Mindfulness in Psychotherapy: What’s it all about

Fifteen years ago, when I was writing a paper on mindfulness for the graduate program I was in, it was difficult to track down much information about it. Since that time mindfulness has moved from the wings to center stage in psychology and psychotherapy in particular. I think it would be helpful to explore how this happened and what benefit we can take from developing some simple mindful practices in our daily lives.

The term “Mindfulness” seems to have originated with T.W. Rhys Davids, an Englishman who worked to translate Buddhist writings into English for publication in 1910. This is according to Tim Lomas in a HuffPost article in 2016. Mindfulness is defined as being fully aware of the present moment (Jon Kabat-Zinn).

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The history of mindfulness meditation practice has its roots in Hindu and Buddhist practices. In the 1960’s a variety of meditation practices began to be of interest to many Americans. There was a strong interest in exploring altered states of mind without the use of drugs. People began to explore various forms of meditation, and many settled on Mindfulness meditation because it was easy to do without affecting other religious beliefs.

Many people contributed to the development of Mindfulness practice in psychology. For this article, three individuals who have played important roles in adapting mindfulness practices into the psychology world will be the focus. These three are Jack Kornfield, John Kabat-Zinn, and Marsha Linehan.

Jack Kornfield is noted for his work in helping to establish the Insight Meditation Society with locations in Barre, Massachusetts, and Spirit Rock Medical Center in Woodacre, California. He trained as a Buddhist monk and later studied clinical psychology. He has worked to bring the ideas of Buddhism to Westerners and into psychological practices in particular.

Cognitive therapy is a form of therapy that focuses on learning to increase your awareness of your thoughts and then change the thoughts that are not helpful. For example, thinking that you will fail at a task before you even try is likely to result in not even trying the task in the first place. An important job in this style of therapy is learning to observe thoughts as phenomena that simply come and go in our minds. Jack Kornfield had a role in adapting the practice of mindful observation of thoughts for this purpose. Once the thought has been observed and identified as unhelpful, then it can be challenged, reframed, or a new focus can be developed.

Jon Kabat-Zinn further adapted Buddhist practices into Western psychological practices by distilling down techniques that are helpful in Buddhist meditation practices and, through scientific research, developing a training program to teach people how to utilize these practices to find relief from a variety of stress-related problems. He adopted T. W. Rhys Davids’ term, “mindfulness”, to this training program and called it Mindfulness-Based Stress Reduction (MBSR). It is Kabat-Zinn who defined Mindfulness as noted above. The full MBSR program consists of 8 weeks of learning mindfulness meditation practices. Some of the sessions incorporate yoga into the training. Yoga is viewed by some as being moving mindful meditation. What made Kabat-Zinn’s work unique is that he studied the MBSR program he developed to see if it was effective. The now classic study he carried out focused on patients with a skin condition called psoriasis. Patients were divided into two groups. One group received treatment as usual with medications. The other group participated in MBSR for an eight-week training. This consisted of eight once a week sessions with participants practicing the meditations they were taught between sessions. At the end of the study, patients’ skin was observed by medical staff who did not know who was in which group. The participants in the MBSR training had improved skin when compared to treatment as usual. The study was carried out several times to be sure that the results were sound. Kabat-Zinn conducted similar studies that focused on other chronic conditions such as pain and the results were also promising for patients who participated in the MBSR training.

Another psychologist who has brought Mindfulness practice into therapy is Marsha Linehan. Linehan developed a behavioral therapy for individuals diagnosed with Borderline Personality Disorder known as Dialectical Behavioral Therapy (DBT). A simple way to think of behavioral therapy is learning to change actions. Individuals who have been diagnosed with borderline personality disorder have a pattern of impulsive emotional overreaction to daily life events, often with self-harming behaviors of a wide variety. Although DBT is a therapy that teaches patients a wide variety of coping skills, the core of the program is centered on Mindfulness skills. Linehan broke down Mindfulness skills into “What” (what is mindfulness) and “How” (how to be mindful) skills. Clients learn to slow down and observe what is happening, describe it, and participate in the moment with awareness. They also work to develop a non-judgmental view while attending to one thing at a time. This in turn leads to being more effective in determining how they might cope with the daily challenges of life in a healthier way.

Much like Kabat-Zinn, Linehan’s work has been subject to a great deal of research to determine its effectiveness. Although it was developed to help one group of individuals, those diagnosed with Borderline Personality Disorder, it has also been found to be an effective treatment for individuals diagnosed with Bipolar Disorder and Drug and Alcohol Dependence.

Maybe you would like to explore Mindfulness further on your own. Here are some possibilities. First, a book that can guide you through developing your own mindfulness practice: Real Happiness: The Power of Meditation by Sharon Salzburg. Another helpful book is Wherever You Go There You Are: Mindfulness Meditation in Everyday Life by Jon Kabat-Zinn.

If you are more of a “do it to learn it” kind of person, then check out local resident Julie Falk’s mindfulness training on Zoom. She has developed a four-session approach that covers Kabat-Zinn’s Mindfulness Based Stress Reduction program. To find out more about this opportunity call Healthy Adams County at (717) 337-4137.

Margaret Swartz is a Licensed Psychologist in private practice with Yorlan Psychological Associates, York. She has been a therapist for over 30 years, starting her practice as an art therapist working with children in wrap-around programs. She also provided art therapy services to adolescents in various levels of juvenile detention. With a desire to build skills and level of competence, she completed a psychology doctorate (PsyD) in 2008 from the Philadelphia College of Osteopathic Medicine. Her current practice is all via tele-health with older adolescents and adults. Dr. Swartz is a resident of Adams County and has been active with Healthy Adams County's Behavioral Health Task Force and Suicide Prevention Task Force for the past 14 years.

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