- Home
- Help Yourself Addiction Tools
- What Are Your Recovery Options
- Interview with Stefanie Goldstein, Ph.D. on Mindfulness-Based Treatment of Addiction
- Home
- Help Yourself Addiction Tools
- Self Management Tool Box
- Cornerstones of Change
- Managing Thinking
- Interview with Stefanie Goldstein, Ph.D. on Mindfulness-Based Treatment of Addiction
Interview with Stefanie Goldstein, Ph.D. on Mindfulness-Based Treatment of Addiction
- By DrsGoldstein Therapy
- Published 08/4/2008
- What Are Your Recovery Options , Managing Thinking
- Unrated
DrsGoldstein Therapy
Stefanie Goldstein, PhD and Elisha Goldstein, PhD provide individual and group psychotherapy and guided meditations in the West Los Angeles area.
http://drsgoldstein.com/
Wise Counsel Interview Transcript: Stefanie Goldstein, Ph.D. on Mindfulness and addiction
Host: David Van Nuys, Ph.D. : Welcome to Wise Counsel, a podcast interview series sponsored by mentalhelp.net. covering topics in mental health, wellness and psychotherapy. My name is Dr. David Van Nuys. I'm a clinical psychologist and your host.
On today's show, we'll be talking about mindfulness in the treatment of addiction with my guest, Dr. Stefanie Goldstein. Stefanie Goldstein, PhD, is a clinical psychologist who integrates traditional psychodynamic psychotherapy with progressive psychotherapeutic interventions such as mindfulness, psychosynthesis and somatic psychology.
Dr. Goldstein is also an addiction medicine specialist and a trained practitioner in psychosynthesis, an integrative form of psychology that focuses on the synthesis, healing and growth of the self. She has worked individually with adolescents, adults, couples and families and has facilitated many process and education groups.
She also had a rich and varied training experience working in multiple community mental health and healthcare organizations in the Bay area.
And now, here's the interview...
Dr. Stefanie Goldstein, welcome to Wise Counsel!
Stefanie Goldstein: Thank you! I'm glad to be here.
David: Yeah, that's great. I'm glad to have you too. I'm particularly intrigued to interview you because as you may know, I recently interviewed the internationally known mindfulness teacher, Shinzen Young, on this show and you're bringing mindfulness into your work on addictions. So, I thought speaking to you would be a good follow-up to that show.
Stefanie: Yeah, I listened to that interview. It was really a great interview. The work that I do is more on a practical, everyday, in the therapy room...
David: Exactly, exactly, and that's precisely why I wanted to bring you on. So, maybe we could start off by having you talk about your own spiritual journey and what led you to incorporate spirituality and particularly, mindfulness, into your work.
Stefanie: Sure! So, I think, for me, my interest and intrigue in spirituality really began in high school. I had a dear friend who was really struggling and then eventually dying from bone cancer when I was in high school. He led this journey of questioning and really just struggling with God and yet never giving up on it and it really incited my own spiritual journey at the time and my initial dissertation research was actually on spirituality in adolescence and looking at is it emerging for other teens and how is it manifesting and how are they experiencing it.
And so, for me, it really set me on a journey at that point of just searching, searching for meaning, for what fits for me, to try and make sense of this world. I read a ton of books and began to be interested in Buddhism and my background initially is in Judaism, and finding that both really began to fit for me together. When I graduated from college, I travelled around the world for a year, which also was quite a spiritual journey, in and of itself.
While I was travelling, I did a 10 day Vipassana meditation retreat in Thailand. That was such a profound experience for me, partially because when I arrived, in my ignorance, I didn't know it was going to be silent...
David: Oh my goodness! [laughter]
Stefanie: So, I got there and they're like, "All right, let the silence begin" and I was like, "What?" Which, at the time, I think actually ignorance was bliss. Had I known, it might have felt too overwhelming and intimidating to actually choose to go. And so, it really deepened my spiritual journey. As I was travelling, I realized I wanted to go back to graduate school and continue my path of becoming a therapist, which is something I always knew I wanted to do.
But realizing and becoming clearer to me that I wanted to somehow incorporate spirituality in that. And I didn't quite know how, I didn't if there were programs that did that, but I knew that that was very important to me because I felt like all aspects of the self were equally important, that it wasn't the therapist and in therapy, it wasn't just about your mind and your emotions, but it was about your heart and your soul.
And so, once I returned from travelling, I began searching programs and I found a few that did that and I ended up going to the Institute of Transpersonal Psychology in Palo Alto, which is really where spirituality is infused throughout the entire program. And I feel incredibly grateful that I got that foundation and education because it ultimately then led me to connect specifically to mindfulness.
One of the things that, personally and professionally, that I love about mindfulness is that it's spiritual and practical. That, sometimes, when you're dealing with mystical aspects of religion or different parts of spirituality, it can get incredibly complicated and intricate and Buddhism and mindfulness certainly can be that way as well, but there are certain things which are just fundamental parts of it, like your breath. Just breathing, we all have to breathe. We wouldn't be here without it.
And so, learning how to use your breath as an anchor can be such a profound tool to help guide us as we go through any trials and tribulations through life.
David: OK. Well, that's all very fascinating. I think that you are probably one of a new breed of younger psychotherapists coming on the scene who see this possibility for integrating facets of spiritual practices into psychotherapy. Let me shift the focus just a little bit now and ask how did you get involved in working with addictions?
Stefanie: Well, I would say it's both personal and professional. Personally, I have had addictions affect my family. I had a grandparent who struggled with alcoholism, and I've also had two dear friends of mine who have died from overdoses, from accidental overdoses. And so, it's always something that I have been interested in learning more about and knowing more about to make sense of my own personal experiences.
And then, professionally, as I was going through my training, I ended up getting a fellowship with Kaiser Permanente's Chemical Dependency Recovery Program in San Francisco, which is where I became an Addiction Medicine Specialist.
I really fell in love with the work because people come in and they're struggling and they're in such a bad place, most often, when they're actually coming to get help. There are so many things they've tried and it hasn't worked, and the transformation that can occur is really quite profound.
In addition, it seemed like a natural fit with my interest and expertise in spirituality and mindfulness because so much of the recovery world is focused around connecting to some sort of higher power, whether it's through something like AA or other ways in which to do that, but really beginning to fill that spiritual void that is often connected with engaging in addictive behaviors. And so, it felt like a really good fit and that's where it took off for me.
And then, my husband, Elijah Goldstein, who is also a psychologist and who also does a lot of work in mindfulness and he's a mindfulness-based stress reduction teacher, we decided to kind of pull our efforts together and do some research and create an audio CD on mindfulness.
Really, it's called "Mindful Solutions for Addiction: Relapse Prevention, " which is a psycho-educational CD where the first three tracks talk about what is mindfulness, how it works with addiction. And then, the next three tracks are actually guided, progressive meditations of 5, 15 and 25 minutes.
David: Well, I'll make sure that we have a link to your CD in our show notes. Now, I'm under the impression that you have either studied with, or been under the influence of, Dr. Alan Marlatt, who, in turn, was influenced by Dr. John Cabot Zinn. Maybe you can fill us in a bit about their work.
Stefanie: Sure! So, John Cabot Zinn created a program called "Mindfulness-Based Stress Reduction" which is now in over 250 hospitals in the United States. And he said to the doctors in the hospital, "Give me all the people with chronic pain that you feel like you can't help. That pain is just too profound, and medication and all these others ways have not helped them."
And he created a program which incorporates mindfulness medication, psycho education, and yoga, it's an eight week program.
There's been so much research, and so many positives results for people really becoming more aggrandized, changing their relationship to their pain, and really reducing their stress. What has now happened is that people have taken the Mindfulness-Based Stress reduction (MBSR) and created different programs offshooting from that.
There's Mindfulness-Based Cognitive Therapy. Dr. Alan Marlatt from the University of Washington and his colleagues are in the midst of creating and doing research on Mindfulness-Based Relapse Prevention. So it's taking the principles from MBSR and applying them specifically to addiction and relapse prevention.
Dr. Marlatt and his colleagues just completed a preliminary study with a two-year grant from the NIDA, the National Institute of Drug Abuse, with really great findings. They are in the process of applying for a five year grant from the NIDA, which they are including RCD as part of their grant, and which will be part of their program as well.
So it's an eight-week program that takes you through psychoeducation, how to work with urges and triggers and uncomfortable and negative emotions, and teaching meditation, and meditation is a part of the program. You need to be meditating 30 to 45 minutes a day, and also yoga.
We haven't directly studied with Dr. Marlatt, but we have a relationship with him and we definitely studied his work. We were just recently at the University of the University and gave a talk to his graduate students.
So there's also been other research that has been done, not necessarily with addictions, but with mindfulness and meditation. Dr. Richie Davidson, a neuroscientist, from the University of Wisconsin, has conducted research with brain imaging technology.
This is a really simplified way to describe it, but his findings show that people who practice mindfulness meditation tend to show more activity on the left side of the brain, which is typically associated with positive emotions, such as feelings of calm and happiness, versus the right side of the brain, which is typically associated with feelings of sadness, worry, and anxiety.
All of those negative or uncomfortable emotions are one of the ways that can trigger and lead us to relapse.
Continued - read rest of transcript and listen to the podcast at Wise Counsel
Host: David Van Nuys, Ph.D. : Welcome to Wise Counsel, a podcast interview series sponsored by mentalhelp.net. covering topics in mental health, wellness and psychotherapy. My name is Dr. David Van Nuys. I'm a clinical psychologist and your host.
On today's show, we'll be talking about mindfulness in the treatment of addiction with my guest, Dr. Stefanie Goldstein. Stefanie Goldstein, PhD, is a clinical psychologist who integrates traditional psychodynamic psychotherapy with progressive psychotherapeutic interventions such as mindfulness, psychosynthesis and somatic psychology.
Dr. Goldstein is also an addiction medicine specialist and a trained practitioner in psychosynthesis, an integrative form of psychology that focuses on the synthesis, healing and growth of the self. She has worked individually with adolescents, adults, couples and families and has facilitated many process and education groups.
She also had a rich and varied training experience working in multiple community mental health and healthcare organizations in the Bay area.
And now, here's the interview...
Dr. Stefanie Goldstein, welcome to Wise Counsel!
Stefanie Goldstein: Thank you! I'm glad to be here.
David: Yeah, that's great. I'm glad to have you too. I'm particularly intrigued to interview you because as you may know, I recently interviewed the internationally known mindfulness teacher, Shinzen Young, on this show and you're bringing mindfulness into your work on addictions. So, I thought speaking to you would be a good follow-up to that show.
Stefanie: Yeah, I listened to that interview. It was really a great interview. The work that I do is more on a practical, everyday, in the therapy room... David: Exactly, exactly, and that's precisely why I wanted to bring you on. So, maybe we could start off by having you talk about your own spiritual journey and what led you to incorporate spirituality and particularly, mindfulness, into your work.
Stefanie: Sure! So, I think, for me, my interest and intrigue in spirituality really began in high school. I had a dear friend who was really struggling and then eventually dying from bone cancer when I was in high school. He led this journey of questioning and really just struggling with God and yet never giving up on it and it really incited my own spiritual journey at the time and my initial dissertation research was actually on spirituality in adolescence and looking at is it emerging for other teens and how is it manifesting and how are they experiencing it.
And so, for me, it really set me on a journey at that point of just searching, searching for meaning, for what fits for me, to try and make sense of this world. I read a ton of books and began to be interested in Buddhism and my background initially is in Judaism, and finding that both really began to fit for me together. When I graduated from college, I travelled around the world for a year, which also was quite a spiritual journey, in and of itself.
While I was travelling, I did a 10 day Vipassana meditation retreat in Thailand. That was such a profound experience for me, partially because when I arrived, in my ignorance, I didn't know it was going to be silent...
David: Oh my goodness! [laughter]
Stefanie: So, I got there and they're like, "All right, let the silence begin" and I was like, "What?" Which, at the time, I think actually ignorance was bliss. Had I known, it might have felt too overwhelming and intimidating to actually choose to go. And so, it really deepened my spiritual journey. As I was travelling, I realized I wanted to go back to graduate school and continue my path of becoming a therapist, which is something I always knew I wanted to do.
But realizing and becoming clearer to me that I wanted to somehow incorporate spirituality in that. And I didn't quite know how, I didn't if there were programs that did that, but I knew that that was very important to me because I felt like all aspects of the self were equally important, that it wasn't the therapist and in therapy, it wasn't just about your mind and your emotions, but it was about your heart and your soul.
And so, once I returned from travelling, I began searching programs and I found a few that did that and I ended up going to the Institute of Transpersonal Psychology in Palo Alto, which is really where spirituality is infused throughout the entire program. And I feel incredibly grateful that I got that foundation and education because it ultimately then led me to connect specifically to mindfulness.
One of the things that, personally and professionally, that I love about mindfulness is that it's spiritual and practical. That, sometimes, when you're dealing with mystical aspects of religion or different parts of spirituality, it can get incredibly complicated and intricate and Buddhism and mindfulness certainly can be that way as well, but there are certain things which are just fundamental parts of it, like your breath. Just breathing, we all have to breathe. We wouldn't be here without it.
And so, learning how to use your breath as an anchor can be such a profound tool to help guide us as we go through any trials and tribulations through life.
David: OK. Well, that's all very fascinating. I think that you are probably one of a new breed of younger psychotherapists coming on the scene who see this possibility for integrating facets of spiritual practices into psychotherapy. Let me shift the focus just a little bit now and ask how did you get involved in working with addictions?
Stefanie: Well, I would say it's both personal and professional. Personally, I have had addictions affect my family. I had a grandparent who struggled with alcoholism, and I've also had two dear friends of mine who have died from overdoses, from accidental overdoses. And so, it's always something that I have been interested in learning more about and knowing more about to make sense of my own personal experiences.
And then, professionally, as I was going through my training, I ended up getting a fellowship with Kaiser Permanente's Chemical Dependency Recovery Program in San Francisco, which is where I became an Addiction Medicine Specialist.
I really fell in love with the work because people come in and they're struggling and they're in such a bad place, most often, when they're actually coming to get help. There are so many things they've tried and it hasn't worked, and the transformation that can occur is really quite profound.
In addition, it seemed like a natural fit with my interest and expertise in spirituality and mindfulness because so much of the recovery world is focused around connecting to some sort of higher power, whether it's through something like AA or other ways in which to do that, but really beginning to fill that spiritual void that is often connected with engaging in addictive behaviors. And so, it felt like a really good fit and that's where it took off for me.
And then, my husband, Elijah Goldstein, who is also a psychologist and who also does a lot of work in mindfulness and he's a mindfulness-based stress reduction teacher, we decided to kind of pull our efforts together and do some research and create an audio CD on mindfulness.
Really, it's called "Mindful Solutions for Addiction: Relapse Prevention, " which is a psycho-educational CD where the first three tracks talk about what is mindfulness, how it works with addiction. And then, the next three tracks are actually guided, progressive meditations of 5, 15 and 25 minutes.
David: Well, I'll make sure that we have a link to your CD in our show notes. Now, I'm under the impression that you have either studied with, or been under the influence of, Dr. Alan Marlatt, who, in turn, was influenced by Dr. John Cabot Zinn. Maybe you can fill us in a bit about their work.
Stefanie: Sure! So, John Cabot Zinn created a program called "Mindfulness-Based Stress Reduction" which is now in over 250 hospitals in the United States. And he said to the doctors in the hospital, "Give me all the people with chronic pain that you feel like you can't help. That pain is just too profound, and medication and all these others ways have not helped them."
And he created a program which incorporates mindfulness medication, psycho education, and yoga, it's an eight week program.
There's been so much research, and so many positives results for people really becoming more aggrandized, changing their relationship to their pain, and really reducing their stress. What has now happened is that people have taken the Mindfulness-Based Stress reduction (MBSR) and created different programs offshooting from that.
There's Mindfulness-Based Cognitive Therapy. Dr. Alan Marlatt from the University of Washington and his colleagues are in the midst of creating and doing research on Mindfulness-Based Relapse Prevention. So it's taking the principles from MBSR and applying them specifically to addiction and relapse prevention.
Dr. Marlatt and his colleagues just completed a preliminary study with a two-year grant from the NIDA, the National Institute of Drug Abuse, with really great findings. They are in the process of applying for a five year grant from the NIDA, which they are including RCD as part of their grant, and which will be part of their program as well.
So it's an eight-week program that takes you through psychoeducation, how to work with urges and triggers and uncomfortable and negative emotions, and teaching meditation, and meditation is a part of the program. You need to be meditating 30 to 45 minutes a day, and also yoga.
We haven't directly studied with Dr. Marlatt, but we have a relationship with him and we definitely studied his work. We were just recently at the University of the University and gave a talk to his graduate students.
So there's also been other research that has been done, not necessarily with addictions, but with mindfulness and meditation. Dr. Richie Davidson, a neuroscientist, from the University of Wisconsin, has conducted research with brain imaging technology.
This is a really simplified way to describe it, but his findings show that people who practice mindfulness meditation tend to show more activity on the left side of the brain, which is typically associated with positive emotions, such as feelings of calm and happiness, versus the right side of the brain, which is typically associated with feelings of sadness, worry, and anxiety.
All of those negative or uncomfortable emotions are one of the ways that can trigger and lead us to relapse.
Continued - read rest of transcript and listen to the podcast at Wise Counsel
