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Mindfulness

Tony Bates

A simple way of relating to our experience, which can have profound impact on painful,
negative experiences we encounter.

Characteristics of mindfulness

Involves:
o ‘Stopping’
o Paying attention
o Becoming aware of present moment realities
o Not judging whatever is happening as ‘good’ or ‘bad’

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).

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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 Harvard Lecture 1900


Ram Daas Be Here Now 1971
Herbert Benson Relaxation Response 1975
American Psychological Association Clinical Effectiveness of 1977
Meditation
John Kabat-Zinn Established Centre for 1979
Mindfulness
John Kabat-Zinn MBSR 1990
M. Linchan DBT 1993
Mark Epstein Thoughts Without 1995
A Thinker
Stephen Hayes ACT 1999
MBCT John Teasdale et al. 2000

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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)

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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)

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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)

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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.

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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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HarperCollins.

Duncan, B., & Miller, S. (2000). The heroic client: Doing client-centered, outcome-
informed therapy. San Francisco: Jossey-Bass.

Gilligan, C. (1982). In a different voice. Cambridge, MA: Harvard University Press.

Guzman, J., Esmail, R., Karjalainen, K., Malmivaara, A., Irvin, E., & Bombardier, C.
(2001). Multidisciplinary rehabilitation for chronic low back pain: Systematic review.
British Medical Journal, 323(7322), 1186-1187.

Hayes, S. (2002b). Buddhism and acceptance and commitment therapy. Cognitive and
Behavioral Practice, 9, 58-66.

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. (2000). Indra’s net at work: The mainstreaming of Dharma practice in


society. In G. Watson, S. Batchelor, et al. (Eds.), The psychology of awakening:
Buddhism, science, and our day-to-day lives. York, ME: S. Weiser.

Keller, M., Yonkers, K., Warshaw, M., Pratt, L., Gollan, J., Massion, A., et al. (1994).
Remission and relapse in subjects with panic disorder and panic with agoraphobia: A
prospective short interval naturalistic follow-up. Journal of Nervous and Mental
Disease, 182(5), 290-296.

Kinnell, G. (1980). Saint Francis and the sow. In Mortal acts mortal words. Boston:
Houghton Mifflin.

Kjaer, T., Bertelsen, C., Piccini, P., Brooks, D., Alving, J., & Lou, H. (2002). Increased
dopamine tone during meditation-induced change of consciousness. Brain Research and
Cognitive Brain Research, 13(2), 255-259.

Kutz, I., Leserkman, J., Dorrington, C., Morrison, C., Borysenko, J., & Benson, H.
(1985). Meditation and psychotherapy. Psychotherapy and Psychosomatics, 43, 209-
218.

Ladner, L. (2004). The lost art of compassion: Discovering the practice of happiness in
the meeting of Buddhism and psychology. New York: Harper Collins.

Lambert, M., & Barley, D. (2002). Research summary on the therapeutic relationship
and psychotherapy outcome. In J. C. Norcross (Ed.), Psychotherapy relationships that
work. New York: Oxford University Press.

LeDoux, J. (1995). Emotion: Clues from the brain. Annual Review of Psychology, 46,
209-235.

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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),

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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 mindfulness-
based 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,
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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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