MINDFULNESS TOO! BRINGING
THE PRACTICE HOME
Presented by
Dianne Lemieux, Ph.D.
&
Elaine Rodgers, R.N.
Mindfulness Oriented Psychotherapy
Practice Options
1) A therapist may develop a personal formal or informal
practice of mindfulness meditation in order to develop a
more mindful presence in psychotherapy.
2) A therapist may utilize a therapeutic frame which is
informed by their own practice of mindfulness, research
or literature regarding mindfulness or Buddhist
psychology.
3) A therapist may teach patients how to practice
mindfulness.
Germer, C. (2005)
Personal Inquiry
1) Am I interested in pursuing mindfulness practice
for my own personal and or professional growth?
2) Am I willing to commit to a daily practice of
mindfulness?
3) How would I like to incorporate mindfulness in
my clinical, teaching or consulting practice?
4) What further training do I need?
Forms of Meditation Practice
• Concentration Practices use one-pointed
focus on a single object (breath, sound,
mantra, word, image) to calm and stabilize the
mind. “Aim and sustain.”
• Mindfulness or awareness practices cultivate
an open awareness on what is happening as it
is happening without judgment. Also
sometimes referred to as insight meditation or
Vipassana in the Theravada Buddhist tradition.
Concentration Meditation
Samatha (laser light beam)
• Samatha (Pali) : tranquility and concentration
• Any object of awareness may be used as an object of
concentration
• Internal objects: words, images, a spot on the body, the
breath
• External objects: candle flame, mandala, image, a dot on the
wall.
• Benefit: calm, stable mind detached from emotional and
interpersonal involvement
• In concentration practice, the mind is gently returned to the
object of meditation when we notice it has wandered.
• The “Relaxation Response” (Benson, 1975)
Germer, C. (2005)
Mindfulness Meditation
Vipassana, Insight (searchlight)
• Sati (Pali): awareness, attention, remembering
• Expanded focus on a wider range of objects as
they arise in awareness one at a time.
• Benefits: Greater awareness of the personal
conditioning of our minds and an understanding
of the mind itself
• May include any sense (sight, sound, touch,
smell, taste, hearing) as well as thoughts and
emotions
Germer, C. (2005)
Mindfulness/Concentration
Meditations
• Concentration and mindfulness practices actually
complement each other
• Mindfulness begins with concentration
meditation. Once a certain stability of the mind is
reached, the practioner shifts to a mindfulness
focus.
• Research suggests that the two forms of
meditation are in fact neurologically different
Lazar, S. (2005)
Definitions of Mindfulness
“Mindfulness is paying attention on purpose
non-judgmentally in the present moment.”
Kabat-Zinn, J. (1994)
“Mindfulness meditation is a consciousness
discipline revolving around a particular way of
paying attention in one’s life. It can be most
simply described as the intentional cultivation of
nonjudgmental moment-to-moment awareness.”
Kabat-Zinn, J. (1996)
Definitions of Mindfulness
• Mindfulness is “self-regulation of attention so
that it is maintained on immediate experience
thereby allowing for increased recognition of
mental events in the present moment” and
“adopting particular orientation toward one’s
experience that is characterized by curiosity,
openness, and acceptance”
Bishop et al. (2004)
Components of Mindfulness
• Intentionality
• Present Centered Awareness
• Acceptance/Non-Judgment
Mindfulness Practice is Not
• Trying to have a blank mind
• Trying to achieve a special state of mind or trance
state
• Avoiding difficulties
• Escaping physical pain
• Pushing away thoughts or emotions
• Bypassing our personality problems
• Withdrawing from other people
• A relaxation technique
• A religion
Attitudinal Foundations of Mindfulness
Practice
1. Non-Judging
2. Patience
3. Beginner’s Mind
4. Trust
5. Non-Striving
6. Acceptance
7. Letting Go
- Kabat-Zinn, J. (2005)
Modes of Practice
• Informal
• Formal
• Intensive Retreat
Guided Informal Practice/Discussion
Informal Practice Examples
For Daily Life
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Washing your hair
Brushing your teeth
Shaving
Taking a shower
Eating
Walking from your house to the car
Driving
Petting the dog
Washing the dishes (any chore)
Practice Opportunities For
Mindfulness During The Day
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Waiting for 3 rings of the phone before answering
Pausing before speaking
Notice getting up from your desk at work
Turning the computer on or off or switching
applications take a mindful pause
• Notice the action of walking through doorways
• Notice the action of picking something up
• Pause after looking at the clock or your watch
Quick and Instant Practice
(Helpful for Anxiety)
• Choose a reference point as a meditation bell
• Stop and take three slow deep breaths
• Bring the mind to the present moment on the in
breath
• Scan the body and relax as much as you can any
tension held in the body on the out breath
• Notice any thoughts/emotions
• Proceed with what you had been doing
Quick and Instant Practice
(with visualization)
• Choose a reference point as a meditation bell
• Stop and take three slow deep breaths
• With each exhalation repeat the phrase “I feel
calm, relaxed and at peace” or choose another
phase that you resonate with. (Your
visualization is a function of your intention for
yourself.)
• Proceed with what you had been doing
MBCT
The 3-Minute Breathing Space Basic
Instructions
1. Awareness
Bring yourself into the present moment by deliberately
adopting an erect and dignified posture. If possible, close
your eyes. Then ask: “What is my experience right now…in
thoughts…,in feelings…and in bodily sensations?”
2. Gathering
Then, gently redirect full attention to breathing, to each inbreath and to each out-breath as they follow, one after the
other.
Your breath can function as an anchor to bring you into the
present and help you tune into a state of awareness and
stillness.
MBCT
The 3-Minute Breathing Space Basic
Instructions Continued
3. Expanding
Expand the field of your awareness around your breathing, so that it
includes a sense of the body as a whole, your posture, and facial
expression.
The breathing space provides a way to step out of automatic pilot
mode and reconnect with the present moment.
The key skill in using Mindfulness-based Cognitive Therapy (MBCT) is
to maintain awareness in the moment. Nothing else.
Segal, Z., Williams, J., Teasdale, J (2002)
On The Spot Informal Practices
1)Whenever you encounter distress this week, turn
your attention toward it.
2) If your reaction is overwhelming to a particular
part of the practice, take a break and switch to
lovingkindness or mindfulness practice
3) Choose one day this week to do a kindness for
someone and pay attention to all of the kindnesses
that come your way on that day.
4) Practice inner smile on a daily basis.
5) Choose one day to do walking Metta meditation.
Guided Formal Practice/Discussion
Examples of Formal Practice
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Sitting meditation
Standing meditation
Body Scan
Walking Meditation
Loving-Kindness/Compassion Practices
Contemplative Prayer
Yoga
Taiji
Qigong
Mindfulness Myths
1) I don’t have the time!
2) I’m too restless!
3) I am afraid of my mind!
4) I won’t get anything done!
5) It will take time away from my kids!
6) I can’t meditate!
7) I’m too tired!
The Five Hindrances to Meditation
(From the Pali Cannon)
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Attachment
Aversion
Sloth/Torpor
Restlessness/Worry
Doubt
Working with Attachment
“Wanting Mind”
Desire, lust, obsession with sensory objects or
spiritual desires
• Shift the attention of the mind from the object
itself to the experience of the wanting mind.
Equanimity practice is useful to bring in.
Working with Aversion
Hatred, frustration, impatience, guilt, depression,
pain, resistance
• Avoid going into the practice with the attitude “If
I’m mindful, it will go away”
• Don’t bore into the aversion or it will feel like a
pressure cooker. Open attention wide and
alternate between the aversive experience and
sound and back (Titrating the experience with the
spaciousness of sound.)
• Notice the quality of mind whatever it is
Working With Sloth/Torpor
Sleepiness, boredom
• Recognize what is happening
• Refrain from acting it out
• Realize it is impermanent
• Get interested in the changing nature of it
• You may need more sleep!
• Keep your eyes open
• Switch to standing or moving meditation
Working with Restlessness
“Wandering Mind”
Restlessness, agitation, often suppression of
another affect that wants to be known
• “Putting the bull in a big pasture”
• Opening the field of awareness to seeing (with
a soft gaze) or hearing without noting
• Attempt to stay as still as possible “vow
sitting”
Working with Doubt
Delusion, indecision, confusion, over
intellectualizing
• Don’t go into the storyline and stay out of the
content of the doubt
• See what else is there
Intensive Retreat Practice
Breath Awareness
Set Up Instructions for Breathing
Meditation
1) Settle into a comfortable posture in which
you are relaxed but alert.
2)Take a few long slow breaths connecting with
the body and releasing any obvious tension.
3) Allow the breath to return to normal.
5) Feel your body as a whole with wide
attention.
4) Continue to scan through the body releasing
any obvious tension as best you can.
Breath Practice Instructions
1) Become aware that you are breathing.
2) What are the sensations?
3) Let your attention center on the part of the body
where you experience the breath most vividly.
4) Let your attention focus on those sensations as
you experience breathing in and breathing out.
5) Note where your mind goes when it wanders.
6) How has thinking impacted your experience?
Has any tension returned?
7) Let the mind open again to the breath.
Breath Practice
Advantages
• Breathing is a neutral object of attention for
most people so less likely to trigger reactivity
• The experience of breathing is present
moment (as are all body centered foci)
• Breathing changes which allows for easier
tracking
• Breathing is rhythmic and cyclic appearing and
disappearing
Working With The Body
Working With Pain Or Discomfort
1) Bring your attention to the sensations themselves. If the
body is in an awkward position that is doing harm, move to a
more comfortable position, mindfully noting your intention to
move and paying attention to the movement itself.
2) If the pain is tolerable bring your attention to the
sensations themselves and note the sensations. Be aware of
any feeling tone as you note. These tones may underlie
emotions your are also experiencing Note any emotions i.e..
“anxiety, anxiety” or “anger, anger” and return to noting the
body sensations. As much as possible try to stay out of the
story about the pain. Focus on the present moment instead
of projecting into the future or slipping back to the past.
Working With Pain Continued
3) If the pain sensations are overwhelming, you
can shift focus to your breath, sound or focus
on a different part of the body such as your
hands or the bottoms of your feet.
Working With Difficult Emotions
Body Awareness
1) Take three deep breaths and focus your attention
on your body and a sense of presence releasing any
obvious tension as best you can.
2) Allow your posture to move into sitting or
standing “with dignity” relaxed, comfortable and
alert.
3) Allow a slight inner smile to come to your lips.
4) Allow the chest to open by rolling the shoulders
back and letting them fall away from the ears.
5) Relax the jaw, the knees and the hands.
R.A.I.N. Practice
Recognize: Notice what you are experiencing. Stay with the experience rather
than thoughts about the experience (the story line), simply note what you are
experiencing.
Accept/Allow: Allow the experience (emotion, thought, body sensation) to be
as it is in the moment without trying to change it. Look for the impulse to
avoid or cling to the experience.
Investigate: Explore the experience with an attitude of openness, curiosity
and self-compassion. Watch for the impulse to judge.
Non-identification: Continue to investigate and note the stream of sights,
sounds, body sensations, thoughts, emotions and other contents of the mind
that come and go. Notice the difference within between claiming the
experience as I, me, of mine and just noting the stream or flow of experience.
Michelle McDonald
Using The Breathing Space- Extended
Instructions
When you are troubled in thoughts or feelings:
1. Awareness
Observe- bring the focus of awareness to you inner experience and
notice what is happening in your thoughts, feelings, and bodily
sensations.
Describe, Acknowledge, Identify- put experiences into words, for
example, say in your mind, “A feeling of anger is arising” or “Selfcritical thoughts are here.”
2. Redirecting Attention
Gently Redirect your full attention to the breath.
Follow the breath all the way in and all the way out.
Try noting “at the back of your mind,” “Breathing in…breathing out” or
counting, "inhaling , one…exhaling, two…etc..”
Using The Breathing Space- Extended
Instructions Continued
3.Expanding Attention
1. Allow your attention to expand to the whole body-especially to
any sense of discomfort, tension, or resistance. If these
sensations are there, then take your awareness there by
“breathing into them” on the in breath, then breathe out from
those sensations, softening and opening with the out- breath. Say
to yourself on the out-breath, “It’s OK. Whatever it is , it’s OK. Let
me feel it.”
Become aware of and adjust your posture and facial expression.
As best you can, bring this expanded awareness to the next moments
of your day.
Segal, Z., Williams, J. , Teasdale, J. (2002)
Working With Difficult Thoughts
Working with Thoughts
• The brain is an organ that naturally produces
thoughts.
• In meditation, there isn’t a need to look for
thoughts.
• Some thoughts are merely a drifting away
from our focus. With these, we can note them
and return to our intentional focus of
awareness
Working with Thoughts Continued
• Some thoughts are compelling.
• With these we can note them and see if there is
an emotional tone to the noting.
• If so we can utilize the instructions for working
with difficult emotions or with the body.
• It is not necessary to investigate the contents of
the thoughts.
• Notice how thoughts appear, persist, change and
disappear.
• How does observing thoughts change them?
Mindful Movement
Walking Meditation
Qi Gong and Taiji
Yoga
Bringing In The Good
Cultivating The Four Wholesome
States Of Mind
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Lovingkindness (metta)
Compassion (karuna)
Sympathetic Joy (mudita)
Equanimity (upekkha)
Lovingkindness (Metta) Meditation
• Metta Defined: lovingkindness, unconditional
friendliness, boundless friendliness of the open
heart toward others
• Masked/Near Enemy: possessive love,
sentimentality, attachment
• Direct/Far Enemy: hatred, fear, closing down of
the mind, constriction of the body mind and
heart
• Progression: oneself, benefactor, dear friend,
neutral person, difficult person, all beings
The bud
stands for all things,
even for those things that don’t flower,
for everything flowers, from within, of self-blessing,
though sometimes it is necessary
to reteach a thing its loveliness,
to put a hand on the brow
of the flower,
and retell it in words and in touch,
it is lovely
until it flowers again from within, of self-blessing
-Galway Kinnell
Lovingkindness Traditional Phrases
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May I be safe
May I be well
May I be happy
May I have ease of well-being
Lovingkindness Variations
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May I be protected in all ways.
May my heart be filled with loving kindness.
May my body be healthy and strong.
May I live with ease and harmony.
• May I be safe from internal and external harm.
• May I be as healthy and strong as it is possible for me to be.
• May I have the peace and understanding that come from
true wisdom.
• May I live my life with ease.
• May I love myself unconditionally
Compassion (Karuna)
• Karuna defined: compassion, a resonating
concern, the quivering of the heart in
response to suffering
• Masked/Near Enemy: pity, righteous anger,
overwhelming grief, fear, aversion
• Direct/Far Enemy: cruelty, gossip
• Progression: a person with great suffering,
self, benefactor, friend, neutral person,
difficult person, all beings
“Every conflict begins with thoughts of
fear, animosity and aggression, which pass
through some people’s minds and spread
like wildfire. The only antidote to these
aberrations is to take on fully the suffering
of others.”
-Matthieu Ricard
Self-Compassion
“A moment of self-compassion can change
your entire day. A string of such moments
can change the course of your life.”
Christopher Germer
Self-Compassion Phrases
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This is a moment of suffering
Suffering is a part of life
May I be kind to myself in this moment
May I give myself the compassion I need
Neff, K. & Germer,C. (2009)
Compassion Practice
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I see your suffering.
I care about your suffering.
May your suffering end.
May the causes of your suffering end.
May your suffering end or if it cannot end may
you meet the suffering with gentleness,
tenderness, and care.
• May you be free of your pain and sorrow
• May you find peace.
Sympathetic Joy (Mudita)
• Mudita defined: appreciative joy, sympathetic
joy, joy for the joy of others.
• Masked/Near Enemy: exuberance, attachment
to happiness
• Direct/Far Enemy: envy, jealousy
• Progression: a person who is currently
experiencing great happiness, friend,
benefactor, neutral person, difficult person, all
beings
“With Mudita the odds of experiencing
increased happiness go up 6 billion to
one. Those are very good odds!”
-Dalai Lama XIV
Sympathetic Joy Phrases
• May your happiness and joy continue to grow.
• May your happiness and good fortune
continue.
• May they increase and never wane.
• May your happiness and joy never leave you.
• I am happy that you are happy.
Sympathetic Joy
Obstacles to Joy/Tormenting
States of Mind
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Judgment
Comparing Mind
Prejudice/Discrimination
Demeaning Mind
Envy/Jealousy
Avarice/Selfishness
Boredom
Allies to Joy
• Gratitude “count your
blessings”
• Lovingkindness
• Compassion
• Rapture-our capacity to take
active delight
Equanimity (Upekkha)
• Upekkha defined: equanimity, evenness of mind/heart
toward all beings, resting the mind before falling into
extremes, a heartfelt connection with spacious balance
immeasurable impartiality
• Masked/Near Enemy: indifference, apathy, callousness,
uncaring distance
• Direct/Far Enemy: reactivity, attachment, aversion
• Progression: neutral person, dear friend, benefactor,
difficult person, self
• The Eight Vicissitudes: praise & blame, gain & loss,
fame & disrepute, pleasure & pain
Equanimity Practice
• May we all accept things as they are.
• May we be undisturbed by the comings and goings of events.
• I will care for you but cannot keep you from suffering. I wish you happiness
but cannot make your choices for you.
• I offer you my good will no matter what.
• May I be open, balanced and at peace.
• May my heart open to your journey.
• My my heart be at ease with the outer/inner changing conditions of life.
• May my heart/mind open to this experience with balance and ease.
• May I accept/open to how it is right now.
• This is how it is right now.
• Whether I understand it or not, things are unfolding according to a lawful
nature.
“With an eye made quiet
by the power of harmony,
and the deep power of joy,
we see into the life of
things.”
-William Wordsworth
Gratitude
Your Top Ten List
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Yoga
“When you slip inside, something happens.
Something deep inside is awakened. You
discover you are more than you previously
thought yourself to be. And the way you live
your life begins to change. If you do not want
this awakening go to the movies. If you want this
awakening, practice yoga. You get to make that
choice every day for the rest of your life.”
-Swami Nirmalananda Saraswati
Mindful Yoga
Mindful yoga is another form of mindful
movement or mindful meditation. Yoga means
“to yoke” or “to unite”. Yoga offers the
opportunity to notice how the body and mind
relate to each other. Because the body is always
in the present moment, uniting the mind with
the body helps bring the mind into the present
moment.
Yoga and Lovingkindness/
Guided Practice and
Discussion
Mindfulness in the Consulting Room
One Size Does Not Fit All
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Cultural/Religious Concerns
Ego Strength/Severity of Diagnosis
Contraindications
Bibliotherapy
Outside referral to a MBSR, MBCT, DBT group
Adapting the protocol to the client rather than
the client to the protocol
• Your own level of training and practice
The Mindfully Oriented Therapist
Finding Your Comfort Level on the
Continuum
Training
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MBSR
MBCT
DBT
ACT
Other Avenues
Training Resources
Ethical Issues
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Sensitivity to religious and cultural issues
Informed consent
Evidenced based
Appropriate training and consultation
Lovingkindness and the
Dedication of Merit
May you be safe
May you be well
May you be happy
May you be free from suffering