Mental Health Awareness Week: A more mindful approach to therapy

by Sarah Graham
Monday 11 May 2015
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The theme of this year's Mental Health Awareness Week is mindfulness, a practice which has seen an enormous growth in popularity in recent years and which, experts say, can have an enormously positive effect on your mental health and wellbeing.

Derived from Buddhist traditions, mindfulness is described as: "a way of paying attention to the present moment, [helping you to] become more aware of [your] thoughts and feelings so that, instead of being overwhelmed by them, [you]'re better able to manage them". It is often associated with practices such as meditation, yoga, and breathing exercises, and is used to help relieve depression, anxiety and other mental health conditions, as well as generally improving self-awareness and wellbeing.

Besides meditation and yoga, mindfulness can also play an important role alongside talking therapies, such as Cognitive Behavioural Therapy (CBT), psychodynamic therapy, and counselling. Of course, as with all mental health treatments, mindfulness may not be right for everyone, but we asked RSCPP therapists to explain how this approach can be used both in and alongside therapeutic practice to help you understand and tackle your mental health issues.

 

What is mindfulness? 

You've probably already heard a lot about mindfulness in the press - it's the stress relief technique du jour, practised by the likes of Gwyneth Paltrow, Emma Watson and Davina McCall, and offered in workplaces across the country. Comedian and mental health advocate Ruby Wax has even written a book, Sane New World, on mindfulness as a treatment for depression, after completing a Masters in Mindfulness-based Cognitive Therapy at Oxford University.

Like Ruby Wax, many RSCPP therapists believe mindfulness can play an important role in therapy for depression, stress, anxiety, and even more complex conditions like trauma and eating disorders. "Mindfulness is essentially about learning to be present in the moment," explains Accredited and Registered Counsellor Gavin Robinson. "While this is what a lot of therapy is about, mindfulness is perhaps more focused on this. Consequently, mindfulness can be brought into the therapy room in many subtle and also more direct ways."

Mindfulness is essentially about learning to be present in the moment.

He adds: "Whether it is by learning mindfulness skills to notice the beauty in day-to-day things, or by actually meditating every day in a more formal way, or by bringing this into therapy as part of the process, mindfulness can be very beneficial."

So how does it actually work? Accredited and Registered Counsellor and Psychotherapist John Threadgold defines mindfulness as "your ability to be aware, to notice, and to keep your issues company, without arguing with them, judging them, or agreeing or disagreeing them." For Gavin, it's like a workout to strengthen the mind, in the same way that going to the gym strengthens your body.

You may notice how often your mind wanders off into thoughts.

Key to mindfulness is learning to focus your attention and awareness on the 'here and now' of the present moment. For example, Registered Psychotherapist Jo Bailey explains, "if you practise mindfulness using your breath as an anchor, you may notice how often your mind wanders off into fantasy, thoughts about later that day, tomorrow, next week, something that happened yesterday, or a distressing event 10 years ago. If you gently bring your mind back to your present anchor each time you notice it wandering off, you are practising mindfulness."

She adds: "It doesn't matter how many times you wander off, it is the gentle 'bringing back' to the present that changes the way your minds work. In effect, it builds a calmer, more focused brain."

Practically speaking, mindfulness may involve paying attention to your physical environment - the floor or chair supporting you, your breath, the feelings within your body, or the colours, shapes, smells and textures of your surroundings.

Be an observer of yourself, without passing judgement.

It "encourages you to be an observer of yourself, not passing judgement on what is occurring, but accepting it, allowing it to express itself and move on," explains Accredited and Registered Counsellor and Psychotherapist Kate Palmer.

 

What does mindfulness have to do with therapy?

This all sounds great, I hear you thinking, but how does that fit in with therapy? Indeed, meditation and yoga aren't necessarily the first things that spring to mind when you think of talking therapies. When you're tackling mental health conditions like depression or anxiety, how can being aware of yourself and your surroundings really help?

As Accredited and Registered Counsellor and Psychotherapist Gill Brennan explains, "whilst mindfulness is not a way to explore how you have become distressed, it is a way of checking in with your thoughts and feelings, accepting them, and learning simple and often brief, breathing meditation techniques to help to regulate those feelings."

Mindfulness is not a way to explore how you have become distressed.

This is perhaps why mindfulness is more commonly associated with treatments such as Cognitive Behavioural Therapy (CBT), which focuses on your present thoughts, feelings and behaviours, rather than more psychoanalytical or psychotherapeutic treatments, which tend to focus on the root causes of your problems, such as past traumas or disturbances in your relationships.

That said, we know that RSCPP therapists use mindfulness alongside a huge range of different therapeutic approaches and many, like Gill, believe that: "practised regularly, it can help to maintain mental good health and prevent relapses of mental ill health."

Take Accredited Counsellor and Psychotherapist Jaimie Cahlil, who says: "Mindfulness, a profoundly empowering and healthy attitude to being and living, is a core ingredient in traditional Buddhist teachings and practice."

Mindfulness helps you to anchor and stabilise yourself.

He adds: "If a person is in a particularly unstable psychological state, I find teaching simple physical, present moment mindfulness helps them to anchor and stabilise themselves, as it offers basic clarity and calming reassurance."

 

What types of mental health treatment can mindfulness be used with? 

Many therapists teach their clients mindfulness techniques, both as a way of exploring their thoughts and feelings within the therapy room, but also as a self-help technique that clients can take away with them, for coping and connecting with their thoughts and feelings outside of the therapy room.

RSCPP therapists report that mindfulness practice and skills have helped their clients cope with a huge range of issues, including: depression, anxiety, panic attacks, Obsessive Compulsive Disorder (OCD), addictions, trauma, chronic pain, stress, eating disorders, personality disorders and relationship problems.

You learn to notice what is going on in a wise, non-judgemental way.

"Mindfulness heightens awareness and wisdom, which helps clarify your thinking and feelings, so you can have a greater emotional intelligence in relating to others, in trying to deal with life's problems and difficulties, and in treasuring enjoyable moments," Gavin says. "You learn to notice what is going on in a wise, non-judgemental way, so that new decisions can be learnt in the new moments and you can use your past wisely, so that each moment is as fresh as possible and you learn not to hold onto the past when this is not helpful."

As a result, mindfulness may be used with any number of therapies, including CBT, Eye Movement Desensitisation Reprocessing (EMDR), psychodynamic therapy, and more. John offers person centred therapy in the counselling room and mindfulness practice outside the therapy room, Jaimie combines mindfulness with integrative-transpersonal psychotherapy, and Accredited and Registered Counsellor and Psychotherapist David Monks uses mindfulness to enhance his work as a therapist trained in Jungian and psychodynamic appraoches.

Indeed, as Jo says, "The great thing about mindfulness is that it can be used in conjunction with a number of therapeutic approaches." She adds: "For instance, the focus on the here and now is useful to help clients leave traumatic pasts behind them. As an integrative therapist, I teach clients techniques to help them calm their anxiety between sessions. This is helpful for clients with traumatic histories as they may not have been helped to self-soothe in healthy ways during their childhoods."

Mindfulness can be used with a number of therapeutic approaches.

Similarly, Registered Psychotherapist Tara Economakis says: "I often begin a session with three moments of assisting my clients to ground themselves in this moment - to feel their feet on the floor, to notice their body becoming heavy in the chair, to bring their attention to a hand, a finger, or even just the touch of their eyelids as the top ones rest on the bottom ones."

She adds: "It is like coming home to themselves, and the work that follows is so much more enjoyable, relevant and powerful. I also encourage them to return to themselves for three minutes a day, and clients discover a joy and completeness in this process."

 

How do mindfulness and talking therapies complement each other?

Fundamentally, "mindfulness complements talking therapies by making you better able to understand your experience, and by allowing you to step back from painful cycles of anxious and depressive thoughts or feelings," Kate says.

"Mindfulness is increasingly used in counselling and psychotherapy to help clients become more curious about their body sensations, behaviour, thoughts and feelings. However, psychotherapy and counselling are also relationship-based processes, so incorporating the concept of 'embedded relational mindfulness' is important," Registered Counsellor and Psychotherapist Lynn Barnes explains.

"Unlike in traditional mindfulness, where only the client is aware of their internal processes, embedded relational mindfulness helps the client and therapist to become aware of the client's internal processes," she adds. "This approach helps the client to gain awareness of the present moment without judgement, and sharing their thoughts, feelings, and body sensations with the therapist also helps create a high emotional connection."

Sharing thoughts and feelings with a therapist creates an emotional connection.

For John, the use of person centred therapy "helps clients feel accepted without conditions attached, and provides a safe place where clients can explore issues safely, feel understood and accepted." Mindfulness both inside and outside of the therapy room therefore "helps clients to stabilise themselves in the midst of that change," he says.

Likewise, Gill says: "My therapeutic approach is focused on a supportive relationship with my clients, so mindfulness is a tool I can offer clients for their own self-help."

In David's experience, "clients appreciate mindfulness as something practical, quick and accessible that they can apply in any moment to make a difference." He uses the three minute breathing space technique, as defined by Jon Kabat Zinn, enabling clients to take the time to tune in to what is happening in the present moment and look at ways of reaching forward into the next."

He adds: "Working with clients in the depths of anxiety and, increasingly, with issues surrounding anger management, I have found that mindfulness not only brings relief but also opportunities for choice of action and response."

You can find out more about mindfulness at BeMindful.co.uk, and join in the Mental Health Awareness Week conversations on Twitter using #MHAW15.


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Updated 20 May 2015