Mindfulness-Oriented Recovery Enhancement (MORE) is an evidence-based psychotherapy supported by more than 13 clinical trials that unites complementary aspects of mindfulness training, cognitive-behavioral therapy, and principles from positive psychology into an integrative treatment for addiction, emotional distress, and chronic pain. I developed MORE by translating fundamental discoveries from affective neuroscience into therapeutic strategies to reduce craving and suffering while simultaneously increasing healthy pleasure, joy, and meaning in life. MORE has been shown to be nearly three times as effective as standard therapy for treating addiction and chronic pain, and adding MORE to standard addiction care significantly improves treatment outcomes.
MORE is founded on a simple yet powerful idea: By engaging in mental training, we can strengthen our minds and change the way our brains function. Through the mindfulness, reappraisal, and savoring skills trained in MORE, we can heal and recover from physical and emotional pain while gaining greater self-awareness and self-control over self-destructive habits.
Learning to strengthen the mind to change the way the brain functions is a critically important part of the recovery process, given that maladies like addiction, depression, and chronic pain involve dysfunction in stress and reward circuits in the brain (e.g., the amygdala, the striatum). As these "diseases of despair" worsen over time, the brain becomes more sensitive to stress, pain, and drug-related cues (e.g., the sight of an opioid pill bottle), while becoming less sensitive to the healthy pleasure from derived from naturally rewarding objects and events in the social environment. Consequently, one suffers and feels empty inside. In the case of someone with a history of using substances (e.g., drugs, alcohol, or even food) to deal with stress, the sense of despair drives them to take higher and higher doses of the substance just to preserve a dwindling sense of well-being, resulting in the downward spiral of loss of self-control that is characteristic of addiction.
Through an integration of mindfulness, reappraisal, and savoring techniques, MORE aims to restructure reward processing in the brain by helping the individual to shift from valuing drug-related rewards back to valuing natural, healthy rewards. This therapeutic focus accords with my restructuring reward hypothesis, which states that shifting from valuing drug-related rewards back to valuing natural, healthy rewards will reduce craving and addictive behavior. Neuroscience data provides strong support for this hypothesis, showing that MORE increases neurophysiological and emotional responses to natural healthy rewards, which in turn are linked with reduced addictive behavior.
In so doing, MORE boosts pleasure, joy, and meaning in life—a potent antidote to the diseases of despair. And in that regard, MORE has been shown to lead to clinically significant reductions in symptoms of depression and post-traumatic stress. So MORE effectively treats both physical and emotional pain.
To date, I have trained more than 900 therapists from around the U.S. and internationally to use MORE to treat their patients. In this Psychology Today blog, I will share some of the essentials from the MORE training and do a deeper dive to explain the mindfulness therapy techniques MORE uses to reduce pain and addiction while enhancing well-being and meaning in life.
References
Garland EL, Hanley AW, Nakamura Y, Barrett JW, Baker AK, Reese SE, Riquino MR, Froeliger B, Donaldson GW. Mindfulness-oriented recovery enhancement vs supportive group therapy for co-occurring opioid misuse and chronic pain in primary care: a randomized clinical trial. JAMA internal medicine. 2022 Apr 1;182(4):407-17.
Cooperman NA, Lu SE, Hanley AW, Puvananayagam T, Dooley-Budsock P, Kline A, Garland EL. Telehealth mindfulness-oriented recovery enhancement vs usual care in individuals with opioid use disorder and pain: a randomized clinical trial. JAMA psychiatry. 2024 Apr 1;81(4):338-46.
Garland EL, Nakamura Y, Bryan CJ, Hanley AW, Parisi A, Froeliger B, Marchand WR, Donaldson GW. Mindfulness-Oriented Recovery Enhancement for veterans and military personnel on long-term opioid therapy for chronic pain: a randomized clinical trial. American Journal of Psychiatry. 2024 Feb 1;181(2):125-34.
Garland EL, Atchley RM, Hanley AW, Zubieta JK, Froeliger B. Mindfulness-Oriented Recovery Enhancement remediates hedonic dysregulation in opioid users: Neural and affective evidence of target engagement. Science advances. 2019 Oct 16;5(10):eaax1569.
Garland EL. Mindful positive emotion regulation as a treatment for addiction: From hedonic pleasure to self-transcendent meaning. Current Opinion in Behavioral Sciences. 2021 Jun 1;39:168-77.
What Is Mindfulness-Oriented Recovery Enhancement?
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08.05.2024
Mindfulness-Oriented Recovery Enhancement (MORE) is an evidence-based psychotherapy supported by more than 13 clinical trials that unites complementary aspects of mindfulness training, cognitive-behavioral therapy, and principles from positive psychology into an integrative treatment for addiction, emotional distress, and chronic pain. I developed MORE by translating fundamental discoveries from affective neuroscience into therapeutic strategies to reduce craving and suffering while simultaneously increasing healthy pleasure, joy, and meaning in life. MORE has been shown to be nearly three times as effective as standard therapy for treating addiction and chronic pain, and adding MORE to standard addiction care significantly improves treatment outcomes.
MORE is founded on a simple yet powerful idea: By engaging in mental training, we can strengthen our minds and change the way our brains function. Through the mindfulness, reappraisal, and savoring skills trained in MORE, we can heal and recover from physical and emotional pain while gaining greater self-awareness and self-control over self-destructive habits.
Learning to strengthen the........
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