Wednesday, March 6, 2013

Ongoing Mindfulness - Chapter 1 in "The Mindful Therapist" by Dr. Daniel Siegel


I’ve continued to work on my mindfulness project. The 1st chapter in “The Mindful Therapist” is about presence. The writer of this book, Dr. Siegel, loves acronyms and so he outlined his book in the introduction based on an acronym for the qualities of mindful therapy – the acronym is PART.: Presence, Attunement, Resonance and then twelve different words starting with Tr (trust, truth, tripod, triception, tracking, traits, trauma, transition, training, transformation, tranquility, and transpiration). Some of these words also have acronyms associated with them. I feel like I’m in medical school again to some extent, but it is interesting.

Presence is defined as being open to possibilities, as opposed to premature focus on one of many possible alternatives. The image used in the book for this is of being on an open plane of possible thoughts. If I then give you a category, say “furniture” you might move into a plateau of probable thoughts. If I then give you a specific such as “blue chair” you might move into a peak of an actual thought of a blue chair.  Part of what is interesting is that these peaks and plateaus are considered two sided (imagine them going up like a mountain and down like a valley) and represent the two simultaneously occurring aspects of a thought; the neural firing that occurs in the brain and the mental experience of the thought. What makes this interesting is that neuroscience tells us the relationship between these aspects is bi-directional. The neural firing of the brain can give rise to the mental experience, but mental experience can also alter and give rise to neural firing. Essentially, mental experience can physically affect our brains, even to the extent of making physical changes in the tissue of the brain.

The concept of presence is moving freely up and down this cycle, being open to new information and not remaining “stuck” in a particular plateau such that we are unable to perceive contradictory information. No one does this perfectly, of course, but we can improve our skills. Part of improving our skill at maintaining this openness is through learning to pay attention to our internal state, to identify what it feels like mentally and physically when we are closing down. The other part of it is regularly practicing a mindful attention exercise, such as mindful breathing, which strengthens our ability to remain open or to re-open when we start to close down by helping us stay out of the fight-flight-freeze responses we experience when stressed or threatened. Fight-flight-freeze states inhibit our ability to be open to possibility and impair our presence. Mindfulness exercises help us react to potential threat with more calm and curiosity and less fear, keeping us present. In therapy, remaining present with another person means continuing to remain open to what they are communicating. It seems fairly obvious to me that presence is a pre-requisite to good psychotherapy.

I tried out the suggested mindfulness exercise of mindful breathing. I have done this exercise before and I have to admit it’s hard for me. I get distracted and usually give up before five minutes is done. I do realize that getting distracted is part of the process and releasing both my distraction and my reaction to it is actually part of the exercise. I just have trouble actually carrying it out. However, even the 1-2 minutes I can do leaves me feeling calmer, so I think I will keep practicing and see if I can lengthen the time I am able to remain in the exercise.

I realize that since today is March 6th and I am still on the first chapter of the first book, I may not be able to complete everything I wanted to read during this mindfulness month. I think that’s probably okay too; if I take the time to absorb the material and work with it I will get what I wanted out of the month. And fortunately for me, no one will take my books away at the end of the month, so I can extend the project if I am enjoying it.