Mindfulness for Treating Addiction: A Clinician’s Guide

Mindfulness for Treating Addiction: A Clinician’s Guide

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An aspect of our scientific work relating to mindfulness involves investigating its applications for treating addiction. In this respect, we have a longstanding collaboration with Dr. Mark Griffiths who is Professor of Behavioural Addiction at Nottingham Trent University (UK) and is internationally recognised for his work in this field of study. Today’s post draws upon findings from our research using Meditation Awareness Training and provides ten recommendations on the psychotherapeutic use of mindfulness in addiction treatment contexts. These recommendations are primarily intended for mental health professionals, but individuals with addiction problems may also find them of interest. Although we have principally based our recommendations on insights gained from using mindfulness and meditation for treating behavioural addictions (e.g., gambling disorder, workaholism, sex addiction), we have also consulted the literature concerning the use of mindfulness for treating chemical addictions (e.g., substance- and alcohol-use disorders). Therefore, whilst we acknowledge that there are important differences between behavioural and chemical addictions (e.g., the physical signs of drug addiction are typically absent in behavioural addiction), we envisage that the following recommendations will be applicable to both addiction categories.

  1. Undertake a Thorough Assessment: Careful evaluation of the client’s history (e.g., clinical history, social history, education history, religious history, employment history, etc.) and presenting problems will come high on the list of any competent mental health clinician. However, we have chosen to include ‘thorough assessment’ as one of our specific recommendations because there appears to be a belief amongst a minority of mental health professionals that mindfulness is a one-stop cure for all mental health issues. As discussed in one of our peer-reviewed papers that was recently published in the British Medical Journal, the only psychopathologies for which the empirical evidence is robust enough to support the wide scale utilisation of mindfulness are specific forms of depression and anxiety. In other words, mindfulness is not a suitable treatment for every individual presenting for treatment. For example, we recommend that clinicians exercise additional caution (including taking into account their own experience with using mindfulness) before introducing mindfulness to clients whose addiction problem occurs in conjunction with psychotic features.
  2. Build Strong Meditative Foundations: Mindfulness is a practice to develop throughout one’s lifetime. It is a marathon and not a sprint. If an individual is to derive lasting benefit from mindfulness, it is essential that they establish strong meditative foundations. If we want to become aware of the subtle aspects of mind, we first need to become aware of the gross aspects of mind. And before we can do that, we need a method of calming, collecting and focussing the mind. This is why breath awareness is a vital feature of meditative development. Using the breath as a concentration anchor provides the client with a reference point – a place of safety to which they can return whenever their mind starts to run away with itself. The mental cravings that underlie addiction can be powerful and consuming, and without strong meditative foundations, it is unlikely that the client will be able to regulate these cravings as well as the withdrawal symptoms that they are likely to encounter during later treatment phases. Another important foundation of mindfulness is awareness of the body. At the early stages of treatment, clients should be taught how to sit with awareness, eat with awareness, walk with awareness and talk with awareness. Clients should be encouraged to adopt mindfulness as a way of life and not just a technique to apply when they are feeling low or susceptible to addiction-related urges.
  3. Make use of Psycho-education: In addiction treatment contexts, we suggest that psycho-education should be utilised at the early stages of treatment and should focus on two key areas: (i) educating clients in the science concerning the aetiology and symptom course of their particular addiction, and (ii) explaining the principles of mindfulness and a meditation-based recovery model. For a comprehensive and insightful academic resource that clinicians can draw upon in this respect, we recommend the chapter on mindfulness and addiction by Dr. Sean Dae Houlihan and Dr. Judson Brewer that features in our recent edited Springer volume on Mindfulness and Buddhist-Derived Approaches in Mental Health and Addiction (see further reading list below).
  4. Teach ‘Urge Surfing’: The term ‘urge surfing’ has been used in the scientific literature to refer to the process of mindfully observing the mental urges associated with addiction. The idea is that the client, having established themselves in awareness of breathing, takes craving as the object of meditation. They follow their breath and observe how craving dominates their cognitive-affective processes. The process of observing mental craving helps to objectify it and creates ‘mental space’ whereby instead of feeding the craving (i.e., by emotionally and conceptually adding to it), craving is allowed to exist ‘as it is’. It may appear as though urge surfing is concerned with controlling craving, but that’s not the case. Rather, the technique involves allowing craving to come and go such that it can progress through its natural cycle of birth, life and dissolution. When we teach this technique, we inform clients that if craving is manifest in the mind, that’s OK. We also inform them that if craving is not manifest, that’s OK too.
  5. Make use of Bliss Substitution: Substitution techniques are sometimes used in the treatment of both behavioural and chemical addictions. For example, studies have shown that some individuals with gambling disorder respond well to gradually substituting their gambling activity for recreational activities such as singing, learning computer skills, communication workshops, dance and music. Our own studies have shown that the substitution principle can also work well in the case of addiction treatments following a meditation-based recovery model. One of the key drivers of addiction is the mood modification (e.g., ‘feeling high’) that results from engaging with a particular substance or behaviour. Meditation may be particularly suitable as an addiction substitution technique because specific forms of meditation can induce blissful feelings. Effectively, the client learns to replace the ‘buzz’ or ‘high’ associated with a ‘negative addiction’ with the bliss and peace of meditation (i.e., a positive form of addiction). Eventually, clients should be encouraged to relinquish any dependency on meditation, but in the early stages of treating addiction, it can be a useful therapeutic technique.
  6. Employ Meditation Exposure Therapy: Exposure therapy is a method employed by various modalities of psychotherapy, and it can also be used as part of mindfulness therapy for individuals suffering from addiction. It is all very well teaching the client how to practise mindfulness from the safety of the psychotherapist’s consulting room, but at some point it is probable that they will encounter the stimuli that have previously caused strong mental urges to arise. Consequently, we encourage the psychotherapist to accompany (i.e., where it is safe and realistic to do so) the client in ‘real-world settings’ that are likely to induce relapse. For example, if the client is addicted to off-line gambling, consider accompanying them to a casino in order to demonstrate that it is possible for them to remain meditatively composed whilst surrounded by the object of their addiction. Meditation exposure therapy isn’t suitable for every client (or indeed for every mental health clinician), but where applicable, we generally recommend that it is used towards the end of the treatment course.
  7. Undermine the Value of the Addictive Object: This technique involves guiding the client to think about the ‘true nature’ of the object of their addiction. More specifically, it involves introducing the client – albeit at an elementary level – to the concepts of impermanence, interconnectedness and emptiness. Again, the clinician will have to assess on a case-by-case basis whether this technique is appropriate, but we have personally found it to be effective in addiction treatment contexts. By fostering meditative awareness of impermanence and the empty nature of all phenomena, the client can gradually begin to question and then undermine the intrinsic value that they have assigned to the object of their addition. For example, an individual suffering from sex addiction can use specific meditative techniques in order to better understand that (i) the individual components that comprise the human body are not particularly desirable in and of themselves (e.g., nails, hair, mucus, faeces, urine, pus, vomit, blood, sinew, skin, bone, teeth, flesh, sweat, etc.), (ii) the inevitable destiny of the body is that of ageing, illness and decay, and (iii) the body exists as a composite entity but does not exist intrinsically. If the client looks deeply using meditation, they can learn to see that in beauty and life, there is foulness and decay (and vice-versa). They can also learn to see that there is ‘other’ in ‘self’ and ‘self’ in ‘other’, and that when they practice kindness and respect towards themselves, they practise kindness and respect towards the entire world.
  8. Schedule Follow-up Sessions: Most of the available treatments that use mindfulness generally adhere to an eight-week treatment course. However, in the traditional Buddhist setting, a person would normally be required to engage in day-to-day mindfulness practice over a period of many years before being deemed to have gained a reasonable grounding in the practice. Consequently, it is important to schedule booster sessions and to meet with the client at regular (e.g., monthly) intervals following the initial programme of treatment. Ideally, clients should also be encouraged to make contact with mindfulness groups that are facilitated by competent teachers.
  9. Lead by Example: As discussed in a previous post where we offered guidelines on the general use of mindfulness in psychotherapy (i.e., not specific to treating addiction), it is important that the mental health clinician emanates a presence of meditative calm and awareness. This has to be natural and as indicated above, it can only arise after consistent daily practice over a period of many years. If the clinician merely ‘acts’ at being mindful, the client is likely (whether consciously or subconsciously) to pick up on this and it will inevitably act as an obstacle to recovery.
  10. Be Inspired: Mindfulness has been practised by spiritual traditions for thousands of years. When a clinician engages with the practice in a sincere manner, and when they wholeheartedly wish to help the client overcome their suffering, that clinician is bestowed with the blessings and wisdom of this ancient spiritual lineage. They become what is known in Buddhism as a Bodhisattva – a rare and beautiful being that conduct acts of kindness in order to alleviate the suffering of others. Skilled mental health professionals perform an invaluable role to society. They are inspired individuals who in turn help to inspire the clients they work with.

Ven Dr Edo Shonin and Ven William Van Gordon

 

Further Reading

Alavi, S. S., Ferdosi, M., Jannatifard, F., et al. (2012). Behavioral addiction versus substance addiction: Correspondence of psychiatric and psychological views. International Journal of Preventative Medicine, 3, 290-294.

Appel, J., & Kim-Appel, D. (2009). Mindfulness: Implications for substance abuse and addiction. International Journal of Mental Health Addiction, 7, 506-512.

Griffiths, M. D., (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191-197.

Griffiths, M. D., Shonin, E., & Van Gordon, W. (2015). Mindfulness as a treatment for gambling disorder. Journal of Gambling and Commercial Gaming Research, 1, 1-6.

Houlihan, S. D., & Brewer, J. A. (2015). The emerging science of mindfulness as a treatment for addiction. In: E. Y. Shonin, W. Van Gordon and M. D. Griffiths (eds.), Mindfulness and other Buddhist-derived approaches in mental health and addiction (pp. 191-210). New York: Springer.

Iskender, M., & Akin, A. (2011). Compassion and internet addiction. Turkish Online Journal of Educational Technology, 10, 215-221.

Jackson, A. C., Francis, K. L., Byrne, G., et al. (2013). Leisure substitution and problem gambling: report of a proof of concept group intervention. International Journal of Mental Health and Addiction, 11, 64–74.

Rosenberg, K. P., Carnes, P. J., & O’Connor, S. (2014). Evaluation and treatment of sex addiction. Journal of Sex and Marital Therapy, 40, 77-91.

Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014). The treatment of workaholism with Meditation Awareness Training: A Case Study. Explore: The Journal of Science and Healing, 10, 193-195.

Shonn, E., Van Gordon, W., & Griffiths, M. D. (2014). Cognitive Behavioral Therapy (CBT) and Meditation Awareness Training (MAT) for the treatment of co-occurring schizophrenia with pathological gambling: A case study. International Journal of Mental Health and Addiction, 12, 181-196.

Shonin, E., Van Gordon W., & Griffiths, M. D. (2014). Mindfulness as a treatment for behavioral addiction. Journal of Addiction Research and Therapy, 5, e122. DOI: 10.4172/2155-6105.1000e122.

Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014). Mindfulness and the social media. Journal of Mass Communication and Journalism, 2014, 4: 5, DOI: 10.4172/2165-7912.1000194.

Shonin, E., Van Gordon W., & Griffiths, M. D. (2013). Buddhist philosophy for the treatment of problem gambling. Journal of Behavioural Addictions, 2, 63-71.

Shonin, E., Van Gordon W., & Griffiths, M. D. (2013). Meditation for the treatment of addictive behaviours: Sending out an SOS. Addiction Today, March, 18-19.

Shonin, E., Van Gordon, W. & Griffiths, M. D. (2013). Mindfulness-based interventions for the treatment of problem gambling. Journal of the National Council on Problem Gambling, 16, 17-18

Sussman, S., Lisha, N. & Griffiths, M. D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.

Witkiewitz, K, Marlatt, G. A., & Walker, D. (2005). Mindfulness-based relapse prevention for alcohol and substance use disorders. Journal of Cognitive Psychotherapy, 19, 211-228.

Shonin, E., & Van Gordon, W. (2013). Searching for the present moment, Mindfulness, 5, 105-107.

Shonin, E., Van Gordon, W., Compare, A., Zangeneh, M., & Griffiths, M. D. (2015). Buddhist-derived loving-kindness and compassion meditation for the treatment of psychopathology: A systematic review. Mindfulness, 6, 1161-1180.

Van Gordon, W., Shonin, E., & Griffiths, M. (2015). Towards a second-generation of mindfulness-based interventions. Australia and New Zealand Journal of Psychiatry, 49, 591-591.

Shonin, E., Van Gordon, W., & Griffiths, M. D. (2013). Meditation as medication: Are attitudes changing? British Journal of General Practice, 63, 654.

Shonin, E., & Van Gordon, W. (2015). The lineage of mindfulness. Mindfulness, 6, 141-145.

“Keeping Your Shit Together”: A Perspective on the Buddhist Middle-Way Approach

“Keeping Your Shit Together”:

A Perspective on the Buddhist Middle-Way Approach

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Some people like fast cars, some people like fine dining, and some people like expensive clothes. Some people are partial towards liquor, some towards gambling, and some towards tobacco. Some people like men and some people like women. Some people have a penchant for extreme sports, some for hot climates, and some for partying. Some people are passionate about video games, some about film, and some about photography. Some people like technology, some like nature, and some like travelling.

Some people like some of the above, some like none of the above, and some people like all of the above. People like certain things when they are young, other things when they are middle-aged, and different things when they are older. Likewise, people like certain things in the morning, other things in the afternoon, and different things in the evening. Some people are comfortable with the fact they like some, all, or none of the above, some people are indifferent about this matter, and some people are uncomfortable or feel guilty about the things that they are partial towards.

As far as the Buddhist spiritual teachings are concerned, there are lots of different methods of relating to the various desires and partialities that we have in life. Some Buddhist paths advocate separation and renunciation from potentially desirous objects and situations. Other paths advocate being in the presence of our various desires but exercising advanced levels of mental discipline. There are also some (often misunderstood and incorrectly practised) esoteric Buddhist paths that advocate accepting and embracing one’s desires.

When correctly taught and practised, each of these approaches represent valid spiritual paths. They have their own rules, they lead to their own spiritual fruits (i.e., levels of awakening), and they are intended to suit the needs of individuals with differing degrees of spiritual capacity. Nevertheless, although the three paths referred to above appear to represent very different modes of spiritual practice, these paths often intersect and feed into each other. For example, an individual who chooses to renounce and completely separate themselves from potentially desirous objects and circumstances may reach a point in their spiritual development when they feel that in order to move forward, they need a greater level of interaction with people and phenomena (i.e., in order to ‘put their practice to the test’). Eventually, the same person might decide that in order to grow even further as a spiritual being, they have to embrace all phenomena and experiences, including those typically considered to be incompatible with a spiritual way of life.

Although there are points of intersection and convergence in the three spiritual paths outlined above, a person who embarks on a path that they are not suited for, or who switches from one path to another before they are ready, is likely to find that the path is of little benefit or that it actually does them more harm than good. In other words, there are many different ways of interacting with the objects, people, and situations that are a potential source of attraction, but in order to grow in spiritual realisation, it is vital to employ the method that is most suited to our particular stage of spiritual development.

Recently, we were giving a talk to a group of young adults from a socio-economically deprived inner-city suburb of a northern English city. The theme of the talk was the principle of the ‘middle-way’. The Buddhist teachings on the middle-way basically assert that the best way to relate to the various desires and partialities that we have in life is to do things in moderation. Too much of something is generally not good for us, and completely avoiding things can also be detrimental to our wellbeing. Following the approach of the middle-way means that we don’t take anything to extremes, but it also means that we are open to new experiences and aren’t afraid of responsibly enjoying our lives. We use the term ‘responsibly enjoying’ here because implicit within the Buddhist teachings of the middle-way, is the premise that however we decide to spend our time, nobody (including ourselves) should be hurt or taken advantage of as a result of our actions. If we keep this basic premise in mind, then the approach of the middle-way seems to provide us with a means of exploring, enjoying, and engaging with life, but without letting our mind be ‘over-run’ by the various objects and activities of our desire.

If we want to embrace spiritual living to a slightly greater extent, then in addition to ‘responsibly enjoying’ life (i.e., by making sure we don’t hurt or take advantage of anybody), we should try to undertake everything we do in a gentle and compassionate manner, and whilst maintaining meditative awareness. If we expand our understanding of the middle-way approach to embody these three basic spiritual principles (i.e., 1. Responsibly enjoying life, 2. Being gentle and compassionate, and 3. Cultivating meditative awareness), then the middle-way philosophy becomes a practical, effective, and expedient means of fostering spiritual growth.

In terms of where the middle-way approach fits within the schema of the three Buddhist paths referred to earlier (i.e., the paths of relating to potentially desirous objects and situations via: 1. Renunciation and separation, 2. Applying advanced mental discipline, or 3. Acceptance and embracing), it could be said that the middle-way teachings apply to each of these different paths. For example, if a person is practising the path of renunciation and separation, then there is a ‘middle-way’ philosophy that they can apply to that path (i.e., by moderating the degree to which they cut themselves off from the world around them). Likewise, if a person chooses to engage with potentially desirous objects by either applying advanced levels of mental discipline or by meditatively accepting and embracing them, then there is a corresponding middle-way approach towards relating to and following each these paths. Thus, whichever spiritual path we choose to adopt, the teachings and approach of the middle-way remain valid.

The above discussion concerning the middle-way teachings and how they relate to different types of spiritual path was basically the subject of the talk that we mentioned above, which was given to a group of approximately 35 young adults. At the end of the talk, the floor was opened to questions and comments. At this point, a young lady who was about 20-years-old stood up and commented as follows:

What you are saying is that as far as Buddhism is concerned, life is basically about keeping your shit together. If you keep your shit together, then so long as you are not hurting anybody, you are free to thoroughly enjoy life. It’s when your shit falls apart and you take things too far that trouble starts. Based on what I’ve understood, it seems that you are also saying that if you manage to keep your shit together and be a kind person at the same time, then that’s even better. I think I can do that. It sounds like common sense to me.

After the talk, we spoke briefly with the young lady and informed her that we liked her comment and thought she had provided some sound words of advice. We asked for her permission (which she kindly provided) to make use of her advice in some of our writing projects. We don’t really consider ourselves to be particularly up-to-date with modern phrases or expressions, but based on our understanding, it appears that an aspect of the meaning of the Buddhist middle-way teachings is captured by the expression ‘keep your shit together’.

In terms of giving some examples of what ‘keeping your shit together’ means in practice, we would say that if you like gambling or alcohol, then by all means enjoy placing a few bets or having a few drinks. However, if you bet to the point of bankruptcy or if you drink yourself into a state of severe inebriation on a daily basis, then it probably means that you are not ‘keeping your shit together’. The same applies to all of the other things mentioned at the start of this post. It is good to responsibly enjoy some of the things that we are partial towards, but if we take things too far (in either direction), then there are likely to be negative consequences.

In terms of the things in life that we are partial towards, people have different levels of tolerance. Therefore, it is up to us as individuals to work out what constitutes a middle-way between extremes, and what amounts to not keeping ourselves together. Similarly, in light of the fact that people have different tolerance levels, it is also important that we don’t judge people by projecting our own ideas of what is right and wrong onto them. What amounts to not keeping it together for one person, might constitute a middle-way approach for somebody else. In other words, if we try too hard not to ‘lose our shit’, and get all haughty and wound up when we deem that others have lost theirs, then this might actually mean that we have ‘allowed our shit to fly all over the place’.

Ven Edo Shonin & Ven William Van Gordon

Deconstructing the Self: A Buddhist perspective on addiction and psychotherapeutic treatment

Deconstructing the Self:

A Buddhist perspective on addiction and psychotherapeutic treatment

(By Ven. Edo Shonin, Ven. William Van Gordon, and Dr. Mark Griffiths)

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Psychological approaches to treating mental illness or improving psychological wellbeing are invariably based on the explicit or implicit acceptance that there is an inherently existing ‘self’ or ‘I’ entity. In other words, irrespective of whether a cognitive-behavioural, psychodynamic, or humanistic psychotherapy model is employed, these approaches are ultimately concerned with changing how the ‘I’ relates to its thoughts, feelings, and beliefs, and/or to its physical, social, and spiritual environment. Although each of these psychotherapeutic modalities have been shown to have utility for improving psychological health, there are inevitably limitations to their effectiveness and there will always be those individuals for whom they are incompatible. Given such limitations, research continuously attempts to identify and empirically validate more effective, acceptable and/or diverse treatment approaches. One such approach gaining momentum is the use of techniques that derive from Buddhist contemplative practice. Although mindfulness is arguably the most popular and empirically researched example, there is also growing interest into the psychotherapeutic applications of Buddhism’s ‘non-self’ ontological standpoint (in which ontology is basically the philosophical study of the nature or essence of being, existence, or reality).

Within Buddhism, the term ‘non-self’ refers to the realisation that the ‘self’ or the ‘I’ is absent of intrinsic existence (Shonin, Van Gordon, & Griffiths, 2014a). On first inspection, this might seem to be a somewhat abstract concept but it is actually common sense and the principle of ‘non-self’ is universal in its application. For example, Buddhism teaches that the human body comprises the five elements of water, wind (i.e., air), earth (i.e., food), sun (i.e., heat/energy), and space (i.e., in the bodily cavities and between molecules, etc.) (Shonin et al., 2014a). This means that although the body exists in the relative sense, it does not exist in the absolute sense because the body cannot be isolated from all of its contributing causes. Just as a wave does not exist in separation from the ocean, the body does not exist in separation from all other phenomena. According to the Buddhist teachings, when looking at the body, we should also be able to see the trees, plants, animals, clouds, oceans, planets, and so forth (Shonin et al., 2014a). Thus, the body, and indeed the entire array of animate and inanimate phenomena that we know of, cannot be found to exist intrinsically or independently.

The Buddhist teachings go on to assert that suffering, including the entire spectrum of distressing emotions and psychopathologic states (including ‘addiction’), results from adhering to a false view about the ultimate manner in which the self (and reality more generally) exists. As a means of operationalising this notion within Western psychological and clinical domains, we recently introduced the concept of ‘ontological addiction’. Ontological addiction can effectively be considered a new category of addiction (i.e., in addition to what are typically called chemical addictions and behavioural addictions) and is defined as “the unwillingness to relinquish an erroneous and deep-rooted belief in an inherently existing ‘self’ or ‘I’ as well as the ‘impaired functionality’ that arises from such a belief” (Shonin, Van Gordon, & Griffiths, 2013, p.64). Due to a firmly-embedded (yet scientifically and logically implausible) belief that the self is an inherent and independently existing entity, Buddhism asserts that afflictive mental states arise as a result of the imputed ‘self’ incessantly craving after objects it considers to be attractive or harbouring aversion towards objects it considers to be unattractive (Shonin et al., 2014a).

In Buddhist terminology, this process is known as ‘attachment’ and it is deemed to be an undesirable quality that reinforces ontological addiction.  We have previously defined attachment as “the over-allocation of cognitive and emotional resources towards a particular object, construct, or idea to the extent that the object is assigned an attractive quality that is unrealistic and that exceeds its intrinsic worth” (Shonin et al., 2014a, p.4). Thus, attachment takes on a different meaning in Buddhism in relation to its construction in Western psychology where attachment (i.e., in the context of relationships) is generally considered to exert a protective influence over psychopathology.

Having understood from a Buddhist perspective that attachment (and harbouring an erroneous belief in an inherently existing self) is not advisable for adaptive psycho-spiritual functioning, Buddhism teaches that the next step towards recovery from ontological addiction is to embrace ‘non-self’ and begin deconstructing our mistaken belief regarding the existence of an ‘I’. Based on this Buddhist approach, a number of novel psychotherapeutic techniques have recently been developed that integrate meditative practices aimed at cultivating an understanding of the ‘non-self’ construct. For example, Buddhist Group Therapy (BGT) is a six-week program that has been shown to be effective for treating anxiety and depression (Rungreangkulkij, Wongtakee, & Thongyot, 2011). Another example is Meditation Awareness Training (MAT), an eight-week secular program that, in a number of separately published studies, has been shown to be an effective treatment for individuals with anxiety and depression, schizophrenia, pathological gambling, workaholism, work-related stress, and fibromyalgia (e.g., see reviews by Shonin et al., 2013, 2014a, 2014b).

From a mechanistic point of view, greater awareness of ‘non-self’ is believed to assist in gradually uprooting egoistic core beliefs and can complement therapeutic techniques that work at the surface level of behaviour and cognition (Chan, 2008). Furthermore, an understanding of non-self can enhance therapeutic core conditions because “the more the therapist understands non-self, the less likelihood that the therapy will be about the selfhood of the therapist” (Segall, 2003, p.173).

For some, Buddhist concepts such as non-self may be difficult to conceptually grasp and reflect what might be seen as a paradigm shift when compared with well-established Western psychological beliefs regarding the ego and the self. As such, psychotherapists will carefully need to assess the suitability of utilising ‘non-self’ meditative techniques for their own clients. Although further empirical evaluation of these new approaches is required, preliminary findings indicate that techniques aimed at cultivating an awareness of the Buddhist ‘non-self’ construct may have applications in psychotherapy settings.

Ven. Edo Shonin, Ven. William Van Gordon, and Dr. Mark Griffiths

References

Chan, W. S. (2008). Psychological attachment, no-self and Chan Buddhist mind therapy. Contemporary Buddhism, 9, 253-264.

Rungreangkulkij, S., Wongtakee, W., & Thongyot, S. (2011). Buddhist Group Therapy for diabetes patients with depressive symptoms. Archives of Psychiatric Nursing, 25, 195-205.

Segall, S. R. (2003). Psychotherapy practice as Buddhist practice. In S. R. Segall (Ed.), Encountering Buddhism: Western Psychology and Buddhist Teachings (pp. 165-178). New York: State University of New York Press.

Shonin, E., Van Gordon W., & Griffiths, M. D. (2013). Buddhist philosophy for the treatment of problem gambling. Journal of Behavioural Addictions, 2, 63-71.

Shonin, E., Van Gordon W., & Griffiths, M. D. (2014a). The emerging role of Buddhism in clinical psychology: Towards effective integration. Psychology of Religion and Spirituality, doi: 10.1037/a0035859.

Shonin, E., Van Gordon W., & Griffiths, M. D. (2014b). Mindfulness as a treatment for behavioral addiction. Journal of Addiction Research and Therapy, 5, e122. doi: 10.4172/2155-6105.1000e122.