Reflection and Psychotherapy

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Reflection is the ability to hold a stimulus in the present moment without reacting automatically. In a state of reflection, a person can notice or observeSONY DSC the presence of a thought or feeling that they are experiencing… noticing or observing can then lead to two different reflective actions; either the person can continue to observe the stimulus (thought or emotion) without judgment or the person can choose to use judgment as a means of guiding their next action (“what do I want to do as a result of this thought or feeling?”).

Without reflection, a person would believe that their actions can be controlled by their environment. This is because of the unconscious belief that the environment MAKES us feel or think a certain way… further, when a certain emotion is felt or a thought is experienced we carry the belief that we MUST react a certain way.

Emotion Examples would be:  “he made me hit him because he made me feel disrespected.” (emotion governed behavior externalized)… or … “He made me stay at home in my despondency because of how disrespected he made me feel.” (Emotion governed behavior internalized)

Thought examples would be:  “He made me hit him because he was being unfair.” (Thought governed behavior externalized)… or…  “I could not go to the same function as him as he is not fair.” (thought governed behavior internalized).

I will go out on a limb and say that the ability to reflect may be the single most important component to mental health. With reflection we become emancipated from automaticity… we are no longer governed by thoughts or emotions as reflection serves as the tool to dis-identify our core self from attachments.

This is where the confusion sets in as people interpret the message of attachment as essentially disputing the validity of emotions… this is absolutely not what I am suggesting. Emotions exist… trying to rationalize them away is a form of avoidance that ironically leads to a life in which there is a dramatic increase in unconsciousness.

To accept a stimulus one must allow the stimulus to exist… denying the existence of a stimulus (such as an emotion) is a form of forced unconsciousness which could be said to be the exact opposite of reflection.

If I can allow myself to feel the sadness which does exist… If I can hold the emotion in a state of non-judgmental reflection, then the burden of that sadness will lessen as I do not fuel the sadness with resistant action (defensiveness, aggression, substance use etc.) or with over identification (ex. “I am the sadness” instead of “I am feeling the presence of sadness.”

As mentioned earlier there are two results of reflection…

The first is intrinsic … reflection is a state of allowing; it is a state of acceptance and presence which allows the clarity and completeness of the moment.  In this moment there is serenity as everything simply is…

The second is instrumental … in a state of reflection a person is given the freedom to choose what actions they would like to engage in as a result of the emotion or thought they are holding in calm observance.

This creates the following sequence: environmental stimulus – automatic thought based on beliefs – reflection (can influence resulting emotion occasionally) – automatic emotion (usually this is automatic as well though with an advanced reflective ability it is not always) – Reflect on the emotion – Choose action based on what would feel most authentic in the relative moment.

The sequence without reflection is generally: environmental stimulus – thought and emotions surface mostly outside of conscious awareness (the person is generally aware of the secondary emotion – ex. “I am pissed” but not conscious of the preliminary emotion = ex. “I am embarrassed.”  Additionally the thoughts tend to be viewed with dogmatic dichotomies ex. “this is the only valid belief concerning this stimulus.” – automatic action or behavior results.

Note: this is not to say that an automatic reaction is never authentic… in fact the resulting action could possibly be exactly the same despite the sequence used, but reflection allows choice, which increases the probability of authenticity (an action which is congruent with the core self).

I have been toying with the hypothesis lately that all effective psychotherapy interventions are essentially doing the same thing… increasing reflective ability and decreasing automaticity.

The reason that this result would be most impact by the therapeutic relationship is that perhaps increasing reflection necessitates a reflective, safe, and accepting space… this would possibly answer why technique (CBT, EFT, DBT, narrative etc) has shown to have very little impact on outcomes… the most important thing that the therapist is doing is holding space.

More on this later

In being a soft reflective water unrippled by judgments we allow the observer to placate the waters of their own existence…  and reflection grows

In reflection we find the existence of dialectics and in this space of co-existing opposites acceptance becomes authentic.

 

William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.

Why should I focus on my Breathing? – Worry reduction.

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Quick summary –Normally breathing is something which is done automatically – you don’t think about breathing it just happens. When you intentionally focus on your breathing you give your mind something to do and this limits your minds ability to worry, which is often the source of your distress. Breathing is happening in the present moment (as opposed to the future or the past) – when breathing is done intentionally our minds must focus on the present moment (and generally speaking there is often nothing to worry about that is occurring at your present location in the present moment).

People in the wellness professions will often recommend that you focus on your breathing to increase wellness and to decrease stress and anxiety. There are many reasons why this is effective and today I will focus on the cognitive effects – future blogs will cover the physiological, behavioral, emotional and spiritual effects.

Often our minds ruminate or worry about situations that either theoretically could happen, are likely to eventually happen, or already did happen… our mind does this under the assumption that if it can work though various troubling scenarios this ‘worrying’ will increase our likelihood of survival if the ‘worried about situation’ were to happen in the future.

We will also ruminate about negative occurrences that took place – we do this under the assumption that either we can create meaning from the occurrence or we believe (unconsciously) that we could learn to avoid the reoccurrence of the negative instance in the future.

Unfortunately life is not fair, life is not 100% predictable, and things happen for reasons that are not easy for our minds to accept. Our minds believe that worrying is a helpful process which increases our likelihood of both surviving and of avoiding suffering – the problem is that this doesn’t seem to be true.

For one thing, the ‘worried about instance’ might simply never occur in which case your mind created suffering (which is a normal bi-product of worrying) over something that doesn’t and will not ever exist.

There is also a strong possibility that you can worry about something that will definitely happen in the future (ex. you know that your company is bankrupt and you will lose your job)… in this example your mind causes suffering in the present for absolutely no future benefit at all.

Do you know the expression “ignorance is bliss”? – perhaps this expression is meant to suggest that people who have less active minds tend to be happier. I would encourage you to answer the following questions for your self…

How much of your suffering is caused by something that is happening in the moment?

-ex. 1) I just was bit by a rattlesnake and my leg is swelling.

                                  Or

-ex. 2) My best friend is telling me right now that he does not like me.

How much of your suffering is created by your minds desire to worry about the past or the future?

-ex. 1) I have two friends that have separate birthday parties in a week and I can’t go to one party without the other friend getting upset.

                      Or

-ex. 2) “My boss had no right to accuse me of not doing the evaluation correctly as I did it the way he taught me to do it.”

 – Ask yourself – in what way is it beneficial to you to let your mind ruminate on thoughts such as these?

Try to focus on the breath to help with these unwanted automatic thoughts… below is an exercise designed to help you. As with most things… the more you practice … the more effective the exercise will be.

Exercise –

 

 sit or stand with your spine straight…follow the breath… breath in deep through your nose for 6 seconds…as the air moves in expand you abdomen, (stomach area) push the stomach out as this will pull air in… now exhale for 4 seconds… repeat this process… notice what is feel like as the air passes down the back or your throat… does it make a sound?… feel the gentle rub of your clothes on you skin as you stomach expands and contracts… your mind will try and tell you something – to get you to think about a plan, a should do, or a have to do… allow this to happen while returning your focus to the breath (if you resist your thoughts your mind will win)… if thoughts enter your mind imagine your thoughts to be leaves floating down a river or clouds expanding, traveling and disappearing…some people enjoy a mantra to further occupy the mind and to add positivity… breath in while saying the word relax to yourself without sound…. breath out while saying release… repeat… notice your heart beat… notice the movement of air as it passes your face… breath.

William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.

Placebo effect – an underrated healer

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Quick summary: I am going to suggest that we might be able to use mindfulness to gain control over the ‘placebo effect’ thereby positively influencing recovery of physical and mental disturbances. In scientific investigation it is always important to rule out the placebo effect when studying the effects of an intervention. To do so, researchers will commonly give one group a sugar pill or some other benign intervention, and the other group will be given the medicine or the treatment. In most cases, those who were given the sugar pill show health improvements… let me explain, if a person is told that they are receiving a pill that will help cure an illness and they are given a sugar pill instead of the actual medicine, they will generally show signs of improvement related to the illness. What does this mean?  Do we human’s have an untapped ability to heal ourselves? What abstraction does a sugar pill represent… hope, belief? If we believed or held hope that we could cure our own illnesses, could we learn to mentally heal ourselves? I would suggest that the answer is yes… the placebo effect is too consistent to ignore… in short, people in control groups across the planet that are experiencing recovery without medical intervention are healing themselves. How can we learn to increase the effect of the ‘placebo effect’?

Perhaps we look at the placebo as a cognitive trick… scientists trick people into believing that they are given a healing agent when that healing agent does not physically exist… yet at the same time, some healing agent must exist as the patients typically show improvement. What is the healing agent inherent in the placebo?

The healing agent is a belief… if a person believes that they will recover than they can recover.

Hope is inherent in this belief… without hope they could believe that they were given a healing agent, but they will not necessarily think that it will be successful for them unless that belief also carries a degree of hope… hope that recovery is possible.

 

Hope is another curious variable in recovery…

In both medical interventions and with psychotherapeutic interventions, hope effects outcome. Both the client’s hope and the clinician’s hope, related to the recovery of the client, effects the outcome of the intervention.

What is the point of all this?

We could positively influence recovery of mental and physical disturbances by intentionally using the so call ‘placebo effect’ as a healing intervention.

I am conscious of how this news might seem insensitive to some people… it is possible to interpret what I am saying as somewhat absolute – as if I am suggesting – “if your loved believed and had hope that they could recover, then they would not have died.” This would indeed be insensitive for me to suggest… Death is unavoidable and inexplicable… I am not suggesting that premature deaths are entirely related to hopelessness. I am suggesting that if we as a collective were able to utilize the placebo effect in an intentional way, we would be able to increase the amount of people who experience recovery.

The first time that I heard this point was at a seminar concerning mindfulness… mindfulness teaches a person how to live within the present moment.

Part of being Mindful involves noticing your thoughts without judgment… in this process a person can reach a degree of separation from the chattering of their brain.

By using mindfulness we learn to not over-identify with the thoughts of the brain.

 

I do not claim to have the answer… yet… as to exactly how we can intentionally use the placebo effect to aid in recovery, but I have an idea of what the fist step would be.

 

It is likely that the 1st step is to gain a greater control over the brain and your thinking patterns… to be mindful

 

–         Note – when I say ‘over identification with the brain’, I am talking about how the brain tricks us into believing that we literally are the thoughts that the brain transmits to our consciousness.

 

–         Mindfulness can help you see that you are perhaps something deeper or more profound than the thoughts that your brain creates… and ruminates on.

 

–         mindfulness can also help you to live in the moment by bringing a person into awareness of the brain’s tendency to focus on the past and the future… most people spend the majority of there time living within the their thoughts… they are either ruminating over something that happened in the past, or they are ruminating over something that could happen in the future. 

 

–         By living within our thoughts about the past and the future we over identify with our brain and lose a degree of control… within this pattern it would be difficult to have control over your hope or beliefs, which would  ultimately make it difficult to control the’ placebo effect’. 

In order to gain more control over your brain you might fist attempt to separate yourself (figuratively) from your brain.

 

When you watch your thoughts… who is the one watching those thoughts? Who is the observer? Your answer could be anything from ‘metacognition’ to ‘the spirit’… the truth is that it does not really matter what you believe the ‘observer’ to be for our purposed related to the ‘placebo effect’.

If the observer could control the brain, then the observer could intentionally create the hopeful belief system which seems to aid in recovery.

 

The 1st thing that is taught in mindfulness training is the skill of observing the breath… from here people are often taught how to take an automated activity (breathing) and add intentionality (you consciously breath in and out as you desire)… the point here is that breathing is automatic until you choose for it not to be…

 

What if the same was true for the brain… for our cognitions? Our thoughts are more automatic and outside of our control than we sometimes like to believe. Perhaps with mindfulness we could gain control of the brain just as we can take control of the breath… we could turn off the autopilot is some respects.

 

So the answer for today is – By involving yourself in Mindfulness practices you can weaken your over identification with your brain… by doing so you might gain a degree of control over your brain… perhaps if you had that control you could intentionally create the ‘placebo’ effect. 

 

Faith and doubt are thoughts… how might we control these…

William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.

The Evolution of CBT = Mindfulness – moving from changing projections to eliminating projections

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Quick summary: I am going to propose that we can use mindfulness interventions to increase our ability avoid projecting our beliefs onto a stimulus. I am also going to suggest that we can use mindfulness to increase our reflective ability so that we can become aware of our projections before we react emotionally or behaviorally to that projection (knowledge, judgment, belief, opinion etc). CBT offers an intervention which helps a person to change a belief that they are projecting onto a stimulus. This is effective as unhelpful beliefs encourage us to experience unwanted emotional reactions and they encourage us to engage in behaviors which are against our best interests… the replacement belief (the helpful belief) encourages more desirable emotions and behaviors. I am suggesting that mindfulness is the next step in the evolution of psychotherapy (even though mindfulness is thousands of years older than CBT – misuse of the word ‘evolution’ has been noted) as mindfulness can teach a person to notice and/or stop projection altogether or at least can help a person to manage his/her reactivity to the projection.

Simple version –

  • We unknowing put beliefs and opinions onto things that we look at or touch or smell etc and then we are automatically and unknowing affected by those beliefs and opinions…
  • We then feel a certain way or do a certain behavior for reason that we cannot always explain or understand…
  • We seem to be acting and emoting without any control… we feel controlled by our environment…
  • Mindfulness may be the way to learn how to stop ‘putting beliefs and opinions onto things.’
  • CBT may be unintentionally encouraging our habit of projecting.

 

Perhaps you are not truly being controlled by your environment… perhaps you are being controlled by your own projections (knowledge, judgments, beliefs, opinions etc).

I propose this question: We are a country of immense privilege and resource… why are so many so depressed and anxious… what is the common source of our suffering?

When a person interacts with something (a person, an idea, a place, an object etc) with any of their five senses they unconsciously place their beliefs, knowledge, opinions, history etc onto that something which is the focus of their attention… people engage in behaviors and experience emotions related to that very projection.

In this piece when I say that people “project there beliefs onto a stimulus” I mean that we unconsciously put knowledge and judgments onto whatever is holding our attention…

We therefore do not solely attend to reality; we attend to a reality influenced by our subjective perceptions.

  • Example 1, if you look at a snake you might place the following beliefs on it: dangerous, evil, annoying, scary, useless, must be avoided, must be killed, the snake is going to try and kill me, snakes attack people for no reason, that is an immoral object.
  • Example 2, if you saw a person with a sticker that labeled them as being in support of a political party that you dislike you may project the following beliefs onto him/her: dangerous, evil, annoying, scary, useless, must be avoided, must be changed, the person is going to hurt our country, He/she attacks people for no reason, that is an immoral object.
  • How might your projected beliefs influence your actions and emotions?

 

What’s the point? Why should I care about negative projections?

  • The emotional and behavioral reaction that you have to the stimulus is automatically affected by your projections… you can’t feel or behave differently until you alter your projections.
  • CBT then helps people to have different emotional reactions and to engage in different behaviors by helping a person to change what they project onto certain stimuli.

 

I was Reading Dan Siegel’s ‘The mindful Brain’ and I was in the middle of one of his more scientifically mind-bending chapters (neurologically complex and specific) that was explaining the current research surrounding the part of the brain that places or projects ‘knowledge’ onto a stimulus and the part of the brain that encourages reflection (which would be your ability to notice that your mind is projecting beliefs) and attention without projection (which would be your ability to see a stimulus without placing judgments, ‘truths’, opinions, analysis etc on to it).

  • For more about Dan’s work please visit – http://www.drdansiegel.com/ – I cannot say enough about this professional… his work is absolutely fantastic. I would say that his scientific ability is respected to be at the highest caliber… what I was pleasantly surprised to find was how engaging and artistic his personal narratives are… wonderful, intelligent, inspiring, revolutionary books.

 

It then hit me that from a neurological perspective CBT is calling on the same part of the brain to simply offer a different and “better” projection onto a stimulus.

In short, if projection is the problem, than CBT might be strengthening the part of the brain which was ‘responsible’ for the problem. Excuse my oversimplification – again this is just a theory.

CBT encourages a client to isolate negative or hurtful thoughts and beliefs. The client is then asked to replace those ‘disruptive’ beliefs with positive or helpful thoughts and beliefs.

  • Research seems to be suggesting that projections primarily come from a specific part of the brain.
  • The physical and functional qualities of the many different brain parts are affected by use. To dramatically oversimplify this concept this would mean that increasing the use of a part of the brain will increase that part both physically and functionally (just like your bicep).
  • CBT might (this is just a theory) be increasing (in size and function) the part of the brain responsible for projections – which is the source of the ‘problem’.

 

Again, what is the point?

  • ‘Negative’ projections cause suffering and CBT helps people to begin projecting more ‘positive’ thoughts and beliefs onto the relevant stimuli.

 

  • Some philosophies suggest that projections cause suffering despite whether the projection is positive or negative.

 

How suffering is caused by Positive Projections.

  • The suffering arises as projection eliminated the novelty of life… instead of living life we begin to live within our projections

 

  • These projections are known and understood and therefore do not require sustained attention or interest…

 

  • Everything then becomes very boring…

 

  • We loose our curiosity and our passion…

 

  • We require the novelty of ‘new’ things or activities such as material items to elicit excitement… but this does not seem to help our suffering.

 

Common Example of projections making life boring

 

  • Think about when you first met your partner or best friend etc… what did you feel? Were you curious about him/her?  of course this person has changed – did your partner become less interesting, exciting, attractive, intricate, or did you become less interested in him or her… is it possible that you lost your curiosity as opposed to her/him losing anything to be curious about? What would happen if you stopped judging your partner? What would happen if you stopped convincing yourself that you had all the knowledge necessary about your partner? What if you removed all of the beliefs and knowledge that you have about your partner and then you met them again ‘for the first time’… what would be different?

 

  • Remember the first time that you saw your house? What did you experience… what do you experience now?

 

  • How about your first time seeing the leaves change… the first time it snowed… the first time you saw the ocean… the first time you experienced a thunderstorm or saw a rainbow…

 

  • You may still have very positive beliefs about all these things, but for some reason they are not able to elicit the same excitement and curiosity out of you…

 

  • These things are just as exciting and inspiring as they once were but your projections are keeping you from experiencing them… this causes suffering.

 

Mindfulness encourages a client to strengthen there ability to reflect upon the thoughts, emotions and sensations which the mind and body experience without taking automatic action.

  • Mindfulness reduces automatic reaction to projections.
  • this increases control and freedom.

 

Mindfulness also teaches a client how to pay attention to a stimulus without placing a projection (judgment, belief, knowledge) onto that stimulus…

  • You learn to see the stimulus as novel as apposed to understood, quantified, known, defined, labeled, categorized etc.
  • This makes everything interesting, exciting, and inspiring.

 

Children tend to be more mindful then adults… they can look at a leaf falling from a tree with complete amazement and glee… through mindfulness an adult can grow to have a similarly novel experience with such a stimulus.

In conclusion

  • CBT teaches us how to change or alter our projections

 

  • mindfulness teaches us how to stop projecting or to stop reacting automatically to projections

 

  • Research is suggesting that mindfulness increases the mass and function of the part of the brain responsible for reflection and for attending without projection.

 

  • I theorize that CBT may be increasing the mass and function of the part of the brain responsible for projections (both ‘helpful’ and ‘unhelpful’ projections seem to come for the same part of the brain).

 

  • I am suggesting that CBT will evolve into mindfulness as mindfulness reduces the unwanted affects of both positive and negative projections where as CBT is designed to reduce the unwanted affects of negative projections alone.

William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.

Mindfulness Interventions for Both the Therapist and the Client to Increase Therapeutic Effectiveness When Treating Trauma

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Mindfulness Interventions for Both the Therapist and the Client to Increase Therapeutic Effectiveness When Treating Trauma

This is a reserach paper that I wrote… it is very involved… it covers many of the bases surrounding mindfulness and recovery.

Abstract: Research has suggested that Mindfulness interventions can be extremely beneficial in the treatment and prevention of symptoms associated with trauma and vicarious trauma. The intention of this paper is to look into the possible positive effects of incorporating Mindfulness practices into therapist self care routines, and therapeutic interventions.  To arrive at such an end this paper will briefly discuss the basic tenants of mindfulness and will then move on in examining studies which have noted the positive effects of mindfulness integration. In closing this paper will outline why a Mindfulness state is so critical in relation to recovery from trauma.

Research has shown that mindfulness based interventions are helpful in promoting overall health (Krasner 2004). Mindfulness is described as a non-judgmental meta-cognitive state in which a person becomes very aware of their thoughts, surrounding, and feelings and attempts to experience all stimuli without judgment and without relating the stimuli to the past or the future. “In contrast, Mindlessness is a state of rigidity in which one adheres to a single perspective and acts automatically” (Carson and Langer 2006). Research has shown that clients who have experienced trauma often engage in avoidance behaviors and therefore make both concerted and unconscious efforts to be mindless (Follette et al. 2006). The research  has shown that participating in mindfulness instruction or therapy has a positive impact in relation to stress reduction, maintenance of and avoiding relapse of depression, stress reduction for therapist and health care workers, longevity for the elderly, proper self care for person’s with diabetes, emotional health for cancer patients, and is found to be positive for self development in general (Waller & Carlson, 2006; Walach et al., 2007; Shapiro et al., 2007; Gregg et al., 2007; Shapiro et al.,2005; Krasner 2004; Helen & Teasdale, 2004; Martin, 2002; Teasdale et al., 2000) (Williams, 2000; Alexander, 1989). New findings specifically related to trauma demonstrate that existing CBT, DBT and ACT methods are more effective when used in conjunction with Mindfulness practices (Follette et al. 2006). Specifically, clients with PTSD seem to be more likely to fully engage in exposure treatment without resorting to avoidance behaviors if they have training in mindfulness (Follette et al. 2006). Avoidance is not only a process of the client; it is also a process of the therapist. Studies have shown that health care workers are particularly vulnerable to vicarious trauma and burnout (Shapiro et al. 2007; Shapiro et al. 2005; Walach et al. 2007). Carson and Langer has suggested that when therapists use mindfulness for self development, they allow themselves to be more authentic and free of judgment in the therapeutic setting; by freeing themselves from the confines of objectivity therapists allow themselves to experience clients and their narratives without psychological avoidance thereby reducing the likelihood of vicarious trauma (2006).

According to Segal, Williams and Teasdale (2000) the following steps are necessary to reach a state of mindfulness.  In a mindful state a person attempts to reach a point of non- judgment in which they remain impartial to their experience and try not to evaluate whether his/her surrounding are positive or negative. The person will be patient in that they can enjoy the now and accept that things will come with time. They will experience the world with a beginner’s mind, meaning that they will view the world with openness similar to if they were to be viewing something for the first time. The person will have a trust in him or herself. The person will have a non-striving disposition in that he/she will not be trying to do anything; instead she/he will simply accept what is. She or he will have an acceptance for all thoughts feeling, sensations and beliefs; in acceptance the person might take a meta-cognitive standpoint and accept that all the perceived stimuli simply are and don’t need to be interpreted. Finally the person will have a position of non-attachment in that they will not attempt to create an identity or a meaning out of their experience. This last point is particularly important for trauma survivors. It is often an inability to assimilate the trauma into a person’s stagnant narrative that results in higher level of symptoms (Crofford 2007; Wilson et al. 2006; Carson and Langer 2006). By helping the client towards a more mindful perspective, the client will be able to attain a wiser more dialectic view of experiences and will therefore be able to accommodate more seemingly contradictory plot lines into their narrative (Carson and Langer 2006). Or the client will reach a higher level of mindfulness in which they attain a comfort in accepting that the self is not defined by subjective of collective narratives and that we simply are.

Mindfulness based interventions usually follow a seven or eight week format in which each session discusses a certain theme (Krasner 2004). The clients learn to identify the automatic pilot (doing something without any awareness of what you are doing),to deal with barriers (firmly held beliefs that limit a person’s ability to perceive things differently), to learn mindful breathing (used to help people experience life without cognitive defensiveness, problem solving or judgment),  to stay present (to experience thoughts feelings and body sensations without judgment), to allow one’s self to attend to stimuli without judgment (this is when clients learn to accept their freedom to choose the way they react to stimuli, they begin by accepting that the stimuli simply is without trying to make sense of it),  to accept that thoughts are not facts (clients focus of feelings that surface with certain thoughts and realize that there are no truths and the way we interact with a thought is a matter of choice), to take care of one’s self (which is to be aware of the thoughts that lead us towards depression and choose to view them in a new way; it also involves joining the community and letting yourself experience positive things), and finally the clients review everything they have learned and use the group to explore the experience (Waller, Carlson, Englar-Carlson, 2006). The goal of a mindfulness intervention is for acceptance to take the place of resistance. After a traumatic incident individuals might find themselves hyper-vigilant and anxious, both of which reduce the individuals present focus in attempt to avoid what has been or what could be. In truth, life is unpredictable and striving to make universal meanings in order to make a predictable future is the very foundation of anxiety (Tolle 1999).

Research has shown that offering mindfulness services to beginning therapists and health care workers has a positive impact on their ability to successfully implement self-care skills and to lead less stressful lives (Shapiro et al.,2005; Shapiro et al.,2007). Shapiro and colleagues found that, “using a prospective, cohort-controlled design, participants in the MBSR (mindfulness based stress reduction) program reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion”(2007). The same was found in the earlier study with health care workers (Shapiro et al., 2005). People in the health care field experience a high potential for stress. The previously mentioned study offers a very practical solution to a rather large issue concerning staff burnout and their resulting ability to aid clients. The positive effects of this study are immense and pave the way for future studies which might find even more useful results. For example, rumination is related to depression, so mindfulness might be a preemptive strike against the possibility of depression (Shapiro et al., 2007). The field of counseling is riddled with jargon, but the author would suggest that rumination is a different way of explaining a mindless state in which an individual strives to assimilate a traumatic plot line into their existing narrative. This is where vicarious trauma comes forth. Therapists are burdened with an existential chaos that erupts as a client’s traumatic experience cannot be integrated into our own subjective narratives. When this happens therapists too can experience PTSP like symptoms, which might put the therapeutic relationship in jeopardy as the therapist engages in avoidance behaviors and is therefore not fully present for the client (Carson and Langer 2006).  

The benefits of mindfulness training are extremely relevant to the therapeutic process. Essentially, mindfulness trainings offer a proactive way of building those core skills which are most important to therapeutic relationship.  Shapiro et al. found that MBSR interventions on beginning therapists raised self compassion and that self compassion is positively related to successful therapy as noted in out come studies (2007).  Carson and Langer have written extensively about how the non-judging process of mindfulness allows individuals to accept themselves as they are and therefore promotes authenticity (2006). They also describe the pitfalls of self evaluation; as the process requires much of the therapist’s mental effort be directed towards assimilating behaviors towards external ambiguous expectations thereby removing energy that could be directed towards the therapeutic process (Carson and Langer 2006).  As mentioned earlier the non-judgmental aspects of mindfulness aid the therapist in curtailing avoidance behaviors; the same process also facilitates unconditional positive regard (Carson and Langer 2006).  If therapists are not evaluating clients based on their constructed belief system they are more able to view the clients, particularly those who might have been perpetrators, with unconditional positive regard. This creates a positive feedback loop as the response to unconditional positive regard is for the client to be authentic in the therapeutic process. The founding principles of mindfulness are related to being in the present or the now, so mindfulness allows for the therapist to be fully present with the client and to not be distracted by the past or the future (Tolle 1999). So then, Mindfulness might directly affect the therapeutic outcomes of client who are experiencing therapy with a therapist who is involved in mindfulness trainings.

Mindfulness appears to be playing a significant role in the resurgence of the philosophy that the mind and the body are connected and should be treated as such. Exciting research has been conducted in which Mindfulness trainings have had a positive impact on patients with cancer, patients with diabetes, and the elderly population (Alexander, 1989; Walach et al., 2007; Gregg et al., 2007). The studies should not be all too surprising as the medical field has long been aware that stress has a negative affect on physical health. Crofford found that, “somatic syndromes characterized by pain, fatigue, sleep disturbance, anxiety, depression, and cognitive dysfunction are associated with stress exposure” (2007). As mentioned earlier Mindfulness studies have been shown to both reduce stress and to prevent a relapse in depression; one might extrapolate that future studies will then find a link between mindfulness and the reduction of somatic syndromes (Shapiro et al. 2007; Teasdale et al 2000).  The body scan is a process by which the participant focuses on his/her breath and is encouraged to pay special attention to specific parts of the body; the goal is for the client to gain a greater awareness of the body. Preliminary research conducted by Berceli and Napoli have found that mindfulness training in conjunction with somatic stress release stretches have the potential to reduce somatic symptoms in trauma survivors (2006). Through mindfulness, patients are learning acceptance of what is without judgment, and with such an acceptance perhaps these individuals are able to look at their situations with a greater honesty. This paper contends that with this greater honesty, people might be encouraged to drop defenses so that they are more willing and able to take that action which is necessary in the present.   Additionally, Hassain et al. found that authenticity is positively related to self esteem; this means that the more authentic a person is in a therapeutic process the more likely they are to feel an increase in self esteem as they make progress; the inverse was found to be true as well in that a lack of authenticity related o poor self-esteem (2003).

Studies on the personal factors that are consistently correlated amongst perpetrator and the factors which seem to inhibit the rehabilitation process amongst perpetrators have a huge overlap with what some authors have termed ‘mindlessness’(Craig et al. 2003; Blake and Gannon 2008; Carson and Langer 2006; Van Wijk et al. 2006; Langer and Louis 1980). The recurring theme amongst perpetrators is their lack of empathetic development and their automatic behavioral patterns based on socially undesirable schemas (Blake and Gannon 2008). The reason that mindfulness is so often used with traditional CBT or the newer DBT is that it allows thought processes, behaviors and feelings to come to awareness without being hindered by those avoidance strategies which arise from a negative evaluation of the relevant action (Follette et al. 2006). In order to help a perpetrator to arrive at more socially conducive thoughts and behaviors it is first necessary that the individual be aware of their existing schema and resulting responses (Follette et al. 2006). Research on rapists has suggested that the perpetrator seems to misinterpret the social cues of the victim and they lack the ability to empathize or to understand the emotions of the victim (Blake and Gannon 2008). Though Blake and Gannon were not suggesting Mindfulness interventions, their description of the perpetrators was clearly overlapping with Carson and Langer’s description of a Mindless state (2008; 2006). If a perpetrator is reacting to stimuli according to rigid schema then the same misinterpretation and resulting response is destined to repeat itself; if, with mindfulness training, the perpetrator looked at stimuli as novel they could be less likely to react according to pre-set principles (Follette et al. 2006).

Mindfulness has long been a positive moment for the human culture and we are currently seeing a resurgence of such practices as the West moves towards an acceptance of greater ambiguity. Mindfulness practice works very well in conjunction with many current therapeutic interventions (Follette et al. 2006). This paper wishes to conclude with an integration of Mindfulness with existentialism. Yalom and other existentialists have contended that much of human suffering is the result of an existential anxiety which arises from trying to arrive at a meaning in life (2002). PTSD symptoms after trauma seem to have relation to this existential drive towards making meaning out of the traumatic experience and in fact some have benefited from the creation of a subjective meaning such as becoming an advocate (Herman 1992). At times it is impossible to incorporate a traumatic instance into what we believe to be an objective and linear existence. In an effort to avoid such an existential anxiety people may become hyper vigilant to use the present to avoid what could happen in the future, or use avoidance to avoid what was in the past. Mindfulness is a method of focusing on the present so as to not concern your self with meaning, thereby reducing the possibility of existential anxiety (Tolle, 1999). If a question were to be used to some up the intention of mindfulness perhaps it would be, “If you have no control over the past or the future why not use your freedom to be as you desire right now?” It is not the intention of the author to minimize traumatic experiences, and it is understood that the Mindfulness worldview can be interpreted as minimizing the impact of trauma. Unfortunately, the impact of trauma can be minimized as Mindfulness all together is not concerned with the past or the future (Tolle 1999).  However, it is necessary for clients to adapt to a post modern/constructionist/present focused/timeless view of reality (or lack of reality) to benefit from Mindfulness practices. By focusing awareness in the present we can all benefit from an increased understanding of ourselves and an increased comfort in our unique authenticity.

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William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.