The Clinician as Neuroarchitect: The Importance of Mindfulness and Presence in Clinical Practice

Interpersonal neurobiology provides a framework from which to examine the incorporation of mindsight and mindfulness into clinical practice, employing the brain’s capacity for neuroplasticity to move oneself and one’s clients toward greater well-being. Through the lens of interpersonal neurobiology, this article will examine the benefits of mindfulness for clinicians, clients, and the therapeutic relationship. Lasting changes associated with mindfulness practices, including the hypothesized potential to alter one’s previously insecure attachment patterns, will also be discussed. An explanation of how to cultivate mindfulness by starting with presence and sustaining the practice with compassion will then be presented. Finally, practices that cultivate growth within the therapist–client relationship will be explained, along with clinical applications and recent research demonstrating the neural correlates of these practices and how they are effective at the level of the brain itself.     

Mindfulness meditation: a path of transformation & healing

As nurses, we have the unique privilege of witnessing and nurturing the healing process of the whole person--mind, body, and spirit. Teaching mindfulness meditation is a nursing intervention that can foster healing. The consistent practice of mindfulness meditation has been shown to decrease the subjective experience of pain and stress in a variety of research settings. Formal and informal daily practice fosters development of a profound inner calmness and nonreactivity of the mind, allowing individuals to face, and even embrace, all aspects of daily life, regardless of circumstances. By emphasizing being, not doing, mindfulness meditation provides a way through suffering for patients, families, and staff. This practice allows individuals to become compassionate witnesses to their own experiences, to avoid making premature decisions, and to be open to new possibilities, transformation, and healing.     

Effect of Seminar on Compassion on student self-compassion,mindfulness and well-being: A randomized controlled trial

ABSTRACT

Objective: Mindfulness-based interventions have been shown to have psychological benefits in college students. We explored the effects of an academic Seminar on Compassion on student psychological health. Participants: Forty-one participants (14 male, 27 female, mean age 19.8 ± 1.4 years) were assessed pre- and post- spring semesters 2013 and 2014. Methods: Students were randomized to the Seminar on Compassion or a wait-list control group. Participants completed self-report measures on anxiety, depression, perceived stress, self-compassion, compassion and mindfulness. Salivary alpha-amylase was also assessed. Results: At baseline, self-compassion and mindfulness were negatively correlated with depression, anxiety, and perceived stress. There were significant changes between the intervention and control group from Time 1 to Time 2 in mindfulness, self-compassion, compassion, and salivary alpha-amylase; however, there were no significant changes in depression, anxiety, and perceived stress. Conclusions: The course was effective in increasing mindfulness, self-compassion and compassion, and decreasing a salivary marker of stress.     

The Process of Personal Transformation for Adolescents Practicing Mindfulness Skills in an Alternative School Setting

This qualitative study examined the experiences of alternative school students as they participated in a mindfulness skills program. A 7-month school-based mindfulness skills program was integrated into the Grade 10 curriculum for high school students (N = 19; 10 boys and 9 girls, ages 15–17). Students engaged in mindfulness practices twice weekly during class time. Students practiced breath awareness, and seated, walking, and lying mindfulness meditation during the course of the program. Students completed initial and final questionnaires about their experiences as well as written journal entries based on their experiences in the program. At the completion of the program, 14 of the 19 program completers were interviewed (6 boys and 8 girls). Data analysis yielded two broad areas of perceived benefits of participation in the mindfulness skills program: intrapersonal benefits and interpersonal benefits. Intrapersonal benefits included themes of self-awareness and self-regulation (including cognition, emotions, and behavior). Interpersonal benefits included themes of building relationships (with peers, family members, and teachers) and learning to trust. These findings may be useful when planning school-based mindfulness programs and may serve as a guide for researchers studying mindfulness practices for youth.     

Effects of Video-Guided Group vs. Solitary Meditation on Mindfulness and Social Connectivity: A Pilot Study

Clinical Social Work Journal - Interest in mindfulness meditation continues to grow as accumulating evidence suggests mindfulness training encourages more positive functioning. However, basic...     

Therapists' Collusion with the Resistance of Rape Survivors

Based mostly upon a qualitative study of nine rape survivors, but also upon intensive review of the literature devoted to countertransference, vicarious traumatization, compassion fatigue, and burnout, this article examines collusive resistance, a process whereby therapists join clients to avoid confronting painful issues. It offers guidelines for the therapist to follow in the therapeutic dance to avert such collusion, and thereby to intervene more effectively especially with traumatized clients to facilitate their recovery actively, and, ultimately, to contribute to their true survivorship.     

The Use of Mindfulness Training to Create an ‘Accompanying Place’ for Social Work Students

Social work students experience emotional stress while having to perform and meet expectations from both academy and field. They may often feel physically and emotionally overwhelmed while struggling to make the time and space to fully process the varied experiences involved. There seems to be an unmet need for an ‘accompanying place’ where thoughts, feelings and dilemmas can be observed in a non‐evaluative way. Mindfulness has evolved lately as an efficient therapeutic technique in therapy. This paper describes a technique that applies mindfulness meditation in a group format in order to create a broader and richer learning experience that answers students' emotional needs. The group met for eight weeks. Its goals were to enhance self‐awareness and increase emotional support in handling field and academic stressors while experiencing different states of consciousness. Findings show that students were able to acquire new knowledge about themselves, experience autonomy in learning self‐containment and regulation, and gain insights regarding their professional self‐concept. Significance for social work training is discussed.     

Effectiveness of mindfulness-based coloring for university students’ test anxiety

Abstract

Objective: This study compared the effectiveness of mindfulness coloring (mandala), free drawing/coloring, and a noncoloring control activity for university students’ test anxiety, and assessed the relationship of dispositional mindfulness and response to intervention on mindfulness and test anxiety states. Participants: University students (n?=?167; 81.4% female; M_age = 21.29?years, SD?=?4.46) were randomly assigned to a mandala (n?=?57), free draw/coloring (n?=?58), or noncoloring condition (n?=?52). Methods: Participants completed standardized measures assessing test anxiety and state mindfulness pre–postactivity before completing a test, and two dispositional mindfulness measures. Results: Participants in both coloring conditions reported significant decreases in test anxiety and significant increases in state mindfulness pre–postintervention, and participants in the control condition reported significant increases in test anxiety. Reports of preintervention state mindfulness and test anxiety fully mediated relations between dispositional mindfulness and postintervention state mindfulness and test anxiety. Conclusions: Implications for research and practice on mindfulness coloring and test anxiety are discussed.     

Mindfulness theory and professional family caregivers in long-term care facilities

This study utilized Ellen Langer's theory of mindfulness to better understand how individuals who work in nursing homes apply their professional knowledge to their personal lives within the context of nursing home family caregiving. Using a sample of 10 professional and 10 non-professional family caregivers (n = 20), qualitative and quantitative methods were used to compare levels of mindfulness and nursing home knowledge. Qualitative analysis revealed similar responses for both types of caregivers in three out of four attributes of mindfulness. This indicates that being a family caregiver of an institutionalized parent is novel for both professional and non-professional caregivers. Narrative data indicates professionals were more mindful than non-professionals when using their nursing home knowledge to approach staff in a non-confrontational manner. Professionals were also more accepting of care-related problems than non-professionals.     

Mindfulness‐Based Relationship Education For Couples Expecting Their First Child—Part 1: A Randomized Mixed‐Methods Program Evaluation

This article is Part 1 of a two‐part series, in which we report on our evaluation of a mindfulness‐based relationship enhancement program for couples who are expecting their first child. In this mixed‐methods randomized clinical trial, we assigned 33 couples to the 4‐week Mindful Transition to Parenthood Program treatment group (n = 16 couples) or to a waitlist control condition (n = 17 couples). Men in the treatment group significantly improved in relationship satisfaction, mindfulness, and negative affect; women had no significant treatment effects. Small to large effect sizes were present for treatment group men and women in multiple areas. Mixed‐methods analyses demonstrated that this intervention may be especially helpful for men because of differences in social support needs, effects of program enrollment, and relational processes in the prenatal period. Video Abstract     

The affordance of compassion for animals: a filmic exploration of industrial linear rhythms

ABSTRACT

Compassion is an emotion that could be useful for improving the lives of animals within the intensive and factory farming system (IFFS). Rhythms that exist within this system play a role in making compassion difficult to realize, which formulates the research question: How do the rhythms of the IFFS shape the affordance of compassion for animals? Drawing on a cultural mode of analysis informed by Henri Lefebvre’s work on rhythms, this paper explored the rhythms of three films that focus on the treatment of animals in this system: Meat; Our Daily Bread and Never Let Me Go. Industrial linear rhythms seem to compromise the compassion offered to animals in the IFFS by manipulating the cyclical rhythms of animals and animalized bodies from birth, through life and at death. Compassion for animals and animalized bodies in the IFFS, this paper concludes, is often provided in a piecemeal and localized manner.     

Mindfulness in Patients With Gambling Disorders

This study explored facets of mindfulness between patients diagnosed with a gambling disorder (n = 26) and a community sample of non-gambling-disordered individuals (n = 33). Multivariate statistics comparing group differences showed the gambling-disordered patients exhibited significantly lower levels of mindfulness, emotional regulation, stress coping, and impulse control compared to the non-gambling-disordered group. Overall, gambling severity was negatively associated with higher levels of mindfulness and positively linked to indices of emotional dysregulation, stress proneness, and impulsivity. Correlations between mindfulness and emotional dysregulation and impulsivity were much stronger than those between mindfulness and the severity of disordered gambling behaviors as measured by the National Opinion Research Center DSM Screen for Gambling Problems (NODS). These findings are discussed in the context of possible implications for future directions in exploring mindfulness-based interventions as a plausible intervention among those with gambling disorders.     

Holding Mutual Vulnerability in Brilliant Sanity

Others’ suffering impacts the body-mind of the clinician, thus exposing his or her own vulnerability during the encounter. Self-defensive reactions naturally arise, probably reflecting one’s own embodied relational history and thus the difficulty to hold difficult affects. Reflecting on some contemplative aspects of Francisco Varela’s life, this paper explores how mindfulness and compassion practice may help therapists in establishing an open and nondissociated relation toward inner and intersubjective worlds. It suggests how particular qualities of being present may act as implicit modeling to mutually regulate and integrate experience. A clinical case investigates the interest of acknowledging mutual embodied vulnerability co-emerging in the encounter, fostering the therapeutic space potential for deep dialogue, connection, and mutual transformation.     

A Place for Every Tool and Every Tool in Its Place: Cognitive Integrative Perspective for Coherence on the New Frontier of Mind and Body Practice

There is currently a growing research and clinical knowledge base regarding the application of Eastern traditions, especially mindfulness and other forms of meditation, to direct practice. As we incorporate new tools for intervention into our toolkit, it is important to expand our theoretical framework so that we can know when to utilize these tools, how their mechanism fits with the tools we already have, and what kinds of change or outcomes we should expect from utilizing them. These new tools are powerful across many experiences of distress, but clear guidelines are necessary to maximize their benefit. Berlin’s cognitive-integrative perspective provides a framework that allows for reflective understanding and application of mind/body/spirit that is consistent with social work values and what we currently know about the underlying science of mind. Using concrete examples from direct practice, this paper will lay out the framework that is consonant with Siegel’s interpersonal neurobiology, discussed in this volume, and also firmly rooted in the person-in-environment perspective that is characteristic of social work.     

Compassion fatigue in marriage and family therapy: implications for therapists and clients

Given that marriage and family therapists are exposed to a wide range of circumstances that leave them uniquely vulnerable to experiencing compassion fatigue, it is important to examine the stresses and hazards they face and what those consequences mean for both themselves and clients. It is essential that they identify how compassion fatigue negatively affects the therapeutic relationship and overall treatment outcome as well as that of the personal life of the family therapist. The marriage and family therapist is responsible and ethically obligated to identify and implement ways in which he or she can prevent and remedy compassion fatigue.     

Is Self‐Compassion Selfish? The Development of Self‐Compassion,Empathy, and Prosocial Behavior in Adolescence

Both self‐compassion and empathy have been theorized to promote prosociality in youth, but there is little longitudinal data examining this possibility. We assessed self‐compassion, empathy, and peer‐rated prosociality yearly, in a cohort of 2,078 youth across 17 schools (M age at T1 = 14.65 years; 49.2% female), as they progressed from Grade 9–12. We utilized multi‐level modeling to predict prosocial behavior, nested within students, classes, and schools. We found that self‐compassion and empathy uniquely predicted peer‐rated prosocial behavior. However, only empathy predicted increases in prosocial behavior across time. While self‐compassion is not selfish, it does not appear to facilitate the development of kindness toward adolescent peers. Self‐compassion may help to buffer against possible negative effects of empathic distress.     

Childhood trauma and problem behavior: Examining the mediating roles of experiential avoidance and mindfulness processes

Objective: Childhood trauma is associated with a variety of risky, unhealthy, or problem behaviors. The current study aimed to explore experiential avoidance and mindfulness processes as mechanisms through which childhood trauma and problem behavior are linked in a college sample. Participants: The sample consisted of college-aged young adults recruited November-December, 2016 (N = 414). Methods: Participants completed self-report measures of childhood trauma, current problem behavior, experiential avoidance, and mindfulness processes. Bootstrapped mediation analyses examined the mechanistic associations of interest. Results: Mediation analyses indicated that experiential avoidance was a significant mediator of the association between childhood trauma and problem behavior. Additionally, multiple mediation analyses indicated that specific mindfulness facets–act with awareness and nonjudgment of inner experience–significantly mediated the same association. Conclusions: Interventions for college students who have experienced childhood trauma might profitably target mechanisms such as avoidance and mindfulness in order to minimize engagement in problem behavior.     

The Use of Common Humanity Scenarios to Promote Compassion in Healthcare Workers

ABSTRACT

The importance of compassion in healthcare is universally acknowledged. However, the factors that enhance compassion are not well understood. The perception of common humanity has been proposed as a prosocial perspective that leads to unbiased universal compassion. There has been a lack of research into the relationship between common humanity and compassion. This study examined the use of common humanity scenarios to promote compassion in healthcare workers. Seventy-five healthcare workers were randomly assigned to two groups and shown a different common humanity scenario. The healthcare workers were asked what effect viewing the videos had on their perception of common humanity and compassion. Thematic analysis was used to identify themes. Four main themes emerged: (a) common bonds; (b) people have the same needs; (c) no one wants to suffer; (d) seeing strangers helping others is motivating. Healthcare workers reported feelings of care, concern, and compassion after viewing common humanity scenarios.

IMPLICATIONS

• Viewing common humanity scenarios appears to lead to enhanced feelings of connection to others and compassion in healthcare workers.

• Using common humanity scenarios may be a useful compassion training strategy in healthcare.

• Further research is necessary to gain a better understanding of how viewing common humanity material influences compassion.

     

A Randomized Clinical Trial of Online Stress Inoculation for Adult Children of Divorce

Interventions for helping young adults cope with the stress produced by their parents’ divorce are rarely described or evaluated. Transitions, derived from a stress inoculation framework, was designed to foster stress-coping and parent–young adult relationship skills via the Internet. Participants (95 young adult college students who had experienced parental separation or divorce within the past year) were randomly assigned to experimental and delayed-treatment control conditions. Intervention modules included psychoeducation, relaxation, mindfulness meditation, cognitive restructuring, and communication skills. A multivariate analysis of variance yielded a significant treatment-by-repeated-measures interaction; univariate follow-up analyses of variance showed improvement on stress but not on relationship variables measuring quality of relationship with mother or father. Neither moderator nor intent-to-treat analyses altered this outcome pattern.     

“Judging a book by its cover”: meditation,memory, and invention in seventeenth-century Ukrainian title pages

This article concerns the use of visual paratexts in seventeenth-century Ukraine, and of illustrated title pages in particular. The books under analysis represent three crucial monuments of seventeenth-century Ukrainian sacred oratory. These are: Lazar Baranovych’s Truby sloves propovidnykh na narochityia dni prazdnikov (Kyiv, 1674), and Antonii Radyvylovs'kyi’s Ohorodok Marii Bohorodytsy (Kyiv, 1676) and his Vinets Khrystov z propovidii nedelnykh (Kyiv, 1688). The author concentrates on the “cognitive” aspect of their titular pages, dealing with them as a rhetorical process that emphasizes meditation, invention, and memory. More specifically, she investigates the correlation between the visual and the written as a specific literary-figurative “mode of thought” that stands in a long Christian tradition of expounding images as meditational tools. She shows how Baranovych and Radyvylovs'kyi interact with this tradition, arguing that their title pages provide readers-viewers with both a machina meditativa, a meditative apparatus for reflecting upon the mystery of the Incarnation, and a machina rhetorica, a repertory of images that the users of the books, often themselves preachers, could use to compose new texts.