THEORETICAL/PHILOSOPHICAL BACKGROUND Mindfulness-based meditation originated in Eastern and Buddhist practices(Dakwar & Levin, 2009). Buddhism is about “being in touch with your own deepest nature and lettingit flow out of you unimpeded, by waking up and seeing things as they are”(Kabat-Zinn, 1994, p. 6). “Buddha means one who has awakened to his or her own true nature”(Kabat-Zinn, 1994, p. 6)
THEORETICAL/PHILOSOPHICAL BACKGROUND continued Mindfulness is also rooted in Taoism and yoga practices, while also found inthe works of Emerson, Thoreau, Whitman, and in Native American wisdom(Kabat-Zinn). Mindfulness first appeared in western psychotherapy in the late 1970s(Whitfield, 2006). Mindfulness-based meditation training was developed by Jon Kabat-Zinn(Dakwar & Levin).
WHAT IS MINDFULNESS? Mindfulness was described by Kabat-Zinn (1994) as“paying attention in a particular way: on purpose, in the present moment, andnonjudgmentally” (p. 4). Mindfulness is about becoming aware of one’s mind and body, and living in thehere and now by accepting the present, in order to fully appreciate each moment(Kabat-Zinn). The ability to direct one’s attention can be developed through the practice ofmeditation, which is the “intentional self-regulation of attention from moment tomoment” (Baer, 2003, p. 125).
W H AT I S M I N D F U L N E SS c o n t i nu e d Mindfulness counter balances Western thinking by honouring that we are apart of nature, rather than trying to control it, and that in investigating our ownminds through self-observation, we may be able to live a more satisfying life(Kabat-Zinn, 1994). Mindfulness is considered as an alternative treatment with mind-bodyinterventions used in therapy (Dakwar & Levin, 2009). Mindfulness has been translated from Buddhist psychology to mean“awareness or bare attention” (Mace, 2007).
W H AT I S M I N D F U L N E SS c o n t i nu e d Our usual state of consciousness is quite limited, often resembling a dream-like state. This is known as automaticity, where we glide through our lives withouttruly noticing or experiencing what happens (Kabat-Zinn, 1994). Thus, we liveour lives on “auto pilot.” A lack of awareness often results in unconscious and automatic actions andbehaviours, often created by fears and insecurities (Kabat-Zinn). Withoutresolving these, we often become stuck. Mindfulness is about becoming unstuckand not taking life for granted.
W H AT I S M I N D F U L N E SS c o n t i nu e d Mindfulness is a “practical way to be more in touch with the fullness ofone’s being, through self-observation, self-inquiry, and mindful action”(Kabat-Zinn, 1994, p. 6). The words for mind and heart are the same in Asian languages, thusmindfulness practice is “gentle, appreciative, and nurturing – orheartfulness” (Kabat-Zinn, 1994, p. 7).
Goals of Mindfulness-based Therapy To promote mindfulness, through meditation if possible. Meditations are used to encourage individuals to attend to bodyexperiences, thoughts, emotions, aspects of environment (sights or sounds)(Baer, 2003). If meditation is not possible or successful, other strategies, such as non-meditation mental exercises, guided imagery, or metaphor, are incorporatedto assist the client in developing insights and perspectives (Dakwar & Levin,2009).
KEY CONCEPTS The Attitudinal Foundation of Mindfulness Practice (Kabat-Zinn, 2009) Non-judging: assume an impartial witness to your own experience (Kabat-Zinn). Become aware of how you automatically judge and react to anyexperience and learn to step back from it. Suspend judgment by simplyobserving, recognizing, becoming aware (Kabat-Zinn). Patience: cultivate patience by giving yourself room to have the experience,whether good or bad, because it is a part of your reality. Do not be in a hurry. Becompletely open to each moment, accepting its fullness (Kabat-Zinn). Live inand experience the present moment.
KEY CONCEPTS continued Trust: develop trust in yourself and honour your feelings, wisdom, and goodness. “Thespirit of meditation is about being your own person and understanding what it means to be you”(Kabat-Zinn, 2009, p. 36). Practice taking responsibility for being yourself and listening to, andtrusting yourself. Beginner’s Mind: “to see the richness of the present moment, cultivate beginner’s mind byhaving a mind that is willing to see everything as if for the first time” (Kabat-Zinn, 2009, P. 35).This is to be free of expectations based on past experiences. Be open and receptive to newpossibilities. Non-striving: meditation is non-doing, non-striving, not achieving. There is no goal otherthan to be yourself and paying attention to whatever is happening. You are simply allowinganything to be experienced in each moment because it is there (Kabat-Zinn).
KEY CONCEPTS continued Acceptance: means seeing things as they actually are in the present(Kabat-Zinn). Denial and resistance is time consuming, energy-draining, andprevents positive change. “Cultivate acceptance by taking each moment as itcomes and being with it fully, as it is” (Kabat-Zinn, 2009, p. 39). Letting go: “cultivating the attitude of letting go, or non-attachment isfundamental to the practice of mindfulness” (Kabat-Zinn, 2009 p. 39).Letting go is a way of letting things be as they are, without judging or holdingon.
ETHICAL CONSIDERATIONS In using Mindfulness techniques, therapists must have a good understandingof Mindfulness, while also having received formal training (Teasdale, Segal,Williams, 2003). Therapists should practice mindfulness themselves as a meansof appropriate modeling to their clients. In order to utilize Mindfulness into practice, therapists must have a goodunderstanding of the disorders they are treating, as well as knowing howMindfulness can be helpful with those disorders (Teasdale, Segal, Williams).
E T H I C A L C O N S I D E R AT IO NS c o n t i nu e d Mindfulness has been deemed most effective when implemented alongsideother treatment modalities and therapists must consider how to implement it(style) in order to be effective (Teasdale, Segal, Williams, 2003). Mindfulness training may only be helpful in certain situations. Thus, therapistsneed to be well aware of the limitations of Mindfulness and when it is/is notappropriate to be used (Teasdale, Segal, Williams). Possible unintended negative effects may include increased restlessness, anxiety,depression, guilt, and hallucinations (Mace, 2007).
APPLICATIONS Addictions/Relapse Prevention: MBRP: http://www.mindfulrp.com/Mindfulness can be used to help in “facilitating the extinction of cue or usingreminders, calming cravings and urges, reducing maladaptive and compulsivebehaviours, and promoting healthier and more resilient choices” (Dakwar &Levin, 2009, p. 264). Pain: Using MBSR, the client is encouraged to observe pain sensationsnonjudgmentally with the intention of reducing distress associated with pain(Baer, 2003). Stress: MBSR and MBCT :http://www.mbct.com/
APPLICATIONS continued Trauma:http://www.rebelbuddha.com/2011/10/using-mindfulness-based-psychotherapy-and-mindfulness-meditation-to-overcome-trauma/ PTSD: Kearnery D., McDermott, K., Malte, C., Martinez, M., & Simpson,T. (2012). Association of participation in a mindfulness program with measures of ptsd,depression and quality of life in a veteran sample. Journal of Clinical Psychology, 68(1), 101-116. doi: 10.1002/jclp.20853
APPLICATIONS continued BPD/DBT: Mindfulness skills are taught to assist in synthesizingacceptance and change and use three mindfulness “what” skills ofobservation, description, and participation, and three mindfulness “how”skills of nonjudgmentally, one-mindfully, and effectively (Baer, 2003) Anxiety/Depression: http://theconference.ca/mindfulness-based-cognitive-therapy-as-a-relapse-prevention-approach-to-depression Personal: To reduce stress, increase quality of life and self-compassion.http://kspope.com/memory/mindful.php#clinician
TECHNIQUESTechniques are learned through a mixture of guided instruction and personalpractice, and include those which are formal, meaning that a person withdrawsfrom other activities to engage in the practice (sitting or moving meditations, suchas attending to breath, body sensations, walking, yoga stretches) or informal, suchas those that can be undertaken in every day life and activities (mindful eating,cleaning, reading, self-monitoring, or mini-meditation, such as a three minutebreathing space) (Mace, 2007).
INTERVENTIONS continuedSession 6: Thoughts are not facts Session 7: Caring for yourself Sitting meditation Mindful response to Moods, thoughts, and persistent visitors alternative views Links between activity and 3-minute breathing and mood coping space Meditations: Mountain or Choiceless awareness Loving Kindness
INTERVENTIONS continuedSession 8: Keeping up the Momentum Review what has been learned (Body Scan, Breathing, etc) Intention Importance of Practice Relapse Planning
REFERENCES Baer, R. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125-143, doi: 10.1093/clipsy/bpg015 Dakwar, E., & Levin, F. R. (2009).The emerging role of meditation in addressing psychiatric illness, with a focus on substance use disorders.Harvard Review of Psychiatry, 17(4), 254-267. doi: 10.1080/10673220903149135 Kabat-Zinn, J. (1994). Wherever you go there you are (10th anniversary ed.). New York: Hyperion.
REFERENCES continued Kabat-Zinn, J. (2009). Full Catastrophe Living (15th anniversary ed.). New York: Bantam Dell. Mace, C. (2007). Mindfulness in psychotherapy: An introduction. Advances in Psychiatric Treatment, 13, 147-154. doi: 10.1192/apt.bp. 106.002923 Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression. New York: The Guildford Press.
REFERENCES continued Teasdale, J. D., Segal, Z. V., & Williams, J. M. G. (2003). Mindfulness training and problem formulation. Clinical Psychology: Science and Practice, 10(2), 157-160. doi: 10.1093/clipsy/bpg017 Whitfield, H. J. (2006). Towards case-specific applications of mindfulness- based cognitive-behavioural therapies: A mindfulness-based rational emotive behaviour therapy. Counselling Psychology Quarterly, 19(2), 205-217. doi: 10.1080/09515070600919536