. That is how it regulates one’s mood.

In addiction, the desire to use drugs or engage in certain behaviors to regulate one’s mood easily become conflated with the otherwise healthy desire to live, succeed and overcome life’s challanges. When the desire to thrive becomes associated with the desire to use, the sense of self is craving. Craving becomes wrapped up in the addict’s very identity.

Both drug users and non-drug users alike have definable relationships to substances, such as heroin and sugar, and behaviors, such as shopping and sex, that affect our neurobiology. In craving however, the drug user has a particularly challenging relationship to desire. Drug users have it hard enough out in every day society. Whether one is a regular drinker of alcohol, caffeine junkie, cigarette smoker, cannabis aficionado or opiophile, drug users are shamed because of their relationship with substances in traditional recovery culture. While the vast majority of drug use involves the use of drugs that are perfectly legal, those drawn to using illicit substances are demonized on all fronts. We are literally criminalized.

Just as the war on drugs scapegoats drug users, traditional treatment models scapegoat craving. Just as scapegoating drug users leads to demonizing drug users, vilifying craving leads to alienation for any self respecting drug user. Drug users don’t just wake up one day and decide to use drugs. There are good, logical, compelling reasons why using makes sense to the user. Anything that has a noticable affect on our neurobiology is useful in affecting our mood state. Drug users use drug because they feel discomfort and dissatisfaction, and substances can alleviate such dis-ease.

There is nothing special or unique about this kind of process. Non-drug users do it all the time, when they self regulate by themselves or co-regulate with others. Herein lays the essential difference between drug users and non-drug users. Non-drug users do not need to self medicate in order self regulate or co-regulate. Their caregivers provided them with positive role models of how to self-regulate. Non-drug users learned how to co-regulate from their care givers in healthy ways. Drug users simply were not provided with positive role models, caregivers who were capable of self regulating their mood state in healthy ways. Drug users were not able to learn from their care gives how to co-regulate their mood state in healthy ways.

Non-drug users learned early on that they could rely on their caregivers to regulate their mood state. They learned to trust others to help meet their emotional needs, because others did so consistently. There was no need for substances to fill when it came to regulating their mood for such people. Drug users use drugs developed their relationship with substances because drugs filled such a need. This need developed because drug users learned that their others were unable to consistently meet their emotional needs. Drugs on the other hand can always be relied upon to affect our neurobiology. Drugs can always be trusted to regulate one’s mood simply by using them! It is much easier for drug users to trust drugs to affect their mood state than other people.

Enforced Abstinence Reinforces an Unhealthy Relationship with Substances

However broadly understood it is in theory, abstinence is defined narrowly as avoidance within the our nation’s recovery industry. In traditional treatment models, craving is understood as the mechanism defining the addict’s relationship to drug user or compulsive behavior. Craving is managed according to such models through periods of enforced abstinence. There is nothing wrong with abstinence in and of itself. It is not inherently good or bad, right or wrong. A period of abstinence, at the very least, is often necessary in most cases to help stabilize patients.

Prioritizing abstinence over a more inclusive understanding of recovery is inherently problematic. Imagine the coercion, manipulation and brainwashing that it would take to restructure one’s life around forcing people to refrain from behaviors they have learned are in their self interest? This is exactly what happens when you take drug users, who have learned to trust in substance to regulate their mood state, and tell them they are no longer allowed to self medicate without consequences.

The harsh consequences externally imposed upon those who are not able to abstain from drug use in treatment settings and recovery culture, like getting ejected from treatments programs or to becoming ostracized from recovery communities, is extremely harmful. It leaves the drug user feeling even more isolated and alienated, reinforcing the earlier experiences of how they cannot reliably trust others to help them grow and heal. Ironically enough, enforced abstinence can easily end up reinforcing an unhealthy relationship with drug use, emphasizing that substances can always be relied upon to do what they do when other people cannot.

For many people who misuse substances, people who would undoubtably benefit from exposure to effective treatment, programs of enforced abstinence represent nothing less than the denial of individual agency. Using can be a very effective way to change one’s mood and manage uncomfortable mood states. Removing the possibility of using thus becomes tantamount to preventing the drug user from caring for themselves. It represents nothing less than suppression of self determination. To many actively self medicating users, this angst feels like nothing less than paternalistic control. Standing in the way of individual agency, enforced abstinence feels like one is being prevent from becoming the person one feels one truly is or would like to be.

To what lengths should you be force to go in hopes of restraining the desire to use or engage in comforting behaviors? What would it look like to structure your life around avoiding desire and temptation, around avoiding those experiences you up until recently found so pleasurable and desirable? Doesn't sounds like fun. It sounds like a lot of work, a lot of very distasteful effort if you ask me. Lets be honest, I love dugs. I love how they make me feel. Why else would I have organized my life around acquiring and using them during my days of active addiction? I love the excitement of procuring them and getting off on them. The thrill involved in having to hide that part of my life from the powers that be has itself consistently gotten me off. Considering that drug use has become such a significant part of my identity, to deny myself a relationship with drug use is to deny my own self. Ironically enough, exactly such a denial of the self is precisely what treatment modalities narrowly focused on abstinence tend to produce.

Modern treatment in the US emphasizes cultivating skills and tools focused on avoidance based coping strategies in addict client populations. Abstinence and personal values, as opposed to ethics and personal health, is the primary emphasis of treatment in my country. It understands a healthy lifestyle as one centered on avoiding drug use and related addictive or harmful behaviors. Paradigms of addiction prioritizing an abstinence only narrative tend to emphasize abstinence from drug use and questionable behavior above all other goals when it comes to understanding or addressing addiction. This stands in rather stark contrast more nuanced paradigms promoted by harm reduction communities, where the focus is on reducing harms associated with drug use and questionable behavior, as opposed to merely reducing the drug use and questionable behavior itself. An abstinence only paradigm, as currently practiced in the US, makes avoidance the primary focus and overarching priority of treatment, promoting a culture of being highly critical, shaming and judging any drug use or potentially addictive (read: pleasurable) behavior.

Narrowly prioritizing abstinence denies individuals new to recovery any chance of beginning to build the foundations of a meaningful life for themselves. This kind of tunnel vision also denies such persons a chance to learn how to create new, healthier relationships to their past trauma, drug use and any other addictive behaviors. Considering how significant one's history of trauma, drug use and the like is to one's present sense of self and identity when one enters recovery, a single minded focus on abstinence prevents the individual from developing a healthier relationship with themselves or cultivating the skills necessary to becoming the healthier, more successful person we all wish to become.

What about why I began using drugs? Putting the emphasis on abstinence and focusing on avoidance based coping strategies does not address all the mass of often jumbled underlying issues that made my addiction possible and shaped its development. I find that a narrow focus on abstinence, and thus a focus and need for avoiding drugs and drug using behavior, does not incorporate or explore any meaningful narrative on the nature of desire.

Putting the primary emphasis on abstinence and avoidance tends to lump all desire together as bad and shameful. It misrepresents desire as craving, even when it might be an otherwise healthy, constructive influence. A narrow emphasis on avoidance and abstinence makes moving forward in recovery both very confusing and very unpleasant.

Unlike CBT with a focus on abstinence, mindfulness trains you to recognize, allow, investigate and then move beyond your problems instead of training you to avoid or attempt to ignore your problems. Becoming more aware of our recovery entails we become mindful of our desires, passions, urges, impulses and cravings. It asks us to gentle investigate difficult emotions like restlessness, torpor, craving, fantasizing, and doubt. A mindfulness practice cultivates an ability to become aware of the present moment such that skillful action become possible.

Abstinence based approaches cultivate a judging mind when it comes to addictive behaviors and drug use, essentially training the mind to label and put certain things into categories of good and bad. Mindfulness removes this moralization, putting the emphasis on how to cultivate an awareness of the same behaviors, but specifically without judging or criticizing them.

Addiction is best thought of as a kind of trap, one we often find ourselves stuck in as drug users with real life struggles. What is the best way to free one's self from a trap? First one must see the trap for what it is. One must understand the mechanics of the trap before one can formulate or implement a strategy to disassemble it. The first step in liberating one's self from the despair of addictioniction is in understanding its nature.

This understanding begins with a paradigm shift. It begins with removing any moralizing tendencies, in understanding that where we find ourselves today is not entirely our own doing. Many things outside ourselves have influenced where were are today, our parents, culture, society, friends, etc. That is not to say we are not responsible for our actions or our choices - actually that is to put the emphasis on the fact that we are the only one responsible for making healthy choices in our lives. Of course, we need skillful teachers and guides to show us the way, but when push comes to shove it is up to us.

It was a truly amazing day when I realized that I had genuinely begun to look at my problems and failures in a new light. Instead of just reeling against discomfort and trying to cling on to pleasure, through a mindful awareness practice we teach our minds to meet them head on skillfully instead of reactively as the challenges and opportunities our pains and pleasures were all along.

The question invariably become then, how do we facilitate this paradigm shift, sea change of the mind? It all begins with grounding. This is the essence of any true mindfulness practice. In mindfulness you cultivate skills such as concentration and relaxation, to bring one into the here and now. In most of our days the focus is on planning what we are going to do next or reflecting on what we just accomplished (or were unable to accomplish).

Practicing mindfulness conditions us to reign our focus on what is going in the present. The goal of mindfulness is largely gaining insight into what is going on right now in our body, our unique and particular sensory and emotional experience of the moment. It might sounds like it is easy and truth be told, anyone can do it, but given our sentient nature it presents many challenges as a practice.

Normally we get lost in our intellectual experience, the thinking mind. Think of a wheeled cart atop a gentle hill. It takes a nudge to get it going, but once it starts moving down the hill momentum carries it along. Similarly, as the wheels of the cart turn round and round, once we engage in an interesting or stimulating thought the thinking mind gains a certain momentum. Anxiety, rumination, lust, obsession, the similarly strong emotional states can easily thus develop around our thought patterns.

A common misconception is that the goal of meditation is to turn off the mind or somehow get the mind to stop thinking. Let me tell you up front that this is not a reasonable expectation. It just isn't going to happen. In fact, the opposite is going to happen, especially at first. When you begin your mindfulness practice, one of the most striking things you may notice is just how much you think, just how intrusive and distracting your thoughts can be.

This is the meat and potatoes of a healthy mindfulness practice. It is an exercise in letting go of stressful and tantalizing feelings, desirable and undesirable sensations, anxiety provoking as well as pleasurable thoughts alike AND bringing the attention back to the experience of the present moment. Only in letting go of this present moment can one allow the movement of the present into our lives. We make room for what is to come by making space in our hearts and mind. And then doing it all over again.

This is the meaning of equanimity. Without being able to tolerate our present feeling state we will always be attempting to escape into some other less tangible but infinitely more tantalizing feeling state. And is not this what we are attempting to correct for and overcome when it comes to our drug use and self medication? Are not we attempting to escape the dis-ease of any discomfort we experience in our perception of the present moment when we self medicate?

I feel it is important here to distinguish between drug use and misuse. Please jettison the term "drug abuse," it is too morally charged to be helpful to any meaningful discussion of behavior or habit. What I will say here is that something isn't inherently good or bad, right or wrong, merely because it promotes pleasant or unpleasant feelings. Pleasure is not inherently good or bad, just as pain is neither good nor bad. Both pleasure and pain, comfort and discomfort are nothing more but signals, alerting us to something significant we'd be best off giving our attention to.

When you experience something as that feels really good, or makes you feel really uncomfortable, what you are really experiencing is what they call a "bell of mindfulness." Your experience it trying to wake you up, saying to you, "Hey! You. Pay attention to me. This is important!" Perhaps now you may understand the significance of awareness without judgement or criticism of your experience of the present moment, because it allows you to pay attention to these signals.

When we are judging and being overly critical, it is very difficult for us to hear the background noise, or see the fine details of our lives. Mindfulness practices train us to let go of judgement and self hate such that we may allow understanding and self compassion into our hearts and minds. Considering the stigma, the highly moralized charge attached to the concept of addiction in our culture, what could be more important and more necessary if we want to become something more than a degenerate, thieving junkbox?
 
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