Yoga and Addiction Recovery

Yoga's Potential in Treatment for Substance Abuse

Tara Shugrue

Yoga: Theory, Culture and Practice

Laura Douglass

Fall 2012

Introduction

Addiction is “the out-of-control and aimless searching for wholeness, happiness, and peace through a relationship with an object of event”(Williams 2002). Addiction is a disease that is unprejudiced in the type of person it infects. An addict or alcoholic does not fit any specifications when it comes to physical traits or cultural background. Our collective culture as Americans, however, “a society that glorifies addiction and subtly and incessantly pushes us toward it”(Williams 2002). Addiction has become an element to popular culture within the past generation. Celebrities cite “exhaustion” and check into glorified rehabs that share more similarites to a five-star hotel than a clinic. It is no longer taboo in our society to check into rehab for any form of addiction. It has evolved to the point of reality television, chronicling lower-rate celebrities as they work through the recovery process. The definition of addiction in our society as Americans has become twisted and warped into something that makes it appear as more of a joke than anything. Addiction, in any form, is a serious disease that can become fatal if left untreated.

The challenge with this population is that each addiction, each recovery is a completely unique experience to that person; thus treating addiction and maintaining sobriety is no easy feat. The desired end result of the drug and alcohol recovery process is to indeed stay clean and sober. There are numerous approaches to treatment, because of the uniqueness of the disease. There is always a need for an improvement to treatment, that may work for the person that nothing else seems to leave an impact on. Yogic practices have been added to addictions treatment as a result of that searching.

From the research I have conducted thus far, three major practices have continue to stand out: Mindfulness Meditation, Transcendental Meditation and Kundalini yoga. The first two practices are significant elements to yoga, which goes beyond the western persepective of simply a form of exercise. Meditation brings focus to being fully present in the moment, completley aware of the mind-body connection that develops through yoga. Meditation quiets the mind, and brings peace to the body, a helpful practice for those going through the recovery process.

Clinical Issues Facing Addicts and Alcoholics

The recovery process is challenging, because the individual has to face their emotions and environment without their main coping device. Addicts and Alcoholics are professionals at avoiding the negative things in their lives, they use to block out the bad emotions, situations, or mental state they were experiencing. Breslin et al. address Experimental Avoidance, “defined as the attempt to alter the form or frequency of unpleasant states by ignoring or distorting bodily sensations, emotions, thoughts, or memories”(2002). The 12-step program, created by Alcoholics Anonymous, is also used in recovery for Addicts. The first step is to admit that the addiction has taken control over one's life, and that their life has become unmanagable. That initial step is a challenge for a population that functions on never being fully present or aware. Denial is an obstacle each addict faces when they begin treatment, but the underlying issue is dealing with the amount of shame that they feel towards themselves. Holding on to their denial of the situation, their addiction, themselves, that is what helps them to function with their overwhelming sense of shame.

Mindfulness Meditation

Incorporating mindfulness practices into treatment does greatly impact patients in recovery, and working through their experimental avoidance. “Mindfulness practices help prevent relapse through increased awareness of overlearned patterns of thoughts and emotions that potentially lead to relapse”(Dakwar & Levin 2009). Although practicing mindfulness is a simple action, it does not make it in any way an easy feat. Treatment is a fragile time, and bringing awareness to thoughts and emotions that have been previously avoided can be overwhelming. Especially when the learned response of coping has been removed. Becoming aware is the first step, how reality is percieved through that newly aquired vision is the next. Integrating the power of positive thought into mindfulness practices is essential to suceeding. “Present-moment awareness also facilitates a cognitive focus on positive aspects of everyday life, rather than past or future concerns”(Kissman & Maurer 2002). Being fully present in the moment takes the focus off of the past and regrets it may bring, and takes the focus off of the future, and the anxieties it can hold. As Omar Khayyam famously said: “be happy for this moment. This moment is your life.” To find contentment is the slightest detail of the present is to enjoy your life for how wonderful it is, this comes from practicing mindfulness.

Breslin et al. (2002) said this about the role negativity has concerning relapse:

Negative affect appears to be an especially important trigger for several reasons. First, the majority of clients attribute their relapse to interpersonal stress or negative emotions. Second, when alcohol clients relapse, the more intense negative affect appears to elicit a conditioned response (e.g., desire to drink) that increaseses the risk for relapse

The above quote is supportive in my belief that positive thinking is essential in addiction recovery. Addicts are surrounded by negativity, from themselves and their projections of how the world views them. O'connell and Alexander (2009) explain it well, “the recovery process necessitates a fundamental change in the patient's identity and conception of reality.” The addict needs to change everything about their life in order to recover, they need to step out of the darkness and negativity, into the light.

Being able to percieve the self and the surrounding environment in a non-negative way is a significant change for most people going through treatment. “One brings an attitude of acceptance to the inevitable distractions that occur when one sits still. Even when experiencing an unpleasant emotion or distracting thought, one observes or investigates the experience rather than avoiding or supressing it”(Breslin 2002). even for someone who is not battling an addiction, simply observing thoughts and emotions is hard. Unpleasant thoughts and emotions are triggers for addicts to use, simply observing those urges and not acting upon them is a true test of willpower, which can strengthen over time.

Mindfulness practice work harmoniously with the 12-Step program, sharing essential points of acceptance of reality, and reacting in a healthy way. Mindful Meditation is applicaple to each of the twelve steps,“the eleventh step involves engaging in prayer or meditation regularly”(Dakwar & Levin 2009). Alcoholics Anonymous is often associated with the idea presented in the literature of a “higher power” which deters those that are not religious. It is worded vaguely enough to give enough room for options, meditation being one of them. Giving that option to those in recovery is likely to bring higher results of success with sobriety, by taking away a religious association to those not comfortable with it.

To commit to becoming mindful and accepting of reality, the person has to learn a completley new way of thinking. Addictions form for different reasons, it really depends on the person. Some are a result from some form of trauma earlier in life, some are predisposed to addiction, and some just don't think they are good enough. Addicts and alcoholics possess a unique sense of shame, a heavy weight that they carry with them. This shame is not from a single action, it is from simply existing. To dull that overwhelming pain, they learn to cope with a substance, and to make themselves feel better by self-medicating. As the addiction progresses, however, they begin to feel shame for using, adding fuel to the fire.

Practicing mindful meditation, although a great challenge, can reap many benefits to those in treatment. They are able to develop skills to help maintain their sobriety, “from the meditation componenet, practioners also develop an increasing self-awareness of both their psychological and physical state, which can lead to an increase in self-control”(Khalsa et al. 2008). Self-control is ultimately the deciding factor when a patient is teetering between sobriety and relapse, which can be defined as a single drink to an overdose. The threat of relapsing is constantly present in recovery, meditation can be a great aid against the cravings.

Dakwar & Levin (2002) mentioned some benficial effects meditation has on cravings:

meditation has been correlated with a reduced stress response and lower cortisol levels. This finding suggests a role for meditation in addressing craving states: it may potentially reduce stress-induced craving, dampen the salience of drug craving, and increase craving tolerance.

Meditation is known for reducing stress, a positive result for anyone, but for this population, stress “may contribute to addiction by throwing out of balance neuro and biochemical pathways”(William 2002). Keeping stress at a minimum is important, especially for those early in their recovery.

Transcendental Meditation

From the very beginning of recovery, starting at detoxification, Transcendental Meditation is an effective approach to healing. Transcendental Meditation or TM plays “a valuable role in the management of withdrawel symptoms...patients who learn TM during detoxification often report reduced feelings of irritation and agitation and less physical pain”(O'Connell & Alexander 1995). TM is an intense practice, that produces results if the person is completley commited to the practice. For those who are truly serious about obtaining and maintaining sobriety, commiting to TM will help them reach their goals. An author of one of the articles I read believed that Transcendental Meditation claimed to work too much and too well, and that TM calimed to be the only treatment needed to get clean and sober.

The truth is, as with any holistic approach to healing, there needs to be a combination of different treatments to create a succesful recovery process; especially for this population. As I said earlier, each recovery process is different, it depends on the individual. Finding that perfect compromise of treatment is key, Kissman & Maurer (2002) cite Dr. Seigel: “patients have higher recovery rates when they take part in medical treatment and are involved in spiritual practices and belief, such as the mental visualization of wellness (Seigel 1998)”.

Kundalini Yoga

Kundalini yoga is a common form of yoga used in treatment centers around the world; not only for addictions, but psychological diseaseses as well, including Obsessive-Compulsive Disorder, depression, and anxiety. Yogi Bhajan, “a living master of Kundalini yoga, Hatha yoga, and White Tantric yoga”(Shannahoff-khalsa 2004) claimed a specific posture would promote sobriety to those in recovery. It involves activating the Pineal gland, where addiction stems from in the brain, and regulating the balance to rid the mental addiction from the mind. This is done by applying pressure to the sides of the head while chanting a mantra that “puts your consciousness through the cycle of-infinity, life, death, and rebirth. This mantra cleanses and restructures the subconcious mind to help live in a conscious state that is merged with the infinite”(Shannahoff-khalsa 2004).

Conclusion

A reoccuring statement made in each article was the lack of research done on the subject of using meditation or yoga therapy to treat addiction. The small-scale studies done yielded different results, and although the benefits can be estimated, there does not seem to be a strong foundation of evidence-based information. Further research on a larger scale would make a hugr improvement on the amount of scattered results that exist currently. Another reoccuring statement was about the difficulty of gauging the results, as meditation is a significantly unique and personal experience, as well as the process of recovery.

It is frustrating that the results found in any study cannot resolve to any concrete conclusions. There can only be speculation or assumptions made on the benefits of yoga with patients in recovery. That seems to be a running theme in Holistic practices, each individualized to work the best for each person; there is no way to then apply those results to a larger scale. The individuality of Holistic approaches to healing is both its greatest strength and its greatest weakness. From what has been found, the results are profound, to those that were receptive to these different approaches to treatment. I believe that taking a holistic approach to treating addiction is the most effective way, combined with standard rehabilitation treatment as well. Because this disease is so unique in each person infected by it, and this way of treatment is so personalized, they seem to be able to fit together like corresponding puzzle pieces.

I am frustrated and even slightly saddened by the weight that our culture has in deciding what is legitimate. Holistic practices, though gaining popularity within the past decade or so, are still treated with a sene of humor, and not taken as seriously or treated with as much respect as traditional medicine. I have a holistic psychology specialization with my counseling major, and it is something that I plan on incorporating in my career in addiction counseling. Because they are not scientific with solid results, and because a good amount of faith is needed for them to work, holisitic treatments and practices are looked at as not effective. Although they can improve the overall quality of life, and can work better than most medications, these treatments are not covered by health insurance. I hope that one day our culture will evolve enough to have an open mind about treatment options, so that they can be made available to those lucky enough to have health insurance. I plan to continue to research the role that yogic practices have in recovery for addiction, and hopefully one day I will be able to use them in my professional career.

References

Brady, Maggie(1995) Culture in treatment, culture as treatment. A critical appraisal of developments in addictions programs for indigenous North Americans and Australians. Social Science & Medicine 41(11) pp 1487-1498 doi: 10.1016/0277-9536(95)00055-C

Brown, R. P., Gerbard, P. L. (2005) Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part II-Clinical Applications and Guidelines. Journal of Alternative & Complementary Medicine 11(4) p711-7 doi: 10.1089/acm.2005.11.711

Breslin, F. C., Zack, M., & McMain, S. (2002) An Information-Processing Analysis of Mindfulness: Implication for Relapse Prevention in the Treatment of Substance Abuse. Clinical Psychology: Science and Practice 9(3) p275-299

Dakwar, E., Levin, F. R. (2009) The Emerging Role of Meditation in Addressing Psychiatric Illness, with a Focus on Substance Use Disorders. Harvard Review of Psychiatry 17(4) p253-267 doi: 10.1080/10673220903149135

Khalsa, S. B. S., Khalsa, G. S., Khalsa, H. K., & Khalsa, M. K. (2008) Evaluation of a Residential Kundalini Yoga Lifestyle Pilot Program for Addiction in India. Journal of Ethnicity in Substance Abuse 7(1) p67-79 doi: 10.1080/15332640802081968

Kissman, K., & Maurer, L. (2002). East meets West Therapeutic aspects of spirituality in health, mental health and addiction recovery. International Social Work, 45(1), 35-43.

Murphy, K.M. (2008). Managing Your Recovery From Addiction.

O'Connell, D.F., & Alexander, C.N. (1995). Self-recovery: Treating addictions using transcendental meditation and Maharishi Ayur-Veda (vol 1). Routledge.

Shannahoff-khalsa, D. S. (2004) An Introduction to Kundalini Yoga Meditation Techniques That Are Specific for the Treatment of Psychiatric Disorders. Journal of Alternative & Complementary Medicine 10(1) p91-101

Williams, P.G. (2002). The Spiritual Recovery Manual: Verdic Knowledge and Yogic Techniques for Addicts, Codependants and Adult Children of Dysfunctional Families. Incandescent Pr.