Providence, Rhode Island, USA
Received Date: March 06, 2017; Accepted Date: March 25, 2017; Published Date: March 27, 2017
Citation: Ackerman BL (2017) Moving Beyond an Addiction Model of Alcohol and Substance Abuse: A Mindfulness Perspective. J Alcohol Drug Depend 5:261. doi: 10.4172/2329-6488.1000261
Copyright: © 2017 Ackerman BL. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Brian L Ackerman MD: Brian L Ackerman MD is a Harvard Medical School Trained Psychiatrist Working to Help Integrate Meditation and Mindfulness into more Traditional Approaches to Psychiatric Care and Mental Health. He is staff Psychiatrist at the Community Care Alliance (CCA) in Woonsocket, RI where he runs a Mindfulness Group Treatment Programs. He also works on the staff of the Acute Stabilization Unit and at Ad Care in N Kingston RI, and is on the staff for the Kent Center in Warwick, RI.
The addiction model of alcohol and substance abuse has provided many benefits to this user population, including treatment centers, and insurance companies who will pay for the treatment of the addiction illness, as well as helping to remove the-being ‘bad’-stigma, associated with a population seemingly hell-bent on making foolish choices. The ‘medical-treatment of illness model’ defines this population as suffering from an illness, a disease, which requires treatment.
The illness model, in my view, is truly most helpful in diagnosing and treating the temporary states of overdoses and of alcohol and drug withdrawal. However, the addiction/illness/medical model is confusing and misleading regarding the bigger picture of drug and alcohol abuse syndromes and for that wider angled perspective on the substance use problem, we can more effectively turn toward a Mindfulness based model for diagnostic and treatment approaches.
From a mindfulness perspective, drug and alcohol use could be redefined as a
Self-Injurious Impulse Disorder (SIID), the alcohol and drug use seen as just one of many ways this population self-injures, and a mindfulness based treatment is geared to helping this population become AWARE of this larger-self-injury-diagnosis. Treatment can then get to work to helping them learn to replace the impulse to self-injure with the impulse to self-care. This population can be taught that act of putting a chemical toxin into their body is as self-injurious as cutting their wrists, and just because they do not see the injury does not mean it isn’t happening. This population can also be called upon to aware of the multitude of ways they self-injure beyond the use of chemical toxins, that their thought patterns (I’m a loser, a disappointment, failure…) and feeling and mood patterns (angry, anxious, depressed, bored, irritable) these ‘mental toxins’ are as self-injurious, if not more so, than even the chemical toxins they use, typically to try to escape the noise and suffering index from these mental toxins. The treatment team then can also help them realize they are dual-natured, and they have a self-caring and self-protecting side to them also…(Why else would they be in treatment?), and treatment can focus on helping them be more aware of the on-going tug of war between their self-injurious ‘nature’ and their self-caring nature. There are a multitude of reasons that need to be explored in treatment, why so much of the time the self-injurious side of their nature, wins the arm wrestle against their self-caring and self-protecting side, but treatment can be geared to helping them strengthen their ‘muscles’ of self-care and self-protection. One of the key muscles of self-care and self-protection is the awareness of the intensity of even the true desire to self-care, and self-protect. This desire is most often buried under the despair and memories this population has of the multitude of ways their yearnings to be taken care of and protected at an age-appropriate time in their lives, was severely frustrated. They can be helped to become aware that their self-injury and self-neglect recapitulates the pattern of parental neglect and abuse they endured. A mindfulness approach also helps them to become aware of how identified they have become with the self-injurious side, and helps them cultivate an awareness of all their negative self-thinking. When they get to the point where they can report, I am aware of having the thought that I am a failure they have reached first base safely. When they report, I used to have many negative self-thoughts that plagued me, they have scored and reached home plate safely.
Meditation/Mindfulness study and practice helps our patients become more fully aware of the duality of their nature, and that they have a robust over-developed lower self, replete with negative thoughts, negative feelings, and a multitude of self-injurious behaviours and attitudes. They also have-a Higher Self, and self-caring and self-protective nature, a side which is underdeveloped yet full of potential. Our treatment is geared to helping them get better access to this side and help them learn to strengthen its muscle. Our role becomes analogous to a physical therapist helping a patient recover strength in their left arm from a stroke they had. We suggest from this model that-residual cravings for drugs and alcohol- that occur *after* the withdrawal period, are not so much physiological cravings, but the voice of the self-injurious nature making noise. We them help them juxtapose their ‘craving’ to use again with their truer desire and ‘craving’ for mental and physical health and freedom from drug dependency.
One of the many blessings of a mindfulness approach is that it is tied to helping cultivate a better awareness and understanding to what it means to be a human being, and becoming more aware of how ALL human beings are actively struggling with the pushes and pulls of their own double-natures. Mindfulness is then taught as tool to help them get unstuck from the tug of war, and to help motivate their doing the lower self and Higher Self work to guide their recovery and rehabilitation.