What is Mindfulness?

A popular tool in Western forms of therapy, mindfulness has made it’s impact on the art therapy and counseling fields. Maybe you’ve heard about practicing mindfulness from a therapist, by taking a class at a university, a local workshop, or from a friend.

I was introduced to the concept of mindfulness while I was in college and first tried the whole "sit and only think about your breathing for as long as you can” meditation, which was very challenging and not enjoyable. I also learned about and practiced yoga for the first time. I began crocheting and knitting, and found myself losing track of time while I created cowls, scarves, hats, and hand-warmers. After college I dropped interest in mindfulness practice, distracted by other life events.

Years later I was drawn to mindfulness again, taking an individual counseling theories course as a graduate student pursuing my masters in art therapy and counseling. I read about the incorporation of mindfulness in Dialectical Behavior Therapy (DBT), the mindfulness-based behavior therapy Acceptance and Commitment Therapy (ACT), Mindfulness-Based Stress Reduction (MBSR), and Mindfulness-Based Cognitive Therapy (MBCT). In the art therapy literature, I discovered mindfulness-based art therapy (MBAT) and mindful art therapy.

We hear the term ‘mindfulness’ a lot, but what exactly is it?

Mindfulness has long been established in eastern philosophy and religion by addressing the human condition and human suffering. The concept of dhyana (attention or meditation) has been present in Buddhism, Hinduism, Jainism, and Sikhism for millennia (Singh, 2023). Meditation has also been a part of the mystic Islam practice of Sufism (Islam & Modernity, 2019).

Mindfulness and Zen Buddhism

In an interview with Inquiring Mind, Jon Kabat-Zinn stated he intended to bring dharma, or truth, to mainstream medicine and health care. His studies with teacher Thich Nhat Hanh allowed him to bring principles of Zen Buddhism to the US by implementing the mindfulness-based stress reduction (MBSR) program at the Stress Reduction Clinic in 1979. Kabat-Zinn (2005, 2013) defines mindfulness as awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally.

From Kabat-Zinn’s (2013) Full Catastrophe Living:

Over the years, I have increasingly come to realize that mindfulness is essentially about relationality—in other words, how we are in relationship to everything, including our own minds and bodies, our thoughts and emotions, our past and what transpired to bring us, still breathing, into this moment—and how we can learn to live our way into every aspect of life with integrity, with kindness toward ourselves and others, and with wisdom (p. xxxvii).

Dr. Kabat-Zinn’s MBSR work influenced the development of other treatment modalities with principles of Zen Buddhism as a mindfulness practice in the field of counseling and art therapy. Mindfulness-Based Cognitive Therapy (Segal, Williams, and Teasdale, 2002; Teasdale et. al, 2002) builds off of elements from MBSR and combines it with Beck’s Cognitive Behavioral Therapy. Mindfulness-Based Art Therapy (MBAT, Monti et al., 2006) builds off of components of MBSR when encouraging participants to observe and describe their illness experiences. Dr. Rappaport was influenced by her meditation teacher Gurumayi, Thich Nhat Hanh, and Jakusho Kwong-roshi to develop Focusing-Oriented Art Therapy (Rappaport, 2009). Many other art therapists were inspired by the mindfulness components from MBSR to engage in outreach work or develop other theoretical approaches (Davis, 2015; Rappaport, 2014).

In her Mindful Art Therapy book, Barbara Jean Davis (2015) states “mindfulness is about paying attention to how things are in the present moment” (p. 22) and proceeds to reference Buddhist philosophy throughout the rest of the book.

Dialectical Behavior Therapy has mindfulness components also informed by Zen Buddhism. Dr. Linehan spent time studying at a local monastery to learn acceptance, eventually pursuing further training from German Zen master and Benedictine monk Willigis Jäger. For more information on the overlap between Zen and DBT, check out this blog article on the Behavioral Tech website. From the DBT Skills Training Manual (Linehan, 2015), mindfulness is defined as intentionally living with awareness in the present moment, without judgment or attachment to the present moment. Mindfulness practice includes mindfulness “how” skills (non-judgmentally, one-mindfully, effectively) and “what” skills (observe, describe, participate), meditation, contemplative prayer, or movement (i.e. yoga, martial arts, dancing).

Mindfulness and Sufism

Radically Open Dialectical Behavior Therapy has mindfulness components informed by Malāmatī Sufism. The first time I heard about sufism was from my level I RO DBT training in 2020 (compared to the meditation and yoga practice I engaged in while at college, which I now know was loosely based off of Buddhist principles). Recently, I found this blog post on discussing the lack of sufism in mainstream “Western” mindfulness practice.

So what is mindfulness as informed by sufism? Rather than encouraging thoughts to come and go without attachment or judgment during meditative practice, sufism instead encourages an exploration of self using self-inquiry, where one finds a good question to learn about one’s motivations.

Quoted from Lynch (2018):

Radical openness can trace its roots to a spiritual tradition known as Malāmati Sufism. Malāmati Sufism originated in the 9th century in northeast of Persia in an area called Korasan (what is now Iran), and in the present day it has a strong following in Turkey and the Balkan States. The name Malāmati comes from the Arabic word malamah, meaning “blame” and referring to the Malāmati practice of sustained self-observation and healthy self-criticism in order to understand one’s true motivations. (Toussulis, 2011). Malāmatis believe that one cannot achieve heightened self-awareness in isolation; as a consequence, emphasis is given to spiritual dialogue and companionship (in Arabic, sohbet). The Malāmatis are not interested so much in the acceptance of reality or in seeing “what is,” without illusion; rather, they look to find fault within themselves and question their self-centered desires for power, recognition, or self-aggrandizement (p. 187).

Mindfulness in Scientific Discourse

Acceptance and Commitment Therapy co-developer Steven Hayes delves more into the definition of mindfulness in this article, and ultimately states:

Mindfulness is a pre-scientific concept, and it is unlikely that any one definition will allow it to enter into scientific discourse unambiguously…Perhaps in the long run it will be less important to define mindfulness per se than it will be to learn how to alter the many psychological processes that seem to be related and to determine their role in positive clinical change (Hayes and Shenk, 2004, p. 253).

Taking Hayes’ lead, not attaching any one definition to mindfulness could quite possibly be the whole point of mindfulness practice—observe what is working now but let go of any attachment to the meaning. There is no right or wrong way to practice mindfulness, there just is.

Mindfulness in the Everyday

After reflecting on these approaches, I realized something has always drawn me to mindfulness practice. Maybe it was an unconscious pull due to the meditative-like state I enter while creating something for as long as I can remember. Maybe it was an unconscious pull of the shared human condition. Mindfulness is a part of my practice as a therapist by teaching mindfulness skills to my patients and my lifestyle as a person existing in the world by practicing yoga. Mindfulness helps me feel connected to myself and others.

References:

Davis, B. J. (2015). Mindful art therapy: A foundation for practice. Philadelphia, PA: Jessica Kingsley Publishers.

Hayes, S. C. and Shenk, C. (2004), Operationalizing Mindfulness Without Unnecessary Attachments. Clinical Psychology: Science and Practice, 11: 249-254. https://doi.org/10.1093/clipsy.bph079

Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior therapy, 44(2), 180–198. https://doi.org/10.1016/j.beth.2009.08.002

Inquiring Mind. (2021, February 28). Interview with Jon Kabat-Zinn: Bringing Mindfulness into the Mainstream of America - Inquiring Mind. https://inquiringmind.com/article/1001_8_kabat-zinn/

Islam & Modernity. (2019, December 4). Mindfulness, Sufism, and “the West”: Islam as (in)Compatible with our Understandings of Mental Health Practice. Islam + Modernity. https://blog.uvm.edu/imorgens-rel195a/2019/12/04/mindfulness-sufism-and-the-west-islam-as-incompatible-with-our-understandings-of-mental-health-practice/

Kabat-Zinn, J. (2005). Wherever you go, there you are: Mindfulness meditation in everyday life. New York, NY: Hachette Books.

Kabat-Zinn, J. (2013). Full Catastrophe Living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Bantam Books.

Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). Guilford Press.

Linehan, M. M. (2020). Building a life worth living: A memoir. New York: Random House.

Lynch, R.T. (2018). Radically Open Dialectical Behavior Therapy: Theory and Practice for Treating Disorders of Overcontrol. Reno, NV: Context Press, an imprint of New Harbinger Publications.

Monti, D. A., Peterson, C., Kunkel, E. J., Hauck, W. W., Pequignot, E., Rhodes, L., & Brainard, G. C. (2006). A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with cancer. Psycho-oncology, 15(5), 363–373. https://doi.org/10.1002/pon.988

Rappaport, L. (2009). Focusing-oriented art therapy: Accessing the body’s wisdom and creative intelligence. London: Jessica Kingsley Publishers.

Rappaport, L. (2014). Mindfulness and the arts therapies: Theory and practice. Philadelphia, PA: Jessica Kingsley Publishers.

Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press.

Singh, S. P. (2023). Sakshi and Dhyana: the origin of mindfulness-based therapies. BJPsych bulletin, 47(2), 94–97. https://doi.org/10.1192/bjb.2022.39

Teasdale, J. D., Moore, R. G., Hayhurst, H., Pope, M., Williams, S., & Segal, Z. V. (2002). Metacognitive awareness and prevention of relapse in depression: empirical evidence. Journal of consulting and clinical psychology, 70(2), 275–287. https://doi.org/10.1037//0022-006x.70.2.275

Toussulis, Y. (2011). Sufism and the way of blame: Hidden sources of a sacred psychology. Wheaton, IL: Quest Books.