Episode 44: How to Overcome Your Cravings Using Mindfulness Episode 44

Episode 44: How to Overcome Your Cravings Using Mindfulness

(Disclaimer: This transcript was created using AI technology. Please excuse any errors).

Music 0:00

Welcome to the Atheists in Recovery Podcast, where we talk about finding hope in recovery.

And now your host, Dr. Adina Silvestri,

Adina Silvestri 0:11

Hello Atheists in Recovery land and welcome to Episode 44 of the Atheists in Recovery podcast. And this episode continues with our four part series of recovery under quarantine. And I have to admit, for today's episode, I geeked out just a little bit. Um, so our guest today specializes in working with mindfulness as it relates to addiction cravings, and relapse prevention, among other things. And I'll get to that in a minute. But I think that you're going to enjoy this episode. I feel like mindfulness if you don't have a practice after listening to this episode You might change that you might begin to think that this is something that can really help in my addiction recovery. That's the hope anyway. And so under our guest, Dr. David Eddie. Dr. David Eddie is a research scientists at Massachusetts General Hospital's recovery Research Institute and Center for Addiction Medicine, a clinical psychologist at Massachusetts General Hospital's Department of Psychiatry, and an instructor at Harvard Medical School. His current research supported by NIAAA and

NIDA is seeking to better understand effective and psycho physiological factors that both heighten addiction relapse risk as well as support addiction recovery. Additionally, Dr. Eddie conducts research aimed at developing mobile health interventions driven by smartphone applications and wearable biosensors. Okay guys, let's get started. Dr. David Eddie, welcome to the show.

Dr. David Eddie 1:58

Pleasure to be here.

Adina Silvestri 1:59

So tell me A little bit more about your spiritual background from childhood, something that I ask all my guests.

Dr. David Eddie 2:09

Sure, sure. I grew up in a agnostic home, I think it would be safe to say, well, maybe that was an atheist. My mom was an agnostic. Though I was schooled in a Christian tradition, I really didn't identify with any particular religion, faith or spiritual path. As a child, I didn't have a sense of spiritual connectedness to something in the universe, I wouldn't have been able to identify that and I didn't have a formal religious practice. Fast forward to my mid 20s. I'm living in San Francisco, and I start to develop an interest in meditation. And I, at that time, wanted to explore different meditation paths. And so I did a little tour of San Francisco and different meditation centers and I explored a lot of different avenues and eventually came to the Zen center. And it was really one of those, like a clarity really, when I remember walking in there and it was fairly sparse, very beautiful space, but very sparse. And I just felt very at peace, in that Zen center. And something inside of me said, this is the path. This is the place to start. And so I started attending walk in Zazen sessions that they would hold their each evening for the public, you could come in and meditate with the resident monks and the abbot.

Adina Silvestri 3:34


Dr. David Eddie 3:34

And that's really that's really where my meditation practice started in the Zen tradition, and I really grow into Zen practice and, and I consider myself a Zen Buddhist now.

Adina Silvestri 3:44

Wow, that's so interesting. And so I'm sure that has informed. Much of the work that you do right now. I was wondering if you could tell the listeners a little bit a little bit about what you do and your research focus.

Dr. David Eddie 3:58

Yeah, sure I'm a clinical psychologist at Massachusetts General Hospital and Harvard Medical School. I'm a part time clinician working at our adult outpatient addiction program called the western clinic. And part of the time, I'm also working as a researcher in the recovery Research Institute at Mass General Hospital and also the Center for Addiction Medicine, where I study both antecedents of addiction and how people come to be addicted. And also, I'm interested in developing novel treatments for substance use disorders. And I'm particularly interested in brain body communication, and psychophysiology. And how psychological phenomenon manifests in the body and how phenomena matter arising in the body can affect the brain and how this relates to substance use disorder, both in terms of how people come to develop the disorder and also how people can recover so I do a lot of technology based research. Now using aps ambulatory psychophysiological monitors and medullary heart rate monitors, for instance. So I can monitor people in real time. I use a lot of apps. And I'm currently putting together some projects working with Primary Care Medicine at Mass General Hospital, one of the things I'm really interested in doing is expanding the scope of addictions treatment, or the bread, so that more people have access to care. I feel like so many folks miss out on solid addiction treatment, because we insist everybody needs to go to a specialized addiction care. And that's not an option for everybody that they can't afford it or they can't take the time off work or they've got kids at home and they just can't go away for four weeks to an addiction treatment program not not to minimize the utility of those programs they're important. You need those. And at the same time, you know, a lot of people come to treatment through their primary care doctor, and I think we need to be doing better in terms of meeting patients where they're at providing care where the patient's at rather than insisting on them coming to us. And so that's that's a little bit about what I've been working on now.

Adina Silvestri 6:07

Yeah, I love that just having different pathways to recovery and making it so that, you know, everybody has these options available to them and in reducing those barriers for access to accessed access to treatment. Yeah. So I wanted you on because you know, your your work is so interesting. And I think, and I know at a time like this, where there's so much uncertainty in the world, mindfulness is what I've been leaning on, personally and professionally. And I thought you would be a great person to talk a little bit more about, you know, maybe what mindfulness is, and mindfulness based interventions, and how they can be used to help with relapse prevention and maybe even cravings. So a couple questions in there.

Dr. David Eddie 6:56

Yeah, yeah, sure. So broadly speaking, I met psychotherapist working primarily in cognitive behavioral therapy and dialectical behavior therapy modalities. And both of these approaches, though, they're very, very similar in a lot of ways, but maybe I'll focus on how DBT understands mindfulness, because I think that's probably most instructive. For our conversation today. dialectical behavior therapy was a treatment that was developed for people who experienced profound problems regulating their emotions, particularly folks with condition, very serious condition called borderline personality disorder. Although we've expanded DBT to many, many other conditions and presentations, we actually have pretty good evidence that it's helpful for addiction as well. And DBT pulls in a lot of the change based strategies of cognitive behavioral therapy. So we're working on changing thoughts and feelings and patterns of behavior. So these are changes initiated by the individual with the help of a provider Now, the counterpoint to that is mindfulness or acceptance based strategies. So the reality is life will often present us with problems that require a change based solution. But sometimes life presents us with problems which we have very little control over. We can't change at least we can't change them in the moment. And so trying to use a change based strategy or tool for a problem that we have no ability to change is futile. And really suffering arises out of that, because we just end up spinning our wheels. And so often in life, were presented with these problems that we really can't control like Coronavirus. And yet at the same time, we try and apply change based strategies or solutions, which are in evitably gonna fail. And that gives rise to frustration, further anxiety and as you can imagine, we can get into a vicious cycle of suffering rather, what's dialectical behavior therapy says, Well, if you can't change the situation, maybe you need to bring an acceptance base position to that or strategy. And I always think of the Serenity Prayer, which is a famous prayer, really, from made famous by 12 step programs, they often say the beginning or end of meeting, and essentially the Serenity Prayer says, you know, grant me the serenity, to accept the things I cannot change, change the things I can and have the wisdom to know the difference. And that's really what we're going for. In dialectical behavior therapy, we want to learn to identify, notice a change based situation, or a situation calling for change based strategy, or is really acceptance, the crucial thing here, and it's really important and often go to great lengths to explain to my patients that radically accepting things as they are doesn't mean we have to like them.

Adina Silvestri 9:56


Dr. David Eddie 9:56

it doesn't mean we have to like them at all bad things happen. The reality is here and refusing to accept that here is going to give rise to suffering. This idea that pain or certain amount of pain is inevitable in life. But suffering arises out of refusing to accept the pain is inevitable. And that's where a lot of people get stuck. And so accepting reality, accepting things as they are, even though we might not necessarily like it is really, really important. And mindfulness really is the tool that helps us, I think, identify or understand whether something is whether a situation really calls for change, or acceptance.

Adina Silvestri 10:40

Yeah, I love that radically accepting things doesn't mean we have to agree with them. Yeah,

Dr. David Eddie 10:47

exactly. Yeah, exactly. We're not endorsing them, endorsing bad actors, bad behaviors or crises in arising in the wall or outside of people's control. Not at all. At the same time that they're here, and you know, we can make ourselves really pretty miserable, refusing to accept that reality that has to be accepted so we can move on to work on the stuff we can control.

Adina Silvestri 11:14

Yeah, thank you for that. So as we look at mindfulness, and this radical acceptance of things that we have no control over. How does that help with addiction?

Dr. David Eddie 11:26

Great question.

Adina Silvestri 11:27


Dr. David Eddie 11:28

Right. So

So if we've got change based strategies and acceptance based strategies, where does mindfulness sit in that? And how can I help us now? Big Questions. So I like to use mindfulness in my clinical practice, really, as a first step, as a tool to help people step back from situations step back from whatever is arising in the moment thoughts, feelings, behaviors that are engaging and to just simply observe, to be able to observe and describe What's arising in that moment, so that we are less reactive to what's arising. Often we get into trouble, especially in addiction, we react to thoughts or feelings or stresses that are arising in our body, we feel anxiety. And often the action is for somebody with a drinking problem, who's in an early recovery to drink?

Adina Silvestri 12:22


Dr. David Eddie 12:22

because that's how they got relief. And you could insert any drug or really any other problematic behavior. Ultimately, we use substances and engage in other addictive behaviors, to manage negative affect, sometimes to try and boost positive affect. So it serves a function in our lives. So it's not surprising that folks with addiction have very hardwired associations between affective states like anxiety, and reflexes to pick up substances because that's just primal brain, the limbic system, the lizard things figured out, you know, that's what works. And so it's very reflect these kinds of lapses are often very reflexive behaviors. And almost always there's some kind of trigger in the environment or in the individual and emotional trigger thoughts, or memory, remorse, regrets, that give rise to substance use. And so mindfulness really allows us to step back from that and say, Whoa, whoa, I'm noticing anxiety. I'm noticing stress, i'm noticing tension in my body. I'm also sensing a really strong desire to go and get a drink and was about and if we can step back from that, so rather than being in it and sucked into the vortex, where it's like, feeling, behavior, you know, where the feeling arises, and bamb we're straight into the behavior we don't want to be doing. Mindfulness allows us to step back and say, Okay, I'm noticing feelings arising I could drink. Option. I would feel better for a few minutes, I get a bit of relief. And at the same time, I know I'd probably feel miserable the next day and I'd be back out and the more I drank, I didn't stop for three days, you know, playing the tape. What am I going to do instead? So mindfulness really buys us some time gives us some space. So instead of having, instead of reacting to the feeling or the thought, we can respond in a way that's in line with our best interests and our goals.

Adina Silvestri 14:29

Yeah, that's, that's really good. And I think, too, I've noticed that there needs to be and correct me if I'm wrong, but there needs to be a practice involved with this. I know for the guys that I see, in my practice, we talk about mindfulness more now than ever. And they just kind of look at me and say, Well, yeah, you know, I'll try it. You know, what is it again, tell me that app. And then it kind of goes by the wayside again, and I'm wondering if there's If there's a way, right, selfishly, I'm like asking you, how do I give them some data, some hard data that says, This is how it's going to help with cravings? You know, this, it says, you know, it's not just just sort of woowoo learning. Yeah.

Dr. David Eddie 15:20

I gave a talk at the American Psychological Association conference last year about mindfulness. And I was discussing on the symposium. And, and and that was, you know, my point, you know, was really, you know, mindfulness is an incredibly powerful tool. And at the same time, is, I think we've all got a bit of mindfulness fatigue. It's like it's on every magazine cover, and it's busy and self help books. And it's starting to feel where it has been feeling for a while, like a bit of a but but, you know, let me tell you, it's not I mean, the idea of mindfulness awareness has been around for millennia. It comes out of the Zen tradition, which is at least 2000 years old, and so mindfulness has been around for a long, long time. And somebody by the name of Jon Kabat-Zinn of U Mass Medical Center really brought this into the western sphere. He was a clinician, a clinical psychologist. And he really introduced the idea that we could use mindfulness in clinical practice as an acceptance based strategy. And so he developed Mindfulness Based Stress Reduction, which is an eight session group course, which is very, very pragmatic and skills based. And then that morphed, and somebody said Zindel Segal. at the University of Toronto, and a few other people who are you know, what this is dynamite stuff is Mindfulness Based Stress Reduction, really is helping people they've been a few clinical trials at that point in the early 90s. Now, I wonder if we could use mindfulness to help people notice the early warning signs of a depression relapse, so people with major depressive disorder are much more vulnerable than the general population to have relapses to depression. People with addiction are always vulnerable for relapse to substance use. So he thought, wow, I wonder I wonder if we could boost people's mindful awareness, maybe they would start to notice the early warning signs or return to depression. And they could take evasive maneuvers to avoid that happening. And interestingly, they did a clinical trial. And it didn't work. didn't work very well at all. And they went back to Jon Kabat Zinn, they said, like, your intervention clearly seems to do pretty well. And clinical trials, we just taken your playbook and you know, changed a few things. And but, you know, we didn't get positive results in our first clinical trial. And he said, Well, who's teaching it? And I said, Well, we you know, we trained some grad students and some some postdocs and, you know, clinical psychologists to deliver this intervention. And he said, Well, do they have a mindfulness of their own?

Adina Silvestri 17:57


Dr. David Eddie 17:58

no. They're you know they're clinicians in training but but they're very skillful. You know, they know a lot about the mind and and, you know, a treatment and, and psychological problems and he said well, why don't you, why don't you send all your, your research staff to mindfulness retreat and help them cultivate a mindfulness practice, and then go and redo your clinical trial, with practitioners delivering, delivering. And sure enough, they did that and they got positive results, they saw significant improvements in patient presentation. And I guess the reason I'm telling you this is because it's important that we practice what we preach as providers, but also, this is it's a practice. It's not something you can just will your way into. You can't just decide to be more mindful, you can't, as I'm making a gym analogy, you can't just decide to be more fit and have better muscle tone and better stamina. You've got to go to the Gym. You've got to walk, walk the talk, so to speak, you've got to go through the practice. And mindfulness is really the same. And that's, that's actually good news because it means there's no no thing we need to figure out. There's no great state, we have to find through deep meditation. We don't have to follow practice through a religious tradition, like zen, but that can be very helpful for folks. It's really about doing and from doing taking the action. By practicing mindfulness, the mind follows and becomes more mindful, just in the same way. If we're going to the gym regularly, the muscles follow from that, and our cardiovascular system improves and we have better stamina, better capacity to buffer stress, it's the same thing. And so in mindfulness practice, when we're trying to cultivate mindfulness practices, we start folks with very simple exercises. And this is all those eight week courses in mindfulness based Stress Reduction and mindfulness based depression. relapse prevention says all they're doing is walking people through a series of mindfulness exercises, there's actually very little thought involved. It's very action based. And so usually we start by doing what we call the raisin exercise, we, you know, we take about 20 minutes to eat a raisin, it sounds kind of absurd. And it feels a bit absurd while we're doing it. But we really, we pick up a raisin, and you know, we encourage people in the group to explore the rainsin, you know, feel it in the texture in your fingers, like really look at it as if you were just had been beamed down from another planet had never seen a reason before you didn't even know what to do with this thing, and really slowing things down. And from that, we started to cultivate a practice of mindfulness. And if we do one thing mindfully, a day like wash the dishes mindfully like really attending to the sensations, the sights, the sounds, the smells, the texture, of washing the dishes, or eating a meal. That's where it mindfulness practice begins and there's guided meditations as well are really helpful. The University of California, San Diego has a great mindfulness Institute with an awesome website with dozens of free mp3 so you can play through the net. And you know, there's guided mindfulness meditations from 10 to 40 minutes. And so that's really helpful as well, but we can do anything mindfully. So it's really about making a decision to jump into this practice. And from that, we start to notice that when we are stressed, or when we are experiencing craving, rather than jumping in bed with the experience of craving, and getting wrapped up in and tangled up in it, because you know, craving is like a vicious cycle. It starts small, and then we thinking about it, thinking about it some more and it gets getting bigger, and that's super uncomfortable and our heart rates going up and our blood pressure is rising. And before we know it, we're completely overwhelmed by it. Well, if we're practicing mindfulness every day when those Feelings of craving arise, we often find that we can step back from them and observe them, we don't have to react to them, we can just step back and respond. And so this this is how cultivating a daily mindfulness practice can really help at a fundamental level with craving. And in fact, there's a there's a great craving management exercise that we use, called urge surfing. And urge surfing really involves, it's a guided imagery meditation where we imagine ourselves closing our eyes riding the wave of craving. So we imagine ourselves literally surfing on a big wave, and we imagine a wave coming in through the set and we come to the top of the wave and the wave is our craving. And we we ride the top of the way we just riding it and riding it and riding it, as long as the cravings last and then noticing how, as is the case for waves which eventually run their course crash on the shore and cease to exist. So it's true for craving as well as cravings impermanent. It's temporary. It's a temporary state like it's a temporary phenomenon, like a wave. And so we imagine ourselves riding the wave of craving, and just noticing the wave petering out. And we can do this, you know, we can do this, we can manage the craving, we can ride it out, we can let it run it's course. And if we do that consistently, craving start to become less intense and less frequent, because we're not fueling them. You know, we're not we're not throwing gasoline on the fire.

Adina Silvestri 23:37

Yeah, I like that. I like the wave imagery, for sure. I'm wondering, now if you could talk a little bit about maybe the brain mechanisms behind mindfulness. I'm just looking for more data. You know, because the addiction high hijacks, right the orbital frontal cortex and among other things, and so, yeah,

Dr. David Eddie 24:04

yeah, so full disclosure, I'm not super well read on the fMRI literature on mindfulness based interventions. But this is really clear. And this is this is being shown over and over again, meditation changes the mind, it fundamentally changes the mind, not necessarily the gross morphology, the mind, that means the structure of the brain doesn't necessarily change. So that if you look at a brain scan and MRI of somebody at baseline, and then after a year of meditation, the brain is gonna look structurally the same. But what you don't get in those images is the complex connectivity between brain cells, neurons, and pathways between sections of the brain that communicate with one another, that are constantly being rewired. And you're absolutely right addiction hijacks the reward centers of the brain and essentially lays down Strong associations between thoughts, feelings, and actions like substance use. And so there's all kinds of complex neurological phenomenon arising as a function of addiction that helped in the development of addiction, but also causes it to be sustained. And so what we can do in meditation practice, and in cognitive behavioral therapy, dialectical behavior therapy as well that they also change the brain. We actually, by changing our thoughts and behaviors and our actions, we start to lay down new tracks in the brain for new associations. Now you can understand that about we're talking sort of at the level of the mind, like when we say, when I talk about an association I have, that's a very ephemeral thing. I think about things in conscious awareness to my brain, but that has a physiological underpinning, right? I mean, behind all that, even though we don't really understand It is a bunch of neurotransmitters, neurons, glial cells, axons, dendrites, like there's an apparatus here. It's like a very sophisticated apparatus. So when we change our thoughts, we change our behaviors. We lay down new pathways in the brain. And that's the amazing thing about the human brain. Even when we've done quite a lot of damage to it, through addiction, it has still has a remarkable ability to lay down new tracks to change connections, and historically. You know, folks in long term, you know, especially with alcohol use disorder, we do lose some of our brain because substances, like alcohol are incredibly neurotoxic. The amazing thing is unless you've really gone down that path, it's amazing how the brain can bounce back. And anybody who's had some time in addiction recovery can tell you, you know, the first six months to a year can be pretty rocky People often don't feel on the beam for a while. But eventually they do. And that's really because the brains repairing itself. So it's reestablishing its own equilibrium. And so mindfulness meditation as a way of not just calming the ephemeral mind, but also changing connectivity in the brain between brain regions. And we know we know that metta, the act of meditation activates certain brain area, and it reduces the intensity of neurological firing in others, right? So it can reduce the activity in the centers of the brain that are regulating more impulsive, Primal behaviors, like you know, wanting to eat everything inside or you know, sleep with everybody or you know, drink you know drink a bottle of wine, right? So we can actually turn down those centers of the brain a little bit and help to ramp up activity in areas of the brain that are going to inhibit those kinds of behaviors or help us make better decisions that are in line with how we want to live and where we want to be.

Adina Silvestri 28:03

So you sent me a good deal of literature before our talk. Thank you. And, and I was reading a lot about sort of updating the reward values. And so, you know, it sort of is in line with what you're saying about laying down these new associations. And I'm wondering if you could talk a little bit about that. So, you know, these associations that we had from childhood maybe that you know, sugar was so pleasant, it was great. When I was five, I ate lots of cake, and I I'm wonderful. And now I eat a ton of sugar and I crash. And so I feel like mindfulness can be used in that way maybe to like, test those old reward values. Is this really relevant to me now?

Dr. David Eddie 28:53

Yeah, I mean, that's such an important point. And we mentioned before the addiction is a process where substance use Really hijacks the reward centers of the brain. So alcohol, cocaine, amphetamines, you name it opioids, all these substances have powerful activators of the dopaminergic reward system in the brain. So we get dopaminergic release. That's the reward feeling, if you will, from all kinds of pleasurable activities. And it makes sense, we've evolved with this capacity because it helps orient us or encouraged us to engage in behaviors that are frankly going to keep us and our species alive. So finding shelter when we're cold cold, by finding warmth when we're cold, eating when we're hungry. These kinds of behaviors are reinforced at a neurological level. And so we're much more likely to repeat them sugar, so sugar is a good one. When you think about our ancestors, primates wouldn't have had access to candy bars, obviously. But at the same time, you know, sugar That environment would have conferred a lot of survival benefits. So we're wired to seek out sugar. And now we just have too much access to sugar. Right. And we have too much access, probably to food. And And importantly, we have access to drugs, alcohol and other drugs, which are so rewarding, they can generate so much dopamine release on the level of 100 times the kind of dogmatic release you would get from perhaps eating something nice having a little bit of sugar. And so that's incredibly rewarding. And what happens is that knocks off the equilibrium of the reward system, and so that it's hard to be rewarded or feel rewarded by other activities. And people will often say an addiction, though they used to have hobbies and interests like that stuff just doesn't interest them anymore. I remember once my patient of mine was telling me, he was feeling awfully, he was in a very early recovery and you know, essentially his reward systems were still hijacked by the drugs and, and he was playing with his kids. And he, you know, he just felt nothing. He felt an emptiness and he knew he loved his kids so much. And he knew he should, you know, once that would have been like just the greatest feeling. And he wasn't feeling anything. And he really felt like there was something wrong with him like it would have been commonly broken. And we, we had a talk about reward systems. And the reality is, it's understandable, given you know, his heavy substance use for a period leading up to that point in time that you know, the solid stuff by playing with his kids or even having something good to eat is not going to reward him in the same way. Because his system his brain systems have been recalibrated to tolerate an onslaught of massive amounts of dopamine. The brain actually takes evasive maneuvers in a neurological level to protect itself from being overheated. It's just a very physiological level. The brain makes fundamental changes. And when you suddenly stop substance use, everything's out of whack. And it's going to take some time for those rewards systems to reregulate. And you know, that's the great thing about recovery is everybody says, at some point, they regain interest in those sorts of things. They enjoy playing with their kids again, they like being around people again, you know, can really get into good food again, gardening and other hobbies. And so, so that stuff comes back, but it can take a while. And so we where does mindfulness sit with that? Well, I think mindfulness can help us ride some of those experiences out and help us manage craving because we can step back from it. It can help us manage the discomfort of early recovery, of not being terribly rewarding, of you know, feeling like nothing's gonna really do it for you ever again. Yeah, you know, I mean, that's a that's a bleak feeling. And I think I think we can bring mindfulness to bear Get through some of those low spots.

Adina Silvestri 33:02

Yeah. Thank you for that. So as we, as we kind of wrap up today, any final thoughts for our listeners that especially the ones that are recovering under quarantine? Yeah,

Dr. David Eddie 33:18

yeah, I mean, a couple thoughts. Firstly, I wanted to just put in a plug for mindfulness based relapse prevention, which is a an eight session program, which came out of Mindfulness Based Stress Reduction that I spoke about earlier. So they did they, you know, started with stress reduction, then they did one for depression. And then in the late 90s, some folks at the University of Washington, Sarah Vaughn, Alan Marlatt, Kay Lewis and a few other people said, you know what this is this stuff's dynamite. Like, why aren't we using this for Addiction Recovery? Like it just makes so much sense because addiction is all about reactivity and impulsivity and like, this is a perfect fit. And so they adapted it Again, they essentially took the Mindfulness Based Stress Reduction playbook and modified it, they included strategies like the urge surfing exercise, and that's now, you know, solid evidence base, relapse prevention intervention. It's not designed as an upfront treatment, but rather is designed to help people recognize the early warning signs of relapse risk, so they can mitigate those risks. At the same time, I think more and more we find ourselves using these kinds of mindful strategies in active treatment as well. When people are in very, very early recovery or even just trying to get into recovery, I think there's a place for them. There's a place for mindfulness across the continuum of addiction recovery. So that's right, if you can, if you can get in on one of those courses, or eight sessions that are taught in groups. Most major cities are going to have somebody in private practice or at a hospital doing a mindfulness based relapse prevention group. So firstly a plug there with, you know, regarding the shelter in place. We're currently on the for the Coronavirus crisis. You know, it sounds sounds kind of trite, doesn't it, but we need to take care of ourselves, we just absolutely have to. And one of the ways, you know, one of the one of the ways we can do that, is in cultivating a mindfulness practice, you need to eat well, we did get a bit of exercise, somehow we need to probably do a lot of things to take care of ourselves in these challenging times, especially for those in addiction recovery or seeking Addiction Recovery because there's a whole nother layer of vulnerability when things go off the rails really off the rails in addiction recovery, you know, the risk of returning to substance you want that proposition? so, so important, folks in recovery, are vigilant about their recovery and taking care of themselves as best they can. And, you know, I think there's a silver lining here, you know, yeah, we're shuttered up and we're practicing physical distancing. You know, I prefer to say physical distance in So, I think we need to be socially close, but physically a little distant. And what an opportunity to start the cultivate a mindfulness practice. You know, this is how we can practice mindfulness. Anytime, anywhere, any activity can be done mindfully, we can go for a mindful walk,

Adina Silvestri 36:18

I was gonna say like a mindful walk.

Dr. David Eddie 36:20

I'm mindful walk. We could do a tour around the house mindfully. We could do a mindful meditation, even just a five or 10 minute one. There's so much out there now. You know, on YouTube, and there's so many videos I usually encourage people to go towards the mindfulness Institute's like the University of California, San Diego University of Washington and UMass Medical School have great mindfulness Institute's and resources on their website. I just feel you're less likely to have somebody trying to sell you a weight loss diet pill, you know if you're getting your mindfulness meditations from these sources, but YouTube's fine as well. But you know what an opportunity to start to cultivate a practice, you know whether whether we're in week one of recovery or, you know, week, 500 and one, we've got some downtime I know at least a lot of us do, and perhaps perhaps something good that's going to come out of this way that we were able to cultivate a new practice that's going to benefit us in remarkable ways.

Adina Silvestri 37:26

David, thank you so much for being on today.

Dr. David Eddie 37:29

My pleasure.

Adina Silvestri 37:30

What are some ways that people can find you on the on

the social?

Dr. David Eddie 37:34

Yes, absolutely. People can reach out but my email address, if I want to get in contact by email is d [email protected] That's D E D D I E @ And also, I'm on Twitter at David Eddie, PhD.

Adina Silvestri 37:54

All right. Well, thank you again, so much for being on.

Dr. David Eddie 37:56

My pleasure. Thanks so much for having me.

Music 37:59

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Welcome to today’s show!



  • Dr. Eddie’s path that led to his practice as a Zen Buddhist
  • Why he feels so many people miss out on addiction treatment due to not being able to afford specialized care and what he’s working on to change that
  • Why change based tools (like certain therapies) tend to not work and how acceptance based strategies (e.g.serenity prayer) can work in a world where we have problems we can’t simply change
  • Why lapses or relapses are reflective behaviors and how mindfulness can help
  • How we can use Mindfulness based stress reduction to overcome the experience of craving
  • What is Urge Surfing and how does it help with cravings
  • How Mindfulness changes the mind (not the physical structure) and lays down new tracks in the brain for new associations and to ramp up areas that will inhibit using drugs
  • How Mindfulness can help with changing our reward values and dopaminergic reward system
  • Why it’s important to start a mindfulness practice in these challenging times
  • What Dr. Eddie’s message is to the A.I.R. community







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