Mindfulness and EMDR Psychotherapy: More Than Just a 'Good Idea'
What is Mindfulness Really?
Incorporating mindfulness sounds like a good idea, right? We’ve all been inundated with versions of mindfulness over the last several decades. It’s become a popular transtheoretical concept that informs many spiritual and therapeutic practices. For us as therapists, it’s a way of being that brings us into an exquisite presence with our clients to help them approach and process their pain. It is a moment-to-moment non-judgmental awareness.
Mindfulness, which is based in the ancient Buddhist tradition was brought into the secular health care system by Jon Kabat Zinn in the late 70’s and early 80’s with the development of the Mindfulness Based Stress Reduction Program at what is now The Center for Mindfulness at the University of Massachusetts, Worcester. This is where I learned the practice in the early 90’s and, like my experiences with EMDR psychotherapy, it was a transformative practice for me as well as for many of my clients who suffered from chronic mental and physical conditions that could not be successfully treated by traditional medicine.
How Does Practicing Mindfulness Help us with our Clients and EMDR Psychotherapy?
Helping ourselves as well as our clients develop and strengthen mindfulness skills applies to all phases of EMDR psychotherapy. Consider the concept of dual awareness as one example. It requires our clients to be able to simultaneously track their experience in the present while revisiting painful moments in the past. It also requires us to simultaneously track how our clients are doing as well as how we’re responding to what’s going on. I especially find it useful in the Preparation phase of the work and would like to share a case as an illustration of how applying mindfulness can help clients who need additional support with self-regulation and self-observation skills.
Working with Megan in the Preparation Phase
Megan was a young woman in her 20’s who presented with depression and anxiety. She was racked with intense shame and had frequent thoughts of suicide after struggling at an Ivy League university and needing to withdraw. Due to her rapidly deteriorating mood, she was admitted for a short inpatient hospital stay. Megan was a brilliant student who came from a long line of high achievers. Approaching her “failure experience” and the shame it evoked was so completely intolerable for her that it would lead to suicidal thinking that was very scary for both of us. She could not separate her value as a person from this experience, leaving her resigned to the falsehood that she was a failure and was to be doomed for the rest of her life, which for her was the full catastrophe.
We Must Pause to See Clearly
So, as I invited Megan, I invite you now to pause for a moment…maybe 30 seconds and focus on the direct experience of your breath. As your mind travels into the past or the future or some thought or criticism, gently shift your awareness back to the present moment and just notice your breath. Lather, rinse, repeat. Simple? Yes. Easy? Not so much. Not even for us.
When I invite clients to accept this invitation, I often refer to a snow globe that, after we shake it up, we then pause to notice how the flakes are settling. In the practice of mindfulness, we pause to notice so we can see things more clearly. We know that the “striving energy” we all engage in is very compelling and hard to shift out of unless we are deliberate about it. With that intention, it not only helps us tolerate distress, but it allows us to just notice and allows us to let whatever happens happen. Sound familiar?
I gave Megan a 10-minute recording, guiding her through her new practice. She returned the next week and proclaimed, “I have never considered myself separate from my thoughts before.” This was very different from knowing intellectually that she was not her thoughts. This was an emotional 'ah ha' moment, the development of an Observer Self that came out of practicing her mindfulness skills. So, how else could mindfulness help Megan approach this experience?
Introducing the Pillars of Mindfulness can Facilitate Readiness Utilizing RDI (Resource Development Installation)
With the space that was created by being able to observe her thoughts, Megan took her next steps, considering self-compassion and the pillars of mindfulness, which strengthened her readiness for EMDR reprocessing. The pillars of mindfulness (Kabat-Zinn) are: non-judging, patience, acceptance, beginner’s mind, trust, and non-striving, and letting go. I asked Megan what quality or qualities could help her approach her recent failure experience. Of course, Megan selected non-striving, the quality she needed, but was the most elusive.
We used the Resource Development Installation Protocol to help Megan begin to explore and embody this important quality. 'Being' instead of 'doing' felt heretical and was very difficult for her, but it was an option she had not considered, a door number 3 if you will, between excelling and failing, which meant death. We were able to apply her determination to help her cultivate this quality in her daily life as she continued to prepare for the memory work that awaited her.
After incorporating mindfulness in the Preparation phase, Megan was able to approach and reprocess the painful memory of withdrawing from the Ivy League school as well as the foundational memories where she learned that she had to be perfect. She can now hold herself to a more reasonable standard and, in fact, has adopted a non-striving approach to her life.
Although mindfulness can be useful in all phases of EMDR psychotherapy, the need to strengthen a client’s readiness for memory reprocessing allows both the therapist and the client to approach this enigmatic territory sooner, and with a greater capacity to trust the process! Finally, it is perhaps the greatest form of self-care we can employ, as it not only helps prevent therapist burnout, but it is also an act of kindness towards ourselves. Taking care of ourselves, too? What a thought…