If your clients aren’t 100% sold on meditation, you can still use mindfulness in your practice. Here are 8 exercises that have helped transform my clients lives. They are all based on mindfulness principles: some draw on mindful cognitive-behavioral therapy, some on Buddhist principles, and some on ancient healing practices. Although I discuss how to use these techniques with panic and anxiety, you can use them with depression, PTSD, ADHD or just about any other issue.
Here are the techniques covered in this post:
1. Mindful Worrying
2. Detachment from Overthinking
5. Freedom from Attachment (Letting Go of Desire)
6. Mindful Living
7. Mindful Movement
8. Mindful Walking
1. Mindful Worry
Is it possible to mindfully worry or mindfully panic? One answer to this question comes from the book Mindfulness In Plain English. In this classic, Henepola Gunaratana says the following:
“In order to observe our own fear, we must accept the fact that we are afraid. We can’t examine our own depression without accepting it fully. . . . You can’t examine something fully if you are busy rejecting the existence of it. . . . ”
To be mindful, we must be able to recognize our negative experiences as such. We must recognize worry as worrying, depression as depression, and so on. So mindful worrying doesn’t mean that we are worry-free. It means that we are aware that we are engaging in worry and recognize our worrying for what it is – a version of reality created by our minds rather than reality itself.
This is one of the first skills that clients need to start managing panic and anxiety. For panic survivors, this means accepting that their panic arises from their own distorted perspectives rather than from the real threat of having a heart attack, for example. For anxious people, it means recognizing that they won’t lose their job if they make a mistake at work. Mindful awareness means recognizing our mental experiences as our own perceptions.
Exercise: Teaching Your Clients To Be Mindful Worriers
Listen to your clients’ anxieties and fears and gently help them to distinguish how much these fears are real vs. how much they are “mental exaggerations.” Have a discussion. See if they buy into this idea. Then bring it up throughout treatment. Here are some helpful questions to raise awareness:
How true have these fears been in the past?
Is there a “kernel of truth” to the fear, meaning there’s some reality to it but the client’s overall perspective is way out of proportion to reality?
If the fear actually comes true, will the consequence happen? For example, if your client is terrified of sweating in public, will it result in negative attention from strangers. Help your client to test out these beliefs in the future or reflect on whether they have come true in the past.
Do they distinguish emotions from reality? Help your clients to understand that their emotions will often be triggered but that doesn’t mean the fear is real. In cognitive-behavioral therapy, this is called “emotional reasoning.” It goes like this, your clients feel so physically over-aroused that they believe their fears are justified. Talk to your clients and help them to see that many times, their negative outlook may be the false signals of negative emotions.
Do you know your clients better than they know themselves? If you can tell your clients about their thought processes, fears, and habits, you can win a lot of credibility. I like to say something like, “When you go to situation _____, is one of the first things you start to think about _______?”
Just one of these questions could be an entire therapy session itself. But remember this is a learning process for your clients – not a once-and-done discussion. You have to come back to these ideas over and over to help them to understand them fully, to buy into them, and to put them into practice.
2. Detachment From Overthinking
One of the challenges that most anxious people have is being painfully aware of how much they worry. So much so that they end up worrying about worrying. This “meta-worry” becomes a problem in itself.
In fact, the harder we try to avoid an unwanted experience, the more it leads to that experience. This is called Ironic process. I’m sure you’re aware of this concept. To oversimplify it, the harder we try to make something unwanted go away, the more that thing intrudes into consciousness and evokes the very response we are trying to prevent.
One of the beauties of mindfulness is the idea that we don’t have to control our thoughts. We don’t have to try to make our negative thoughts go away. We just have to learn to accept them. I was going to write up some steps for this but I actually came across a guided meditation created by Michael Sealey called Detachment from Overthinking. It is so spot on to the idea of detachment that I’m just going to put the link to the video below. I have recommended this to many clients. It can also be purchased as an MP3. (I am not promoting anything here and get nothing for this mention. I honestly think this meditation is one of the best I’ve heard).
This seemed like a crazy idea to me when I first heard it, but hear me out because this idea is profound and can change your clients.
In our high stimulation world, we are often presented with so much information, images, opportunities, that it’s overwhelming for our minds. One consequence of this is thinking and thinking and thinking . . . Tell me if this quote from one of my clients sounds familiar: “I just can’t shut off my brain when I try to go to sleep.” Of course, we can’t just shut off our mind if it’s been running all day. The issue isn’t shutting it off before bedtime. The issue is shutting it off during the day so we don’t have to at bedtime.
Many of many anxious and panicked patients have a hard time because they tend to think and think and engage in endless mental chatter. Unfortunately, this kind of thinking is really a form of self-criticism, over-analysis, or rumination. Sometimes we become reactive to our thinking if we do it too much. We can benefit from learning to stop the constant mental chatter that is a part of modern life.
Other examples of overthinking include bemoaning our job and how awful it is, analyzing our relationship and our partner’s flaws, wondering why life hasn’t been fair to us, thinking about small negative thing that happened over and over, dreaming about how much better life would be if we had more money.
Ekart Tolle has opened my eyes to the concept of nonthinking. In this article, he explains the idea of nonthinking. In the video below, he talks about how to break the habit of overthinking.
Ekhart Tolle Explains How to Avoid Overthinking
Exercise: How to Recognize and Let Go Of Overthinking
- Point out the problems with overthinking, e.g., ruminating, obsessive thinking, self-critical analysis, and so on.
- Introduce the idea of nonthinking, that is, doing without internal dialogue.
- Give a few concrete examples of how to do this, e.g., listening to music you don’t have to talk to yourself, taking a walk you don’t have to think, or even talking can be done without thinking about what we are going to say.
- Listen for examples where your clients are overthinking.
- Discuss how your clients can get involved in the present moment instead of analyzing. Distraction and other techniques can direct the mind elsewhere and are usually more effective than just trying to just stop thinking.
One of the first steps to changing how we react to our fears is recognizing them. Many patients with panic see their fearful thoughts as reality. They think about attending a meeting at work and imaging themselves being criticized in front of others.
Perspective taking is hard for those with anxiety, panic, depression and other problems. A helpful way to recognize judgment is to look at examples of extreme thinking. I like to use the distorted thinking list from David Burns’ book, “The New Mood Therapy.” This list of 10 cognitive distortions is a simple way to start.
- All-or-Nothing Thinking / Polarized Thinking.
- Mental Filter.
- Disqualifying the Positive.
- Jumping to Conclusions
- Jumping to Conclusions
- Magnification (Catastrophizing) or Minimization.
- Emotional reasoning
- Should statements
In the video below, David Burns provides a powerful explanation of how our negative thinking can lead to depression, helplessness, and other negative reactions. It won’t be anything new to a trained professional but it’s an eyeopener for many clients. Assign it as homework to watch and it will help your clients understand how thinking affect emotion.
Exercise: Recognizing and Changing Negative Thinking
Have your clients write about their negative thoughts for two days. Write as much detail as possible and bring them back into the next session. Explain to your clients that you want descriptions of their negative beliefs and negative thinking – not descriptions of their behaviors or emotions. You’re trying to answer the question, “What did I say to myself that made me feel this way” not the question “what did I feel?” Instead of writing, “I was pissed off when my wife said I didn’t handle the kids right.” Write “I was pissed off because my wife always criticizes me and never appreciates what I do with the kids.” In session, discuss your clients’ two worst negative thoughts and ask the following questions:
- In what ways was this thought extreme? Can you find at least one cognitive distortion that applies to this thought (there could be many)?
- Is there a kernel of truth to this thought? What part is true and what part is exaggerated?
- What would be a more accurate way to look at this thought?
- If there was something negative can you acknowledge without fault finding in yourself, others, or the situation? Can you acknowledge the negative without then going on to think of even more negatives?
5. Freedom from Attachment (Letting Go of Desire)
Exercises: Overcoming Attachment and Desires
- Ask your clients to write three things they most feel they are lacking in themselves or their life. Ask why they feel that? How would life be different for them if they had “this thing?”
- Where you go from here depends on your style but think of it like self-esteem work. When we help clients with low self-esteem, we help them recognize that they either already have what they feel they are missing or they never needed these things in the first place.
- The mindful approach is to recognize your attachments to ideas about who you are, what you have to be, how the world should work, what has to happen to make you happy, and so on. You can only achieve this understanding, as with many ideas in mindfulness, through understanding your views of reality, accepting that they are the source of emotional suffering, and learning to let go of those desires (i.e., nonattachment). This takes many discussions and much time with your clients and doesn’t come in a single session. Here is a blog that provides a down-to-earth description of this.
- To narrow the focus for our nervous clients, we can focus on their desires to rid themselves of their negative emotions or undesirable parts of themselves. We can enlighten them to see that the more we want something to be different the more that thing defines us.
6. Mindful Living
The ultimate goal of any mindfulness training is to help our clients live life in a more mindful way. They are not just mindful during meditation; they are mindful when they are driving to work, cleaning the house, or eating dinner with the family.
For many, mindfulness doesn’t come automatically. It requires deliberate attention to do things mindfully. That’s why I like to help my clients select specific task to practice mindfulness. Without exception, my clients who are putting mindfulness into practice in everyday life are benefiting the most.
Exercise: Mindful Living
- Set aside 10 or more minutes to do something mindfully. Find a time when you aren’t going to be rushed, e.g., it’s not a good idea to mindfully eat breakfast if you chronically run late.
- Don’t multitask. Just do this one thing. Make sure it is something you can focus on.
- Approach this task as if it is the only thing you have to do. Nothing else matters.
- Pay attention to all the steps in this experience. Use your senses. Notice things that you might have done hurriedly before.
- If you start to think about other things bring your attention back to the task at hand.
- If you start to feel rushed, bored, impatient, or worried, just do your best to sit with that feeling. If it doesn’t go away, focus on your breath for a minute and then go back to the task at hand.
Here are some activities to practice mindfulness. I recommend simple and pleasant activities to start.
- Brushing teeth
- Taking a walk
- Making coffee
- Eating breakfast
- Cleaning dishes
- Folding laundry
- Playing with pets
- Listening to music
- Getting dressed
- Walking from the house to your vehicle
- Riding a bicycle
In your next session, discuss how this experience contrasts with the typical way of doing things. Mindful living is something everyone can use in modern life. The average person has more than the wealthiest person a century ago yet feels no happier. We can all benefit from learning to be more engaged in life.
7. Mindful Movement: Yoga, Tai Chi, Qigong
Meditation is the go-to technique when we think about teaching mindfulness to our clients. But for many people, meditation is a foreign idea and may not appeal to them. (I’m not saying don’t teach it but how about starting with something else for these people). Mindful movement (Yoga, Tai Chi, and Qigong) may be a better way to teach mindfulness for some.
I can say as a participant in yoga, I totally get why it helps anxiety. Yoga not only helps increase flexibility but it also increases mindful awareness of the breath and body. Shauna Harrison writes on the MindGreenBoby website about how yoga helped her with panic attacks. You don’t have to be an expert at yoga or even do it yourself to recommend it. Think about it. Have you ever recommended AA? Do you feel you have to be a member yourself? No! The same applies to yoga.
Many studies have looked at the effectiveness of mindful movement for all kinds of mental health conditions. One interesting study found that yoga was an effective intervention for panic, reducing all kinds of panic symptoms. So that means just referring your clients to yoga, Tai Chi, or Qigong can be a good intervention. The most interesting part was that yoga added to a cognitive-behavioral therapy (CBT) program was more effective than yoga alone. If you can incorporate yoga into what you do, that is, specifically teaching yoga to your client in session and explaining how it helps whatever problem they’re struggling with, that could make it most effective. That is not something I can do (since I am not an active yoga practitioner) but if you can, more power to you.
8. Mindful Walking
Exercise: Mindful Walking
- Find a space to take about 10 to 20 steps to walk and then turn around. You will be walking the path slowly and then turning around and going the other way.
- Bring your awareness to your body.
- Walk more slowly and focus on some part of the experience, like the sensations in your feet.
- Notice the feelings as your feet leave the ground, as your feet are in the air, and as your feet reconnect with the ground.
- As a simple alternative, just focus on one part of walking, like the feeling as your feet reconnect with the ground.
- Be present moment aware. Try not to anticipate steps, getting to the end of the path, or finishing the exercise.
- Like any mindfulness meditation, when your mind wanders, bring it back to the present in an accepting and non-judgmental way.
Another alternative is to apply mindful walking to taking a normal walk. Make sure to tell your clients not to multitask. Don’t do this while exercising or shopping. Yes, you can do it then but I find that people get sucked into the other activity and aren’t approaching it mindfully. Instead of focusing on the feelings in their feet; they can focus on any sensation while they walk: sights in the area, sounds, the feelings on their skin . . .