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Mindfulness - The clinical method

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Mindfulness in clinical practice builds on the principles of cognitive therapy.

Mindfulness is a form of conscious awareness in which we are fully aware of experience as it is unfolding. This may not seem different to our usual understanding of awareness, so in order to better understand mindful-awareness we need to first examine common awareness. When we encounter an experience, which could be external, such as a sight, sound, or touch, or internal, such a thought, memory or emotion, the mind tends to react to the experience according to past conditioning. When we look at a tree, we don’t just see the tree as it is, but see a composite of the objective reality of the tree combined with our subjective reality, our internal representation of the tree. We see the products of our subjective reactions to the tree, and often this dominates our perception and awareness so much that we see very little of the truth of what is in front of us.

We can describe consciousness as a continuum between the totally objective truth at one end and the completely subjective reactivity at the other. Many of us reside more on the subjective side than the objective side and our experience is dominated by subjective habitual reactivity that has the effect of blinding us to reality.

Mindfulness is the conscious attempt to correct this imbalance, minimize subjective habitual reactivity and shift consciousness towards objective perception. Hence mindfulness is often described as the direct awareness or bare attention to present experience. It is non-reactive awareness that allows us to completely experience any object of consciousness. One of my favorite terms, which I use to describe mindfulness to clients, is presence. Mindfulness teaches us to be fully present for our experience as it is, rather than thinking about what we are experiencing, analyzing our experience, or reacting with attraction or aversion to what we are experiencing.

In relation to the mind, the Buddha made it very clear that if you want to transform inner emotional suffering, you must open your mind’s eye and look inside to see what’s there. Reactivity and thinking take you away from this primary and direct perception, because when you react, you experience the reaction, not the original object. When you think about your anxiety or trauma, you are experiencing thinking about the object, which is not the same as the original emotion. Reactivity takes you away from being present and this is actually a subtle form of suppression, and when the mind remains ignorant through suppression of any kind, it is prevented from changing.

The first requirement for transforming anxiety is to allow yourself to observe it fully. Without this effort to overcome unawareness, nothing can change. In fact, the unawareness is an essential factor that creates the anxiety in the first place. This is particularly the case for depression, where there is a complex superstructure of negative reactive thinking around the core emotion or trauma. Therefore, the first characteristic or dimension of the mental factor called mindfulness is the active watchful component, called recognition, or vigilance. We train ourselves to recognize each and every movement of reactivity in the mind so that we can stop its proliferation and return to being mindfully aware of the core emotions.

Mindfulness is multi-dimensional; it is not simply learning to be more aware, but continuing from basic awareness to a state of complete presence, in which you look and listen with a clear, still mind. The second dimension of mindfulness is about how you relate to the core emotion, or any other experience that you are observing. Mindfulness is like a spotlight that illuminates the emotion so we can direct our attention to it, and it keeps our attention from being distracted away. Now, we need to continue to shine the light on the emotion and begin the process of mindful-investigation. Mindfulness allows us to build a relationship with our inner emotional complexes that is spacious, non-threatening and safe. We are so used to reacting, that we never actually spend any quality time with our emotions. It is like the busy friend who never seems to have time to have coffee with you. “Sorry, can't stop now. Catch you later.” This is what we do with our emotional suffering all the time; we don’t take the time to simply be present with our inner pain, and it is hardly surprising that the pain persists. Mindfulness is all about making time to be with your emotion, literally sitting with it as you would with a friend, and listening. Hence the second dimension of mindfulness is relationship and presence. We all know how important it is to be fully present with your spouse or friend when they are suffering. They need your presence more than advice or words.

The third dimension of mindfulness emerges quite naturally after you have established mindful-presence and this is investigation. When we investigate an emotion like anxiety or depression with mindfulness, it responds by differentiating into more subtle feelings, memories and inner imagery. We simply see more, and this is very important, because it is in the details of what we see that transformation becomes a possibility. Just like a car that won't start, the best response is to open the hood and look inside the engine. Solutions present themselves. If you see a loose wire, the solution is simple; but you had to look inside first or you would never have discovered the solution. We tend to stay stuck at the superficial outward appearance of our emotions; we take our anxiety or depression to be solid entities, when in fact they are never solid and never what they first appear to be. An emotion is a construct, like a fortress, and mindfulness is the process of taking apart the bricks and mortar. When you begin to disassemble the emotion, then the solutions begin to present themselves quite spontaneously.

Hence, there is a fourth dimension to mindfulness, a transformational domain. First we learn not to react; then we learn to be present. When we are present, we begin to discover the inner structure of the emotion, and this paves the way for transformation. Actually, each of these preliminary dimensions of mindfulness is transformational; overcoming reactivity and learning to relate to inner pain is the hallmark of successful psychotherapy. However, making the inner structure of our depression conscious will directly lead to the transformation at the core level. The psyche has a remarkable ability to heal itself if given the freedom to change and this freedom is provided by mindfulness. It is assumed that we all have an innate inner wisdom-intelligence, called satipanna in Buddhist psychology, which directs change from instability to stability; from discord to harmony; from suffering to well-being. This natural intelligence is just like the wisdom of the body, called homeostasis, which continually makes adjustments to maintain health. It is thought that the psyche is also guided by psychological homeostasis towards well-being and happiness. When mindfulness is established, we create the ideal conditions of inner freedom in which this natural intelligence will direct the process of inner transformation.

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