Mindfulness-Based Relapse Prevention

March 11, 2015

  1. The integration of mindful awareness (mindfulness) is being used and integrated with Relapse Prevention Therapy (RPT), a cognitive-behavioral therapy for changing addictive behaviors related to addiction, a wide variety of compulsive behavios, and the change of self-defeating habitual behaviors. The article below is an excellent description of Minfulness-Based Relapse Prevention (MPRP). This article is reposted from the Website: http://www.mindfulrp.com/default.html I strongly recommend this website for addition information on MPRP. 
~ Terence T. Gorski (Gorski’s Books on Relapse Prevention: http://www.relapse.org 

MBRP (Bowen, Chawla and Marlatt, 2010) is a novel treatment approach developed at theAddictive Behaviors Research Center at the University of Washington, for individuals in recovery from addictive behaviors. 

The program is designed to bring practices of mindful awareness to individuals who have suffered from the addictive trappings and tendencies of the mind. MBRP practices are intended to foster increased awareness of triggers, destructive habitual patterns, and “automatic” reactions that seem to control many of our lives. The mindfulness practices in MBRP are designed to help us pause, observe present experience, and bring awareness to the range of choices before each of us in every moment.  We learn to respond in ways that serves us, rather than react in ways that are detrimental to our health and happiness. Ultimately, we are working towards freedom from deeply ingrained and often catastrophic habits.

Similar to Mindfulness-Based Cognitive Therapy for depression, MBRP is designed as an aftercare program integrating mindfulness practices and principles with cognitive-behavioral relapse prevention. In our experience, MBRP is best suited to individuals who have undergone initial treatment and wish to maintain their treatment gains and develop a lifestyle that supports their well-being and recovery.

The primary goals of MBRP are: 

1. Develop awareness of personal triggers and habitual reactions, and learn ways to create a pause in this seemingly automatic process. 

2. Change our relationship to discomfort, learning to recognize challenging emotional and physical experiences and responding to them in skillful ways. 

3. Foster a nonjudgmental, compassionate approach toward ourselves and our experiences. 

4. Build a lifestyle that supports both mindfulness practice and recovery.  



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Lying and Second Chances

January 18, 2015

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By Terence T. Gorski
Author (The Books of Terence T. Gorski)

“For every good reason there is to lie, there is a better reason to tell the truth.” ~ Bo Bennett

When you catch someone telling a lie, should you give him or her a second chance? Or should you follow the advice of William Shakespeare: “Trust not him that hath once broken faith.”

This question, when approached thoughtfully, is more difficult to answer than it first appears.

When I ask people whether they should give a second chance to someone who tells them a lie, the answers I get range from “absolutely yes” to “absolutely no.”

Other people have developed rules for when to give a second chance and when to cut their losses by getting the person out of their life, or at least out of their box of sensitive secrets.

The answer to the question of what to do when you discover they are lying depends upon how we define the idea of telling lies and telling the truth. So let’s ask the tough questions that are not as easy to answer as they may seem.

What is a lie?

Here’s the dictionary definition: “a false statement made with deliberate intent to deceive; an intentional untruth; a falsehood.
Synonyms include prevarication and falsification. Antonyms include truth.

What is the truth?

The dictionary tells us that it is “the true actual state of a matter. That which is really happening or going on. Conformity with the facts or reality.” The the concept of the truth is further clarified as: “the real facts about something: the things that are true: the quality or state of being true: a statement or idea that is true or accepted as true; A statement that is supported by evidence.”

Wow! These are really circular definitions that essentially tell us “the truth is what is true!”

These definitions of truth beg a very important issue: the truth is rarely absolute and is usually relative to what is accepted as truth at the time and the “truth as we see it from our point of view.”

Most of the time to “tell the truth” means to “explain our best understanding given our point of view, the extent of our knowledge, and the currently best known and most widely accepted evidence.”

Honesty and lying are as much about the intent to deceive as it is about giving mistaken information.

If you make an honest mistake in solving a mathematical problem, it is usually not considered a lie. It is a mistake or unintentional error. It might be a lie if you deliberately falsify the answers for some secondary gain.

So, in my opinion, it would make sense to make the distinction between an honest mistake (I believe that what I am saying to be factual or true) and a lie (I know what is true and deliberately try to tell you something else).

I find that most people who tell one lie (i.e tell others that something is true when they know that it is not), tend to tell other lies as well. They use lies as an habitual tool to gain things of value in life or to deny some painful truths.

Sometimes the habitual liar can convince themselves that a lie is actually true. This can be a useful skill if you have to pass a lie detector test. Some people are skilled at catching people who are telling lies. This can be a useful skill to recognize and avoid getting hurt by con men and habitual liars.

Most actively addicted people tell lies about their alcohol and other drug use. They minimize how much they use and try to cover up the damage caused by their use.

Some addicts don’t actually lie, they just block out some aspects of reality so they are intentionally ignorant. This is called being sincerely deluded.

Must alcoholics, for example, never count the number of drinks they have or add up how much money they are spending on alcohol or drugs. They keep themselves willfully or intentionally ignorant in order to avoid facing the truth.

The truth is a continually evolving thing based upon our best understanding at the time. All we can really tell someone is our best understanding of the truth as Wevsee it at the current time and then explain why we believe it to be true (i.e. Present the evidence we have that makes us believe that it is true).

In the everyday world we operate on a common-sense definition of truth.

– I did or did not do this!
– I was or was not at a certain place at a specific time!
– This is what has happened in the past !
– This is what is happening now!
– This is what I believe will happen in the future!

Anyone who tells you they know exactly what will happen in the future is guessing or is sincerely deluded. No one can be certain about the future.

Many people have beliefs without evidence. They accept things are true without any real proof. Every culture teaches thousands of truths, both little and big, that people are supposed to accept as true.

So what should you do if you believe someone is lying to you?

The first step is to ask the question again and make sure you are understanding their answer. Many accusations of telling a lie are based in poor communication and misunderstanding.

Tell the other person very clearly that you don’t believe it is true and present your evidence. Tell them you are open to reconsider if they have better evidence. This gives the people their day in court. They get to describe the “truth as they see it from their point of view.”

Before jumping to conclusions it is helpful to detach, back up, observe, and investigate. The serious problem is not a single lie told in isolation to deal with a specific situation. The most serious problem is the person who uses deceit and dishonesty as a habitual way to cope with life.

If there is a pattern of lying, it is foolish to trust. Many people are habitual liars. In other words they are in the habit of twisting the truth to get what they want.

Trust must be earned. It must be built little by little, one step at a time. When building a relationship, it is best to self-disclose a little bit at a time. If the person responds by self-disclosing at the same level to you, go back a try again. If they continue self-disclose at the level that you are they are, they are probable trustworthy. If they don’t reciprocate, be wary and ask yourself if they are trying to hide something or to get you at a disadvantage by knowing more about you than you know about them.

If what you told them in confidence ends up on the grapevine, run the other way. People who gossip and tell you the secrets of others that were told to them in confidence will almost certainly do the same to you.

Recovery demands a policy of rigorous honesty this means:

– The willingness to look honestly at yourself and your past behavior;
– The intent to be honest by reporting the truth as you believe it to be while acknowledging that “I might be wrong.”
– To promptly admit mistakes and be willing to correct them;
– To look with a critical eye at what you believe and the evidence you have to support that belief; and
– To be willing to act in faith upon your best understanding of the truth until you find new and more compelling evidence that causes you to change your mind.

Rigorous honesty is a skill that needs to be learned and practiced. This is because, as fallible human beings we are prone to lie to ourselves and it others. It is also because the truth is hard to find.

LIVE SOBER – BE RESPONSIBLE -LIVE FREE

Don’t miss Terry Gorski’s books and workbooks on recognizing and managing denial.

Denial Management Counseling (DMC)

The Books of Terence T. Gorski


Positive Mental Attitude Plus

December 31, 2013
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Don’t Worry – Be Positive

By Terence T. Gorski, Author
December 31, 2013

Positive mental attitude (PMA) is effective in many ways. There are limits to the effectiveness of positive thinking. It is not always enough to change deeply entrenched irrational core beliefs about self, others and the world that developed in early childhood. These core mistaken beliefs are often described using the idea of a  SCHEMA. When a core schema is challenged, it I feels like having a killer put a gun to our head and threaten to shoot. Our survival reactions kick in and our brains kick our body into action to get ready to fight or flee. These, of course are the classical fight or flight responses.

The consciously created positive thoughts are often unable to penetrate the survival responses (Fight, Flight, Freeze) that are activated in defense of our core beliefs.

Our core beliefs are developed in childhood to defend us from threats to our survival. Alfred Adler was the first to talk about the idea of core mistaken beliefs. Today, there is a method of therapy entirely devoted to identifying and changing core bore beliefs.

Our childhood beliefs have become the truth as we see t. As a result we defend these core irrational and destructive beliefs because we are firmly convinced that they are needed for survival.

Mindfulness meditation helps people to develop the skill of being detached and aware. As a result we can become aware of these core irrational beliefs about self, others, and the world without activating self-destructive survival behaviors driven by high stress. There are simple ways to get people into using mindfulness meditation.

Combining mindfulness meditation, which allows a detached awareness of emerging thoughts, without activating survival mechanisms, can add to the effectiveness of positive thinking and affirmations. Mindfulness meditation also stops the automatic self-talk, called rumination, driven by mistaken childhood beliefs from constantly running through our minds.

The final component is a learned system for emotional management and problems solving. A comprehensive system for managing thoughts and feelings and the core belies that drive them is described in the workbook entitled Cognitive Restructuring for Addiction.

These components can make an effective combined practice for recovery:
1. Positive (Rational) Thinking
2. Mindfulness Meditation
3. Emotional Management
4. Problem solving.


Mindfulness Made Simple

December 30, 2013
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Mindfulness Can Be
A Brightly Colored Experience

By Terence T. Gorski, Author
December 30, 2013 

See the related blogs:
Stress Self-Monitoring and Relapse ,
The CENAPS Model and Mindfulness in Relapse Prevention,  and
Mindfulness Made Simple.

Meditation has been a part of the GORSKI-CENAPS Model since it was developed in the late 1970’s. In the 1970’s meditation was first being introduced and was controversial in the field of addiction and psychotherapy. Some viewed it as a fringe science. The first recognition that meditation could be helpful was in the form of relaxation training, which used a wide variety of relaxation methods whose origin was in meditation.

Mindfulness is a form of meditation that, if used consistently, becomes a habit of mind.  It stops, for a moment the ever-present chattering within our minds. As we detach and let go of thinking, we stop disrupting the balance of stress chemicals in the brain. We allow the ripples in the pool of emotions to settle as we release and relax. The letting go calms us. Our mind can become like a clear pool instead of a stormy sea of emotion.

In this blog I explain a simple process of Mindfulness Meditation that many people find helpful. It is the system I personally use. As with all things, it works better for me on some days than on others. I hope you will find it helpful.

Mindfulness #1: Looking Within & Seeing What I Saw

I heard about Mindfulness Meditation and decided to give it a try. I sat in a quiet place and just looked within my mind to see what I saw. I found that there was this constant stream of words running through my mind that blinded me to everything else I was experiencing. This stream of words is called: SELF-TALK. Knowing that my self-talk is there and running wild and chattering endlessness in my mind was a first step.

Mindfulness #2: Setting a Meditation Schedule

I decided that I would do five minutes of mindfulness meditation, four times a day, when I awoke in the morning, at midday, in the early even, and at night. I used these four of five-minute breaks to look silently within – not to know, but for a moment to let go of knowing and the need to know. I was developing the art of doing nothing. No big deal, right? I was amazed at how often I forgot my plan, or talked myself out of doing it because more important things came up!

Mindfulness #3: Allowing the Thoughts to Stop

To get my thoughts to stop, even for a moment, I used the idea of noticing the thoughts, detaching from them and letting them be. I then imagining the flow of words in my mind was like a long freight train. I just watched as the train and allowed the cars to slowly coast to a stop. I experiment with letting go by using different images like drifting in a gentle stream, rocking slowly on a swing.  I focused on slowly breathing in and out. I let go, and each time I took it back, I said “that’s interesting” and then I let go and started again to drift.

Mindfulness #4: Passive Awareness

I use “Passive Awareness” like this:

(1) I say to myself “I am not my thoughts, I am the one who thinks my thoughts;
(2) I detach from my thinking and imagine my thoughts passing by on a black board or movie screen;
(3) I peacefully observe my thoughts and let them go.
(4) I put no effort into this. I challenge my thoughts. I don’t judge, dismiss or change them. I just notice my thoughts, whisper to myself the words release and relax, and then I let the thoughts drift by. I call this letting go.
(5) I focus on my slow rhythmic breathing.
(6) I suspend judgment. I just notice and let them go.
(6) I say the words “release and relax” and allow my mind to slowly settle itself.

Mindfulness #5: Dealing With Distracting Thoughts and Feelings

When I noticed the thoughts coming back into my mind, I say to myself: “Ah! The thoughts are back! Isn’t that interesting. I’ll just watch them for a while and let them go as I did before.  If I noticed a feeling like fear rising up, I say to myself: “Isn’t that interesting, I am becoming afraid. I’ll observe that feeling for a while and let it go!” In becoming passive and detached I keep changing my focus back to my slow rhythmic breathing.

Mindfulness Made Simple -A Formula for Dealing With Distractions

The formula is: “I am now experiencing _____. Isn’t that interesting. I’ll observe it in a detached way, quietly name it, and let it go.” Next I say to myself: “I am breathing and notice my slow rhythmic breath as I slowly inhale, hold for a moment, slowly exhale, hold for a moment, and repeat the process while passively noticing what my brain/mind is doing in the background of my consciousness. I say: “Let go! Release and Relax.”

This is an overly simplistic system for mindfulness. It strips away a lot of the jargon and mystique that made meditation difficult for me to practice. This simplified system has worked for me and many other people I shared it with. I hope it can help you.

YOU MAY ALSO ENJOY READING
The Magic Circle Relaxation Method

LIVE SOBER – BE RESPONSIBLE – LIVE FREE

GORSKI BOOKSGORSKI TRAINING/CONSULTATION

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The CENAPS® Model and Mindfulness In Relapse Prevention

December 8, 2013

imagesMindfulness meditation is currently a major interest in the field of addiction treatment and relapse prevention. It is also becoming a popular modality integrated into pan management by in the work of Dr. Grinstead in Addiction-free Pain Management (APM) and in the form of acceptance and commitment therapy (ACT). This is because mindfulness-type meditation is a useful technique for interrupting stressful patterns of automatic self-talk or rumination that elevates stress to the point of activating craving in addictive disorders, symptoms of a mental disorder, such as depression, and activating acute episodes of pain in chronic pain patients.

The Gorski-CENAPS® Model has used forms of mindfulness meditation since the early 1980’s. In the Gorski-CENAPS Model the form of meditation used was based upon techniques used with biofeedback based upon the early research in meditation especially the work in stress and illness (Pelletier 1977) and The Peniston Protocol (Peniston 1989) used in the treatment of alcoholism The Menninger Clinic. Mindfulness Meditation has a strong basis in the Marlatt’s Model of Relapse Prevention.

The goal of using mindfulness mediation and related meditation methods in Relapse Prevention Therapy (RPT) is to help patients to achieve a state of consciousness often described as detached awareness. This is the same state of mind produced by mindfulness mediation. Detached Awareness is a state of consciousness that allows people to stay aware of their flow of thoughts and feelings without become attached to them.  Detached awareness of thoughts and feelings, in this context, means to allow them to come into awareness without activating the the sympathetic nervous system. In other words to be able to be aware of what we are thinking and feeling without having a stress reaction or activating a fight or flight response.

1533785_10151948786018172_1927814949_nIn the CENAPS® Model, this involved developing the psychological system identified as the Higher Self  (The Observing Self, The Silent Witness) as reported in the book Keeping The Balance by Terence T. Gorski. It involves become physically relaxed while being able to observe and then release or detach from the flow of thinking and the rise and fall of feelings and emotions. This technique was later described as Immediate Relapse Prevention Training and rapidly became a primary goal in Relapse Prevention Therapy (RPT) and is listed as the first skill in the Workbook entitled Starting Recovery With Relapse Prevention. The methodology was first presented in a Professional Paper authored by Terence T. Gorski and Joseph E. Troiani entitled: Application of Biofeedback To Alcoholism Treatment, Ingalls Memorial Hospital, 1976. (Currently not in print).

References:

Pelletier, K. R. (1977). Mind as healer, mind as slayer . NY: Delta.

Peniston, E. G., & Kukolski, P. J. (1989). Alpha-theta brain wave training and beta-endorphin levels in alcoholics. Alcoholism: Clinical and Experimental Research , 13 , 271-279.

Ma, S. Helen and Teasdale, John D., Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects, Journal of Consulting and Clinical Psychology, 2004, Vol. 72, No. 1, 31–40


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