Buddhist cosmology describes addiction as the “land of the hungry ghost’, where people have huge appetites
that are unable to be quenched or satisfied. Buddhism describes addiction as a “false refuge”, a delusional place
to try to hide and escape from being present, with both the good and the bad in life. Dharma (Buddhist teachings)
describes addiction as the inability to see or have gratitude for the joy and abundance in our everyday lives.
Alcohol/drug relapse has traditionally been met with confrontation, shame, criticism, and self-hatred. Getting
sober is not the hard part, staying sober is. Most relapses occur in the first 30-180 days of recovery. Ironically
most people leave inpatient/residential alcohol/drug treatment facilities after thirty days, just when they are most
prone to relapse.
I see mindfulness and compassion skills as a natural and ideal way to help with relapse prevention, and considering
the high relapse rates, a necessary new modality.
The three major reasons that people relapse are:
– negative emotional states
– the abstinence violation effect
– shame and disconnection
Negative emotional states could include escalated conflicts (especially with spouses/partners), anxiety and worry(
especially about job or financial security), depression, and other negative emotions, feelings, and thoughts.
Where mindfulness and compassion skills help are in reducing the reactivity so the problem isn’t escalated by
unwise, and impulsive behaviors and poor decisions. It also helps with putting the problem in perspective, in
the now, and making the next best wise decision, moment to moment. Many times this involves patience and
doing less until there is more clarity. Relapse is viewed with compassion, which alleviates the shame of violating
abstinence. Relapse is viewed as something to be concerned about, but also an opportunity to explore what is
not working in your life. Relapses that occur several years into recovery, are usually an indication that something
might be in need of attention. Recently I was at a workshop, and a fellow participant disclosed to me that after
seven years of sobriety she relapsed last month. I asked her if she had gone back to her home meeting. She
said she didn’t because she felt so shamed.
Unfortunately I hear many stories like this. What is frightening about this is a month had passed and I was the
first one she was sharing this with. People need to talk about urges, cravings, fears and mistakes with other
people (i.e. silence is the enemy of recovery, AA proverb). I bring this up because people often do not talk about
urges or cravings. They try to ignore it, as something that will pass. Much like the warning signs of a heart attack.
Ironically by ignoring and not talking about urges or cravings, one tends to withdraw , be secretive, isolate
and disconnect, which increases the risk of relapse. It is said that most relapses are planned. That is because the
person is thinking about relapse, but not talking about it. The more they think about relapse and don’t talk about
it , the more likely it will occur.
Quieting the hungry ghost is a multi-faceted approach, including guided meditations, mindfulness and compassion
lessons, compassion practices, meditation, that contributes to a more mindful and compassionate way of
Urge surfing is just one example of a guided meditation technique to tolerate an urge or craving to use (alcohol/
drugs or whatever the abuse or addiction). Essentially the person visualizes the urge or craving as an ocean wave.
The wave has a beginning, a crest, and smooth cycle until it crashes on shore and then rolls to conclusion. The
wave visualization helps one realize that one can tolerate the urge, and breathe through it, and the associated
desries. It reminds us that we can delay reaction and that urges will quiet with focus and patience.
Mindful and compassionate relapse prevention addresses these issues. Relapse is viewed as something that can
be prevented with the proper skills. The individual is encouraged to talk about urges and cravings, and to recognize
and learn from previous relapses, without shame and criticism from others. The person can use mindfulness
and compassionate relapse skills to reduce reactivity, see relapse as less shaming, and the most important element
has a circle of compassionate support, and is not isolated.