Mindfulness Techniques Can Counter Stress in Clients


Traffic jams. Job woes. Visits from the in-laws. Life is full of stress and, more often than not, people feel it physically as well as mentally. Although the stress response begins in the brain, it is a full-body phenomenon. When someone encounters a threat — real or imagined — the brain triggers a cascade of stress hormones. The heart pounds, muscles tense, and breathing quickens.

One of the best ways to counter stress is to pay attention to what is going on. That may sound counterintuitive, but paying attention is the first step toward cultivating mindfulness--a therapeutic technique for a range of mental health problems (and physical ones).

The opposite of multitasking

Multitasking has become a way of life. People talk on a cell phone while commuting to work, or scan the news while returning e-mails. But in the rush to accomplish necessary tasks, people often lose connection with the present moment. They stop being truly attentive to what they are doing or feeling.

Mindfulness is the opposite of multitasking. The practice of mindfulness, which has its roots in Buddhism, teaches people to live each moment as it unfolds. The idea is to focus attention on what is happening in the present and accept it without judgment.

Jon Kabat-Zinn, MD, professor of medicine emeritus at the University of Massachusetts Medical School, developed a mindfulness-based stress reduction program for people with major depression (since adapted for other disorders). Another adaptation of mindfulness to clinical practice is mindfulness-based cognitive therapy, which combines mindfulness techniques with cognitive behavioral therapy.

However it is practiced, mindfulness is a powerful therapeutic tool. Studies have found, for example, that mindfulness techniques can help prevent relapse in people who have had several past episodes of major depression. Other research suggests that mindfulness techniques can help alleviate anxiety and reduce physical symptoms, such as pain or hot flashes.

For more information about the health dangers of stress — and how mindfulness can help people relax — watch this video of a talk by Dr. Michael C. Miller, editor in chief of the Harvard Mental Health Letter, at www.health.harvard.edu/MillerStress.

One of the best things about mindfulness is that it is something people can try on their own. Here's how to suggest that your clients get started.

Center down. Sit on a straight-backed chair or cross-legged on the floor. Focus on an aspect of your breathing, such as the sensations of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale.

Open up. Once you've narrowed your concentration, begin to widen your focus. Become aware of sounds, sensations and ideas. Embrace and consider each without judgment. If your mind starts to race, return your focus to your breathing.

Observe. You may notice external sensations such as sounds and sights that make up your moment-to-moment experience. The challenge is not to latch onto a particular idea, emotion or sensation, or to get caught up in thinking about the past or the future. Instead you watch what comes and goes in your mind, and discover which mental habits produce a feeling of suffering or well-being.

Stay with it. At times, this process may not seem relaxing at all, but over time it provides a key to greater happiness and self-awareness as you become comfortable with a wider and wider range of your experiences.

Clients can also try less formal approaches to mindfulness by trying to become more aware while doing activities that are enjoyed. Playing the piano, juggling, walking--all can become part of mindfulness practice as long as the client pays attention to what is happening in the moment. Listen to the sounds of the music, feel the weight of the balls as they fall into your hand or really look at what you are walking past.

Practice makes perfect

Mindfulness is something to cultivate and practice, on a regular basis.

Make a commitment. Aim for doing 20 to 45 minutes of mindfulness practice most days of the week. (If that sounds like a lot, remember that a key part of mindfulness means letting go of expectations. Just commit to trying to become more mindful, and do the best you can.)

Make small changes. It's hard to make big changes. It's better to start slow and build gradually. The famous Alcoholics Anonymous motto is "one day at a time." Mindfulness involves taking it less than one day at a time — aim for one moment at a time.

Mindfulness really does not have to be more complicated than learning to pay attention to what is going on around you. But this "simple" advice is often hard to sustain in a busy world. Try making the effort to become more mindful — and you may find the results make it worth it.

Chiesa A, et al. Mindfulness Based Cognitive Therapy for Psychiatric Disorders: A Systemic Review and Meta-Analysis, Psychiatric Research 187 3 441–453 (May 2011)

Rapgay L, et al. New Strategies for Combining Mindfulness with Integrative Cognitive Behavioral Therapy for the Treatment of Generalized Anxiety Disorder, Journal of Rational-Emotive and Cognitive-Behavior Therapy 29 2 92–119 (June 2011)

From the Harvard Mental Health Letter

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