I am currently working with my friend Michaela (Ki) James, an experienced NHS dietitian, on a new Mindfulness Based Healthy Living (MBHL) course to help us to change unhealthy habit patterns. For this course we will be drawing on teachings from our Level 3: Seeing Deeply or insight meditation training on how to work with the ‘mind poison’ of desire. The term ‘mind poison’ is derived from Buddhist teachings and can be described as an ‘egocentric habitual pattern which leads to suffering’. Also, we might reframe the word ‘desire’ as ‘wanting’. So what we are considering is an egocentric habitual pattern of my wants which, while providing short term gratification, may lead to suffering in the long term. Examples might be wanting that third glass of wine, or wanting to stay in our cosy bed rather than getting up to meditate or exercise on a cold dark winter morning.
I was interested in research related to mindfulness, neuroscience and the wanting mind, which in psychological terms equates to research into addictive behaviour. As I wanted an overview of the research I looked for meta-analyses and systematic reviews covering this area. And this is what I found.
Garland et al, 2018 is a review of current research relating to Mindfulness-Based Interventions (MBIs) for an array of addictive behaviours, including drinking and smoking. It focusses on clinical outcomes and biobehavioural mechanisms. It concludes that MBIs reduce craving by modulating thinking, emotional and physiological processes that facilitate self-regulation and reward processing. MBIs such as Mindfulness Based Relapse Prevention (MBRP) and Mindfulness Oriented Recovery Enhancement have been developed to directly address mechanisms of addiction and initial research indicates that they may be beneficial, although the field is young and many initial studies have methodological weaknesses. These MBIs are based on standard 8 week programs, such as MBSR and MBCT and have a similar structure and mode of delivery. For example, MBRP includes practices intended to increase discriminative awareness, with a specific focus on acceptance of uncomfortable states or challenging situations without reacting automatically (Witkiewitz et al, 2013).
Garland et al point out that mindfulness practice generally includes an aspect of focussed attention (eg. resting on a mindfulness support) and open awareness (eg. resting in an awareness of our whole present moment experience). They link self-reflective open awareness practices with reduced emotional reactivity by revealing the insubstantiality of mental contents, such as thoughts and emotions. They also make a link between mindfulness practice mapping onto neuropsychological processes, such as sustained attention, attentional re-orienting, conflict monitoring, retaining information in working memory, inhibitory control and emotion regulation, with long term practices cultivating durable changes in daily life. They argue that this occurs by a process of neuroplasticity due to repeated activation of these processes during meditation. They cite research indicating that mindful qualities such as acceptance, reduced reactivity and an ability to observe rather than be caught up in inner and outer experience may reduce craving and improve the ability to let go of addiction related cues. Of interest is a classic description that addictive processes are a product of automaticity, because mindfulness practice has the capacity to enable practitioners to become aware of automatic behaviours and then refrain from them due to improved self-regulation.
Garland et al. argue that MBIs can be seen as behavioural strategies for strengthening functional connectivity between the pre-frontal cortex and sub-cortical networks in the brain that have become atrophied by chronic addictive processes. They argue that increased connectivity between top-down pre-frontal networks and bottom up limbic-striatal brain circuitry involved in reward processing and motivated behaviour might provide the physiological substrate through which mindfulness de-automatises addictive behavior and enables increased intentionality.
McConnel et al, 2015 explores Garland et al’s Mindfulness-to-Meaning theory, which provides a theoretical framework for how the iterative cycle of appraisal, leading to decentering, leading to metacognitive awareness, coupled with positive reappraisals in a broader context, which is inherent in MBIs, may help to extinguish conditioned negative emotional processes and promote positive emotions and wellbeing. Although, research is in it’s early days, in particular in relation to addiction, McConnel et al find the model promising. In terms of the Mindfulness Association’s training, we might refer to this as the concept of ‘energy follows focus’, ie. a repeated focus on present moment experience with an attitude of openness, allowing and kindness, leads to this becoming a way of being with extended practice.
Tang et al, 2016 provides and overview of neuroscience and psychological research in the field of mindfulness with a focus on it’s self-regulatory effects in terms of a prevention strategy. It broadly reinforces the conclusion of the papers discussed above. It proposes a ‘translational prevention framework’ that links underlying neurobiological structures with observable self-regulatory behaviour, that are mediated by mindfulness meditation. The behaviours involved are attention control, emotion regulation and self-awareness and Tang et al review evidence relating to mindfulness meditation changing brain structures underlying these observable behaviours.
The final paper I looked at was Witkiewitz et al, 2013, which characterises addiction as a chronic relapsing condition, with relapse strongly predicted by craving and negative emotions. A randomised control trial looking at the efficacy of MBRP found that the MBRP group demonstrated significantly lower rates of substance use and reduced craving and in particular, did not report increased craving when experiencing negative emotions. They refer to neuroscience research demonstrating that areas of the brain associated with craving, negative emotion and relapse are affected by mindfulness training. They go on to postulate mechanisms via which MBRP may change responses to experiences of craving and negative emotion and so might then result in a reduction in relapse risk.
So, there seems to be a consensus that mindfulness meditation can help us with the mind poison of desire or the wanting mind. When we deliver our new Mindfulness Based Healthy Living course for the first time in October, we plan to collect some data to evaluate its affect. I will let you know how it goes.
written by Heather Regan-Addis
Garland et al (2018) – Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research –
McConnel et al (2015) – Mindfulness, mechanisms and meaning: perspectives from the cognitive neuroscience of addiction –
Tang et al (2016) – A translational neuroscience perspective on mindfulness meditation as a prevention strategy – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807201/
Witkiewitz et al (2013) – Retraining the addicted brain: a review of hypothesized neurobiological mechanisms of mindfulness-based relapse prevention –