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The purpose of this paper is to provide an overview of how Buddhist philosophy can be applied in the treatment of individuals with substance abuse problems (alcohol, smoking, and illicit drug use) and other addictive behaviors (e.g., compulsive eating and gambling). First I describe the background of my own interest in meditation and Buddhist psychology, followed by a brief summary of my prior research on the effects of meditation on alcohol consumption in heavy drinkers. In the second section, I outline some of the basic principles of Buddhist philosophy that provide a theoretical underpinning for defining addiction, how it develops, and how it can be alleviated. The third and final section presents four principles within Buddhist psychology that have direct implications for the cognitive-behavioral treatment of addictive behavior: mindfulness meditation, the Middle Way philosophy, the Doctrine of Impermanence, and compassion and the Eightfold Noble Path. Clinical interventions and case examples are described for each of these four principles based on my research and clinical practice with clients seeking help for resolving addictive behavior problems.

There is increasing evidence for the utility of mindfulness training as a clinical intervention. Most of this research has examined secular-based mindfulness instruction. The current study examined the effects of a 10-day Buddhist mindfulness meditation course on the psychological symptoms of 53 participants. A repeated-measures analysis of variance indicated reductions in overall psychological distress from the pre-course baseline to a 3-month follow-up. Correlation analyses indicated that the reported reduction in psychological distress was not influenced by social desirability bias and that the effect was not dependent on daily meditation between course completion and follow-up. Issues regarding modality of mindfulness training (secular versus Buddhist) are discussed.

Cognitive-behavioral approaches to alcohol and drug use disorders have received considerable empirical support over the past 20 years. One cognitive-behavioral treatment, relapse prevention, was initially designed as an adjunct to existing treatments. It has also been extensively used as a stand-alone treatment and serves as the basis for several other cognitive and behavioral treatments. After a brief review of relapse prevention, as well as the hypothesized mechanisms of change in cognitive and behavioral treatments, we will describe a "new" approach to alcohol and drug problems called mindfulness-based relapse prevention. Preliminary data in support of mindfulness-meditation as a treatment for addictive behavior are provided and directions for future research are discussed.