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COMPASSIONATE & MINDFUL RELAPSE PREVENTION
Richard Fields, PhD
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HUNGRY GHOST OVERVIEW
I. Alcohol/Drug Recovery & Relapse Prevention
II. Core Relapse Issues
III. Mindfulness & Compassion Overview
IV. Anger, Criticism/Blame, Impatience
V. Mindful & Compassionate Tools for Relapse Prevention
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Alcohol / Drug Recovery& Relapse Prevention
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Compulsion/Obsession
Inability to Control
Continued use despite “significant”
negative Consequences
3 C’S OF ADDICTION
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Negative Emotional States – Reactivity
Abstinence Violation Effects
Shame - Disconnection
ALCOHOL/DRUG RELAPSE
STAGES OF RECOVERY
(0-15 days)
(15-45 days)
(45-120 days)
(120-180 days)
(180-360 days)
Withdrawal
Honeymoon
The Wall
Adjustment
Resolution Stage
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MOST RESEARCHED AREAS
Tension & Stress Reduction
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*SELF-MEDICATION MOTIVE*Khantzian, Edward (1985)
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ALTERED STATES OF CONSCIOUSNESS
• NARCOTICS – painkillers, numb out
• CNS DEPRESSANTS – sedation, loss of inhibitions
• STIMULANTS – increase in energy, motivation, sense of power
• HALLUCINOGENS – distortion of reality, different perspective, escape reality
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REASONS FOR USING MARIJUANA
• Stimulation of thought
• Relieve boredom
• Enhance senses & sensations
• Relieve anxiety & dysphoria
• Stimulate appreciation, creativity, & artistry
• Increase enjoyment
• Completing mundane tasks
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• Stimulate interest, different perspective
• Improving self-confidence & quieting pessimism
• Enhancing conversations & social interactions
• Increasing fun, joy, & happiness
• Quieting anger, frustration
• Enjoying nature
• Entertainment
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DISEASE MODEL FOR ALCOHOLISM
1. Known etiology (causes)
2. Symptoms get worse over time
3. Known outcome
AMA (1957)
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BOREDOM
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CRISIS OF UNCERTAINTY
“Each transition to a new phase
of purpose is accompanied by
a ‘crisis of uncertainty’, a chaotic
period of time in which we
are organizing ourselves around
a new core question.”
Richard Leider; The Power of Purpose: Find Meaning, Live Longer, Better, 2010
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RESTING IN UNCERTAINTY
Awareness of awareness
Attention to intention
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MINDFULNESS
The Big Three:
• Anger
• Criticism (Blame)
• Impatience
Delusion, Grasping, Resistance
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AA Dharma
Denial Delusion
One Day at a Time Being in the Now
The Serenity PrayerIssues of Control, Surrender,
Acceptance
Progress not PerfectionLetting go of Attachment to
Outcome
Shit Happens Life includes Suffering
Let Go & Let GodForgiveness & Loving
Kindness
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Clinical Psychology Psychology of Buddhism
Focus on pathology Focus on living and freedom
25 states of depression 25 states of rapture
A list of anxiety disordersA list of states of extremetrust and contentment
Emphasis on independenceEmphasis on interdependence
Focus on pathology Focus on living and freedom
25 states of depression 25 states of rapture
Jack Kornfield, Ph.D., The Wise Heart
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God grant me the serenity
to ACCEPT the things I cannot
change, COURAGE to change the
things I can, and the WISDOM
to know the difference.
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Grant me the serenity
to accept the PEOPLE
I cannot change,
Courage to change
the ONE I can,
And the wisdom
to know it’s ME.
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“You must be
the change you wish
to see in the World”Mahatma Gandhi
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“Wherever you are that is the entry point.”
Kabir, 15th Century Indian Poet
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Anger
THE BIG THREE
Criticism Impatience
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ANGRY“If you get angry easily, it may be because the seed of anger in you has been watered frequently over many years, and
unfortunately you have allowed it or even
encouraged it to be watered.”
Thich Nhat Hanh,
Taming the Tiger Within,
(Riverhead Books, 2004)
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“The thought manifests as the word;
The word manifests as the deed;
The deed develops into habit;
And habit hardens into character.
So watch the thought and its ways with care;
And let it spring from love,
Born out of concern for all beings.”
The Buddha
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H A L T S
HUNGRY – feed the hunger
ANGRY – quiet anger & regain compassion
LONELY – “cool” loneliness
TIRED – rest, relax, recreate, renew
SICK – heal and nurture back to wellness
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F E A R
F – False
E – Evidence
A – Appears
R – Real
F – Frequent
E – Exaggerations
A – About
R – Reality
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CRITICAL OF OTHERS
“Paying attention to another’s faults
is just a distraction from paying
attention to what is happening
right here and now.”
Healing Zen, Ellen Birx, 2002
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RIGHT
RIGHT
RIGHT
WRONG
WRONG
WRONG
B L A M E
“We habitually erect a barrier called blame that keeps us from communicating genuinely with others, and we fortify it with our concepts
of who’s right and who’s wrong.”
Pema Chodron
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WOULD YOU RATHER BE
RIGHT HAPPY?orTireless Debate
Alcoholics Anonymous
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R A I N
ecognize
ccept
nvestigate
ot identify/personalize
R
A
I
N
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“Your fondest dreams will be transformed into fruitful realities if you just know
the secret of growing the patience-tree in your heart.”
Sri Chimnoy,
The Wisdom of Sri Chimnoy,
Blue Dove Press, (2000)
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Pessimists Optimists
Permanent Temporary
Pervasive Specific
Personal External
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“The courageous act of starting to address one’s anger and developing greater
patience is, to me a sacred art.”Allan Lokos,
Patience: The Art of Peaceful Living,
2012
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PATIENCE: THE ART
OF PEACEFUL LIVING
by Allen Lokos, 2012
“For a home to be a refuge it needs to be a place where love, compassion and patience prevail.”
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“I am the cause
of most of my
suffering because of
the habits of
my own mind.”His Holiness The Dalai Lama
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Delusion
AwarenessClarity
Wisdom
Source: Jack Kornfield, The Wise Heart
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“The essence of bravery is being without
self-deception.”Pema Chodron
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“All beings want to be happy, yet so very few know how. It is out of ignorance that any of us cause suffering, for ourselves or for others”
Sharon Salzberg, Loving-Kindness, 2004
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Grasping
Letting GoKindness
Flexibility
Source: Jack Kornfield, The Wise Heart
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“When one door of happiness closes,
another opens, but often we look so long at the closed door that we do not see the one that has been opened for us.”
Helen Keller, We Bereaved, 1929
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ResistingOpen-Heartedness
Loving-Kindness
Source: Jack Kornfield, The Wise Heart
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“Mindfulness is within your grasp, holding on to it
is the difficult part!”Richard Fields, Ph.D.
Compassion
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“Love and compassion are necessities, not luxuries, without them humanity cannot survive.”
His Holiness the Dalai Lama
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SHAME
DEFINITION – Self looking in on self, finding the self lacking or feeling exposed –“seen” in a public way and wanting to cover up – feeling hunted.
Fossum and Mason, 1987
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Shame-based
System
Self-compassionate
System
1. No hope – hopelessness 1. Hope – choice
2. Inescapable 2. Can make amends
3. Exterior based 3. Internally based
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SHAME – FEELING BOUND
Anger + Shame
Anxiety + Shame
Sadness + Shame
Loneliness + Shame
= Rage
= Panic
= Depression
= Abandoned/Isolated
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COMPASSION RESISTANCEFEARS of RECEIVING COMPASSION
I wonder if displays of warmth and kindness from others are genuine.
When people are kind and compassionate towards me I feel anxious or embarrassed.
I’m fearful of becoming dependent on others, because they might not be available or willing to give compassion
Gilbert, et. al, 2011
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FEARS OF COMPASSION FOR OTHERS
I worry that if I am compassionate and vulnerable people will drain my emotional resources.
People will take advantage of me if they see me as too compassionate.
There are some people in life who don’t deserve compassion.
Being compassionate towards people who have done bad things is letting them off the hook.
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The door to the human heart can only be opened from the inside.
Spanish Proverb
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SELF–COMPASSION
“The curious paradox is that
when I accept myself just as I am,
then I can change.”
Carl Rogers (1961)
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“Caring for othersrequires caringfor oneself.”
His Holiness the Dalai Lama (2000)
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“In this world hate never yet dispelled hate.
Only love dispels hate.
This is the law, ancient and inexhaustible.”
The Buddha
HURT PEOPLE HURT PEOPLE
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