Academic journal article The International Journal of Behavioral Consultation and Therapy

Interpersonal Mindfulness Informed by Functional Analytic Psychotherapy: Findings from a Pilot Randomized Trial

Academic journal article The International Journal of Behavioral Consultation and Therapy

Interpersonal Mindfulness Informed by Functional Analytic Psychotherapy: Findings from a Pilot Randomized Trial

Article excerpt

The literature of the past decade has seen a dramatic increase of studies on clinical benefits of mindfulness practice (Chiesa & Serretti, 2009, 2011; Zgierska et al., 2009) in treating a range of psychological problems, including chronic pain (e.g., Kabat-Zinn, 1990), anxiety (e.g., Orsillo, Roemer, & Barlow, 2003; Hofmann, Sawyer, Witt, & Oh, 2010; Miller, Fletcher, & Kabat-Zinn, 1995), depressive relapse (e.g., Segal, Williams, & Teasdale, 2002; Teasdale et al., 2000), and addictive behaviors (e.g., Bowen & Marlatt, 2009; Brewer, Bowen, Smith, Marlatt, & Potenza, 2010; Vieten, Astin, Buscemi, & Galloway, 2010). Although there are varied definitions and practices based on both historical and contemporary traditions, mindfulness has been described as, "paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally" (KabatZinn, 1994). Meditation instructions typically involve sitting or walking in silence, either in group or individual settings, and attending to one's own immediate, primarily intrapersonal, experience. The current pilot randomized trial assessed the feasibility and efficacy of a brief mindfulness-based intervention informed by Functional Analytic Psychotherapy (FAP; Kohlenberg & Tsai, 1991; Tsai et. al., 2009) in which an interpersonal element was added to traditional practice.

FAP aims to improve interpersonal relationships through an experiential teaching of skills intended to increase closeness and connection with others. FAP focuses on interpersonal factors, positing that a major cause of psychopathology stems from problematic interpersonal relationships (e.g., Horowitz, 2004). One hindrance to improving closeness and connection is avoidance of openness and honesty in interactions with others. From a behavioral perspective, overcoming this avoidance often involves taking a risk by being more honest and open with others (Cordova & Scott, 2001). Termed "courage" in the FAP literature, this risk taking creates the possibility of improved and more satisfying relationships (e.g. Reis & Shaver, 1988; Rubin, Hill, Peplau, & Dunkel-Schetter, 1980). FAP also seeks to increase awareness, which includes the ability to view interpersonal interactions from multiple perspectives, allowing new interpersonal skills to emerge.

The present study used a two-phase intervention to evaluate a brief FAP-informed interpersonal meditation (FAP-IM). FAP-IM integrates intrapersonal mindfulness meditation practices, based on contemporary, secularized mindfulness practices used in therapies such as Mindfulness-Based Stress Reduction (Kabat-Zinn, 1990) and Mindfulness-Based Cognitive Therapy (Teasdale, et al., 2000), with Benson's Relaxation Response (Benson, 1975). Although there is some variation in these practices and their foci, we will refer to here them as "traditional meditation." Phase 1 of the current study focused primarily on breath meditation and relaxation techniques. Instructions included a body scan (becoming aware of physical sensations in the body), and attending to breath (noticing the sensations of the rising and falling of the chest or abdomen). Participants were instructed to notice internal and external stimuli, such as thoughts, feelings, bodily sensations, and sounds. It was suggested that, as best they could, they refrain from judgment, and allow experiences to naturally arise and pass, repeatedly returning attention to the chosen target when their attention wandered. For example, participants practiced bringing attention to the process of thinking. Rather than identifying with the content of thoughts, they were instructed to view them as leaves floating down a stream, observing them as they float in and out of awareness. If their attention was carried away by the content of a thought, they were instructed to notice the mind had wandered, allow their attention to remain with it for a moment, and then gently return their focus to the chosen focus. …

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