Fear is an emotion aroused by the perceived threat to one's safety and well-being, and it is one of the greatest obstacles to recovery from chemical dependence. For those still in the contemplation stage of change, fear might surface not just with respect to anxiety surrounding the physical pain of withdrawal but as the dread of judgment, punishment or rejection by others. Individuals driven by the fear of losing control (e.g., being powerless) believe they must avoid such natural human feelings as anger, grief or loneliness.
As G. Allan Marlatt, PhD has pointed out in his work on mindfulness-based relapse prevention (MBRP), addiction is a learned response built on both positive and negative reinforcements. While the (initial) pleasure in getting high or intoxicated acts as a positive reinforcement, sustained use is maintained through aversion to fear as the user seeks release from the pain, anxiety or depression associated with the crash or withdrawal from a substance.1
As I wrote about in a previous article on MBRP, cravings and urges are triggered by a desire for things to be different from the way they are.2 Paradoxically, aversion to fear only produces increased attachment to one's own intrusive and obsessive ruminations about it. Thus, in our desire to avoid that which is fearful, we end up at its mercy, creating our own unnecessary emotional suffering. Mindfulness, with its roots in Buddhist vipassama (insight) meditation, asks us to accept ourselves nonjudgmentally in the present moment. It teaches us to observe and accept the sources of fear within ourselves without having to act on them. As Pema Chodron writes in her book The Places That Scare You, “In sitting meditation … we train in opening the fearful heart to the restlessness of our own energy. We learn to abide with the experience of our emotional distress.”3
The goal of MBRP is not to change negative thoughts and feelings but to change our relationship to them. As David Richo suggests in his book The Five Things We Cannot Change: And the Happiness We Find by Embracing Them, “The counterpart of fear is excitement … The freedom to feel leads to fearless honesty.”4 When we give ourselves the emotional space to simply “be” with our fears, they are made ordinary and temporary. The results are a greater sense of empowerment and enhanced self-efficacy, both of which are necessary for sustaining recovery.
Mountain Well guided meditation
Mountain Well was designed to be a guided mindfulness meditation that allows participants to engage the affective processes that underline and reinforce the addictive mind or the “stinkin' thinkin'” familiar to those who attend 12-Step groups. It was derived from two sources: a guided mindfulness meditation on wishes taught by Jon Kabat-Zinn and a Celtic tale of transformation and nurturance conveyed by Joseph Campbell in his book The Hero With a Thousand Faces.5 Given the fear that accompanies the first steps of recovery, I have found this meditation helpful in creating a holding environment for patients to feel safe enough to admit their fears. It consists of a narrative with two integrated parts: The first addresses the concept of embracing fear, while the second instills hope and promotes a vision for recovery.
Mountain Well asks us to face those monsters-real or imagined-that we believe will destroy us. In accepting rather than avoiding those unwanted or shadow aspects of ourselves or our lives, we learn that fear is meant to be felt and let go of. By learning how not to be possessed by fear, we begin to experience a new flexibility of attitude and spirit that can serve us well in recovery.
Because the meditation asks people who are in raw and fragile emotional states to partake in an experience that might touch upon traumatic thoughts or images, it should be introduced and presented in a non-threatening fashion. I do not force people to participate in the meditation; rather, I invite them to partake in the experience to the best of their ability. If at any time they are unable to continue, they may simply open their eyes and stop. While Mountain Well is designed to help people transform fears, it should not in itself become retraumatizing.
Mountain Well begins with an invitation to sit upright, if possible, and close one's eyes. I often begin each formal meditation by softly chiming a pair of Tibetan meditation bells three times, though this is not necessary. I ask everyone to begin by observing their breathing, and if possible to breathe from the belly. They should simply notice the rise and fall of their abdomen without trying to breathe in any special or particular way. Once the participants begin to settle into silence and stillness, I speak in natural measured tones that permit space for pauses. The script below may be embellished or modified, but do allow about 20 minutes to complete the meditation as is:
Now I would like to invite you to imagine with your mind's eye that you are on a mountain. It can be a mountain that you're familiar with or perhaps one that you've seen in a photograph or a movie. Either way, you have climbed up among the trees and rocks to a high point under a hot sun, and now you are thirsty but you haven't brought any water with you. There's a clearing in the trees below you, though, and in this clearing you see what looks like an old-fashioned well. Imagine, if you can, a fairy tale well with a bucket and a rope and crank to drop the bucket down and pull it up. However you see it, I invite you to walk down from where you are to the clearing.