Mindfulness as a psychological concept is the focusing of attention and awareness, based on the concept of mindfulness in Buddhist meditation. It has been popularised in the West by Jon Kabat-Zinn. Despite its roots in Buddhism, mindfulness is often taught independently of religion.
Clinical psychology and psychiatry since the 1970’s have developed a number of therapeutic applications based on mindfulness for helping people suffering from a variety of psychological conditions,and research has found therapy based on mindfulness to be effective, particularly for reducing anxiety, depression and stress. Source: Wikipedia
Hearing Voices and Mindfulness
Mindfulness is increasingly being used for psychological approaches to voice-hearing and other experiences that can be seen as ‘psychotic’ (e.g. Chadwick, Taylor and Abba, 2005; Abba, Chadwick and Stevenson, 2008). Its roots are in Buddhist psychology, which has been developed over the last 3,000 years. We often use mindfulness at the beginning or end of self-help groups and the concept is becoming a progressively popular therapeutic approach; Acceptance and Commitment Therapy (e.g. Fletcher and Hayes, 2005) and Dialectical Behavioural Therapy (e.g. Robins, 2002) are two techniques for working with voice-hearers which place mindfulness at the heart of the method.
The aim of mindfulness is to develop an accepting approach to thoughts and feelings and through understanding these experiences develop more detachment and choice about how they influence us. Mindfulness aims to anchor the mind in ‘the here and now’ and promote a warm and compassionate approach to difficult events and experiences. The writings of Jon Kabat-Zinn (e.g. 2001, 2005) and Thich Nhat Hanh (e.g. 2002, 2005) have been instructive self-help texts for many people using hearing voices groups. The following are mindfulness exercises that individuals within the hearing voices self-help movement report finding of benefit:
There are many mindful breathing exercises. Counting the breath involves counting each in-breath and out-breath: “Breathing in one, breathing out one, breathing in two, breathing out two” and so on up to five (or ten). If the person becomes distracted and loses count they return to one again. This is continued for a set time, say ten minutes.
Sitting calmly, focussing on the breath is another possible approach. Every time the person notices they have become distracted, they acknowledge the thought or feeling and come back to their breathing. If someone finds they are too easily distracted, visualising breathing in ‘healing white light’ and breathing out ‘black smoke of negativity’ is another exercise that can be used.
Alternate nostril breathing
Alternate nostril breathing involves the following exercise: hold one nostril closed and breathe in, then close the other nostril and breathe out, breathe back in the same nostril, close that nostril and breathe out the other. Repeat for ten minutes.
As we walk along the street, we can focus on each step whether we are breathing in or out, so we might be saying ‘in, in, in, out, out, out’ and so on. This technique can again reduce the number of thoughts flowing through our mind as we focus our concentration on our breathing. If indoors, we can do a slower meditation where we walk, very slowly, moving one foot forward in time with each in-breath or out-breath. If the person is practicing mindful walking on their own, they can invite someone they trust and respect to accompany them in their mind. For example as someone is walking and he/she breathes in they can say, for example “Ben, Ben, Ben,” inviting their friend’s presence to be with them; and as they breathe out say in their mind “I am here, I am here, I am here” which also says that the person is there for their friend too (adapted from Nhat Hanh, 2002). A fourth type of mindful walking involves just walking slowly and focussing on each step and the environment as it is perceived through the senses. This can be very calming and grounding if we do it in a park or other more natural setting.
Adopting a non-judgemental approach to challenging thoughts seems also very applicable to voice-hearing. Thich Nhat Hanh (2002) recommends smiling towards challenging thought structures, which he describes as habit energies, saying “Hello habit energy, I know you are there but you cannot make me do anything I don’t want to do. I acknowledge you are there but I am free form your influence.” We can use this same non-judgemental but assertive attitude towards voices. From this position of tolerance we can go on to understand what emotions and relationship issues the voices might be representing. This is similar to the attitudinal change recommended by Romme and Escher (2000): “Changing the relation to the voices is to become respectful to them, not fighting against them but talking to them slowly and with warmth, which has as a consequence that they also change their approach. It can also be testing out their power and finding that they are not almighty at all.”
Information about mindfulness, hearing voices and related topics
Article in Mad in America by Rufus May Rufus May describes mindfulness is the ability to live life with as full awareness as possible of the present moment. His article considers how we can live more in the present moment and how we can ground ourselves in this awareness and deal wisely with powerful memories and voices from the past. Mindfulness is rooted in Buddhist meditation practice but over the last 40 years has been developed in the west as a tool for reducing stress and increasing well-being. Read the full article by clicking on the title.
Be Mindful A campaign raising awareness of mindfulness meditation by the Mental Health Foundation. Mindfulness helps people change the way they think, feel and act. In November 2013 the University of Oxford published research that shows that the MHF online mindfulness course reduces anxiety by 58%, depression by 57%, and stress by 40%. Anyone can learn mindfulness. It’s simple, you can practise it anywhere, and the results can be life-changing.
Mindfulness and imaginary voices Article by Gustavo Estrada “Mindfulness is the permanent and impartial attention to our body, our sensations and our mental states. The habit of mindfulness, according to the Buddha, is the path that leads to the elimination of suffering and hence to the blossoming of inner harmony. Though some people seem to be mindful by nature, most of us must work on our faculty of awareness through the practice of meditation”
Mindfulness for Voices (M4V) Research Project: A current research study run within the Research & Development Department at Sussex Partnership NHS Foundation Trust.