Mindfulness-Oriented Recovery Enhancement
MORE strengthens metacognitive control over automatic cognitive biases through mindfulness training – teaching clients to:
A) become aware of when their attention has become fixated on addictive cues, stressors, or (physical or emotional) pain;
B) shift from affective to sensory processing of craving, stress, or pain sensations;
C) re-orient attention to the breath via the practice of mindful breathing.
This technique is also aimed at enhancing self-control over automatic behavioral habits elicited by addictive cues, stressors, and pain. By disrupting negative habit responses, mindfulness may free up cognitive resources to devote to more helpful or healthful ways of thinking, perceiving, and acting in the world, including accessing self-transcendence – a deep sense of connection to something greater than the self.
Mindfulness of Pain and Craving
MORE uses mindfulness practices to potentiate cognitive reappraisal of maladaptive thoughts contributing to negative emotions and addictive behaviors; such “mindful reappraisal” is aimed at fostering adaptive coping in the face of stress. MORE increases psychological flexibility by explicitly teaching mindfulness skills in tandem with cognitive restructuring techniques. MORE teaches people to first mindfully disengage from negative appraisals of stressful events and then to reframe them into positive reappraisals to promote resilience and meaning in the face of adversity.
MORE enhances positive emotion and motivation by providing instruction in mindful savoring – the practice of focusing attention on and deeply absorbing naturally rewarding experiences (e.g., enjoying the beauty of nature or the sense of connection with a loved one). During savoring, one pays attention to the pleasant sensory features of a positive object or event, while simultaneously noticing and enjoying the pleasurable body sensations, positive emotions, and higher-order affective meaning that arise in response to pleasant life experience. MORE uses exercises to promote focus on positive daily experiences as a means of restoring dysregulated reward neurocircuitry function associated with addiction, mood disorders, and chronic pain, and to increase the healthy sense of pleasure, joy, meaning, and self-transcendence in everyday life.
MORE is distinct from other mindfulness-based interventions in that it uses mindfulness training as a means of promoting positive psychological processes to improve health and well-being. In this sense, the treatment is truly “integrative,” combining the complementary strengths of different therapeutic techniques into one, synergistic approach. For instance, mindfulness skills are used to help clients to disengage from unhealthy cognitive and behavioral habits, while reappraisal skills are used to develop new, more helpful beliefs and actions. Savoring skills are then used to provide the motivational energy and sense of reward needed to promote positive emotions and sustain behavioral change; this latter feature of MORE is especially innovative, as few (if any) empirically-supported treatments directly aim to strengthen the capacity to extract pleasure from naturally rewarding events and experiences. Unlike other mindfulness-based interventions which eschew a focus on evaluation, narrative processing, and positivity, MORE aims to foster the development of valued ways of seeing and responding in the world – generating a sense of eudaimonic meaning in life. Yet, unlike other third wave CBT approaches which focus on values but do not offer instruction in formal mindfulness meditation, MORE provides mindfulness training as a means of strengthening self-regulatory capacity. This enhanced capacity is then channeled in service of promoting psychosocial flourishing. The tripartite MORE approach is guided by fundamental discoveries from neuroscience about the biobehavioral factors integral to suffering and its alleviation. Indeed, studies indicate that cognitive control of attention (i.e., mindfulness), negative emotion (i.e., reappraisal), and reward processing (i.e., savoring) goes awry in addiction, stress, and chronic pain; these processes are integral to healthy brain and body functioning. Thus, MORE aims to cultivate and leverage these basic human strengths to foster therapeutic change, self-actualization, and ultimately, to transcendence – the sense of being connected to something greater than the self.