In this episode of Mindfulness Off the Cushion, we continue on our journey to understand and apply the healing techniques of mindfulness, with special guest Dr. Richard Sears as our guide. Today, we will explore how mindfulness has grown to become integrated into modern-day therapy and how the practice impacts various presenting issues that patients bring to their therapy sessions. Along the way, we’ll offer up examples of scientific findings correlating mindfulness with physiological changes in our brains, as well as methods we can use to overcome overwhelming thoughts and feelings. Let’s get started.
What are Presenting Issues?
Before diving into the impact mindfulness can have on our lives, let’s pause to identify a working definition of the term presenting issues. Presenting issues can be thought of as an industry term, a shorthand way in which those in therapy and the general field of psychology refer to the symptoms people bring to their therapists or mental healthcare providers. Presenting issues are often commonly referred to as presenting problems, but the essence is the same.
What are some frequently cited reasons why you or I might seek out the help of a qualified therapist?
Depression
Anxiety
Grief and loss
Chronic pain
Stress
Burnout
Mood changes
Trouble coping with life changes
These reasons make up just the tip of the iceberg when it comes to presenting issues, and nearly all of us will experience one or more in the course of our lifetimes. Next, let’s take a look at what might attract patients to mindfulness as a way to deal with their presenting issues in the therapeutic setting.
Why Mindfulness?
Mindfulness has seen an upward trend in America, but that trend reaches back much further than the relatively recent event of social media and mindfulness influencers. Dr. Sears takes us back to the 1960s and 1970s when pre-internet spiritual influencers like Ram Dass and Alan Watts expounded on the benefits of being alive in the present moment. The works of these and other American spiritual teachers helped to revolutionize American spirituality by making Eastern wisdom traditions more accessible to American minds.
The figure who really sought to help people in a controlled, research-driven way was Jon Kabat-Zinn. We refer to Kabat-Zinn frequently in this podcast. As the founder of the Mindfulness Based Stress Reduction (MBSR) program in 1979, Kabat-Zinn revolutionized the use of mindfulness as a non-pharmacological treatment for a variety of health-related presenting issues. Decades of controlled studies and clinical research have demonstrated that MBSR not only reduces stress but also improves conditions ranging from mood regulation to chronic pain associated with terminal illnesses, to diabetes, psoriasis, and lowering blood pressure. Part of the work involved with proving the efficacy of MBSR in these studies includes measuring brain activity in order to demonstrate changes that occur in the very structure of the organ.
But why would we want to change our brains? And why are our government and research institutions - in addition to corporations - increasingly interested in investing in this mindfulness research?
While we speculate on several factors in our discussion, the general consensus comes down to this - people want help overcoming their stress. With decades of clinical research backing up what was once considered an esoteric practice, we’re increasingly recognizing that mindfulness is just one tool to help optimize our lives. So, where does therapy come in on this quest for human optimization?
Therapeutic Applications of Mindfulness
With more factors that can detract from our attentional processes around than ever (hello, smartphones), we are constantly searching for changes we can make to enhance our ability to calmly connect with the present moment. It's well understood that, in terms of human performance and productivity, maintaining calm presence of mind despite stressors and distractions is a critical skill to develop. There’s good reason why so many organizations are increasingly buying into the concept of mindfulness in the workplace.
On a more individual level, however, mindfulness has long played a major part in mental health therapy - even if it was not always recognized as such. For example, one treatment modality, Cognitive Behavioral Therapy (CBT), predates MBSR by well over a decade and focuses on providing thought-based solutions to troubling issues. More generally speaking, it makes good sense that for a therapeutic session to be of value, the ability to be present with your emotions, bodily sensations, and arising thoughts can allow for a much more direct discussion to take place.
CBT also taught us something simple that has had profound implications on the successful outcomes of therapy patients - our thoughts affect the way we feel. When we realize that:
our thoughts are fleeting
our thoughts are products of our minds
we can change our minds
and we can change our thoughts
we discover that we can also change the way we feel. Of course, this discovery comes with an oft-cited caveat. Sometimes, we think ourselves into a rut, internally arguing with ourselves over the undesirability of certain thoughts and in turn, certain emotions. This hyper-awareness of the processes that occur in our minds can become temporarily debilitating. When this happens, a mindfulness-based approach known as decentering comes in handy. With a decentered approach, we learn to view our thoughts from an objective, yet non-judgmental perspective. This shift, in turn, can soften our emotions.
The important thing to note here is that the need for de-centering does not imply that our thoughts are not important. Rather, it tells us that our thoughts do not make our reality.
Let’s repeat it another way: thinking is a representation, not reality itself.
Our thoughts are just thoughts.
Conclusion
Sometimes, you may not feel adequately equipped to practice decentering or other mindfulness practices on your own. Be sure to tune in to this episode of Mindfulness Off the Cushion to follow along towards the end of the episode for a beneficial guided meditation. This is also where just getting your thoughts off your chest -- ideally, with a qualified therapist -- can help you achieve a feeling of relief. An objective professional can offer that extra sense of distance that is so needed when thoughts overwhelm us. Request an appointment with the Austin Mindfulness Center if you need help.
Listen to the Mindfulness Off the Cushion podcast and learn how to be as alive as you can be while you have the chance!