Episode Summary
Executive Summary: Dan Harris interviews neuroscientist Eric Garland about Mindfulness-Oriented Recovery Enhancement (MORE), a therapy blending mindfulness, CBT, and positive psychology to treat addiction, pain, and distress. Garland explains how mindfulness reduces automaticity, reappraisal changes stress appraisals, and savoring retrains reward circuitry—offering practical tools for everyday habits like scrolling, overeating, and rumination, not just severe addiction.
Main Topics: Origin and development of MORE: Garland traces MORE to his early interest in meditation, contemplative traditions, hypnosis, and clinical work with complex patients suffering from addiction, chronic pain, and mental health issues. He describes how this clinical and research path led to integrating mindfulness into CBT. Mindfulness as de-automatization: Mindfulness is framed as awareness of present-moment thoughts, emotions, and body sensations without judgment. Garland argues it helps interrupt automatic habits by making unconscious behaviors conscious, especially through practices like mindful breathing and body scans. Non-dual awareness and self-transcendence: MORE includes practices that broaden awareness beyond the body and self, aiming for non-dual or self-transcendent states. Garland says these states may quiet the default mode network, reduce identity fusion with pain or addiction, and provide an alternative source of well-being. Mindfulness for addiction and pain: Garland explains the STOP practice for cravings and a zoom-in/zoom-out technique for pain. These methods help people observe craving or pain as impermanent sensations, reduce reactivity, and regain control over compulsive behavior or pain catastrophizing. Reappraisal as cognitive reframing: The second component of MORE teaches people to challenge negative thoughts, use ABCDE-style cognitive restructuring, and reinterpret stressors as opportunities for growth. Garland emphasizes that this can lower emotional distress and physiological arousal. Savoring and retraining the reward system: The third component, savoring, trains people to attend to everyday pleasures—sunlight, nature, a child’s smile, food, conversation—and then internalize those positive sensations. Garland says this helps restore sensitivity to natural rewards and reduce craving. Clinical evidence and dissemination: Garland cites multiple randomized trials and federal funding to support MORE, and notes active dissemination through therapist training, a book, and an upcoming app. The conversation closes with resources for clinicians and the public.
Key Arguments: Addictive behavior often becomes an automatic habit; mindfulness helps by increasing awareness of automaticity and restoring conscious choice. MORE is designed to treat addiction, emotional distress, and pain in one integrated protocol rather than with separate therapies. Self-transcendent experiences may reduce identification with pain or addiction and provide a healthier source of reward than compulsive behaviors. Chronic pain is amplified by stress, fear, and catastrophizing; mindfulness can help people zoom into sensations without becoming overwhelmed. Reappraisal reduces stress by changing the meaning of events, which can lower negative emotion and physiological arousal. Savoring natural pleasures is not indulgent; it is therapeutic because it retrains reward circuitry that addiction and depression blunt. The practices are useful for everyday problems like doomscrolling, overeating, shopping, and rumination, not only for severe clinical populations.
Data Points: Federal research funding: More than $90 million - Garland says MORE has been supported by over $90 million in federal research grants. Clinical trials: 16 clinical trials - He cites 16 clinical trials supporting MORE. Opioid misuse reduction: 45% - Garland reports MORE reduced opioid misuse 9 months after an 8-week treatment. Drug relapse reduction: 42% - He says MORE reduced drug relapse. Craving reduction: 50% - Garland says MORE cuts craving by half. Chronic pain reduction: 25% - He reports MORE drops chronic pain by about 25%, lasting nine months after treatment. Immediate pain relief during practice: 30% on average - The mindful pain technique can reduce pain in the moment by about 30%. Comparable analgesic effect: About 5 mg of oxycontin - Garland compares the acute pain reduction to the relief expected from five milligrams of oxycontin. Population with high-impact chronic pain: 50 million U.S. adults - He says roughly 50 million American adults experience high-impact chronic pain each year. Training duration: 8 weeks - He repeatedly refers to MORE as an eight-week program. Pain as prevalent as combined conditions: More chronic pain than diabetes, heart disease, and cancer combined - Garland uses this comparison to emphasize the scale of chronic pain. Compassion/training reach: 20-year research program - He describes MORE as the product of roughly 20 years of research and clinical development.
Pivotal Quotes: "Mindfulness is the practice of cultivating awareness and acceptance of your present moment thoughts, emotions, and body sensations, and observing those experiences as if you were a witness." — Dr. Eric Garland: Definition of mindfulness within the MORE protocol. "The problem isn't the problem, it's your view of the problem, and we can shift our view." — Dan Harris: Summarizing the rationale behind reappraisal and cognitive reframing. "Life is a target-rich opportunity for savoring. And why would we pass that opportunity up?" — Dr. Eric Garland: Garland explaining why everyday positive moments should be intentionally noticed and enjoyed.
Implications: MORE offers a practical, evidence-backed toolkit for reducing compulsive habits, pain, and distress by changing attention, interpretation, and reward. For listeners, it suggests small daily practices can improve well-being; for clinicians, it points to scalable, integrated treatment for addiction and pain.