Meditation and Addiction

Hello all,

I was recently approached to help organize a residential treatment facility that would employ meditation as the primary treatment of alcoholism and addiction. I met with a Vietnamese Zen monk who has almost completed a Psy-D who lives in the area and had a round-table discussion regarding how to make it work. This seems like a pretty exciting opportunity, and I was wondering if anyone had thoughts or suggestions about it. Apparently the monk I met with has affiliations with the Buddhist Recovery Network.

Some of the things we covered were:
1.The efficacy of meditation as a treatment modality (considering there are some enlightened masters who have substance abuse disorders)
2. The use of medication (how to know when to use an antidepressant and when to ride out the Dark Night)
3. Secular presentation of material
4. How to deal with differing belief systems (I think we decided to tell people, "We don't care what you believe, just shut up and sit."

A few other things we haven't covered yet are - what other treatment modalities, therapy, etc to include, and the role of 12 step methodologies in the program (which I think should be a modality, but not the sole one).

Any suggestions are welcome!
David

Have you seen these books? Might help with general ideas.
One Breath at a Time: Buddhism and the Twelve Steps - Kevin Griffin
The 12-Step Buddhist: Enhance Recovery from Any Addiction (Kindle Edition) - Darren Littlejohn
12 Steps on Buddha's Path: Bill, Buddha, and We (Paperback) - Laura S.
Steps to Happiness: Travelling from depression and addiction to the Buddhist path (Paperback) - Taranatha

I have a lot of opinions on all this and will try to chime in later.
but, one thing I've thought of a lot that is a little related:
I am VERY compulsive. Anything worth doing once I'll do 1,000 times no matter how much it might screw things up.
I think this might be why i find it so hard to get to a jhana state. I want it so bad, that as soon as I come close I grab on tight and thus lose it. I think my compulsivity makes it very hard for me to stay with the object itelf and not grab onto the potential bliss. I wonder if other addictive types have this as well.
That's why I think I do so much better at vipassana techniques -- the technique is to notice what is actually happening whatever that may be -- pain or pleasure or whatever. So, the temptation to latch onto bliss is not a factor. Though, some nice feelings and experiences are a bi-product.

Interesting topic.

What type of facility and program are we talking about? Super structured or more relaxed? Just curious.

I've heard really good things about Dialectical Behavior Therapy (DBT), which utilizes mindfulness to treat Borderline Personality Disorder (BPD). I'm sure you're quite familiar with both due to your profession. I think there are some aspects to DBT that would work well for treating substance abuse or dependency. For instance, having someone on call 24/7 to talk to a person before they consider using. Combine that with good, secular mindfulness training, and I think you'd be off to a good start.

Also, yeah, it's true that many people who are meditation adepts also have substance abuse problems. That doesn't mean they're applying their mindfulness skills in order to quit drinking. This seems obvious to me, and a sort of non-issue. It's an easy straw man to set fire to.

Jackson

"
David: 1.The efficacy of meditation as a treatment modality (considering there are some enlightened masters who have substance abuse disorders)

Jakson: Also, yeah, it's true that many people who are meditation adepts also have substance abuse problems. That doesn't mean they're applying their mindfulness skills in order to quit drinking. This seems obvious to me, and a sort of non-issue. It's an easy straw man to set fire to.

"


Are you guys saying that someone could be alcoholic and enlightened/awakened at the same time?

Amr

"
Are you guys saying that someone could be alcoholic and enlightened/awakened at the same time?

Amr"

Yes, that's what I'm saying.

It all depends on your model. The enlightenment model that makes the most sense to me is quite simple: abiding non-dual awareness (a term I took from Jed McKenna's books).

From what I've experienced, non-dual awareness has nothing to do with the habits or dependencies of a particular sentient organism.

In other words, "enlightened" doesn't mean responsible, nice, compassionate, friendly, self-controlled, or any other virtuous adjective. It just means "awake."

~Jackson

I understood from previous discussions that an enlightened person is still a human with weaknesses. But being alcoholic pushed that a little bit far for me.

Let me flip the question then. What is the effect of waking up on a person? Is it just 'improvement' in the well being in a general sense? Is there something binary (on/off) about waking up?

Thanks,

Amr

haquan:
what is the relationship, you think, between the "dark night" and clinical depression?

"

I understood from previous discussions that an enlightened person is still a human with weaknesses. But being alcoholic pushed that little bit for me.

Let me flip the question then. What is the effect of waking up on a person? Is it just 'improvement' in the well being in a general sense? Is there something binary (on/off) about waking up?

Thanks,

Amr"

This is just my opinion, but...

It's difficult to say what exactly gets "improved" when one wakes up, waking up has nothing to do with what you think is your "self", so what is there to be improved upon?

And yes, I do think that full enlightenment is binary. You either are or you aren't. When you're done, you're done. When you're not, you're not.

One of my favorite analogies of what it's like to get enlightened is that of actors in a play. Say you're watching a play, and the actors really, truly believe that everything going on in the play is absolutely 100% real. What would happen if you, knowing that the play were a fiction, jumped in and started playing along. You would be acting, but you would know that it was all a big show.

Now, imagine you were able to show some other actors how to discover that they're in a play -- that the play is not "real" -- how do you think it would affect their performance? How would they feel?

Waking up to the truth is like realizing that this whole mess of life we're in -- there's nothing substantial about it. There's no real "I" in the mix. Just stuff. Just drama. It's one thing to understand this intellectually, and another thing entirely to know it in your bones. So yeah, you could say it effects your life for the better, but not in a way that improves any of the characters or circumstances within the drama. It just keeps on going.

~Jackson

AMR, let me add one more thing to my stark digression

I think it would be incredibly difficult for someone to get enlightened if they were perpetually intoxicated. I'm not saying it hasn't happened, I just think that it's hard to meditate when loaded.

But, there have been many highly enlightened individuals who have been known to drink themselves in to an early grave. The first one I can think of is the late Chogyam Trungpa Rinpoche -- founder of the Shambhala tradition of Tibetan Buddhism. His dharma is as good as anybodies (I own two of his books -- amazing stuff), but the guy drank like a fish, and often showed up drunk to speaking engagements.

That's all. Back to our regularly scheduled programming

~Jackson

Do we take the blue pill, Jackson, or the red pill?

I've studied in the field of addictions, and been a certified addiction counselor, worked with difficult to treat addicts, and a variety of addictions both process and chemical. You can view my profile for more background.

Since you asked: Lately, I heard from a few folks around here that 12-step meetings are including 15 minutes of silence. I find the short check-in is also good because folks need to hear themselves,-- listen to themselves. There is no cross-talk (or interrupting) or feedback. Usually if folks want feedback they can ask for it, and it can be given outside, after the meeting, that helps keep the meeting simple.

For an early recovering chemical addict, I wouldn't advocate for meditation as a primary treatment option. I'd rather see the recovering practitioner in a group that balances sharing one's story, silence and study. I can say a lot on this, but one has to get clean first, and clean up the damage in their life a bit to obtain some serenity to move onward.

Nice idea, good luck.

"
Do we take the blue pill, Jackson, or the red pill?



"

Haha! I wonder what happens if you take both.

Here are a couple of resource pages for recovery programs not related to the 12-Step program: www.unhooked.com/ and www.rational.org/ Both sites seem to fill a void in treatment options for those who prefer a more secular approach to recovery.

"Also, yeah, it's true that many people who are meditation adepts also have substance abuse problems." Alan Watts comes to mind - he apparently drank about a quart of scotch per day (!).

Interesting discussion. It does seem counterintuitive that someone who is enlightened could also be an addict.

This is an interesting question - enlightenment and addiction.

Personally, I can't really reconcile it - stories like Trungpa and his behaviour. I'm more inclined to question his enlightenment. Politically appointed or developed status by virtue of recognition as a tulku etc. from childhood is the norm in Tibetan society, so enlightenment perhaps should not be taken necessarily for granted, or at face value. I know when I am in Rigpa, I am completely free - absolutely, without qualification - this is because there is no' me'; emotions, thoughts, situations, all irrelevant - the display that liberates of its own accord. Me is where the suffering is. So, in Rigpa, there is no way I could be an addict, and do what Trungpa is said to have done. When not, definitely.

Could I be an addicted smoker? Sure. The smoking is perfect like anything else. It follows, a pre-existing drinking addiction could be ongoing also as lines of cause and effect. However, if I was enlightened per se, and spent much of my time in Rigp, my suspicion is these addictions would fall way naturally over time - self-liberate. This is speculation though.

I don't know what the truth of the story is, really, with Trungpa. I know the Tibetans, publicly, thought the world of him. Was he 'really' enlightened, I don't know. The publicly accessible stories suggest he his behavior was not enlightened, at least.

It is not clear to me what the answer is or if there is indeed a paradox at all.

I think certainty on this matter is premature though.

In kind regards,

Adam. edited for typos

My humble opinion is that we need to separate the concept of enlightenment from its baggage. We need to enlighten our idea of enlightenment, so to speak. No matter how enlightened a person gets I suspect they will remain human and have human frailties. So, as Vonnegut used to say, "So it goes...."

Hey Chris!

I agree. Enlightenment does not preclude imperfection or the fragility of the human condition. The human condition is perfect right now, despite its display and appearance. It is only the confused mind that sees imperfection. However, when one is awake, one's perception is not clouded by confusion, and thus, one's motivation is not what is was. So, there is no drive or need for much of the common obnoxious behavior; or indeed much of the ordinary behavior that is nothing other than a compensation for suffering - maladaptive coping strategies. When or if this behavior persists, what does that say about the mind of the individual? Some speak of crazy wisdom, but this is different again.

[cont.] edited for grammar

This afternoon, I was anxious, my behavior reflected this in very subtle compulsive addictive behaviors - much of what constitutes daily social action is none other than this, if you look closely - then I sat and practiced Trekchod and went into Rigpa, and complete freedom was seen to have been present here and now, as the very condition of my own mind or existence as no-self, reality as it is. All addictive, compulsive anxiety compensating behavior ceased for a couple of hours during this time. Then I slowly slipped back into the confused stated of 'me'. The bliss and ease continued for a time, but then steadily the natural condition that is reality was progressively obscured - and the compulsive behaviors of cause and effect returned. So, it seems to me, there is a clear display of karmic traces that can be observed in behavior with precise developmental pathways. In their cessation, there is freedom. More accurately, in the clear seeing, they self-liberate of their own accord, due to their inherent insubstantiality, and impermanence. Where there is no cause, there is no effect. This, I would argue, is the cessation of the Suttas; and thus, the Nirvana that is none other than the clear seeing of Samsara - one and the same.

We are addressing age old questions and debates; I would suggest there are no easy or simple answers - at present I am not so confident in mine.

In kind regards,

Adam. edited for clarity.

"Here are a couple of resource pages for recovery programs not related to the 12-Step program: www.unhooked.com/ and www.rational.org/ Both sites seem to fill a void in treatment options for those who prefer a more secular approach to recovery.

"Also, yeah, it's true that many people who are meditation adepts also have substance abuse problems." Alan Watts comes to mind - he apparently drank about a quart of scotch per day (!).

Interesting discussion. It does seem counterintuitive that someone who is enlightened could also be an addict."

Regarding enlightenment and addiction, that is why the process is an ongoing adjustment in morality and congruity.

In the Big Book of AA (upon which the 12 step program is founded) there is a chapter for atheists and a chapter for agnostics. In my experience it is up to individuals to define their own spiritual practice. The program allows for certain principles of morality to be reviewed regularly along with one's own way of practice.

I appreciate the additional links from n8sense, but wanted to be clear about secularism in the 12 step program for those that may not be aware of this. It is truly an invaluable resource that is most likely right in your own neighborhood. It has to do with how you work it.

Part 1

I have seven years of experience in 12 step movements and about six years serious training in zen buddhism. I also established a group for 12 step buddhists where the idea was to utilize the tools from the 12 step program without need for judeo-christian based belief systems. I also worked some time with a local psychiatrist who was utilizing mindfulness, we planned to start mindfulness group for 12 steppers at that time but it didn't work out.

My current understanding of the 12 step movement is that it is more of a religion than it is a dogma free peer group for overcoming addictions. Great book that in my opinion captures the essence of mind converting tools that are used in the 12 step movement: www.morerevealed.com/library/mr/newmr_0.jsp

Now that I have studied this subject both inside the groups and more objectively outside the groups I find that 12 step program might do more damage that it does good. I have personally witnessed groups turning to cults, where newcomers are converted to the belief system of AA, and people who do it don't even understand it. I know because I was one of them for few years. There are also studies that shows that the percentage of recovered addicts in the groups are about the same that without the groups - but those who recover without the groups will stay happier and sober for longer than those in the groups. I personally believe that it is the very dogmatic atmosphere in the groups that will become counterproductive after the "spiritual rush" of the groups will wear out. Of course these dogmas are in-built and hidden in the sense that people are saying over and over again things like "this is spiritual, not religious program", "you can choose your own higher power", "it was my rational mind that lead me to drink, how could rationality make me sober" etc.

You can read more about these things f.ex. from the link I provided.

Part 2

Peer groups can be very helpful for people, I know they were for me. But when the program is based on a very fundamentalistic christian groups teachings, it becomes something else than just a peer group. The "Big Book" includes tons of material that are designed to convert people towards few dogmas that aren't clearly addressed but instead built-in the vocabularity, historical stories, ceremonies and rituals. They aren't easy to preserve if you don't know what to look for. But as soons as you understand the game they become very obvious. In a sense it's a bit similar to the Zen traditions "Dharma Transmission" and other means of casting power to the teachers.

So you should be very careful if you plan to include 12 step dogma in your recovery program. I have tried to plan ways to tke only the best parts of the program and leave the parts that aren't actually helpful for the recovery from addiction but instead designed to strengthen the institution over the people in that institution. When you start to do that you will quickly understand that there aren't actually many things that are left. And with those things that you are left with, there isn't really much reason to talk about 12 steps anymore.

These are my 2 cents, I don't mean to put down the 12 step movement as it was helpful for me too in the beginning (the peers), but it is also important to really understand how it works and towards which goals. This isn't really addressed or talked openly about in the movement as it isn't understood by the members themselves. There are only few people who really understand this and those people will most often leave the movement. There are also some people that possess a status that they can take advantage of who might not want to see these things discussed - but majority just don't or don't want to understand these things, because they fear relapse.

Part I
Hello all,

Thanks for all the responses - I got very busy right around the time I posted this, and have been unable to post anything up.

Telecaster - I'm not sure what the relationship of the Dark Night is to clinical depression - or even the A&P to bipolar mania - but I'm sure there is one. This is something we touched on in the meeting of minds I attended on this.

I think one can develop alcoholism or addiction post-enlightenment - I think Kenneth even makes a comment somewhere on this site that he's known some highly realized individuals "who could have used a good 12 step program." In some sense we can never completely escape the forces of habit, and alcohol and drugs are addicting substances - period.

Apparently there is some research that supports the use of meditation in the treatment of addiction. Here are some links that were just forwarded to me:
www.buddhistrecovery.org/default.aspx
Noah Levine's Sangha (Author of Dharma Punx) againstthestream.org/
And a recovery center in Thailand boasting the "highest success rate in the world": www.east-westdetox.org.uk/

To some extent, I'm a fan of AA and the 12 steps (in it's original conception). It's not a bad map to lead your life by - it's helped many, many people, and overall is a positive organization. However, in it's original conception, it was an entirely voluntary organization. Today, many people are forced to attend by judges, or have it forced down their throat in rehab centers. Unfortunately, it's a system that works to the extent that one can buy into it, and many people simply can't. There's very little research to support the widespread use of 12 step programs (and a fair bit of research that supports other modalities over it) but that is what insurances reimburse, etc.

Continued

Part II
I don't want to dis AA, but I do think there is a fair bit of dogma and "one size fit's all" attitude that goes along with it. For example, I treat opiate addicts with Suboxone - which works extremely well - above an 80% success rate. Many of them do not have problems with alcohol, and drink normally now - some do not, but the cross addiction theory does not describe my experience. In another program, if they had a beer, they'd be called out for relapsing, etc. Simply not the case that that will lead to an opiate relapse for these people. Many addiction counselors are extremely uncomfortable when one challenges assumptions like this, or mentions other evidenced based treatments. My theory is that many of them got sober through AA and that the idea that someone else with a history of addiction could have a drink is extremely anxiety provoking - maybe they could too... (but most can't risk that!)

My main beef with the 12 step approach though, is it's lack of efficacy. Most rehab facilities have an 18-20% success rate. Dismally poor - it's hard to imagine billing someone for any other medical treatment with this kind of success rate!

There's an AA saying that applies to this;
"Definition of Insanity: Doing the same thing over and over, and expecting different results."

David

Hi guys!

I was listening to Jon Kabit-Zinn's material on mindfulness, the other night, it is very good. I had an epiphany last night while listening to it and practicing sky gazing and choice-less awareness over the previous days. I've had some great success in practicing sky gazing and the realization of Rigpa. I noticed that if one sits and sustains uncontrived, natural attention within or upon the sense consciousnesses '“ particularly on the visual field of one's environment, with a gentle gaze and simultaneous focus on the foreground, middle ground, and back ground of one's environment contained in the visual field, one enters Rigpa after a time. This is because in reality there is just-seeing, just-hearing, just-feeling etc. - no subject that sees - and in doing so, the subjective sense of self-consciousness becomes inactive, as does the discriminatory, discursive consciousness for the most part.

[cont.] edited for spelling

I have noticed recently, that when we are existing in subjectivity, even very subtly '“ a subject that experiences apart from the world '“ subject-object duality '“ we suffer, if we shift into the natural state of just seeing, just feeling, the natural condition of mind arises and there is no suffering. It follows, that we do not need to be practicing sky gazing for this. We may practice choice-less awareness mindfulness of all the sense consciousnesses, including the sixth, and in doing so, there is no judgment of what is, no grasping and pushing away of what presents '“ no subjectivity '“ there is just seeing, just hearing, just feeling etc. This is a kind of non-meditation mindfulness that results in the same realization as sky gazing - Rigpa. And as such, I think mindfulness as taught by Kabit-Zinn and others, where they build up to choice-less awareness by starting with a single sense consciousness and steadily including all of them at once, concluding in choice-less awareness may be a very useful practice for dealing with addiction and suffering generally. So Dave, you may be onto something with this!

In kind regards,

Adam. Edited for spelling and typo

Part 1

Haquan, I can see you are well educated with 12 step program and you have fair amount of critical thinking with it's dogmas. That's good. I have also positive experiences in the groups and I honestly believe those helped me, let's say, the first 2-3 years.

I live in Europe and we don't have the problem that you have in the states where people are forced to join AA by some court decisions. Still I have seen that rehab industry is pushing 12 step dogma to the addiction treatment field and it has way too much influence on the recovery professionals thinking - given the fact that AA's success rate is something like 5-7%. Basically the same that people without AA have.

I have been service delegate for our district for 3 years in AA and member of national ACoA committee for 4 years. In those years I have seen many groups within the 12 step movement where the dogma has become more important than the individuals. There were lots of sexual and other kinds of abuse in the groups and first I thought that the problem were the few individuals that propably had some narcissistic personality disorder and everything would become alright again if those people were just clamped down. Then I started to see this pattern repeating over and over again in different places and with different people. I understood that the basic dynamics of the movement are based upon very dogmatic and religious teachings where the authority isn't regulated in any ways. This means that people who are good in acting a "spriritually awakened" role can easily become informal authorities. For narcissist this is of course very easy task to do and given the fact that there are lots of people with narcissistic disorder in the field of addiction, it is very likely that this will happen over and over again. There are some exceptions of course, if the authority is already given to some fairly decent people who can then protect the groups.