PSY 621- Mindfulness Lesson #6

The two ways to introduce mindfulness to clients who may not want to practice regularly are....

(a) to clients who likely be able to practice regularly without too much added stress, and (b) at a time when they are likely to be motivated to do so.

Page 152 Reflecting on Mindful Experience After one of the above exercises, therapists can invite clients to reflect on what they learned....

1) "It sounds like you were able to experience your thoughts and feelings from a slightly new perspective. 2) May I ask you more about this?" 3) Do you have any new thoughts or feelings about the situation? 4) Did anything surprise you? What didn't surprise you? 5) Did you gain any insight or wisdom from this experience? 6) Did you gain even a little more compassion for you and others in the situation? 7) Did anything you experience give you ideas about how to handle this situation in the upcoming week? 8) How do you think the stories you tell yourself about this situation may slightly change based on what you just described?

Focusing aids Many people find focusing on the breath hard in the beginning, so there are other options:

1) Counting : Count each breath up to ten and then go back and begin at one again. 2) Mantra: A repeated phrase or word, such as peace in/peace out or breathe in/breath out. 3) Visual : A candle, flower. 4) Sound : Periodic ringing of bell to remind one to focus or chanting a mantra such as "om" or "amen."

Common counter - indications for readiness for mindfulness practices

1) Current crisis or chaotic situation. 2) Lacking sense of ownership of problem and/or solution. 3) High conflict in couple or family relationships. • 4) Extreme exhaustion or feelings of being overwhelmed. 5) Active psychosis, mania, or trauma symptoms (although clients with such symptoms can benefit from mindfulness, therapists should be well trained before using it with these populations and proceed with caution).

Focus—Lose Focus—Refocus (Page 112)

1) Focus on breath: The focusing part of mindfulness practice: Focus on your breath while quieting your mind. 2) Internal & External Experiences 3) Refocus when distracted : The refocusing element of mindfulness: When the mind gets distracted and wanders off (which it will numerous times per minute), gently and compassionately return your focus. Examples of distractions: Thoughts, feelings, physical sensations, external - noise, temperature, or wind: any internal or external stimuli that the mind begins to think about

Common Indications of Readiness for Mindfulness Practices

1) Have struggled with presenting problem long enough to be annoyed or frustrated with it and/or a strong desire to address the problem. 2) Asking "what-should-I-do" questions in therapy. 3) Strong desire to avoid psychiatric medications. 4) Couple or family able to agree on common goal of wanting to improve their relationships. 5) Couple or family able to generally acknowledge positive feelings for each other in session. 6) A current spiritual practice or positive history of one.

The most successful programs for teaching mindfulness (group therapy approaches) are

1) Mindfulness-Based Stress Reduction 2) Mindfulness-Based Cognitive Therapy

Page 152 (Diffusion Exercise) Conversational Invitations for Mindful Observation of Thoughts and Feelings

1) Observing in an imaginary room : Imagine you could put this troubling feeling/thought in a room, then shut the door, and go to a safe place outside and observe it through a window. Describe what you see and notice as you watch it in the room? (Adapted from internal family system; Schwartz, 1995 ) . 2) If it could speak: If that (symbol, word, metaphor mentioned by client, e.g., knot or little girl inside) could speak, what would it say? 3) What is happening : What is happening for you inside right now? (For couples): What is happening for you inside right now as your partner is speaking? 4) A look inside: If someone could look inside you right now, what would they see?

Page 142 Setting the Stage for Acceptance-Generating Conversations The following characteristics set the stage for acceptance-generating conversations.

1) Slow: The conversational pace should be slow to allow all participants to hear themselves speak and have time to let it "sink in." 2) Reflective pauses : Allow for pauses between talk turns to encourage reflection about what was just said by oneself, the therapist, or another in the session. These should not be forced but rather a natural expression of sincere curiosity, perhaps accompanied by "hmmm" or encouragement for reflection: "that is an interesting thought." Although only a few seconds in duration, these pauses can significantly increase a client's ability to be present with what is in the room. 3) Lingering : When clients say something that seems to have great significance for them, the therapist allows those words to linger in the air, by repeating the "charged" words with the greatest meaning and allowing a pause for the words to echo in the minds of everyone present. 4) Sincerity and presence. As already described in Chap. 4 , therapeutic presence—the deeply felt sense that the therapist is present as another human being—is also key to setting the stage for accepting what is.

Page 112 Mindfulness Breath Meditation in a Nutshell

Focus on your breath while quieting your mind or more simply put... Focus—Lose Focus—Refocus

Why is it easier to get couples and families to develop a regular meditation practice is generally easier ?

Peer Pressure

Page 151 Guided Mindful Observation If clients are willing, you can invite them to spend a few moments mindfully experiencing troubling thoughts or emotions in session.

Process: "You said you felt/thought X. Can you take a moment to just watch and notice the thought/feeling—notice the details about it": * Is it one thought/emotion or many? * Does it dominate your mind or flitter in and out? * Is it familiar or unfamiliar? * Do you have secondary thoughts or feelings about it? * Is it strong or weak? * Do you experience it anywhere in your body? * Are there colors or images associated with it? * What other thoughts and feelings seem to be associated with it? * Does it make you feel tired, wired, or some other way? * How does it affect your sense of self? Your feelings about the day? * Your feelings about life? After a period of mindful experiencing, the therapist and client can discuss the implications of these observations for how to relate to these thoughts and feelings outside of session.

Refocus Emphasize: the key for mental health benefits is to - refocus without berating the self and instead be patient, understanding, and compassionate.

Provide options for compassionately refocusing: - * Labeling thoughts (e.g., worry, planning, etc.); then return to the focus of the meditation. * Visualizing thoughts as clouds or bubbles that drift away; then return to focus * Thinking "ah, yes, that too" ("not surprised you showed up today") then return to focus

Page 105 TRUE/ FALSE? Getting the average client (or student) to practice mindfulness regularly for any length of time is challenging

TRUE

TRUE/FALSE Compared to working with individual clients, getting couples and families to develop a regular meditation practice is generally easier

TRUE

Problems you may face working with families....

relational dynamics