Thursday, May 16, 2019

Learning to Take a Mindful Pause

By Janet DiGiorgio-Miller, Ph.D. & David Prescott, LICSW

Dr. Jon Kabat-Zinn describes mindfulness as a “process of being present in the moment without judgment and with care, concern, and compassion for self and others.” Teachings related to mindfulness have been around for thousands of years and are found in many religions. There have been numerous studies and meta-analyses showing mindfulness meditation to be a helpful adjunct to treatment for many types of physical and psychological issues. Neuroscience has also shown that regular meditation changes the composition of the brain and gives individuals techniques to manage their reactivity to stressful events.

There is emerging research regarding using mindfulness and meditation as a technique to enhance coping skills and reducing impulsivity with individuals involved in the criminal justice system. Gillespie, et. al (2012) found that controlled breathing techniques, which are the foundation to mindful based approaches and mediation could potentially increase prefrontal control over the amygdala thus leading to improved emotional control and sexual self-regulation.  Borders, et al (2009) determined that mindfulness decreased anger, hostility and aggression by decreasing rumination. Samuelson, et al (2007) found that mindful-based stress reduction courses offered in a correctional facility assisted the inmates with a decrease of hostility and an increase of self-esteem. Although this research has been criticized for methodological flaws, Van Dam, et. al. (2018), in self-report measures subjects report a difference in their reactivity to experiences after regular mediation.  

Why should professionals working with people who have abused care? The direct contributions of mindfulness and other forms of meditation described above can also assist clients in being more amenable to participating in treatment and supervision. Improved self-control can further boost client capacity in responding to the services once involved. Each of these aspects aids in programming adhering to the responsivity principle. Finally, there is one point that is often overlooked: Before a person can use cognitive-behavioral interventions to change their thought patterns and behaviors, they must first be able to more fully observe these patterns.  

Inasmuch as they include an explicit focus on examining – even contemplating – internal states and ultimate concerns, approaches such as the Good Lives Model and Motivational Interviewing can dovetail effectively with mindfulness. Likewise, it is not difficult to see how mindfulness can help people who have abused become more empathic. Further, clients practicing mindfulness are better poised to recognize that the tools they need for change exist within them and that they have better control over their thoughts and emotions than they realize. Eventually with practice, clients learn to better regulate themselves and to come to more thoughtful responses to the situations which present themselves. 

Kabat-Zinn, et al (2009) introduced the attitudinal foundations of mindfulness. 
He outlined 9 Principles of Mindfulness:

 Beginner’s Mind
 Letting Go
 Recently two principals were added: Generosity and Gratitude

How can we learn to take a mindful pause ourselves and allow our clients to do the same? There are any number of ways. An excellent first step is simply to take a meditative breath to a count of four in and a count of four out (sighing doesn’t count). In moments of stress, slowing your breath allows the prefrontal cortex to signal the amygdala to relax and in turn slow the body’s response to stress. This breath repeated over time allows the body to relax and thus a mindful space is created. In this mindful space, you can think more clearly about the events occurring and allow alternative explanations for the event, in turn allowing you to respond in a calmer, more deliberate way. While you are in the mindful space it is helpful to remember Dr. Kabat-Zinn’s foundational attitudes. 

As therapists, if we practice the tenets of mindfulness in our own lives, we are more likely to instill hope in our clients’ outlook. When we practice nonjudgement, we can convey to our client a sense of safety in therapy. We can be patient and allow clients to fully discuss their issues in a more reflective way. We can have a beginner’s mind and not expect the same results. We can learn to pause, which is also being patient and give ourselves a “mindful space” to fully examine all of the variables in the therapy not just one theory. We can be kind to ourselves and model this behavior to our clients as they learn to change. We can be generous with our time and thoughts as our clients navigate the road to change. Most importantly we can be grateful and teach our clients the value of gratitude. 

If we practice self-compassion and care for ourselves, we are more able to do this difficult work. As we become more focused on the good around us, we become more optimistic about positive change for our clients. At the same time, we become less attached to the outcomes, knowing we have done our best to facilitate change.

“The stiller you are the calmer life is.” – Rasheed Ogunlaru 

Borders, A., Earleywine, M., & Jajodia, A., (2009) Could Mindfulness Decrease Anger, Hostility, and Aggression by Decreasing Rumination? Aggressive Behavior, 36, 28-44

Gillespie, S., Mitchell, I., Fisher, D., Beech, A. (2012) Treating Disturbed Emotional Regulation in Sexual Offenders: The Potential Applications of Mindful Self-Regulation and Controlled Breathing Techniques. Aggression and Violent Behavior 17, 333-343

Kabat-Zinn, J., & Hanh, T. N. (2009). Full Catastrophe Living: Using the Wisdom of your Body and Mind to Face Stress, Pain, and Illness. Delta.

Van Dam, N. T., van Vugt, M. K., Vago, D. R., Schmalzl, L., Saron, C. D., Olendzki, A., ... & Fox, K. C. (2018). Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspectives on Psychological Science, 13, 36-61.

No comments:

Post a Comment