Mindfulness-Based Relapse Prevention

In-Depth Explanation

Mindfulness-Based Relapse Prevention (MBRP)

Mindfulness-Based Relapse Prevention (MBRP), developed by Dr. Sarah Bowen, Dr. Neha Chawla, and Dr. G. Alan Marlatt, integrates traditional relapse prevention skills with mindfulness meditation practices. The core insight is revolutionary: cravings, urges, and difficult emotions are temporary experiences that will pass if you observe them without reacting. By developing present-moment awareness, you learn to ride out urges rather than automatically acting on them. MBRP doesn't teach you to fight cravings—it teaches you a fundamentally different relationship with them.

The Core Philosophy

MBRP is built on several key insights about how the mind works:

Cravings Are Temporary: Urges feel permanent and overwhelming, but they actually rise, peak, and fall—typically within 20-30 minutes. You don't have to act on them; you can wait them out.

Reaction Creates Problems: When a craving arises, the automatic reaction is to either give in (use) or fight (resist through willpower). Both approaches are exhausting. Mindfulness offers a third way: observe without reacting.

Autopilot Leads to Relapse: Most slips happen on "autopilot"—you act before you're fully aware of what's happening. Mindfulness increases the space between trigger and response.

Acceptance Is Not Approval: Accepting that a craving exists doesn't mean you approve of it or will act on it. It means you acknowledge reality without adding the extra suffering of resistance.

Urge Surfing: The Central Technique

Urge surfing is the signature practice of MBRP—learning to ride the wave of craving without being pulled under:

1. Notice the Urge: When a craving arises, pause and acknowledge it: "I'm having an urge right now." Name it without judgment.

2. Observe with Curiosity: Get curious about the urge. Where do you feel it in your body? Is it in your chest, stomach, throat? What's the texture—tight, burning, hollow? What shape would it be? Does it have a color?

3. Breathe with It: Don't try to make the urge go away. Don't fight it. Don't feed it with fantasy. Simply breathe and observe. Each breath is a wave.

4. Watch It Change: Notice that the urge isn't static. It fluctuates. It rises, peaks, and falls—just like a wave. You don't have to do anything except observe.

5. Let It Pass: Urges typically peak within 20-30 minutes if you don't act on them. Surf the wave until it naturally subsides. Each time you do this, you build confidence that you can survive cravings without using.

The SOBER Breathing Space

This quick technique creates a pause when you're triggered. Practice it until it becomes automatic:

S — Stop: Whatever you're doing, pause. Just stop. This interrupts the autopilot response.

O — Observe: What's happening right now? What sensations are in your body? What thoughts are in your mind? What emotions are present? Don't judge—just notice.

B — Breathe: Bring your full attention to your breath. Take several deep breaths. Feel your feet on the ground. Ground yourself in the present moment.

E — Expand: Expand your awareness beyond the breath to include your whole body and the situation around you. What's really happening here?

R — Respond: With this expanded awareness, choose how to respond—rather than react automatically. What's a skillful response in this moment?

Understanding Autopilot

Much of addiction operates on autopilot—automatic patterns that unfold without conscious awareness:

The Autopilot Problem: You feel stressed → Your body moves toward the substance → You use → You only fully "wake up" afterward, wondering what happened. The whole sequence can occur with minimal conscious involvement.

How Mindfulness Helps: Mindfulness increases awareness throughout the sequence. You notice the stress arising. You notice the impulse to use. You notice the thought "just this once." You notice your body moving toward the substance. At each point, you have a choice.

Creating Space: Between trigger and response, there is a space. In that space is your freedom to choose. Mindfulness expands that space.

Practice Makes Awareness: Like any skill, awareness builds with practice. Regular meditation trains your brain to be more aware more of the time.

Core Mindfulness Practices

MBRP uses several foundational practices:

Mindful Breathing: Focus attention on the breath—the sensation of air entering and leaving, the rise and fall of the belly. When the mind wanders (it will), gently bring it back. This is the basic training.

Body Scan: Systematically move attention through the body from head to toe, noticing sensations without trying to change them. This builds body awareness—crucial for catching urges early.

Sitting Meditation: Sit in a comfortable position with an alert, upright posture. Focus on the breath. When thoughts, emotions, or sensations arise, notice them and return to the breath. Practice observing without engaging.

Walking Meditation: Walk slowly and deliberately, paying full attention to the sensations of walking—feet touching ground, legs moving, balance shifting. Practice being fully present during movement.

Mindful Daily Activities: Bring mindful attention to ordinary activities—eating, showering, walking. Practice being fully present rather than mentally elsewhere.

Working with Thoughts and Emotions

Mindfulness changes how you relate to thoughts and emotions:

Thoughts Are Not Facts: "I need to use" is a thought, not a command. "I can't handle this" is a thought, not a truth. MBRP teaches you to observe thoughts as mental events—clouds passing through the sky of awareness—rather than as reality.

Noting Practice: When thoughts or emotions arise, simply note them: "Thinking." "Craving." "Anxiety." "Judgment." This creates distance between you and the mental content.

Allowing Difficult Emotions: Rather than running from difficult emotions (often by using), MBRP teaches you to turn toward them with gentle curiosity. What does this emotion actually feel like? Where is it in my body? Can I breathe with it?

Acceptance vs. Approval: Accepting that anxiety or craving is present doesn't mean you like it or will act on it. It means you're dealing with reality rather than fighting with what is.

Building Your Mindfulness Practice

Mindfulness is a skill that develops with practice. Here's how to build it:

Start Small: Even 5 minutes daily builds the skill. Don't try to start with 30 minutes—you'll likely get discouraged and quit.

Be Consistent: Daily short practice is more effective than occasional long practice. Same time each day helps build the habit.

Use Guided Resources: Apps like Headspace, Calm, Insight Timer, or the free UCLA Mindfulness App offer guided meditations to help you learn.

Practice When Calm: Build the skill when you're NOT in crisis. You can't learn to swim when you're drowning. Practice daily so the skills are available when you need them.

Be Patient with Yourself: Your mind will wander constantly. This is normal. The practice IS the returning—noticing you've wandered and gently coming back. Each return is a mental pushup.

Applying MBRP to Your Recovery

Morning Practice: Start your day with 5-20 minutes of meditation. This sets a foundation of awareness for the day.

Daily Mindfulness: Bring awareness to at least one daily activity (eating, walking, showering). Practice being fully present.

SOBER Space in Challenging Moments: Use the SOBER breathing space whenever you feel triggered, stressed, or pulled toward old patterns.

Urge Surf When Cravings Arise: When you notice a craving, don't fight or give in. Observe it with curiosity. Breathe with it. Wait it out.

Evening Reflection: Before bed, briefly review the day. Where were you mindful? Where did autopilot take over? No judgment—just noticing.

Weekly Group or Class: If possible, join a meditation group or take an MBRP class. Practicing with others supports the habit.

What the Research Shows

MBRP has solid research support:

Reduced Relapse: Studies show MBRP reduces relapse rates compared to treatment as usual and is comparable to other evidence-based treatments.

Longer Time to Relapse: When relapse does occur, people who practiced MBRP often had longer periods of abstinence first.

Reduced Craving: Mindfulness practice is associated with lower reported craving intensity and reactivity.

Improved Emotional Regulation: Participants show better ability to manage difficult emotions without using substances.

Works for Various Substances: Benefits have been shown for alcohol, drugs, and tobacco.

Going Deeper

For more on MBRP and mindfulness:

Mindfulness-Based Relapse Prevention for Addictive Behaviors by Bowen, Chawla & Marlatt — The definitive clinical guide
The Mindfulness-Based Relapse Prevention Workbook — Practical exercises for personal use
Full Catastrophe Living by Jon Kabat-Zinn — Foundational mindfulness text
Apps: Insight Timer, Headspace, Calm, UCLA Mindfulness — Guided meditations
MBSR/MBRP Classes: Look for Mindfulness-Based Stress Reduction or MBRP classes in your area

Important Considerations

Not a Replacement for Treatment: MBRP is powerful but works best alongside other treatment—therapy, support groups, medication if appropriate. Don't use it to avoid getting help.

Trauma Caution: If you have significant trauma, meditation can sometimes bring up difficult material. Consider working with a trauma-informed teacher or therapist.

Takes Practice: The benefits of mindfulness develop over time with consistent practice. Don't expect instant results. Trust the process.

It's Not About Feeling Good: The goal isn't to feel calm and peaceful (though that may happen). The goal is to be aware of whatever is present—including difficult experiences—so you can respond skillfully rather than react automatically.

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