Mindfulness for Addiction Recovery

In the 20th century, most people working in health sciences lumped mindfulness in with new-age practices that had no real evidentiary foundation that made them appropriate for clinical application in mental health or addiction treatment.

However, in the 21st century, the practice of mindfulness is no longer considered experimental. Once a novelty without much data or evidence to verify its benefits, research into the mechanisms and efficacy of mindfulness practices on health and wellness began in the 1970s. It gained momentum in the 1980s and 1990s. Then interest surged in the 2000s. Between 2000 and 2010, the volume of mindfulness studies published in peer-reviewed scientific journals exploded. This piqued the attention of the traditional medical establishment. It forced a shift in the way doctors, therapists, and health scientists view techniques once considered interesting but unverified fluff.

Since 2010, wide-ranging surveys and meta-analyses have addressed and verified the scientific basis for mindfulness. The current consensus is that practices such as meditation, yoga, tai chi, and basic breathing exercises are practical and effective components in the treatment of mental health disorders of all sorts. People in recovery from substance use disorders find mindfulness particularly effective.

This article offers a brief history of mindfulness in the U.S. We’ll discuss the neural mechanisms mindfulness training targets, and describe general theory to explain why mindfulness plays an important role in any treatment and recovery plan for people in treatment for substance use and addiction disorders.

Mindfulness in the U.S.

While a majority of the population may view mindfulness as a relatively new phenomenon, history tells a different story. Mindfulness arrived in the U.S. over a century ago. The renowned Indian guru Swami Vivekananda addressed the Parliament of World Religions in Chicago in 1893 tht’s now legendary. Vivekananda represented India, Hinduism, and yoga. But his speech triggered national interest in spiritual and physical practices from Tibet, China, and Japan.

In the decades that followed, the secular aspects of Hinduism, Taoism, and Buddhism – yoga, taiji/qigong, and meditation, respectively – slowly worked their way into American culture. The 1960s saw an explosion of interest in yoga. The publication of a popular series of books by Richard Hittleman helped. Then, in 1970, yoga made it to television. The show Yoga for Health proved yoga, and by extension, mindfulness practices in general, were here to stay.

Dr. Jon Kabat-Zinn, a researcher at the University of Massachusetts, conducted the first scientific studies on the mental health benefits of mindfulness. He began by examining the effect of mindfulness on chronic pain management. Next, he widened the scope of his research to include stress, anxiety, and depression. He synthesized his work into a system known as Mindfulness Based Stress Reduction (MBSR). MBSR is now a default therapeutic technique in use by therapists, treatment centers, and addiction experts worldwide.

It’s been combined successfully with a variety of traditional psychotherapeutic modes. These include Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Relapse Prevention (RP). Evidence for the complete integration of MBSR with these techniques – and its acceptance by the scientific community – is reflected in a new family of acronyms. We now have MBCBT (Mindfulness-Based Cognitive Behavioral Therapy), MBDBT (Mindfulness-Based Dialectical Behavioral Therapy), MBACT (Mindfulness-Based Acceptance and Commitment Therapy), and MBRP (Mindfulness-Based Relapse Prevention).

Mindfulness Training: Neurochemical Mechanisms

For generations, neuroscientists believed that after a certain point early in life, the formation of new brain cells stopped. This misconception was debunked in the late 1990s, when scientists identified the formation of new brain cells in songbirds. They then documented the formation of new brain cells in adult humans in the early 2000s. A growing body of research proves definitively that mature humans can not only produce new brain cells, but the new brain cells can be produced in a relatively short amount of time. It only takes eight weeks – and the process can be facilitated by the practice of mindfulness techniques.

Mindfulness training results in an increase in brain matter density (neurogenesis) in the following brain regions:

Hippocampus

The hippocampus is an essential structure in the limbic network, the part of the brain primarily responsible for emotional regulation. The hippocampus also contributes to the formation of memory and cognitive functions like self-awareness, compassion, and reflection.

Amygdala

Part of the limbic network, the amygdala is known to be associated with sensations of stress and anxiety.

Posterior Cingulate Cortex (PCC)

The PCC is involved in the process of assessing the relevance of external stimuli to oneself. In addition, it contributes to placing these self-referential stimuli in an individual’s emotional and autobiographical context.

Cerebellum

The cerebellum is primarily known for its function with regard to sensory perception and motor control. However, it also contributes significantly to the regulation of cognitive and emotional processes.

Temp-parietal Junction (TPJ)

The TPJ facilitates the integration of internal and external sensory information, social cognition, and the ability to interpret the desires, intentions, and goals of others. Activation of the TPJ is linked to feelings of empathy and compassion.

The brain structures stimulated and strengthened by mindfulness training combine to form a functional group uniquely relevant to the treatment of substance abuse and addiction. Substance use disorders compromise and lead to deficits in emotional regulation, stress response, anxiety, self-awareness, social intelligence, and empathy.

While these deficits manifest in different ways for different people, their cumulative effect leads to dysfunctional behavior. This can manifest in the form of counter-productive coping skills. Self-medication – a common reason people use illicit substances – suppresses powerful emotions. Disproportionate stress-response and exaggerated anxiety increase the desire for self-medication. Distorted perception normalizes the self-destructive consequences of substance abuse. Diminished social intelligence and reduced empathy contribute to the tendency of people with substance use disorder to lose sight of the consequences of their actions.

Mindfulness training reinforces the neural mechanisms necessary to bolster the perceptive skills required to bring these deficits back into balance. It enables individuals to see and understand their behavior. This, in turn, allows them to build healthy and life-affirming coping skills that lead to sustainable recovery.

A Mindful Model of Addiction

A deep dive into the scientific literature available on the effects of mindfulness training on mental health disorders, including addiction treatment and recovery, leads the diligent reader to mountains of data describing the positive benefits of mindfulness. Most of these are related to well-being, mood, self-efficacy, stress tolerance, and the ability to gain a non-judgmental perspective on behavior. However, only one study elucidates the connection between Buddhist philosophy – the theoretical basis of most practical mindfulness techniques – and contemporary theories of addiction. In “Craving to Quit: psychological models and neurobiological mechanisms of mindfulness as treatment for addictions”, a 2012 paper published in Psychology of Addictive Behaviors, researchers apply the Buddhist theory of human suffering to substance abuse disorders.

They call it “an early model of addiction.”

The Buddhist Model

The Buddhist theory of suffering is relatively simple. It states that desire causes all human suffering. Therefore, the path to enlightenment – or in the case of regular people living 21^st century lives, the path to health and wellness – lies in releasing attachment to objects of desire.

Buddhist philosophy also asserts that personal identity is formed, in part, by associations created by habitual behavior. An individual desires an object or subjective sensation and connects fulfillment of that desire to a concept of identity. This reinforces both the habitual fulfillment-seeking behavior and concept of self to the sensations and emotional states achieved by fulfilling the desire.

In the case of an individual with a substance use disorder, pleasurable sensations that follow substance use are the objects of desire. Those sensations become an aspect of identity. When those sensations fade, so fades the habituated sense of identity. The fulfillment of desire, therefore, becomes the search to maintain identity. Identity becomes inextricably intertwined with substance use.

Mindfulness Training: Interrupting the Craving Cycle

The way to break this cycle is to separate the habituated sense of identity from the cycle of desire. Substitute the idea of craving for the phrase cycle of desire, and addictive behavior becomes logical. A person with an addiction craves reinforcement of their sense of identity. More simply put, they crave being themselves. In the case of an individual with an addiction, the created self is counter-productive. It damages long-term health, function, and survival. When the cycle continues in unchecked, iterative repetition, it undermines the true self by distorting emotion, perception, memory, and cognitive function. It supplants and ultimately destroys the original self and becomes the default state of identity.

Buddhist scholars call this cycle “the chain of dependent origination.” Craving is what connects identity to the chain. Therefore, breaking the cycle of craving enables an individual to escape the cycles of addiction. Mindfulness training teaches the skills required to see the cycle as it is – a self-destructive one – and replace it with constructive patterns of behavior. Dr. Lawrence Peltz, author of “The Mindful Path to Addiction Recovery: A Practical Guide to Regaining Control over Your Life” describes mindfulness training as

“… In essence, mindfulness is the quality of awareness that sees without judgment, shining a light on each moment just as it is. This includes physical sensations, feelings, thoughts, and the nature of our experience continually shifting and changing. With practice, it is a skill that can be developed by anyone.”

The first step in developing this important recovery skill is learning to slow the mind down, relax, focus, and “shine a light on each moment just as it is.” There are many paths to this mind-state.  Seated meditation, walking meditation, breathing exercises, and the practice of yoga postures all work. What all these techniques have in common is that they help an individual see what drives their actions. It helps them gain the perspective they need to decide whether those actions help them or hurt them.

Benefits Of Mindfulness In Recovery

Mindfulness allows an individual to observe, for instance, that stress triggers a cascade of emotions that leads to a particular behavior, like substance use. Mindfulness allows the individual to understand that though substance use temporarily alleviates the symptoms of stress, that same stress, anxiety, and tangle of uncomfortable emotions returns when the substance clears their system. The clarity of mindful perception can lead to the insight that substance use, in the end, does not work. This insight may lead new levels of understanding. The authors of “Craving to Quit” summarize the benefits of mindful perception in this way:

“By decoupling pleasant and unpleasant experience from habitual reactions of craving and aversion, careful attention to the present moment can function to bring a broadening or spaciousness of awareness that allows new appraisals of life situation. A possible result of this…is the ability of mindfulness to facilitate positive reappraisal.”

Using Mindfulness To Overcome Cravings

When a craving hits, habituated patterns drive behavior toward the self and identity created by addiction. Traditional therapies based on talking and thinking often fail to interrupt these patterns.  Mindfulness training – through breathing exercises, somatic practices, and the cultivation of non-judgmental detachment – teaches skills to stop the cycle of craving in its tracks. It allows the moment of craving to pass without acting upon it. It creates the internal space to replace the negative patterns of addiction with the positive patterns of recovery.

In the context of treatment and recovery, the power of mindfulness lies in its ability to support, complement, and functionalize more traditional modes of therapy. While methods such as Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Relapse Prevention (RP) help individuals identify patterns of behavior that undermine health and well-being, they do not offer specific techniques with the strength to arrest craving cycles during the critical moments in which cravings occur.

Final Thoughts On Mindfulness Based Addiction Treatment

For decades, mindfulness training has helped individuals with substance use and addiction disorders achieve balance and harmony in their lives. In the early days of the mindfulness movement, the scientific establishment often ignored these techniques. Those days, thankfully, are over. Advances in neuroimaging have allowed researchers to identify discrete changes in brain structure following mindfulness training. This research offers clear data on the mechanisms by which mindfulness supports recovery.

Coupled with a compelling, logical theory to elucidate the role of mindfulness vis a vis identity, choice, action, and behavior, mindfulness is now part of a 21st century approach to addiction treatment. It’s no longer a novelty. The mental health community now accepts mindfulness as an effective, practical, and evidence-based model of treatment for substance use and addiction disorders – and that’s a sign of real progress.

Keep Acute Stress from Becoming Chronic

Everyone gets stressed.

It’s part of the human experience.

And anyone who’s lived through the past two years in the U.S. knows all about stress.

2020 gave us the pandemic and the election season. 2021 gave us more pandemic, more politics, and a dose of complicated world affairs. Two months into 2022, and guess what? More pandemic and more politics. And now we’re on the verge of another election season, which means even more politics.

Unfortunately, we can’t put our heads in the sand like an ostrich and ignore everything around us until it goes away. Because even if it does go away, more stress will come.

That’s why we say it’s part of being human.

And that’s why each of us needs to learn practical stress management skills. If we didn’t, we’d all walk around all day stressed, worried, and probably irritable or outright angry. At our families, at our coworkers, at our friends, or at the world in general.

That’s no way to live.

Stress and Addiction Recovery

If you’re in recovery from an alcohol or substance use disorder (AUD/SUD) or undergoing a detox program, you know how important it is to manage stress. From the small stressors to the major life stressors, you have to learn how to deal with them all. Because for you, too much stress can lead to the one thing you most want to avoid: relapse.

You understand that when you don’t address your stress head on, it builds up. What starts small – if ignored – gets large. It can happen quickly. Like a snowball rolling downhill. Let it gain momentum and it gets hard to stop. The more momentum it gains, the harder it is to stop.

Therefore, you go to meetings. You follow your sobriety plan. You stick to your aftercare program. Your meetings give you a place to talk things out in a supportive environment designed for you to share anything and everything that threatens your sobriety or might lead to relapse. Your aftercare program includes daily activities that support your sobriety and, by design, reduce your overall daily stress levels. You spent time during treatment learning what works for you and what doesn’t, so you should have the tools you need to manage your days and nights.

Sometimes, though, all that gets tough.

Your program may seem like too much. It might feel overwhelming. You may find yourself in the tricky position of feeling like the thing designed to keep you from being stressed and preventing you from relapse is actually causing stress, which you know can lead to relapse. When that happens, it’s important to take a step back, get perspective, and recalibrate.

It’s time to get back to basics.

How to Recalibrate

The most basic thing to remember is that you need to stick to your recovery plan. But here’s an important point: if you’re not doing basic stress reduction as part of your daily routine, it can undermine your recovery plan and disrupt your sobriety.

That’s how this post will help you. We’re going to remind you of the essential basics of stress management, so you can review them, check them against your daily routine, and make sure you’re setting yourself up for both success in recovery and success in life.

We’ll start by giving you a quick refresher on exactly what stress is and how it functions in our lives.

Stress: What You Need to Know

It’s important to understand that stress itself is not a bad thing.

It’s actually a productive force in our lives.

But not all stress is good.

There are two different kinds of stress: acute and chronic.

Acute Stress

In most cases, acute stress is positive, although it doesn’t always feel positive when it happens. Acute stress is what happens in your brain and body in response to immediately threatening external stimuli. When you have a near miss driving your car and your adrenaline spikes – that’s acute stress. It’s our natural fight-or-flight response kicking in. When the threatening stimulus disappears, so does the stress. It may take a few minutes, but it happens.

We feel the rush, then we calm down. That’s totally normal. And that’s the course acute stress is supposed to take when we experience it. There’s a spike, a denouement, then a reset back to normal. It’s as if the commanding officer in your brain shouts “High Alert! Battle Stations!” then five minutes later says, “Threat passed! At ease, soldiers, as you were.”

Chronic Stress

Chronic stress is stress that persists for a longer period of time. It lingers after the immediately threatening stimulus disappears. And, more importantly, it can also appear in response to stimuli that are not an immediate physical danger, but instead, cause psychological discomfort. Think of spending months or years in a job you don’t like, a marriage you’re not happy in, or in circumstances you don’t like: that’s what chronic stress feels like.

The problem is, your body doesn’t know the difference between acute and chronic stress, and that’s when problems can happen.

If we extend the military metaphor, chronic stress is like when the commanding officer in your brain shouts “High Alert! Battle Stations!” and then never tells you to stand down or to be at ease. Your brain and body stay on high alert. Sometimes for days. Sometimes for weeks. And for some people, this state of high alert may last for months or years.

If you’re in addiction recovery, you know chronic stress is one reason many people turn to alcohol or drugs in the first place, and why many people relapse: it’s painful and overwhelming. That’s why anything you do to keep acute stress from becoming chronic stress is important: it can keep you from feeling overwhelmed, keep you grounded, and keep you on your sober path.

The Consequences of Chronic Stress

If you’re in recovery, you should understand that stress management is not just for you.

Everyone needs to know how to keep acute stress from becoming chronic stress.

Why?

We need to learn productive ways to cope with stress because, according to the Mayo Clinic, long-term exposure to stress hormones – a.k.a. chronic stress – has a significant negative impact on your emotions, on your body, and on your behavior.

The behavioral consequences of chronic stress include:

• Withdrawal from friends, family, and social activities
• Overeating or undereating
• Misuse of alcohol and/or drugs
• Tobacco use
• Exercising less

The emotional consequences of chronic stress include:

• Sadness/depression
• Anxiety
• Anger/irritability
• Decreased focus

The physical consequences of chronic stress include:

• Fatigue
• Insomnia
• Stomach problems
• Headaches
• Muscle/joint pain and stiffness

And as we mention, if you’re in recovery, you know about another negative consequence of stress. It increases the likelihood of relapse. That’s why it’s important for all people in recovery to know the signs of stress, and to have a robust array of stress management strategies and techniques at the ready.

How to Manage Stress: First, Identify It

Practical stress management can be tricky, but the most effective stress management techniques are simple and straightforward. The tricky part lies in recognizing when to apply them and applying them consistently. We’ll repeat the main point of this article: if you make stress management a habit, you’re ahead of the game.

Before we offer our five tips for creating the foundation for effective stress management in your life, we want to address what we mean by the trick lies in recognizing them. Here’s what we mean: it’s critical for you to understand that the behavioral, emotional, and physical consequences of chronic stress are also the symptoms of chronic stress.

And to tie this together for people in recovery, what we mean is that when you feel overwhelmed by recovery and by your program, it’s time for you to take inventory – a phrase you should recognize from your time in treatment and from participating in community support groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).

You take your stress inventory by asking yourself the following questions, which are derived from the list above.

Personal Stress Inventory: Twelve Questions to Ask Yourself

1. Am I withdrawing from my friends, family, and my recovery community?
2. Have I been eating too much or too little?
3. Have I been thinking about drinking or using drugs?
4. Has my tobacco use increased?
5. Am I exercising less, or not at all?
6. Have I been unusually sad lately, and don’t know why?
7. Have I been unusually anxious lately, and don’t know why?
8. Am I more angry or irritable than usual?
9. Am I having problems concentrating at work, or following through on projects?
10. Have I felt tired all the time over the past few weeks?
11. Am I getting good sleep, and enough of it?
12. Have I been having unexplained stomachaches, headaches, or muscle/joint pain lately?

We don’t have an official scoring system for these questions. However, if you answer yes to at least half of them, we think you need to be honest with yourself: you’re probably stressed – and your stress management techniques aren’t keeping up with your stress levels.

We don’t have to remind you – again – what happens when your stress overmatches your capacity to manage it.

Thankfully, we know how to help.

How to Manage Stress: Our Five Top Tips

When you realize you let your stress levels get unmanageable, or let them approach unmanageable, it’s time to do what we say in the beginning of this article. It’s time to recalibrate and make sure you set yourself up for stress management success. If you’re in addiction recovery, stress management success is almost synonymous with effective relapse prevention: that’s why managing stress should be a top priority.

Here are our top five tips for beating the stress in your life:

1. Hobbies and Sober-Friendly Activities

Spend time doing things you love, like practicing hobbies such as reading, playing/listening to music, or anything you enjoy that’s sober friendly and feels good.

2. Exercise and Activity

Get out of the house and move every day. Stay active and exercise in any way that works for you. Start with simple, fun activities like walking, running, or taking group exercise classes. Find something you love doing, and do it as often as your schedule allows.

3. Mindfulness Practices

Learning mindfulness techniques such as meditation, deep relaxation, mindful walking, tai chi, or yoga can make a big difference in your life. If you learned these techniques during treatment but dropped them when you returned home, we get it. Sometimes responsibilities force us to put mindfulness practices – and self-care – on the back burner. Now is the time to get back to that yoga, tai chi, or meditation practice that helped you find balance during treatment. It can bring you back into balance, now.

4. Social Contact

This one is simple: connect with friends and family as often as possible. If you’re isolated, or in a place without many family or friends around, we recommend recommitting to your recovery community. Go to more meetings, find a sponsor if you haven’t yet, and say yes to any sober-friendly get-togethers or events organized by people in your community support groups.

5. Good Food Every Day, Three Times a Day

Eat a healthy, balanced diet high in whole grains, fruits, vegetables, and lean protein. This is truly the foundation of good health. That means mental health, emotional health, and physical health. To achieve recovery success you need all three, and food is a great place to start. You don’t have to go gourmet, you just have to get the basics right: three healthy meals a day.

If you’ve been so busy you find yourself justifying drive-through fast food more than you can care to admit, we sincerely urge you to keep driving until you get home to your fridge or to a grocery store with healthy options. We promise your body will thank you. And making a good, healthy choice will boost your self-esteem and increase your chances of avoiding temptation the next time all you want is that happy meal or triple-decker.

The trick, as we mentioned above, lies in making these stress busting techniques habits that you practice daily, rather than exceptions that you implement when stress overwhelms you. The core philosophy behind successful stress management is creating a strong foundation of positive routines for your mind and body. That way, when things in your life do get stressful, your mind and body can handle them without getting out of balance.

Senior Adults and Binge Drinking: A Serious Problem

A study published in 2019 in the Journal of the American Geriatrics Society indicates that approximately one in ten senior adults (age 65 +) reported binge drinking in the month prior to completing a questionnaire for the National Survey of Drug Use and Health. Study authors pooled data from the years 2015-2017 to ensure they reported on a legitimate trend in the drinking habits of seniors, rather than a single year with unusually high results.

Researchers recognize the actual numbers might be higher, as seniors may be hesitant to admit the extent of their drinking. They also report the possibility that, due to various cognitive issues associated with aging, senior respondents may not offer an accurate account of their past drinking habits.

The study shows that binge drinkers in the senior population are more likely to be male. However, the rate of binge drinking among men remained stable compared to previous years, while rates among women increased. Men are also more likely to use tobacco and cannabis and are more likely to have visited an emergency room during the 12 months before completing the survey.

In addition, research from the National Institute on Aging Care indicates that widowers (men who have lost their spouse) over age 75 have the highest rate of alcohol use disorder in the nation. Nearly half of all nursing home residents have a problem with alcohol, which may or may not include binge drinking.

What is Binge Drinking?

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as five drinks or more on the same occasion for men, or four drinks for women. However, it’s important to note that as we age, we become less tolerant of alcohol, and the effects of alcohol appear more rapidly than earlier in life.

The NIAAA recommends that seniors should consume no more than three drinks per day. Experts from Harvard University suggest that older people should stop at one or two drinks, and should drink only occasionally, not every day.

Why Senior Adults Turn to Alcohol

Senior citizens may be long-term drinkers who started using alcohol many years ago. However, researchers estimate that at least 10 to 15 percent of older drinkers didn’t drink heavily until later in life.

Senior drinkers may experience a number of life challenges, such as grief and loss of loved ones, concern about reduced income, illness, chronic pain, depression, anxiety, loneliness, lack of social support, or boredom.

Why Binge Drinking and Excess Alcohol Use are Dangerous for Senior Adults

The National Council for Aging Care explains that muscle tissue absorbs alcohol rapidly, but as we age, fat gradually replaces muscle. As a result, more alcohol enters the bloodstream, and it takes longer for the body to process.

Binge drinking and excess alcohol intake are dangerous for anybody at any age, but the risks are compounded as we grow older. Potential dangers include:

• Increased risk of falling resulting in broken bones or other injuries
• Higher incidence of car accidents
• Negative interactions with prescribed medications, including sleeping pills, pain relievers, and anti-depressants
• Negative interactions with over-the-counter medications, including aspirin, acetaminophen, cold and allergy medicines, and cough syrup
• Nutritional deficiencies
• Worsened existing health conditions
• Problems with muscle coordination
• Increased risk of serious illness, including diabetes, heart disease, and dementia
• Osteoporosis and gradual weakening of the bones
• Compounded memory loss and confusion
• Higher risk of heart attacks, strokes, and kidney failure
• Decreases libido, increased impotence, and erectile dysfunction
• Increases risk of alcoholic fatty liver disease and cirrhosis of the liver
• Mood disorders
• Severe dehydration

Does Your Elderly Loved One Have a Drinking Problem?

It can be challenging to determine if an older person has a drinking problem. Confusion, forgetfulness, unsteady gait, social isolation, irritability, or other symptoms of excess drinking may resemble typical issues associated with aging.

Friends and younger family members often hesitate to discuss an elderly loved one’s drinking habits. They may be embarrassed, or they may think senior citizens should be able to enjoy their later years.

However, without the input of friends, caregivers, and younger family members, binge drinking and excess drinking among the elderly would likely go unnoticed.

Physicians tend to focus on the drinking habits of their younger patients more than their older patients. They may be reluctant to broach the issue for a variety of reasons, and many physicians lack adequate training to identify the signs of excess alcohol use among seniors.

However, anyone can recognize the red flags that may indicate your elderly loved one drinks too much:

• Depression
• Anxiety
• Memory lapses
• Changes in appearance
• Poor hygiene or grooming
• Unsteady gate
• Occasionally slurring words
• Insomnia
• Irritability and anger
• Mood swings
• Fatigue
• Blackouts

Talking About Treatment: Finding Treatment for Senior Adults

It’s not easy to talk to an older person about their drinking problem, but it’s necessary. Here’s an approach we advise.

Five Tips for Talking to An Older Loved One About Drinking

1. Choose a quiet time to discuss your concerns. Choose another time if you think your loved one is under the influence or isn’t feeling well.
2. Express your concern in a direct, straightforward manner. Be patient and supportive. Don’t lecture, and don’t be critical or judgmental.
3. Keep in mind that seniors benefit from treatment as much as any other age group. Treatment for alcohol use disorder can ensure those later years are healthy and fulfilling lives.
4. Offer to help your loved one find the best treatment possible. Twelve-Step community support programs like Alcoholics Anonymous (AA) are invaluable, but many people require professional treatment from a provider that understands the unique needs of older people. Outpatient treatment may be good enough for some seniors, but a person with a serious drinking problem may need inpatient treatment.
5. Seniors with a severe or long-term drinking problem benefit from medical or supervised detox. Medical detox programs offer around the clock monitoring and support, which makes withdrawal as safe and comfortable as possible.

Addiction treatment programs for the elderly should be age-specific, since what works for a younger person may not be the best solution for an older adult. Treatment for seniors should move at a steady, comfortable pace. Counselors should be compassionate and well-trained regarding the issues of the elderly. They should understand how to cope with hearing loss, memory loss, or other cognitive changes.

Suitable treatment for older folks should also address issues such as stress management, loneliness, lack of social support, anxiety, depression, and grief. Finally, a good treatment program should include a thorough aftercare plan. An aftercare plan or program is an organized approach to sustaining sobriety when official inpatient or outpatient treatment ends. Aftercare programs are critical to prevent relapse, as the risk is higher for seniors who live alone.

A diverse array of therapeutic options exist for the treatment of alcohol and substance use disorders.

One option is dialectical behavior therapy (DBT), a type of therapy developed by psychologist Marsha Linehan in the 1980s. Linehan initially devised DBT to help treat people with borderline personality disorder (BPD), but over the past three decades, therapists have adapted and used DBT to effectively treat a number of behavioral and emotional disorders, including alcohol use disorder (alcoholism) and substance use disorder (drug addiction).

This article offers a basic definition of DBT and explains how it benefits people in treatment, detox and recovery.

Understanding Dialectical Behavior Therapy

Behavioral therapies involve one-on-one and/or group counseling that focuses on teaching people how to identify and correct problems in their thoughts and actions. DBT is a specific subtype of cognitive behavioral therapy (CBT).

To learn about CBT and addiction treatment, click here.

During CBT, a trained therapist helps a person in recovery learn how their specific thoughts influence their emotions and behavior. By identifying and changing negative thought patterns, a person in recovery can change their non-productive, life-interrupting feelings and actions.

DBT takes this principle – changes in thought lead to changes in behavior – and adds specialized components that focus on emotional regulation, stress tolerance, and mindfulness. The core idea behind DBT lies in the word dialectical, which has two meanings that are relevant to understanding how DBT works.

Dialectical means:

1. Of or relating to the logical discussion of ideas and opinions
2. Concerned with or acting through opposing forces.

During DBT, therapists engage in an open and honest dialogue with individuals in treatment – that’s how DBT relates to the first part of this definition. The primary distinguishing feature of DBT, however, lies in the second definition. DBT therapists help people in recovery understand that two opposing ideas or concepts can coexist and that this interplay of fundamental opposites is a defining aspect of reality. Dynamic opposites are a feature of reality – not a bug.

The dialectic at the core of the disordered use of substances is the oppositional relationship of acceptance and change. A person in recovery must accept the reality that they have a behavioral disorder while simultaneously realizing they have the power to change that reality by taking steps to manage their behavioral disorder.

What Are the Benefits Of DBT?

The benefits of DBT are best explained by understanding the core skills DBT therapists teach patients in recovery. These include:

1. 
   

   Emotional Regulation

   
   

People with alcohol and substance use disorder often experience erratic behavior and extreme mood swings. DBT therapists use mindfulness to help people in recovery identify their emotional states without judging them. Once they accept their internal reality as-is, they can then step back and learn to process their disruptive emotions or patterns of thought in ways that help them, rather than hurt them.

2. 
   

   Distress Tolerance

   
   

Painful emotions related to past trauma or present challenges often play a large role in addiction. People turn to alcohol and drugs to soothe their emotions and live with difficult circumstances. A DBT therapist teaches people in recovery the skills needed to accept their emotional states and life circumstances without judgment – as mentioned above – then teaches them specific practical skills to handle stressful situations without resorting to non-productive behaviors, such as drinking or using drugs.

3. 
   

   Improved Self-Esteem

   
   

DBT teaches real skills that people in recovery can apply immediately – even before they leave treatment. With practice, over time, the emotional regulation and distress tolerance skills learned during DBT becomes new default coping skills. People in treatment learn they have the power to navigate life without using alcohol and drugs. This improves their feelings of self-worth and ultimately improves their confidence, self-image, and self-esteem.

4. 
   

   Setting and Achieving Goals.

   
   

Active addiction can cause an individual to give up on both short-term and long-term goals. Improved emotional regulation combined with enhanced distress tolerance and elevated self-esteem can lead a person in recovery back to goals they may have forgotten, or lead them to a place where they can create new goals – and use their DBT skills every day to achieve those goals.

5. 
   

   Improved Relationships.

   
   

Addiction often impairs the ability to maintain healthy and positive personal relationships. It can damage friendships, romances, workplace dynamics, and family interactions. This is not always because the person in active addiction engages in problematic behavior while they’re under the influence of intoxicants. It’s often because they lose the ability to create and maintain healthy boundaries. They forget how advocate for their basic emotional and psychological needs. They lose the ability to communicate effectively in difficult situations.

DBT skills give people in treatment the tools they need to do all of the above: create positive boundaries, seek and find emotional and psychological safety, and discuss their emotions without precipitating a crisis. The net effect of these skills on relationships is that they become enriching and fulfilling – or they have the potential to, when DBT skills are applied appropriately

The full suite of DBT skills enables an individual in recovery from alcohol or substance use disorder to create sustainable behavioral change. Once they begin to create the change they want to see in their lives, DBT skills give them the ability to review and revise their behavior as needed. This dynamic element is critical. As people grow in recovery, they change. As they change, they need the skills to create new coping skills that match their development. DBT creates that template, which evidence shows is durable, adaptable, and capable of supporting both small and large behavioral changes over time.

Treatment Helps You Take Control of Your Life

If you’re seeking treatment for an alcohol or substance use disorder, look for one that offers elements of DBT, like mindfulness. That’s not the only thing to look for, though. The most effective treatment centers use an integrated, holistic approach to treatment. DBT is one piece of the puzzle. It’s important, but it’s not the be-all, end-all therapy that solves everything. That doesn’t exist.

At treatment centers that use up-to-date, evidence-based therapeutic practices, individual counseling approaches like DBT are included alongside other treatment approaches, such as:

• Group therapy
• Family therapy
• Experiential therapy
• Dual diagnosis treatment
• Cognitive behavioral therapy

Recovery is a lifelong journey that you do not have to take on your own. Compassionate, evidence-based treatment provided by caring, experienced practitioners can help you change your life for the better. Inpatient and other treatment programs can give you the practical tools you need to learn, grow, and thrive. The life you create in recovery is a life you live on your own terms, free from the painful cycles of alcohol and drug addiction.