Earlier this year I sat in on a MBRP addictions treatment group led by Chris Finucane, a LCSW with Kaiser Permanente, where I was an intern for a year (in the Mental and Behavioral Health department), and Suzanne Cooper, a Nurse Practitioner in the Addiction Medicine department at Kaiser. Suzanne is one of the kindest people anyone could meet. She’s a devotee of Thích Nhất Hạnh, the Vietnamese monk who is widely considered one of the greatest living Zen masters, and has practiced with him in Vietnam, France, and the United States. I asked her how she arrived at incorporating her personal mindfulness background into her clinical practice with addictions, ways in which she felt that mindfulness could address shortcomings in traditional addiction treatment, and of course, what Thầy is like! Continue reading
Category Archives: Interviews
Back in February, I got the chance to talk to Marsha Linehan, the developer of Dialectical Behavioral Therapy (read her bio here in PDF form), which was originally aimed at treatment of borderline personality disorder (BPD). I asked her a few burning questions such as: it’s been written that there is a high comorbidity rate of BPD and substance use disorders. What are the implications of this in terms of treatment? DBT is extremely popular in clinical settings right now—has any part of this explosive growth given you pause? And finally, how do we as mindfulness-based clinicians grow the field?
Her responses were that she hasn’t tried to grow the field of mindfulness-based clinical interventions. DBT, she told me, was not straight mindfulness, but mindfulness skills. She stated,
“Mindfulness may be a trend right now, there’s no doubt about it. The main thing to hold us back at this moment is the absence of data and limited research. They’ll do research. It’s not hard to research. There just isn’t much right now, and until there is, I won’t try to grow [the clinical mindfulness] field. I colead several retreats a year with therapists….the only people I only teach mindfulness to are looking for personal mindfulness practices. I’m a mindfulness teacher and a zen teacher. With my clients, however, I teach mindfulness skills, not straight mindfulness. We don’t know why it’s effective. What we know is that the group of skills are effective and mediate against relapse [of various clinical disorders].”
As for the correlation between borderline personality disorder, she stated, “Well, many things are comorbid with borderline and with substance abuse. It’s not surprising to see these two conditions occurring frequently together.”
On Monday night, about 20 people gathered in the quiet zendo of the Zen Center of Portland and settled themselves unto zafus and zabutons. Darren Littlejohn sat quietly and patiently at the front of the practice space and looked out at the faces gathered around him, eyes turned in his direction. It could’ve been any one of the thousands of sitting groups across the United States, but this group was different. In addition to being a Buddhist, Littlejohn is a recovering addict–and so were almost all of the people in attendance.
A few days later, I was sitting across from him at Bipartisan Cafe, a coffeeshop in southeast Portland. “I don’t consider myself a substance abuse counselor–I don’t have the training–but I consider myself in that field,” he said, taking a bite of his sandwich. Littlejohn’s been running his 12-Step Buddhist sitting group there since March of 2009, and it’s reaching a surprising number of people who want to learn how to use Buddhism and meditation to prevent relapse. With personal experience both in Buddhism and in the 12-step model, as well as an eerie memory for faces, Littlejohn seems uniquely poised to reach addicts who are looking for something a little different. Littlejohn used the 12-Step Buddhist approach in traditional addiction treatment settings for several years before taking it to the Zen Center, but he feels that running the group independently in the community is a better fit for him. His book, The 12-Step Buddhist, was published last year to wide acclaim.
Littlejohn likes Buddhism as an intervention because it’s customizable, saying that practicing Buddhism is not superior for relapse prevention than 12-step meetings–rather, it’s simply another way to assist recovery from addiction. For him, they both go together. “I don’t want to be one of the guys who practices meditation instead of going to meetings,” Littlejohn says. “If you can be an example of someone who goes on through suffering, you can create a strong movement. This is why I labor at this. If I can get one person on their own path, there’s no stopping them.”
With Buddhism as a tool for recovery, he says, “I feel freer to deal with people and meet them where they are.” He believes that people in recovery are uniquely qualified to help others into recovery. “You can’t fabricate the experience of waking up in your own puke. [If you haven’t been an addict yourself,] you can’t look at an addict and say, ‘Me too.’ ” Littlejohn believes that this applies to more than just issues of abuse; it’s also necessary in order to reach historically maginalized communities. “The majority of people I reach with this work are white, middle-aged, and predominantely female–not unlike the 12-step communities which I’ve been in my whole life,” Littlejohn said. Buddhism must grow on a grassroots level to reach other audiences, he says. “People from those populations are uniquely qualified to go back to deliver services to their communities,” he said.
His observation hints at a widely-known yet little-acknowledged truth: there is a lack of ethnic and racial diversity in the American Buddhist movement. A report on the subject by Harvard University’s Pluralism Project quotes bell hooks as saying, “when people of color are reluctant to enter predominantly White Buddhist settings it is not out of fear of some overt racist exclusion, it is usually in response to more subtle manifestations of white supremacy” (“Racial Diversity and Buddhism in the U.S,” 2006).
How does Buddhism–or addiction medicine, for that matter–reach a more diverse population? Littlejohn says he falls back on the universality of both Buddhism and the 12-step model of addictions treatment, as well. “I’m trying to introduce some concepts which can be used with any population, anywhere, regardless of criteria,” he says. “It’s not that the principles are flawed. In principle, the 12-steps are applicable to everyone, but we have a bit of tunnel-vision; ethnocentricity; groupthink mentality. I’m trying to open up the field so more people have the opportunity.”
“My general mission is to wake people up to what recovery is if they’re not in recovery, to wake people up to what Buddhism is if they’re not a Buddhist, and to help us all realize that we can all practice the dharma.”
I had the opportunity to interview Dan Dickinson, who works for Kaiser Permanente as Clinical Services Manager in the Department of Addiction Medicine. Dan has a personal mindfulness practice and uses it in his work with clients. He states,
“People with addictions have incredible needs around self-maintenance, self-soothing, [and could benefit from] detachment from thought, just being able to observe thinking. Addiction patients are so much on automatic pilot, based on their drug use. Any sort of difficult feelings that they’re experiencing or their stressors, their automatic pilot will say “go get some sustenance,” from alcohol or whatever drug that they use. So I thought boy, this has some real relevance. I started bringing individual [mindfulness] skills into my practice from then on.”