Rebecca Williams and Julie Kraft

Rebecca Williams and Julie Kraft join us to speak about their co-authored The Mindfulness Workbook for Addiction.

Many people are introduced to mindfulness through its efficacy with stress reduction. Increasingly, however, this practice is being recognized for helping in other areas of human suffering. In particular, how mindfulness can have a positive impact on those dealing with addiction.

Rebecca E. Williams, PhD, is a psychologist, teacher, author, and mentor. She specializes in recovery from mental illness and addictions. She received her master’s degree from Harvard University and her PhD from the University of California, Santa Barbara. She is currently a clinic director at the Veterans Affairs San Diego Healthcare System. In addition, she is an associate clinical professor in the Department of Psychiatry at the University of California, San Diego, and an adjunct faculty member at the University of San Diego. Dr. Williams is coauthor of another book entitled Couple Therapy for Alcoholism: A Cognitive Behavioral Treatment Manual. She has a psychotherapy practice in San Diego, CA.

Julie S. Kraft, LMFT, is a licensed marriage and family therapist. She received her master’s degree in marriage and family therapy from the University of San Diego’s School of Leadership and Education Sciences. She has provided counseling to veterans and their family members at the Veterans Affairs San Diego Healthcare System and has provided psychotherapy to individuals, couples, families, and groups in community settings. In her current position with Sharp HealthCare, she treats clients struggling with both addiction and mental health concerns. Julie also sees clients in her private practice, treating such concerns as relationship issues, anxiety, depression, and substance abuse. She lives and works in San Diego, CA.

Quote

Today’s quote is from Jon Kabat-Zinn’s book, “Wherever You Go There You Are: Mindfulness Meditation in Everyday Life” —

“We use the word ‘practice’ to describe the cultivation of mindfulness, but it is not meant in the usual sense of a repetitive rehearsing to get better and better so that a performance or a competition will go as well as possible. Mindfulness practice means that we commit fully in each moment to being present. There is no ‘performance.’ There is just this moment. We are not trying to improve or to get anywhere else. We are not even running after special insights or visions. Nor are we forcing ourselves to be non-judgmental, calm, or relaxed. And we are certainly not promoting self-consciousness or indulging in self-preoccupation. Rather, we are simply inviting ourselves to interface with this moment in full awareness, with the intention to embody as best we can an orientation of calmness, mindfulness, and equanimity right here and right now.” p.8

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Ted: Our guests today are Rebecca Williams — Rebecca, thank you for being here —

Rebecca: Thank you for having me.

Ted: And Julie Kraft. Julie, thank you for joining us on Present Moment.

Julie: I’m happy to be here.

Ted: So let’s talk a little bit about your backgrounds, this intersection of mindfulness practice with addiction therapy. Rebecca, let’s start with you: how did you first encounter mindfulness?

Rebecca: Well that’s a great question, uh, I have been — I’m a psychologist, by trade, ha — but I’ve [indistinguishable] also practicing yoga for about thirty years now. It’s been a life-long joy for me to use yoga to calm myself down and keep myself healthy and happy, and I noticed that when I do yoga and learn mindfulness in that regard it helps me as a psychologist. So I’ve been trying for years to figure out a way to incorporate um my mindfulness and meditation with a practice of psychology — and this was a natural progression to, to bring into the practice.

Ted: Great and, Julie, how about you; how did your experience with mindfulness begin?

Julie: Yeah I first learned about mindfulness in my studies as a therapist there, slowly starting to incorporate mindfulness into, uh, more of a therapeutic technique so something like D.B.T., which is Dialectical Behavioral Therapy which has been proven to be very effective for people that struggle a great deal with strong emotions, so it is starting to work its way into the field, so I did learn about it in school a bit, um but I’ve also had my own experiences with being very mindless [laughs] in my life, [indistinguishable] around, uh, you know mindless eating and that kind of behavior, which I think is very common. So I went ahead and took a class at — here at U.C.S.D. — on, uh, mindful eating and that was a big turn-around for me; I learned a lot about how to bring more present-moment awareness into the eating behaviors.

Ted: And how have you resonated with these practices and brought them into your own practices in terms of addiction therapy? ‘Cause I know that’s also part of your experience, each — eh Julie how about you; starting with you on that one.

Julie: Yeah you know I think it’s a natural fit, as Rebecca was saying, ah — you know, encountering those who are dealing with addiction especially ah, brand-new in recovery, the emotions are so strong, they are so intense, and a lot of them have been in — avoiding emotions for so long, um that really bringing anything that calms the situation, that brings more groundedness, and even just teaching people to tune in and be aware of their emotions and their thoughts, even physical sensations are going, you know, without awareness, was just a really natural progression in terms of how to treat, you know patients I was working with at a local hospital in out-patient therapy for their addictions. Again brand-new, in recovery — [indistinguishable] started doing things like, you know brief mindfulness exercises in our groups, uh brief meditations even breathing exercises where you bring that mindful attention to the breath; I’ve seen just great results for people who take — you know, two to five minutes and the entire tone of the group will have changed. And I — anytime you experience something like that is, is very positive.

Ted: Rebecca how about you, how have you incorporated mindfulness practices with your own therapy?

Rebecca: Well I start at the beginning and, and the basics, which is my office space, and my own mind, so I want to make sure my environment is very calm, clean, and available for both clients and I also do supervision with other trainees and American Family Therapists and other psychologists in training, so I try to start at the beginning. So I want to look in my office and make sure everything is soothing, relaxing, and mindful so I can create an environment and bring either patients or trainees into my environment and make sure they can calm down, relax their own minds and bodies so that they can process what’s going on for them as therapists and what’s going on for them as clients. So, that’s my starting point and from there I certainly use mindfulness skills with clients, and with trainees, and similar to what Julie said we start with breathing, we focus on diaphragm breathing, making sure that the client can center themselves in order to do this challenging work of, uh psycho-therapy.

Ted: Wonderful, thank you. So how did the two of you come to collaborate on the book itself?

Rebecca: I can start with that one. Speaking of “trainee” [mutual laughter] [as] Julie was one of my trainees a couple of years ago, I saw a spark in her, very bright, very in tuned, with excellent outcomes with clients, and I really wanted to work deeper with her in terms of bringing some of our, our conversations to fruition with a book. And we worked really closely together, a lot of trust, a lot of respect, and put together some ideas that were picked up by New Harbinger as very useful for the New Harbinger workbook series.

Ted: And Julie, how about for you; that experience of partnering with someone you had had as a, eh [mentor] before; how was that experience for you and collaborating on the book?

Julie: Well you know I would say Rebecca is still a mentor and probably always will be even though we did kind of collaborate on this piece! It was extraordinary to have this opportunity, I mean, uh obviously working under Rebecca and learning so much from her, ah knowing what she brings to the field clinically, ah, is just extraordinary so, having the opportunity to, to work more closely with her on a project was huge — but I also really could see that she had conceptualized this idea for the books, for years, I mean I — I think she could probably speak to that, that she had said that this was really, you know rattling around in her mind this idea of loss being such a huge trigger for addictive behaviors, and she had seen this again and again clinically and felt that there was really something missing from the addiction field in terms of dealing with loss in a, in a mindful way. Um so listening to her when we first sat down to collaborate and hearing you know all the expertise that she was bringing to this and this, you know fantastic idea of integrating the loss and the mindfulness. Ah was just fantastic and so it, it was a wonderful process writing the book; it gave me a chance to sit down with Rebecca and think about, you know, clients that we will never meet, what do they need from us? You know people that pick up the workbook, you know somewhere in another state that, you know will never interact with us directly, we wanted to speak to them in a way that they could, you know receive the skills and learn something from this, so, that was a great way to, to think about the writing.

Ted: So tell us about the book. It’s a, a workbook — so a bit more hands-on?

Rebecca: Yeah the workbook is exactly hands-on Ted — I, I couldn’t have said it better myself. What’s interesting [indistinguishable] about a year, I’m getting e-mail from across the country, from all sorts of different folks who are using the book, it’s at a very manageable reading level, I think, uh, New Harbinger ha — requested that we put it at a like a ninth or tenth-grade reading level so that it can be accessible for anybody, from for — everything from teenagers are picking up the book in recovery centers all the way to prisoners who are incarcerated — I’ve gotten e-mails across the country, folks wanting to use the book in the prison system, which I — which we are thrilled about — I mean can you imagine getting, getting a workbook like this, on mindfulness, into the prison system? I just — I’m thrilled, we’re, we’re both super-thrilled about that. So um the, the book is extremely friendly there are sixty-four worksheets and hand-outs that any counselor can Xerox and use for any, any session and I think just the ability to pick up it really at any point in the book, and use a worksheet, for, for counselors to use — also for clients to use — is really why it’s so user-friendly.

Ted: Have you been able to incorporate some of what you have in the book into your own private practice or is it something that the book really represents, what you’re already doing with your clients?

Julie: Yeah I think it’s a little bit of both you know, I — I think part of the fun of writing a book, uh was to have all of these ideas and concepts you know in a workbook form that was easy for me to bring to clients, um and to photocopy and to just kind of have it at the ready so, you know concepts that we were already using with clients now really easily accessible and all in this — you know this format, start-to-finish kind of a process to move through, has just been great. And it is, you know I think very accessible to clients, we wrote it in a, you know, a friendly way, it’s warm, it’s, you know — it’s sometimes, you know, as you probably know, the addiction treatments of old were very confrontational, very aggressive, you know, addiction was the one field in which, you know, clients would get attacked, this idea of kind of ripping their defenses away [indistinguishable] and getting rid of the denial — it was, it was quite aggressive. So there’s been, luckily, a wonderful shift towards the more mindful approach and a more loving approach in addiction and this book is really in keeping with that, it’s very warm.

Ted: You mentioned the, the use of the book in the prison system and I imagine that mindfulness practices — uh, just through some other experiences that we’ve had — can help reduce recidivism. Have you found that the book itself, since it’s been published about a year ago, has grown into other areas that you just didn’t contemplate [chuckles] when you first published it?

Julie: You know I, I actually know it’s being used now in some eating disorder programs, um and that was not something I had anticipated, that eating disorders are very similar to addictive behaviors, um although there are some differences, ah but you know when we were originally writing the book that wasn’t an audience that we were writing for, but it’s become quite useful for them and that’s, that’s been really exciting because of course eating disorders are, are quite devastating.

Rebecca: Yeah I, I agree, the eating disorder field is another field that does requires some compassion, and some self-compassion and loving-kindness, so this works great with that population; I think the other area that it’s been picked up quite a bit on is the grief and bereavement population; I knew that addiction and loss went really tightly together in terms of understanding addiction and the addiction pathway. I really was surprised to get so many e-mails from folks who, uh — websites, similar — you know — to yours, where they’re really trying to focus on managing loss and grief, bereavement, so, I — we’re just really thrilled to be able to have it branch a little further than just addiction for drugs and alcohol.

Ted: So what is it you hope people get out of the book — above and beyond the regular dealing with their addictions?

Julie: Yeah I think we’re looking a lot at better management of emotions, better management of thoughts, and also better management of relationships. And one of the longest chapters and the most thorough chapters in the book is, ah Chapter Nine, which is the relationships chapter. Um, just huge, you know, and I myself am a, am a, American Family Therapist so of course I — my training is focused on relationships and how their influence our lives and vice-versa. So I, I do think that’s a really important component, ah for people to get out of this, to just basic communications skills, enhancing relationships that we have, building relationships that we want, um, even getting away from isolation which is such a big issue in, in addiction, ah and building healthy relationships is a, is a big piece. But also this — you know we integrated, you know D.B.T. [indistinguishable] Behavioral Therapy, Cognitive Behavioral Therapy, and Acceptance and Commitment Therapy so these multiple therapies are focused on mood management and on management of our thoughts and behaviors, so, really you know aside from addiction we could all use some of these skills [laughs] big-time, in just coping with strong emotions, ah, experiences that we have, and we want to [indistinguishable] just our thoughts, so, you know we walk around all day having interpretations of our experience, right, which is our thought, and if we can interpret our experiences in a more positive and healthy way, it just changes everything so that’s something we hope people could get.

Ted: You also have a website, MindfulnessWorkbook.com, which we linked on the Episode Page for this episode, and there’s a blog there as well. Can you tell us a little bit more about this site and what’s on it?

Rebecca: Yeah it’s a simple, easy-to-read site similar to our style, and, again it’s warm and inviting, and the purpose of the website is to, as you said to link to the book, but it’s also — the blog helps you, anyone who, who takes a look at it, helps them — just warmly understand that the mind can chatter and be, like we say in Buddhism, a monkey mind where it’s jumping all over the place, and the, the blog is just a way to remind ourselves just to calm down, there is a way to make peace with the mind, and it’s normal for things to get out-of-hand but it’s also normal to bring yourself back to the present moment — which is why I love your website so much, too.

Ted: [chuckles] Thanks I appreciate that. So are there any particular recommendations you would make for those suffering from addiction or their loved ones who might be listening?

Julie: Yeah I think you know the first thing to know, when you are struggling with an addiction, is that you’re definitely not alone. Unfortunately this is a widespread issue. Uh, as Rebecca mentioned not only substance abuse but all kinds of addictive and compulsive behaviors: gambling, pornography, [indistinguishable] et cetera, shopping — um there’re many behaviors that can just start to slowly unfortunately take over a person’s life, ah and become, you know more important than the things that they actually value in life, which is when you start to notice the problem. Um, so I would say you know there is a lot of support out there, gratefully, ah there’re many valuable treatment programs; [indistinguishable] for those who, you know don’t have a lot of money to spend there’s always 12-Step Groups. There’s a 12-Step group for just about every addiction you can think of, and for every compulsion, every disorder. Ah, so there is, you know free support in the community; ah you can find others who’ve been through a similar issue or who are willing to offer continuous support. They’re looking into these — you know thank God now we have the internet, we can use it to for, you know searching out this kind of recovery, ah, community that’s out there for us, and ah, I think that’s a great place to start. There’s a lot of hope.

Rebecca: Yeah I would also add — to what, to what Julie said: be mindful of meditation and potentially yoga, um opportunities that are available. If you have an addictive behavior and you need help, trying to calm the mind down with a class, a mindfulness class, uh, a mindfulness workshop, is extremely helpful as a starting point. In addition we have in our book — at the end of our book we have resources for the journey. There’s about fifty books and ideas in the back of the book to help anybody, whether you’re a therapist or a client or just someone who’s curious, it’ll help you to start the journey — uh or continue the journey, to be well and be strong.

Ted: In the writing of the book, in the gathering of the background information that lead to it, were there any stories or events that stood out to you as being inspiring and remindful of you as to why you were putting it together?

Julie: Gosh I’m wracking my brain I think there was, you know several that come to mind for me working at the, uh as I mentioned at one of the local hospitals here, Sharp Mesa Vista Hospital, um I was working in an outpatient program so many of my clients had just come out of detoxing, um from alcohol or several of them opiate pain-killers — and so working with them, in groups, and again you know seeing some of this mindfulness, these brief mindfulness exercises, ah just gave me a huge shift; I did have, ah one patient who had been through a terrible car accident and was in chronic pain for, you know, the past couple of decades, ah and was now trying to get off this pain medication, and mindfulness was huge for him. Doing, ah, y’kn — he would do mindfulness or meditation podcasts; he had an app on his phone, that we talked about him getting to help him sleep at night, um to do these kinds of exercises before bed; ah he learned to kind of sit in his car sometimes when he was getting overwhelmed at work, uh, and to do one of the exercises; and it was really life-changing for him: I got a, a Christmas card you know a year later — that’s the kind of thing that, ah, just really warms your heart, when you know they’re still, still practicing these behaviors, still sober. Um, and — you know, that’s just huge.

Rebecca: Yeah, that’s, that’s a great story — I probably have twenty stories to select, that’s [indistinguishable] I work at the V.A. hospital and there are daily I see successful positive stories — but my own personal story is really that I saw my mother struggle with addiction for decades and I really felt like I could’ve done more, uh — you know, she’s gone now but I really think this book is a tribute to my ability to kind of take a step back, look at what she might have needed in terms of getting well herself, and being able to get it out there to as many people as possible. So that’s my private story that I [indistinguishable] is, is, really, ah, inspirational to me.

Ted: Well thank you both so much for sharing that. The book is “The Mindfulness Workbook for Addiction” and we’ve been speaking with the authors Rebecca Williams. Rebecca, thank you so much for being here.

Rebecca: Thank you for having us.

Ted: And Julie Kraft; Julie, thank you for joining us.

Julie: It’s been great.

Music for This Episode Courtesy of Rodrigo Rodriguez

The music heard in this podcast is from Rodrigo Rodriguez. You can visit his website to hear more of his music, get the full discography, and view his upcoming tour dates.