Mindfulness and Substance Use

By Kasi Howard, PsyD


Mindfulness-based therapies have gained traction over the past three decades. First pioneered by Jon Kabat-Zinn in 1979, and later presented by Marsha Linehan as a key tenant in Dialectical Behavior Therapy (DBT), mindfulness practices continue to gain empirical support.

Numerous studies have supported mindfulness-based therapy as an effective treatment for anxiety, depression, PTSD, substance use and eating disorders, to name a few. Other benefits include improved immune system functioning, enhanced relationships, increased self-compassion, lower blood pressure, and greater focus

Mindfulness is defined by Kabat-Zinn as “a way of paying attention: on purpose, in the present moment and non-judgmentally.” This includes being open to feelings and thoughts as they arise and just accepting them for what they are, without trying to change them or run away from them.

Given that substance use disorders are inherently avoidant in nature, this ability to stay in the present moment is an integral part of recovery. Mindfulness exercises can be used to help individuals with substance use disorders see things as they are in the moment, rather than focusing on finding their next “fix” to escape the pain.

Mindfulness also promotes the awareness of the constantly changing state of our minds, bodies and environment. Rather than fixating on the idea that “this feeling will not go away unless I get high,” individuals learn that feelings really do pass if he or she can just ride them out.

Think of a time when you were in deep emotional pain. Was it constant? Did it fluctuate? How long did it last? Helping someone to see that their current state is not everlasting can greatly reduce their need to escape by means of a temporary high.

Individuals also work on acceptance of their urges. Those in recovery often get discouraged when they have urges to use, and they feel as if they have failed. Mindfulness techniques, such as urge surfing (which is a relapse prevention technique) teach acceptance of the urge without judgment. Urges are natural. They come and they go. One must simply be willing to ride them out without acting on them in order to truly understand this aspect of reality.

These techniques, combined with other coping skills, provide a framework for recovery that creates self-awareness and mitigates shame by creating a sense of self-acceptance. It is in that self-acceptance that one can move on to address the issues that first led to the substance use disorder, thus creating a foundation for lasting recovery.


Dr. Howard is a clinical psychologist treating eating disorders, anxiety, depression, and marriage issues in the San Antonio area. For more info, visit www.kasihoward.com.