Smoking, cocaine, alcohol, food addictions...meditation works for all of them?

As discussed in several blogs, i am a collaborator and subject in the Yale study on "advanced meditators", led by Jud Brewer, the Medical Director of the Yale Therapeutic Neuroscience Clinic and an Assistant Professor.  

Jud has published a lot on addiction, including cocaine, cigarette smoking, alcohol, etc.  His goBlue start-up company in New Haven, CT has a focus on using meditation to deal w/addiction, particularly smoking.  Jud's recent TEDx video "You're Already Awesome. Just Get Out of Your Own Way!" explains his work.  Here is a redacted version: 
    
     "There I was barreling down this mountain bike descent …one of those descents where there is a lot of descent and not a lot of trail, so I was really focusing on just staying on the trail.  

At some point there was no “me”.  No “me”, no bike, no trail…that’s the best way I can describe it.  There just “was”… It was effortless, it was selfless, it was immensely joyful.  "I" wasn’t there, yet there I was, one of the most awesome events of my life.  When my sense of self came back on line, it said “What was that, when can I do that again?”.   This was “flow”.   I was in the flow state.  And it was delicious. 

We’ve all been in flow at some point in our lives.  Maybe we were playing sports or getting engrossed in music.   Let’s say you get really immersed in a project and you look up and it’s five hours later, it’s dark outside, because you’ve been so focused on what you’re doing.  If this is so great, why don’t we do it all the time?  The answer is “we get in our own way”. 

LoLo Jones
After falling @ Olympics
by "thinking" 

Here’s an example; remember Lolo Jones, the American hurdler favored to win the 2008 Beijing Olympics.  She was in the lead, at the ninth of ten hurdles and then what happened? 

She said “I was just in this amazing rhythm.  I knew I was winning the race.  It wasn’t like “I’m winning the Olympic Gold Medal”, it was just another race.  And then I started telling myself to make sure my legs were snapping out, so I overtried.  That’s when I hit the hurdle.”  

She got in her own way.  She tripped herself up, literally, and finished 7^th.   She got caught up in thinking.  She “overtried”.  So how often do you think we get in our own way?

 

A study at Harvard found that 50% of the time we get caught up in regretting things from the past, worrying about what we’re going to do in the future, etc.  Even when we’re daydreaming about that perfect Hawaiian vacation, we’re no happier than when we’re in the present moment.  They concluded “A wandering mind is an unhappy mind.”  (Killingsworth, 2010, Science).  

Jud Brewer
Yale

As Lolo and the Harvard research have shown, getting caught up in self-referential thinking can get us in our own way.   I’m an addiction psychologist @ Yale and my lab is looking at ways to help people quit smoking.   So what’s a craving like?  You feel all restless and squirmy.  That isn’t great.  I had a smoker tell me that his cravings were so strong that he felt his head would explode.   These folk get caught up in, or resisting, craving.  Flow is just being with all this stuff.  We taught smokers mindfulness.  How to really pay attention and be with their cravings.

What did they learn?  The first thing was that these were just body sensations that were driving their lives.  The next thing they learned was that they could just let these things come up, do their dance and let them go away.  And they quit smoking.  We found that this training was twice as good as the “Gold Standard” (Cognitive Behavioral Therapy - CBT).   We’re using iPhones to deliver this using videos and animation.   Giving people exercises to ride out their cravings as they come up.  

Default Mode Network

We also wanted to see what’s going on in people’s brains.  So we brought in experienced meditators.  Here’s the default mode network (DMN).  Remember that 50% of the time when we’re not present?  Mark Reichle discovered this (2001) by telling people to just lay in the fMRI during a scan and do nothing in particular.  Experienced meditators have this region, the posterior cingulate cortex (PCC), which gets active when you’re craving and getting in your own way, especially quiet in meditation. 

We turned to a new technology, called real time fMRI (rt-fMRI) feedback, where we can take a picture of (one center in) people’s brains while they're meditating and see what it looks like from moment-to-moment.   We did this with both novice and experienced meditators.   We had them lay in the scanner and check in w/the graph to see how it was corresponding to their experience.

Novice Meditator rt-fMRI
Blue - PCC deactivated
Red - PCC activated

"my" rt-fMRI 
Blue - PCC deactivated
Red - PCC activated

They all reported a good correspondence w/the graph and when they were  getting in their own way or when they were in a meditative state.   Here’s the result from an experienced and a novice meditator.   A big difference between the two brains.  Some of our experienced meditators were reporting getting into “flow”.   This lined up w/their PCC getting really quiet (blue - which is where 'goBlue' came from). 

Some of our novices were learning.  One said “my graph was all red (activated PCC) and all I was thinking about was my breath”.  What’s the problem?  He got caught up in thinking.  The next run his brain looked completely different.  He said “I get it…the physical sensation of the breath”.   He learned the difference between getting caught and getting out of his own way.  Perhaps he got a taste of flow.   He came out of the scanner and said “Wow, that was great!  When can I do it again?”

Reality is so much more delicious than our concept of it.  If we can track it, we can train it.  Pay attention.  What’s it like to get caught up in thinking?  How is this different from just noticing thought?   What’s it like getting caught up in a craving or resisting an experience?  Just be with bodily sensations when they come up.   We can help, with neurofeedback, to practice it better.

When we get out of our own way, we get happier, more engaged with the world, more compassionate.   We can perform at our best.  We all are awesome, we just have to get out of our own way."




Jud also has a recent paper in the Psychology of Addictive Behaviors of the American Psychology Association, "Craving to Quit: Psychological Models and Neural Mechanisms of Mindfulness Training as Treatment for Addictions", May 28, 2012, by Brewer, J. A., Elwafi, H. M. and Davis, J. H.

This image, which relates to all addictions, demonstrates that both positive and negative cues create positive and negative affects to produce our craving for our particular addiction, whatever it is.  The key is to use meditation to change the nature of our craving for the object of our addiction.    

Jud focused on mindfulness in this paper, although he has used several different meditations in his work. (See  blogpost "Folk Who Meditate Decrease Mind Wandering".)

The traditional techniques of substituting another behavior, like eating candy or going for a walk, or avoiding the situations which provide cues, don't work long-term because they don't change the structure of the craving. 

The key element in these craving behaviors is the Default Mode Network (DMN) (See blogposts "What Is the Default Mode Network?...", "nondual awakening and autism...the battle of the "blah, blah" and "tasking networks", and "Can you stop your "blah, blah" thoughts?...).  Shutting down the DMN by deenergizing its core centers is the key to eliminating craving of any kind.  

In addition to Jud's paper and TEDx video, Jud's goBlue company (in which i have no financial interest), has also produced a new app to help folk to quit smoking, called "Craving to Quit". 


BTW, i will be in Europe the next two weeks, meeting w/some folk in Bruges, Belgium and then at the Science and NonDuality Conference in Doorn, The Netherlands, giving a talk "How Nondual Awakening and Psychedelics Generate Similar Mystical Experiences", and two panel discussions a) "What is Enlightenment?" w/Paul Smit and Tim Freke and b) "Filling in the Details" w/Tim Freke, Lisa Cairnes, and Meriel Gold.