Mindfulness and Self-Development in Psychotherapy
Segall, Seth Robert, Journal of Transpersonal Psychology
ABSTRACT: This article explores how the Buddhist concept of mindfulness and techniques for fostering it can, when expropriated by Western clinical psychology, play a valuable role in self-development in psychotherapy. Mindfulness practice expands the field of awareness, allowing for improved monitoring of somatic and affective experiencing, and thereby enhancing the capacity for self-regulation of arousal, affect, and behavior. It facilitates the development of a sense of embodiment and the capacity to tolerate and accept painful experience. It promotes the self-monitoring and decontextualization of automatic thoughts that serve to sustain pathological structures. Mindfulness also facilitates the development of inner resources that help stabilize affect and reduce impulsivity. Case examples of the use of mindfulness-based techniques in individual and group therapy sessions illustrate these points.
Mindfulness is a skill derived from Buddhist meditative practice that the scientific literature suggests may be of benefit in the symptomatic relief of chronic pain (Kabat-Zinn, 1982; Kabat-Zinn, Lipworth, & Burney, 1985; Kabat-Zinn, Lipworth, Burney, & Sellers, 1985; Kabat-Zinn et al., 1986) and anxiety (Kabat-Zinn et al., 1992; Miller, Fletcher, & Kabat-Zinn, 1995; Roemer & Orsillo, 2002; Toneatto, 2002), the prevention of relapse in recurrent depression (Teasdale et al., 2000; Segal, Williams, & Teasdale, 2002; Ma & Teasdale, 2004), the treatment of addictive disorders (Marlatt, 2002; Breslin, Zack, & McMain, 2002; Kavanaugh, Andrade, & May, 2004; Marlatt et al., 2004), borderline personality disorder (Linehan, 1993; Robbins, 2002), binge eating disorder (Kristeller, 2003b), body image disorder (Stewart, 2004), posttraumatic stress disorder (Urbanowski & Miller, 1996; van der Kolk, 2002), and stress-related medical disorders such as psoriasis (Kabat-Zinn et al., 1998). Mindfulness may also be of value in improving quality of life in cancer (Speca et al., 2000; Carlson et al., 2003) and traumatic brain injury patients (Bedard et al., 2003), and in supporting immune system function (Robinson, Mathews, & Witek-Janusek, 2003; Davidson et al., 2003). It has also been of suggested value in increasing positive hedonic tone in non-clinical populations (Easterlin & Cardeña, 1999; Davidson et al., 2003), reducing stress in professional caregivers (Shapiro, Schwartz, & Bonner, 1998; Rosenzweig et al., 2003; Cohen-Katz et al., 2005a; Cohen-Katz et al., 2005b) and promoting changes in brain function (Davidson et al., 2003) and structure (Lazar et al., 2005). Efforts have also been made to extend the use of mindfulness meditation to populations that span the age spectrum from childhood (Ott, 2002; Wall, 2005) through old age (McBee, 2003; Smith, 2004).
Ruth Baer (2003) reviewed the experimental literature on the quantitatively assessed value of clinical mindfulness applications and concluded that ''mindfulness-based interventions may help alleviate a variety of mental health problems and improve psychological functioning'' (p. 139). A meta-analysis of mindfulness studies (Grossman et al., 2004) also supported the value of mindfulness-based stress reduction in a broad range of chronic disorders. Future quantitative studies of mindfulness will no doubt be aided by current efforts to develop scales for the measurement of mindfulness such as the Toronto Mindfulness Scale (Bishop et al., 2003) and the Kentucky Inventory of Mindfulness Skills (Baer, Smith, & Allen, 2004). In addition, several recent review articles have suggested directions for future research from both a cognitive-behavioral point of view (Dimidjian & Linehan, 2003) and a humanistic/transpersonal point of view (Shapiro & Walsh, 2003).
Transpersonal psychologists (c.f., Weide, 1973; Boorstein, 1983; Kasprow & Scotton, 1999) were the earliest pioneers in exploring how meditation and mindfulness practice might contribute to the process and outcome of psychotherapy. …