Mindfulness is a powerful skill that has been taught for thousands of years by many world religions: Judaism, Islam, Buddhism, and Christianity, to name a few. In the 1980s, Dr. Jon Kabat-Zinn introduced nonreligious mindfulness skills to patients dealing with chronic pain. Since this time, mindfulness meditation and exercises have been integrated into many forms of psychotherapy, including Dialectical Behavior Therapy. A recent study has even shown that daily meditation and being mindful of daily events may be just as effective as taking medication to prevent relapses of depression.
Yet another study indicated that meditation exercises are shown to boost mood and mental toughness. While this all sounds wonderful, it can be quite difficult to be fully present to the reality unfolding around us. To be mindful of the present moment involves being aware of emotions, thoughts, physical sensations, and actions in the present moment, without judging, criticizing, or assigning meaning to these events (McKay, Wood, & Brantley, 2007). Simple enough, right? Maybe not. We live in an incredibly fast-paced society, full of distractions and diversions. At any given moment, there may be so much sensory input coming in from the external world and from our internal chatter that it can be quite challenging to bring ourselves back to the present moment.
Basic Mindfulness Exercises
Below are some basic mindfulness exercises to begin the process of awakening to the constantly unfolding present moment, adapted from The Dialectical Behavior Therapy Skills Workbook (McKay, Wood, & Brantley, 2007):
1. A “Mindless†Exercise
People often get distracted from the present moment and “zone out.†When this happens, you are no longer present to your life. It is going on around you, but you are not participating. Common consequences of not being present are feeling lost, anxious, or frustrated. Other people in your life may
be frustrated with you for not being present. What follows are some common situations in which many of us experience being unmindful. Notice which situations resonate with you. Identifying common themes is a great place to start re-engaging with the present moment.
- In the middle of a conversation, you suddenly realize that you haven’t heard what the other person just said and you feel lost or confused.
- While walking into a room, you suddenly forget why you entered the room in the first place.
- While talking with another person, you are so distracted by what you want to say next that you aren’t really listening to what is being said.
- After putting something down, you find that you cannot remember where you just placed it.
- While taking a shower, you are so busy thinking about something that just happened or is going to happen later that you forget what you’ve already washed or not washed.
- While driving, you are so distracted about your day’s events or tomorrow’s events that you forget which roads you took or where you are going.
2. Focus on a Single Minute
This is a simple concept that can have a powerful impact. The purpose of this exercise is to help you become more aware of your internal sense of time. Many of us have the sensation that time passes very quickly, resulting in the desire to rush to “get things done.†When you are always focused on the next thing to do, you lose sight of the present moment. Others have the sense of time passing very slowly, which may result in the sense that you have more time than you actually do. Find a comfortable place to sit where you will be undisturbed. Begin timing yourself with a watch or timer. Now, without looking at the timer, simply sit. When you believe one minute has passed, stop the timer. Notice how much time has actually passed. What insight did you gain from this simple exercise?
3. Focus on a Single Object
One of the biggest hurdles to mindfulness is the experience of your attention wandering from one thought to the next. The result is feeling lost, anxious, or overwhelmed. You are unfocused in these moments. The purpose of this exercise is to train yourself to focus your attention on a single object that you are observing. Begin by sitting comfortably in a place where you will be undisturbed. Choose an object to focus on and, without touching it, begin looking at the object with mindful awareness. Take your time to notice all aspects of this object: shape, texture, color, etc. Now, hold it in your hand and notice the different ways that it feels. If your attention wanders during this exercise, gently bring your focus back to the object. Was this surprisingly difficult for you, or not?
4. Band of Light
Many of us may feel a sense of disconnection between our thoughts, feelings, and physical sensations. We may even feel that our physical body is foreign or detached. This exercise is intended to help you become more mindful of the physical sensations in your body. Find a comfortable place to sit where you won’t be distracted for about ten minutes. Use your imagination to envision a narrow band of white light encircling the top of your head like a halo. Now imagine this band of light slowly moving down your body, becoming mindfully aware of the physical sensations of each part of your body as the band of light progresses down. If your attention wanders, just gently direct it back to the physical sensations you experience as the light moves from the top of your head all the way down to your toes. What did you notice while engaging in this exercise?
5. Inner-Outer Experience
The previous exercises helped you focus on being mindful of both internal and external events. This exercise is designed to combine these two experiences. Try shifting your attention back and forth between your internal experience (i.e., bodily sensations, thoughts, and feelings) and your external experience (i.e., what you notice with your eyes, ears, nose, and sense of touch). What was it like for you to practice mindfully guiding your attention between these two realms of experiencing?
Consider how you can integrate one or more of these basic mindfulness exercises into your daily routine. Something as simple as taking a few minutes each morning to practice mindfulness can result in wonderful changes in your everyday experience of the present moment.
6. Record Three Minutes of Thoughts
Similar to the “Inner-Outer Experience†exercise, this mindfulness practice is intended to encourage you to recognize and focus on your thoughts, emotions, and physical sensations. Try setting a timer for three minutes and simply begin to write down every thought that goes through your mind on a piece of paper. Don’t try to edit your thoughts or write them out word for word, just record each idea or concept that occurs to you. An example of a thought might be about an important upcoming presentation.
Rather than writing out specific details about the presentation, simply write “presentation.†See how many thoughts you can record in three minutes, no matter how small or seemingly unimportant. When you are finished, count the number of thoughts that you had in those three minutes and multiply that number by twenty to get a sense of how many thoughts you tend to have in a whole hour. Are you surprised by the results? What meaning can you take away from this exercise?
7. Thought Defusion
This technique is borrowed from Acceptance and Commitment Therapy and is shown to be quite effective in the treatment of emotional distress. When we have distressing thoughts, there is a tendency to get “stuck†on them. Thought defusion can help you mindfully observe these distressing thoughts without getting bogged down by them. Ultimately, it can allow you the freedom to consciously select which thoughts you wish to focus on and which thoughts you would like to let go.
The idea of this exercise is to visualize your thoughts (e.g., as pictures, words, or symbols) harmlessly floating away from you. Try imagining your thoughts as leaves floating past you on a slowly moving river. If any particular thoughts keep coming up, just allow them to pass by again – notice them, observe them, and let them go.
8. Describe Your Emotion
The previous exercises have focused on becoming mindful of both thoughts and physical sensations. This exercise, aptly named “Describe Your Emotion†is designed to do just that. Simple enough, right? Try picking an emotion – it can be pleasant or unpleasant, but not so overwhelming that you worry about feeling out of control. Ideally, choose an emotion that you are experiencing right now. Once you have an emotion in mind, write it down on a piece of paper. Begin by naming the emotion and then continue with the exercise by drawing a picture that you believe represents this emotion for you.
Next, try writing down a related action and sound for the emotion. Notice what you are experiencing throughout the exercise. If you feel overwhelmed at any point, pause momentarily and bring your focus gently back to the exercise. Continue by describing the intensity and quality of the emotion. What thoughts are related to this emotion? Becoming more mindful of the full experience of a given emotion helps us to be more present in our emotional experiences.
9. Focus Shifting
This exercise is about learning to identify what you are focusing on in your ongoing moment-to-moment stream of conscious awareness. This is somewhat similar to the “Focus Shifting†exercise, where you practice shifting your attention between your inner and outer experiences. The difference is that this exercise centers around learning to shift your attention between emotions and senses and to understand the difference between the two.
Begin by checking in with yourself to identify how you are feeling. If you think you’re feeling “nothing,†try giving that emotional experience a label … it could even be “bored†or “content.†Close your eyes and bring your attention towards your current emotional experience – what would this emotion look like if it were an object? Imagine this object. Now, open your eyes and redirect your focus toward a physical object in the room. Mindfully observe this object. If your attention begins to wander, just gently bring it back to the exercise.
Return your focus towards your internal emotional experience. Next, shift your mindful awareness towards another sensory experience in the room – perhaps noticing a particular sound or smell. What was it like for you to mindfully shift your attention between your internal emotional experience and your outer senses?
10. Mindful Breathing
This tenth basic mindfulness exercise will help you learn to separate your thoughts from your emotions and physical sensations. A wonderful strategy to use when feeling overwhelmed or overstimulated by something in your internal or external experience (e.g., intense negative emotions or an unpleasant external situation) is to return to your breath. Your breathing is something that you always carry with you that you can return to in moments of distress or even crisis.
To breathe mindfully, focus on three parts of the experience: count your breaths, focus on the physical act of breathing, and be aware of any thoughts that arise while breathing. Remember what you learned in the thought defusion exercise to let go of distracting thoughts without getting “stuck†on them. Many people report a sense of becoming “one†with their breath.
Remember not to be too hard on yourself if you find it difficult to keep your attention focused. The more you are frustrated with yourself and react, the more difficult it will become to be mindful. When your attention wanders, simply gently redirect it back to your breath.
While the concept of mindfulness may be very simple in theory, it is far more difficult in practice. It may be especially difficult if you find that you have been living a large portion of your life essentially on “autopilot.†This results in going through the motions of the days, the weeks, and even the years, without being fully present to your ongoing moment-by-moment experience. For some, the realization of living on autopilot is like suddenly recognizing that life is not really being lived – it is being wasted. There is no time like the present moment to wake up to this realization and begin to actively reengage with your life’s purpose.
What benefits did you notice from beginning to practice these basic mindfulness exercises? For many people, basic mindfulness is surprisingly difficult. Rather than letting this difficulty frustrate you, recognize that any difficulties you have with focusing mindful attention on the present moment are simply telling you what you need to work on. Was it difficult to sit still for even five minutes without external distractions? This is a good indicator that this ability to sit still is something you need to cultivate.
Or perhaps, was it difficult to notice your thoughts in a nonjudgmental manner, watching them pass by as leaves on a stream? If so, then this may be an area for you to focus on in the future. Instead of seeing difficulties as insurmountable hurdles or telling yourself that you “can’t†do something, use these difficulties as opportunities and signs of important areas for growth. Start learning how to reframe your personal difficulties as challenges toward becoming the best version of yourself.
References:
McKay, M., Wood, J.C., & Brantley, J. (2007). The dialectical behavior therapy skills workbook. Oakland, CA: New Harbinger Publications, Inc.
By Dr. Jocelyn Markowicz, PhD, Psychologist
Attachment Hope for Couples: How to Improve Your Security Odds
You walk into the room and lock eyes with the most gorgeous human being you have ever seen. This individual locks eyes with you as well. You begin talking and realize that the chemistry between you is intense. You plan a date. You have several great dates. You fall in love and begin to talk about spending the rest of your lives together. You have the wedding. You go on the honeymoon. You begin to live your day-to-day lives together. (Perhaps not quite in that order.) But then, as you settle into shared lives, you notice that something is changing. The arguments are more frequent. The emotions are not all positive. Why does your partner leave when there is conflict? Why does your partner walk away when you need soothing? Why are they sometimes exhaustingly clingy and other times too independent? John Bowlby and Mary Ainsworth offered an answer rooted in attachment styles to these questions. Several researchers after them offered solutions. I’d like to share them with you.Â
The Evolution of a Relationship
It is important to acknowledge that it takes time for interpersonal patterns to emerge within a romantic relationship. A perception bias occurs when you first fall in love that naturally heightens your connection to your partner’s strengths and limits your awareness of their weaknesses. Thus, it is in day-to-day living that you develop more accurate perceptions of patterns that are problematic.Â
Why You Relate the Way You Do
In the 1960s, John Bowlby asserted that we learn positive and negative ways of relating based on our parent-child experiences. Our ways of relating are designed to strengthen our bond with our attachment figures (parents/caregivers) growing up. They help us survive. An attachment behavioral system gradually emerges wherein we attempt to regulate our emotions and behaviors toward an attachment figure. To do this, Bowlby (1980) asserted that the attachment system essentially asks the following fundamental question: Is the attachment figure nearby, accessible, and attentive? According to Bowlby (1980), an individual who has experienced a secure attachment is likely to view attachment figures as available, responsive, and helpful. An insecurely attached individual would view attachment figures as inaccessible, untrustworthy, and unreliable.
Different Attachment Styles
Ainsworth expanded on Bowlby’s attachment behavioral system and introduced specific attachment styles that explain our attachment behaviors. She outlined three specific attachment styles: (1) secure attachment and two insecure attachment styles: (1) anxious-resistant, and (2) avoidant (Ainsworth, 1979). In adult romantic relationships, the insecurely attached adult who is anxious-resistant would be dependent on their partner and yet reject their soothing attempts. The insecurely attached adult who is avoidant would not seek emotional or physical comfort from their partner when experiencing emotional distress.Â
Bowlby and Ainsworth helped us to understand that our way of relating to others is guided by our early attachment experiences, but do we indeed exhibit the same attachment behaviors in our adult romantic relationships?
Further Research into Attachment StylesÂ
Hazen and Shaver (1987) evaluated Bowlby’s theoretical premise that early attachment behaviors extend to adulthood and are relatively stable. They conducted research and found that adults also reported the three attachment categories that Ainsworth determined (secure, anxious-resistant, and avoidant). Their research identified that romantic relationships are attachment bonds and share similar attachment behaviors that characterize parent-child interactions. In essence, Bowlby and Ainsworth were right to suggest that we can look at our adult relationships and evaluate our partner’s attachment behaviors based on their childhood attachment experiences.Â
Are People Stuck Forever in Patterns from Childhood?Â
What happens if you partner with someone with an insecure attachment style? Can their attachment style become secure?Â
Researchers had the same questions about whether or not early attachment behaviors could be changed in adulthood. Findings across several studies did indicate that while early attachment style is relatively stable (Kim, Baek, & Park, 2021), attachment behaviors can change (Tmej, AMA et al., 2020;Â Sims, 2000;Â Rimane, Steil, Renneberg, & Rosner’s, 2020; Overall, Simpson, & Struthers, 2013;Â Gazder & Stranton, 2010; Park, Johnson, MacDonald, & Impett, 2019). Therein lies the hope for the couple. So, back to the question, what happens if you partner with an insecurely attached individual? How can you increase your secure attachment odds in your relationship?
Distress in romantic relationships is the leading cause for adults to seek psychological services (Bradbury, 1998). There are specific interventions that increase attachment security or reduce the negative impact of insecure attachment behaviors in romantic relationships. The following interventions are supported by empirical examination.
Transference-Focused Therapy
Transference-focused therapy (TFT) is a therapeutic intervention that aims to reduce impulsivity, stabilize mood, and improve interpersonal and occupational functioning. The intervention is specifically designed for individuals who struggle with borderline personality disorder. Trauma can impact the internalized representations of personality. It is not uncommon for individuals to develop maladaptive personality traits in response to trauma. Trauma impacts attachment bonds. TFT is a great choice for an individual partner in a couple dyad who may also struggle with borderline personality. A recent study found that individuals who participated in TFT moved towards securely attached with some preoccupied behaviors away from insecurely attached with preoccupied behaviors (Tmej, AMA et al., 2020)
Emotionally Focused Therapy
Emotionally focused therapy (EFT) for couples focuses on reshaping distressed couples’ structured, repetitive interactions and the emotional responses that evoke partners and foster the development of a secure emotional bond (Jonson, 1996; Jonson, 1999). The EFT model assumes that the negative emotions and interactional cycles typical of distressed couples represent a struggle for secure attachment (Bowlby, 1969). Sims (2000) randomized 26 couples in which at least one partner had been rated as insecurely attached to EFT or a waitlist control group. Couples in the EFT treatment condition increased their attachment security (and decreased attachment-related avoidance) more than the control couples.Â
Trauma-Focused Cognitive Processing Therapy
Trauma-focused cognitive processing therapy (CPT) focuses on changing the dysfunctional beliefs associated with trauma. Trauma during our early attachment years impacts our attachment functioning, thereby shaping how we related to others in romantic relationships. CPT offers hope for couples in that an insecurely attached partner, who has been the victim of trauma, can participate in this mode of treatment to improve functioning. In Rimane, Steil, Renneberg, and Rosner’s (2020) study, individuals who participated in CPT experienced reduced avoidance attachment (insecure) behaviors when assessed post-treatment.
Dyadic Regulation Processes
Dyadic regulation processing occurs in couples therapy and is designed to improve attachment-relevant dyadic interactions between them. Applying the Dyadic Regulation Processing Model, researchers evaluated how partners can buffer the impact of their partner’s anxious resistant or avoidant behaviors due to their insecure attachments. Overall, Simpson and Struthers (2013) videotaped romantic couples discussing relationship problems identified by one partner who wanted changes in the other partner. Results indicated that insecurely attached partners whose partners displayed more softening exhibited less anger and withdrawal, and their discussions were more successful. These partners buffered their insecurely attached partner’s responses by learning to be sensitive to their autonomy needs, validating their viewpoint, and acknowledging their constructive efforts and good qualities.
Partner Relationship Mindfulness
General mindfulness is defined as the awareness of what is happening in the moment. In their study, Gazder and Stranton (2010) defined relationship mindfulness (RM) as open or receptive attention to and awareness of what is taking place internally and externally in a current relationship. They found that an individual’s own daily relationship mindfulness did not buffer the effects of their own insecure attachment on same-day relationship behaviors, but their partner’s daily relationship mindfulness did. In essence, you can buffer the impact of your partner’s insecure attachment behaviors by increasing your own relationship mindfulness. Therapy is a great place to learn how to practice relationship mindfulness techniques.
Partner with Someone with a Secure Attachment Style
As outlined, various treatment interventions can move an individual and couple towards more secure attachment relating. At this point, you may be thinking that hope is only achieved within a therapeutic setting. I have good news for you. If you are a securely attached individual, you play an important role in your relationship with an insecurely attached partner. Experiencing secure behaviors within romantic relationships can reduce representations of insecure attachment style (Park, Johnson, MacDonald, & Impett, 2019). How romantic! Your secure attachment behaviors can provide a secure base for your insecurely attached partner to grow. In the context of your relationship, you and your partner will experience many life events together. In their most recent study, Fraley, Gillath, and Deboek (2020) found that life events could change attachment style presentations in adulthood, with some changes yielding an enduring pattern. Â
What Lies within Our Power?
We cannot go back to our childhood and choose caregivers that would prevent us from developing an insecure attachment style. We, therefore, cannot prevent the impact of any dysfunctional early childhood attachment experiences on who we are, interpersonally, as adults. However, there is hope. We can increase our secure attachment odds by choosing partners who are securely attached. We can participate in couples therapy interventions. We can also offer a secure attachment base for our insecurely attached partner. Attachment styles do not equate to fixed potential in your relationship – there is always room for growth.Â
If you’re ready to explore how therapy can help you and your relationship, click through to find a couples therapist near you.
References
Ainsworth, M. D. S. (1979). Attachment as related to mother-infant interaction. In Advances in the study of behavior (Vol. 9, pp. 1-51). Academic Press.
Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. New York: Basic Books.
Bowlby, J. (1980). Loss: Sadness & depression. Attachment and Loss (vol. 3); (International psycho-analytical library no.109). London: Hogarth Press.
Bradbury, T. N. (1998). The developmental course of marital dysfunction. New York: Cambridge University Press.
Gazder, T. & Stanton, S. C.E (2020). Partners’ Relationship Mindfulness Promotes Better Daily Relationship Behaviors for Insecurely Attached Individuals. Int J Environ Res Public Health. 5;17(19):7267.
Hazen, C., & Shaver, P.R. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511-524.
Johnson, S. (1996). The practice of emotionally focused marital therapy: Creating connection. New York. Brunner/Mazel.
Johnson, S. (1999). Emotionally focused couples therapy: Straight to the heart.Â
In J. Donovan (Ed.), Short term couple therapy (pp. 14-42). New York Guilford Press.
Fraley, R.C., Gillath, O. & Deboeck,P.R.(2020, August13).Do Life Events Lead to Changes in Adult Attachment Styles? A Naturalistic Longitudinal Investigation. Journal of Personality and Social Psychology.Â
Kim, S.â€H., Baek, M., & Park, S. (2021). Association of parent–child experiences with insecure attachment in adulthood: A systematic review and metaâ€analysis. Journal of Family Theory & Review.
Overall, N.C., & Simpson J. A.( 2013) Regulation processes in close relationships. In: Simpson JA, Campbell L, editors. The Oxford handbook of close relationships. New York: Oxford University Press; 2013. pp. 427–451.
Park, Y., Johnson, M. D., MacDonald, G., & Impett, E. A. (2019). Perceiving gratitude from a romantic partner predicts decreases in attachment anxiety. Developmental Psychology, 55(12), 2692–2700.
Rimane, E., Steil, R., Renneberg, B. & Rosner, R. (2020). Get secure soon: attachment in abused adolescents and young adults before and after trauma-focused cognitive processing therapy. European Child and Adolescent Psychiatry.
Sims A. Unpublished doctoral dissertation. University of Ottawa; Canada: 2000. Working models of attachment: The impact of emotionally focused marital therapy.
Tmej, A., Fischer-Kern, M., Doering, S., Hörz-Sagstetter, S., Rentrop, M., & Buchheim, A. (2021). Borderline patients before and after one year of transference-focused psychotherapy (TFP): A detailed analysis of change of attachment representations. Psychoanalytic Psychology, 38(1), 12–21.
By Dr. Victoria Raymond, Licensed Marriage and Family Therapist
5 Tips to Help You Get the Most Out of Your Virtual Therapy Session
Virtual therapy sessions are the new normal. Our lives have changed profoundly in the past few months. As we continue to process the impacts of this pandemic, I believe we might be developing a new normal in the field of psychology: virtual therapy. (It’s got a lot of synonyms, including online therapy, telehealth therapy, telemental health, and teletherapy.)
I have been offering virtual therapy appointments to clients for years. My clients are professionals, parents, couples, and students. They prefer virtual sessions for a variety of reasons, including flexibility in scheduling and the convenience of connecting from their own home, completely cutting out commute time.
The concept of privacy is especially important in therapy, as the therapeutic relationship between client and therapist relies on the principles of confidentiality. Many of my clients are physicians, attorneys, entrepreneurs, and executives who are well-known in the local community. These clients often prefer virtual sessions, as it eliminates the risk of seeing patients or clients of their own in a therapist’s office. The ability to choose this option for telehealth therapy increases their privacy.Â
If you are thinking about beginning virtual therapy or want more out of your telehealth sessions, here are some tips to help you fully benefit from your sessions.Â
 1. Find a Private Space
Sometimes you may need to get creative – especially if you have a partner or roommate also working from home, little ones running around, or are in the office – in order to find a place to be alone. Your car parked somewhere private, can be a great option. Other clients like to sit on their balcony or patio or take walks while we speak. It is important to find a space where you feel free to express yourself authentically, without fear of being overheard or seen. Some of my clients schedule our appointments on their shared calendars as a recurring meeting and therefore can avoid any questions from colleagues or family.
2. Set The Scene…and Yourself
Take a few moments before each session to center yourself. Oftentimes, when attending in-person therapy sessions, clients will sit in the waiting room for a few minutes, sipping tea and gathering their thoughts before the session begins. With virtual sessions, it is helpful to give yourself a few minutes prior to the appointment to prepare. I suggest that clients set a reminder for 5-10 minutes before their appointment time; this way they can set up a comfortable space, get themselves some water or tea, and take a few calming breaths. This is also a useful time to review any notes you may have taken between sessions.Â
 3. Check Your Connectivity
Try to figure out where you have the strongest internet connection. If WiFi is acting up, switch over to data. If neither one is working, switch to the phone. One thing this pandemic is teaching us: Flexibility is key. It is helpful to keep your devices (including headphones) charged so you can approach your session with mindfulness and be fully present- and not worrying about whether your phone battery is too low.Â
 4. Give Feedback
Please tell your therapist if you cannot see or hear, if the connection is bad, or if your dog barking in the background is distracting you. We want to make this the best possible experience for you; so please be honest.Â
 5. Be Yourself
One of the best parts of virtual therapy is that it allows clients to feel comfortable in their surroundings: Wear your most comfy sweats, wrap up in your favorite blanket, stay in your sweaty gym clothes, have your furry friends close by (I love meeting my clients’ pets!). We are more likely to be open and authentic – and to talk about things we really need to talk about – when we feel most comfortable. Telemental health offers a unique opportunity to lean into this – take advantage of it!
To start your search for a therapist who offers virtual therapy, click here to search your area and then filter your results by the Type of Service “Telehealth.”