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Cart items. Toggle navigation. Stock photo. Search Results Results 1 -5 of 5. Academic Press. Textbooks may not include supplemental items i. More recently, mindfulness-based treatment approaches have been successfully utilized to treat anxiety, depressive relapse, eating disorders, psychosis, and borderline personality disorder.

This book discusses the conceptual foundation, implementation, and evidence base for the four best-researched mindfulness treatments: mindfulness-based stress reduction MBSR , mindfulness-based cognitive therapy MBCT , dialectical behavior therapy DBT and acceptance and commitment therapy ACT. All chapters were written by researchers with extensive clinical experience.

Each chapter includes the conceptual rationale for using a mindfulness-based treatment and a review of the relevant evidence base.

Mindfulness-Based Treatment Approaches

Interventions based on the practice of mindfulness meditation and related skills are increasingly popular and empirical support for their efficacy continues to grow. This introductory chapter provides a general overview of MBSR and MBCT in their standard forms, with emphasis on their mindfulness and acceptance-based skills, practices, and exercises.

Mechanisms through which mindfulness training leads to beneficial outcomes are briefly discussed and important questions remaining for future research are considered. Building on the foundation provided by this introductory chapter, the remaining chapters describe adaptations and new interventions for specific populations. Each chapter includes theoretical foundations, a summary of empirical support, and a case study illustrating a typical course of treatment and practical issues that arise in implementing it.

From a Western psychological perspective, mindfulness is typically defined as a form of nonjudgmental and nonreactive attention to experiences occurring in the present moment, including bodily sensations, cognitions, emotions, and urges, as well as environmental stimuli such as sights, sounds, and scents Kabat-Zinn, ; Linehan, a.

Most Western discussions of mindfulness acknowledge its roots in Buddhist meditation traditions, which for many centuries have maintained that the practice of mindfulness facilitates insight into the nature of human suffering and develops adaptive characteristics such as wisdom, equanimity, compassion, and well-being. Instruction in mindfulness has become widely available in Western society. Meditation centers in North America and Europe offer retreats in the Buddhist traditions with guidance and instructions in mindfulness practices.

Numerous books about mindfulness and meditation are available for the general audience e. Of most importance to the present volume is the rapidly growing array of mental health treatment and stress-reduction programs based on secular adaptations of mindfulness training, several of which now have extensive empirical support for their efficacy in a wide range of populations.

Mindfulness has been conceptualized as a state, as a trait-like or dispositional quality, and as a set of skills. The first component is the intentional self-regulation of attention so that it remains focused on present-moment experiences i. The second component is an attitude of openness, acceptance, and curiosity toward whatever arises. In general, a person in a mindful state is intentionally and flexibly aware of and attentive to the ongoing stream of internal and external stimuli occurring in each moment, and is observing them with a stance of openheartedness, interest, friendliness, and compassion, regardless of whether they are pleasant, unpleasant, or neutral.

The skills training approach to mindfulness, which characterizes the treatments described in this volume, suggests that with the regular practice of a variety of exercises, people can learn to be more observant, accepting, and nonjudgmental of their daily experiences and to participate with awareness in their ongoing activities. That is, they learn to adopt a mindful state more often and more consistently across situations and over time.

The evidence suggests that practicing mindfulness leads to increases in general tendency to be mindful in daily life and to improvements in mental health. Empirically supported mindfulness-based interventions include many methods for teaching mindful awareness. Some of these are formal meditation practices, in which participants sit quietly for periods of up to 45 minutes while directing their attention in specific ways.

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Others are shorter or less formal exercises emphasizing mindfulness in daily life, in which participants bring mindful awareness to routine activities such as walking, bathing, eating, or driving. Several general instructions are common to many formal and informal mindfulness practices. Often, participants are encouraged to focus their attention directly on an activity, such as breathing, walking, or eating, and to observe it carefully. They are invited to notice that their attention may wander into thoughts, memories, or fantasies. When this happens, they are asked to note briefly that the mind has wandered, and then gently return their attention to the present moment.

If bodily sensations or emotional states arise, participants are encouraged to observe them carefully, noticing how they feel, where in the body they are felt, and whether they are changing over time. Brief covert labeling of observed experience, using words or short phrases, such as aching, sadness, thinking, or wanting to move is often encouraged.

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Some mindfulness exercises encourage observation of environmental stimuli, such as sounds, sights, or smells. Participants are encouraged to bring an attitude of friendly curiosity, interest, and acceptance to all observed phenomena, while refraining from evaluation and self-criticism and noticing these nonjudgmentally when they occur , or attempts to eliminate or change what they observe. For example, no attempt is made to evaluate thoughts as rational or distorted, to change thoughts judged to be irrational, to get rid of unwanted thoughts, or to reduce unpleasant emotions or sensations.

Rather, cognitions, sensations, and emotions are simply noted and observed as they come and go. The previous edition of the current book included chapters on all four of these treatments. Currently, the literature is so large that it is no longer practical to cover all four of these interventions in one volume. Applications for nonclinical populations seeking stress reduction and enhanced well-being are also covered. The remainder of this introductory chapter provides a general overview of MBSR and MBCT in their standard forms, with emphasis on their core skills, practices, and exercises.


This will prevent redundancy across chapters in basic descriptions of the primary practices, freeing the subsequent authors to focus on adaptations or new exercises developed for their specific population, detailed accounts of how their participants respond to the treatment, empirical support for the efficacy of their treatment, and practical issues in implementing it.

MBSR Kabat-Zinn, , , is based on intensive training in mindfulness meditation and was developed in a behavioral medicine setting for patients with chronic pain and stress-related conditions. In its standard form, it is conducted as an 8-week class with weekly sessions lasting 2. An all-day intensive mindfulness session is often held during the sixth week. Extensive homework practice of mindfulness exercises is encouraged.

Classes may include up to 30 participants with a wide range of disorders and conditions. Rather than grouping participants by diagnosis or disorder, MBSR has traditionally included people with a wide range of problems in each group, emphasizing that all participants, regardless of disorder, experience an ongoing stream of constantly changing internal states, and have the ability to cultivate moment-to-moment awareness by practicing mindfulness skills.

Many MBSR programs begin with an individual or small-group orientation and assessment session, in which the group leader explains the rationale and methods of the course and encourages potential participants to ask questions and to discuss their reasons for participating. A wide variety of mindfulness exercises is taught. Didactic information about stress is incorporated, including topics such as stress physiology, responding to stress, and effects of appraisals on perceptions of stress.

The group leader gives everyone a few raisins and asks participants to simply look at them, with interest and curiosity, as if they have never seen such things before. Participants are then guided through a slow process of observing all aspects of the raisins and the process of eating them. First, they visually examine a raisin, paying careful attention to all aspects of its appearance.

Then they notice its texture, smell, and how it feels between the fingers. Next they put it slowly into their mouth, noticing the movements of the body while doing so. This is followed by feeling the raisin in the mouth, biting it, noticing the taste and texture, and observing the sensations and movements of the mouth and throat in chewing and swallowing the raisin. When thoughts or emotions arise during the exercise, participants are asked to notice them nonjudgmentally and return attention to the raisin. The raisin exercise provides an opportunity to engage mindfully in an activity often done on automatic pilot, or without awareness.

Many participants report that the experience of eating mindfully is very different from their typical experience of eating, in which attention is focused elsewhere and the food is not really tasted. These comments illustrate the general point that paying attention to activities that normally are done on automatic pilot can significantly change the nature of the experience.

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Increased awareness of experience can lead to increased freedom to make choices about what to do in a variety of situations. Participants are encouraged to eat a meal mindfully during the week following session 1. Participants are invited to lie on their backs, or to sit comfortably in their chairs, with their eyes closed.

Over the next 40 minutes or so, they are guided in focusing their attention on numerous parts of the body in sequence, often beginning with the toes of one foot and moving slowly up the leg, then slowly through the other leg, torso, arms, neck, and head. With each body part, participants are instructed to notice the sensations that are present with openness and curiosity, but without trying to change them.

If no sensations are noticeable, they simply observe the absence of sensations. This exercise differs from traditional relaxation exercises in that participants are not instructed to try to relax their muscles. If any part of the body is tense, they simply notice, as nonjudgmentally as possible, that it is tense. If they feel an ache or pain, they are asked to observe its qualities as carefully as they can. When their minds wander, which is described as inevitable, they are asked to notice this as best they can and gently to return attention to the body scan, without self-criticism or blame.

The body scan is practiced during sessions 1, 2, and 8, and is assigned for homework practice during the first 4 weeks. Participants are provided with recordings to guide their home practice. The body scan provides an opportunity to practice several important mindfulness skills: deliberately directing attention in a particular way; noticing when attention has wandered off and returning it gently to the present moment; and being open, curious, accepting, and nonjudgmental about observed experience, regardless of how pleasant or unpleasant it is.

Several common experiences can be used to make these points during the discussion that follows the body scan. For example, some participants will worry about whether they have done it right. It is important to point out that there is no such thing as success or failure in the body scan, as there is no goal to achieve any particular outcome, such as becoming relaxed. Participants may also perceive obstacles to completing the body scan, such as sleepiness or restlessness, the mind wandering, aches or pains, or emotional states.

These experiences do not mean that the exercise was unsuccessful. The task is simply to notice whatever is present without judgment. Participants sit on a chair or meditation cushion in a comfortable posture that is both alert and relaxed. Generally, the back is relatively straight and aligned with the head and neck. Eyes can be closed or gazing downward. Participants first direct their attention to the sensations and movements of breathing. When the mind wanders off, which may occur frequently, they gently return their attention to breathing.

After several minutes, the focus of attention may be shifted to bodily sensations. As best they can, participants are instructed to notice these nonjudgmentally and with acceptance, bringing an attitude of interest and curiosity even to unpleasant sensations. When possible, urges to move the body to relieve discomfort are not initially acted on. Instead, participants are invited to observe the discomfort with acceptance.

If they decide to move, they are encouraged to do so with mindful awareness, noticing the intention to move, the act of moving, and the changed sensations resulting from having moved. Sitting meditation also may include a period of listening mindfully to sounds in the environment. Participants are encouraged to notice the tone quality, volume, and duration of the sounds, without judging or analyzing them, and to observe periods of silence between sounds.

Next, the focus of attention may shift to thoughts. Participants are instructed to observe their thoughts as events that come and go in their field of awareness and to note thought content briefly without becoming absorbed in it. A similar approach is taken to emotions that may arise. Participants practice observing these, briefly noting the type of emotion they are experiencing anger, sadness, desire , and noticing any thoughts or sensations associated with the emotion. In later sessions, sitting meditation may end with a period of choiceless awareness, in which participants notice anything that may enter their field of awareness bodily sensations, thoughts, emotions, sounds, urges as they naturally arise.

Sitting meditation is practiced during sessions 2 through 7, for periods ranging from 10 to 45 minutes, and is assigned for homework most weeks. Recordings for guided practice are provided. Slow, gentle Hatha yoga cultivates mindful awareness of the body while it is moving, stretching, or holding a position. The movements are readily adjustable for participants with varying levels of strength and mobility and are practiced with moment-to-moment awareness of the sensations in the body and of breathing.

Participants are encouraged to observe their bodies carefully, to be aware of their limits, to avoid forcing themselves beyond their limits, and to avoid striving to make progress or reach goals, other than moment-to-moment awareness of the body and breathing. Thus, yoga is conceptualized as a form of meditation rather than physical exercise, although strength and flexibility may gradually increase.

Mindful movement provides the opportunity to practice nonjudgmental observation and awareness of the body and acceptance of the body as it is. Participants sometimes report that during yoga practice, they are better able to maintain a state of relaxed alertness than during the body scan and sitting meditation, which may induce boredom or sleepiness. Yoga is practiced in session 3 and assigned for homework in weeks 3—6. Participants are provided with recordings to guide their practice.

Slow, deliberate walking provides another way to practice focusing on the sensations in the body while moving. The gaze is generally straight ahead, rather than looking down at the feet. Attention is directed to the movements, shifts of weight and balance, and sensations in the feet and legs associated with walking. As in other meditation exercises, participants are encouraged to notice when their minds wander off and gently to bring their attention back to the sensations of walking.