EFPT Psychotherapy Guidebook chapter on Mindfulness
Before reading this chapter, we invite you to sit down in a comfortable place, if possible in a quiet environment, and to take some time to turn your attention to the present moment, here and now.
Do you recognize your breathing ? If you want, take some time to observe it, without judging, just follow it calmly and peacefully. Breathing in ... breathing out ... without anything to prove, just observe and welcome warmly the different sensations and thoughts inside you.
If you have some time, try to become aware of the sounds around you, of the the colors, of the sensations in your body, without thinking “oh that's nice” or “oh that's bad”, just by being kindly aware to them.
That's already a start into the wide range of Mindfulness exercises and applications!
Mindfulness is the psychological process of bringing one's attention to the experiences occurring in the present moment, with compassion and without judgment. Being aware of the present moment calms down the ruminations and worries of the past and future, often observed in people suffering from anxiety or depression. It also helps to develop features such as compassion, concentration, acceptance and it lowers negative thoughts, emotions or behaviors such as auto-critics, stress, impulsive behavior etc. It's considered as a third generation cognitive behavioral therapy.
Though it has its roots in Buddhist meditation, secular practice of mindfulness has entered medical healing centers in part through the work of Jon Kabat Zinn and his Mindfulness-Based Stress Reduction (MBSR) program, which he launched at the University of Massachusetts Medical School in 1979. Since that time, thousands of studies have documented the physical and mental health benefits of mindfulness, inspiring countless programs to adapt the MBSR model for schools, prisons, hospitals and beyond.
Different programs based on Mindfulness exist and have shown their efficacy. You can find some of them here :
MBSR : mindfulness based stress reduction. Helpful to people coping with stress, anxiety, depressive disorder,...
MBCT: Mindfulness based cognitive therapy. Program developed at the end of '90 by Zindel Segal, Mark Williams and John Teasdale to prevent depressive relapse. Inspired by MBSR, with accent put on cognitive improvement.
MBRP: Mindfulness based relapse prevention. Useful in the treatment of addictions.
MBCI: Mindfulness based compassion and insight training
MBDBT: Mindfulness-Based Dialectical Behavior Therapy, Used to help borderline patients.
MBCP - Mindfulness-Based Childbirth and Parenting
MBSR for Teens (MBSR-T) or MBCT for Children (MBCT-C)
But mindfulness can be used in much more fields (pain regulation, anorexia or bulimia, insomnia, hypertension... ). Be just careful not to practice this exercises with people suffering from acute psychosis, manic episodes, PTSD, or severe major depressive disorder with melancholic symptoms. Your patient should be stabilized before starting.
The programs are often taught in an eight-week workshop given by certified trainers that entails weekly group meetings (two-hour classes), a one-day retreat (six-hour mindfulness practice) and some homework (45 minutes daily).
Mindfulness therapy has shown growing attention in research.
Breath awareness: Bring attention to each breath
Body scan: Bring attention to body parts, from the toes and up towards the head
Sitting meditation: Meditate in a seated posture
Walking meditation: Walk with attention and careful pacing
Loving kindness (Metta) meditation: Send love and kindness to oneself and others
Passing thoughts and emotions: Notice and let go thoughts and feelings
Three-minute breathing: Be aware (1 minute), focus attention (one minute), and grow attention (one minute)
“Silence is for noise, what the shade is for light and what sleep is for awake: another essential side.” Dr Christophe André
“Drink your tea slowly and reverently, as if it is the axis on which the world earth revolves – slowly, evenly, without rushing toward the future; live the actual moment. Only this moment is life.” Thich Nhat Hanh
“In today’s rush, we all think too much — seek too much — want too much — and forget about the joy of just being.” Eckhart Tolle
“ Hi, i'm a psychiatry trainee in France. In third year of our medicine studies, I was lucky to follow a research course and to develop a short research program. I went to a department for patients who cope with alcohol abuse and searched into article databases information about how to help them to prevent relapse. I found the MBRP program. It was great, because it combined the benefits I felt in my personal meditation practice, with the medical field. I followed the 8-weeks MBSR Program and since then, I'm fond of Mindfulness, and discovered how much patients are also interested in it. Sometimes, before a psychiatric interview, i'm taking some time with them to do 5-min breathing exercise. It calms everyone down and the interview becomes often more interesting. Another exercise I like to practice, particularly with patients who are depressed and don't feel pleasure anymore, is mindful eating. Normally we do it with a dried grape but it also works really well with a peace of chocolate. Patients love it !”
some examples of apps: “Headspace” (free), “smiling mind” (free), “Stop, Breathe & Think” (free), “mindfully me” (free), “calm”, “mindfulness training app”
You can find a huge amount of books, here are some examples; some are sold with a CD:
“Mindfulness for beginners” , 2006, Jon Kabat-zinn
“The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness”, 2007, Williams, Taesdale, Segal and Kabat-Zinn
“Wherever you go, there you are”, 1994, Jon Kabat-Zinn
“The miracle of Mindfulness”, 1975, Thich Nhat Hanh
“Mindfulness for dummies”, 2014
A very well known specialist is Dr Christophe André; his website: www.christopheandre.com
2 famous books : “méditer jour après jour: 25 lecons pour mieux vivre en pleine conscience” ( + CD) and “méditer pour ne plus déprimer” ( + CD)
Another interesting book related with “mindfulness eating”: “Manger en pleine conscience: la méthode des sensations et des émotions" (+CD) writen by Dr Jan Chosen Bays
www.emergences.org rubrique “activités pleine conscience”
A well knows specialist: Edel Maex, l'hôpital ZNA Middelheim d'Anvers
2 good books: “Mindfulness: apprivoiser le stress par la pleine conscience : un programme d'entrainement en 8 semaines.” and “Werken met mindfulness Basisoefeningen”, Edel Maex
a website for training : www.mindfulness-belgium.net
Well known specialists: John Taesdale, Mark Williams www.mbct.co.uk
a well known specialist: Tania Singer
a well known autor :Alexandre Jollien “vivre sans pourquoi”, “Eloge de la faiblesse”
well known specialist: Zindel Segal
you can find a link for a national website on: www.eamba.net
Chapter writen by Kremers Laura, psychiatry trainee in Amiens, France