Disclaimer: This post is geared toward counselors and psychotherapists wishing to use mindfulness with their clients. However, there is information in here that might be beneficial to anyone interested in personal growth.
This post was inspired by a comment by Becky on my last post. How do you propose mindfulness as a practice to someone who has no interest and doesn’t see how mindfulness practice could possibly relate to their life, issues or problems?
I recently had a client come into my private practice who was struggling with anxiety issues. My knee jerk reaction to this was to suggest a mindfulness-based intervention strategy…..
The response: ‘I don’t want to just sit there and meditate, I WANT RESULTS!’
90-100% of clients will not know what mindfulness practice is probably won’t see how it can help.
I have tried various ways of introducing mindfulness practice to clients who have never before tried it or heard of it.
Here are a few guidelines that I have found helpful. I invite the posting of any other approaches that therapists who are reading this might suggest. Please comment!
Go Slow
Start at the first session with introducing some concept of mindfulness and that its application may help your client. I will often tell my clients and prospective clients that one of the main modalities that I use in therapy is experiential therapy. This means that I will ask them to notice and become more aware of their own experience on the levels of their thoughts, feelings, physical body, etc. This opens the conversation for how awareness can be helpful. I push the idea that therapy is about awareness and feelings. The more complete our understanding is of our emotional patterns, belief/thought patterns, and behavioral patterns the more easily we can change.
This awareness gives us the power to act differently, and the expression and full acceptance of our emotional state gives both relief and the opportunity to tap into positive feelings as well. You can’t feel joy without feeling the depths of your sorrow. Mindfulness is just a fancy way of saying that we will experience what is going on in the moment in our body, our intellect and our emotions.
Depending on the client’s issue I may pick one of these three areas to focus our mindfulness-based experientials on. If a client is dealing with obsessive thoughts, or worries and anxiety that are largely in the talk space, or image space (they hear them in their mind, or see visual content in the mind) I will often move towards increasing body awareness with a mindfulness-based approach.
The word mindfulness may not even cross my lips. I will say instead that I want to work with with their body increasing their body awareness and do some psychoeducation around how body awareness helps us to access and work with difficult emotions more directly and with better results. Working with just the mental content can be deceptive and very slippery. This task can be saved for later on in therapy when the client has heightened their awareness of their body.
A good way to begin with this is to work with body scans and progressive relaxation (see Don’t Call it Mindfulness, below) This will teach the client skills that will translate into spatial and ‘felt sense’ awareness of their body, the location of sensations, and the quality of those feelings. This is mindful awareness of the body, and these skills can then translate into focusing that same type of mindful awareness onto mind-body experiences and their experiences in relationship, or with belief systems and thoughts.
Often when clients become fluent in the body-scans and the progressive relaxation I ask them to work on this at home. As these exercises often produce pleasant feelings this is not a difficult task for the client to take on. 5-10 minutes a day is all it really takes to begin building this type of mindfulness into the body. Often the client will become more interested in this point in how awareness and being present with their experience is helpful, and they have also experienced it first hand.
At this point a conversation and psychoeducation around mindfulness can begin in earnest.
Bibliotherapy
If your client responds to reading or is already in the habit of processing information in a cerebral way, giving them reading material is often a good way of introducing mindfulness. I would like to recommend a book I’ve been reading lately called Mindfulness in Plain English by Ven. Henepola Gunaratana. This can also be found as a free ebook.
I will often start the conversation by suggesting that I know of a technique that will let my clients know themselves better and form a better relationship to themselves and break out of habitual and negative patterns. I will then ask if they might want to read more about this. Also Shinzen Young’s site had many interesting articles that systematically explain mindfulness in a very logical manner. This might appeal to the rational, scientific type client.
Some other inspiring reading that can be an introduction to mindfulness meditation:
- Insight Meditation: The Path of Freedom by Joseph Goldstein
- Path with a Heart by Jack Kornfield
- Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life by Jon Kabat-Zinn
- Mindfulness for Beginners by John Kabat-Zinn (audio CD)
- Breath by Breath: The Liberating Practice of Insight Meditation by Larry Rosenberg
- The Miracle of Mindfulness by Thich Nhat Hanh
The Insight Meditation Center teachers Sharon Salzberg and Joseph Goldstein offer a Insight Meditation: A Step-By-Step Course on How to Meditate, for those who might want to start on establishing a daily mindfulness practice.
You might also recommend this blog as a starting point for general information about mindfulness and how it can help.
Don’t call it mindfulness.
I covered some of this already in the Go Slow section above.
Who doesn’t want to be more relaxed? I will often start a session, or end it with guided relaxation. This is another name for mindfulness practice in the body. The main difference is we are working for a result: relaxation. Though it is often a natural function of mindful awareness that it produces a letting go and release.
I will often work with a progressive relaxation routine that involves tensing and releasing each muscle group in the body, starting with the feet and working upwards. I will also incorporate a body scan into this drawing the client’s attention to the various large groups of muscles and parts of the body that might hold tension. Potential trigger points for tension, include the fascia of the face, neck, shoulders, jaw, the hollows of the eyes, the upper back.
Other ways to introduce this exercise would be to call it a guided relaxation, grounding technique (focusing awareness on the feet and contact with the ground/earth) , stress relief visualization, etc. After enough practice the clients will eventually be able to guide themselves and have taken powerful steps in taking responsibility for creating their own practice of mindfulness.
If the client comes into your office anxious, and is open to trying a guided relaxation exercise right then and there, seize upon that opportunity. Let them have a taste of this relaxation.
I have had great success with using a guided mindfulness practice in this way. By following simple instructions the client is able to feel successful in relaxing themselves in the first session. Besides the benefit of satisfaction and relaxation you are also making a powerful statement about the benefits of the therapeutic relationship, and helping to deepen the client-therapist relationship through creating trust. If the client feels that you can help and is strongly impacted in the first session they will naturally move to a place of trust more easily as they perceive you as impactful and helpful from the get go.
Do something else first
Many clients come in wanting quick results. Respect this. Often if they can have their concerns, doubts fears about getting helped addressed they will be more amiable and open to trying alternate treatments like mindfulness-based interventions and other experiential options.
Listen to them speak about their fears, and often their doubts that anything at all will help.
Offer them resources: Psychiatic evaluation (if appropriate for their issue), support groups, books, a supportive presence, exercise options, nutritional recommendations. Whatever they are asking for give space for this to be addressed.
I will often offer up a book or a CD that gives a guided relaxation exercise and suggest that the client may want to try explore this on their own. I will often give a relaxation CD I’ve recorded for clients for them to try at home. If I receive positive feedback from them about their experience I may then explore their interests in mindfulness further.
More often then not, I have found that a trusting relationship needs to be formed before any type of experiential therapy can be commenced. Once this relationship is there then the client will most likely be open to any variety of interventions, mindfulness-based therapy included. This may require weeks or months of relating to the client through good old talk therapy to establish.
Appeal to a Sense of Health
Often clients will have their own health regimens or practices such as running, bicycling, working out the gym, yoga etc.
Be well versed in the health benefits of mindfulness practice and present these when introducing mindfulness:
- Stress reduction / increased relaxation
- Better quality of sleep
- Benefits in circulation and coronary health
- Better listening skills
- Increased concentration
- Increased capacity for memory
- Lowers blood pressure
- Relieves muscular tension
- Increased tolerance and relief from physcial/mental/emotional pain
- Increases performance and satisfaction in any other physical/mental exercise.
Mindfulness can be presented as a health regimen for the mind, physical body and emotional body.
Speak from your own experience.
When I speak with clients regarding mindfulness it with my deepest personal conviction. I have personally practiced mindfulness meditation for 10 years and found it to be the single most healing factor in my journey. I used to suffer with debilitating anxiety and depression in my teens and early twenties. The combination of regular mindfulness practice (both sitting practice and yoga, which I consider mindful movement), and regular psychotherapy over a number of years helped me to learn how to work with my mind, emotions, and physical body. I have not suffered with any form of clinical anxiety or depression in over 8 years.
Of course, we all have regular ups and downs; that is part of life. Mindfulness helps us to feel our emotions fully, but not be so fixated on them, allowing them to move through us on the mental and physical levels. As one of my meditation teachers often says our emotions are just ‘passing weather.’ So called ‘negative’ emotions may last for a few minutes, or an hour, but will disappear if we allow them to. Mindfulness allows us to listen deeply to the process of these emotions, learning about them non-judgmentally, and forming a relationship with them; while letting them come and go.
The impermanence of our emotional states is an important message for clients struggling with depression to hear, as they often mistakenly believe that they will feel sad, energy-less, unmotivated, heavy, despairing, (or however the depression manifests itself) forever. Being mindful of their emotional states can help these clients to realize that they do feel other ways, and these feelings will end. Shattering the belief that the constellation of feelings we call depression are static and constant can be a huge breakthrough.
Speak from your own story with mindfulness. How has it helped you? If you haven’t thought about this explore it. Create a narrative for yourself about how mindfulness has worked for you.
A personal endorsement is about the most convincing recommendation for mindfulness-based interventions I can think of. In my experience it is my deeply held belief that mindfulness heals that most appeals to clients. If you have doubts or mistrust the method your clients will sense this.
The best ways to address your own fears, doubts, or mistrust of mindfulness practice, or mindfulness-based interventions is to try it yourself. Make a commitment to practicing. When I began to meditate I would do a 5-minute daily sitting practice. Even that tiny amount of time had a huge impact on my mood and outlook on life. I also attended a donation based (Dana in Pali) drop in Vipassana Meditation group once per week.
The books I listed above give basic directions on how to begin a mindfulness meditation regimen. There also audio CDs out there and community meditation centers that will offer free meditation instruction. Shambhala International has centers throughout the US and abroad, and Insight Meditation Community (just Google this and many of the regional centers will show up) has many teachers throughout the US that can be resources for this instruction and offer drop in groups for meditation practice.
I will be writing a future post that gives basic directions on how to begin a mindfulness practice. The best way to learn is under the guidance of a qualified meditation teacher / instructor (not from a blog). I will also gather some further resources there of possibilities of how find instructors in your community.
I am also happy to do my best to help other professionals find resources for their clients. If you are unsure how to find a qualified meditation instructor for your clients feel free to email me from the About page on this blog, and I will try my best to help.
Explore examples of how your clients are already being mindful.
Therapist: ‘Remember how you told me that you love playing piano? What was it that you loved about it?’
Client: ‘I just feel so focused when I’m playing, its like nothing in the world exists but me and the music.’
Therapist: ‘What would you say if I told you that I could share with you a skill that could help you deal with your anxiety and achieve that same type of presence, attention and concentration you have when you are playing piano, at any time in your daily life?’
Mindfulness is an innate human ability, we are not creating something from nothing, through practice we are simply strengthening something that is already present in the client.
This same conversation could hold true for about any activity that requires concentration, attention, and focus, and also bring enjoyment. Some examples: running, bicycling, artwork, playing a musical instrument, hiking, needlepoint, sewing, computer games, taking baths, gardening, the list goes on and on.
I have found that a client will often be more apt to use mindfulness-based exercises on their own if it is associated with some activity that they already engage in, and it gives them enjoyment. Once they experience for themselves increased satisfaction that mindfulness brings to these activities the desire to use mindful awareness keeps increasing.
I hope this post has been helpful. I will continue to add more approaches to introducing clients to Mindfulness practice and Mindfulness-based interventions as they occur to me.
There are probably as many ways to introduce mindfulness to clients as there are therapists. I invite anyone reading this post who may have useful suggestions to add a comment. I would find any new ideas immensely helpful as would other professionals who may be reading this blog.
Mindfully yours,
David
Filed under: Body, For counselors / psychotherapists, Mindfulness, Practice
