Transcript is experience as a client important for being an

mindfulness
& hypnosis
Stewart Mercer & James Hawkins
what is mindfulness?
there are several quite widely used definitions:
 Kabat-Zinn (Full catastrophe living, 1990): paying
attention in a particular way, on purpose, in the
present moment and without judgement.
 Bishop et al (Mindfulness: a proposed operational
definition, 2004): The first component involves the
self-regulation of attention so that it is maintained
on immediate experience … the second component
involves adopting a particular orientation toward
one's experiences in the present moment … that is
characterized by curiosity, openness, & acceptance
mindfulness: two helpful lenses
one lens sees mindfulness interventions as adaptations
of various traditional Buddhist meditation practices
 Mindfulness-based stress reduction (MBSR); Mindfulness-
based cognitive therapy (MBCT); Mindfulness-based
relapse prevention (MBRP); Loving-kindness meditation
and Compassionate mind training (CMT).
 This is where the current flowering of scientific interest in
the clinical possibilities of mindfulness began.
 Research grows showing the value of these approaches.
 There are interesting & important questions about the
mechanisms involved e.g. improvements in mindfulness,
self-compassion, experiential tolerance, self-regulation …
mindfulness: two helpful lenses
a second lens sees mindfulness as a useful attentional
and attitudinal mode which can be encouraged in a
variety of ways – of which meditation is only one
 Here mindfulness is considered to overlap with a number
of related concepts – attention, acceptance, de-centring,
cognitive defusion, metacognition, openness, compassion
 There are a series of so-called “Third wave” cognitive
behavioural therapies that emphasise developing a
different response to distressing experience rather than
trying to challenge the content or alter the experience
 These include mindfulness training, metacognitive
therapy, acceptance & commitment therapy, DBT, etc
the buddhist noble eightfold path
to relieve suffering & lead to self-awakening
the eightfold path divides into 3 basic divisions
 wisdom:
 right understanding & right intention
 ethical conduct:
 right speech, right action, right livelihood
 meditation:
 right effort, right mindfulness, right concentration
buddhist meditation
right
mindfulness
right
concentration
NICE guideline for
recurrent depression
NICE guideline for
generalised anxiety
right effort
marshmallow research &
2011 1000 child NZ study
broad to narrow focus spectrum
mindfulness
concentration
broad focus
awareness
acceptance
narrow focus
effort, depth
peacefulness
mindfulness meditation works
a wealth of emerging research demonstrates the value
of mindfulness practice both for patients & practitioners
 tested across a broad range of problem areas – depression,
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anxiety, substance abuse, eating disorders, chronic pain and a
variety of chronic medical conditions
tested too with diverse populations – adults, adolescents, children,
parents, teachers, students, therapists, doctors
meta-analysis (39 studies) – Hofmannn, S. G., et al. (2010). "The
effect of mindfulness-based therapy on anxiety and depression: A
meta-analytic review." J Consult Clin Psychol 78(2): 169-183.
systematic review (15 studies) – Merkes, (2010). "Mindfulnessbased stress reduction for people with chronic diseases." Aust J
Prim Health 16(3): 200-210.
well over 200 studies in my personal database & growing!
research challenges include
 better quality research – for example more studies that
compare mindfulness meditation approaches with active
alternative treatments (like applied relaxation), better
controls for example for allegiance effects
 improved understanding of the important therapeutic
mechanisms – reduced reaction to potentially upsetting
thoughts/emotions/events (especially spirals of rumination
& worry); reduced internal/external avoidance; reduced
self-judgement & increased self-compassion; increased selfcontrol/emotion-regulation; relevance of home practice to
changes in mindfulness; increased value-driven action
 better integration with other interventions – for example
value-driven action, broader health practices, concentration
meditation forms, other seven aspects of the eightfold path!
other “mindfulness approaches”
there are a whole series of emerging therapeutic
approaches that include an emphasis on mindfulness &
acceptance rather than trying to change difficulties
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Compassionate mind training (CMT)
Acceptance & commitment therapy (ACT)
Metacognitive therapy (MCT)
Functional analytic therapy (FAP)
Behavioural activation (BA)
Integrative behavioral couple therapy (IBCT)
Dialectical behavior therapy (DBT)
other “mindfulness approaches”
a recent excellent overview of this field is provided by:
Hayes, S. C., M. Villatte, et al. (2011). "Open, aware, and active: Contextual
approaches as an emerging trend in the behavioral and cognitive therapies." Annual
Review of Clinical Psychology 7(1): 141-168. A wave of new developments has
occurred in the behavioral and cognitive therapies that focuses on processes such as
acceptance, mindfulness, attention, or values. In this review, we describe some of
these developments and the data regarding them, focusing on information about
components, moderators, mediators, and processes of change. These “third wave”
methods all emphasize the context and function of psychological events more so than
their validity, frequency, or form, and for these reasons we use the term “contextual
cognitive behavioral therapy” to describe their characteristics. Both putative
processes, and component and process evidence, indicate that they are focused on
establishing a more open, aware, and active approach to living, and that their
positive effects occur because of changes in these processes.
four aspects of helpful inner focus
reducing
negative states
nourishing
positive states
exploring &
processing
encouraging
mindfulness