Mindfulness Components PDF

Let's take a look at the core components of mindfulness. There are three core components for mindfulness. These are flexible attention, non elaborative processing and acceptance. And we'll talk about each of these three in more detail. And you'll notice I put there acceptance being the contrast or...

Let's take a look at the core components of mindfulness. There are three core components for mindfulness. These are flexible attention, non elaborative processing and acceptance. And we'll talk about each of these three in more detail. And you'll notice I put there acceptance being the contrast or the reverse of that being avoidance, which we often want to encourage our clients not to do in therapy. But we'll take a closer look at each of these. So starting off with flexible attention. Now, you would have read earlier that sometimes I explain to clients that mindfulness, the way we present in therapy, can sometimes be thought of as a way of attention training. And that's particularly with reference to this component, flexible attention. So what we're trying to do here is encourage the client to have more control over the things in life they pay attention to and the things that they focus on. And so what that means is being able to have flexible attention, being able to let things go when they need to, and being able to focus on something else. And so this often involves a reduction in self focused and selective attention. So self focused attention is the attention simply that you give yourself. And we see this a lot with people with anxieties. That they're often quite self focused. They're often very aware of, what do I look like right now? Are people looking at me? Are they judging me? Those sorts of thoughts, very self focused thoughts and selective attention is really focusing only on particular pieces of evidence rather than the full picture. And we can see the selective attention across a range of different difficulties. If we think about the client who has depression, they might have selective attention for what they perceive as being the negative aspects of themselves or the negative aspects of a situation. Or indeed, the negative possibilities of what might happen in the future, that sense of hopelessness or helplessness, so that real sort of selective attention on things that may not be going well for them. A person with anxiety may have selective attention specifically related to threat that they perceive in their environment. Or even when we think about a person who has post-traumatic stress, there's often a lot of selective attention to things that have happened in the past, things that they keep going back to and they can't seem to be able to stop going back to that. And so, a lot of the time, what we're trying to do in mindfulness is reduce that selective attention and give people more control over where they can shift their attention to. And this often means shifting attention to the present moment. And so we can think about many difficulties that people have with their mental health as often being related to either putting too much attention on the past or too much attention on the future. So ruminating over things that have happened in the past and not being able to process them and move on or conversely, worrying about things that might happen in the future and being really concerned about that. So we often try to, with mindfulness, shift the attention back to the present moment. And when we do shift that attention back to the present moment, of course, we're looking for broad attention, not so focused attention or focus on a particular problem. So that very broad attention and that ability to intentionally shift where you're focusing. So pulling yourself out of personal past focus or self focused attention and being able to shift where you put your focus. So that's that first component, flexible attention. Then we have non elaborative processing, and this might sound similar to some of the things that we covered in cognitive therapy already, and that's because there are similarities here. So what we're looking for with non elaborative processing is essentially just being able to leave a thought or an experience as it is and not interpret it excessively. So, for example, having a thought that I haven't studied enough for the exam, I might not do well, being able to leave that thought as it is rather than escalating it to I'm going to fail the exam, I'll have to redo the course. I'm not going to graduate on time. That sort of elaborative story put a lot of meaning on the internal experience that you have as opposed to letting it sit there as one possibility of many possibilities that exist. So that non elaborative style and we can think of this as thought decentring. And this is actually the same process that we do when we do cognitive restructuring. It's just done through a bit of a different technique with different mechanisms. But the overall aim of what we're trying to achieve with the client is actually the same, and that is that we want the client to understand thoughts and mental events are not necessarily real or accurate representations of of reality. And they don't require a behavioural response. You actually don't have to do anything about thoughts. You could just let them sit there and just let them be so you don't have to respond or react to them in any way. And that if you don't respond to them, thoughts will pass through your mind. If they're not subject to elaborative processing, if you just let the thoughts sit there and not elaborate on it, not do anything with it, it will eventually pass. And we use in our mindfulness and in acceptance and commitment therapy lots of metaphors for this. For example, we might talk to clients about envisioning leaves on a stream, and if they can imagine that they are on the banks, they can see all these leaves floating by on the stream and they will have their thoughts. And so the trick is that you are standing on the bank or they are standing on the bank, they're not engaging with the thoughts or the leaves on the stream. They're simply being an observer and watching them pass. And if you do that, the leaves won't change or the thoughts won't change in any way. They will simply come and go along the stream. And that's what we're aiming for. So we will often use that metaphor with clients where they simply have to be the observer and watch the thoughts come and go like leaves on a stream. So not elaborative processing, our second component. And then finally, acceptance versus avoidance, and this is of your general experience. And so what we mean by acceptance is to accept your experiences in life, even the uncomfortable ones. Now, that doesn't mean that you can't problem solve or make goals and make your attempt to make your life better. That's not what we're doing here. But what we're trying to do is encourage clients not to avoid things in life that are difficult, or tricky, because it often just makes the problem worse. So what we encourage is this idea of sitting with an uncomfortable experience rather than trying to distract yourself, avoid it or escape it or change it through elaborative processing. So, again, this is related to elaborative processing in that we want a client not to try and change their experience to make it easier through avoidance or conversely, to make it worse through elaborative processing, but to just sit with experiences as they occur. And often when you sit with something, it naturally gets better. And then when you're in a state of reduced distress, you actually make better decisions and can problem solve better. So the key is to try and sit with something until it's less distressing. And that's what we try and encourage clients to do rather than avoid difficult experiences in their life. So this is actually very similar to exposure, because you might remember when we spoke about behavior therapy, what we get clients to do is to enter difficult or feared situations and stay in them until the fear comes down and to try not and change the experience or avoid it or escape just to stay in that feared situation until it comes down. And that's what acceptance is. So exposure actually relies heavily on this idea of acceptance, of accepting an experience. And as you do that, naturally emotions will reduce in intensity. The problem is, is that people often try to leave the experience before the distress reduces. A lot of times people will be in a difficult experience and think this is way too much. I need to leave or I need to think about something else that's too difficult to think about. And so they try to distract themselves or avoid the experience. And oftentimes when they're doing that, they usually actually near the peak of distress. And if they just stuck with it a little bit longer, it would naturally come down. And when it comes down, they're more equipped to deal with it when it comes up again next time and they're better able to make decisions from that. So one of the clinical applications of this, what we spoke about exposure, but also urge surfing. We often use urge surfing with clients who have addictions or have behaviors that are really driven by strong emotions. So even things like non suicidal self-harm is often driven by really strong emotions or binge eating is another example. And what we ask clients to do is urge surf, which is a type of acceptance. And so what we mean by that is that when the person notices that they're getting this urge to do the behavior or the thing that is somewhat destructive, whether that's binge eating or self-harm or smoking a cigarette, that's usually driven by an emotional response. And if they can just sit with that and not engage in the behavior. So remember that you don't have to respond to a to an emotion or thought. You can just let it sit and accept it. So noticing I'm having an urge to do this and I'm just going to sit and I'm going to essentially wait this urge out. We think of it as urge-surfing because you can imagine it being like a wave and the point at which people usually dip out and engage in behaviors close to the top. And if they just stay with it, they'll actually crest that wave and come on down and surf down it. And so what we want them to do is think of it like a wave and just imagine that even though it may be really uncomfortable and distressing, eventually the wave will peak and it will pass. And so that idea of urge-surfing as a form of acceptance. And the more people, it's really difficult to do, but the more they do it, the less intense urges will become and the quicker they will be to resolve. So it's very similar to exposure as well. So all of these therapeutic techniques based on this idea of acceptance and acceptance, being one of the three core components of mindfulness. So recapping, we have non elaborative processing, flexible attention and acceptance as our three core components of mindfulness. So let's have a look at a case example of this. So imagine that a person that has social anxiety. Now, let's start with the middle column, because we're going to imagine that they're, they are being non mindful or they're being mindless, perhaps in the way they approach a situation. So let's assume that they've gone to a party. Where is their attention? Well, they're focused on their blushing. And they're also scanning people's expressions because they can sense people don't like them. So they have very focused attention on people's expressions. And also that's self focused, negative attention and noticing that they're blushing. And of course, then they're elaborating. They're elaborating on their processing. So they've got this elaborative style so they can see me blushing. They can tell I'm anxious, I look like an idiot. And you might think back to cognitive therapy and even pick up some of the thinking traps that the person is engaging in there. But with mindfulness, we're less concerned about the actual type of elaborative processing they're doing, which is the type of thinking trap. We're really just concerned that they are doing it and they probably shouldn't be doing it. So they've got this elaborative processing. And so what do they do about it? Well, they engage in some avoidance and distraction type behaviors, so they increase their alcohol intake because that makes them feel calmer. So rather than sitting with the uncomfortable emotion of anxiety, they engage in a behavior designed to reduce it. And and it's not, it's not a very adaptive way of trying to reduce your anxiety. They leave the situation, so they leave the party early. So they're engaging in active avoidance there and they only talk to familiar people. So another type of avoidance, because talking to unfamiliar people might increase their anxiety further. So they're being non mindful. Now, if we think across those three categories, if we were if we were to encourage them to be more mindful about their experience in that party, well, let's start with their broad and flexible attention. We'd encourage them to be aware of the temperature of their face. So they're aware of it. It's something that they've noticed. They're aware of people in the room and of other conversations. We're trying to make their attention broad and to pick up more things than just the self focus and the checking for reactions from others. But then we also want them to do it in a non elaborative way. So just noticing that those things exist and not having to do anything with it. So noticing that they're having thoughts around themselves blushing or worried about what other people think, but not getting involved in those thoughts. So letting the thoughts pass through their mind, but choosing instead to focus on the conversations, so redirecting their attention to focus on the conversation. And this is something we often see with people with social anxieties. They become so involved in their own mind that they actually miss key things from the conversation, which means then that it's kind of a bit of a cycle that they could get caught in, because then other people think that they're not being very social because they're not actually engaging in the conversation when in actual fact, it's just because they're so caught up in their own mind. So we're trying to redirect the attention from the internal to the actual present moment of what's going on, which is the conversation that they are involved in. And finally, we want them to simply accept the experience so they accept that they're feeling a little bit anxious. They accept that they're having these thoughts come through their mind, but remembering that it will pass, the blushing will pass, that it won't stay there forever. In fact, it usually last only a few minutes. The thoughts will pass, particularly when they don't focus on them and elaborate on them. They'll pass quicker and they just continue talking to others and redirecting their attention to others. So that's how we would encourage a person to be mindful in that particular instance. It sounds easy, but it's not. It actually takes a lot of practice to be able to have flexible attention redirected, to not get involved in elaborative processing and most importantly, to accept uncomfortable experiences and not try to change them. So sounds simple, but it's not. So how do we actually develop a person's mindfulness skills? Well, firstly, there's the assumption that it's an inherent quality. We all have some degree of mindfulness. It's about developing what's already there. And as I mentioned, it may sound simple, but it's actually quite complex and takes a lot of practice. So there's two main ways to try and facilitate or practice mindfulness. Firstly, you can do it through formal practice or what's known as meditation or informal practice. And that, and when we work with clients, we actually probably want to do both of those. We want to include both of those in the treatment planning. So formal meditation is when we ask a client to set aside a period of time, sit down and practice mindfulness, and this is usually done with an audio script. So there's usually a script that you might follow in session to help them practice mindfulness or that you might give them a recording of to practice at home. And there's various apps that also have these. And the purpose of these scripts is to give clients an opportunity to practice directing their attention. So in these scripts, it might firstly encourage them to focus on what can they hear around themselves or what can they see, what are their thoughts? What can they feel in their body? So it's encouraging the direction and or being able to choose where your focus goes, but also that broad attention, being able to shift your attention to a whole range of different things in your environment. So it's an opportunity to practice that. And it also encourages acceptance of feelings and thoughts. So as they as you're going through these scripts with clients, they'll be moments where they assess what their thoughts are or when they assess what their emotions are. And you encourage them to simply accept those thoughts and return their attention to the present moment. So to not get involved with them, to not get involved with their emotions at the time and so oftentimes with clients we'll start small, maybe a 10 minute practice or 10 minute meditation and build up from there. Because the longer meditation is, the longer you want to sustain this attention, the harder it is. And it requires ongoing practice. I often just call them mindfulness practices rather than meditations with clients, because I think people sometimes have an idea of what meditation is. And that's often not what we're doing here. We're really trying to practice this different style of attention and focus and acceptance. And then secondly, we do these informal, informal practices. This is when we encourage clients to bring all of their mindfulness skills into their everyday environment. So these are very brief and it's often about trying to get a client to shift their attention quickly in an everyday environment and to practice that non elaborative and acceptance style of processing. So some of the ones I've used in the past is I'll often encourage clients that when they go for their daily little trip to the coffee shop in the morning to while they're standing in line, instead of letting their thoughts wander, practice mindfulness, try and pick up all of the sights, sounds, smells around them, try and bring their attention to the present moment and not let it waver and try and keep that going until they reach the front of the queue. And so the more busy the environment or the more things are to compete for the person's demands or in fact, the stronger the emotion that is tied with the situation. So, for example, a high anxiety situation, the harder that will be. And so we want to build up on those informal skills and starting somewhat easy, which might be the line at the coffee shop and building up to something much harder, which is being mindful in an anxiety provoking situation or in a situation that might bring out anger or distress or whatever the strong emotion is. So our two methods of practice, formal and informal practice. So this is just a final note on meditation, because it is often misunderstood and sometimes, you know, you might have clients come in and when you say we're going to do some mindfulness and and I'd like you to practice this meditation, it can be a bit confronting, particularly if they've never done meditation before. And as I mentioned, I often will change the terminology depending on the client as to what's going to be most accessible for them to think about the strategy or the technique that we're using. But you might be wondering, what does a 20 minute meditation have to do with mindfulness or reducing distress in real life? Well, the purpose of it is that the more you practice something and in an easy environment, the better you are actually learning that skill and solidifying it. And then when it comes time to apply, to apply that skill in the real world, particularly when your emotions are high, the better your odds are of success. So what happens in the therapy room happens in life. So you want these long practices to occur and to occur in fairly non-threatening environments to begin with, and the therapy room is is usually one of those non-threatening environments and then to build up from there. And as I mentioned, you want it to be this this period of sustained attention, it's not something that you can just do for 30 seconds, and then they, and then that's all they can manage, particularly if they're having ongoing difficulties with past or future focus or difficulties with their emotions. You want them to be able to sustain this attentional control for long periods of time. So it's like a muscle. The more you use it, the stronger it will get, which is why the actual formal practice is really important. It would be very hard for client to learn mindfulness just off of the informal practice. The formal practice is really where you build up those foundational skills and you want it to be able to generalise to other areas of their life, as I mentioned. So hopefully this gives you a bit of an idea of those three core components of mindfulness and why they or why and how they might be useful in therapy.