A Mindfulness-Based Stress Reduction Workbook

Mindfulness and Psychotherapy has been gaining a mounting interest among  thousands of clinicians and clients. The following is one in a series of informal conversations between Trudy Goodman, Ph.D., Elisha Goldstein, Ph.D. and Steven Hickman, Psy.D., the teachers for a unique upcoming professional training retreat entitled “Mindfulness in Psychotherapy” to be held October 2-7, 2011 at the Joshua Tree Retreat Center in Southern California. This series is primarily aimed toward clinicians, but I’m hoping if you are not a healthcare professional you can also gain some insight from it. Enjoy!

Today Steve, Trudy and I talk about the importance of mindlessness in the therapeutic session.

Steve: Today as I worked with a particularly frustrating client whom I experience as quite intransigent and unwilling to make change despite constantly extolling his desire for things to be different, I was caught off guard. I had just pointed out his apparent lack of motivation to change, and he replied by asking in a slightly defensive tone of voice, “Do you talk to all your patients like this?” I’m embarrassed to admit it, but he called me on my mindlessness in that session. Fortunately, I was able to make use of the moment clinically.

Call it countertransference if you like, but for that period of time I was not responding to the human being sitting across from me (and suffering, I might add), but was marching to the beat of some other drummer of my own mind’s making. It strikes me now that it is in these moments of having our mindlessness become vividly apparent, that we actually become more fully mindful, just as when we notice that our attention has wandered in meditation, we are actually as present as we can be! It seems that mindFULness actually becomes most apparent against the backdrop of mindLESSness. What do you think?

Elisha: There’s a very common misunderstanding in the practice of mindfulness that the practice is to stay focused on whatever we’re paying attention to and deviation from that is “bad” mindfulness. In my personal experience in session with a client or out of session in my own life, it is these moments that I wake up to recognize that I’ve been drifting that seem the most valuable to me. Why? It is this precise moment that I wake up to the fact that I have a choice to intentionally practice cultivating a sense of presence once again and this, in  my mind, is the foundation to mindfulness and psychotherapy.

Presence may be something that some people naturally have more than others, but the truth is, it’s a skill and we can all cultivate it through practice. For better or worse, our brains seem to make things more habitual after they are practiced and repeated. So we need the moments where we’re drifting off the path of being connected to the moment to exercise that intentional muscle of nonjudgmentally guiding our attention back to being present with what’s here.

Trudy: Since psychotherapy is a relational process, I look at the times of ‘mindlessness’ as a time of disconnection in the relationship. What’s interesting about drifting away from being present in the relationship is to look at what was happening the moment before, when I was still present? And what is happening now, when my attention has wandered away? Where did it go? And how might this be a mini/micro re-enactment of the client’s conditioned relational patterns, or my own?

Rather than see this temporary disconnect as a failure to practice either mindfulness or psychotherapy well, these times actually provide an opportunity to understand the relationship better. If, as the late psychoanalyst Paul Russell suggested, we define resistance as the therapist’s resistance to what’s happening in the clinical encounter, mindless disconnections can get much more interesting! What’s going on in the moment that makes us turn away in restlessness, boredom, frustration? What’s being revealed about the relationship?

As clincians, we work to cultivate our own mindful presence in a way that is suffused with compassion towards oneself and others, so that we can choose more wisely how to respond to such moments of disconnection. Mindfulness offers us a bridge back to adjusting our stance as therapists to be more continuously curious, congruent and caring. Moments of mindful awareness are quite accessible, but continuity of this quality of compassionate presence has to be consciously chosen, intended, and developed through our own meditation practice.

For me, working with this kind of authentic attentiveness – while staying open to learning about myself in the process — is an act of love. And love is part of what mindfulness meditation is all about! Wisdom and clarity without compassion and love is like a bird with one wing. We need two wings to ‘fly’ in all our relationships — clinical, professional and personal. How wonderful that even moments of mindlessness can be a bridge to insight, to understanding what gets in the way of loving. Mindless moments of disconnection, when met with kindness and curiosity, can teach us how to connect and be wholeheartedly present with ourselves and all those whose lives we touch, just the way we are.

As always please share your thoughts, questions and stories below. Your interaction creates a living wisdom for us all to benefit from.

Reposted from Elisha Goldstein’s Mindfulness Blog on Psychcentral.com

Happiness has been a major buzz word in magazines, books, online blogs (like this one) and a source of philosophical inquiry for centuries. The fact is, happiness is what people want in life and it sells. But what is happiness and is that really the aim of life? Some pretty influential people seem to think so.

It is the Dalai Lama who tells us “I believe that the very purpose of life is to be happy” and Aristotle who said “Happiness is the meaning and the purpose of life, the whole aim and end of human existence.” These two leaders are from different cultures, religions and philosophies, yet have markedly similar views.

I believe wholeheartedly that we all want to be happy. So we walk down the aisles of the book stores, see the magazines at the checkout lines or surf through the various blog posts and news stories and see invitations to read this or do that to be happy. But do we know what we mean when we say we want to be happy? Are we all talking about the same definition of happiness?

The simple answer is no.

Some people think that happiness can be measured by someone’s life satisfaction and the amount of positive emotion they experience; while others believe it’s more about having a sense of meaning and purpose in life. Both are defined as happiness and there are deep camps of people that firmly believe one is more right than the other.

Martin Seligman is past American Psychological Association (APA) president and in 2006 came out with a book called Authentic Happiness. This book focused on helping us connect with what we value and cultivate our personal strengths in life and this would lead to true happiness. Recently, he came out saying that he believes his earlier work was overly simplistic and is now promoting a new book called Flourish, which says that it’s not all about happiness, it’s about an acronym he created called Perma” (positive emotion, engagement, relationships, meaning and accomplishment).

How do we Flourish? The idea here is to find which of these matter most to you, create a goal on how to improve this in your life, a plan on how to reach that goal and then monitor it.

But what does it mean when Thich Nhat Hanh, a longtime Buddhist Monk, peace activist, author and poet says, “There is no way to happiness, happiness is the way?”

Oh boy, this can all get kind of confusing.

At the end of the day, there are a lot of writings and prescriptions out there to be happy, flourish, thrive, and generally feel well. We can point the compass in the general direction of what we believe will provide us a sense of inner peace, but there will be deviations along the way. We’ll get sick, anxious, depressed, or experience trauma.

This can lead to what might be called a “Happiness Trap.” For Seligman’s book, this could also be called a“Flourishing Trap.”

In my view, we’re in danger of falling into this trap when we’re constantly striving to be somewhere else than where we are. This focuses on a gap between where we are and where we want to be reinforcing a cycle of deficiency. The more we try to be somewhere else than where we are, the message that gets reinforced is “something is wrong with me.” It’s important to be mindful of this trap as it’s easy to slip into.

I’m not suggesting staying away from titles or programs with the intention of helping you thrive, flourish or be happy, just to notice that if this trap occurs, to bring yourself back to the present moment and nurture the ability to be with the uncomfortable emotion with a kind attention. This inevitably waters the seeds of self-love, which is the foundation for feeling well. Even the happiness trap can be an opportunity to cultivate the ability to be present and loving in the midst of our personal storms. This is closer to what Sharon Salzberg calls Real Happiness.

I have my views of how to nurture a sense of goodness, which is a practice of self-love, being kind to myself in the difficult moments, cultivating caring relationships with others, engaging causes I believe will help others and having the belief that all of this actually lends itself to a better world. I’m not perfect at it, but I also practice making peace with my imperfections. But this is the direction of my compass, perhaps not yours and that is perfectly okay.

The truth is you are your best teacher when it comes to this life. So whether you’re drawn to authentic happiness, flourishing, real happiness, stumbling on happiness or the happiness project, it works best when we treat all of these prescriptions as an experiment, dropping our expectations for results and just seeing what we find. If we really want to give it our best effort, it’s often most effect to surround ourselves with a community of people who are trying to do the same to help sustain intention. Even if the only thing that is available is an online community.

See what works best for you and let the rest of us know. Your interaction below provides a living wisdom for us all to benefit from.

Reposted from Elisha Goldstein’s Mindfulness Blog on Psychcentral.com

Mattie was born on July 17^th, 1990 with a genetic defect leading to Dysautonomic Mitochondrial Myopathy. He was bound to a wheelchair his entire life until he body finally came to rest at age 13. But Mattie was born into this world with a gift, a gift that lead all 7 of his books, including Heartsongs, Hope Through Heartsongs, among many others, to become NY Times Bestsellers and landing him on the Oprah Winfrey Show, Larry King Live, Good Morning America, Primetime, The Today Show, CNN News and many other programs many times to share wisdom with millions of lives.

When I heard what Mattie’s final words to his Mom were, it popped me into a space of clarity.

This 13 year old little boy said:

“Choose to inhale; do not breathe simply to exist.”

How many of us just exist in a choiceless world? How often do we actually choose this breath?

Of course the body will continue to breathe if we don’t choose to breathe, it’s automatic. The newsflash that we may not think about is many of our thoughts and behaviors over time have also become just as automatic as breathing.

Most of the time we’re not choosing to check that next email, scan through Facebook, light up that next cigarette, or even call the person who cut us off a jerk. It just happens.

We don’t choose to flip through channels, shut down in an emotional interaction with a loved one, or even start planning for work in the shower, it’s a routine.

Rabbi Abraham Joshua Heschel said, “Life is routine and routine is resistance to wonder.”

If this quote resonates with you, what would it be like to actually choose to inhale a few times throughout the day? Bring your attention to your breath and intentionally ride that breath in and ride it back out.

There’s something that happens when we drop our minds into a state of presence throughout the day, we get more in touch with the power to choose what we want to do next, choose the life we want.

Ask yourself, does Mattie’s quote mean something else to you as well? How are you breathing simply to exist? Can you choose to inhale?

As always, please share your thoughts, stories and questions below. Your interaction creates a living wisdom for us all to benefit from.

Reposted from Elisha Goldstein’s Mindfulness Blog on Psychcentral.com

You may have heard about the hot topic of bringing mindfulness into the workplace and the benefits of:

• Stress-reduction
• Increased clarity of mind, balance, energy, zest for life
• Improve complex problem-solving and decision-making
• Enhanced leadership
• More emotional intelligence, less reactive
• Mood regulation and immune system enhancement

You might have even says it sounds like a good idea. Maybe you even practiced it a couple times. But the dependable habitual ways of thinking and acting take over and it goes by the wayside.

So let this post be an opportunity to commit or recommit to cultivating mindfulness at work.

Take a few deep breaths right now after reading these words. Then go down the list and honestly ask yourself, when was the last time I did this and where can I bring it into my day?

Here are 9 ways you can start today:

• As the workday begins, slightly slow down as you walk to the car, check in with your body and notice any tension. Try and soften it.
• Trying driving to work a little slower today and let red lights be reminders to just notice your breathing.
• As you walk to the office, breathe in and out with every three steps. Notice the sensation of walking, it took you over a year to learn how to do this.
• If you sit at a desk, take a few breaths before checking the computer for emails or updates
• If possible, maybe once a week, eat by yourself in silence, eat slightly slower and really tune into the sense of taste while eating.
• When talking to a colleague, notice if your mind is wandering onto something else and gently come back to mindful listening.
• When walking back to the car from work, practice the same way you walked to your car.
• No need to ‘rush’ home to ‘relax’, drive slightly slower and experiment with new radio stations, maybe reflect on what you actually did that day. What was positive, what was stuff you would like to do better?
• When getting home, if you have a family, take a few minutes in the car and keep your breath company, notice if your body is tense, and if so, try to soften those muscles by breathing in and out of them, with awareness, and just letting them be.

As always, please share your stories, suggestions for bringing mindfulness to work, and questions. Your interaction below provides a living wisdom for us all to benefit from.

Reposted from Elisha Goldstein’s Mindfulness Blog on Psychcentral.com

For this APA Mental Health Blog Party, I’m going to get right down to it. If there’s one major lesson I’ve learned it’s that we can’t always control what happens to us, but true freedom lies in cultivating the awareness to choose how we want to respond.

Mindfulness is fundamental to mental health.

In my work I see people who have suffered from addiction, anxiety, depression, and multiple forms of trauma. The fact is, they didn’t choose to struggle with this pain and stress, it just happened to them.

An unknown person once said:

“A diamond is just a piece of charcoal that handled stress exceptionally well.”

But how do we get to the place where we can handle this stress exceptionally well? That’s the trick. It doesn’t just happen overnight and it’s often a lifetime practice and one that thrives with patience.

For most of us, realizing that we don’t have to be held hostage by our uncomfortable feelings is a revelation. We can choose to hold them and relate to them from a place of curiosity and warmth. But before we can even do that we need to be aware that the feeling is there.

There is a tremendous amount of freedom in this and is also a practice in connecting with our own inner wisdom. We all have the power to be aware and to break free from the habitual ways of living that bind us. I wholeheartedly believe this.

The great question for you is how do your emotions run your life? Does fear hold you back from engaging in things that could make you happy? Are there moments in your life where you shut down from communication because you feel overwhelmed or angry? Does shame keep you stuck in the same addictive cycles?

Here is 3 steps to get started on regaining control over your life and beginning to recognize how much more freedom there really is.

1. Recognize the feeling – You might even want to be on the lookout for it, calling it out when it’s there. This immediately disengages you from the narrative network in your brain and gives the choice to step into the next step.
2. Get curious about the feeling – Give yourself the chance to do something different. Imagine that this feeling wasn’t good or bad, but just an arising sensation in your body. What is the texture of the feeling, the shape, the size, does it have a color? In doing this, you’re training your mind that it doesn’t have to be so reactive to this feeling.
3. Wrap it in compassion – Imagine surrounding this feeling in a pool of warmth, a loving presence. This may not come naturally, but try to imagine this feeling like a wounded child and see how you could relate to it then.

Of course these instructions are simple, but this is not an easy task. Recognize that you have a choice in how you relate to your feelings, choose this different response, and start recognize that even though you can’t control what happens to you, you can control how you respond to it and this is where freedom lies.

As always, please share your thoughts, stories and questions below. Your interaction creates a living wisdom for us all to benefit from.

Reposted from Elisha Goldstein’s Mindfulness Blog on Psychcentral.com