WHAT IS MINDFULNESS?

Theory effectiveness

OUTCOME STUDIES

The literature on effects of mindfulness training contains many methodological weaknesses,

Mindfulness interventions may improve pain, stress, anxiety, depressive relapse, and disordered eating (e.g., Kabat-Zinn, 1982; Kabat-Zinn et al., 1992; Kristeller & Hallett, 1999; Shapiro, Schwartz, & Bonner, 1998; Teasdale et al., 2000).

Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review by Ruth A. Baer

SOME THEORY Grant, J. A., J. Courtemanche, et al. (2011).  Meditative practice, has been associated

with pain reduction, low pain sensitivity, chronic pain improvement, and thickness of pain-related cortices. 

Zen meditation is more akin to 'no appraisal' than 'reappraisal'. This implies the cognitive evaluation of pain may be involved in the pain-related effects observed in meditators.

"A non-elaborative mental stance and decoupling of executive and pain-related cortices predicts low pain sensitivity in Zen meditators." Pain 152(1): 150-156.

THE PIGEON AND THE COWBOY

WAYS TO BE UNMINDFUL Ruminations re past

(if only, guilt, shame, anger, hatred, revenge

WAYS TO BE UNMINDFUL Ruminations re present

(I wish) EnvyBitternessdiscontent I can’tI don’tI won’t

WAYS TO BE UNMINDFUL Ruminations re future

(what if?) Negative predictionsCatastrophising AnxietyHopelessness

MINDFULNESS IS NOT

Relaxation Distraction Feeling better

EXPERIENCING THE PRESENT: WAYS TO BE MINDFUL

Turning the mind Accepting the present Observing Describing Participating Non-judgemental stance Wise Mind

WISE MIND

Wise MindEmotion

al Mind

RationalMind

WHEN ACCEPTANCE IS BETTER THAN CHANGE: when trying to change it makes it worse;

when it can’t be changed

COGNITIVE AVOIDANCE Thought Suppression

The Green Rabbit

Chocolate: Behavioural Rebound

Distress tolerance (mindful focus)

HOW TO STOP BANGING YOUR HEAD ON A BRICK WALL

Client avoidance

client resistance

see saw

ALTERNATIVES TO YOUR USUAL TREATMENT PRACTICE

Therapist mindfulness accepting one’s own emotions and urges

REASONS TO BE MINDFUL 1,2,31. reduce avoidance

2. empower client

3. empower/relieve/relax therapist

BEHAVING MINDFULLY

1 Non-judgmental stance

Identifying judgments in your clients’ perspectives:

Shoulds, oughts

rephrasing non judgmentally

2 OBSERVING AND DESCRIBING

Say it just as it is: I can’t, it won’t work, it’s impossible, re-phrasing realistically

3 PARTICIPATING

Committing to action in parallel to pain

4 STAYING IN THE MOMENT

Turning the mind from past/present/future rumination

REASONS TO BE MINDFUL 1,2,3

1. to act your values2. to achieve your goals3. to do what works (be

effective)

HOW TO INTRODUCE MINDFULNESS TO CLIENTS Mindfulness metaphors,

relate these to particular client circumstances

IN-SESSION AND OUT OF SESSION PRACTICE Targeting when and how to be

mindful

setting ‘homework’ mindfulness tasks

reminding and re-phrasing

USING MINDFULNESS IN CHALLENGING SITUATIONS Convincing clients not to judge success by ‘feeling better’

Managing crises: mindful breathing

Mindful observation

BUILDING MINDFULNESS INTO CLIENTS’ EVERYDAY LIVES

Practising skills in all different settings, the mindfulness habit

MINDFULNESS IN DBT Taught as part of skills training Practise in individual therapy:

At beginning and/or end of sessions

As coping skill e.g. during exposure work

As attitude /stance towards doing hard things (acceptance)