Mindfulness seems to be popping up everywhere these days – for stress reduction, anxiety, and overall quality of life – but for gambling addictions?
A main strategy used to cultivate mindfulness is meditation, and although a number of meditation techniques have their origins in Buddhist spiritual philosophies, contemporary psychology has focused on mindfulness-based clinical applications to address a variety of psychological issues associated with distress and emotional suffering. Since many people with addictions also have co-occurring mental health problems, it makes sense that mindfulness interventions are also being explored in the field of addictions with some promising results as noted in a separate article on this site authored by one of my colleagues at Harvard, Dr. Judson Brewer.
Now, emerging research suggests mindfulness meditation may be useful to help individuals with gambling disorders to increase tolerance for cravings, enhance stress coping, and improve their ability to manage unpleasant emotions. Some have also offered that mindfulness can help reduce impulsivity, a common contributing factor to problem gambling and relapse in recovery.
What is Mindfulness?
First, it involves the self-regulation of attention so it is directed and maintained on the immediate experience…-Rory C. Reid
Mindfulness is typically defined as the process of bringing awareness and non-judgmental acceptance to one’s present moment experience of thoughts, emotions, and bodily sensations. Essentially, mindfulness consists of two components . First, it involves the self-regulation of attention so it is directed and maintained on the immediate experience (including unpleasant emotions and addictive cravings). This is why a lot of mindfulness meditation is dedicated to simple exercises such as focusing and sustaining attention on something like our breathing.
My patients will often report that this is more difficult than they expect. In part, this is because our minds have a tendency to wander off and entertain a great deal of “chatter” – thoughts, memories, experiences, or various worries about unfinished tasks. It can be a real strain just to learn how to focus and regulate our attention. This is why we practice so we can cultivate a better ability to “attend” and as part of this process, we also increase our awareness of things that may historically have gone unnoticed. For instance, someone may begin to appreciate small things in life for which he or she is grateful or discover aspects about themselves that were previously outside of consciousness. This in turn, can significantly enhance the depth and breadth of our life experience.
The second component of mindfulness entails adopting an orientation towards one’s present experience characterized by openness, curiosity, and acceptance. That means we don’t pass judgment on the various experiences that arise in any given moment. Consider the application of this principle in the wake of an addictive craving. Historically, problem gamblers frequently get into a tug-of-war with their cravings and approach such cravings with an “I have to slay the dragon” mentality. In part, this is because the cravings are judged as “bad” or “problematic.” Yet, in reality, the cravings are simply a physiological and psychological experience that is neither good nor bad.
In mindfulness, we simply pay attention with curiosity to how we experience the craving, the bodily felt sensations that accompany such cravings, in a non-judgmental manner.-Rory C. Reid
A mindfulness approach doesn’t give the experience special status or indulge the craving but we don’t ignore or avoid the craving either. In mindfulness, we simply pay attention with curiosity to how we experience the craving, the bodily felt sensations that accompany such cravings, in a non-judgmental manner. Being mindful is about recreating a new relationship with the craving that allows it some space to co-exist with the self. If the craving feels too intense, we can take a break from it by focusing our attention for a short period on something neutral like the breath. When we are ready, attention is refocused on being present with the craving again. As part of this practice, various thoughts will arise and in mindfulness we just note such thoughts rather than getting wrapped up in them. A thought is just a thought, not a fact!
This is what mindfulness is about. Being present, in the moment with an experience, rather than getting caught up with the stories we often tell ourselves about what the experiences should mean (e.g. this craving is too difficult, I can’t handle it, etc.). With problem gamblers, mindfulness teaches individuals to “lean into experiences” rather than avoid them by turning to one’s addiction.
Often I hear people say that mindfulness is meditation. This would be like saying taking a road trip on a vacation is synonymous with just traveling in a car.-Rory C. Reid
Mindfulness is often cultivated through meditation practices. It’s important not to get the two confused. Often I hear people say that mindfulness is meditation. This would be like saying taking a road trip on a vacation is synonymous with just traveling in a car. While a car is the vehicle through which one is able to visit a constellation of destinations and attractions that contribute to the overall vacation experience, we would be amiss to limit the description of a vacation to simply just riding in a car. Similarly, meditation exercises are a vehicle that allows us to cultivate a wide array of mindful moments, experiences, and increased levels of new awareness.
Several forms of meditation are taught in mindfulness-based approaches to psychological treatment with gamblers and each have similarities in their procedures and goals.
An example of a typical meditation exercise may instruct a patient to sit quietly, either cross-legged or on the floor and focus attention on the sensations of breathing. This might include the temperature of the air as it flows through our nostrils, the rate, depth, or rhythm of breathing. Efforts to regulate the breath are discouraged as mindfulness is about accepting whatever arises in the moment without trying to change it in anyway. As various thoughts might compete for attention, a patient is encouraged to take note of them (e.g., a planning thought, a worrying thought, a judging thought) and then let go of the thought while returning the focus of attention to the breath.
Throughout this process, patients cultivate the ability to observe incoming thoughts without over-identifying with them or judging them (e.g., my thoughts are neither good nor bad, they are just thoughts). Moreover, when a shift in self-awareness occurs, patients are instructed to redirect focus back to the breath and away from distressing thoughts or ruminations.
Patients are further encouraged to apply the concepts learned in meditation to activities in their daily lives including various thoughts, feelings, and cravings associated with gambling behaviors. In essence, one goal of mindfulness is to help reorganize our relationship with these experiences in a way where we don’t allow them to provoke us to a place where we engage in self-destructive addictive behavior.
Mindfulness and Gambling Disorders
…increased levels of mindfulness are linked to a reduction in tendencies to engage in problem gambling and the host of distressing emotions often encountered by those with gambling disorders.-Rory C. Reid
My colleagues and I at UCLA have conducted research showing increased levels of mindfulness are linked to a reduction in tendencies to engage in problem gambling and the host of distressing emotions often encountered by those with gambling disorders. Other studies have found evidence that cognitive behavioral therapy combined with a mindfulness intervention can reduce gambling severity . Thus, those with gambling disorders should consider discussing participation in mindfulness training of some type as part of the recovery process.
As with most things, proficient mindful practice requires an investment of effort and energy. However, sobriety in recovery is about commitment and dedication to worthwhile activities that can facilitate the process of positive change. Mindfulness appears to be one of these meaningful activities leading to powerful experiences for those with a gambling addiction.
 Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J.,…Devins, G. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241.
 Toneatto, T., Pillai, S., & Courtice, E. L. (2014). Mindfulness-Enhanced Cognitive Behavior Therapy for problem gambling: A controlled pilot study. International Journal of Mental Health & Addiction, 12, 197-205.
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