Mindfulness and the Addictive Process: Psychological Models and Neurobiological Mechanisms

Few conditions cause as much suffering on a personal and societal level as addictions. Though efforts have helped to delineate the neurobiological mechanisms of the addictive process, treatment strategies have lagged behind. Mindfulness training, which is based on ancient Buddhist psychological models of human suffering, has recently shown promise in the treatment of addictions. Interestingly, these early models are remarkably similar to modern-day models, namely in their overlap with positive and negative reinforcement (operant conditioning). Remarkably, the early Buddhist models may take it one step further, both in explaining the psychological mechanisms of mindfulness and importantly also pointing to key elements of the addictive process, such as craving as essential targets of treatment. In this chapter, we describe the overlap and similarities between early and contemporary models of the addictive process, review studies of mindfulness training for addictions and their mechanistic effects on the relationship between craving and behavior, and discuss recent neuroimaging studies that help to inform our understanding of underlying neural mechanisms of mindfulness.