Mindfulness Basics

Mindfulness has become a hot topic in mental health and addictions treatment in recent years. Mindfulness techniques, including mindfulness meditation, have become standard items in the cognitive-behavioral therapy toolkit. This makes sense if you understand that many symptoms (including anxiety, depression, and cravings or urges to drink or use substances) represent experiences or expectations of psychological pain and distress that we instinctively try to avoid.

Human beings are, unfortunately, all too prone to using strategies that seem to provide immediate relief from distress, but carry long-term costs. The most obvious example is relapsing in a substance use disorder. But phobic responses (such as avoiding a situation that was previously associated with an anxiety attack) are also examples of short-term “solutions” that actually make the problem worse in the long term. Therefore, treatment approaches that help a person learn to cope with and reduce psychological distress should be very helpful in managing symptoms and fostering improvement over the longer term.

Jon Kabat-Zinn founded the Stress Reduction Clinic at the University of Massachusetts Medical School in 1979. In 1995, the clinic became known as the Center for Mindfulness. Kabat-Zinn, in his books and other writings, has credited Eastern philosophy, especially Buddhism, with the inspiration for many of his recommendations. The paradoxical directive to “stop fighting it” and “just be aware of” distressing thoughts and feelings is quite powerful, though difficult to master without a great deal of practice.

Mindfulness also links closely with a branch of cognitive-behavioral therapy called Acceptance and Commitment Therapy. This approach is recognized as an evidence-based practice, and has been applied to anxiety, depression, and many other psychological problems. A workbook that I have found useful, and recommend to clients, is titled “Get Out of Your Mind and into Your Life.”

One common thread that I have noticed running through these approaches is the idea that we cannot trust our own “mind” (itself an illusion, to some extent) to know what is best for us. This echoes the Buddhist warning that human striving is a source of frustration and disappointment. As a follower of Alfred Adler, I had a little trouble reconciling the idea of “letting go of striving” with Adler’s concept of “striving for significance.” But I have found resolution in Adler’s belief that all goals are fictional. So some of the “striving” that keeps people unhappy – for example, the desire never to fail, or never to be thought poorly of by others – represents over-driven or mistaken goals. In that case, letting go and trusting oneself (or karma, or God) can free a person from those over-driven demands.

Kabat-Zinn makes a good point about this in a chapter devoted to “Karma” in his book, “Wherever You Go, There You Are.” He describes karma as not so much a matter of fate, but a matter of aligning one’s goals with the natural world and the proper order of existence. Letting go of striving can accomplish this re-alignment. Letting go of the idea that we “have” a mind which “knows” things is crucial to CBT, Rational-Emotive Behavior Therapy, and ACT. This is because part of the skill-set in each of those approaches is to keep in mind that what we “know” can be questioned and changed. Often, for example, our first instinct is to fight or flee. That may be exactly the worst choice in many stressful situations, especially work or social situations. Unfortunately, we have different parts of our nervous system that handle emotion, safety, and executive function. And these “parts” may not always be working together, especially when we are under stress..

Kabat-Zinn titled one of his chapters “if you can’t stop the waves, learn to surf.” That idea is at the heart of these approaches. Instead of fighting against forces we can’t stop, we can learn to ride them out. This is especially useful when applied to anxiety symptoms. We need to remind ourselves that – despite what our mind seems to be telling us – we will not die from anxiety.

 
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