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A simple way of relating to our experience, which can have profound impact on painful, negative experiences we encounter.
Characteristics of mindfulness Involves: o o o o Definition “The non-judgemental observation of the ongoing stream of internal and external stimuli as they arise”. Ruth Baer (2003) “Keeping one’s consciousness alive to the present reality” (Thich Nath Hanh, 1976) “Mindfulness is simply the knack of noticing without comment whatever is happening in your present experience” Guy Claxton (1990), p.18 “In mindfulness we learn to awaken from unconscious absorption in thoughts and feelings” Germer (2005), p. 11 “By learning to set aside discursive thinking, and to see products of cognition as events with no special reality, we become familiar with the tendency of our minds to build imaginary scenarios, which are inhabited as if they are real “ (Falton, 2005). ‘Stopping’ Paying attention Becoming aware of present moment realities Not judging whatever is happening as ‘good’ or ‘bad’
Relevance of Mindfulness Practice to Emotional Distress • • • • Creates a “holding environment” Mindfulness gives us a safe “platform” from which to observe Practice enables us to stay safely with distress until it disperses Mindfulness steadies and grounds us
Mindfulness in Psychotherapy 1. Awareness 2. Of present experience 3. With acceptance (Germer et al., 2005) All three components are required for a moment of full mindfulness. What Mindfulness is Not • Not a relaxation exercise • Not a way to avoid difficulty • Not a way to by-pass personality problems • Not about achieving a different state of mind What Mindfulness is About • Being present to our experience however distressing or upsetting it may be • Brings us closer to difficulties but without becoming caught up in our reactions to difficulties • It is a slow, gentle coming to grips with who we are • Settling in to our current experience in a relaxed, alert, open-hearted way Growth of Meditation & Mindfulness William James Ram Daas Herbert Benson American Psychological Association John Kabat-Zinn John Kabat-Zinn M. Linchan Mark Epstein Stephen Hayes MBCT Harvard Lecture Be Here Now Relaxation Response Clinical Effectiveness of Meditation Established Centre for Mindfulness MBSR DBT Thoughts Without A Thinker ACT John Teasdale et al. 1900 1971 1975 1977 1979 1990 1993 1995 1999 2000
Using Mindfulness in Therapeutic Work • • • Mindfulness as personal practice Mindfulness as theoretical resource Mindfulness as a practice that is taught to patients in a systematic way (e.g. MBSR, MBCT, DBT)
Incorporation of Mindfulness in Different Schools of Psychotherapy CBT/DBT/ACT • Encourages non-adversarial relationship to symptoms • Acceptance-based approach • Focuses on cognitive “processes” rather than cognitive “content” • Creates holding environment which allows both therapist intent(??) to listen in to beliefs and thoughts and consider their value Psychodynamic Psychotherapy • Encourages “menalization” (Peter Fonagy, 2000), ie., the capacity to think about one’s own mental states and those of others • Mindfulness used to highlight what’s happening in the therapeutic relationship, in any given moment (Daniel Sterd, 2004) Humanistic Psychotherapy • Teaches therapist to remain “present” • Focusing on “felt sense” (Gendlin 1996) • Emphasises a person’s inherent capacity to become healthy, make responsible decisions, and tolerate uncertainty • Teaches ‘affect tolerance’ Health Psychology • Mindfulness is used to encourage a less reactive autonomic system – to feel less stressed • Mindulness is used to help patients recognise and respond to their health needs, before they develop into illness (e.g. patients with diabetes, asthma, obesity) • Mindfulness improves immune function (Davidson et al., 2003)
Instructions on mindfulness all point to the same thing: being right on the spot that nails us. It nails us to the point of time and space that we are in. When we stop there and don’t act out, don’t repress, don’t blame it on anyone else, and also don’t blame it on ourselves… we encounter our heart. Pema Chrodron (The Wisdom of No Escape)
If you embrace a minor pain with mindfulness, it will be transformed in a few minutes. Just breath in and out, and smile at it. But when you have a block of pain that is stronger, more time is needed. Practice sitting and walking meditation while you embrace your pain in mindfulness, and sooner or later, it will be transformed. If you have increased the quality of your mindfulness through the practice, the transformation will be quicker. When mindfulness embraces pain it begins to penetrate and transform it, like sunshine penetrating a flower bud and helping it blossom. When mindfulness touches something beautiful it reveals its beauty. When it touches something painful it transforms and heals it.
THich Nhat Hanh, (Touching Peace)
Exercises Exercise 1 1. Assume a comfortable posture lying on your back or sitting; keep the spine straight and let your shoulders drop. 2. Close your eyes, if it feels comfortable. 3. Bring your attention to your belly, feeling it rise or expand gently on the inbreath and fall or recede on the outbreath 4. Keep the focus of your breathing, “being with” each inbreath for its full duration and with each outbreath for its full duration, as if you were riding the waves of your own breathing. 5. Every time you notice what it was that took you away and then gently bring your attention back to your belly and the feeling of the breath coming in and out. 6. If your mind wanders away from your breath a thousand times, then your “job” is simply to bring it back to the breath every time, no matter what preoccupies it. 7. Practice this exercise for 15 minutes at a convenient time every day, whether you feel like it or not, for 1 week, and see how it feels to incorporate a disciplined meditation practice into your life. Be aware of how it feels to spend some time each day just being with your breath, without having to do anything. Kabat-Zinn (1990, p.58) Exercise 2 1. Tune in to your breathing at different times during the day, feeling the belly go through one or two risings and fallings. 2. Become aware of your thoughts and feelings at these moments, just observing them without judging them or yourself. 3. At the same time, be aware of any changes in the way you are seeing things and feeling about yourself. Kabat-Zinn (1990, p.58)
Mindfulness and Psychotherapy - Resources and References Books on personal practice Brach, T. (2003). Radical acceptance: Embracing your life with the heart of a Buddha. New York: Bantam/Dell. Goldstein, J. (1993). Insight meditation: The practice of freedom. Boson: Shambhala. Gunaratana, B. (2002). Mindfulness in plain English. Somerville, MA: Wisdom Publications. Hanh, T. N. (1987). The miracle of mindfulness. Boston: Beacon Press. (Original published in 1975). Kabat-Zinn, J. (1994). Wherever you go there you are: Mindfulness meditation in everyday life. New York: Hyperion. Kabat-Zinn, J. (2005). Coming to our senses: Healing Ourselves and the world through mindfulness. New York: Hyperion. Kornfield, J. (1993). A path with heart: A guide through the perils and promises of spiritual life. New York: Bantam. Books on applications of mindfulness to psychotherapy Epstein, M. (1995). Thoughts without a thinker: Psychotherapy from a Buddhist perspective. New York: Basic Books. Germen, C. K., Siegel, R. D., &: Fulton, P. R. (2005). Mindfulness and Psychotherapy. New York: Guilford Press. Hayes, S. C., Follette, V. M., & Linehan, M. m., (Eds.). Mindfulness and acceptance: Expanding the cognitive-behavioral tradition. New York: Guilford Press. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press. Kabat-Zinn, J. (1990). Full catastrophe living. New York: Delacorte Press. Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.
Magid, B. (2002). Ordinary mind: Exploring the common ground of Zen and psychotherapy. Boston: Wisdom Publications. Molino, A. E. (1998). The couch and the tree. New York: North Point Press. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press. Websites Mindfulness-based stress reduction: www.umassmed.edu/cfm Dialectal behavior therapy: www.behavioraltech.com Acceptance and commitment therapy: www.acceptanceandcommitmenttherapy.com Institute for Meditation and Psychotherapy: meditationandpsychotherapy.org Mindfulness and Acceptance Special Interest Group of the Association for the Advancement of Behavior Therapy: listerv.kent.edu/archives/mindfulness/html Audiovisual materials of all kinds: www.soundstrue.com Mindfulness teacher talks: www.dharmaseed.org Journal for mindfulness practitioners: www.inquiringmind.com Thich Nhat Hanh link: www.iamhome.org Journal articles Bickman, L. (1999). Practice makes perfect and other myths about mental health services. American Psychologist, 54 (11), 965-979. Bohart, A., Elliott, R., Greenberg, L., & Watson, J. (2002). Empathy. In J. C. Norcross (Ed.), Psychotherapy relationships that work. New York: Oxford University Press. Breslin, F., Zack, M., & McMain, S. (2002). An information-procession analysis of mindulness: Implications for relapse prevention in the treatment of substance abuse. Clinical Psychology: Science and Practice, 9(3), 275-299. Brown, K., & Ryan, R. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822-848. Csikszentmihalyi, M. (1991). Flow: The psychology of optimal experience. New York:
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Lesh, T. (1970). Zen meditation and the development of empathy in counselors. Journal of Humanistic Psychology 10(1), 39-74. Libet, B. (1999). Do we have free will? In Liebet, A. Freeman, & K. Sutherland (Eds.), The volitional brain: Towards a neuroscience of free will. Thorverton, UK: Imprint Academic. Logsdon-Conradsen, S. (2002). Using mindfulness meditation to promote holistic health in individuals with HIV/AIDS. Cognitive and Behavioral Practice, 9, 67-72. Macy, J., & Brown, M. (1998). Coming back to life: Practices to reconnect our lives, our world. Gabriola Island, BC, Canada: New Soceity. Marlatt, G., & Kristeller, J. (1999). Mindfulness and meditation. In W. R. Miller (Ed.), Integrating spirituality into treatment. Washington, DC: American Psychological Association. Maslach, C., & Leiter, M. (1997). The truth about burnout: How organizations cause personal stress and what to do about it. San Francisco: Jossey-Bass. Miller, J. J. (1993). The unveiling of traumatic memories and emotions through mindfulness and concentration meditation: Clinical implications and three case reports. Journal of Transpersonal Psychology, 25(2), 169-176. Murphy, S. (2002). One bird one stone. New York: Renaissance Books. Myers, D. (200). The funds, friends, and faith of happy people. American Psychologist, 55(1), 56-67. Neff, K. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223-250. Newberg, A., Alavi, A., Baime, M., Pourdehnad, M., Santanna, J., & d’Aquili, E. (2001). The measurement of cerebral blood flow during the complex cognitive task of meditation. A preliminary SPECT study. Psychiatry Research, 106(2), 113-122. Pearl, J., & Carlozzi, A. (1994). Effect of meditation on empathy and anxiety. Perceptual and Motor Skills, 78, 297-298. Peng, C., Mietus, J., Liu, Y., Khalsa, G., Douglas, P., Benson, H., et al. (1999). Exaggerated heart rate oscillations during two meditation techniques. International Journal of Cardiology, 70, 101-107. Shapiro, S., Schwartz, G., & Bonner, G. (1998). Effects of mindfulness-based stress reduction on medical and premedical students. Journal of Behavioral Medicine, 21(6),
581-599. Siegel, R. D., Urdang, M., & Johnson, D. (2001). The developing mind: Toward a neurobiology of interpersonal experience. New York: Guilford Press. Siegel, R. D., Urdang, M., & Johnson, D. (2001). Back sense: A revolutionary approach to halting the cycle of back pain. New York: Broadway Books. Sing, N., Wahler, R., Adkins, A., & Myers, R. (2003). Soles of the feet: A mindfulnessbased self-control intervention for aggression by an individual with mild mental retardation and mental illness. Research in Developmental Disabilities, 24(3), 158-169. Smith, J. (2004). Alterations in brain and immune function produced by mindfulness meditation: Three caveats. Psychosomatic Medicine, 66, 148-152. Sweet, M., & Johnson, C. (1990). Enhancing empathy: The interpersonal implications of a Buddhist meditation technique. Psychotherapy: Theory, Research, Practice, Training, 27(1), 19-29. Tugade, M. M., & Fredrickson, B. L. (2004). Resilient individuals use positive emotions to bounce back from negative emotional experiences. Journal of Personality and Social Psychology, 86, 320-333. Waddell, G., Newton, M., Henderson, I., & Somerville, D. (1993). A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain, 52(2), 157-168. Westen, D. (1999). Psychology: Mind, brain and culture (2nd ed.). New York: Norton. Westen, D. (2000a). Commentary: Implicit and emotional processes in cognitive behavioral therapy. Clinical Psychology: Science and Practice, 7(4), 386-390. Witkiewitz, K., & Marlatt, G. A. (2004). Relapse prevention for alcohol and drug problems: That was Zen, this is Tao. American Psychologist, 59 (4), 224-235. Zetzel, E. (1970). The capacity for emotional growth. New York: International Universities Press.
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