Mindfulness in Counselling

Mindfulness is becoming increasingly important as a tool in counselling and features as a central feature of Mindful CBT, but what is mindfulness and how does it help in counselling. This article hopefully provides some answers.

Mindfulness stems from ancient Buddha practice and has profound relevance for our present-day lives. This relevance has nothing to do with Buddha per se or with becoming a Buddhist, but has everything to do with waking up to and living with harmony with the world. It has to do with examining who we are, with questioning our view of the world and our place in it, and cultivating some appreciation for the fullness of each moment we are alive. Most of all, it has to do with being in touch. (Kabat-Zinn, 2004)

The value of incorporating mindfulness into our lives is that it has the potential to teach us be aware, in the moment, of our thoughts and sensations without judgement. There are considered to be two main modes of mind:

• Doing mode
  A goal-oriented state. Often gives rises to a sense of discrepancy between how things are versus how the mind wishes things to be. If the mind continuously dwells on discrepancies, then negative feelings and emotions arise leading to habitual patterns of the mind designed to close that gap.
• Being Mode
  Not focused on achieving specific goals but, instead, on accepting what is without any immediate pressure to change. The mind processes from moment to moment, enabling the person to be completely engaged in the present.

In doing mode, goals are used to ensure good or bad feelings continue, whereas in being mode thoughts and feelings are viewed simply as events that arise in the mind, become objects of awareness, and then are allowed to pass from the mind.

Although meditation and guided visualization are examples mindfulness practice (Kabat-Zinn, 2001), mindfulness is not by definition meditation and this is an important insight for those whom meditation is a new experience (Wellings & McCormick, 2000). One seemingly unlikely example of mindful functioning I like to use is that of Formula 1 racing drivers who are able to observe and respond to events, bodily sensation and their existence in their environment with microsecond resolution by being mindfully present in the the process. Paradoxically, while the aim of the driver is to be first over the finish line to be greeted by the chequered flag, he can only do this by experiencing at the deepest level every turn, straight line and pit stop and being mindfully present in every millisecond.

Mindfulness and counselling

The skills we seek to promote in counselling are intended to avoid rumination about events and feelings that would tend to reinforce depression or anxiety. Instead, we seek to create a curiosity and awareness of the processes and how we experience them, allowing the client to focus less on reacting to stimuli and more on accepting and observing them without judgment.

A key feature of mindfulness is that it changes our relationship with our internal experiences. Although anxiety prompts us to turn away from uncomfortable or painful experiences, mindfulness allows us to approach them. Rather than judging some internal experiences to be acceptable and others to be unacceptable or loathsome, mindfulness involves bringing curiosity and compassion to all or our experiences. (Susan M Orsillo, 2011).

Again, paradoxically, by not being focussed on the outcome of forcing changes to behaviour, mindfulness encourages us to observe without judgement changes that occur through the practice mindfulness. In this way it is a powerful aid to developing the self-observer who is able to fully participate in, for example, the development of a formulation rather than to be the recipient of an expert diagnosis.

Using mindfulness with clients

My inclination in using mindfulness with any client is introduce it at a cognitive level. In this way is linked with the autonomic arousal model that illustrates how mental states and physical states are intimately linked. Of particular interest is the effect of raised levels of cortisol in the brain (Gerhardt, 2004) and in maintaining depression or anxiety (Greenfield, 2002). To counter this I enjoy sharing with clients the concept of mental strawberries which promote endorphins (Bloom, 2001) through being mindfully present during all moments in life.

One client who benefitted from this approach was a young woman who suffered with depression and low self esteem. Over a number of sessions we worked with a graphical representation of her significant relationships in which she used symbols to represent significant others. She elaborate symbols for her mother,  father, and siblings and her husband. She depicted herself as a plain unadorned letter D.

We worked a visualization for which we developed the image of a large shallow and rock strewn Canadian stream with sun glinting off the surface rapidly flowing water, “Like diamonds”. This was the symbol she chose to adopt to represent herself. The effect of this was to allow her to observe herself with much more kindness than before and free herself from a overwhelmingly powerful inner critic.