Clinical Handbook of Mindfulness (4 page)

Graduate School of Arts and Sciences at Vanderbilt University. Mr. Treadways

research focuses on the behavioral and neurobiological mechanisms of emo-

tion regulation among healthy individuals and individuals with depression.

He is especially interested in understanding how the utility of different emo-

tion regulation strategies may vary according to context.

Varra Alethea A.
is a Mental Illness Research, Education, and Clinical Center

(MIRECC) Postdoctoral Psychology Fellow in Post Traumatic Stress Disorder

(PTSD) at the VA Puget Sound Health Care System in Seattle, WA, USA. Her

primary clinical and research interests involve the application of acceptance

and mindfulness-based therapies to the treatment of individuals with post-

traumatic sequalea including PTSD and substance abuse disorders. She is the

author of several chapters and research articles concerning the application

and conceptualization of Acceptance and Commitment Therapy.

Vijay Aditi
is a graduate student in the Clinical Psychology doctoral program

at the University of Nevada, Reno. Her research interests are in the area of

interpersonal violence and the impact and prevention of sexual revictimiza-

tion. Ms. Vijay’s clinical interests and in the applications of mindfulness based

treatments for trauma survivors.

Walsh Erin
is a doctoral student in clinical psychology at the University

of Kentucky. Her current research examines how particular ways of emo-

tional responding (acceptance vs. avoidance) influence psychological and

physiological states. Other interests include investigating the psychological

and physiological mechanisms of change associated with mindfulness-based

practices, as well as exploring the transdiagnostic utility of such practices.

Warren Brown Kirk, PhD,
completed graduate training in Psychology at

McGill University and post-doctoral training at the University of Rochester.

He is currently an Assistant Professor of Psychology at Virginia Common-

wealth University. His research centers on the role of attention to and aware-

ness of internal states and behavior in self-regulation and well-being. He has

a particular interest in the nature of mindfulness, and the role of mindful-

ness and mindfulness-based interventions in affect regulation, behavior regu-

lation, and mental health in healthy and clinical populations. He has authored

numerous journal articles and chapters on these topics. His research is

funded, in part, by the National Institutes of Health.

Woods Susan
, M.S.W., L.I.C.S.W. is a psychotherapist who has practiced

meditation and yoga for 25 years. Ms. Woods has been a long time teacher of

Mindfulness-Based Stress Reduction (MBSR) and more recently Mindfulness-

Based Cognitive Therapy (MBCT). She is certified as an MBSR teacher by

the Center for Mindfulness in Medicine, Health Care, and Society, Univer-

sity of Massachusetts Medical School, Worcester, Massachusetts, USA and has

taught there. Ms. Woods trains health care professionals in mindfulness-based

interventions and teaches a MBCT professional training program with Zin-

del Segal, PhD. Ms. Woods co-designed and leads an Advanced Teaching and

Study professional training program for experienced MBCT teachers.

xxiv

Contributors

Zylowska Lidia, M.D,
adult psychiatrist, is a Co-founder of and the

Assistant Clinical Professor at Mindful Awareness Research Center in the

Semel Institute at UCLA. Her research investigates the use of the Mind-

ful Awareness Practices (MAPs) for ADHD adults and teens. In her work,

Dr. Zylowska promotes integration of conventional psychiatric treatment

with mindfulness training and other self-regulation tools to enhance psy-

chological well-being across the lifespan. http://www.marc.ucla.edu and

http://www.lidiazylowska.com.

Foreword

Anytime a handbook such as this one appears, we know from experience

that it represents a kind of pause in the head-long momentum of research,

inquiry, and application within a field; a moment in which we can individu-

ally and collectively stop and reflect, take a breath so to speak, and consider

where we are at. In twenty years, if it does its job, many of the details herein

might be obsolete, or perhaps seen as na¨ıve or preliminary; even as, in the

broad-brush strokes of the field and its inevitable links to, if not, hopefully,

embeddedness within the dharma, many aspects of these pages and findings

will always be germane, perhaps even timeless and wise. In twenty years,

this book might, as most handbooks do, take on a new role as an historical

object in its own right, a marker of a creative moment in the history of an

emerging field, still in its infancy.

But in this here and this now, this handbook is a marvelous vehicle for

gathering from far and wide a range of different current views and efforts. It

offers the contributors an opportunity to say to the world and to each other:

“This is what we have been thinking,” “This is what we have tried,” “This

is what we have seen,” “This is what we suspect is going on,” “This is what

we have learned.” It is also an occasion to say with a degree of openness

and candor: This is where we have not succeeded, or were surprised, or dis-

appointed.” “This is what we feel is missing. “This is what we don’t know.”

Or even, “This is what we suspect we don’t even know we don’t know.”

Most of the presentations in this book do just that, and the authors are to be

congratulated for their openness and courage in this regard. As a result, this

handbook presents a rich treasure trove of important issues for contempla-

tion, deep inquiry, and study, as well as a hearty invitation to come to it all

with a broad and an open-minded skepticism, renewing hopefully, over and

over again, our commitment to keep a beginner’s mind, in Suzuki Roshi’s

immortal phrase
[1].

A volume such as this one is a potentially powerful resource for actually

educating ourselves to the nature of possibly new dimensions embedded

within our own work and the work of others ... orthogonal ways of thinking

and seeing that can reveal and open up new dimensions of clinical under-

standing and care as well as new dimensions of basic research into questions

such as the nature of what we call
mind
, and how it relates to emotion,

xxv

xxvi

Foreword

thinking, consciousness, awareness, attention, perception, the brain, the

body as a whole, and what we call “the self.”

As so many of the contributors point out, none of us should imagine that

we fully understand mindfulness, nor its implications in regard to these or

other questions. Nor should we fall into the conceit that we come even close

to fully embodying it in our lives or work, whatever that would mean, even as

we speak of the importance of doing so. It is very important that we neither

idealize nor reify whatever we mean when we speak of mindfulness. Really,

we are all beginners, and when we are truthful about it, we also cannot but

be humbled by the enormity of the undertaking. This is a very healthy frame-

work to adopt. Happily, it is palpable in the work presented here by the many

different authors and groups. The editor, Dr. Didonna is to be congratulated

for taking on such an ambitious and challenging project and shepherding it

to completion.

It is also important to keep in mind that, as deep and broad as the author

list is for this handbook, there are many more colleagues out there, liter-

ally around the world, who are doing important work under the umbrella

of mindfulness and its clinical applications who have not contributed to this

volume. Their contributions as individuals and groups to the overall conver-

sation, inquiry, and forward momentum of the field are immense. No doubt

many will study these presentations in some detail, perhaps agreeing with

or arguing with particular formulations or findings, recommending the hand-

book to their students, and possibly here or there making particularly cre-

ative use of some of the nuggets lying within to stimulate their own thinking.

So while a handbook such of this cannot in the end be all-inclusive, it can

nonetheless serve as a catalyst within the entire field (and, dare I say,
sangha

of clinicians and investigators and practitioners, hopefully overlapping in the

majority of people?) in pausing in the way I have just suggested, reflecting

on where things are now in their fullness and their incompleteness, and then

participating in both the inner and the outer conversations (through, respec-

tively, silence for the former, and speech, deep listening, and writing for the

latter), asking the deep questions and trusting our deepest intuitions about

what is called for now, given the scope of the conditions, challenges, and

promises inherent in psychology and psychotherapy, medicine and health

care, neuroscience and phenomenology, and indeed, in the world – domains

in which we are all agents of creativity, wonder, and caring.

The welcome advent of this volume
[2]
is diagnostic of a remarkable phe-

nomenon that has been unfolding in both medicine and psychology over the

past five years or so, and promises to continue long into the future in ways

that may be profoundly transformative of both disciplines and of our under-

standing, in both scientific and poetic terms, of what it means to be human,

and of our intrinsic capacity to embody the full potential of our species –

to which we have accorded the name
homo sapiens sapiens
– for wakeful-

ness, clarity, and wisdom. This intrinsically self-reflective nomenclature and

the implicit promise or potential it carries brings to mind the rejoinder of

Gandhi when asked by a reporter what he thought of Western Civilization,

to wit: “I think it would be a very good idea
[3].
” The same might be said of our species’ name.

For
homo sapiens sapiens
really means
the species that knows and knows

that it knows
, from the Latin verb
sapere
(to taste or to know). To
know

Foreword

xxvii

invokes awareness and meta-awareness, certainly one of the core mysteri-

ous elements, along with language, cognition, compassion, and music that

together constitute the final common pathway, one might say, of what it

means to be fully human. I prefer
awareness
and
meta-awareness
to
cog-

nition
and
meta-cognition
, as the latter formulation unavoidably privileges

conceptualization. Any direct first-person introspective examination of the

human repertoire from the perspective of experience itself requires a much

larger container, one that distinguishes between thinking and awareness, and

differentiates wisdom from knowledge and information; one that includes a

capacity to embody what is known in ways that round out and complete

the full potential of that human repertoire. One might say that the fate of

the earth and of the species itself hangs in the balance. The challenge may

come down to whether or not, and to what degree we can embody and enact

the qualities that this appellation is pointing to. Mindfulness may be the key

to this awakening to the full potential of our nature as human beings, both

individually and as a species.

If one charts the number of scientific papers over the past twenty-five

years or so with the word
mindfulness
in the title, one sees the phenomenon

depicted in Fig.
1
[4].

Fig. 1.
Number of publications with the word “mindfulness” in the title by year since

1982.

It is immediately apparent that the field is growing exponentially. As sug-

gested above, this volume both in number of contributors and in its shear

size represents a watershed in this process. It allows us to drink in the vast

range of interest and potentially useful applications of mindfulness in the dis-

ciplines of psychology, psychiatry, and psychotherapy and the breadth and

depth in the quality of the work and the thought and effort behind it.

The book itself will also very likely serve as a catalyst to amplify even

further the phenomenon depicted in Figure
1,
as it both legitimates aca-

demic and scholarly interest and invites students and young investigators and

clinicians to consider whether this emerging exploration of mindfulness res-

onates in some deep way with their calling in both professional and personal

xxviii

Foreword

terms. My hope is that it will also germinate a whole new generation of

research investigations that bring together the emerging fields of what is now

being called
contemplative neuroscience
or neuro-phenomenology on both

the cognitive and affective sides, with practical high-quality mindfulness-

based clinical applications that may be of benefit to large numbers of people

who are experiencing pain and suffering in their lives, both from outright