Teaching Clients How to Use Mindfulness
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Many clients disconnect from their thoughts, feelings, and bodily sensations to mentally survive. Short term, this benefits a client and helps them endure a traumatic event. Over time, this disassociation from mind and body will harm your client’s health and block their healing. The more they disconnect, the more they lose awareness of any emotional, mental, or physical sensations they experience.
The practice of mindfulness helps clients become in the present moment by teaching them techniques that bring their attention to the here and now. Mindfulness techniques can be used with various clients to help them reconnect to the physical sensations in their bodies and find new ways to heal.
Mindfulness skills are a part of Dialectical Behavioral Skills training, Marsha Linehan’s work. She discovered that observing and describing emotions and thoughts, in a nonjudgmental way, helped client’s regulate their moods. From the American Journal of Psychotherapy (2018):
Mindfulness is central to DBT, and thus mindfulness skills are labeled the “core” skills. These skills…are behavioral translations of common instructions given across Eastern and Western contemplative practices. Each skills module has at least one mindfulness skill, e.g., mindfulness of others in interpersonal skills, mindfulness of current emotions in emotion regulation, and mindfulness of current thoughts in distress tolerance.
How to Begin Mindfulness Practices in Your Sessions
The first recommendation for all clients, whether they experience depression, anxiety, trauma, or other disorders, is to have a physical exam with their primary care physician. This is done to rule out any health issues that could be the cause or a contributing factor to the symptoms they are experiencing. Once they receive the all-clear from their doctor, mindfulness exercises can be taught.
Psychoeducation will help your clients learn how these tools will help decrease their symptoms. Begin by explaining the mind’s natural tendency to wander out of the present moment. A person’s mind often focuses on the past, tries to predict the future, and classifies or judges themselves, people, and experiences. Normalizing these propensities helps clients to accept these thought processes.
Education will also aid clients in understanding what to expect during a mindfulness session. They may experience their unpleasant physical sensations increasing at first. Assure them that this is normal because they are now drawing the attention back into the body rather than outside the self or to another part of the brain.
If they practice and sit with the sensation momentarily, it will decrease. It is important to tell your clients that desensitizing them through mindfulness will help them become aware and that their symptoms are not dangerous, even though they feel uncomfortable. Counselors hold the space in session for their clients as they safely feel and explore each sensation.
Mindfulness alone will not address cognitive distortions. Once the client is more settled into their physical body and experiences a sense of safety, cognitive work needs to be done to address distorted thoughts. There is a mindfulness-based cognitive therapy, which is different from mindfulness, called Mindfulness-Based Cognitive Therapy. Mindfulness-Based Cognitive Therapy (MBCT) trains clients to use mindfulness meditation and elements of cognitive-behavioral therapy (CBT) in a group setting. Numerous researchers on this topic have recommended more studies to be conducted with this specific method of treatment.
Who Can Benefit the Most from Mindfulness Exercises?
Clients with anxiety disorders tend to do well with mindfulness techniques. Many clients with anxiety avoid the unpleasant physical and mental sensations they experience. These physical sensations are a racing heartbeat, dry mouth, and shortened breaths, to name a few. Mindfulness helps these clients reconnect with the physical body and be in the present moment.
Clients who have experienced trauma often benefit from mindfulness. Many clients with trauma symptoms tend to dissociate to separate themselves from traumatic memories or sensations in the body. To address trauma, the client needs to be in their body and in the present moment. Once the client learns to be in the present moment and establishes a feeling of safety in their body and environment, work needs to be done to address the trauma cognitively.
Clients who are living with depression may find relief through mindfulness exercises. Clients with depression have a tendency to experience more negative thoughts about themselves and ruminate in these thoughts. A 2019 study conducted by Parmentier et al found,
We sought to determine the extent to which four mechanisms of emotional regulation (cognitive reappraisal, expressive suppression, rumination and worry) mediate this relationship, factoring in the experience of participants with mindfulness meditation. All four emotional regulation mechanisms mediated the relationship between mindfulness and depression. As expected, mindfulness decreased depression and anxiety by increasing reappraisal (negatively associated with depression and anxiety) and reducing worry, rumination and suppression (negatively associated with depression and, expressive suppression, with anxiety). Worry and rumination proved to be the most potent mediating factors, while suppression and reappraisal played a significant but relatively smaller role.
Counselors could benefit greatly from practicing the mindfulness techniques in which they are trained. The field of therapy has high rates of burnout and compassion fatigue. Mindfulness may decrease these effects to help counselors tolerate ambiguity and stress. In a study of counselor trainees conducted by Fulton for the Journal of Mental Health Counselors, it was reported, “The current study offers support for the suggestion that both mindfulness and self-compassion are associated with important counselor variables such as client-perceived empathy, affect tolerance, ambiguity tolerance, and session dynamics.”
When counselors experience an energy drain or overwhelm during the day, using mindfulness techniques is one way to bring your attention back into the present moment. If the counselor is distracted or upset, being present with the client and help them effectively is more challenging. The more you practice these techniques, the more at ease and confident you will be with yourself and teaching these exercises to your clients.
Types of Mindfulness Techniques For Counseling Sessions
One specific technique to teach your clients within the counseling session is holding an ice cube. The cold sensation of the ice will draw your client’s attention to their hand in the present moment.
A couple of ways you could help your clients to reconnect to their bodies is to have them make contact with the Earth. Go outside and invite your client to take off their socks and shoes to walk on the grass barefoot. Join them in this exercise as an act of modeling. As you walk, describe the sensations you experience. This helps normalize your client’s activity and connects them to this moment. As your clients walk, have them describe their sensations. Outside the session, ask your client to practice placing their hands in the soil, feel their feet on the beach sand, etc. After each experience, have them describe each sensation and write their observations in a journal.
Another mindfulness counseling activity done in the office is to focus on one object in the room. The client describes the object without applying any judgements. For example, a red ball rather than if the ball elicits a positive or negative memory. The senses can be applied to this exercise. Using sight, touch, smell, taste (if applicable), and hearing to describe an object.
Mindful Eating
Mindful eating is held as a group activity or in an individual session. Have the client describe each sense using a piece of fruit or chocolate. For example, the client describes what the food looks like, the taste of the food, the feel of the food, the smell of the food, and the sound of the jaw chewing. Slowing down and focusing on each sensation of eating, without judgment, brings relaxation to the body, mind, and spirit.
According to Cherpak 2019,
Mindful eating is a non-standardized protocol that complements other interventions to optimize digestive function, while enhancing self-acceptance, mind-body-food awareness, and overall wellness. Mindful eating offers a scientifically-proven, effective way to help regulate the stress response for optimal digestive function, which is the cornerstone of wellness and survival.
The goal of mindful eating is not to lose or gain weight but rather to be present to eating in an accepting way. Clients learn the feeling of fullness and the signs of hunger and often choose to eat healthier. Nelson 2017 explains,
Mindfulness is a process-oriented, rather than an outcome-driven, behavior. It is based on an individual’s experience of the moment. The individual focuses on appreciating the experience of food and is not concerned with restricting intake. The person eating chooses what and how much to consume. It is not coincidental that, within a mindful approach, the person’s choices often are to eat less, savor eating more, and select foods consistent with desirable health benefits.
Lisa Hutchison, LMHC
Writer & Contributing ExpertLisa Hutchison, LMHC, is a licensed mental health counselor for the Commonwealth of Massachusetts. She works for professionals who want to treat and prevent compassion fatigue. With over 20 years of psychotherapy experience, she helps her clients assert themselves, set boundaries, and increase their coping skills. Her specialty is decreasing stress, anxiety, and depression while increasing realistic methods of self-care for those who help others. Ms. Hutchison’s psychological advice has been featured in Reader’s Digest and the Huffington Post. Her articles have been published in numerous magazines, including Grief Digest and Today’s Caregiver.
Lisa is the bestselling author of I Fill My Cup: A Journal for Compassionate Helpers and a faculty member writer for NetCE. Her latest continuing education unit publication is “Setting Ethical Limits for Caring and Competent Professionals.” She has taught creative writing in colleges and presented on boundaries for the compassionate helper; the use of expressive art to heal grief, anxiety, and depression; inspirational and motivational topics; and creative writing techniques.