Category Archives: Mindfulness in Psychotherapy

THANKFUL: Appreciating Beautiful Gifts from Children and Youth

By LeesaMaree Bleicher

LiseeMaree-Bleicher-300x168-2Visit LeesaMaree Bleicher, along with M. Mick Gardener, at the 2015 Bridging the Hearts & Minds of Youth Conference in their 90-minute breakout session called enlighten: a Trauma Informed Mindfulness Based Therapeutic approach combining Restorative Justice as an answer to youth involved in the criminal justice system. Promoting the concept of: Survivor Empowerment not Victimization of Recovery not Incarceration.

LiseeMaree BleicherAlbert Schweitzer said, “At times our own light goes out and is rekindled by a spark from another person. Each of us has cause to think with deep gratitude of those who have lighted the flame within us.”

Nowhere is this spark as bright than in the heart of a youth. Nowhere does there lay a stronger elixir to waken your purpose than in the sparkling enthusiasm of a child’s spirit. And nowhere is there a grander purpose than the need to ease the suffering of a child.

The beautiful thing about helping children is that buried beneath the armor and attitude is this snow-white innocence, this flawless foundation, this feral potential still connected to God, or source, or that which is greater than us individually. This goodness remains steadfast despite the harm adults have done.

Our mission is to guide them back to this place of bliss, if only momentarily. In the shift to recovery, not treatment, we have come to understand “recovery” as recovering that which was lost from us: innocence, joy, light, that feral potential. Discovering the road back to that place of purity and reclaiming our power is the key to freedom from suffering.

Our mission, should we choose to realize it, is to be the guides whose purpose is to steer youth back to reclaim their potential. We do this each time we teach that even in the unbearable moments in life and in the dark of a night of unimaginable pain, there shines a dim but powerful light that will one day illuminate the darkness. And within this light, there shines their power and their way out of suffering.

Ideally we strive to plant the seeds of patience, tolerance and acceptance in our youth.

We affirm: “Life is not fair 8359890249_ed085986b0_b-360x200-1and no you did nothing wrong. No it is not your fault. No you do not deserve what happened to you. No one can make it better, but one day if you just hang on — have faith — one day, I promise you will be OK. One day you will emerge from this stronger and more powerful than you can ever imagine.”

When the testimony of sharing lived experience trumps our cool “professional boundaries,” we make a true and lasting difference. Speaking from the heart and sharing our human experience plants seeds of hope, inspiration, and resilience in youth. Nowhere can we feel the way of freedom from suffering than knowing someone who has walked down a similar path of torment, come out standing steady despite someone else’s best effort to make them fall, and still has enough fierce courage left to tell their story.

Speaking candidly, most youth who like myself come to be in jail, in foster care, or other programs do so by force of their external circumstances. Many come from fragmented, broken homes where they witness and endure unspeakable acts of cruelty from the adults who should be protecting them. Rarely do youth land in these places by their own choice.

Emotional, physical, spiritual, and sexual abuse manifest in the blueprint of our souls and spirits. Such abuse might express itself as a 4th grader bullying his classmate, a youth stealing, a youth who yells obscenities at authority figures, who refuses to eat, who is promiscuous, who skips school, who takes drugs, who cuts their flesh in an effort to feel or not feel pain. It’s the days of silence before an attempted (or successful) suicide where we often mistake the symptom for the cause and fail in our attempts to “treat” them. It’s that approach which undermines the very core of their suffering. And it’s where we as adults fail them yet again.

It was in the vacant blue eyes of an 8-year-old boy named Travis who came to live in my home when I first realized how futile, how misguided, and how inhumane this system to care for children was. It is still raw, and I am not sure yet if I can fully capture how profoundly my time with him altered my heart. This experience both expanded my heart beyond what I thought was possible and then reduced it to nothing when he was gone.

One day while we were together, Travis “disconnected.” Fell silent, withdrawn. And I asked him, “What are thinking about? What makes you so sad? You can tell me anything, and I will believe you. And there’s nothing you tell me I won’t think is important.” After awhile, he came to me and said, “I’m sorry. I don’t know why sometimes I can be happy, and all of the sudden I feel sad. It comes out of nowhere.” I looked at him, cupped his tiny perfect chin in my hand, peered into his blue eyes and wrapped my arms around him. I hugged him tightly and said “I know. And it’s OK. I feel like that sometimes too. And you know what? One day you won’t feel like that all the time. One day you’ll take that sadness and turn it into happy.”

All he was unable to say was conveyed in the way he hugged me back. And in that precious moment when he mumbled “Thank you.” I thought my heart would break.

There was nothing I learned from a text book, nothing from evidence-based practice, and nothing in the foster parent orientation that prepared me for that moment. I reacted from my heart.

My only desire was to ease his suffering and instill within him the tiniest notion that no matter what he felt, it was OK and that it was only temporary.

The reality is that when we come into a child’s life to aid them, they are held in a punitive, restrictive, inflexible system. We don’t always look past that to what brought them into that system to begin with. If we increased our awareness, we would see that few children are delinquent, homeless, end up in jail, or in foster care by their own volition. They come to these places battered, bruised, and sad, having been victimized by adults.

In the months that passed with Travis, after my heart ran ahead of any reason, I watched a sad little boy turn into a bright, happy, fun-loving child who didn’t need medication or to be bounced around from foster home to foster home. What he needed was to be loved.

Now, there was nothing I could have offered Travis that ever could have replaced what his parents failed to give him. My love was a Band-Aid to soothe him until he could grow enough to care for himself. But far more miraculous than anything that I gave him was what he gave to me.

One of my tendencies was to over-explain myself; to offer excuses and/or apologies for nearly everything to everyone. One day, I was going on and on to a friend about why I didn’t do something when from the top of the stairs I heard this little voice say, “LeesaMaree, stop that. You don’t have to explain yourself. It’s OK whatever you do.” I froze at his wisdom and the fact that he cared to try to ease my suffering. Wow.

Then, I came to deeply understand the bigger context of this whole boundary thing. And I came to know that anytime we seek to engage in the helping of another being, it is not so simply a gift we give. It is not one sided.

The moment we think this, we have already failed. We as the perceived “givers” are really part of a mutually beneficial healing exchange connected to a greater energy. Once we come to understand and seek to increase our sensitivity and re-establish the heart in recovery and treatment, once we incorporate living testimony in our practice, only then will we make a true and lasting impact.

This time of year we celebrate thanks for Bridging Badgemany blessings. But as a “profession,” we overlook the rich and beautiful gifts that the children we encounter give us: the opportunity to care, to express our warmest compassion, and to ease suffering. All these things alter us. They allow us to ascend toward the deeper meaning of our shared human experience. The next time a child or a parent or someone else says thank you for the work you do, with humility and honor defer him or her and say, “No, thank you.”

Thankful

(a poem inspired the youth who have walked into my life and left imprints upon my heart)

The leaves fall…fluttering to the ground…landing like a thrush
Awaiting winter’s rush from summer’s dream
I remember summer… bright green and sparkling
and I remember you…your hand extended towards mine…offering me your heart
Giving me that moment…your time…yourself
You said, “Come this way. Here, let me show you… See the sun how it shines?”
Your smile confused the sun and stole starlight’s sparkle
“Listen. You can hear the grass tell its secrets …follow the burrowing bunny, he knows the way…see the Stellar Jay…as he chats up dawn…urging the flowers to wake up…he knows what I am talking about. His blue wings touch heaven”
I ran away from you…but never far… You were everywhere…in everyone
You tied me with a fragile cord of compassion…bound me to the fertile ground…tied me to heaven…left seeds in my hand
You allowed me to fall but not be crushed
Like the leaves, I too have been pink, russet, pumpkin and golden
It was the seeds you left… clutched tight in my hand
One day I remembered…it all came back in one fell whoosh
You cared …You took the time…You forgave me
You gave me another chance and a million more
You listened to me…You reignited the spark
Oh I am so thankful for You
Oh those seeds you left… I planted them under the moonlight…and when they blossomed…I crushed them and stuffed them in my heart
I knew what to do ’cause you said “the best way to show someone how much you appreciate them is to pass on what they gave to you.”
So…I watered the seeds with tears…transformed my fears…infused them with love
Oh I didn’t have it for myself…that care and concern
But I do for them…the ones that come behind me
So I scattered the seeds in the wind of each encounter
Oh, and I did exactly as you taught me …I gave my heart generously and… I fertilized the seeds with glitter…so that those who come behind me will sparkle brighter…than I ever did

Conference Keynote Speaker Daniel J. Siegel, Neuropsychiatrist, on Why Our Teenagers Feel Compelled to Connect on Social Media

by Daniel J. Siegel, M.D. republished from The Huffington Post , Dec. 30, 2013

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bridgingTile_forUCSDWe are inviting you to start the new year by reading this insightful post on the effects of social media from Dr. Daniel Siegel  (author of the forthcoming book (Brainstorm: The Power and Purpose of the Teenage Brain). Hear, see, and meet him at this year’s Bridging the Hearts & Minds of Youth Conference! Dan will offer a keynote talk on Saturday afternoon following the regular sessions. The general public will be able to purchase tickets to hear his talk, and attendance will be free for conference registrants.

In these fast and furious days of digital overload, we parents often worry about our teenagers’ interactions with one another on social media. Who hasn’t seen a teenager deeply absorbed with a smartphone or breaking off a face-to-face conversation to take a picture for their friends on Snapchat? With heads down and screens lit up, watching our teens plug in can feel confusing, disappointing and even like rejection to us.

It can, however, be helpful to realize that the teen years are a time of incredibly important brain changes. Changes that drive an adolescent to turn toward peers rather than to the parents they leaned on for support during their childhood years.

In one way, it’s simply evolution: Throughout history, adolescents banded together to find safety in numbers as they moved out into the world, a world that was unfamiliar, uncertain and unsafe.

That world remains risky, even with all the advantages that modern gadgets provide us to map out our routes and pinpoint our coordinates. But to leave home and feel safe, we need to belong to other teens on the same journey. As teenagers, we are compelled to turn towards one another.

In order to get ready to leave the home nest, adolescents seek out membership in groups of other adolescents in order not only to feel good, but to survive. And feeling connected to others doesn’t just seem crucial to contemporary teenagers. In fact, the very engrained genetic programming of our brains gives us a feeling that connection is a matter of life and death.

Understandably then, social media can become a modern medium of connection that is deeply compelling for adolescents.

Here’s the great news: Social media provides a way for our evolved (and evolving) teenagers to find that connection in one another. That’s because social media actually provides the opportunity for creating relationships, and even can promote more face-to-face time.

Our traveling son, headed out to a new country without any contacts, checked on Facebook and found some college classmates headed to exactly the same town — with a spare room in their rented apartment! Years ago, when we traveled, such a connection would have been impossible to create.

While this medium may not be right for all teens, especially those with social challenges like anxiety, phobia or communication difficulties such as those on the autistic spectrum, some studies suggest that social media actually enhances positive relationships in adolescence — as it did for our son. And these relationships not only influence us, supportive relationships actually create health in our lives. Isn’t that something we all want for our adolescents? (And, yes, for ourselves too!)

Indeed, many of the changes in the remodeling adolescent brain can be seen to support a drive to explore novelty and to take risks, just like it encourages teenagers to make and sustain social connections. These adolescent changes are not signs of immaturity, but signs of preparation.

The emotional spark and social engagement, the novelty seeking, the courage and creativity of adolescence all have downsides and upsides, but the essence of these changes is to prepare for the transition between childhood dependence and adult responsibility. And social media may just be a modern means to make us become more deeply social and even more fulfilled in our lives.

Instead of viewing their behavior as impulsive or irresponsible, we can now see the adolescent period as one of wonderful transformation, of needed exploration of a new and changing world. The key is how to best make these vital means of social connection deeper, more meaningful and more likely to cultivate a sense of well-being in all our lives.

In the Wisdom 2.0 meeting held in Northern California each year, these are the very issues we toss around in our in-person meetings. You should see the pre-meeting buzz on social media channels that gets us all connected and primed to engage with each other face-to-face!

Together, we can cultivate a new conversation in our culture about how to make the most of these channels of communication, our collective effort to create media with meaning.

Brainstorm_Cover_LGLearn more about ways to communicate with your teen in Dan’s new book Brainstorm: The Power and Purpose of the Teenage Brain available on January 7, 2014.

Like Dr. Dan Siegel on Facebook
Follow @DrDanSiegel on Twitter (#Brainstorm)

Mindful Matters: Nourishing Our Wellbeing in Clinical Practice

by Chris Gauthier

There are lots of people, many of them healthcare professionals, who are serving this world by caring for others. Something within some of them is so completely synchronous with the desire to heal others that there is nothing in this life they would rather do. The fact that there are people so committed to helping others become whole is awe-inspiring. However, too many times the basic premise of healing is forgotten: we must heal ourselves if we have intentions of healing others, so we can better serve all.

stethoscopeWith the world of medicine constantly changing, areas of improvement in patient care are abound while its practitioners continue to meekly manage mindful self-care rather haphazardly. In America, this recent structural revolution in the medical industry, regardless of personal opinions and politics on the subject, is significant. The demand for physicians, psychologists, and other medical practitioners is exponentially growing. Medical professionals that do well in their care – because let’s face it, we have or know someone who has had a needlessly negative experience seeking quality care, can be likened to an oasis in this increasingly desert-esque landscape. How do we as practitioners, continue to offer the top care that we do, while combating increasing instances of burn-out, fatigue, and a general lack luster experience where on occasion we may dip our toes into the depths of existential darkness? With greater work loads and less time that we do not have, it is imperative for us to find ways to care for ourselves. These sharp changes in the field require equally acute transformations of focus.

There is another movement germinating in this field z krasner9258-1within the western context that proffers a way for us to take care of ourselves so that we can do what we love: take care of others. This movement is towards mindfulness. Mindfulness in clinical practice is essential to thriving long-term in the duty of serving our patients to the best of our abilities. Mick Krasner, MD FACP practices primary care internal medicine in Rochester NY and teaches that the University of Rochester School of Medicine and Dentistry. Going strong after 12 years of integrating Mindfulness-Based Stress Reduction into the lives of his patients, medical students and various health professionals, Mick might be on to something. A plethora of research on this topic shows an improvement in quality of care of patients, and an increase in well being for the health professionals who practice it. An example of one of the aspects whereby we can incorporate mindfulness is within the context of communication education with our colleagues.

Howard B. Beckman et. al. published a fascinating study exploring mindfulness-based interventions with practitioners, finding that these kinds of mindful communications skills when learned and practiced, promote a sense of community and an increase in time devoted to personal growth. In the paper, “The Impact of a Program in Mindful Communication on Primary Care Physicians,” they conduct in-depth interviews with physicians who had completed a specific 52-hour mindful communication course, which had known effects of reducing distress and burnout as well as increasing empathetic capacities. Generally there were three main themes that surfaced through the randomized qualitative data: 1) sharing personally the experiences from medical practice with other colleagues in the class setting reduced professional isolation, 2) increased skill sets to listen attentively to patients, 3) developing a greater sense of self-awareness is a positive experience. It is clear here as is true in other studies, that learning how to engage in mindfulness practice (and practicing!) does tremendous good for the individual and by proxy, for the community as a whole.

This education in mindfulness has ineffable multi-facetted value, but we already don’t have enough time as it is! So what do we do? Well, one way is by looking for those CE’s that will offer us this kind of education that will teach us to nourish ourselves so we can continue to do the important work that we do. Being aware of the consequences, good and bad, of our decisions we make for ourselves and about ourselves is one of the pillars of this mindfulness journey to creating the life we want to live. We can seek out continuing education courses that we have to do anyway, that will also aid us in this journey towards taking care of ourselves therefore enabling us to sustainably care for others.

We are delighted Dr. Krasner is coming to San Diego on May 11, 2013 to present a daylong workshop on mindful practice entitled “Mindfulness in Clinical Practice: Our Patients, Ourselves.” This event will include an hour-long presentation on the Neuroscience of Mindfulness by Tom Chippendale, MD, Director of Neuroscience at Scripps Health and longtime MBSR teacher. The day-long training has been approved by the AMA PRA for Category 1 Credit.

Work Cited:

Beckman, Howard B., MD, Melissa Wendland, Christopher Mooney, MA, Michael S. Krasner, MD, Timothy E. Quill, MD, Anthony L. Suchman, and Ronald M. Epstein, MD. “The Impact of a Program in Mindful Communication on Primary Care Physicians.” Academic Medicine 87.6 (2012): 1-5. Print.

Krasner, M. S., R. M. Epstein, H. Beckman, A. L. Suchman, B. Chapman, C. J. Mooney, and T. E. Quill. “Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians.” JAMA: The Journal of the American Medical Association 302.12 (2009): 1284-293. Print.

About the Author:

Chris Gauthier is an alumnus of the University of California, San Diego with a degree in Cognitive Science and a focus in Neuroscience. He has many passions, most revolving around skills of wholeness, health, and self-discovery. Chris is affiliated with the UCSD Center for Mindfulness. He also travels and presents a variety of topics in a workshop style, mostly to college-level minds. Mr. Chris Gauthier can be reached at: chris.a.gauthier@gmail.com.

Jon and Myla Kabat-Zinn to Present at 2013 Mindfulness & Youth Conference in San Diego

Jon & Myla Kabat-Zinn

Jon & Myla Kabat-Zinn

Conference organizers announced today that scientist, author and noted mindfulness teacher Jon Kabat-Zinn will be offering a public lecture in San Diego on Friday, Feb. 1, 2013 as part of the 2nd Annual Bridging the Hearts and Minds of Youth: Mindfulness in Clinical Practice, Education and Research conference. Jon and his wife Myla, co-authors of Everyday Blessings: The Inner Work of Mindful Parenting will also present a 3-hour workshop on Mindful Parenting on Saturday afternoon, Feb. 2 as part of the conference.

“We are so excited to have Jon and Myla with us for the conference to maintain the tremendous momentum we built with last year’s inaugural event,” said Steven Hickman, Director of the UCSD Center for Mindfulness and conference organizer. “And the best news is that this is only the first of several exciting developments in the works for 2013.”

Hickman went on to note that the conference will start a half-day earlier than in 2012, largely to accommodate two research symposia, a poster session and optional pre-conference workshop. The focus will remain on the “three pillars” of clinical practice, education and research, and keynote speakers and sessions will be devoted to each of these areas of interest. “In order to assure a varied and interesting agenda for 2013, the Program Committee has opted to issue a call for submissions to fill much of the conference schedule,” Hickman reported. “We invited the people we knew doing the work we were most familiar with last year, and the result was wonderful. But this year we are casting the net much wider in hopes of involving people and programs from a much broader background and expertise.” Deadline for conference submissions is August 1, 2012, and the final conference agenda will be announced by September 1.

A number of other enhancements to the program are already underway, including a number of mechanisms by which people can be kept abreast of additions to the agenda, the latest work by conference presenters, and other activities planned to coincide with the conference. A separate “Bridging the Hearts and Minds of Youth” blog has been launched, as has a conference Facebook page as well. Those interested in following the unfolding of this groundbreaking conference are urged to subscribe to the blog and/or “Like” the Facebook page to keep in touch and be notified when registration opens.

Jon and Myla Kabat-Zinn to Present at 2013 Mindfulness & Youth Conference in San Diego

Jon & Myla Kabat-Zinn

Jon & Myla Kabat-Zinn

Conference organizers announced today that scientist, author and noted mindfulness teacher Jon Kabat-Zinn will be offering a public lecture in San Diego on Friday, Feb. 1, 2013 as part of the 2nd Annual Bridging the Hearts and Minds of Youth: Mindfulness in Clinical Practice, Education and Research conference. Jon and his wife Myla, co-authors of Everyday Blessings: The Inner Work of Mindful Parenting will also present a 3-hour workshop on Mindful Parenting on Saturday afternoon, Feb. 2 as part of the conference.

“We are so excited to have Jon and Myla with us for the conference to maintain the tremendous momentum we built with last year’s inaugural event,” said Steven Hickman, Director of the UCSD Center for Mindfulness and conference organizer. “And the best news is that this is only the first of several exciting developments in the works for 2013.”

Hickman went on to note that the conference will start a half-day earlier than in 2012, largely to accommodate two research symposia, a poster session and optional pre-conference workshop. The focus will remain on the “three pillars” of clinical practice, education and research, and keynote speakers and sessions will be devoted to each of these areas of interest. “In order to assure a varied and interesting agenda for 2013, the Program Committee has opted to issue a call for submissions to fill much of the conference schedule,” Hickman reported. “We invited the people we knew doing the work we were most familiar with last year, and the result was wonderful. But this year we are casting the net much wider in hopes of involving people and programs from a much broader background and expertise.” Deadline for conference submissions is August 1, 2012, and the final conference agenda will be announced by September 1.

A number of other enhancements to the program are already underway, including a number of mechanisms by which people can be kept abreast of additions to the agenda, the latest work by conference presenters, and other activities planned to coincide with the conference. A separate “Bridging the Hearts and Minds of Youth” blog has been launched, as has a conference Facebook page as well. Those interested in following the unfolding of this groundbreaking conference are urged to subscribe to the blog and/or “Like” the Facebook page to keep in touch and be notified when registration opens.

Mindfulness Interventions for Bipolar Depression

Dr. Marchand is an investigator at the George E. Wahlen Veterans Administration Medical Center in Salt Lake City, Utah and Assistant Professor of Psychiatry at the University of Utah.

Bipolar disorder is a severe psychiatric illness characterized by episodes of depression as well as periods of elevated mood, known as mania. This condition, previously known as manic-depressive illness, causes considerable suffering and disability. Furthermore, bipolar depression is often difficult to treat and associated with anxiety symptoms and an increased risk of suicide. Thus, additional treatment approaches are needed. Interventions that target anxiety and suicide risk, in addition to depression, could be particularly useful.

Mindfulness-based interventions have demonstrated effectiveness for symptoms of unipolar depression (major depression not associated with manic episodes) and anxiety. There is also evidence accumulating that these approaches may help reduce suicide risk. Therefore, I recently reviewed the literature to determine whether clinical trials of mindfulness-based approaches for bipolar depression are warranted. The results of that review were recently published in Depression Research and Treatment.

Several lines of evidence support studies of mindful-based interventions for bipolar depression. From a psychological perspective, bipolar depression appears to be associated with abnormal self-referential thinking, as has been established for unipolar illness. Further, ruminative analytical thinking about the self may contribute to symptom expression in both disorders. Thus, the practice of mindfulness would be expected to be beneficial for bipolar depression as a result of decreasing maladaptive self-focused thinking patterns. Similar mechanisms might also contribute to decreased suicide risk among those suffering from this condition.

Brain imaging studies also support clinical trials of mindfulness-based interventions for bipolar depression. Evidence links the function of the cortical midline structures with both emotional dysregulation and self-referential thinking in unipolar illness. Therefore, this brain region may mediate the relationship between aberrant self-referential thinking and negative emotion in major depression. Some evidence suggests that similar mechanisms may play a role in bipolar depression. Thus, while unipolar and bipolar depression are different psychiatric disorders, similar psychological and neurobiological mechanisms may underlie symptom expression in both conditions. This suggests that the response to mindfulness-based interventions may be similar across the disorders and provides a theoretical basis for the study of these approaches for bipolar depression.

A few studies (see references) have provided early evidence that mindfulness-based treatments may be useful for bipolar disorder. Moreover, diverse lines of investigation provide a conceptual background supporting continued clinical trials of mindfulness-based approaches for bipolar depression.

Please see Mindfulness Interventions for Bipolar Depression by William R. Marchand, MD for a free download of the complete review.

References:

P. Chadwick, H. Kaur, M. Swelam, S. Ross, and L. Ellett, “Experience of mindfulness in people with bipolar disorder: a qualitative study,” Psychotherapy Research, vol. 21, no. 3, pp. 277–285, 2011.

W. R. Marchand, J. N. Lee, C. Garn et al., “Aberrant emotional processing in posterior cortical midline structures in bipolar II depression,” Progress in Neuro-Psychopharmacology and Biological Psychiatry, vol. 35, no. 7, pp. 1729–1737, 1729.

W.R. Marchand, “Self-Referential Thinking, Suicide, and Function of the Cortical Midline Structures and Striatum in Mood Disorders: Possible Implications for Treatment Studies of Mindfulness-Based Interventions for Bipolar Depression,” Depression Research and Treatment, doi: 10.1155/2012/246725

B. Weber, F. Jermann, M. Gex-Fabry, A. Nallet, G. Bondolfi, and J. M. Aubry, “Mindfulness-based cognitive therapy for bipolar disorder: a feasibility trial,” European Psychiatry, vol. 25, no. 6, pp. 334–337, 2010.

J. M. G. Williams, Y. Alatiq, C. Crane et al., “Mindfulness- based cognitive therapy (MBCT) in bipolar disorder: preliminary evaluation of immediate effects on between-episode functioning,” Journal of Affective Disorders, vol. 107, no. 1–3, pp. 275–279, 2008.

Mindfulness, Hypnosis and Psychotherapy: Where do they meet?

The following is the next in a series of informal conversations between Trudy Goodman, Ph.D., Elisha Goldstein, Ph.D. and Steven Hickman, Psy.D., the teachers for a unique upcoming professional training retreat entitled “Mindfulness in Psychotherapy” to be held October 2-7, 2011 at the Joshua Tree Retreat Center in Southern California. Enjoy! Today, Trudy Steve and Elisha talk about the relationship between mindfulness and hypnosis in psychotherapy and beyond.

Trudy Goodman, Ph.D.

Trudy: (I recently had an opportunity to explore the differences and similarities between mindfulness practice and hypnosis with a client. I thought it might be worth exploring here in our ongoing conversation on mindfulness and psychotherapy.) 

In mindfulness practice, we give our full attention to one subject at a time as a way of training our minds to be attentive to another dimension of awareness, “beneath” the discursive consciousness and the thinking mind (what the hypnotherapist calls executive functioning), and yes – the protective activity of the amygdala can be activated and trained via conscious, mindful breathing for example. Meditation does mirror the receptivity of hypnosis in this way.

In hypnosis, one is led and taught how to drop down beneath the flow of habitual patterns of thinking and perception to a receptive, open state where the therapist’s suggestions can be embedded and incorporated into conscious living. We are doing something similar but different, too. We may also invoke the relaxed, alert, receptive altered state, but we emphasize investigation, inquiry, and looking deeply at what is arising (with the intention to understand, rather than to judge, and the accepting, non-judgmental approach is similar in hypnosis).

One difference is that with mindfulness meditation we are learning how to be both receptive – open, relaxed, alert; and active – forming the intention to stay with experience as it arises and passes away. One goal of MBSR training is to establish and cultivate mindfulness — your ability to direct your awareness intentionally towards what is actually happening, in real time, moment by moment, so you can receive more information, understanding, and compassionate insight as your life unfolds.

There’s no conflict between what your hypnotherapist tells you and what we’re doing because we are actually engaging many capacities of consciousness simultaneously when we focus on one thing at a time – many cognitive and emotional qualities come into play, like the intention to aim or direct awareness, to sustain a close connection with the subject of awareness, AND with awareness of the ebb and flow of mindfulness itself – a kind of meta-awareness – with clear comprehension combined with the suffusion of warmth, acceptance, kindness, even affection, into our mindful awareness of ourselves, others and our world.

So yes, your mind can and does operate on more than one level at a time. What we are doing is bringing more and more of this activity into conscious awareness. We are cultivating strong mindfulness and metta, enabling us to make more conscious choices about the way we relate to experience.  Hopefully, wise choices that result in our living committed, compassionate lives, and enjoying more peaceful, harmonious, loving relationships along the way!

Steve: While I am no expert in hypnotherapy, I do have a strong sense that both mindfulness and hypnosis share an interest in helping people “get out of their own way” in regard to longstanding but dysfunctional, limiting or unskillful habits, attitudes and behaviors. The single-pointed, quiet and patient focus of both practices allows us (both client and therapist) to see these habitual patterns against a plain backdrop of awareness, rather than the cluttered one of everyday busy-ness.

I liken our attempts to make sense of our problems with our typically distracted, multi-tasking minds to trying to watch a movie when someone is trying to carry on a conversation with you at the same time. Both the movie and the conversation might make sense in their own rights, but together they become a mass of conflicting and confusing features that seems completely overwhelming and sometimes discouraging. Mindfulness practice (and therapy) allow the client to develop the attitudinal skills to observe this chaos and respond patiently and kindly, and the attentional skills to direct attention (and psychological resources) toward the “real” issues and perhaps away from imagined or feared ones. This shift can allow a person to see things for what they are, and to recognize where the constructions and stories that we all create are just that: creations, and not facts to be dealt with or resolved.

I am told that hypnosis cannot bring about behavior that is not first desired by the patient or client. If someone does not truly want to change a particular behavior, hypnosis has no magical ability to transcend that desire. Similarly, intention is at the heart of mindfulness in psychotherapy. We seek to tap into the natural intention that each of has to move toward ease, kindness, compassion and fulfillment, by reducing the “obscurations” of habit and conditioning, and thereby reduce suffering. Not much difference between hypnosis and mindfulness in that, is there?

Elisha: I want to make sure we’re differentiating here between mindfulness as a way of life and formal meditation practice. We can practice mindfulness in formal and informal ways and I think the guided formal meditation practice is the one that can be confused with hypnosis. Having been the recipient of both, I would say the big difference for me is that mindfulness is couched within a much larger context and can be seen as a way of life. Not in any dogmatic religious way, but as a philosophy and practice that we can bring into all the things we do.

Mindfulness at its core trains the mind to more actively drop into a kind attention, cultivating a natural warm presence to bring with us throughout our days. In my opinion, this is at the core of self-healing.

Mindfulness also brings people together in community who are interested in living a more present and compassionate life. This may be one of the most important pieces. Ultimately it’s my belief that the most helpful way for people to make change is through a community of peers who support them with this. I see people who engage with mindfulness in psychotherapy and beyond having an inclination toward wanting to be a part of a community that supports a more mindful life.

We invite you to join in this conversation.  Please share your thoughts, questions and stories below. Your interaction creates a living wisdom from which all of us can benefit. As these conversations accumulate, we are collecting them on a separate page of our blog (see the tab above labeled “Mindfulness and Psychotherapy” for the archive) for review and comment. Visit the UCSD Center for Mindfulness Professional Training site for information on Mindfulness in Psychotherapy retreat training.



How Does MindLESSness Inform Psychotherapy? Join the Conversation Amongst Teachers

The integration of Mindfulness and Psychotherapy is a topic of fast-growing interest among clinicians and clients worldwide. The following is the first in a series of informal conversations between Trudy Goodman, Ph.D., Elisha Goldstein, Ph.D. and Steven Hickman, Psy.D., the teachers for a unique upcoming professional training retreat entitled “Mindfulness in Psychotherapy” to be held October 2-7, 2011 at the Joshua Tree Retreat Center in Southern California. Enjoy!
 
In the first of a series of conversations,  Steve, Trudy and Elisha talk about the importance of mindlessness in the therapeutic session.

Steven Hickman, Psy.D.Steve: Today as I worked with a particularly frustrating client whom I experience as quite intransigent and unwilling (unable?) to make change despite constantly extolling his desire for things to be different, I was caught off guard. I had just pointed out his apparent lack of motivation to change (in appropriately therapeutic terms), and he replied by asking in a slightly defensive tone of voice, “Do you talk to all your patients like this?” I’m embarrassed to admit it, but he called me on my mindlessness in that session. Fortunately, I was able to make use of the moment clinically.

Call it countertransference if you like, but for that period of time I was not responding to the human being sitting across from me (and suffering, I might add), but was marching to the beat of some other drummer of my own mind’s making. It strikes me now that it is in these moments of having our mindlessness become vividly apparent, that we actually become more fully mindful, just as when we notice that our attention has wandered in meditation, we are actually as present as we can be! It seems that mindFULness actually becomes most apparent against the backdrop of mindLESSness. What do you think?

Elisha Goldstein, Ph.D.Elisha: There’s a very common misunderstanding in the practice of mindfulness that the practice is to stay focused on whatever we’re paying attention to and deviation from that is “bad” mindfulness. In my personal experience in session with a client or out of session in my own life, it is these moments that I wake up to recognize that I’ve been drifting that seem the most valuable to me. Why? It is this precise moment that I wake up to the fact that I have a choice to intentionally practice cultivating a sense of presence once again and this, in  my mind, is the foundation to mindfulness and psychotherapy.

Presence may be something that some people naturally have more than others, but the truth is, it’s a skill and we can all cultivate it through practice. For better or worse, our brains seem to make things more habitual after they are practiced and repeated. So we need the moments where we’re drifting off the path of being connected to the moment to exercise that intentional muscle of nonjudgmentally guiding our attention back to being present with what’s here.

Trudy GoodmanTrudy:   Since psychotherapy is a relational process, I look at the times of ‘mindlessness’ as a time of disconnection in the relationship. What’s interesting about drifting away from being present in the relationship is to look at what was happening the moment before, when I was still present? And what is happening now, when my attention has wandered away? Where did it go? And how might this be a mini/micro re-enactment of the client’s conditioned relational patterns, or my own?

Rather than see this temporary disconnect as a failure to practice either mindfulness or psychotherapy well, these times actually provide an opportunity to understand the relationship better. If, as the late psychoanalyst Paul Russell suggested, we define resistance as the therapist’s resistance to what’s happening in the clinical encounter, mindless disconnections can get much more interesting! What’s going on in the moment that makes us turn away in restlessness, boredom, frustration? What’s being revealed about the relationship?

As clinicians, we work to cultivate our own mindful presence in a way that is suffused with compassion towards oneself and others, so that we can choose more wisely how to respond to such moments of disconnection. Mindfulness offers us a bridge back to adjusting our stance as therapists to be more continuously curious, congruent and caring. Moments of mindful awareness are quite accessible, but continuity of this quality of compassionate presence has to be consciously chosen, intended, and developed through our own meditation practice.

For me, working with this kind of authentic attentiveness – while staying open to learning about myself in the process — is an act of love. And love is part of what mindfulness meditation is all about! Wisdom and clarity without compassion and love is like a bird with one wing. We need two wings to ‘fly’ in all our relationships — clinical, professional and personal. How wonderful that even moments of mindlessness can be a bridge to insight, to understanding what gets in the way of loving. Mindless moments of disconnection, when met with kindness and curiosity, can teach us how to connect and be wholeheartedly present with ourselves and all those whose lives we touch, just the way we are.

We invite you to join in this conversation.  Please share your thoughts, questions and stories below. Your interaction creates a living wisdom from which all of us can benefit. As these conversations accumulate, we will collect them on a separate page of our blog for review and comment. Visit the UCSD Center for Mindfulness Professional Training site for information on this and other trainings offered.