Tag Archives: Steven Hickman

Surfing A Global Wave

By Chris Gauthier

Global Wave            You know something’s working when it makes it to the big time “for Dummies” book publishing. Today a person can Google “Mindfulness” and will find almost 12 million global links for the word/practice/healing revolution in less than a second. What we find on the internet today and in the contemporary programs of our time is historically linked to practices in other parts of the world about 1500 years before our common era (Alidina, 2011). The folks at UCSD’s Center for Mindfulness work to train professionals, empower those who come to learn the skills, and research this nebulous field to better understand why what they do is successful.

            Variations of this practice of mindfulness, some with traditions hundreds of generations long, are compacted, packaged and exported around the globe. The methodology and application remains in essence, however newly formulated semantics, developed contemporarily by Jon Kabat-Zinn and others describe these activities and practices for this generation. With the success that he has had (Zinn, 2003) along with others, Mindfulness-Based Stress Reduction (MBSR) programs are popping up like Starbucks all over the place. Recently interviewed, Steven Hickman, Psy.D, the founder and current Director of the growing UCSD Center for Mindfulness discusses the continual development of their program.

            Generally, these programs educate people with scientific explanations and evidence for many data-driven and evidence-based consumers today. Hickman knows that mindfulness is somatically located, based on this research and his own practice, so the Center’s programs provide “a way in for people to then let that go and to experience what that is for real” paired with discussions of research, art, and sharing experiences. Researched, tried, and tested, this methodology seems to ‘click’ with human minds and brains to institute real, long-lasting change on a neuronal level (Baer, 2003). UCSD CFM has come a long way from its conception, more than a decade ago.

           steve-hickman Hickman’s vision was and is still: not a business plan, not any sort of “strategic plan” at all. Confident in this work, the practice itself akin to the roots of kelp that meld with the ocean floor, swaying with the change of tide, but never adrift and disconnected. This is what makes UCSD’s program unique: “All of these interventions, even though each one’s different, they all share a core of mindfulness practice, and needing to be grounded in a practice if you are going to teach.” Still, designing an authentic and effective mindfulness program for a large range of participants from chronic pain patients to lawyers is challenging. UCSD’s success is a teaching framework whereby these skills are taught, experienced and made into habits is reflected in the center’s growth. Steve explains that, “people are coming in because they are suffering over something…We help people identify that they have stressors, then set that aside and give people the experience of watching their mind.” This is not where influence of the center stops for long, however.

               The Neuroscience behind Professional Training Institute BannerMindfulness is of increasing interest to healthcare professionals and they are pursuing mindfulness training through the UCSD Center for Mindfulness’s Professional Training Institute. When the center was founded, it quickly became a hub. Hickman describes the experience, “I was just standing on the beach when the global wave of interest hit.” Currently, the CFM is creating programs, training and research opportunities that will help to spread the practice far beyond the center’s current reach. With the instructors here also continually practicing and growing, it is only natural that what the center teaches “can take care of itself.”

              

     Keeping with the pace of the global wave of interest mindfulness brings, Steve is heartened by knowing, “the nice thing is that you can do life and mindfulness at the same time.”


Work Cited

 Baer, Ruth. “Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review.” Clinical Psychology: Science and Practice 10 (2003): 125-43. Print.

Bishop, S. R. “What Do We Really Know about Mindfulness-Based Stress Reduction?” Psychosomatic Medicine 64 (n.d.): 71-84. Print.

Kabat-Zinn, Jon. “Mindfulness-Based Interventions in Context: Past, Present, and Future.” Clinical Psychology: Science and Practice 10.2 (2006): 144-56. Print.

“A Tidal Wave of Mindfulness: An Interview with Dr. Hickman.” Interview by Sara Kimmich. May 2013.

Alidina, Shamash, MA. “History of Mindfulness.” Learn Mindfulness. Learn Mindfulness, 2011. Web. 1 June 2013.

 

Image credit: http://apogeepoet.blogspot.com/2012_07_01_archive.html

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 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

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New training pathways for MBSR and MBCT teachers now available through UC San Diego

By Steven Hickman, PsyD, Director, UCSD Center for Mindfulness

“How can I become a teacher of Mindfulness-Based Stress Reduction?” I cannot begin to calculate how many times I have been asked this question in the past ten years as a teacher of the MBSR program. I am constantly moved and touched by the people in my classes and the tremendous change and healing that can happen through the regular practice of mindfulness. This profound impact on people has more recently manifested in a huge demand among people touched by the practice who wish to share it with others. As MBSR programs have spread across this country and the world, there is a growing (and unprecedented) need to provide well-designed training for those who wish to teach MBSR and share this practice with a wide variety of people and groups in a whole host of settings.

Susan Woods

That is why I am particularly excited to announce that two highly qualified mindfulness teachers and trainers, Susan Woods and Char Wilkins, will be teaching our first 5-Day Foundational Training in Mindfulness-Based Stress Reduction for professionalson June 2-7, 2013 at the Joshua Tree Retreat Center.  Intended to support and develop people along their path toward teaching MBSR, this intimate foundational training will provide attendees the opportunities to learn in depth about the program, but more importantly to explore it “from the inside out” in the role of teacher, through small group exercises, mindful feedback and reflection.

Char Wilkins

The second of our two new trainings, also taught by Susan Woods and Char Wilkins, is the 5-day Advanced Professional Training for MBCT/MBSR Teachers, June 9-14, 2013 at EarthRise Retreat Center in Petaluma, California.  The demand for advanced training in mindfulness-based interventions has grown over the years and a foundational professional training is just the beginning of becoming a skilled and knowledgeable teacher.  This ground-breaking advanced training brings together, for the first time in the U.S., both MBCT and MBSR teachers allowing for a rich learning experience.  Susan has designed a training in which there is less dependence on teaching to the curricula of either MBCT/MBSR, and greater attention to strengthening core competency skills allied with teaching mindfulness. The heart of this program lies in closely attending to and strengthening the development of universal mindfulness principles such as investigating how one comes to understand and embody mindful presence and mindful reflective inquiry.

The training model that has evolved here at UCSD has proved to be efficient and effective. By providing intense retreat-style trainings that combine personal mindfulness practice, experiential learning of the curriculum and opportunities to guide practices, engage in mindful inquiry and take part in dialogue with skilled teachers, we have found that our participants leave feeling prepared to actually begin the important work of leading Mindfulness-Based Interventions (MBI’s).

Thus begins the next phase in the development of the Professional Training programs at the UC San Diego Center for Mindfulness. This new pathway toward becoming an MBSR teacher is situated alongside intensive training in Mindfulness-Based Cognitive Therapy (MBCT), Mindfulness-Based Relapse Prevention (MBRP), Mindfulness-Based Childbirth and Parenting (MBCP), Mindful Self-Compassion (MSC), and Mindful Eating, Conscious Living (MECL). The longer-term goal is the establishment of an entire UC San Diego Mindfulness-Based Training Institute that incorporates foundational aspects of all the MBI’s, specific training in the various curricula, opportunities for live consultation and supervision, and ultimately a process of certification in specific MBI’s. The Training Institute is only in its infancy, but arises out of this increasing demand for training and the assurance of competency in delivery of these wonderful programs that are becoming increasingly popular and are being demonstrated through rigorous research to be effective. 

Registration is now open for both the Advanced Training for MBCT/MBSR Teachers and the 5-Day Foundational Training in MBSR and we expect both to fill up quickly. Plans are also in the works to offer these trainings on an ongoing basis, so if these dates don’t work for your schedule, join our mailing list on our Professional Training website to be notified of upcoming additions to the schedule.

 

Wondering about ways that MBSR touches lives? This graduate says it beautifully and powerfully.

By Steven Hickman, Psy.D.
Director, UCSD Center for Mindfulness

In the course of teaching Mindfulness-Based Stress Reduction, I have had the opportunity to hear first-hand how participation in the program has had an impact on the lives of many people. I know from my own experience of mindfulness practice how powerful it can be, but I often struggle with how to put that into words that really capture the experience. Fortunately, every now and then, one of our MBSR participants articulates it so poignantly and eloquently that I get a new look at how this practice changes lives. Recently, in a class taught by my colleagues Luis Morones and Amy Holte, one of their participants (we will call her Katie to protect her privacy, but she has given us permission to quote her) offered some wonderful feedback about her experience that we felt would be helpful to anyone considering embarking on a practice of mindfulness or in taking an MBSR course. Here is what she had to say:

“Thank you … for letting me attend most of the recent class  (in which I had) a 60% attendance rate, which makes me laugh because in addition to suggesting kindness to ourselves and not always striving towards something (like counting attendance) a mere 60% of your class has changed at least 90% of my life.  Although I have read only the opening of the book and made very little time to practice outside of the class, I cling to the concept of my breath always being there for me, or my feet being planted on the ground, and that has consistently redirected my next action in every situation.  Pausing for a moment to just be present gives you the time to envision a desired outcome or at least remember your long-term goal in any given interaction.

“Always a mellow driver, I now am even more inclined to let others race along without getting upset (hard not to urge others to do the same).  When working with my children, my focus is not on being right, but on getting them to decide for themselves what is right and why.  When there is a work crisis, it is amazing how many people already have the solution but have not dared to allow themselves to solve it.  Or friends who want you to solve their problems but don’t like your solutions, you realize they want the problem, and you can let go without guilt.

“Mostly I am finding that giving myself a moment to reflect keeps me calm and much more able to enjoy everyone’s company.  Just this week, all five of my family were in 1) my bathroom, 2) my closet, 3) our bedroom, and in each instance I stopped myself from saying “why are you all here, stop following me” but thought instead, how wonderful that you want to be with me, that we trust each other and listen to each other and want to be together.”

Katie works in the same office space as that of the UCSD Center for Mindfulness, and her group recently experienced a significant reduction in their workforce. The stress of the process of “downsizing” was immense, and we were moved to extend the offer of free participation in MBSR to any of their group affected by these layoffs. Katie noted, “I know that Steve may have been thinking about laid off employees when he so generously offered us a space in your class, but for those of us left behind to pick up the pieces of the dozen or so people we’ve lost, it has been stressful in a different way – survivor guilt, maybe, and the inability to share about the quality and quantity of work when we should be grateful to still have the opportunity to serve.  If I were going through all of these changes without the anchor of this class, my flame would definitely be starting to flicker!!  It is also such a grounding experience to learn from those whose life situations harbor even darker days. I do so regret having missed the retreat, I felt like I was letting my classmates down, but it was unavoidable.

“I feel so empowered about how to live my life in a way that is healthier and happier and that has positive effects on those I love.”

When I wrote to ask Katie’s permission to share what she wrote in her email to the teachers above, she responded with still more wonderfully descriptive feedback: “. . . essentially this experience has been the best gift since my wedding and the birth of my three healthy boys.  That is really not an overstatement or overly enthusiastic – I feel so empowered about how to live my life in a way that is healthier and happier and that has positive effects on those I love, which was my original goal for joining the group.  It will obviously take a lot more practice, but I can already tell that I am making better choices and just thinking before I speak (I can have a sharp tongue) is improving many relationships.”

It seems as though there is nothing else to say, as Katie said it all quite well! If someone you know could benefit from the practice of mindfulness or may be interested in taking a Mindfulness-Based Stress Reduction course, I highly recommend that you share this blogpost with that person. It could change their life in the way that it changed Katie’s. (NOTE: We have a morning sitting group on weekdays in our office and Katie continues to attend with us many times each week.)

The 2012 Schedule of MBSR Classes offered through the UCSD Center for Mindfulness is now online and available for online registration. Take a look at the lineup starting in mid-January and consider joining us to more fully experience the practice of mindfulness for yourself.

Bridging the Hearts & Minds of Youth: February Conference on Mindfulness with Youth in San Diego

Mindfulness, as a powerful and important means of cultivating health, well-being and equanimity, is nowhere more important than in our work with the young people of our society. Alongside the explosive and transformative growth of mindfulness-based programs for adults, there is a particularly heartening and vibrant effort to bring mindfulness to youth of all ages, in a plethora of settings and formats designed to have a significant impact on the lives and futures of literally millions of young people around the world.

To support and grow this important movement, the UCSD Center for Mindfulness has teamed with Stressed Teens to organize and present a first of its kind conference on February 4 and 5, 2012 entitled Bridging the Hearts and Minds of Youth: Mindfulness in Clinical Practice, Education and Research . The intention of this conference is to bring together a number of key thought leaders in the field of mindfulness, both those engaged in bringing it to youth and those whose influence extends well beyond that one area, with the hope that the synergy created by such a gathering will provide further impetus to a growing and important field.

Keynote speakers, breakout sessions and half-day workshops will form the structure of this gathering, but the intention is to create an overall atmosphere of connection, collaboration, encouragement, support and innovation that will inspire attendees to continue or begin the work of teaching mindfulness to the young people with whom they work. A full description of the conference is available on the UCSD Center for Mindfulness Professional Training website, but a  few highlights include:

Rick Hanson, author of The Buddha’s Brain and Just One Thing: Developing a Buddha Brain One Simple Practice at a Time will be presenting a public talk on Friday evening, February 3 entitled “Taking in the Good: Helping Children Build Inner Strength and Happiness” and then will provide a keynote address on Saturday at the conference itself with the intriguing title “Managing the Caveman Brain in the 21st Century”.

Psychologist and well-known mindfulness researcher Amishi Jha will be offering her insights in another keynote address, entitled “From Dazed and Distracted to Attentive and Calm: What the Neuroscience of Mindfulness Reveals”. Dr. Jha will be joining the other keynote presenters, Susan Kaiser Greenland, Pamela Siegle and Chip Wood on a discussion panel on Saturday as well.

Three post-conference half-day workshops will be offered on Sunday, February 5, allowing attendees to deepen their understanding and training in working with mindfulness and youth. Workshops include one by conference co-organizer Gina Biegel, developer of the Mindfulness-Based Stress Reduction for Teens (MBSR-T); another by Randy Semple, who has adapted Mindfulness-Based Cognitive Therapy (MBCT) for children, and a wonderful session on “Nurturing Your Self in Your Work With Youth” offered by mindfulness teacher and holistic physician, Amy Saltzman.

These are just a few of the highlights of this inaugural conference that promises to be literally packed with interesting and engaging speakers, presentations and experiences. Co-organizers Steven Hickman, Director of the UCSD Center for Mindfulness and Gina Biegel, founder of Stressed Teens, hope that this will become an annual event that makes a significant contribution to the field of mindfulness with youth. If you are an educator, therapist, physician, or just a concerned and engaged parent looking to explore how you might integrate mindfulness in your work with youth, you may want to consider joining this impressive lineup of presenters in San Diego at the Catamaran Resort Hotel on February 4 and 5, 2012. Space is limited, register early and receive a $50 Early Bird Discount.

Mindfulness Based Cognitive Therapy 10 Years and Onwards: A Personal Reflection by Zindel Segal

Zindel Segal, Ph.D.

Zindel Segal, Ph.D.

Zindel Segal is one of the co-founders and developers (along with John Teasdale and Mark William) of Mindfulness-Based Cognitive Therapy (MBCT). Dr. Segal, along with Sarah Bowen and Steven Hickman, will be leading a 5-Day Professional Retreat Training in MBCT on February 19-24, 2012 at the EarthRise Retreat Center in Petaluma, California. Registration is now open for this experiential training event.

With the 10-year anniversary of the publication of Mindfulness Based Cognitive Therapy for Depression nearly upon us, it is a good time to perhaps stop and reflect on where the field stands at this juncture.

Mindfulness-Based Cognitive Therapy for DepressionFor the past decade John, Mark and I have been largely concerned with reaching the first milestone of treatment development – reliable evidence for MBCT’s effectiveness.   Data from 6 Randomized Controlled Trials and 2 meta-analyses (Hoffman, 2010; Piet & Hoogard, 2011) now indicate that Mindfulness Based Cognitive Therapy is associated with a 50% reduction in depressive relapse risk as well producing symptom relief in  anxiety disorders for both adults (Kim et al., 2010) and children (Semple & Lee, 2011).

Having addressed the efficacy question, we are still left to ponder how exactly this multi-modal treatment achieves its benefits.  For example, what is the relative contribution of cognitive therapy principles versus mindfulness practice to outcome?  What about the role of kindness and compassion, both of which are implicit in the program and, as Willem Kuyken’s work suggests, may be one of the consistent gains reported by participants?

Clarifying mechanisms of action is of more than just academic interest, as it will likely inform the approach taken to training the next generation of MBCT practitioners.  The fact that these are questions being asked shows how far we have come from the early days when MBCT was described as a form of attentional control training.

It is always hard to predict what the next 10 years will bring, but my bet is that efforts to disseminate MBCT via online technologies will start to have an impact.  Online approaches may be a response to the fact that there are still far too few MBCT instructors and too many patients seeking care.  The challenge for online MBCT will be to adapt to an internet friendly format, while holding onto the practice dimension, which however you slice it, always comes down to being a personal, non-electronically mediated experience.  It should all make for a very interesting ride.

References
Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010 Apr;78(2):169-83.
Piet J, Hougaard E. The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clin Psychol Rev. 2011 Aug;31(6):1032-40.
Geschwind N, Peeters F, Drukker M, van Os J, Wichers M. Mindfulness training increases momentary positive emotions and reward experience in adults vulnerable to depression: A randomized controlled trial. J Consult Clin Psychol. 2011 Jul 18. [Epub ahead of print] 
Kim B, Lee SH, Kim YW, Choi TK, Yook K, Suh SY, Cho SJ, Yook KH Effectiveness of a mindfulness-based cognitive therapy program as an adjunct to pharmacotherapy in patients with panic disorder. J Anxiety Disord. 2010 Aug;24(6):590-5. Epub 2010 Apr 3.
Semple R & Lee, J (2011).  Mindfulness Based Cognitive Therapy for Anxious Children.  New Harbinger:  Oakland.

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.

Cheers! Here’s to Wonderful Old Wine in Amazing New Mindfulness-Based Bottles

By Steven Hickman, Psy.D.
Director, UCSD Center for Mindfulness

A colleague of mine emailed me yesterday to ask my advice. She had submitted a paper for publication in a respected scientific journal that looked at one particular aspect of Mindfulness-Based Stress Reduction (MBSR). One of the reviewers, apparently intending it as a significant criticism, asked if MBSR wasn’t just “old wine in new bottles”, noting that Carl Rogers and Gestalt therapists had been bringing mindfulness into psychotherapy years before anyone had heard of MBSR. She wanted to know how to respond to this rather stern criticism of her very thoughtful and innovative work.

I told her that she should agree with the reviewer.

Mindfulness is indeed, VERY old wine. Relatively speaking, MBSR and all the rest of the mindfulness-based interventions being devised and deployed in clinical practice these days are indeed quite new “bottles.” But nobody has suggested otherwise! From the beginning, Jon Kabat-Zinn (MBSR) , Marsha Linehan (Dialectical Behavior Therapy – DBT), Zindel Segal, Mark Williams and John Teasdale (Mindfulness-Based Cognitive Therapy – MBCT) and other treatment developers have openly and reverently acknowledged the very deep and ancient roots of mindfulness, mindfulness practice and the wisdom of drawing on these roots for the relief of suffering.

In his book Full Catastrophe Living, Jon Kabat-Zinn writes:

Although at this time mindfulness meditation is most commonly taught and practiced within the context of Buddhism, its essence is universal. Mindfulness is basically just a particular way of paying attention. It is a way of looking deeply into oneself in the spirit of self-inquiry and self-understanding. For this reason it can be learned and practiced, as we do in the stress clinic, without appealing to Oriental culture or Buddhist authority to enrich it or authenticate it. Mindfulness stands on its own as a powerful vehicle for self-understanding and healing. In fact, one of its major strengths is that it is not dependent on any belief system or ideology, so that its benefits are therefore accessible for anyone to test for himself or herself. Yet it is no accident that mindfulness comes out of Buddhism, which has as its overriding concerns the relief of suffering and the dispelling of illusions. (p. 12-13)

But where the analogy of old wine in new bottles falls apart, is that the “bottles” or the interventions themselves are an integral part of what makes these new programs effective and powerful. These are not meditation classes or silent retreats at remote monasteries, but fully thought out, carefully devised and thoroughly researched psychological interventions that honor the roots of their “wine” and skillfully bring it to suffering individuals in very systematic, deliberate and empirically-supported ways.

A plethora of studies have established MBSR as an effective intervention for addressing the suffering associated with chronic pain, cancer, sleep disturbance, anxiety, and ADHD, just to name a few (Grossman, 2004)(Hofmann, 2010). The 8-week program has been shown to not only reduce a variety of physical and psychological symptoms, but more recently has been shown to bring about structural, measurable changes in the brain itself. Constructed thoughtfully, MBSR has a relatively standardized protocol and logical progression that has consistently (for over 30 years) guided skeptical novices (facing the full spectrum of illness and symptoms, both medical and psychological) through a series of specific exercises and homework practices to a place of ease and equanimity that motivates them to want to continue various forms of mindfulness and meditation practice for years to come.

Focused on helping people alter their relationship with the experiences of their lives (whether those experiences are physical symptoms like pain, or mental phenomena like critical thoughts), mindfulness practice exposes options and flexibility that many never realized they had. One patient of mine with chronic neck and back pain (and significant depression as well) said it best when he noted, “I’ve been a tough guy all my life. I learned to play hurt in sports, to claw my way to the top of my field, and even to fight every day with this horrendous pain. What mindfulness allowed me to do was to see that I could dance with my pain.”

A recent randomized clinical trial reported in the Archives of General Psychiatry by Zindel Segal and his colleagues has established MBCT as an equally effective treatment to antidepressant medication in preventing relapse in previously depressed patients (Segal et al. 2010). Based upon the twin foundations of cognitive behavioral therapy and mindfulness, MBCT is being implemented with a wider and wider variety of diagnostic populations with repeated (if still somewhat preliminary) success. The heart of MBCT is encouraging the patient to simply notice the activity and patterns of the mind, adopting a “decentered” stance toward thinking in which thoughts are experienced as arising phenomena in awareness and not fact or imperative. The patient begins to become aware of the constructions of the mind, the “stories” if you will, that the mind constructs around the actuality of experience. The unreturned wave of a friend soon balloons into yet another indication that one is not worthy of friendship. The flutter of a heartbeat in a stressful situation soon billows into the anxious mushroom cloud of the specter of a heart attack.  And the patient learns to adopt an abiding presence that notices these processes and recognizes the option to not become entangled in them in the way in which they have in the past.

In his 1923 encyclopedia article “Psycho-Analysis,” Freud noted that “the attitude which the analytic physician could most advantageously adopt was . . . a state of evenly suspended attention, to avoid so far as possible reflection and the construction of conscious expectations.”

“Construction of conscious expectations” indeed! And with some perspective and “evenly suspended attention” one can encounter the frightful booming Wizard of Oz and also notice the presence of the pathetic little man behind the curtain. Thoughts are not facts. “Don’t believe everything you think,” says the bumper sticker.

It is my observation that mindfulness, at its essence, is not a treatment in and of itself. It is a very important component of all good treatment, whether explicitly named or not. It is the attitude that we embody when we work with clients and patients, the space we create with them in the therapy room, and healing force that works in them when they encounter what they have often encountered and respond in a healthy way rather than react in a habitual way. And it can also be utilized in a very specific, explicit and replicable way to address a variety of psychological disorders.

I happily and gratefully acknowledge the roots of the old wine in its “new bottles.” And raise my glass to toast those who have applied their considerable wisdom, experience and intelligence to finding ways to relieve suffering in thousands, if not millions of our fellow human beings.

Cheers!

NOTE: This article will be appearing in the upcoming edition of the newsletter of the California Psychological Association.
REFERENCES:
Kabat-Zinn, J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Delta. 1990

Grossman, Niemann, Schmidt and Walach Mindfulness-based stress reduction and health benefits: A meta-analysis Journal of Psychosomatic Research/Vol 57 (No. 1), July 2004

Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol./Vol 78 (No. 2), Apr 2010

Segal, Bieling, Young, MacQueen, Cooke, Martin, Bloch and Levitan Antidepressant Monotherapy vs Sequential Pharmacotherapy and Mindfulness-Based Cognitive Therapy, or Placebo, for Relapse Prophylaxis in Recurrent Depression Arch Gen Psychiatry/Vol 67 (No. 12), Dec 2010

Humble in the Presence of Learning and Growing: The Experience of Leading a Professional Training

Steve HickmanBy Steven Hickman
For the eighth time in the past five years, I have had the profound honor and deep joy to participate as a teacher in a 5-Day Professional Training Retreat in Mindfulness-Based Cognitive Therapy (MBCT). The training took place at beautiful EarthRise Retreat Center in Petaluma, California and I had the privilege of teaching alongside my friends and esteemed colleagues, Dr. Zindel Segal and Dr. Sarah Bowen.

31 professionals came from as far away as Hong Kong to learn about MBCT andMBCT Professional Training how it is taught, learning “from the inside out” in this amazing retreat format. Early morning movement and meditation practice and periods of silence (including several silent meals) punctuated our five days together in a way that allowed participants to ground their learning in the refuge of mindfulness. They began as students and ended as teachers, in that they first were participants in an actual MBCT group (reacting and responding to the various practices and exercises that are part of MBCT) and by the end of the training they were leading each other through sitting meditations, body scans and more.

Each time that I get to do this I experience something different, and this time what I took away was captured in the comments and questions people offered late in the week. Early in the week I was struck by the virtual collision between the typical ways in which therapists encounter patients and how an MBCT teacher meets those same individuals. Wanting to teach, fix, shift and “improve” is embedded in our training as therapists, but what we are doing here is so different. Gently guiding people to their own discoveries or awarenesses and to trust their direct moment-to-moment experience above all else feels awkward and insubstantial at first.

But oh, those shifts that took place during the week! It was as if the largely internal process of attending non-judgmentally to all that arises and staying rooted in the fullness of the moment, began to blossom and flourish outwardly in the space between teacher and student, therapist and client. What a great honor and privilege it is to be a part of that process, in some small way, and to be reminded of the power and potential of mindfulness practice. To prevent relapse in depression, to facilitate effective psychotherapy, to bring depth and richness to life itself. There are moments when it all becomes more than words can fully express.

A deep and reverent bow to my colleagues, my students, my new friends. Thank you for the honor of your presence and your hard work.

Meeting 2011 With Beginner’s Mind

The Starbucks barista just commented to me as she prepared my coffee that she feels this is going to be the year to shine. I agree with the optimism and was also reminded that we have the opportunity to meet each moment of every year with the same sense of wonder, hope and enthusiasm that we are all feeling on this first day of 2011. Every day is its own New Year’s Day, every hour its own New Year’s Hour, every moment its own New Year’s Moment.

Throw a little figurative confetti in every moment, blow a virtual horn in your mind and periodically wear that little smile you wear when you know you have a ridiculous sparkly hat on your head!

Happy New Moment!

Mindfulness for Dummies: The UCSD Connection

I (S.H.) was recently honored to be asked by Shamash Aldina to write the foreword for his new book Mindfulness for Dummies. The book was published a few months ago, and there I am in the opening pages!

Below is the text of that Foreword. I strongly urge that you check out the book when you have a chance.

Sitting down to start a book has many similarities to sitting down to a great meal. There is a warm felt sense of anticipation (in body and mind) of a pleasant experience. There is curiosity in the mind. There is an awareness of a certain “hunger” for what is about to be taken in. And there we are, fully present to what we encounter before us: whether it is the visual experience of the design of the book or the plate presentation of the meal, whether it is the aroma of a desired food or the fresh smell of a newly-printed and opened book. Perhaps this captures something of your experience as you read these words, but on the other hand, as they say, “your mileage may vary.” Take a moment to stop and notice what your experience ACTUALLY is right now in this very moment. What is the quality of your mind? What do you notice in your body? Are you aware of your breath moving in and out of your body, essentially “breathing itself”?

Few things are more elementally basic and simple, yet so hard to convey in words and instructions, than mindfulness. At its essence it is simply being present, to our experience, our whole experience, and nothing but our experience. Yet you can read that previous sentence dozens, even millions of times, and still not know (at a level well below words) how to systematically practice it and bring it into your life with all its stresses and challenges. The only way to truly know mindfulness and cultivate it in one’s life is to practice it like your life depends on it. Because in many ways it does. The degree to which you can be fully present to your experience, letting go of judgment when it is not useful and truly seeing things as they are, really determines the degree of suffering and stress you will experience in this crazy life of ours.

So the biggest difference between sitting down to this book and sitting down to a fine meal in a gourmet restaurant is that this book, as wonderful, instructional and inspirational as it is, is simply the menu and not the meal itself. We’ve all seen many beautiful menus in amazing restaurants the world over, but not a one of them would have tasted anything like the meals they described! Those menus, like Mindfulness for Dummies, simply (but elegantly) point to the real heart of the matter: the practice of mindfulness. A practice that has the potential to nourish and fulfill us in ways that nothing else truly can, and bring equanimity, kindness and balance into every corner of our busy, full lives.

So, the invitation is to approach this book as Derek Wolcott (in his poem Love After Love) suggests we approach our very existence: “Sit. Feast on your life.”