Clinical Handbook of Mindfulness
very appealing. Early in their
    meditation careers, many people become distressed when they find that their
    minds wander and they feel agitated or unsettled. While exceptionally pleas-
    ant states of mind do occur, in mindfulness meditation we allow them to
    arise and pass—not clinging to blissful states nor rejecting unpleasant ones.
    Not escaping pain : Rather than escaping pain, mindfulness practice helps
    us to increase our capacity to bear it. We deliberately abstain from auto-
    matic actions designed to make ourselves feel better. For example, if we
    are meditating and an itch arises, a typical instruction is to observe the
    itch and notice any impulses that arise (such as the urge to scratch)—
    but to not act on the urge. As a result, we actually experience pain and
    discomfort more vividly. This extends beyond itches and physical pain to
    include the full spectrum of emotional discomfort as well. As we explore and
    accept these unpleasant experiences, our capacity to bear them increases.
    We also discover that painful sensations are distinct from the suffering
    that accompanies them. We see that suffering arises when we react to
    pain with resistance, protest, or avoidance rather than moment-to-moment
    acceptance.
    Forms of Practice
    There are many ways to cultivate awareness of current experience with
    acceptance. Not surprisingly, all of them involve repeated practice. If we
    want to improve our cardiovascular fitness, we might begin by integrating
    physical exercise into our everyday routine—taking the stairs instead of the
    elevator or riding a bicycle instead of driving to work. If we want to become
    even more physically fit, we might set aside time to exercise formally, per-
    haps at a gym or health club. To really accelerate the process, we might go
    on a fitness-oriented vacation in which much of the day is spent in vigorous
    exercise. Similar options are available for cultivating mindfulness.
    Chapter 1 Mindfulness
    23
    Everyday mindfulness : This involves reminding ourselves throughout the
    day to pay attention to what is happening in the moment without radically
    altering our routines. It means noticing the sensations of walking when we
    walk, the taste of our food when we eat, and the appearance of our sur-
    roundings as we pass through them. The Vietnamese Zen teacher Thich Nhat
    Hahn suggests a number of techniques to enhance everyday mindfulness.
    For example, when the telephone rings, try just listening at first, attending
    to the tone and rhythm of the sound as one might listen to a musical instru-
    ment. Or while driving, when the red tail lights of another vehicle appear, try
    appreciating their color and texture as one might do in looking at a beautiful
    sunset.
    Formal meditation practice : This involves setting aside time to go to the
    mental “gym.” We regularly dedicate a certain period to sit quietly in med-
    itation. There are many types of meditation that can cultivate mindfulness.
    Most involve initially choosing an object of attention, such as the breath,
    and returning our attention to that object each time the mind wanders.
    This develops a degree of calmness which, in turn, enables us to better
    focus the mind on the chosen object. Once some concentration is estab-
    lished, mindfulness meditation entails directing the mind to whatever begins
    to predominate in the mind—usually centering on how the event is expe-
    rienced in the body. These objects of attention can be physical sensations
    such as an itch, an ache, or a sound, or emotional experiences as they man-
    ifest in the body, such as the tightness in the chest associated with anger or
    the lump in the throat that comes with sadness. Regardless of the chosen
    object of attention, we practice being aware of our present experience with
    acceptance.
    Retreat practice : This is the “vacation” that is dedicated entirely to cul-
    tivating mindfulness. There are many styles of meditation retreats. Most
    involve extended

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