Working With Mindfulness We know what it is, but do we really know what we are doing? James Hegarty PhD PgDipClinPsych FNZCCP Image accessed from:

Working With Mindfulness

We know what it is, but do we really know what we are doing?

James Hegarty PhD PgDipClinPsych FNZCCPImage accessed from: http://visionpsychology.com/topics-of-interest/mindfulness/

A Proposed Plan

What is mindfulness?

Why is our definition or understanding of mindfulness important for therapy?

Identify some of the anomalies around common approaches to mindfulness.

Look at some ways of using it in therapy?

Hopefully have conversations around some of these issues.

What Did We Experience

Self asContext

Contact with the Present Moment

Defusion

Acceptance

Committed Action

Values

Acceptance and Mindfulness

Processes

What is Mindfulness?

“paying attention in a particular way: on purpose, in the present moment, and non-judgmentally”

(Kabat-Zinn, 1994)


a receptive attention to and awareness of present events and experience (Brown & Ryan, 2003).

‘awareness of present experience with acceptance’ (Germer, Siegel, & Fulton, 2005, p. 7).


“the self-regulation of attention so that it is maintained on immediate experience,

thereby allowing for increased recognition of mental events in the present moment.”

and ‘a particular orientation toward one’s experiences in the present moment, an orientation that is characterised by curiosity, openness, and acceptance.’ (Bishop et al., 2004,)


The DBT conceptualization of mindfulness includes a set of skills that are “the intentional process of observing, describing, and participating in reality nonjudgmentally, in the moment, and with effectiveness” (Dimidjian & Linehan, 2003).


“can best be understood as the process of drawing novel distinctions” (Langer and Moldoveanu,2000).

Which is seen as leading to

“1) a greater sensitivity to one's environment, (2) more openness to new information, (3) the creation of new categories for structuring perception, (4) enhanced awareness of multiple perspectives in problem solving”.


“Sati” - memory, presence, wakefulness with a sense of attending, and sati of the present moment

Not strong concentration


Now go to the woods, to the root of a tree, or to an empty hut, sit down in cross legged position, and straighten your body. Establishing present moment awareness right where you are, breath in, simply aware, then breath out, simply aware.

Anapanasati suta

Breathing in long, know directly I am breathing in long.

Breathing out long, know directly I am breathing out long.

.

.I breath in, sensitive to the entrie body. I breath

out sensitive to the entire body.


‘the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment’ (Kabat-Zinn, 2003,)

- An operational definition: defines an ‘operation’ which is practiced in meditative training.

a non-conceptual seeing into the nature of mind and world’ (Kabat-Zinn, 2003)



“paying attention in a particular way: on purpose, in the present moment, and non-judgmentally”


paying attention in a particular way: on purpose, in the present moment


paying attention in a particular way: on purpose


paying attention


Allowing the present to be as it is.Glenn Wallis Roshi


Mindful attention requires allowing experience. This requires trust

“trust in actual experience before we make anything of it – before beliefs, thoughts, signs, explanations, justification, and other constructions of our minds take form.”

Stave Hagen

A conscious attending without any conceptual overlay.

Jim


Derived stimulus relations

Dick

JaneSpot

Derived stimulus relations and the transformation of stimulus functions

Snake

Danger Grass

Pain

HurtCancer Death

Agony

Hospice

Limp

Embarrassed

Laughed at

Shame

UnclePeter

NoJob

Grief

Not again

I can’t Stand it

No MoneyCan’t give

kids money

Self asContext


Defusion

Acceptance

Committed Action

Values


Processes

What do we do when we try to be mindful?

The first thing we do is we attend to what is happening

Then we learn to tolerate our experience. Stick with it and tolerate what is occurring.

We allow our experience. Accept it, fully embrace it.

Investigate, or inquire (in a non-conceptual way)

In Psychological Terms What Do We Do when we are Mindful?


attend

exposure

response prevention

Compare this to our normal approach to exposure

Thinking of mindfulness as a method of exposure what do we do?

develop the skill to attend

develop the skill to defuse from thoughts

develop the skill to tolerate unwanted emotions

develop the skill to become aware of and not respond to urges, or impulses (that at first seem automatic)

With mindfulness practice we develop these basic skills with generally neutral stimuli

We build the skills from the ground up - building skills which we hope will generalize to various situations

once the skills are developed they can then be used (hopefully) more effectively with difficult material

then these skills can be used with a range of situations


Self asContext


Defusion

Acceptance

Committed Action

Values


Processes

“This is your life. It's all you've got. So live your life to the fullest by looking it in the eye, and do what you can to help others do the same; and so the chain continues”

Diane Rizzetto (form Waking up to What You Do)

Extra Bonus SlidesNot used in the presentation

Many conceptualizations of mindfulness confuse the results of mindfulness practice with the practice of mindfulness

Mindfulness as an operation – An Activity

Versus

The results of Mindfulness practice

Correlations Between Mindfulness Facets and Related Constructs

.. Mindfulness Facet Mindfulness Facet . . Construct Construct Observe Describe Actaware Nonjudge Observe Describe Actaware Nonjudge NonreactNonreactPredicted positive correlations:Predicted positive correlations:Openness to experience Openness to experience .42.42*** *** ..1919*** *** . .02 02 –.07 –.07 ..1818******Emotional intelligence Emotional intelligence ..2222*** *** .60.60*** *** . .3131*** .*** .3737*** .*** .2121******Self-compassion Self-compassion ..1414*** *** ..3030*** *** . .4040*** .48*** *** .48*** .53***.53***Predicted negative correlations:Predicted negative correlations:Alexithymia Alexithymia –.–.08 08 –.68–.68*** *** –. –.4242*** –.*** –.3434*** –.*** –.1919******Dissociation Dissociation ..2727*** *** –.–.3232*** *** –.62–.62*** –.*** –.4949*** –.*** –.1212Absent-mindedness Absent-mindedness ..1616*** *** –.–.2828*** *** –.61–.61*** –.*** –.4141*** –.*** –.1515******Psychological symptoms Psychological symptoms ..1717*** *** –.–.2727*** *** –.48*** –.48*** –.50–.50*** –.*** –.3131******Neuroticism Neuroticism ..07 07 –.–.2323*** *** –.44*** –.44*** –.55–.55*** –.*** –.3535******Thought suppression Thought suppression ..1616*** *** –.–.2323*** *** –. –.3636*** *** –.56–.56*** –.*** –.2222******Difficulties Difficulties emotion regulation emotion regulation –.–.02 02 –.–.3838*** *** –. –.4040*** *** –.52–.52*** –.*** –.3636******Experiential avoidance Experiential avoidance ..12 12 –.–.2323*** *** –. –.3030*** *** –.49–.49*** –.39****** –.39***

NOTE: In each row, the largest correlation is shown in bold, and correlations that differ NOTE: In each row, the largest correlation is shown in bold, and correlations that differ significantly from the largest (significantly from the largest (p p < .01) are shown in italics. ***< .01) are shown in italics. ***p p < .001.< .001.

Baer, R. A., et al. (2006). p41.

Many conceptualizations of mindfulness confuse the results of mindfulness practice with the practice of mindfulness

Is describing mindfulness?

Is being non-judgemental mindfulness?

Is observing mindfulness

Is beign equanmous part of mindfulness?

What is the realtionship of compassion to mindfulness?

These are the sort of questions we need to be aware of if using mindfulness as part of therapy

The language we use to describe mindfulness determines how people will approach it

Why use mindfulness in therapy

It seems to be useful

there is evidence that it helps:

↓ Anx, ↓ Dep, ↓ Emotional reactivity, ↓ substance abuse, ↓ rumination, helps improve relationships, useful in the treatment of pain,

may make better therapists

Theoretical (psychological) and Biological mechanisms seem to exist

Kirk, U., Downar, J & Montaqgue, R (2011) Interoception drives increased rational decision-making in meditators playing the ultimatum game, frontiers in Neruoscience, 5, Article 49.

Kerr, C, Sacchet, M. D., Lazar, S. W., Moore, C. L., & Jones, S. R., (2013). Mindfulness starts with the body: somatosensory attention and top-down modulation of cortical alpha rhythms in mindfulness meditation. Front. Hum. Neurosci., 2013 | doi: 10.3389/fnhum.2013.00012

Mindfulness starts with the body: somatosensory attention and top-down modulation of cortical alpha rhythms in mindfulness meditation

Various Therapies use Mindfulness in different ways

MBSR / MBCT

MiCBT

DBT

CEB

ACT

Widely used, poorly understood

No agreed upon definition

No fully valid psychological measure of mindfulness

No agreement on the best method of training mindfulness

No agreed upon skill set, or training for therapists

Problems of Mindfulness in Clinical Practice

Why don't you want to practice?

Why Don't you want to Practice?

Mindfulness is a body based practice

Mindfulness can be uncomfortable

Mindfulness can be scary

These can be described as things to do

Embrace (fully know) sufferingLet go of graspingExperience stoppingand create a path – live it

ACT as the most Buddhistic of modern therapies.

It is not Buddhism, however it's core processes map fairly clearly on the basic tenets of Buddhism

The three pillars of the hexaflex can be seen as

a) fully knowing craving/suffering and letting go of craving

b) mindful attention and stopping

c) identification of our own path and walking it

Documents

Working With Mindfulness We know what it is, but do we really know what we are doing? James Hegarty PhD PgDipClinPsych FNZCCP Image accessed from: