First of all, there is no consensus in the psychological literature on the definition of mindfulness or its mechanisms.
However, the evidence base for the effectiveness of the 8-week Mindfulness-Based Programme (MBP) entitled Mindfulness-Based Stress Reduction (MBSR), created by Dr Jon Kabat-Zinn over 40 years ago, is vast, and so is the MBP pedagogy.
Through mindfulness practice and a group process used by MBP teachers to help participants recognise general mind tendencies which predispose all humans to suffering termed universal vulnerability, participants of MBSR courses for the general public explore their relationship to stress and cultivate the ability to let go of unhelpful stress-perpetuating patterns to improve their health and wellbeing.
This is very different from quick-fix relaxation “mindfulness” advertised on social media…
In this brief article, a selection of vulnerabilities and ways in which participants learn, along with proposed associated mechanisms of mindfulness, are explored through the explicit and implicit MBP teaching curriculum lenses. These curricula refer to content and process respectively and work together to provide a connected learning experience for participants.
The main components of the explicit curriculum are mindfulness practice, inquiry, and didactic presentations.
Starting with the “raisin practice,” participants have an experiential introduction to mindfulness by intentionally exploring a raisin with all their senses and a fresh curiosity, or beginner’s mind. A key learning that comes from paying deliberate attention is to experience mindful awareness versus automatic pilot, referring to engaging in physical or mental activity without conscious awareness.
Automatic pilot is a vulnerability because in this mode of mind it is harder to notice stress rising and unconscious repetitive self-critical negative thinking, or rumination, when attention dwindles can perpetuate mental ill health.
The early cultivating of attention regulation; the ability to deliberately maintain attention on immediate experience, is an essential ingredient of MBPs and a foundational mechanism for the development of additional mechanisms of mindfulness, discussed hereafter.
Another curriculum intention of the raisin exercise is to introduce Kabat-Zinn’s operational definition of mindfulness as “the awareness that arises from paying attention, on purpose, in the present moment, and non-judgementally.”
In their IAA model, Shapiro and colleagues propose that when Intention, Attention, and Attitude come together, a shift in perspective can be experienced called reperceiving, akin to decentering. Through this mechanism, an increased clarity and objectivity in relation to one’s experience, internal and external, can develop. Reperceiving is sometimes referred to as a reframing of perception.
Our usual perceptual process is a vulnerability because we may look at a situation through lenses tinted by life experience and interpret a situation in a limiting way. However, perception can be slowed down to notice more aspects of what is being attended to in the present moment. This creates options for participants to move beyond preconceptions, preferences, or automatic routines and to become more awake to themselves and their lives. The skill of intentionally paying attention in a kindly, inquiring way is further developed in the body scan.
The body scan is a methodical investigation into the body to feel and acknowledge any sensations present. In addition to directing attention intentionally, participants learn to explore the felt sense of physical sensations as they are, rather than thinking about the body. The mechanism of body awareness; the capacity to notice internal body sensations, is being developed as participants are also introduced to the core mindfulness principle of learning to be with what is, without changing or controlling the situation. This cultivates additional mindfulness attitudes like non-judging, acceptance, and letting be, and contrasts with avoidance, a habitual reaction to discomfort.
Wanting to avoid the unpleasant is natural, but avoidance is a vulnerability that can exacerbate stress by driving maladaptive coping strategies like rumination. During the body scan, however, participants learn to notice the flux of sensations and stay present with the body as it is. They come to know the difference between direct sensations and one’s related thoughts and emotions so these can pass without rumination. Bringing this more compassionate attention to the body can thus dissolve the link between the unpleasantness of discomfort and the automatic reaction of avoidance. This learning extends into mindful movement practice.
Mindful movement is another way to cultivate intentionally paying kindly attention to present-moment experience through a felt sense of the body which can create a decentered perspective. A key learning opportunity is becoming aware of connections between practice and habits in daily life, such as striving (e.g., to attain a certain pose). The striving can be noticed because it is experienced physically but reflects the doing mode of mind. This mode is helpful when applied to external tasks but a vulnerability when involved with solving our inner challenges because of its focus on the discrepancy between desire and actuality, increasing the risk of engaging in negative self-talk and creating more stress.
Participants may also discover that when exploring intensity related to physical boundaries in a mindful way, the narrow perception they have of their body and its possibilities is not aligned with the actuality of those boundaries, and that bodily and mental resistance can be distinguished from the actual physical difficulty. The allowing and present-moment focused way of being with physical sensations cultivated during the body-based practices is foundational learning to help participants relate differently to thoughts and emotions during the sitting meditation.
Gradually introduced, the sitting meditations increase in duration and objects of attention during the various practice segments, from concrete (posture, breath, body) to more abstract (sounds, thoughts, emotions) and are guided around core session themes so that participants can explore the aforementioned vulnerabilities and cultivate mindful attitudes and resilience.
The segments “mindfulness of thoughts and emotions” and “open awareness,” or acknowledging any experience without preference or attempting to change it, are of particular significance for building resilience and equanimity in times of stress since participants cultivate clear seeing of the flux of moment-to-moment experience, akin to the flux of everyday life. They learn to observe thoughts as transient mental events, a decentred perspective that can decrease identification with the contents of those thoughts.
This maps onto the mechanism called, change in perspective on the self since one discovers that there is no self in the aspects of experience and thus the self is not as fixed as is often assumed, which can reduce reactivity like clinging or avoidance and associated habits.
Any emotions and accompanying physical sensations are also encouraged to be met with a spacious, non-reactive quality of mind to further foster the skill of observing how everything comes and goes as naturally unfolding experience. This maps onto the mechanism of emotion regulation; strategies for influencing the arising and duration of emotions and altering emotional responses.
Taken together, Hölzel and colleagues propose that the mechanisms of attention regulation, body awareness, a change in perspective on the self, and emotion regulation interact during mindfulness meditation to develop enhanced self-regulation; the effective modulating of one’s impulses and behavioural responses which can mitigate stress by restoring psychological homeostasis or balance.
Core session themes are further conveyed through interactive inquiry and didactic teaching. Through teacher-led inquiry, a reflective and exploratory process Crane et al. refer to as “disciplined improvisation” since it is based on identifiable patterns of interaction yet unfolds within moment-specific conditions, participants can investigate their experience in more detail than they would have done on their own. By identifying which aspects of experience (e.g., sensations, thoughts, impulses) were present, they might discover ways of thinking and feeling that are automated and unknown to them, how cognitive reactivity may hinder learning and growth, and how relating to experience with kindly awareness instead increases one’s capacity to allow rather than fix.
Even if participants are not directly engaged in inquiry, they are exposed to the discussion and involved in the learning since they might recognise themselves in the patterns being explored. Moreover, participants may gain a sense of common humanity; a reassuring sense that one is not alone in struggling with difficulty.
Connections between personal experience and a broader human context strengthen during didactic presentations. For example, in Week 4, didactic elements come alive when participants can personally identify with the universal vulnerability of the stress reaction cycle; conditioned reactions to internal and external stressors that increase stress. This boosts insight and willingness to pay close attention to the felt somatopsychic signs of reactivity to learn how stress operates in their everyday life and to avoid sustaining it.
In addition to what is systematically taught, participants learn mindfulness from how MBP teachers teach. This is the implicit curriculum and includes embodying, relational skills, and holding the group learning environment. Embodying mindfulness is core to MBSR facilitation, not as an end goal to reach, but an alive, changing process. It refers to a teacher’s presence and behaviour which is rooted in their sustained personal practice being aligned with the core mindfulness attitudes, enabling them to communicate mindfulness effectively. Mapping onto Yalom and Leszcz’s theme of imitative behaviour, a teacher who models steadiness and skills like observing and moving towards difficulty with compassion can influence participants to experiment with novel, more adaptive ways of exploring challenge, thus increasing their tolerance to stress.
Closely linked to embodying but specific to interpersonal connection are the teacher’s relational skills. These include active listening, asking open-ended questions, and conveying acknowledgement of participants’ difficulties through verbal and non-verbal empathic responding so they feel understood. The teacher relates with qualities of interest, warmth, and acceptance to inspire participants to relate to themselves in similar ways and realise they can access internal resources and be their own experts (e.g., around degrees of exploring difficulty). Equally, this means the teacher should respect participants’ boundaries and provide a relational container that is safe, inclusive, and trauma informed. This requires pre-course assessment and teachers to engage in unconscious bias and racial awareness training so they can practise holding a safe learning environment which enables participants from all demographics of society to connect to new learning and avoid re-traumatisation or perpetuation of historical oppression.
Effective holding of the group learning environment also requires a teacher to have a thorough understanding of group theory like the five stages of group development and leadership styles. The teacher can then use this knowledge to “read the group” (viscerally sensing what is happening in the group) and respond appropriately.
Reading, along with holding (considering the group as an identity within a safe space) and befriending (kindly meeting all experience in the group) are interconnected capacities of the Inside Out Group (IOG) model (Griffith et al., 2019). At the centre is the teacher’s inside-out embodying, a helpful intentional awareness of their own body sensations and thoughts and of outside phenomena (individuals and group) while teaching, also known as intra- and interpersonal wakefulness, enabling skilful responding. The IOG model can thus be used by the teacher to guide the group process and influence effective learning.
In summary, participants of the Mindfulness-Based Stress Reduction course learn mindfulness through an explicit and implicit curriculum with various mechanisms involved in the development of enhanced self-regulation, considered instrumental for reducing stress and increasing wellbeing. This is in stark contrast with the way mindfulness is often advertised on social media... It's not a quick fix, but a trainable skill for life.
Interested in taking an MBSR course? My next course starts on 3 September 2024 (Tuesdays, 7 pm - 9:15 pm UK via ZOOM, £175 + VAT).
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