"Mindfulness" is changing our cultural conversation about health, including recovery from alcohol and other drug dependence.

Interest in the therapeutic uses of mindfulness has increased. The National Institutes of Health has launched studies of mindfulness as an adjunct treatment for people dealing with substance abuse, cancer, bone marrow transplants, problem gambling, low back pain, fibromyalgia and other conditions. Mindfulness is also a core element of new developments in mental health treatment, including mindfulness-based cognitive therapy and dialectical behavior therapy.

Mindfulness comes from the oldest practice of Buddhist meditation--vipassana, usually translated in English as "insight meditation." This practice combines mindfulness (nonjudgmental observation) with concentration (focused attention).

Buddhist teachers sometimes compare mindfulness and concentration to the wings of a bird. A bird can fly only when both wings move in harmony. Likewise, said the Buddha, both mindfulness and concentration are needed to bring liberation from suffering.

This idea is taking hold among people who practice the Twelve Steps of Alcoholics Anonymous. Elene Loecher, a retreat leader at Hazelden's Dan Anderson Renewal Center in Center City, Minn., leads retreats based on Insight Meditation. These include "Prayer and Meditation: The Path to Conscious Contact" and "Meditation: Antidote to Self-will Run Riot."

Loecher compares the relationship between mindfulness and concentration to the relationship between Steps Ten and Eleven. According to "Twelve Steps and Twelve Traditions" (AA World Services, 2007), the daily practice of both steps is needed to create "an unshakable foundation for life."

"Step Ten is the spiritual principle that invites us continually to take a personal inventory each day, and, when we are wrong, to promptly admit it," says Loecher. "It invites us to pay attention, to notice, to show up for our lives, to be in the present moment."

Yet this is precisely what the practicing alcoholic or other drug addict wants to avoid.

"The present contained too much pain, and what we wanted most was relief," Loecher says. "Much time and effort was given to the past, trying to make it different, trying to fix it in some way. When we weren't busy doing this, we were focused on the future, trying to control it. The result of all our effort was growing disconnection from the self, other people, and Higher Power."

Rebuilding those connections is the purpose of the Twelve Steps, and especially Step Eleven: "Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out." The result of Step Eleven practice is a sense of belonging--of rejoining the human community and getting daily guidance from a source of help beyond ourselves.

To experience the full benefits of mindfulness, concentration and Steps Ten and Eleven, you can create a daily practice. Loecher offers the following suggestions:

• Find a form of meditation that works for you. You can start with the instructions on pages 85-88 of "Alcoholics Anonymous" (AA World Services, 2001), a core Twelve Step text. In addition, consider taking a class or workshop on Insight Meditation. If possible, join with a qualified teacher and other committed students once a week to deepen your practice.
• Do a Step Ten "spot check" at any point during the day. Focus on a behavior that threatens relationships, such as dishonesty. Then use your meditation technique to observe this behavior in your own life. "Look at yourself from the vantage point of a fair witness, an observer--one who does not judge or criticize," says Loecher. "This is the mindfulness element. Simply notice when you practiced dishonest behavior and then make amends. Also note when you practiced honest behavior, and express gratitude to your Higher Power for the change."
• Welcome insights. If you consistently practice meditation, you will receive spontaneous insights about the next actions to take in overcoming selfishness, dishonesty, resentment and fear. In the spirit of the well-known prayer--"Thy will, not mine, be done"--welcome these insights as guidance from your Higher Power.

Published September 29, 2008