Quieting the Hungry Ghost
Mindful & Compassionate Relapse Prevention
By Richard Fields, Ph.D.
Buddhist cosmology describes addiction as the “Land of the Hungry Ghosts”, where people have huge appetites that are unable to be quenched or satisfied. Buddhism describes addiction as a “false refuge”, a delusional place to try to hide and escape from being present with both the good and the bad in life. Dharma (Buddhist teachings) describes addiction as the inability to see or have gratitude for the joy and abundance in our everyday lives.
Alcohol/drug relapse has traditionally been met with confrontation, shame, criticism, and self-hatred. Getting sober is not the hard part, staying sober is. Most relapses occur in the first 30-180 days of recovery. Ironically, most people leave inpatient/residential alcohol/drug treatment facilities after 30 days, just when they are most prone to relapse.
I see mindfulness and compassion skills as a natural and ideal way to help with relapse prevention and, considering the high relapse rates, a necessary new modality. The three major reasons that people relapse are:
•negative emotional states
•the abstinence violation effect
•shame and disconnection
Negative emotional states could include escalated conflicts (especially with spouses/partners), anxiety and worry (especially about job or financial security), depression, and other negative emotions, and loss of hope and meaning. Mindfulness and compassion skills help in reducing reactivity so the problem isn’t escalated by unwise and impulsive behaviors and poor decisions. It also helps with putting the problem in perspective, in the now, and making the next best wise decision, moment to moment. Many times, this involves patience and doing less until there is more clarity.
Relapse is viewed with compassion, which alleviates the shame of violating abstinence. Relapse is viewed as something to be concerned about, but also an opportunity to explore what is not working in your life. Relapses that occur several years into recovery are usually an indication that something might be in need of attention. Recently I was at a workshop and a fellow participant disclosed to me that after seven years of sobriety she relapsed last month. I asked her if she had gone back to her home meeting. She said she didn’t because she felt so shamed.
Unfortunately, I hear many stories like this. What is frightening about this is a month had passed and I was the first one she was sharing this with. People need to talk about urges, cravings, fears, and relapses with other people (i.e. silence is the enemy of recovery, according to an AA proverb). I bring this up because people often do not talk about urges or cravings. They try to ignore it as something that will pass, much like the warning signs of a heart attack.
Ironically by ignoring and not talking about urges or cravings, one tends to withdraw, be secretive, isolated, and disconnected, all of which increases the risk of relapse. It is said that most relapses are planned. That is because the person is thinking about relapse, but not talking about it. The more one thinks about relapse and doesn’t talk about it, the more likely it will occur.
Quieting the hungry ghost is a multi-faceted approach, including guided meditations, mindfulness, and compassion lessons, compassion practices, meditation, that contributes to a more mindful and compassionate way of being.
“Urge surfing” is just one example of a guided meditation technique to tolerate an urge or craving to use (alcohol/drugs or whatever the abuse or addiction). Essentially the person visualizes the urge or craving as an ocean wave. The wave has a beginning, a crest, and smooth cycle until it crashes on shore and then rolls to a conclusion. The wave visualization helps one realize that one can tolerate the urge and breathe through it and the associated desires. It reminds us that we can delay reaction and that urges will quiet with focus and patience.
Mindful and compassionate relapse prevention addresses these issues. Relapse is viewed as something that can be prevented with the proper skills. The individual is encouraged to talk about urges and cravings, and to recognize and learn from previous relapses, without shame and criticism from others and more importantly self-criticism. The person can use mindfulness and compassionate relapse skills to reduce reactivity and see relapse as less shaming. The most important element is a circle of compassionate support so that one is not isolated.
For additional training on “Quieting the Hungry Ghost: Mindful and Compassionate Relapse”, you can attend a one-day training Sept. 21, 2013 at the Hyatt, Mission Bay, San Diego, CA with Richard Fields, Ph.D. (see facesconferences.com). This training is both for mental health professionals and those wanting to learn about mindful and compassion relapse-prevention skills.
Two related tools for relapse prevention are the books:
A Year of Living Mindfully: 52 Quotes & Mindfulness Practices, FACES Publishing, 2012.
A Year of Living with More Compassion: 52 Quotes & Compassion Practices, FACES Publishing, forthcoming, fall 2013.
To order your copies and to preorder the Compassion book, go towww.facesconferences.com, or call toll free 1-877 63 FACES.