Mindfulness and meditation are becoming increasingly mainstream features of cognitive and behavioral approaches to treatment. Although their origins are thousands of years old, it has been in the last few decades that Western sciences have become more aware of these ancient approaches to well-being. Technologies, such as fMRI, have been helpful with describing the beneficial effects of meditation for long term practitioners. Rigorous methodology and innovative psychological and neuro-cognitive research studies have helped move the topics of mindfulness and meditation from the realms of faith and philosophy to those of scientific inquiry and evidence-based treatments.
Mindfulness-based approaches have contributed a great deal to our understanding of how to help people deal more effectively with emotional distress, difficult behavioral problems and medical conditions that may persist in spite of appropriate care. Some of these contributions have come in the form of remarkable convergences of ancient insight and modern day research. We have come to a better scientific appreciation, for example, of our extraordinary human brain as it functions to help us survive by looking for, recognizing and trying to predict problems. Unfortunately, we sometimes respond to these processes as if they are actual events occurring in the physical world, rather than best-guess scenarios unfolding in our own thoughts and feelings. To make things even more remarkable, our bodies may become part of the experience, akin to the pounding heart or white knuckles that come with amusement park simulation rides. Our bodies are obedient servants to what our brains are telling us, and if you have ever been moved to tears by a patriotic ceremony or found yourself ducking out of the way of a 3-D dinosaur, you know about it first hand.
Cognitive-behavioral treatments typically focus on emotional, behavioral and physiological consequences that are shaped by one’s perceptions and learning. In particular, CBT works primarily with the “here and now” of experiences. Very often, the troublesome anxiety or the energy depleting symptoms of depression involves something that may have happened in the past, or may be anticipated as a future challenge. The “here and now” focus of CBT recognizes, however, that one is responding to what our mind is presently telling us about those things, whether or not they have occurred or we are worried might occur.
It is CBT’s commitment to evidence and innovation that has opened its doors to mindfulness and meditation as effective tools for psychotherapy. Research and practice have taken us far beyond the out-moded and mistaken notions that meditation, for example, is about gazing into space or useful primarily as a way to distract oneself from uncomfortable thoughts or feelings. The opposite is actually a more accurate explanation of how mindfulness and meditation can help. Rather than trying to help someone temporarily escape from an uncomfortable experience, only to dread if and when it will return, mindfulness and meditation are practices that can help one learn a more adaptive way of relating to experiences.
There are several well-established and research-based treatments that come under the large umbrella of cognitive and behavioral therapy, and are referred to as mindfulness-based approaches. Two of the more familiar names include Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT). Mindfulness, within such approaches, is often described as learning to pay attention, on purpose, non-judgmentally, to whatever is in one’s field of awareness. In behavioral terms, it means learning, through practice, to allow ourselves to observe or experience something without automatically trying to get more of it, on the one hand, nor automatically trying to avoid or escape from it, on the other. At the same time, these therapeutic approaches also tend to promote the importance of discovering values that reflect what is important to the person, and then taking action to bring about a life built around those values.
Consider the example of someone who had panic attacks for several years, came to realize that what she was doing was not working, and was willing to consider something different: instead of trying to get rid of or pretend she didn’t have the scary thoughts and feelings that she obviously experienced with each panic episode, she agreed to try an acceptance (mindfulness) exercise. She said she was willing to observe, without trying to interrupt, the amazing machinery of her mind as it worked to transform a situation that her intellect recognized as ordinary and safe, into one she habitually associated with dying, losing control and feeling terrified. When she returned the next session, she said the experience was “empowering.” She explained that she was aware of the frightening thoughts and feelings her mind was creating, but with no need to fight with them. She said she could also focus on the task of walking slowly through the situation and realized that she suffered no harm.
There is certainly much more to mindfulness and meditation than is possible to discuss here. You may find it interesting to experience a taste of it for yourself by trying a simple exercise of sitting and breathing. Often, it is helpful to work with someone who is experienced in the practice of meditation, and can answer questions and offer guidance. Contrary to the commonly held impression that meditation requires one to somehow “clear the mind” of thoughts, the mindfulness-based approach to meditation is more often a skill for learning how to “let go” of thoughts, allowing them to come and go without trying to control or banish them. The good news is that it is impossible to fail. Each time one becomes aware of getting caught up in thinking, it is an opportunity to practice letting go of it by labeling it “thinking,” and then going back to observing.
Below are instructions for a simple (though not necessarily easy) form of mindfulness meditation. Please note that there are many variations. Please do not judge all meditation practices by this example!
Sit in an upright posture. You may wish to use a firm, straight back chair for this exercise that allows for sitting up straight, head and neck erect, with feet flat on the floor and palms resting on your thighs. Eyes may either be partially open and looking slightly downward with a soft focus, or closed gently. Face and jaw are relaxed with lips slightly parted, if desired. Allow yourself to breathe in and out naturally, with an intention to breath into the belly region, rather than limiting the breath to the rise and fall of the chest. Gently follow each breath with your attention, but not to the exclusion of other things (sounds, sensations, etc.) that may come along. The key is to become open to the flow of awareness. If you notice you are caught up in thinking, silently say “thinking,” and go back to the breath. Similarly, if you notice you are caught up in something else (sounds, sensations, emotions) simply label it (“sensing,” “feeling”) and return to the breath. You really cannot fail at this! Try sitting for a few minutes, or more if you decide. When you are finished, just open your eyes, stretch, take a few minutes to reflect and orient yourself to ordinary life, and take a little bit of mindfulness into your day.
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