As a researcher, I spend a good deal of time studying mindfulness-based treatments for alcohol and other drug use. Jon Kabat-Zinn defined mindfulness as, “awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally.” When working with this approach, we explain mindfulness to our clients and then ask them how they think it relates to alcohol and other drug use. I’ll start here by giving you the answer we’re usually looking for, and then talk a bit about how you might consider incorporating mindfulness into your work.
The short answer is: Mindfulness helps people notice urges and internal experiences before they automatically turn them into behavior.
Much of our day-to-day life operates on what you could call autopilot. Have you ever been driving home from work, and all of a sudden, you’re at your exit without remembering much of the drive? That’s autopilot. It can also look like pouring a glass of wine at the end of a stressful day without really thinking about it. The fact is we’re all on autopilot for some portion of the day. We have to be that way. It would be far too cognitively taxing to operate with full awareness all the time.
Though a necessity in daily life, autopilot creates risk for people with alcohol and other drug problems. That’s because “automatic loops” are often well-established. The brain learns that certain cues (like getting home after work, feeling stressed, being alone) lead to drug use that provides relief, reward, or escape. The transition from cue to craving to use can happen quickly and quietly. They become stronger and more rehearsed over time. Just like we find ourselves at our highway exit without realizing how we got there, we might also find ourselves with a drink in hand before we’ve had a chance to pause.
Mindfulness is one important tool among many that can help disrupt this automatic loop and give people a chance to retake control of their behavior. By bringing attention to the present moment, particularly in high-risk situations, we can help clients begin to more fully notice their internal experiences (including cravings as well as emotions, thoughts, and bodily sensations) without automatically reacting to them by using drugs. They can pause and consciously choose how to behave.
Moving from concept to practice
This is where mindfulness sometimes gets misunderstood. Mindfulness is not about clearing the mind, getting rid of cravings, staying calm all the time, or feeling relaxed. Mindfulness is a tool for slowing the moment down just enough to notice what’s happening.
When a client experiences craving, you can promote mindfulness by inviting them to pause for 30 seconds and then asking:
- What do you notice in your body right now?
- What thoughts are popping up?
- What emotion might be underneath this urge?
The goal is not to make the craving disappear. The goal is to help them see that cravings are experiences, not commands. They rise, peak, and fall no matter whether someone acts on them or not (if you want to learn more about this, look into urge surfing).
For clients with problems due to their alcohol or other drug use, this framing can be powerful. Rather than telling them to “make better choices” or “use more willpower,” mindfulness gives them a way to step out of autopilot. It creates a small gap between urge and action, a gap that allows new options to become visible.
Over time, repeated practice helps clients learn something important: I can notice an urge without immediately doing something about it. This is ultimately the difference between automatically reacting or mindfully responding. That realization alone can be a turning point.
Mindfulness and The Seven Challenges
Mindfulness is one of many approaches that pairs naturally with The Seven Challenges. Both are flexible, and most importantly, both take a non-judgmental, curious approach to behavior change that puts the client in the driver’s seat with an opportunity to make their own choices.
Historically, substance use treatment has required abstinence as the starting point and only acceptable treatment goal. The Seven Challenges takes a different path: It meets clients where they “are at” and supports them in working toward their substance use goals. Mindfulness operates the same way. It doesn’t require a specific outcome or decision. It simply asks clients to slow down, notice what’s happening, and respond with awareness rather than autopilot.
When someone pauses in a triggering moment and chooses how to respond, mindfulness is working. When that pause helps a client move closer to the life they want, The Seven Challenges is working. Used together, these approaches don’t demand perfection, they create space for learning, choice, and real, lasting change.