Mindfulness means being in the present moment. How is mindfulness used in DBT?

Mindfulness as a concept has grown in importance in the field of psychotherapy over the last several decades. Jon Kabat-Zinn is credited for bringing mindfulness to the United States back in the 80’s. He describes mindfulness as “a means of paying attention in a particular way; on purpose, in the present moment, and nonjudgmentally.” While not always clearly stated, Kabat-Zinn’s work on mindfulness is rooted in buddhist meditation practices.

Around that same time, Marsha Linehan, the developer of dialectical behavior therapy (DBT), was curious as to whether or not mindfulness could be helpful for those who were suicidal and experienced severe emotion dysregulation. Marsha translated what she had learned of Zen principles into accessible skills that we teach in DBT skills group today. More specifically, her translation led to the three “What” skills, three “How” skills, and “Wise Mind.” These specific skills aim to increase attentional and emotional control without formal meditation.

Why is mindfulness so important? Because it helps us cope with a variety of concerns including problems with mood, chronic pain, and attention. The research has shown that mindfulness facilitates emotion regulation because it helps us to remain in the present and focus on the facts alone. When we feel something intensely, there are often ineffective urges present, and mindfulness allows us to see potential (skillful) alternative options before we act. Cedar Koonz, a DBT practitioner, says that “mindfulness helps us by waking us up in the middle of an emotional storm…it helps us see what is going on and what choices we have by bringing our attention into the moment.”

Allowing our minds to wander tends to negatively impact our mood, even when we are engaging in a pleasant event; however, a major barrier to effectively practicing mindfulness is a lack of acceptance.

Acceptance is needed in situations that we cannot change easily and allows us to accept the pain in each moment rather than relying on ineffective behaviors to avoid our emotional pain. Radically accepting something does not mean that we approve of it, but rather acknowledging that something occurred without judging it. For example, saying something “should” be different than it is, or asking questions like “why did this happen to me” are indicative that you are rejecting reality!

Acceptance is a core aspect of mindfulness. Those who learn to accept their experiences and not just notice them are less reactive to stress and are less prone to mind-wandering. When we accept difficult situations, the situation will run its course and eventually go away. Acceptance helps us to stop ruminating on what is “wrong” and allows us to experience other feelings and thoughts. In this way, we get to see the entire picture. 

Mindfulness Research

The research on mindfulness has been impressive. For instance, one study found that mindfulness training lead to important maternal mental health benefits and prevention of post-partum depression, as well as decreased use of opioid pain medication. Mindfulness based interventions have been found to delay hippocampal damage in mild cognitive impairment and Alzheimer’s disease, as well as reduce stress and depression in those individuals. In regard to adolescents, mindfulness education was found to be helpful in minimizing the impact of bullying, helping students with learning disabilities, benefiting students who are training in careers with high emotion and stress, and coaching. Moreover, mindfulness has a positive impact on well-being, physical health, mental health.

DBT Mindfulness Exercise: Loving Kindness

One of my personal favorite mindfulness exercises is Loving Kindness, which is the practice of mentally sending warmness, kindness, and love towards yourself and others. Loving Kindness is based on an ancient Buddhist spiritual meditation, Metta.

Loving Kindness is helpful in decreasing negative emotions, which tend to have negative physical effects as well, and can reduce self-hatred, and increase positive emotions. Loving kindness has been reported to reduce self-criticism and depression, as well as increase self-compassion and positive emotions.

To practice Loving Kindness, you want to think of a “script” or wishes that are sincere. A commonly used script is:

• May I/you/they be happy.

• May I/you/they be health.

• May I/you/they be safe.

• May I/you/they live a life with ease.

When starting out, it is typically easiest to start by sending warm wishes to someone that you love. Then, you can practice towards yourself, someone you feel neutral about, everyone in the universe, or someone you are experiencing negative feelings towards. When practicing, it is important to let go of tension or tightness, and when you notice that you are distracted, gently return your attention back to the practice.

Mindfulness has made a significant impact on my own well-being and mental health, and it is a difficult process! If you are someone who has a hard time sitting still or wants to avoid your internal experience, start with external mindfulness practices (i.e., go on a walk and focus on what information you can take in through your senses) and slowly work your way to observing your breathing, physical sensations, thoughts, and emotions. If you experience difficult, intense emotions and think that you might benefit from mindfulness, contact us today to schedule an appointment!