The use of mindfulness in therapy

The term 'mindfulness' is everywhere. What is it and why is everyone talking about it?

Mindfulness is about noticing exactly that; when our minds are full. This article explores what mindfulness is and how we can use it in everyday life, as well as in therapy, to help ease the symptoms of anxiety and depression.

How many times have you driven somewhere and realised that you had no idea how you got there? You had no recollection of the drive, red lights, stop signs, or pedestrians. Maybe you were running through this morning’s meeting or your shopping list? You were on autopilot and completely lost in thought. Or, how many times have you acted on impulse and, afterwards, thought to yourself that you had no idea why or what on earth you were thinking, never mind feeling at the time?

Mindfulness encourages us to live in each moment so that we spend less time ruminating on the past or present. The past is where depression dwells and the future can be where anxiety sits. We may ruminate about the past, metaphorically beating ourselves up about what we 'should' have done. Our internal voice or inner critic becomes loud, telling us that we are useless or worthless, and before we know it we are spiralling down into low mood or depression, which in turn makes our self-talk even worse. Or, we become anxious or fearful of the unknown, so that anything we may have to do that takes us out of our comfort zones induces anxiety. Mindfulness allows us to focus on moment to moment thoughts and emotions and allows us to reflect more deeply on moment-to-moment awareness.

So, what is mindfulness?

Very simply, mindfulness is about focusing on each breath entering and leaving the body. We notice thoughts and feelings as they come, without attaching meaning or judgement to them. We develop an open curiosity about our thoughts and feelings and allow them to come and go. Almost as if we are bystanders to them instead of being carried along and lost in them. And that’s it. Sounds simple? It’s not.

As anyone who has tried it will tell you, those thoughts come and, before you know it, minutes have passed and you've got lost in a story. Or you feel bored, restless, and start thinking about that 'to-do' list. But that is the point. That is just your mind telling you that you should be elsewhere - do we always have to follow what our thoughts tell us? Notice how many times you get pulled away from just focusing on the breath and you will realise just how much of a monkey mind you have. One of the benefits of practising mindfulness is that it strengthens everyday concentration. Research has shown that improved attention can last for up to five years after developing mindfulness-based practice.

Neuroscience research has also discovered that meditation can reduce activity in our amygdala’s (the emotion centres of our brains that fire up when we feel high emotions like fear or anxiety). Practising mindfulness can strengthen the connection between our amygdala and pre-frontal cortex (the thinking, rational parts of our brain). The implications of this are very useful for treating anxiety and depression. In anxiety, our amygdala is constantly firing up, signalling to us that there is a threat somewhere. If the threat is high, then the thinking part of our brains will shut down for us to go into the fight, flight, or freeze response. However, if we practise mindfulness and help these parts of our brains become less reactive to stressors, then this will be beneficial.

The use of mindfulness in counselling and psychotherapy can be found to help depression and anxiety. It allows us to first notice what we are feeling and thinking. All too often, we are not aware of what we feel. We just know that we don’t feel right. Some counsellors will ask clients to become curious about what they are feeling. They'll guide the client to notice any feelings, where that feeling sits inside the body; what does it look like, how does it feel? Just becoming close to the feeling can be enough to shift the sensation. When we turn away from feelings or try to push them down then those ignored feelings can sometimes turn into anxiety or depression; how many times have you drank or binged in order not to feel? Have you noticed that trying to numb the feelings in this way hasn’t helped?

Tara Brach in Radical Acceptance states "the key to awakening from the bonds of fear is to move from our mental stories into immediate contact with the sensations of fear. While the mind will continue to generate thoughts about what we fear, we recognise thoughts for what they are and drop under them, again and again, to connect with the feelings in the body".

It may also be that other emotions that you never realised were there may surface, and that’s OK. We can explore that in counselling and find some answers to what is bothering you. Mindfulness allows us to calm our thoughts, slow down, and notice. In this way, we can begin to deal with our worries and anxieties little by little.

References and further reading

• The State of Mindfulness Science
• Williams et al. (2007) The Mindful Way through Depression. Guilford Press.
• Brach, T (2003) Radical Acceptance. Bantam Books.
• Chodron. P (2007) When Things Fall Apart: Heart Advice for Difficult Times. Element Books.