Transforming fear

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.

Imagine yourself in the clearing now, and as you walk toward the well a frightening creature steps out from behind it. Just the sight of this creature fills you with fear. Perhaps it is burning with fire or covered with scales or snakes. Perhaps it is known to you and that makes it even more frightening. You may want to turn away and run but if you can, stay here by the well, facing the monster. And if you do, it speaks to you saying, “I know you are thirsty but this water is poisoned.” You can smell that the water is sour and foul. The creature steps toward you, holding out its hand. You can feel the trembling in your body as it tells you that in order to drink from the well you must first look into its eyes and take its hand. And even though you can feel your stomach churning, you force yourself to look at the creature's eyes as you reach out to take its hand.

The moment you do this, something wonderful happens: The creature transforms into a golden spirit that fills you with peace. You look down at its hand and see that it is holding a small rock in its palm that glows with a golden light as well. The spirit smiles at you as it thanks you for embracing it. Then it tells you to take the stone and use it to make a wish before dropping it into the well. And with that it disappears.

All alone now, you walk to the well and look down into the musty blackness. Now I invite you to make a personal wish for yourself from your heart for what you want out of your recovery. When you're ready, drop the stone into the well. Hear it splash as the water below brightens with a golden light and this water instantly smells sweet and pure. You pull up the bucket and drink from it, quenching your thirst. Then, with your mind's eye, you watch the stone sink deeper into the wellspring of your own heart. Perhaps this deepens your wish or transforms it. Perhaps not. Either way, content now, you walk to the grass near the meadow and sit down or lie down beneath the sun and begin to observe your breath again as it moves in and out of you. Not wanting anything more than to be present in this moment, fully alive.

After a few moments of silence, I chime the bells again, signaling the end of the meditation.

Processing the meditation

After completing the meditation, I leave time for processing the experience. Part of its power comes from an unspoken recognition among group members that they have kept company with one another despite their fears. This tends to lessen the sense of devastation that might accompany the existential terror of being all alone.

As with any intervention, Mountain Well does not work the same way for every person. While I have found that most people respond quite positively to the meditation, there are those patients who remain unwilling to invest enough cognitive or emotional energy into the experience to benefit from its healing power. Some might still be too impaired or fatigued from detoxification to remain focused on the task; others might reject it for lack of motivation for recovery or distrust of the value of meditation in general. They might “tune out” my voice and drift off to their own thoughts.

In processing all forms of resistance, I have found that it is important to accept each person's experience as valid to that person. After all, this was the meditation they had. Yet resistance provides a teachable moment in that it allows us to recognize the power of the concept of desiring things to be different from the way they are.

On the other hand, there are those patients who deeply engage in the meditation, often with profound results. I have seen patients brought to tears through the experience, and some have expressed powerful insights as to the nature of the fears that have contributed to their continued use and suffering. For some patients the fearful issue is their addiction, while for others it is their sobriety. Some put the face of a family member on the creature, while some see their own face. Each of these responses can be explored for qualities of insight, transformation and hope. While I sometimes ask patients to share their wishes-and these are often for health, strength and sobriety-there is no obligation placed on them to do so.

The guided meditation session ends with a summation on the themes of acceptance, transformation and vision. In particular I like to address the latter as essential to a successful recovery. It is one thing for patients to follow a treatment plan but quite another for them to envision themselves as capable in sobriety. This meditation can help bring them closer to creating such a vision for themselves-one that is unfettered by fear, in which goals can be set and a treatment plan implemented.

References

1. Marlatt GA. Buddhist philosophy and the treatment of addictive behavior. Cogn Behav Pract 2002; 9:44-50.
2. Singer BF. A mindful recovery. Addiction Professional 2006 Nov; 4:30-5.
3. Chodron P. The Places That Scare You: A Guide to Fearlessness in Difficult Times. Boston:Shambhala Classics; 2002.
4. Richo D. The Five Things We Cannot Change: And the Happiness We Find by Embracing Them. Boston:Shambhala; 2006.
5. Campbell J. The Hero With a Thousand Faces. Novato Calif.:New World Library; 2008 (originally published 1949).

Sidebar

For more on meditation practices that can benefit clients at various stages of treatment, visit https://www.addictionpro.com/singer1106.