Treatment Modalities

Nonjudgmental awareness

Mindfulness refers to a process that leads to a mental state characterized by nonjudgmental awareness of the present moment experience, including one’s sensations, thoughts, bodily states, consciousness, and the environment, while encouraging openness, curiosity, and acceptance.

Research on mindfulness-based interventions (MBIs) has increased exponentially in the past decade. The most common include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). MBIs have demonstrated efficacy in reducing anxiety and depression symptom severity in a broad range of treatment-seeking individuals. MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy. MBIs also perform comparably to cognitive-behavioral therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with those of standard CBT.

Mindfulness stands in stark contrast with much of our common daily experience, as the default mode of attention for many individuals is, in fact, non-attention. Mind-wandering is constant, as is the state of mindlessly going through our daily activities, or “running on autopilot.” When we do manage to focus on internal experiences in the present moment, this attention is often filled with self-critical, ruminative, or otherwise worrisome thoughts and emotions which we then attempt to suppress. Indeed, the experience of attending to one’s present moment can be so aversive that some people prefer almost anything else; a review of 11 laboratory studies with healthy adults found that most people choose to do mundane tasks, or even receive mild electric shocks over being left alone with their own thoughts.

Despite their predominance in our daily life, mindless states have been demonstrated to be maladaptive. In a large study using ecological momentary assessment data, it was found that approximately 47% of subjects’ waking hours were spent in a state of mind-wandering; furthermore, the authors demonstrated that mind-wandering predicts subsequent unhappiness. In contrast, the capacity to keep one’s mind focused on the present moment is associated with higher psychological well-being. Taken together, these findings suggest that mindfulness is a difficult state to achieve, but is ultimately beneficial.

There are many different mindfulness-based approaches used in therapy, but the general idea is that mindfulness interventions are used to increase attention on the present moment, enhancing the ability to remain aware of and recognize thoughts, feelings, and emotions as they arise in response to stimuli vs. engaging in common avoidant behaviors.

Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-Based Interventions for Anxiety and Depression. The Psychiatric clinics of North America, 40(4), 739–749.
https://doi.org/10.1016/j.psc.2017.08.008