The Two Pillars of Mindfulness-Based Therapy

Two yellow, fan-shaped ginkgo biloba leaves arranged on a white backgroundMindfulness-based therapy is an approach in which the principles of mindfulness are applied for therapeutic purposes. What does this mean? My previous article discussed basic elements of mindfulness:

  • Pause.
  • Bring awareness to body, sensations, feelings, and thoughts.
  • Connect with the breath.
  • Be in the present moment.
  • Adopt a nonjudgmental approach: apply compassion.

While working with clients, I developed recognition of two main components that emerge from these elements of mindfulness: I call them the two pillars of mindfulness-based therapy. These two pillars—observation, and the cultivation of compassion, acceptance, and virtues—bring about change in peoples’ perspective, and consequently in
their lives.


Observation emerges from the first four elements of mindfulness. It calls us to place attention to the process, to bring awareness to the way that thoughts come and go, appear, develop, and disappear. One is asked to acknowledge patterns of thinking, as well as the expression of emotions in the body, the subtle changes in body sensation, and the movement of the breath in and out of the body.

Even though the content of thoughts is there and recognized, the intention is not to engage with it, cling to it, or feed it. This is similar to the way that, in therapy, the past, traumas, and personal stories are important to acknowledge, but they don’t become the center and focus of the therapy. The focus, rather, is on what is happening now, how feelings express themselves in the body, and what triggers reactivity.

This approach allows release of attachment to “my story,” “my depression,” or “my anxiety.” Observation empowers the client to choose between letting thoughts, emotions, and even real-life events control his or her life, actions, and reactions, or, alternatively, to be more active and present in his or her outer and inner life and choose how to respond to challenges that present themselves at any moment.

Observation calls to bring awareness not just to destructive patterns, but also to positive and pleasurable thoughts, emotions, and events. Here observation allows for the positive to be part of the experience of life. While observing, the emphasis is still on the process and not the content: how does a positive experience feel in the body, how does the feeling change when awareness is brought to it, how do positive thoughts appear and disappear?

The Cultivation of Compassion, Acceptance, and Virtues

The cultivation of compassion, acceptance, and virtues emerges from the last element of mindfulness. This second pillar does call for attention to content. In this case, there is an attempt to focus on and produce positive thoughts. Clients are encouraged to wish themselves well while practicing Loving-Kindness meditation and reciting phrases with positive wishes. They are invited to look at and further develop their virtues, and to focus on the good in their lives even when it is small or hidden.

The more I work with people, the more I realize how much this pillar is crucial for positive change and growth. In this practice, it is not just about observing inner activity, but rather cultivating and expanding that which is already present. Even when one is not aware of having any compassion for their self or of having any virtues, we work together to discover positive elements that do exist and develop ways to integrate compassion, acceptance, and virtues in everyday life. I have a few clients who cannot feel any compassion for themselves, but through their ability to feel compassion for others, like kids and pets, we can work on slowly shifting the flow of kindness from the heart and direct it toward themselves.

Working with these two pillars in mind, I use two opposite powers to help a client reach balance. Observation helps to reduce negativity and unhealthy patterns of reactivity and behaviors, and cultivation of compassion, acceptance, and virtues supplies the positive energy necessary to help one grow. It helps increase positive attitude, self-esteem, trust in self, and healthy activities.

© Copyright 2011 by Yael Schweitzer, LCSW, BC-DMT. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • Ann

    February 1st, 2011 at 2:23 AM

    What I understand from all this is mindfulness is not very different from trying to maintain a calm and being aware of what you are doing and being immersed and think deep about what you are doing.Isn’t that right?
    It does sound like a good way to actually do things in the best possible manner,something that we always want in whatever we do.

  • DocLC

    February 1st, 2011 at 5:33 AM

    What a wonderful basis for therapy, and given in such an encouraging and uplifting spirit.

  • Yael Schweitzer

    February 12th, 2011 at 9:34 PM

    Thanks for the comments. As for your question Ann – mindfulness means not just being present with what we do but also being aware of what we think, feel and sense. In addition, as I wrote above – developing compassion to our human nature, acknowledging the positive and cultivating a non-judgmental approach support the practice of mindfulness.

  • Bree Kalb, LCSW

    March 11th, 2013 at 7:00 PM

    Nice, clear description. I also use this approach in my therapy practice. (And in my personal life!) It is helpful for most people if they are willing to practice over and over and over again.

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