Mindfulness in Therapy

Mindfulness has become a buzz word. It is a term that has found its way across the internet, in philosophical and self-help books, throughout courses, podcasts, advertisements, glossy magazines, and mainstream psychology. Mindfulness has become a strong reference point for many therapeutic modalities such as cognitive-behavioural therapies, given it’s proven health benefits of reducing stress, improving immune system effectiveness, and improving mood and relationships. As such, this topic has been explored time and again, and value continues to be found in the benefits of it’s practice.

With the word ‘mindfulness’ becoming so increasingly popularised, you may have a sense that mindfulness is “good for you”, yet not have much context for why this may be, where it came from, or what it’s unique applications to psychotherapy can be. I would like to carve out a space in this journal to explore some of those questions.

Where did mindfulness come from?

Mindfulness originated from ancient Eastern and Buddhist tradition, over 2500 years ago. Sati is a word from the Pali language of ancient India that describes what we eventually came to understand in the West as, mindfulness. Jon Kabat-Zinn is often acknowledged for his influential role in the translation of this Eastern wisdom to Western culture, through coining the term ‘mindfulness’ and introducing a therapy program that he named ‘Mindfulness-Based Stress Reduction’. When the concept reached the West, for some it also carried with it a sense of esotericism and spirituality that seemed difficult to relate to; something that only certain people could attain. Decades of research have now provided valuable insight into the collective capacity to engage with mindful awareness, regardless of religious orientation, intellect or class, as well as the impact that practicing this state of consciousness can have on the physical structure of the brain and therefore, our way of being in the world.

What is it?

You may be familiar with Kabat-Zinn’s explanation that says that mindfulness is a type of awareness that arises through, “paying attention, on purpose, in the present moment, non-judgementally”. Sylvia Boorstein explains that mindfulness is a state of consciousness whereby one is able to receive “the present moment, pleasant or unpleasant, just as it is, without either clinging to it nor rejecting it”. There are many definitions of mindfulness, yet they all share the same common thread of referring to a way of paying attention with the quality of non-judgement. I also find Daniel Siegel’s description helpful, of the mindful attitude being one that is open, curious and objective.

·      Openness – being receptive to whatever comes into our awareness in a moment, without limiting our awareness by the idea that something ‘should’ or ‘shouldn’t’ be presenting itself to us.

·      Observation – the capacity to observe our self experiencing something as it is happening to us. To see our self in a broader context, so that we can sense our role in our habits and behaviours, without being automatically triggered into them.

·      Objectivity – to become aware of thoughts, sensations, impulses, memories and beliefs without getting lost in them. To retain a bit of distance from them to know that they are only parts of our experience, not the totality of who we are or our identity. This is also referred to as dis-identification.

Anatomy feels things too

In order to understand the mechanisms that underly the benefits of mindfulness practice and mindfulness approaches to psychotherapy, it can be helpful to have some information about the basic structure of the brain. The ‘hand model’ of the brain (seen below) is a simple and embodied way to reference the brain structures that are involved when practicing mindful awareness. Feel free, if you are able, to make a fist with one of your hands to use as a map as you read through the next section.

Lets get oriented. In this model, the front of your hand represents the face of a person, and the back of your hand represents the back of their head. Your wrist is the spinal cord, which travels up the spine, taking messages to and from our brains, from and to our bodies. The palm of your hand is the brainstem, your thumb the limbic area, and your fingers represent what is called the cerebral cortex. Your finger tips represent the front part of the brain that sits just behind the forehead, called the pre-frontal cortex.

• Brainstem - controls many subconscious functions such as heart rate and blood pressure, swallowing and breathing. It also is our ‘motivation powerhouse’, influencing behaviour to meet our survival needs such as safety, shelter, hunger and reproduction.

• Limbic area - the limbic regions help evoke emotions that give a sense of meaning and motivate us to act in response to our current situation. It is home to structures that provoke the release of hormones that control our sexual organs, thyroid and adrenal glands, as well as areas that process memory, therefore plays a huge role in regulating our response to stress and trauma. Conversely, it is also helps us to connect meaningfully in relationships with others.

• Cerebral cortex - the outer layer of the brain, like the bark on a tree. This part of our brain is host to the refined skills and processing of information outside of the survival functions. It is separated into ‘lobes’ and each has a different speciality, but overall, the cortex helps us to process and make information given to the brain, meaningful and applicable to our own world.

• Pre-frontal cortex - the part of the brain that makes us uniquely human. It is the area of the brain that has evolved to help humans experience the more abstract, symbolic nature of our existence. To be able to tell and believe a story, have a sense of time, construct frameworks for morality and judgement.

Each of these structures communicate with each other in wonderfully intricate ways to help us go about our daily lives. However, when we face life’s stressors, or haven’t experienced optimal situations for growth and development throughout childhood, this dance of communication between these parts can be thrown off balance, impacting our capacity to cope and be resilient to life’s circumstances. Research with magnetic resonance imaging (MRI) has shown time and again that mindful attention supports these structures to communicate in a more eloquent and integrated way. When one is mindfully aware, the above mentioned neurological structures become more integrated in a vertical direction (from the lower brainstem, up to the cortical regions), and horizontally (our left and right brain hemispheres). This slowed down and particular type of attention allows specifically for the more considered pre-frontal cortex to communicate more effectively with the highly reactive limbic region. This thereby supports an improved capacity to regulate emotions, respond to situations with more flexibility (have more choices), and empathise more deeply with others.

Mindfulness in psychotherapy

As you can see, mindfulness may be used in therapy quite effectively as a tool to assist people to regulate distressing emotions. However, more than that, it provides a new lens for the client and therapist to explore information that might be unconscious material, or outside of their awareness usually. We all have layers of unconscious beliefs, experiences and memories that have been laid down over our lifetime, many that are implicit or that were filed away when we were very young, perhaps from a time before we could talk or even consciously recall being alive. This unconscious material - may it be beliefs, memories, emotions, sensations, impulses or thoughts - is so useful to recognise as it plays such a significant role in determining how we make sense of things now and how we behave. From this place of mindful awareness, when unconscious material is made conscious, we are able to make choices in a moment that we never realised were available to us before. After all, as Moshe Feldenkrais wisely puts it,

“If you know what you are doing, you can do what you want”.

When mindfulness is engaged by both the client and the therapist during a session, the capacity for studying the client’s experience is deepened immensely, sensitising the client’s and therapist’s ability to track and stay with experiences as they arise as well as improve the resonance and empathy that exists between them in the therapeutic relationship. Present moment experience met in this way allows us to more clearly follow the threads that connect us to a different place and time where old wounds were forged. When we can observe these with openness, objectivity and kindness, we are able to see them from a safe vantage point that doesn’t overwhelm us or disorient us. This is where deep healing can happen in the ‘bubble’ of the therapeutic relationship, and where new neuronal pathways are sculpted in the brain to reflect the evolving and more expansive way of being in your wider world. It is in this way that mindfulness is not only available as a ‘strategy’, but can also be employed to bring about deeply satisfying characterological change for clients.

If you feel moved to work with us in this way, or would like some more information, you can find our contact details using the link below.

Thank you for reading.

Warmly,

Megan.