Handbook of Mindfulness-Based Programmes

Mindfulness Interventions from Education to Health and Therapy

Itai Ivtzan

• Publisher: Routledge
• Year: 2019
• Print ISBN: 9781138240940
• eBook ISBN: 9781351967150
• Topic: Philosophy
• Subtopic: Eastern Philosophy

Handbook of Mindfulness-Based Programmes: Mindfulness Interventions from Education to Health and Therapy offers the first comprehensive guide to all prominent, evidence-based mindfulness programmes available in the West.

The rapid growth of mindfulness in the Western world has given rise to an unprecedented wave of creative mindfulness programmes, offering tailor-made mindfulness practices for school teachers, students, parents, nurses, yoga teachers, athletes, pregnant women, therapists, care-takers, coaches, organisational leaders and lawyers. This book offers an in-depth engagement with these different programmes, emphasising not only the theory and research but also the practice. Exercises and activities are provided to enable the reader to first understand the programme and then experience its unique approach and benefits.

Handbook of Mindfulness-Based Programmes will enrich your knowledge and experience of mindfulness practice, whether you are a practitioner, researcher or simply interested in the application of mindfulness.

Chapter 1
Handbook of Mindfulness-Based Programmes

An introduction

Itai Ivtzan

When we think about mindfulness we frequently picture a monk, wearing orange robes, sitting rigidly for hours, days, maybe even weeks, with his hands resting on his thighs and without moving his body. Although we can indeed practice mindfulness in this way, it is only one option amongst an infinite list of possibilities. This is because mindfulness is not about what we do, or which posture we adopt; it is about our way of being. We practice mindfulness every time our mind (our attention) is one with the activity we are performing. Yes, it is as simple as that. When your mind and activity are one, you are present in the moment; your mind does not wander, and you are free of judgement, criticism, avoidance, and many other cognitive processes that take place in our normal state of consciousness.

But what is that normal state of consciousness? It is usually characterised by contemplation of things other than the activity in which you are engaged. For example, when you speak to your friend while thinking about an email from your boss; when you read the email from your boss while thinking about tonight’s date; when you sit with your date while thinking about a task you need to do for work; when you complete this task while thinking of your lunch; when you eat your lunch while thinking of your friend. This is a vicious circle in which we are constantly anywhere but in the present moment. This creates a duality between what we do and where we are (mentally). Such duality distances us from our experiences of life, from ourselves, and from our loved ones. If we are not present as things happen, as we feel and eat and talk and make love and write, we are not in touch with the heart of the experience, the essence of the moment. This is exactly what mindfulness therefore offers: a unity of mind and action, a presence. When these come together our experiences are transformed. We know from scientific research that being mindful changes our experiences, making them more meaningful and enjoyable while enabling us to become more efficient and engaged with life.

Mindfulness research has been conducted with many different groups and the results have consistently demonstrated the important impact mindfulness can have on very different experiences. For example, we now know that practicing mindfulness when we eat makes the food taste better and makes us more aware of the point at which we have had enough and need to stop eating. Practicing mindfulness when we have sex makes the experience more sensual, enjoyable, and connected. And one final example, which I find wonderful because of its mundanity, mindfulness has been found to have an extraordinary impact on the experience of washing the dishes! In such as study, participants are randomly assigned to either “traditional” or “mindful” groups. The first group of participants washes the dishes in a traditional way. This involves washing the dishes while thinking about different things (as most of us do when we wash the dishes). This is the duality I referred to earlier: the activity (washing the dishes) and the attention (wandering into thoughts and images that have nothing to do with the activity at that moment) are disconnected, cleaving the here-and-now experience into two elements that fight for control over one’s consciousness. The second group of participants, however, washes the same number of dishes mindfully for the same length of time. What does it mean to wash the dishes mindfully? If mindfulness is all about unity of activity and attention, then all I would need to do is devote my full attention to the activity. For example, I would notice the temperature of the water, feel the texture of the plates and cutlery, notice the feel of the liquid soap as it touches my hand, become aware of how the soap smells; these are all examples of presence. My mind is not wandering off into irrelevant thoughts and instead is fully aware of and embracing the experience and activity of the moment. The results of such studies indicate that participants in the “mindful” washing group exhibited a significant increase in positive emotions and a corresponding decrease in negative emotions. Such benefits were not found in the “traditional” washing group. The same pattern of results can be seen in numerous other mindfulness studies: whatever the circumstances, whatever the activity, integrating a mindful way of being into our lives offers a meaningful transformation.

The discussion above lays the foundations for this book. We now realise that we can implement mindfulness in any population, at any age, for any challenge, and in any circumstances – to support both individuals and groups. A nurse could be seeking mindfulness to help her deal with patients, a teacher might need it to reduce burnout, students may find it helps them to concentrate, employees could improve the quality of their relationships with colleagues, the elderly could find it helps them accept the losses experienced with aging, athletes could concentrate better and improve their performance, and therapists could deepen their feelings of empathy with a client. However, each of these populations is different in many ways, which needs to be taken into account in the delivery of mindfulness so that a personalised and relevant experience is provided for each practitioner.

This realisation has initiated an abundance of mindfulness programmes in the West, each comprising different practices that utilise a variety of exercises and creative approaches and are constructed in a way that feels “right” for each specific practitioner or group of practitioners. For this book I have chosen to select well-established programmes, with a clear rationale, which have demonstrated creativity and wisdom in their application of mindfulness. These programmes have also been scientifically studied and have been shown to provide the practitioner with a positive transformation.

The book is divided into sections, each covering a different theme or population. In each section there is a list of chapters describing different mindfulness programmes. The first section is Mindfulness programmes in therapy, which takes the reader through different therapeutic approaches that integrate mindfulness to deepen psychological healing. The second section is entitled Mindfulness Programmes in Families and offers a variety of programmes to support parenting, childbirth, relationships, and growing old. The next section, Mindfulness programmes in health-care, shows how mindfulness programmes can be integrated into medical practice while also supporting people who are recovering from cancer, eating disorders, and insomnia. As part of the mindfulness programmes in education this book offers a variety of mindfulness practices for both teachers and students. The next section, Mindfulness programmes in children and adolescents, focuses specifically on child-oriented mindfulness programmes while the following section, Mindfulnessprogrammes at work, focuses on leadership and law. The next section, Mindfulness programmes in addiction then describes two mindfulness-based approaches that can help with addiction and substance abuse. Mindfulness programmes in compassion, on the other hand, is a section in which the emphasis is on the relationship between mindfulness and compassion, offering programmes that deepen both self-compassion and compassion to others. The final section, Mindfulness programmes in psychological flourishing, describes two mindfulness programmes that focus on flourishing through strengths, hope, meaning, and other concepts derived from positive psychology. Thus, this is an indisputably diverse group of sections and mindfulness programmes, providing the reader with a full spectrum of knowledge and experience of mindfulness applications.

When I see the long and varied list of mindfulness programmes in this book I feel both excited and proud. Excited because of the incredible potential these programmes offer to improve people’s lives, thereby making the world a slightly better place. Proud because in the West we have taken an Eastern-based practice and translated it into a practice that is relevant to the Western world in a 21st century marked by turmoil. I hope you enjoy this wonderful development in the history of mindfulness practice.

Section I
Mindfulness programs in therapy

Chapter 2
Acceptance and Commitment Therapy

Jennifer E. Krafft, Grayson M. Butcher, Michael E. Levin, and Michael P. Twohig

Introduction

Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999) is a transdiagnostic psychotherapy shown to be effective for a variety of problem areas, including but not limited to mood and anxiety disorders (Bluett, Homan, Morrison, Levin, & Twohig, 2014; Twohig & Levin, in press). ACT is considered a contextual cognitive behavioural approach to psychotherapy that has developed out of both traditional behaviour analysis and contemporary interest in mindfulness and acceptance processes. The defining aspect of contextual psychotherapies is an emphasis on targeting “the context and function of psychological events” rather than their content, often through the use of mindfulness and acceptance techniques (Hayes, Villatte, Levin, & Hildebrandt, 2011, pp. 157–158). The goal of this chapter is to introduce ACT as a therapeutic approach. Furthermore, because ACT is a product of a reticulated approach to scientific development, the critical elements underlying ACT need to be introduced: its underlying philosophical assumptions and behaviour analytic account of cognition.

Getting to the roots

ACT is guided by a pragmatic philosophy of science called functional contextualism (Hayes et al., 1999). The core assumption of functional contextualism is its truth criterion, known as effective action, which refers to the goal of predicting and influencing behavioural events with precision, scope and depth. This means that a psychotherapy based in functional contextualism needs to align with other fields of knowledge (e.g., psychology must adhere to principles in biology), use concepts that apply across many areas (e.g., reinforcement has broad applicability), and have specificity in explaining how these concepts apply to an event (e.g., there are specific parameters to reinforcement). The other core assumption of functional contextualism is the focus on the whole event, which situates all therapeutic and scholarly analyses in the larger environmental context. Events are not looked at in isolation as that would exclude important functional elements.

The foundation for ACT

The role of mindfulness in ACT is rooted in Relational Frame Theory (RFT), a behavioural account of human language and cognition (Hayes, Barnes-Holmes, & Roche, 2001). The core assertion of RFT is that humans have the unique ability to learn to relate events, regardless of their formal properties. A simple example is the relation between objects and the nouns that label them, such as when humans learn that the spoken word “dog” is the same as an actual dog, and the written word “d-o-g” is the same as an actual dog. As a result of learning these two relations, a language-able human knows the written word is the same as the spoken word even with no direct training regarding their equivalence. It is derived automatically. This is expansive. It has been shown that this occurs with many other types of frames such as comparatives (more than, bigger than, worth more). Thus, given the ability to relate things, one can respond to just about anything without needing to have previously interacted with it. The automaticity and expansiveness of this thinking process fits well with how many mindfulness approaches conceptualize cognition; one good example is the restless and frantic “monkey mind.”

Not only is language expansive and automatic, it also can transform experiences that are “thought about.” More technically, the function of a stimulus can be transformed due to what it is verbally related to. For example, if a child is taught that dogs are dangerous, the child will likely show an emotional response to many dogs, the spoken word dog, and the written word dog. A child might even avoid going to new places if told dogs might be there. One clinically important feature of this is that therapists can either target the relational frames themselves (the actual information), or the context that informs what function should be transferred (and therefore the impact of the relations on behaviour). ACT uses acceptance and mindfulness techniques to alter the context that informs the function to be transferred (for instance, noticing a thought as just a thought versus relating to the thought as absolutely true information that must be acted on).

The psychological flexibility model

The basic research underlying ACT highlights a primary source of psychological suffering, the tendency for behaviour to be overly guided by internal experiences (thoughts, feelings, urges), or attempts to avoid these experiences, at the expense of more effective or meaningful action. This process is referred to as psychological inflexibility, and it is the core pathological process targeted in ACT. ACT conceptualizes psychopathology and psychological health as two sides of the same coin, characterized by a set of generally effective psychological flexibility processes and a corresponding set of generally ineffective psychological inflexibility processes.

There are six functionally defined processes, which directly address promoting psychological flexibility. The six interrelated processes are acceptance, defusion, contact with the present moment, self as context, values, and committed action (see Figure 2.1). Each process is described briefly here and in greater detail in the “ACT in Practice” section. In ACT, mindfulness is defined as the combination of four of the component processes of psychological flexibility, namely, acceptance, defusion, present moment awareness, and self as context. The other two process of change, values and behavioural commitments, are seen as the active and overt sides of psychological flexibility.

Acceptance: Acceptance describes the action of actively and willingly interacting with ongoing inner experiences without attempting to regulate their occurrence. Like all aspects of psychological flexibility, acceptance is a means to another end. By actively and willingly accepting inner experiences, even those considered unwelcome or uncomfortable, acceptance increases contact with the breadth of experiences and fosters contexts in which one may act more flexibly and in tune with values. By shifting the focus away from regulating unwelcome inner experiences, acceptance can be seen as the opposite strategy of experiential avoidance: a pattern of attempting to reduce or avoid contact with unwanted inner experiences, which narrows one’s repertoire of effective action and overall functioning (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996).

Figure 2.1 The six psychological flexibility processes.
Source: Copyright Steven C. Hayes. Used by permission.

Defusion: Cognitive defusion describes the process of relating to thou...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Dedication
• Contents
• 1 Handbook of Mindfulness-Based Programmes: an introduction
• SECTION I Mindfulness programs in therapy
• SECTION II Mindfulness programs in families
• SECTION III Mindfulness programs in health-care
• SECTION IV Mindfulness programs in education
• SECTION V Mindfulness programs in children and adolescents
• SECTION VI Mindfulness programs at work
• SECTION VII Mindfulness programs in addiction
• SECTION VIII Mindfulness programs in compassion
• SECTION IX Mindfulness programs in psychological flourishing
• Index