Using Mindfulness Interventions with Problem Gamblers

RORY C. REID, Ph.D., LCSWResearch Psychologist / NeuropsychologyLicensed Clinical Social Worker

Semel Institute for Neuroscience & Human BehaviorDepartment of Psychiatry and Biobehavioral Sciences

Mindfulness is a philosophy and a practice of cultivating increased awareness of our moment-to-moment experience in a non-judgmental way.

The practice of mindfulness, although based on many principles of Buddhism, was medicalized by Dr. Jon Kabat-Zin and has been applied to a variety of psychological and medical issues.

What is Mindfulness

The Spirit of Mindfulness

The Movie: A Beautiful Mind

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Outcome studies have provided evidence that mindfulness can be helpful for attenuating psychological distress associated with a number of mental health issues including:

Anxiety

Depression

Obsessive-Compulsive Disorders

Pathological Gambling

Substance-Related Disorders

Hypersexual Behavior

Mindfulness Applications

Gambling

SufferingCravings

Stress

ImpulsivityBoredom

Attention

Emotion

Goodness of Fit for Mindfulness & Gambling

Shame Entitled/Ungrateful Emotionally Reactive Intolerance for Discomfort Critical/Judgmental Rumination Anticipatory Anxiety Tug of War with Cravings Special Status to Thoughts Thought Suppression Disconnecting/Inattention

Self-Compassion Gratitude/Humility Emotionally Present / Aware Being Present w/h Suffering Curious/Non-Judgmental Reflection Present in the Present Acceptance of Cravings A Thought is Just a Thought Noting, Curiosity, Present Connecting / Attentive

Gambling Problems Mindfulness

Healing Gambling Problems through Mindfulness

Research Supporting MBSR for Emotion Regulation

Reduction of Food Cravings

Reduction of Food Cravings

Alberts, Mulkens, Smeets, & Thewissen (2010). Coping with food cravings. Investigating the potential of a mindfulness-based intervention. Appetite, 55, 160-163.

“…acceptance was found to reduce the extent to which participants experienced loss of control when exposed to food cues. This finding is not only practically relevant, but interesting from a theoretical point of view as well. After all, acceptance requires one not to control cravings, which paradoxically leads to higher levels of perceived control.”

Mindfulness Increases Cortical Gray Matter

Mindfulness Increases Cortical Gray Matter

Baby Steps to Meditation

3 Minute Mindfulness

Exercise

Being Present with the Present

In meditation, nothing happens next. This is it!”

PositiveComfortable

GoodPleasant

AwkwardUncomfortable

BadUnpleasant

Emotionally avoidant people become numb and detached from both good and bad feelings. True, they’ve avoided pain and negative emotion, but they’ve also diminished or extinguished their ability to feel positive emotions.

PornographyGambling

SexFood

Drugs / Alcohol

Bandwidth of Positive Emotions

Emotional Avoidance

Tug of War with Cravings Doesn’t Work

Thoughts on Thought Suppression

“Trying not to think about ‘it’, in some funny way, is just what makes such thoughts happen…and any attempt at mental control contains the seeds of itsown undoing. Under certain conditions, in other words, mental control may not only fail to achieve desired states of mind, but can ironically create precisely the most undesired state of mind. Trying to be happy can make us sad, trying to be relaxed can make us anxious, trying not to think of alcohol can make us obsessed with our next drink. A person innocently engaged in what seems to be a program of self-improvement may unwittingly create the very psychological problem he or she is working so hard to overcome.”

Daniel M. Wegner, Ph.D., ProfessorDepartment of Psychology

Harvard University

Irony of Thought Supression

Boredom and Emotional Dysregulation

Research on Boredom

“Boredom, in some form, appears to be a common and perhaps unavoidable part of human experience. Nevertheless, it is important to consider ways in which individuals and society as a whole might alleviate boredom and the distressing psychological conditions with which it has been linked. In this regard, the present results are intriguing because they suggest the common antidote for boredom — getting busy or plunging into stimulating activity — might, in the long run, be counter productive.”

Research on Boredom

In his provocative essay ‘In Praise of Boredom’, Brodsky (1995) proposes: “When hit by boredom, go for it. Let yourself be crushed by it; submerge, hit bottom. In general, with things unpleasant, the rule is, the sooner you hit bottom, the faster you surface.” On the contrary, our typical impulse when bored is to fight the experience with frenetic activity and intense, varied stimulation. However, like the trap of quicksand, such thrashing only serves to strengthen the grip of boredom by further alienating us from our desire and passion, which provide compass point for satisfying engagement with life. This is the insidiousness of boredom.

Research on Boredom

“In the short run, bombardment by intense stimulation will surely alleviate boredom, but tragically, this leaves us more susceptible to future episodes of boredom and in need of yet more intense experience imposed from without.”

Dr. Hedy Kober, Assistant ProfessorYale University School of Medicine

Developing a New Relationship with Cravings and Urges

Attention Regulation [3 min exercise]

Necessary in Conflict Monitoring

Body Awareness

Attention to Somatic Experience, “What am I really craving?”

Emotion Regulation

Being present with uncomfortable / unpleasant emotions

Change in Self-Perception

Observing mental processes with increased clarity

Non-Judgmental Self-Appraisals

Hypothesized Mechanisms of Action in MBSR

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Feasibility Study MBSR

Frequency TimeBaseline

Frequency TimeAfter 10 Weeks

8 week Mindfulness (n=15)

8 week Psycho-Education (n=10)

6 Minute MindfulnessWorking with Difficult

Emotions Exercise

Being Present with the Present

Mindfulness: Being Present with the Present

Mindfulness Exercises Freely Downloadable at:marc.ucla.edu insightla.org mindfulrp.com