working with mindfulness
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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: http://visionpsychology.com/topics-of-interest/mindfulness/. A Proposed Plan. What is mindfulness? - PowerPoint PPT PresentationTRANSCRIPT
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)
What is Mindfulness?
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).
What is Mindfulness?
“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,)
What is Mindfulness?
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).
What is Mindfulness?
“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”.
What is Mindfulness?
“Sati” - memory, presence, wakefulness with a sense of attending, and sati of the present moment
Not strong concentration
What is Mindfulness?
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.
What is Mindfulness?
‘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)
What is Mindfulness?
What is Mindfulness?
“paying attention in a particular way: on purpose, in the present moment, and non-judgmentally”
What is Mindfulness?
paying attention in a particular way: on purpose, in the present moment
What is Mindfulness?
paying attention in a particular way: on purpose
What is Mindfulness?
paying attention
What is Mindfulness?
Allowing the present to be as it is.Glenn Wallis Roshi
What is Mindfulness?
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
What is Mindfulness?
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
Contact with the Present Moment
Defusion
Acceptance
Committed Action
Values
Acceptance and Mindfulness
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?
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
In Psychological Terms What Do We Do when we are Mindful?
Self asContext
Contact with the Present Moment
Defusion
Acceptance
Committed Action
Values
Acceptance and Mindfulness
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