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Mindfulness for Clients, their Friends, and Family Members

"The description of mindfulness that follows is for anyone interested in the topic, although it's written mainly for those of you brand new to the concept. It's drawn from the work of Marsha Linehan, Ph.D., the psychologist who developed DBT. When you read things in quotation marks, they are her words verbatim. Dr. Linehan is among several prominent therapist-researchers who are integrating mindfulness skills with other standard ways of doing therapy. They all are working to create new and more effective ways to help people.

While Dr. Linehan's ideas are what I'll be discussing below, I want to acknowledge, as she would, that she has drawn on the work of many other people and reads widely on the research being conducted on mindfulness. She "practices what she preaches", meaning, she practices mindfulness, as do I and the majority of therapists who teach DBT. My way of teaching mindfulness is to write or talk a bit about it and then give plenty of examples. I hope you'll find this way of teaching helpful."

Cindy Sanderson, Ph.D. Lost to cancer in 2003, her compassion and dedication to helping others lives on in this introduction to Mindfulness written while the Director of Training at Behavioral Tech.

Definition of Mindfulness

Mindfulness is "awareness without judgment of what is, via direct and immediate experience." Marsha M. Linehan, Ph.D., ABPP.

You're being mindful when:

If you stop to think about it, you'll realize that very few of us devote ourselves to living mindfully, meeting each moment of life as it presents itself, with full awareness, letting our judgments fall away. Instead, we do things automatically, without noticing what we're doing. We churn out judgments about ourselves and others. We regularly do two or three or five things at once. We frequently get so caught up in our thoughts and feelings about the past or future that we're lost in them, disconnecting from what is happening right now in front of us.

There are lots of rewards for living this way – we can get a lot done quickly, think of ourselves as efficient, and be seen by the world as productive and smart. In highly industrial or technological societies, a high value is placed on doing a lot at once. In fact, people sometimes make fun of each other by saying, "What's wrong with you? Can't you do two things at once?"

We also live without awareness because sometimes living with full awareness is very painful. We avoid painful thoughts, feelings, and situations when we are afraid or angry or ashamed or sad because we're convinced that we can't do anything to change them AND because we're convinced we can't stand to live with them.

For instance, have you ever avoided bringing up a problem in a relationship with someone because you're afraid the person will get mad at you, attack you, or leave you? You keep avoiding bringing up the problem because you feel so scared. So, you get yourself off the fear "hook" temporarily by not talking it over. In the meantime, you're ashamed of yourself for not speakingup. You get more and more annoyed with the other person. You try to ignore what he or she does that bothers you, but the problem gets worse and worse. Finally you just give up, letting the relationship end. Maybe the problem could have been solved; maybe not.

But there's an important distinction to make between the unavoidable pain of having a problem with a person you love versus the suffering you cause yourself by letting fear control you, judging yourself for feeling afraid, assuming nothing you'd try would work instead of trying out solutions, feeling guilty about feeling anger towards someone you love, or judging the person for causing the problem.

There's so many ways mindfulness could help with the above example, it's hard to know where to start. Because of limited time and space, I'll only discuss a few.

  1. You could use mindfulness skills and bring your full attention to the feelings of annoyance, instead of pushing them away or trying to talk yourself out of them. Maybe you're afraid you can't stand to feel annoyed, but actually, watching how you feel inside, you realize, "hey, it's just annoyance for 10 minutes and I CAN stand it."
  2. You could use mindfulness to become a great detective and notice exactly how and when you feel annoyed. Maybe it's when he or she has had three cups of coffee before seeing you; maybe it's when both of you are tired; and, maybe it's when he or she's had a bad day at work. In this way, you use awareness to get specific and clear about what contributes to the problem. The more specific you get about what goes into the problem, the better chance you have to solve it. Ask her to drink less coffee or switch to decaffeinated coffee; make plans to get together when you're both rested; don't meet on bad work days.
  3. You could use your mindfulness skills to watch how your mind generates thoughts like "It shouldn't be this way; why can't we just get along! Real friends don't have problems'. Listening in on your thoughts, you realize that your expectations don't fit with reality, so you work on changing your expectations.
  4. You could use mindfulness skills, as you talk through the problem with your friend, to bring your full and open awareness to whether or not you experience your friend listening to and understanding you or defending herself and criticizing you. If she's really listening and caring, you might notice relief inside and decide to keep working with her on the problems in the friendship. On the other had, if you notice that she is dismissive or non-responsive each time you talk about a problem, you might notice that you are sad and disappointed but not willing to put more energy into a friendship that makes you unhappy.

To summarize, mindfulness is awareness, without judgment, of life as it is, yourself as you are, other people as they are, in the here and now, via direct and immediate experience. When you are mindful, you are awake to life on its terms – fully alive to each moment as it arrives, as it is, and as it ends. Of course, in order to build and maintain mindfulness requires specific skills that are practiced over and over. That's what comes next.

How and Why to Practice Mindfulness

Mindfulness is a skill that can be learned like any other. There is nothing mysterious about it. It's like learning to ride a bike or cook good meals or paint with watercolors or play a musical instrument. You start with easy practice and progress to harder practice. You take classes in it from people who know more about it than you do. You make friends with other people who are interested in it so you have a built in support group to keep you going when you get discouraged. Sometimes you'll feel like you're making a lot of progress; other times you'll be discouraged. But, it is certain that if you practice, practice, practice, your skill at mindfulness will improve.

So what's the practice? The practice of mindfulness is "the repetitive act of directing attention to only one thing in this one moment". And if you are brand new to mindfulness, you may respond with either "I can already do that" or "Why on earth would I do that?'

My reply is: a) it's a lot harder than it sounds; b) the reason you do this kind of practice is to gain control of your attention.

I hope you'll stop and think about the following sentence:
Whatever your attention is on, that's what life is for you at any given moment.

EXAMPLE: Perhaps you've decided to take a break from working so you can make yourself some tea; as you stand at the stove, your mind wanders off and ruminates about a conversation you had yesterday. You don't get a break because your mind isn't on the tea; your mind is worrying and carrying you away.

EXAMPLE: Perhaps you are sitting in a session with a therapist who cares about you and has a kind expression on her face; but you're not looking at her face...not really. Instead, you are feeling so self-conscious and ashamed that you begin to "space out". You miss out on a moment of connection with a person who cares for you and instead have one more moment of rejecting yourself.

"The repetitive act of directing your attention to only one thing in this one moment" means training your mind to pay attention to what you choose to pay attention to instead of letting your mind hijack you. There are lots of metaphors that describe what the untrained mind is like and they provide a good contrast to the trained mind. Here are several:

If you train your mind to pay attention, then you've found the remote control, trained the puppy, and become a smarter crow. To teach your mind to pay attention, you practice paying attention over and over again. Here's an example of a typical practice. If you want to, you could take a break from reading right now and do the practice.

TYPICAL PRACTICE

Get in a comfortable position that won't cause you discomfort, with your feet on the floor and your back straight but not tense. Sit very still, breathing normally, in a quiet room. Now, just watch your thoughts for a few minutes. Don't try to force thoughts or think specific thoughts. Don't push some thoughts away or hold on tight to others. Just watch what your mind generates. If your mind wanders away from watching your thoughts (e.g., you get stuck on one thing, like planning what you're going to do after you read this web page) just notice that it wandered and gently bring it back to watching thoughts. If you start to judge yourself ("I'm terrible at this"), your thoughts ("That's a stupid thing to be thinking"), or the practice ("This is a real waste of time") just notice your judgments and go back to watching your thoughts. Practice for five minutes.

Linehan has a helpful metaphor for this type of practice: Your mind is like a boat that is tied to a chain with an anchor. Mindfulness is the anchor and chain that gently pull the boat (your attention) back each time the waves start to carry it away. Even if your mind wanders off 1,000 times, you've done the exercise if you gently pull your attention back to your point of focus. There's no right or wrong to it. All that matters is paying attention to your experience while you do the exercise as well as you can. You can do this type of practice with anything you care to bring your full and undivided attention to. In doing so, you'll learn a lot about yourself, about other people, and about any situation in which you find yourself. And, just like a muscle that gets stronger and stronger with exercise, your capacity to move your attention to what you want it to focus on will grow stronger.

This is one type of practice but there are others. In Linehan's Skills Training Manual for Treating Borderline Personality Disorder (1993), there is a clear explanation of mindfulness, as well as lots of suggestions for practice. It's an excellent place to learn more about the topic. Further, she has broken mindfulness into six specific skills that can be practiced by anyone to strengthen the capacity to pay attention in a way that leads to greater and greater awareness.

Mindfulness Reading List

Mindfulness From A Spiritual Perspective

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