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Being Is Relational: Considerations for Using Mindfulness in Clinician-Patient Settings

  • Donald McCownEmail author
Part of the Advances in Mental Health and Addiction book series (AMHA)

Abstract

In the clinical use of mindfulness, there may be a group gathering, as in one of the many mindfulness-based interventions (MBI) targeted to specific clinical populations, or a therapist and client may apply mindfulness in their work together. This positions the MBIs and other clinical uses of mindfulness as relational or, we might say, collaborative or dialogical in nature. Ironically, the extent of this relationality has been obscured by the juggernaut of a scientific evidence base that has, in effect, reified mindfulness, reduced evidence to individual outcomes and ignored or factored out the actions and effects of the teacher and group participants. Pedagogical theory and teacher training, thus, require a different discourse from that of the science as practiced. The intention of this chapter is to counteract the dominance of the individualist and positivist discourse of mindfulness, by exploring the relational dimensions that underlie the activities of teaching and learning. This chapter will define the relational situation through resources offered by interpersonal neuroscience, communications theory, cultural anthropology and social psychology. It will discuss the identity and formation of mindfulness teachers within the milieu of clinical applications, including explorations of professional qualifications, lineage and training. It will describe four basic skill sets for teaching, from stewardship of the group or dyad; to guidance of meditation and other practices; to the sharing of didactic information in conversational format, such as physiology and neurophysiology of stress and meditation; to the subtleties of inquiring into a participants’ direct experience in the present moment. Finally, it will consider how a teacher may know that what they are doing is ‘working’ and what to do when it is not. This will be characterised as an ethical stance for clinicians when using mindfulness and an aesthetics of the pedagogy.

Keywords

MBI Pedagogy Social construction Relationality Teacher formation Stewardship Guidance Homiletics Inquiry Aesthetics Sublime Ethics Ethical space Co-creation 

References

  1. Agazarian, Y. M. (1997). Systems centered therapy for groups. New York: Guilford.Google Scholar
  2. Baer, R. A., & Krietemeyer, J. (2006). Overview of mindfulness- and acceptance-based treatment approaches. In R. A. Baer (Ed.), Mindfulness-based treatment approaches: Clinician’s guide to evidence base and applications. Academic: Burlington, MA.Google Scholar
  3. Batchelor, S. (1997). Buddhism without beliefs: A contemporary guide to awakening. New York: Riverhead Books.Google Scholar
  4. Burke, E. (1999). A Philosophical enquiry into the origins of the sublime and beautiful: And other pre-revolutionary writings. London: Penguin.Google Scholar
  5. Carmody, J., Reed, G., Kristeller, J., & Merriam, P. (2008). Mindfulness, spirituality, and health-related symptoms. Journal of Psychosomatic Research, 64, 393–403.CrossRefPubMedGoogle Scholar
  6. Carr, L., Iacoboni, M., Dubeau, M.-C., Mazziotta, J., & Lenzi, G. (2003). Neural mechanisms of empathy in humans: A relay from neural systems for imitation to limbic areas. Proceedings of the National Academy of Sciences, 100, 5497–5502.CrossRefGoogle Scholar
  7. CFM. (n.d.). Mindfulness meditation retreats. http://www.umassmed.edu/cfm/training/detailed-training-information/meditation-retreats/. Accessed April 27, 2015.
  8. CFM/TDI. (n.d.). Teacher development intensive. http://www.umassmed.edu/cfm/training/detailed-training-information/teacher-development-intensive---tdi/. Accessed April 27, 2015.
  9. Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. Journal of Alternative and Complementary Medicine, 15(5), 593–600.CrossRefPubMedGoogle Scholar
  10. Cozolino, L. (2006). The neuroscience of human relationships. New York: Norton.Google Scholar
  11. Crane, R., & Elias, D. (2006). Being with what is. Therapy Today, 17(10), 31–33.Google Scholar
  12. Crane, R., Kuyken, W., Hastings, R. P., Rothwell, M., & Williams, J. M. (2010). Training teachers to deliver mindfulness-based interventions: Learning from the UK experience. Mindfulness, 1, 74–86.PubMedCentralCrossRefPubMedGoogle Scholar
  13. Crane, R. S., Stanley, S., Rooney, M., Bartley, T., Cooper, L., & Mardula, J. (2014). Disciplined improvisation: Characteristics of inquiry in mindfulness-based teaching. Mindfulness. doi: 10.1007/s12671-014-0361-8 [published online 29 November].Google Scholar
  14. Creswell, J. D., Way, B. M., Eisenberger, N. I., & Lieberman, M. D. (2007). Neural correlates of dispositional mindfulness during affect labeling. Psychosomatic Medicine, 69, 560–565.CrossRefPubMedGoogle Scholar
  15. Foucault, M. (1995). Discipline & Punish. New York: Vintage.Google Scholar
  16. Gallese, V., Fadiga, L., Fogassi, L., & Rizzolatti, G. (1996). Action recognition in the premotor cortex. Brain, 119, 593–609.CrossRefPubMedGoogle Scholar
  17. Gallese, V., & Goldman, A. (1998). Mirror neurons and the simulation theory of mindreading. Trends in Cognitive Sciences, 2(12), 493–501.CrossRefPubMedGoogle Scholar
  18. Gergen, K. (2009). Relational being: Beyond self and community. Oxford, UK: Oxford University Press.Google Scholar
  19. Gergen, K. (2011). From moral autonomy to relational responsibility. Zygon, 46(1), 204–223.CrossRefGoogle Scholar
  20. Gergen, K. (2015). An invitation to social construction, third edition. London: SAGE.Google Scholar
  21. Greeson, J. M., Webber, D. M., Smoski, M. J., Brantley, J. G., Ekblad, A. G., Suarez, E. C., et al. (2011). Changes in spirituality partly explain health-related quality of life outcomes after mindfulness-based stress reduction. Journal of Behavioral Medicine, 34(6), 508–518 [published online March 1].PubMedCentralCrossRefPubMedGoogle Scholar
  22. Grossman, P. (2010). Mindfulness for psychologists: Paying kind attention to the perceptible. Mindfulness, 1, 87–97.CrossRefGoogle Scholar
  23. Hayes, A., & Feldman, G. (2004). Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy. Clinical Psychology: Science and Practice, 11(3), 255–262.Google Scholar
  24. Horrigan, B. J. (2007). Saki Santorelli, EdD, MA: Mindfulness and medicine. Explore, 3(2), 137–144.CrossRefGoogle Scholar
  25. Horvath, A., & Bedi, R. (2002). The alliance. In J. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (pp. 37–70). New York: Oxford University Press.Google Scholar
  26. Imel, Z., Baldwin, S., Bonus, K., & MacCoon, D. (2008). Beyond the individual: Group effects in mindfulness-based stress reduction. Psychotherapy Research, 18(6), 735–742.CrossRefPubMedGoogle Scholar
  27. Ingold, T. (2006). Rethinking the animate, reanimating thought. Ethnos, 71(1), 9–20.CrossRefGoogle Scholar
  28. Ingold, T. (2008). The social child. In A. Fogel, B. J. King, & S. G. Shanker (Eds.), Human development in the twenty-first century: Visionary ideas from systems scientists (pp. 112–118). Cambridge: Cambridge University Press.Google Scholar
  29. Kabat-Zinn, J. (2004). The uses of language and images in guiding meditation practices in MBSR. Audio Recording from 2nd Annual Conference sponsored by the Center for Mindfulness in Medicine, Health Care and Society at the University of Massachusetts Medical School. March 26.Google Scholar
  30. Kabat-Zinn, J. (2010). Foreword. In D. McCown, D. Reibel, & M. Micozzi (Eds.), Teaching mindfulness: A practical guide for clinicians and educators (pp. ix–xxii). New York: Springer.Google Scholar
  31. Kabat-Zinn, J. (2011). Some reflections on the origins of MBSR, skillful means, and the trouble with maps. Contemporary Buddhism, 12(1), 281–306.CrossRefGoogle Scholar
  32. Kabat-Zinn, J., Santorelli, S., Blacker, M., Brantley, J., Meyer, F. M., Grossman, P., et al. (2012). Training teachers to deliver mindfulness-based stress reduction: Principles and standards. Downloaded from http://www.umassmed.edu/cfm/trainingteachers/index.aspx. Accessed January 15, 2012.
  33. Kuyken, W., Watkins, E., Holden, E., White, K., Taylor, R. S., Byford, S., et al. (2010). How does mindfulness-based cognitive therapy work? Behaviour Research and Therapy, 48(11), 1105–1112.CrossRefPubMedGoogle Scholar
  34. Lieberman, M. D., Eisenberger, N. I., Crockett, M. J., Tom, S. M., Pfeifer, J. H., & Way, B. M. (2007). Putting feelings into words: Affect labeling disrupts amygdala activity in response to affective stimuli. Psychological Science, 18(5), 421–427.CrossRefPubMedGoogle Scholar
  35. Lindahl, J. R. (2015). Why right mindfulness might not be right for mindfulness. Mindfulness, 6, 57–62.CrossRefGoogle Scholar
  36. Mamberg, M. H., Dreeben, S. J., & Salmon, P. (2015). MBSR Languaging: Discursive analysis of the body scan (in preparation).Google Scholar
  37. McCown, D. (2013). The ethical space of mindfulness in clinical practice. London: Jessica Kingsley.Google Scholar
  38. McCown, D. (2014). East meets West in the pedagogy of the mindfulness-based interventions. In A. Ie, C. Ngnoumen, & E. Langer (Eds.), Wiley-Blackwell handbook of mindfulness. Oxford: Wiley-Blackwell.Google Scholar
  39. McCown, D., & Ahn, H. Dialogical and Eastern perspectives on the self in practice: Teaching mindfulness-based stress reduction in Philadelphia and Seoul (unpublished manuscript).Google Scholar
  40. McCown, D., & Reibel, D. (2009). Mindfulness and mindfulness-based stress reduction. In A. Weil (Ed.), Integrative psychiatry. New York: Oxford.Google Scholar
  41. McCown, D., Reibel, D., & Micozzi, M. (2010). Teaching mindfulness: A practical guide for clinicians and educators. New York: Springer.CrossRefGoogle Scholar
  42. McCown, D., & Wiley, S. (2008). Emergent issues in MBSR research and pedagogy: Integrity, fidelity, and how do we decide? 6th annual conference: Integrating mindfulness-based interventions into medicine, health care, and society, Worcester, MA, April 10–12.Google Scholar
  43. McCown, D., & Wiley, S. (2009). Thinking the world together: Seeking accord and interdependence in the discourses of mindfulness teaching and research. 7th annual conference: Integrating mindfulness-based interventions into medicine, health care, and society, Worcester, MA, March 18–22.Google Scholar
  44. Monteiro, L. M., Musten, R. F., & Compton, J. (2015). Traditional and contemporary mindfulness: Finding the middle path in the tangle of concerns. Mindfulness, 6, 1–13.CrossRefGoogle Scholar
  45. Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. New York: Norton.Google Scholar
  46. Purser, R. E. (2015). Clearing the muddled path of traditional and contemporary mindfulness: a response to Monteiro, Musten, and Compson. Mindfulness, 6, 23–45.CrossRefGoogle Scholar
  47. Santorelli, S. (2001). Interview with Saki Santorelli, Stress Reduction Clinic, Massachusetts Memorial Medical Center. In L. Freedman (Ed.), Best practices in alternative and complementary medicine (pp. 11-8–1–4). Frederick, MD: Aspen.Google Scholar
  48. Santorelli, S. (Ed.). (2014). Mindfulness-based stress reduction (MBSR) standards of practice. Worcester, MA: UMASS Medical School, Center for Mindfulness in Medicine, Health Care & Society.Google Scholar
  49. Sauer, S., Lynch, S., Walach, H., & Kohls, N. (2011). Dialectics of mindfulness: Implications for western medicine. Philosophy, Ethics, and Humanities in Medicine, 6, 10.PubMedCentralCrossRefPubMedGoogle Scholar
  50. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press.Google Scholar
  51. Sennett, R. (2009). The Craftsman. New Haven: Yale.Google Scholar
  52. Sennett, R. (2012). Together: The rituals, pleasures and politics of cooperation. New Haven: Yale.Google Scholar
  53. Shaw, P. (2006). The sublime. New York: Routledge.Google Scholar
  54. Shonin, E., & Van Gordon, W. (2015). The lineage of mindfulness. Mindfulness, 6, 141–145.CrossRefGoogle Scholar
  55. Shotter, J. (1984). Social accountability and selfhood. Oxford, UK: Blackwell.Google Scholar
  56. Shotter, J. (1995). In conversation: Joint action, shared intentionality, and ethics. Psychology and Theory, 5, 49–73.Google Scholar
  57. Shotter, J. (2008). Conversational realities revisited: Life, language, body and world. Chagrin Falls, OH: Taos Institute Publications.Google Scholar
  58. Shotter, J. (2011). Getting it: Witness-thinking and the dialogical…in practice. New York: Hampton Press.Google Scholar
  59. Shotter, J. (2012). Ontological social constructionism in the context of a social ecology: The importance of our living bodies. In A. Lock & T. Strong (Eds.), Discursive perspectives in therapeutic practice (pp. 83–105). Oxford: Oxford University Press.CrossRefGoogle Scholar
  60. Siegel, D. (2007). The mindful brain. New York: Norton.Google Scholar
  61. Van Gordon, W., Shonin, E., Griffiths, M. D., & Singh, N. N. (2015). There is only one mindfulness: Why science and Buddhism need to work together. Mindfulness, 6, 49–56.CrossRefGoogle Scholar
  62. Williams, M., & Kabat-Zinn, J. (2011). Mindfulness: Diverse perspectives on its meaning, origins, and multiple applications at the intersection of science and dharma. Contemporary Buddhism, 12(1), 1–18.CrossRefGoogle Scholar
  63. Williams, M., & Kabat-Zinn, J. (Eds.) (2013). Mindfulness: Diverse perspectives on its meaning, origins, and applications. New York: Routledge.Google Scholar
  64. Wittgenstein, L. (1953). Philosophical investigations. Oxford, UK: Blackwell.Google Scholar
  65. Zimmerman, J., & Coyle, V. (1996). The way of council. Las Vegas: Bramble Books.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Center for Contemplative StudiesWest Chester University of PennsylvaniaWest ChesterUSA

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