Integrating Intentional Breathing,
Meditation, and Visualization in
Substance Abuse Treatment
stebnickim@ecu.edu
http://www.ecu.edu/cs-dhs/rehb/stebnicki.cfm
Mark A. Stebnicki, Ph.D, LPC, DCMHS, CRC, CCM
Professor- Dept. of Addictions & Rehabilitation
Coordinator- Military and Trauma Counseling
Certificate Program
East Carolina University
SAGE
(Stress Annoyance of Guilty thinking on a Everyday basis)
1.Have you ever thought about cutting down on your stressthinking and stress use?
2.Have people annoyed you by criticizing your thinking and
stress-use?
3. Have you ever felt bad or guilty about your thinking or stressuse?
4. Have you ever had to think the first thing in the morning to
quiet your mind, steady your stress, or get rid of a stress
hangover?
If you scored 1, there is an 80% chance you are not mindful of your stress addiction.
If you scored 2, there is an 89% chance you are not mindful of your stress addiction.
If you scored 3, there is a 99% chance you are not mindful to your stress addiction.
If you scored 4, there is a 100% chance you are not mindful of your stress addiction.
SUD
There are two major changes in DSM-5 to the diagnostic
criteria:
(1)Eliminate recurrent legal problems
(2)New criterion: craving or strong desire/urge to use a
substance.
The DSM-5 defines a substance use disorder as the presence of
at least 2 of 11 criteria, which are in clusters. Severity of the
DSM-5 substance use disorders is based on the number of
criteria endorsed:
2–3 criteria indicate a mild disorder
4–5 criteria, a moderate disorder
6 or more, a severe disorder
DSM -5 CRITERIA
IMPAIRED CONTROL: taking more or for longer than intended, unsuccessful efforts to stop or
cut down use, spending a great deal of time obtaining, using, or recovering from use, craving for
substance.
SOCIAL IMPAIRMENT: failure to fulfill major obligations due to use, continued use despite
problems caused or exacerbated by use, important activities given up or reduced because of
substance use.
RISKY USE: recurrent use in hazardous situations, continued use despite physical or psychological
problems that are caused or exacerbated by substance use.
PHARMACOLOGIC DEPENDENCE: tolerance, withdrawal symptoms
EMOTIONAL SYMPTOMS: Anxiety, Restlessness, Irritability, Insomnia, Headaches, Poor
concentration, Depression, Social isolation
PHYSICAL SYMPTOMS: Sweating, Racing heart, Palpitations, Muscle tension, Tightness in the
chest, Difficulty breathing, Tremor, Nausea, vomiting, or diarrhea
Show-up
Pay Attention
Be Open to the Outcomes
What is Mind-Body-Spirit?
Mind: consciousness (waking, dream, transcendental or non-ordinary states)
perceptions, philosophies, beliefs, thoughts,
attitudes, feelings, and cognitions.
Body: physiological, cellular, and
biological functioning of all body systems.
Spirit: (different from religiosity) that which
cannot be seen, made-up of experiences of faith,
hope, comfort, beliefs, philosophies, rituals, belief
in a divine source of energy that guide our lives.
Acceptance of Integrative Approaches and
The Power and Control of Medicine
• Beginning in 1500 China imposed a death sentence on anyone building a
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ship with more than two masts in attempt to control the flow of
medicinal herbs, books about health and healing and other cultural items.
Shamanism and its approaches dates back 10 thousands yrs +
Shaman acted as the tribal leader, priest, counselor, physician,
healer, mystic, folk-healer for healing the mind-body-spirit.
The shaman transitions between the lower, middle, and upper
worlds in non-ordinary states of consciousness to seek awareness,
knowledge, spirit guides, and power animals to help facilitate
healing.
By communicating with the sprit world, and using a heightened
sense of intuitiveness, the shaman finds answers and cures for
illness.
A Very Brief History of
Good - Bad Medicine
• European colonialists arrived and brought new
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medicine from religious-spiritual beliefs London-based
churches/medical schools.
Despite documented therapeutic effects of Native
North American spirituality, herbal, botanical, other
natural treatments- European attitude was that of fear,
ignorance, and perceptions of godless creatures.
New World medicine and religious-spiritual beliefs
brought political power, influence of the medical
model, economic, and dominance of Christianity.
A Paradigm Shift in 20th century
Counseling & Psychology
• 1960s: Human Potential and Personal Growth
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Movements began in Big Sur CA- Eslen- strategies for
empowerment, creative problem solving, happiness, selfactualizing, transcendental meditation, and Zen
Buddhism.
1970s: Birth of New Age spirituality movement; people
leaving traditional religious practices; the birth of the
“self-help” book.
New Age movement incorporated primarily Native
American and Eastern philosophies and spiritual beliefs
that combining psychology, spirituality, and theology.
Late 1970s inspired the growth in transpersonal
psychology, the esoteric, secular mysticism, existential
phenomenology and developing one’s psychic-intuitive
abilities, shamanism, and everything M-B-S.
MBS Wellness-Health Begins with
Taking a Cleansing Breath
Preparing a Sacred Space
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Sound Therapy
Aroma Therapy
Light Therapy
Cultivating your Soul
Show up-Pay AttentionBe Open to the Outcomes
Journaling Experiences
* Spontaneous writing
(dreams, visions, symbols)
* Open and honest
* Accept whatever comes to mind
* Grammar- spelling fagetta-bout-it
* Process is just for You
Hindu Parable: The Monkey
and the Banana
The Problem of Monkey Mind
Taking a Deep Cleansing Breath
Letting Go
Prayer vs. Meditation
Solitary-Collective-Vocal-Silent
CONTEMPLATIVE PRAYER
Adoration: acknowledges the vastness and incomprehensible
greatness of the universe, God, Divine Source of Energy; How
Great Thou Art.
Thanksgiving: offers Gratitude for the gifts we receive.
Contrition: apologies for transgressions, bring unity of self
with God, the Divine.
Petition: asks for needs to be met, divine wisdom, guidance.
Mystics, Monks, Saints & Sages
St. Teresa of Avila (1515-1582): Prayer is quieting
the mind-body-soul to facilitate the “incipient
union” or “rapture”; all sensory elements cease,
one feels transported to another realm or
dimension;
Next- comes the prayer of marriage where
individual feels a spirit presence (light) and
maintains in permanent contact with the divine;
All prayer states are gifts, they cannot be earned.
Mystics, Monks, Saints & Sages
St. John of the Cross (Spanish Mystic1541-1597):
“Dark Night of the Soul” A sense of “dryness” “futility”; a dark
soul (depression) is natural, individuals should accept this
challenge of transcending a “dark night”.
Thomas Merton (American Trappist Monk 1915-1968):
“Contemplation does not arrive at reality after a process of
deduction, but by an intuitive awakening in which our free and
personal reality becomes fully alive to its own existential
depths, which open out into the mystery of God….not a trance
or ecstasy…it is not we who choose to awaken ourselves, but
God who chooses to awaken us…”
Zen Meditation & Enlightenment
Chop Wood-Carry Water
Bodhidharma (Indian Monk, Founder of Zen 5th century)
• Intent is to achieve “enlightenment” [satori] the
state of being able to meditate continually (washing
dishes, sweeping the floor, chopping wood, walking the beach, woods, shooting an arrow)
• Zen (different than Buddhism) IS NOT a journey;
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rather it is the sudden attainment of
enlightenment or illumination.
When enlightenment or illumination is attained it
is spontaneous where one lives completely in the
present moment; there is no past or future.
Koans
Meaning is found in actions not rationale thoughtsPurpose is to enlighten
“What is the sound of one hand clapping?
“Show me your face before you were born?”
A monk came to the famous teacher Choa-chou
and asked to be enlightened. The teacher asks
“have you eaten yet?” The monk responds
“Yes”. Teacher states: “Then go wash your
dishes”
THE Most Important Questions or
East vs West Koans
1. Where did we come from and where are we
going after we leave planet Earth?
2. Is there a grand design or unified theory at
the quantum level that remains unchanging,
static, or fixed?
3. Do all things happen for a reason- or can we
control and change things?
4. Why do bad things happen to good people?
Zen Master
Could Be GoodCould Be Bad
Mindfulness
• IS a meditative practice evolved from the Buddhist
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practice of vipassami. It has no dogma or list of
other rituals required.
IS (not a technique) but described as: a heightened
state of awareness about yourself in your
environment, sensing others around you, an
emotional release, a deliberate choice just to “be” is
enough, experiencing many feelings (vulnerability,
compassion), being in a here-and-now state of total
unconditional experience with the world.
Mindfulness
• IS a Meditation practice that requires skill and training
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to be present-in-the-moment in a totally unconditional,
objective, non-judgmental way.
IS a practice of acceptance of our inner and outer
experiences as it unfolds in the present moment.
IS a practice that has the intent to fully experience our
all-body consciousness at the highest optimal level.
MBSR (Kabat-Zin) est. 1979 UMASS Med Center
Developed as a model approach to treat stress, pain, illness, and disease.
Breathing In- Visualizing- Letting Go
What do You need more of in Your life?
Joy
Love
Compassion
Healing
Peace
Creativity
Part 2
Western Medicine and the Sympathetic-Parasympathetic
Nervous System
Emoto’s Hidden Message in Water
http://www.whatthebleep.com/crystals/
• Experiment: using high speed photography, the
positive/negative energy could change the consistency
and patterns of water crystals.
7th- Crown
{Consciousness,
Spiritual awareness}
6th- Third Eye
5th- Throat
4th- Heart
{Intuitive/Inner vision}
{Self-expression}
{Love of self/others}
3rd- Solar Plexus
2nd- Sacral
1st- Root
{Power, Strength}
{Self-esteem, Relationships}
{Survival, fertility}
Meridians of the Body
Neurons: The Function & Structure
of the Nervous System
• Neurons are a highly specialized cell used to transmit
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messages to-from the brain.
Process uses chemical (neurotransmitters) and electrical
impulses (generates 20 watts) that send and receive
messages in the body through long nerve fibers (axon).
Two highly specialized neurons: sensory (afferent) &
motor (efferent) carry information from the brain to
different body systems within milliseconds (250 mph).
Avg. neuron makes 15,000-200,000 connections.
It’s all just a big shell game
Why Zebras Don’t Get Ulcers:
Relationship between Stress & Disease
Dr. Robert Sapolsky
Stress and Disease: Result of Too Many
Unhealthy Thoughts, Perceptions & Feelings
• Excessive, recurrent, and intense emotional arousal
of an unhealthy nature results in stress and disease;
• Repeated reactivation of our perceptual-cognitiveaffective response that is unhealthy in nature…;
• Stored unhealthy thoughts, perceptions, and
emotions, become a worn neural pathway which
leaves an imprint on our cognitive unconscious
and causes a mind-body interaction.
So Why Don’t We All Die from
Stress?
• We all differ as to the:
-pattern
- frequency
-exposure
-magnitude/intensity
-immune competence & resistance
…..of how we turn-on our own stress
response
“The tragedy of life is not death;
itself but what dies inside of us
as we live”
-Norman Cousins
Inflammation: The Cornerstone
of the Body’s Healing Response
• Inflammation evidenced on the surface of the body
(externally) as redness, heat, swelling, pain.
• Inflammation not as obvious (internally) – but occurs in
lining of arteries, in the brain, various tissues and organs.
• Any biological, psychological, social, emotional,
physical, ANYTHING that promotes inflammation
increases the risk of cell proliferation, and increasing the
risk of malignancies.
Inflammation: No Friend of Mine
•INFLAMMATION IS THE ROOT CAUSE OF
MOST COMMON AND SERIOUS DISEASES OF
AGING, CARDIO, ALZHEIMER’S, CANCER,
OTHER DISEASES OF THE CNS.
• Cytokines - substances secreted within the immune
system (hormones, proteins, peptides, glycoproteins)
used to regulate immune response to disease, viruses,
and IS the principal chemical cause of the
inflammatory response.
Evidence for Spontaneous Healing
from M-B-S Level
•Human body is in a constant state of
equilibrium- it requires a high degree of coherence
and organization to produce 600 billion cells every
24 hrs (or 10 million cells per second).
•Every 90 sec. millions of antibodies are
synthesized from about 1200 amino acids (200/hr).
•No matter how diverse cells and organs are- they
co-exist in the same body maintaining harmony,
balance, and an interconnected vibrational energy.
Your Body Can Heal ItselfIt Wants to be Healthy
• A natural healing system is in place at the very
biological-physiological level (DNA, Cell
structures, immune functioning)
• Our DNA IS our natural repair system because
it goes through the complex chemical process
of replication-transcription-translation.
Immune Response
http://www.youtube.com/watch?v=90hSVkaOG_w&feature=related
• Check-point Charlie-Sorting-AnalyzingMemorizing-Educating-Seek & Destroy
Impaired Defenses
Stress Research
• Persistent and overwhelming infections or a
physiological assault on our immune system.
• Toxins in our body:
- water we drink
- air we breathe
- food we eat
- pharmaceutical products we take
- thoughts, feelings, cognitions we have
Journey to Spirit Mountain
Self Regulation
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Compassion & Empathy
Behavioral Health [exercise, diet, supplements]
Body-Physiological Awareness
Breathing, Meditation, Relaxation, Stress
Inoculation
Visualization, Spontaneous Belief, Hopefulness
Sound, Aroma, Environmental Therapy
The Resiliency Advantage
Dr. Al Siebert
1. Making conscious choices in life.
2. Power of Positive Thinking.
3. Take responsibility.
4. Internal locus of control.
5. Self motivate yourself.
6. Don’t fear trying-out new things.
7. Take control of your life.
8. Practice positive approaches to life.