Clinical Handbook of Mindfulness by Jon Kabat-Zinn, Fabrizio Didonna Page A
Authors: Jon Kabat-Zinn, Fabrizio Didonna
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periods of formal practice, often alternating sitting med-
itation with walking meditation. They are usually conducted in silence, with
very little interpersonal interaction, except for occasional interviews with
teachers. All of the activities of the day—getting up, showering, brush-
ing teeth, eating, doing chores—are done in silence and used as oppor-
tunities to practice mindfulness. As one observer put it, the first few
days of a retreat are “a lot like being trapped in a phone booth with
a lunatic.” We discover how difficult it is to be fully present. The mind
is often alarmingly active and restless, spinning stories about how well
we’re doing and how we compare to others. Memories of undigested emo-
tional events enter, along with elaborate fantasies about the future. We get
to vividly see how our minds create suffering in an environment where
all of our needs are tended to. Many people find that the insights that
occur—during even a single week-long intensive meditation retreat—are life
transforming.
The effects of mindfulness practice seem to be dose related. If one does
a little bit of everyday practice, a little bit of mindfulness is cultivated. If
one does more everyday practice, and adds to this regular formal practice
and retreat practice, the effects are more dramatic. While this has long been
evident to meditators, it is beginning to be documented through scientific
research (Lazar et al., 2005).
24
Ronald D. Siegel, Christopher K. Germer, and Andrew Olendzki
Why Mindfulness Now?
We are currently witnessing an explosion of interest in mindfulness among
mental health professionals. In a recent survey of psychotherapists in the
United States (Simon, 2007), the percentage of therapists who said that they do “mindfulness therapy” at least some of the time was 41.4%. In comparison, cognitive–behavioral therapy was the most popular model (68.8%), and
psychodynamic/psychoanalytic therapy trailed mindfulness at 35.4%. Three
years ago, we speculated that mindfulness could eventually become a model
of psychotherapy in its own right (Germer et al., 2005). That time is rapidly approaching.
Why? One explanation is that the young people who were spiritual seek-
ers and meditators in the 1960s and 1970s are now senior clinical researchers
and practitioners in the mental health field. They have been benefiting per-
sonally from mindfulness practice for many years and finally have the courage
to share it with their patients.
Another explanation is that mindfulness may be a core perceptual process
underlying all effective psychotherapy—a transtheoretical construct. Clini-
cians of all stripes are applying mindfulness to their work, whether they are
psychodynamic psychotherapists who primarily work relationally; cognitive–
behavioral therapists who are developing new, more effective, and structured
interventions; or humanistic psychotherapists encouraging their patients to
enter deeply into their “felt experience.” The common therapeutic question
is, “How can I help the patient to be more accepting and aware of his or her
experience in the present moment?”
Perhaps the strongest argument for the newfound popularity of mindful-
ness is that science is catching up with practice—the soft science of contem-
plative practice is being validated by “hard” scientific research. Meditation is
now one of the most widely studied psychotherapeutic methods (Walsh &
Shapiro, 2006)—although, admittedly, many of the studies have design limitations (Agency for Healthcare Research and Quality, 2007). Between 1994
and 2004, the preponderance of the research on meditation has switched
from studies of concentration meditation (such as transcendental meditation
and the relaxation response) to mindfulness meditation (Smith, 2004).
We are currently in a “third wave” of behavior therapy interventions
(Hayes, Follette, & Linehan, 2004). The first wave focused on
itation with walking meditation. They are usually conducted in silence, with
very little interpersonal interaction, except for occasional interviews with
teachers. All of the activities of the day—getting up, showering, brush-
ing teeth, eating, doing chores—are done in silence and used as oppor-
tunities to practice mindfulness. As one observer put it, the first few
days of a retreat are “a lot like being trapped in a phone booth with
a lunatic.” We discover how difficult it is to be fully present. The mind
is often alarmingly active and restless, spinning stories about how well
we’re doing and how we compare to others. Memories of undigested emo-
tional events enter, along with elaborate fantasies about the future. We get
to vividly see how our minds create suffering in an environment where
all of our needs are tended to. Many people find that the insights that
occur—during even a single week-long intensive meditation retreat—are life
transforming.
The effects of mindfulness practice seem to be dose related. If one does
a little bit of everyday practice, a little bit of mindfulness is cultivated. If
one does more everyday practice, and adds to this regular formal practice
and retreat practice, the effects are more dramatic. While this has long been
evident to meditators, it is beginning to be documented through scientific
research (Lazar et al., 2005).
24
Ronald D. Siegel, Christopher K. Germer, and Andrew Olendzki
Why Mindfulness Now?
We are currently witnessing an explosion of interest in mindfulness among
mental health professionals. In a recent survey of psychotherapists in the
United States (Simon, 2007), the percentage of therapists who said that they do “mindfulness therapy” at least some of the time was 41.4%. In comparison, cognitive–behavioral therapy was the most popular model (68.8%), and
psychodynamic/psychoanalytic therapy trailed mindfulness at 35.4%. Three
years ago, we speculated that mindfulness could eventually become a model
of psychotherapy in its own right (Germer et al., 2005). That time is rapidly approaching.
Why? One explanation is that the young people who were spiritual seek-
ers and meditators in the 1960s and 1970s are now senior clinical researchers
and practitioners in the mental health field. They have been benefiting per-
sonally from mindfulness practice for many years and finally have the courage
to share it with their patients.
Another explanation is that mindfulness may be a core perceptual process
underlying all effective psychotherapy—a transtheoretical construct. Clini-
cians of all stripes are applying mindfulness to their work, whether they are
psychodynamic psychotherapists who primarily work relationally; cognitive–
behavioral therapists who are developing new, more effective, and structured
interventions; or humanistic psychotherapists encouraging their patients to
enter deeply into their “felt experience.” The common therapeutic question
is, “How can I help the patient to be more accepting and aware of his or her
experience in the present moment?”
Perhaps the strongest argument for the newfound popularity of mindful-
ness is that science is catching up with practice—the soft science of contem-
plative practice is being validated by “hard” scientific research. Meditation is
now one of the most widely studied psychotherapeutic methods (Walsh &
Shapiro, 2006)—although, admittedly, many of the studies have design limitations (Agency for Healthcare Research and Quality, 2007). Between 1994
and 2004, the preponderance of the research on meditation has switched
from studies of concentration meditation (such as transcendental meditation
and the relaxation response) to mindfulness meditation (Smith, 2004).
We are currently in a “third wave” of behavior therapy interventions
(Hayes, Follette, & Linehan, 2004). The first wave focused on
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