The Neuroscience of Reducing Chronic Pain and Everyday Addictions | Eric Garland
Dr. Eric Garland, a neuroscientist and Professor at UCSD, discusses his MORE protocol (Mindfulness-Oriented Recovery Enhancement). This protocol integrates mindfulness, cognitive behavioral therapy, and positive psychology to address everyday addictions, chronic pain, and emotional distress through its three core parts: mindfulness, reappraisal, and savoring.
Deep Dive Analysis
17 Topic Outline
Introduction to the MORE Protocol and Dr. Eric Garland
Dr. Garland's Personal Journey and the Origin of MORE
High-Level Overview and Benefits of the MORE Protocol
Applying MORE to Common Daily Struggles and Everyday Addictions
Mindfulness: Cultivating Awareness and Meta-Awareness
How Mindfulness De-automatizes Addictive Habits
Specific Mindfulness Practices Used in MORE
Defining Non-Dual Awareness and Self-Transcendence
Therapeutic Benefits of Self-Transcendence for Suffering
The 'STOP' Practice for Interrupting Automatic Habits
Understanding Pain from a Neuroscientific Perspective
Mindfulness for Pain: The 'Zooming In and Out' Technique
Reappraisal: Changing Negative Thought Patterns
Practical Steps for Effective Reappraisal (ABCDE)
Savoring: Retraining the Brain's Reward System
Integrating Savoring into Everyday Moments
Disseminating MORE Therapy and Available Resources
7 Key Concepts
Mindfulness
Mindfulness is the practice of cultivating awareness and acceptance of present moment thoughts, emotions, and body sensations, observing them as an objective witness. In the MORE protocol, it is used to generate meta-awareness, which helps de-automatize behavior.
Meta-awareness
Meta-awareness is the awareness of awareness itself, allowing an individual to step out of the contents of consciousness and view them with non-judgmental remove. It is considered the therapeutic heart of mindfulness, enabling greater control over automatic thoughts and behaviors.
De-automatization
De-automatization is the process of making unconscious behaviors conscious. Mindfulness practices help individuals become aware of automatic habits, such as mind wandering or reaching for a phone, allowing them to regain conscious control over these actions.
Non-dual Awareness / Self-Transcendence
Non-dual awareness refers to moments when the normal subject-object duality fades, leading to a sense of closeness, interconnectedness, or oneness with the world. Psychologically, this is termed self-transcendence, going beyond the normal sense of self to connect with something greater.
Pain (Neuroscientific Model)
Pain is the body's alarm system, where nerve signals from injury are relayed to higher-order brain regions like the prefrontal cortex, amygdala, and insula, which then decode the signal into the conscious experience of pain. These brain regions can act as a 'volume knob,' amplifying pain when stressed or dampening it when calm.
Reappraisal
Reappraisal is the practice of challenging and changing negative thought patterns to reduce negative emotions and decrease self-destructive behavior. It is a cornerstone of cognitive behavioral therapy, helping individuals reframe challenges as opportunities for personal growth.
Savoring
Savoring is the practice of focusing mindful attention on pleasant or positive everyday events and the positive emotions and sensations that arise. It is used to retrain the brain's reward system, helping it regain sensitivity to natural, healthy pleasures and thereby weakening the pull of addictive behaviors.
9 Questions Answered
The MORE (Mindfulness-Oriented Recovery Enhancement) protocol is an evidence-based mind-body therapy rooted in ancient wisdom and modern neuroscience designed to simultaneously address addictive habits, emotional distress, and physical pain.
Mindfulness helps by de-automatizing behavior, making the unconscious conscious. By increasing awareness of automatic actions, it allows individuals to catch themselves before engaging in habitual behaviors and bring them under conscious control.
Non-dual awareness is an experience where the separation between subject and object disappears, leading to a sense of oneness or interconnectedness with the world. It helps by quieting the normal sense of self, which can interrupt activity in the brain's default mode network, freeing one from being fused with suffering like pain or addiction.
When the mind touches self-transcendent places, these experiences carry inherent reward value, bringing feelings of positivity, peacefulness, or bliss. Tapping into this inner wellspring of well-being can naturally make one feel good, reducing the need to seek positive feelings through external addictive behaviors.
Pain is the body's alarm system, where nerve signals from injury are relayed to higher-order brain regions that decode them into conscious experience. These brain regions can also act as a 'volume knob,' amplifying pain when stressed or afraid, and dampening it when calm or engaged.
Since all pain is processed in the brain, changing the way one's mind functions through practices like reappraisal can change brain function and, consequently, the experience of pain, potentially turning down its 'volume'.
Reappraisal is the practice of challenging and changing negative thought patterns. By consciously reframing stressful situations as opportunities for personal growth, it decreases negative emotions and cuts off the physiological stress response.
Savoring helps retrain the brain's reward system to regain sensitivity to natural, healthy pleasures, which often diminishes in addiction and chronic pain. As the capacity to feel healthy pleasure returns, it weakens the pull of addictive behaviors and reduces craving.
Savoring can be integrated by mindfully focusing attention on pleasant sensory features of everyday events (e.g., warmth of sun, child's smile, pleasant sounds). The key is to then turn attention inward to savor the positive inner feelings that arise, allowing them to pervade the mind and body.
11 Actionable Insights
1. Savor Natural Healthy Pleasure
Focus mindful attention on pleasant everyday events, noting their sensory details. When positive emotions and pleasurable sensations arise, turn your attention inward to deeply immerse yourself in and expand those feelings throughout your mind and body. This practice retrains the brain’s reward system, increasing sensitivity to natural pleasures and weakening the pull of addictive behaviors.
2. Reframe Negative Thought Patterns
Challenge and change negative thought patterns by asking yourself questions like, “What’s a more helpful way to see this situation?” or “How is facing this adversity helping me to grow as a person?” This reframes challenges as opportunities for personal growth, reducing negative emotions and cutting off the stress response.
3. STOP Automatic Unhealthy Habits
Use the “STOP” method to interrupt automatic habits: Stop right before engaging, Take a few mindful breaths to calm your mind, Observe your thoughts, feelings, and body sensations (noting cravings are impermanent), and Proceed with intention. This simple practice helps gain awareness and control over unhealthy automatic behaviors, often leading to the desire fading away.
4. Mindfully Manage Physical Pain
Calm your mind with mindful breathing, then “zoom in” by focusing intensely on the pain sensation, breaking it down into subcomponent parts (e.g., heat, tightness, tingling) and noticing any spaces or pleasant sensations within or near it. If overwhelmed, “zoom out” by returning to your breath and imagining sending breath to soften the pain. This practice can acutely alleviate pain by about 30%.
5. Structured Reappraisal: ABCDE Method
When stressed, identify the Activating event, your negative Beliefs about it, and the emotional and behavioral Consequences. Then, Dispute or challenge these negative thoughts using mindfulness (e.g., “Is there an alternative explanation?”), and Evaluate the positive effect of this reappraisal on your emotions and constructive actions.
6. Integrate Savoring Daily
Integrate savoring into your daily life by pausing for 20 seconds to a minute to mindfully appreciate pleasant sensory experiences, such as the warmth of the sun or a child’s smile. Focus on the positive feelings that arise, letting them pervade your being, to cultivate joy and reduce cravings or pain.
7. Practice Mindful Awareness
Cultivate awareness and acceptance of your present moment thoughts, emotions, and body sensations by observing them as an objective witness. Focus on your breath, and each time your mind wanders, gently notice it without judgment, acknowledge it, and bring your attention back to your point of focus. This de-automatizes habits by increasing awareness of automatic behaviors and regaining conscious control.
8. Seek Self-Transcendent Moments
Cultivate self-transcendent experiences—moments where the normal sense of self becomes quieter and you feel connected to something greater (e.g., absorbed in music, awe in nature). These experiences provide inherent reward value and inner well-being, which can reduce the need to seek positive feelings through addictive behaviors.
9. Enhance Practice with Savoring
Conclude any mindfulness practice by turning your attention towards any positive mental states that have arisen, taking a moment to immerse yourself in them and appreciate them. This helps retrain the brain’s reward system and rewire it for healthy pleasure and joy.
10. Expand Body Scan Awareness
After moving your attention through your body during a body scan, extend your awareness beyond your body to the space enveloping it. Progressively expand your focus further out into space, as far as you can conceive, and then rest your awareness in that expansive space. This helps cultivate non-dual or self-transcendent awareness.
11. Mindful Breathing for Oneness
Conclude your mindful breathing practice by directing your awareness towards non-dual or self-transcendent states, aiming for a sense of oneness where awareness and space are indistinguishable. This helps tap into a deeper sense of interconnectedness and insight into the fundamental nature of reality.
7 Key Quotes
We are disturbed not by events, but by the views which we take of those events.
Stoic philosophers of ancient Rome (quoted by Eric Garland)
If you say to yourself in your head, I'm in pain enough times over and over again, that little preposition 'in' gets dropped and 'I am in pain' becomes 'I am pain'.
Eric Garland
If you can change the way your mind functions, you can change the way your brain functions, and that'll change your experience of pain.
Eric Garland
Mindfulness is the WD-40 of the mind.
Philippe Goldin (quoted by Eric Garland)
Life is a target rich opportunity for savoring. And why would we pass that opportunity up?
Dan Harris
The Buddha observed that life is suffering. There's suffering inherent in life, but there's also beauty and joy inherent in life. And they co-arise, they exist together.
Eric Garland
If all you pay attention to in life is stress and pain, what kind of quality of life do you have? Your life feels pretty bad.
Eric Garland
3 Protocols
STOP Practice (for addictive habits)
Eric Garland- Stop: Halt right before engaging in the addictive habit.
- Take a few mindful breaths: Focus on the sensation of breath for 30 seconds to 3 minutes to calm the mind and physiology.
- Observe: Notice your thoughts, feelings, and body sensations in the presence of the craving, observing that cravings are impermanent. If overwhelmed, return to the breath.
- Proceed with intention: Consciously choose whether to engage in the behavior. If so, do it mindfully, contemplating potential negative consequences.
Mindfulness for Pain: Zooming In and Zooming Out
Eric Garland- Begin with mindful breathing to calm and center the mind.
- Focus attention on the sensations of pain, zooming in to break it down into subcomponent sensations (e.g., heat, tightness, tingling).
- Notice spaces between sensations where there is no sensation or potentially pleasant sensations.
- If overwhelmed, return attention to the sensation of your breath, imagining sending the breath into the pain sensation to soften it (like water seeping into soil).
- Toggle between zooming in and zooming out, observing that sensations change over time, which can bring hope and relief.
Reappraisal (ABCDE)
Eric Garland- A: Activating event - Become aware of the event that led to feeling stressed out.
- B: Beliefs - Identify the negative thoughts about the event.
- C: Consequences - Recognize the emotional and behavioral impact of those negative thoughts.
- D: Dispute/Challenge - Stop, practice 1-2 minutes of mindfulness to calm down, then consciously challenge and reframe negative thoughts by asking questions like: 'What's a more helpful way to see this situation?', 'What's the proof my thoughts are true/not true?', 'Is there an alternative explanation?', 'What are the positive sides?', 'How is facing this helping me grow or bringing meaning?'.
- E: Evaluate - Assess the effect of this reappraisal on emotions and how it can help take more constructive action.