Mindfulness and Healing in an Outpatient Setting

Wendy Mullen is a Licensed Clinical Social Worker and Certified Professional Life Coach in Los Angeles, California, as well as co-founder and director of SOAR Outpatient and Recovery located in Malibu, California. SOAR offers a modern approach to healing from alcohol and drug addiction integrating Mindfulness, Life Coaching and 12-Step Recovery as core life skills to develop one’s own inner wisdom for living and awareness.

Wendy received her Master’s Degree in Social Work from Smith College in Northampton, Massachusetts and completed advanced training in Mindfulness, Buddhist Psychology and Relational Psychotherapy at the Center for Mindfulness and Psychotherapy in Santa Monica, California. Her book, Mindfulness and 12-Step Recovery, is now available.

Question: What inspired you to integrate Mindfulness Practice as a core therapeutic tool to treat alcohol and drug addiction in the outpatient setting?

Answer: Many clients who seek treatment for addiction also exhibit severe, chronic, co-occurring disorders that are difficult to treat using traditional treatment modalities. These individuals struggle with impulsivity, emotional sensitivity and a deeply polarized worldview leaving them extremely vulnerable in between weekly therapy sessions. Mindfulness is a self-directed technique that can be used in any moment to initiate mind-body awareness. This is very empowering.

Clients learn mindfulness skills and are encouraged to practice in-between sessions. As their practice deepens so, too, does their commitment to make positive change in other areas of their life. The benefits include positive self-regard, increased motivation and progress toward establishing a life worth living.

Question: How does Mindfulness Practice work as a therapeutic tool?

Clients learn how to directly experience sensation in their body without thinking and judging cultivating a different, wiser way of knowing, a different way of being.  This new moment-to-moment awareness offers a release from the habitual impulsive cycle of thoughts and behaviors that lead to relapse, allowing space for new ways of being to unfold.

Clients learn how to cultivate awareness throughout their entire body, extending to their thoughts, behaviors and environment. They learn to identify signals in the body they can trust.  This is a huge step for many in recovery especially those individuals with trauma histories. Clients are empowered to befriend thoughts, emotions and feelings without judgment. As tolerance to face painful negative affect develops so does acceptance, interrupting the vicious cycle of anger, shame and pain that ultimately leads to relapse.

Question: What is Mindfulness Practice?

Answer: Mindfulness Practice is just one of many teachings (Dharma) descending from the Buddha “the Awakened One” over 2500 years ago.  Today there are two main schools of Buddhism: Theravada and Mahayana. Theravada means “the teaching of the Elders” and Mahayana means “Great Vehicle”. The two main goals of Buddhism are getting to know ourselves and learning the Buddha’s teachings. The Buddha who was said to have achieved Enlightenment taught, “All living beings have ‘Buddha nature’ and can become Buddha’s”. ‘Buddha nature’ refers to the part of us that is pure, wise, and perfect opposed to ‘ordinary nature’, which is ruled by unpleasant feelings such as fear, anger and jealousy.

The Basic Teachings of the Buddha include The Three Universal Truths (Nothing is lost in the Universe, Everything Changes, The Law of Cause and Effect known as ‘karma’); The Four Noble Truths (Suffering, The Cause of Suffering, The End of Suffering, The Path to the End of Suffering); and The Noble Eightfold Path known as ’The Middle Way’.

Contained within the Eightfold Noble Path you will find the Buddha’s explanation of Right Mindfulness Practice (moment-to- moment awareness of thoughts, words and deeds without judgment).  “Like all spokes of a wheel are necessary to keep the wheel turning so, too, does one need to follow each of the eight steps on the Noble Eightfold Path to cultivate wisdom and achieve happiness,” taught the Buddha.

Question: Does practicing Mindfulness mean I am practicing Buddhism?

Answer: No.  Practicing Buddhism is a life long process including a commitment to study all teachings of the Buddha while striving to achieve self-awareness, inner wisdom and enlightenment. In the Theravada tradition the goal is to become an Arhat, which means a person free from suffering. The goal of Mahayana Buddhism is to follow the Bodhisattva Path. A Bodhisattva is one who enlightens oneself as well as others.

Question: Do you require your clients to meditate in-between sessions?

Answer: Like any new skill we wish to acquire Mindfulness Practice will require a certain amount of energy, homework and commitment. I am very clear with clients that I am not a meditation teacher and I am not asking them to take up a formal meditation practice, although I will refer them to a qualified teacher if they so desire. I explain that I am adapting mindfulness exercises. The goal is to bring focused attention into the present moment, increase awareness in the body for sensation, emotion, and behavior while enhancing skills for observing thoughts and letting go of judgment.

Question: Is Mindfulness really “Ancient Wisdom” or just the latest craze?

Answer: In 2004, Scientists met at the home of the Dali Lama in Dharmsala India to present research findings on a study involving Buddhist monks and one of the hottest topics in brain science: neuroplasticity.

“Neuroplasticity refers to the brain’s ability to change its structure and function, by expanding or strengthening circuits that are used and by shrinking or weakening those that are rarely engaged.” (Begley, 2004)

The study compared MRI scans of brain activity in volunteers (novice meditators)  to those of Buddhist monks who reported more than 10,000 hours of formal meditation. The study asked participants to practice “compassion” meditation, generating a feeling of loving kindness toward all beings. The results were simply amazing!

Buddhist monks showed dramatic increases in high-frequency brain activity known as gamma waves during compassion meditation, allowing researchers to suggest that mental training can bring the brain to a greater level of consciousness.

Activity in the left prefrontal cortex (the area of positive emotions such as happiness) showed overwhelming activity compared to the right prefrontal cortex (site of negative emotions and anxiety). Surprisingly significant were findings to support that even novice meditators showed an increase in brain activity in the same areas.  Scientists report that like muscles in the body, which can be trained and developed, so too can the brain be altered intentionally through mental training.

Later, in June 2007, the same researcher, Richard Davidson, a professor of psychology and psychiatry at the University of Wisconsin, in collaboration with colleagues from the UW-Madison W.M. Keck Laboratory for Functional Brain Imaging and Behavior released findings comparing newly trained meditators to experienced meditators with up to 54, 000 hours of meditation experience.  This time practitioners were instructed to focus attention intently on a stimulus, and when the attention wandered off, to simply bring the attention back to the object.

As expected all experienced practitioners exhibited greater activity in the prefrontal cortex of the brain, which controls and regulates attention. However, when looking at those meditators with 40,000 hours of experience and above  “There was a brief increase in activity as they started meditating, and then activity returned to baseline, as if they were able to concentrate in an effortless way” (Davidson, 2007). When subjects were blasted with disturbing noises the experienced meditators showed less effect on the brain areas involved in emotion and decision-making than novice meditators. Among those with 40,000 hours and above these areas were hardly affected at all.  Although they did hear the sound as measured in the auditory cortex, they virtually showed no emotional reaction in the prefrontal cortex.

Davidson and his colleagues concluded that areas of the mind known to control attention, concentration and decision-making could all be trained and improved dramatically through systematic meditation practice.

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