Dr. G. Alan Marlatt is the founder and director of the Addictive Behaviors
Research Center at the University of Washington, where he developed the
Mindfulness-Based Relapse Prevention (MBRP) outpatient treatment
program. He is also the author of Relapse Prevention: Maintenance
Strategies in the Treatment of Addictive Behaviors. Following are
. excerpts adapted from our interview with Dr. Marlatt, in which he
describes of some of the practices taught in the MBRP program to
those recoveringfrom addiction. To read the complete interview, visit
the “Current” page at www.inquiringmind.com.
By G. Alan Marlatt
RELAPSE PREVENTION is a cognitive behavioral approach that
mainly teaches people skills: how to cope with triggers and high-risk
situations, how to manage urges and cravings. It also helps people
get a better sense of their own personal journeys and the forks in the
road that lead either to recovery or to falling off the wagon. In getting
this bigger picture, mindfulness meditation enhances what many
people call “meta-cognition”-the ability to stand back, observe what
is happening andthink about what you are doing rather than being
on automatic pilot. We’re trying to promote approaches that will help
people see their feelings and then develop more of a sense of choice.
It’s when they’re in the habit-stimulus response that most people get
into drug use and its consequences.
S.O.B.E.R. is one of the meditation breathing spaces we’ve
developed. You can use it when you’re right on the verge of taking a
drink. It enhances meta-cognition, giving you a chance to stand back
and look at what’s going on. Say you’re walking by a bar you used to
visit and the thought arises: “Maybe I’ll just pop in and see if anybody
I know is inside:’ 5 is for “stop” where you are. Stop walking. Then 0,
“observe” how you’re feeling-what are the physical sensations and
cravings? 8, focus on your=breath.Take a deep breath, then another
breath, and center your attention there. And E, “expand” your aware-
ness so that you’ll have a larger sense of what would happen if you
did go in the bar. How would you feel? In AA they call this “thlnklnq
through the drink:’ Finally, R, “respond” mindfully.
When you’re on the verge of actin.g, you have a choice, but you
need a little space. Otherwise, the habit will drive you to drink.