Mindfulness and Cravings

In my new book The Willpower Instinct, I describe one of my favorite studies of self-control. I call it the “torture experiment.” It reveals how mindfulness can help us break free from even the most difficult habits.

Sarah Bowen, a research scientist in the Addictive Behaviors Research Center at the University of Washington, invited smokers who wanted to quit to participate in a study. Each brought an unopened pack of their favorite brand of cigarettes. When the smokers were all there, Bowen seated them around a long table. Then the torture began.

“Take out your pack and look at it,” Bowen instructed. They did. “Now remove the cellophane,” she commanded. “Now open the pack.” She walked the smokers through each step, from breathing in the first smell of the opened pack to pulling out a cigarette, holding it, looking at it, and smelling it. Putting it in their mouth. Taking out a lighter. Bringing the lighter to the cigarette without igniting it. At each step, she forced participants to stop and wait for several minutes.

Bowen wasn’t enjoying the smokers’ agony; her real aim was to investigate whether mindfulness can help smokers resist cravings.

Before the torture test, half of the smokers had received a brief training in a technique called “surfing the urge.” [Click here to listen to Bowen talk about the technique.] Bowen explained to the smokers that urges always pass eventually, whether or not you give in to them. When they felt a strong craving, they should imagine the urge as a wave in the ocean. It would build in intensity, but ultimately crash and dissolve. The smokers were to picture themselves riding the wave, not fighting it but also not giving in to it. They were instructed to pay close attention to the urge to smoke, without trying to change it or get rid of it. What thoughts were going through their mind? What did the urge feel like in the body?

An hour and a half later, after being fully put through the wringer, all of the smokers were released from Bowen’s torture chamber. She didn’t ask them to cut back on cigarettes, and she didn’t even encourage them to use the surfing-the-urge technique in everyday life. But Bowen did give ask them to keep track of how many cigarettes they smoked each day for the following week, along with their daily mood and urges to smoke.

For the first 24 hours, there was no difference in number of cigarettes smoked by the two groups. But starting with the second day, the surfing-the-urge group smoked fewer cigarettes. By day seven, the control group showed no change, but those surfing the urge had cut back 37 percent. Surprisingly, for smokers who had learned to surf the urge, stress no longer automatically led to lighting up.

A new study sheds some light on what’s happening in the brain when we apply mindfulness to tempation. This study recruited 47 smokers who wanted to quit, and asked them to abstain from smoking for 12 hours before the experiment. The researchers taught the participants basic principles of mindful attention—like in Bowen’s study, it was a very quick and simple “intervention,” no formal meditation training required.

The researchers then showed the smokers smoking-related images designed to induce cravings. For some images, the smokers were asked to view them passively, without any special mindfulness to their experience; for other images, they were asked to view them mindfully. They also asked smokers to report any cravings they were experiencing. All the while, the researchers were watching what was happening in each smoker’s, tracking brain activity using a functional magnetic resonance imagine machine.

First, the self-report: mindfulness reduced cravings. It’s counter-intuitive, because research has conclusively shown that images trigger strong cravings in smokers. But mindfulness seems to provide some kind of inoculation to the images.

The reduced cravings correlated with reduced activity in craving-related areas of the brain (e.g. the anterior cingulate cortex). Interestingly, mindfulness didn’t just reduce activity; it functionally disconnected the different regions of the brain that make up the “craving network.”

The experience of a strong craving is the product of several brain areas co-activating: regions that make you make you focus on the object of the craving; regions that create the mixed feelings of desire (anticipating the pleasure of reward, while also experiencing the pain and stress of not yet having what you want), and regions that motivate action to get what you want.

Paying mindful attention to the trigger of the craving interrupted this complex brain response, and ultimately protected smokers from their own desire.

It’s likely that this process can help all sorts of temptation and addiction, from food cravings to shopping addiction, substance abuse, and Internet porn. Want to get started? Researcher (aka torturer of smokers) Sarah Bowen leads you through the practice of surfing the urge (click to stream audio, or right-click/control-click and “save file as” to download MP3).

 


Kelly McGonigal is a psychologist at Stanford University. Her latest book, which is full of strategies for mindful and self-compassionate change, is The Willpower Instinct: How Self-Control Works, Why It Matters, and What You Can Do to Get More of It.

Studies referenced:

1. Bowen S, Marlatt A (2009). Surfing the urge: brief mindfulness-based intervention for college student smokers. Psychol Addict Behav, 23(4):666-71.
2. Westbrook C, Creswell JD, Tabibnia G, Julson E, Kober H, Tindle HA (2011). Mindful attention reduces neural and self-reported cue-induced craving in smokers. Soc Cogn Affect Neurosci. [Epub ahead of print]