Professor Per- Einar Binder, Ph. D. Department of Clinical Psychology University of Bergen

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1 Professor Per- Einar Binder, Ph. D. Department of Clinical Psychology University of Bergen

2 Mindfulness paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally (Kabat-Zinn, 1994, p. 4) bringing one s complete attention to the present experience on a moment-to-moment basis (Marlatt & Kristeller, 1999, p. 68) the state of being attentive to and aware of what is taking place in the present (Brown & Ryan, 2003, p. 2)

3 Presence, with: Bodily sensations Feelings and emotions Thoughts Wishes Being aware that these are transient mental events Being open to them both when they are pleasant, unpleasant and neutral And meeting what turns up inside oneself with friendliness and acceptance

4 Mindfulness in clinical psychology First introduced by Erich Fromm The art of loving An implicit and explicit part of humanistic therapies (especially Emotion Focused Therapy) present-centeredness The contemporary mindfulness- wave stareted with Jon Kabat-Zinn s Mindfulness Based Stress Reduction. Empirical studies on effect on stress, anxiety, depression, pain, immune response etc. Today a broad range of mindfulness-based approaches: Dialectical Behavioral Therapy (Linehan), Mindfulness Based Cognitive Therapy (Segal, Williams, Teasdale), Acceptance and Commitment Therapy (Hayes), Interpersonal neurobiology (Siegel)

5 Mindfulness in context of buddhist psychology: The four noble truths and the eightfold noble path (a) suffering is inevitable; (b) suffering is a consequence of the automatic tendency to cling to phenomena; (c) the cessation of suffering is possible; (d) this cessation can be achieved by practicing the eightfold noble path; right understanding, conception, speech, action, livelihood, effort, mindfulness, and concentration

6 Some general effects of mindfulness on emotional well-being (see Richad Davidson (2010), Hofman & Sawyer et al (2010), Davis S. Ludwig & Jon Kabat Zinn (2008) and Ruth Baer (2003)) Better regulation and tolerance of emotion Increase in positive emotions, decrease in negative Decrease in stress-related disorders, anxiety, depression and insomnia. Possibly increasing interpersonal competence (empathy) Better functioning in a broad area of biological systems: Immune system, autonomic nerve system, neuroendocrine functioning.

7 Trauma Events that completely overwhelm the individual's ability to cope or integrate the emotions, sensations and cognitions involved with that experience Hyper-arousal/hypo-arousal/dissociation if clinicians fail to look through a trauma lens and to conceptualize client problems as related possibly to current or past trauma, they may fail to see that trauma victims, young and old, organize much of their lives around repetitive patterns of reliving and warding off traumatic memories, reminders, and affects (van der Kolk, et al., 1996)

8 Some existential dimensions of mindfulness and trauma Being mode Doing and survival mode (Active) responding vs (passive) reacting From facts to constructions - becoming aware of how personal and social meaning is constructed Freedom in ones way to experience (not fighting against thoughts and feelings) and construct meaning give possibility for more freedom in choices

9 Integration of mindfulness in clinical work with psychological trauma 1) Mindfulness as a perspective on psychological suffering and growth (Epstein) 2) Mindfulness in the therapeutic relationship the therapist s mindful presence (Safran, Siegel, Geller and Greenberg) 3) Inviting the patient into experiencing here-and-now, both in the relationship and in his or her own sensations, feelings and thoughts (Humanistic/EFT, Siegel) 4) Teaching the patient mindfulness tools to stay present in his or her everyday life (MBSR, third-wave CBT, Siegel)

10 Three ways to utilize mindfulness in trauma work:

11 Mindfulness on the body and the senses The basic sense of existing and being alive is strongly connected to bodily awareness Being grounded in bodily awareness increases general psychological presence Being anchored in the body gives a sense of experiential space around ones mental states The experience of emotions have their origin in bodily experience

12 Mindfulness on emotions To be present in the whole range of feelings and accept them both the pleasant, the unpleasant and the neutral Feelings are welcome adaptive feelings give information about relationships and needs (but maladaptive feelings mixes past and present) To become free from fighting against and freedom to relate to them To become aware of the transient and fluctuating nature of feelings To achieve an experiential space around feelings

13 Mindfulness on thoughts To allow thoughts to be just thoughts, not reality To have thoughts vs being thoughts to not identify to close with them To discover the transient nature of thoughts To hold ones assumptions with a light touch Thoughts are good servants, but dangerous masters (Jack Kornfield)

Noga Zerubavel, PhD 10/26/2015

Noga Zerubavel, PhD 10/26/2015 UNC School of Social Work s Clinical Lecture Series University of North Carolina at Chapel Hill School of Social Work October 26, 2015 Noga Zerubavel, Ph.D. Psychiatry & Behavioral Sciences Duke University