Mindfulness Over Merlot

Mindfulness Over Merlot

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It’s not about willpower. Tools like meditation can help in recovery from alcohol use disorder.

If you've ever woken up with a pounding head and a vague memory of saying something embarrassing the night before, you may have told yourself, “I really overdid it. Better keep it to two drinks next time!”

For some people, that reminder will be enough to enforce a new limit. But for others, two drinks always becomes three or four or more. The broken boundary becomes a painful reminder that the commitments we make before alcohol starts flowing often don’t align with the decisions we make after.

I say “we” because I am one of those people. Before I quit drinking, I made and broke rules constantly. Even when I didn’t drink every day, I always drank more than I meant to, and my inability to moderate made me feel terrible about myself. I exercised self-discipline in other areas of my life. Why wasn’t I able to rein it in when it came to alcohol?

[Read: “Does it Matter if You're an Alcoholic?”]

One of the many things that confused me about my drinking was a culturally inherited belief that there were only two kinds of drinkers: alcoholics and “normal” people. In my mind, alcoholics were unable to function without booze, and certainly unable to go days at a time without drinking. This belief left me without a framework to understand my own situation. I was not physically addicted to alcohol, but when I did drink (which was often), my consumption was definitely not normal. So, was I an alcoholic or not?

Scientist, educator, and podcast host Gill Tietz asked herself this question for years while she struggled with problem drinking. On her popular podcast and YouTube channel Sober Powered, Tietz continues to look for answers in research studies while summarizing her findings for her listeners. One important discovery she shares is that disordered drinking falls across a spectrum, meaning the term “alcoholic” isn’t very useful as a descriptor.

“Some people can have half a drink and they’re satisfied,” Tietz explains. “And that’s why they stop drinking. It’s not because alcohol is amazing for them but they’re strong enough to resist it. It’s because they’re actually satisfied with the amount they drank. [Other] people just are not satisfied with one or two or three drinks. And you can’t change that because that’s not something that you chose for yourself.”

Why some people enjoy or crave alcohol more than others is not straightforward. Explanations like “it’s genetic” or “it’s a disease,” while helpful for reducing stigma, don’t fully account for the constellation of variables like adverse childhood experiences, family or cultural dependency patterns, or the high correlation between alcohol use disorder (AUD) and anxiety, for example.

“I exercised self-discipline in other areas of my life. Why wasn’t I able to rein it in when it came to alcohol?”

For me and other people with AUD, alcohol is so rewarding that cravings, inversely, become so intolerable that they overpower the prefrontal cortex, the part of our brains that engages in long-term thinking and delayed gratification. “Learning how powerful [cravings] actually are was very interesting for me and very freeing to know,” Tietz says. “This is real and it’s not what everyone experiences. It’s not a matter of strength or weakness.”

Neuroscientist and addiction psychiatrist Dr. Jud Brewer has spent over two decades researching the craving mind (which is the title of one of his books). An associate professor in the School of Public Health at Brown University, director of research and innovation at The Mindfulness Center (also at Brown), and executive medical director at Sharecare, Brewer focuses both his research and clinical work on finding evidence-based treatments for habit change and addiction. He agrees with Tietz that willpower is no match for the brain’s reward system.

“If you think from a neuroscience perspective, willpower is more myth than muscle,” says Brewer. “There’s not actually a lot of neuroscience evidence that willpower even exists.”

[Read: “Virtue Fatigue: The Anatomy of Temptation.”]

Brewer explains that, over time, using alcohol, nicotine, and other drugs creates a deficit in the brains of addicted people; they need the drug to get back to baseline, and the brain sends that message very loudly: Give me alcohol. This helps us feel better. Give me what I need!

But, as Tietz reminded me, cravings can also strike once a person is no longer actively using due to changes in the brain caused by substance use disorders.

“The reason dopamine exists is to form memories of things that are good for our survival: eating, drinking water, having sex. Those all feel good because our brain wants to motivate us to keep doing them,” she explains. “But since drugs and alcohol release way more dopamine than any other reward, your brain thinks it’s really important for you.”

Tietz also emphasizes that people who did not learn healthy coping strategies when they were younger may have a harder time overcoming cravings because they aren’t well equipped to respond to strong emotions when they occur.

“If you’re very upset and you don’t know what to do about that or, even worse, you don’t even know how you feel or why you’re upset, then what’s the solution to that?” she says. “If you can’t understand how you’re feeling, the only solution is to do something to get rid of the feeling, which alcohol does an excellent job of doing.”

If you think from a neuroscience perspective, willpower is more myth than muscle. There’s not actually a lot of neuroscience evidence that willpower even exists.

Brewer explains why understanding the brain’s trigger-behavior-reward cycle is such a powerful step toward changing our relationship with cravings.

“Neuroscientists don’t talk about behavior change in terms of willpower; they talk about reward value. We’ve been focusing on developing treatments that help people update the reward value of using,” he says. “It’s helping them see very, very carefully what they actually get from the use itself, whether it’s a hangover or all the problems that come with addiction.”

Brewer is a champion of mindfulness meditation, both in clinical settings and in his personal practice.

“I started meditating my first day of medical school,” he tells me. “When I was finishing out my MD-PhD program, my patients, especially with addictions, were talking the same language that I was learning in my own mindfulness practice: craving, clinging, things like this.”

The reason meditation is such excellent mindfulness training is because it allows space and time for the meditator to observe their thoughts rather than chase them, suppress them, or try to control them. Over time, mindfulness helps create a sense of distance between the self and the urgent and sometimes unhelpful messages our brains may send us, empowering us to respond thoughtfully rather than react impulsively.

While at Yale, Brewer launched a study on whether mindfulness could work as a first-line treatment for certain substance use disorders. Not only did the mindfulness protocol match the gold standard of treatment success for alcohol and cocaine, it was five times more effective than the gold standard for smoking cessation.

[Read: “Drink Less, Meditate More.”]

Learning about the brain science of cravings and addiction is powerful for many reasons. This growing body of research has paved the way for new and increasingly accessible treatments (including Unwinding Anxiety and Craving to Quit, which are apps based on Brewer’s work). It also supports a more nuanced understanding of who develops problems with alcohol and why, meaning more gray-area drinkers are taking their experiences seriously before they reach the threshold of physical dependency.

As someone who endured decades of disordered drinking and believed it was the result of my own weaknesses, I can tell you this: Understanding what was happening to me and that it was not my fault completely changed the way I felt about myself. It allowed me to forgive myself and to this day supports my ability to remain joyfully sober. And, as more and more people awaken to this realization, the stigma around problem drinking is slowly starting to change.

“No one would ever choose not to be satisfied with one or two drinks. We’re not choosing to go so hardcore that we can never consume it again. We’re not choosing to spend that much time thinking about alcohol,” Tietz reflects. “Learning that I’m not actually a weak loser helped me so much with the shame I felt. … I wanted to put it all out there to help people understand why this happened to them and to help them understand the steps that they need to develop those life skills to stay sober—like awareness and processing emotions. Like mindfulness.”

Brewer and Tietz’s work is particularly interesting to me because of my own experience of getting sober and maintaining long-term recovery from AUD.

After years of trying and failing, I had given up trying to remove alcohol from my life. Instead of striving to quit, I decided to focus on making my life more manageable by improving my mental health and my habits. Part of this campaign included meditating daily.

About three months into my new practice, I started noticing that the time between when I experienced the impulse to drink and when I actually reached for a bottle felt a little longer. Eventually, that pause extended long enough that I started hearing from my more rational mind: “Remember, you really don’t like how you feel when you drink. You’re much happier when you wake up without a hangover.”

It wasn’t an immediate transition and I still had some slip-ups, but within a few more months, and with the help of a supportive sober community, I freed myself from alcohol. By slowing down the trigger-behavior-reward cycle, I was able to reevaluate the benefits of not drinking relative to the benefit of instantly satisfying my craving. To Tietz’s point about coping, daily meditation also made a huge difference in my ability to handle stressors that would have previously driven me to drink.

My experience doesn’t prove anything in scientific terms, but I do think of it as a kind of natural experiment because I wasn’t trying to quit. It wasn’t until months later when I had some professional recovery support that I realized the timing; years after that, The Craving Mind and other resources confirmed for me that meditation was likely a key variable that strengthened my awareness and allowed me to begin changing my behavior.

It’s not a magic bullet, but being sober does feel magical. I no longer dream about drinking—and I would never dream of missing my daily meditation.

What Does Recovery Based in Mindfullness Look Like?

When my cofounder and I set out to design our own recovery coaching program, we knew mindfulness and movement would be the pillars. Unlike more traditional programs that might encourage meditation or yoga as supplementary activities, in REVA they are the core.

One of the first lessons we teach in our curriculum is the brain science of mindfulness and its influence on the reward cycle. For students to receive the optimal benefits, it’s critical that they understand why what they are doing works. It’s also vital that they know there is nothing wrong with them. They simply didn’t have the skills they needed to cope previously, and they can learn those skills.

Our students learn eight different meditation modalities. They receive meditation coaching to support their daily practice and regularly meditate together as a group. They attend virtual yoga or Pilates classes five days a week, receive personalized nutrition support, learn emotional freedom technique (also known as EFT or tapping), and work with coaches across multiple modalities to gain skills and practice releasing harmful attachments.

Many of our students report having to suppress or alter pieces of themselves to fit into social or professional spaces or to fulfill expected roles. We believe strongly that no one should have to suppress themselves in their recovery. Much of our one-on-one work focuses on helping students establish a core relationship with themselves based in self-compassion. Meditation and befriending the body are fundamental aspects of nurturing that relationship.

Today, there are more options than ever to help address alcohol use disorder; our approach is a great fit for some people, but no single option is best for everyone (claims to the contrary should be viewed with caution). Even in programs that are not based in mindfulness, meditation can be a powerful amplifier for healing!

Recovery is highly personal. Similar to finding a diet or a therapist that works with your personality, values, and goals, finding the right recovery program may take several tries.

Want to give it some more thought? Ask: What is alcohol costing you?

Mindfulness over merlot

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