Mindfulness: Meditation vs. Skill Set
February 6th, 2008 | Email this to your Friendsby Lisa Dale Miller, LMFT
Click here to contact Lisa and/or see her GoodTherapy.org Profile
As a long term yogic and vipassana meditator, and a mindfulness-based psychotherapist who regularly teaches meditation practices to my patients, I find the growth of mindfulness as a clinical intervention very timely. Last year, I attended two conferences focused on the use of mindfulness as a clinical intervention: “Meditation and Psychotherapy” at Harvard Medical School and “Mindfulness and Psychotherapy” at UCLA.
Interestingly, the conference at Harvard featured a greater percentage of presenters who do not use meditation as an intervention in their clinical work. For them, mindfulness is a teachable skill set, extrapolated from a way of viewing life gained from sustained Buddhist meditation practices. These presenters included: Steven Hayes, founder of ACT, Lizbeth Roemer, U Mass GAD researcher and clinician, Tal Ben-Shahar, Harvard Lecturer on Positive Psychology, and Jayme Shorin, LICSW, sensorimotor trainer. The fact that the organizers of the Harvard conference felt it necessary to devote over half of the presentation time to methodologies that do not include meditation was, for me, significant.
Though this might be expected at a “Mindfulness and Psychotherapy” conference, in fact the UCLA conference featured more presenters discussing the use of meditation and compassion practices as a clinical intervention. These presenters included: Thich Nhat Hahn, Vietnamese Buddhist monk and meditation teacher, Jack Kornfield, Tara Brach, Harriett Kimble Wrye, and Trudy Goodman, all psychologists and meditation teachers, and Dr. Daniel Siegel & Harvard neuroscientist Sara Lazar presenting the neurobiology of meditation.
Due to the continuing trend in mental health toward brief, CBT methods and away from depth-oriented, psychodynamic therapies, one can easily see how a reduction of “mindfulness” to an easily deliverable skill set would be a natural outcome of the environment in which it is delivered. But is the doing away with meditation practice psychotherapeutically wrong or ineffective? Not necessarily.
Even in the East, Karma Yoga is an example of a path to liberation which eschews formal meditation practice in favor of a commitment to the work one does in the world as spiritual practice. Also, with neuroscience showing significant brain changes from long-term mindfulness meditation, one can easily see how a researcher like Steven Hayes could create mental exercises that simulate, through active questioning of the validity of language, the realization of the contextual nature of the self., i.e., “Am I really these thoughts and beliefs that my mind continually comes up with?”
Years of meditation cultivates a natural non-reactivity to experience. But why wait years, when simple instructions for distress tolerance, like those featured in DBT can be dispensed to patients suffering from emotion dysregulation? Following in the footsteps of ACT is Acceptance-based psychotherapy which focuses on delivering skills for realizing and accepting here and now experience with compassion; something vipassana meditation and metta practices are well documented at cultivating in long-term practitioners. Yet again, why practice meditation at all when mindfulness skills can be learned and behaviors changed?
Additionally, it must be acknowledged that most psychotherapists will not want to learn and commit to a daily mindfulness meditation practice, or be trained to teach mindfulness meditation. Therefore, it may be more desirable and practical in clinical settings to deliver a CBT-like mindfulness skill set rather than teach meditation
In light of all these benefits, what do we lose in clinical practice when we allow instruction of vipassana/mindfulness meditation to fall into disfavor or become outmoded? The following list is my best guess at an answer to this question:
1.The long and short term stress-reducing physical effects of meditation
2.The plethora of profoundly, positive neural changes evidenced in the brains of long term vipassana/Tibetan Buddhist meditators
3.The deep emotional healing that comes from metta/forgiveness/compassion meditation practices
4.The benefits of setting aside time in our busy lives for silence, meditation and contemplation
5.The cultivation of peacefulness
6.The deepening of connection with and respect for our planet and all living things upon it, which naturally arise from sustained meditation practice
7.The shared joy of a community of meditators; whether traditional sanghas or 8-week mindfulness-based groups like Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy for Depression Relapse Prevention (MBCT), or Mindfulness-Based Relapse Prevention for addiction recovery (MBRP).
I have seen patients experience radical change from incorporating mindfulness meditation and mindfulness skills into their daily lives and I am excited to offer MBRP, a mindfulness-based intervention for addiction relapse prevention in San Jose, CA in March 2008. Please contact me for more information.
©Copyright 2008 by Lisa Dale Miller, LMFT. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Lisa and/or see her GoodTherapy.org Profile
February 7th, 2008 at 5:59 am
I’ve never practiced meditation before. I guess I fear that I might be bored. Is this a common mindset? What, if any, flawed thoughts are present in this fear?
February 7th, 2008 at 6:02 am
I am so glad there are those like the author who still adhere to meditative practices. It is very sad to see the practice of psychotherapy going the way of so many other American institutions. If we as a society can boil something down to a few steps, throw some statistics at it, and teach it in a one day seminar, it suddenly becomes the latest and greatest thing. In this case, as probably in most others, this boiling down makes for a practice that is unrecognizable from its original. And, no, Mary, meditation is not boring. As long as you take the time to really whole heartedly embrace meditation, you’ll find it anything but boring.
February 7th, 2008 at 6:03 am
I agree that what I call experienced meditation is not boring. But, inexperienced meditation often can be. If you want to really derive meaning from meditation, you have to be willing to commit yourself to the process on a long term basis.
February 7th, 2008 at 6:05 am
I personally think that meditation is way overrated. It is so much more effective to work with someone on understanding the root of his or her behavior rather than telling someone to sit quietly for 30 minutes. If clients don’t understand why they behave the way they do, how are they to change it?
February 7th, 2008 at 6:07 am
While it is imperative that people come to understand why they do what they do, meditation can play a key role in helping someone change behavior. If someone gives him or herself the opportunity to understand why they do something and then meditate on making a change, a very powerful thing can happen. Marrying both sides of this equation produces excellent results with most of my clients. Not all, but most. I feel that giving someone the option of meditating once they see the big picture of their lives is very empowering. I feel that I would be irresponsible if I helped someone see why they were engaging in an unhealthy behavior and left it at that. Often meditation can be the catalyst that brings about change.
February 7th, 2008 at 6:37 pm
I so appreciate this dialogue on meditation and psychotherapy. Mary, meditation is anything but boring. The mind is infinite in its expressions and is also capable of experiencing infinity. Release your fear and dive in, I am sure there must be resources in your area to learn vipassana or mindfulness meditation. Would like to hear from more of you!