When you practice mindfulness as a way of life, over time you start to notice that your understanding of what it means will naturally deepen. You may find an increased capacity to respond more flexibly to the present moment both in your personal life and your clinical work. But even when you have intimately experienced and felt the depth of the practice, you may somehow still struggle to describe it or put it into words when necessary for client work.
Steven Alpers, a clinical social worker and author of Mindfulness Meditation in Psychotherapy: An Integrated Model for Clinicians developed a visual model that he hoped would address the challenges faced by clinicians who wished to incorporate mindfulness meditation into their clinical work.
The mindfulness pyramid model is a conceptual framework that how mindfulness works in psychotherapy. The four faces of the pyramid represent the four dimensions, or facets, of mindfulness most relevant to psychotherapy. If you’d like to learn more about the model, check out Alpers’ book. For now, we’ll introduce the four faces to provide a fundamental framework for using mindfulness meditation in psychotherapy.
The Four Faces of Alpers’ Mindfulness Pyramid
1. Formal Mindfulness Meditation Practices
Just as weight lifting builds muscle mass and increases strength, and yoga develops flexibility, formal mindfulness meditation practices strengthen the capacity to be mindful in daily life. And yet, we don’t do formal mindfulness practices with the intention to get somewhere or accomplish a goal—not even as a way to strengthen awareness, or to cultivate attitudes like gratitude or equanimity. In fact, doing so would be antithetical to the spirit of mindfulness, which involves nonstriving, letting go, and being with each moment as it is without trying to get somewhere.
“Mindfulness meditation as a form of nondoing, and ceasing from striving to accomplish anything, may seem fundamentally in conflict with psychotherapy’s mission to alleviate suffering, which undoubtedly is a goal-oriented behavior. But it is precisely within this paradox that the healing power of mindfulness resides,” writes Alpers.
2. Skills, Inner Capacities, Attitudes, and Perspectives
Beyond formal meditation practices, mindfulness can be understood as a specific set of skills, inner capacities, attitudes, and perspectives that can be taught and learned in therapy and then deployed in daily life to alleviate distress and to live more effectively and with greater ease.
The skills, capacities, attitudes and perspectives that are learned through mindfulness practice are emphasized in the approaches of dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT), which are two of the most dominant third wave approaches.
Mindfulness-based stress reduction and mindfulness-based cognitive therapy focus on formal and informal meditation practices, while recommending attitudes and behaviors that support and strengthen one’s capacity to be mindful in daily life.
Buddhist psychology, also, has many lists of attitudes, behaviors, and psychological states that are recommended as healthy behavioral and mental habits, which support and strengthen the development of mindfulness.
3. Method of Inquiry and Investigation and Mode of Knowing
Mindfulness involves inquiring into and investigating each moment of experience as it arises; it is a form of self-exploration with the potential to develop profound insight and inner wisdom that is far more trustworthy than perception, emotion, or intellectual analysis alone.
Mindful awareness operates below the level of conditioned, automatic thinking and emotional reactivity. When we’re being mindful, we are more able to objectively observe thoughts, emotions, sensations, perceptions, and mind states without identifying with and getting caught up in them.
When we start to use mindful inquiry and investigation as a way of knowing, it becomes possible to see how the structure of language and cognition predisposes us toward suffering. This process, known in acceptance and commitment therapy as cognitive fusion, can be addressed with mindfulness, which encourages defusion, a process in which we create distance between our selves and the content of our minds.
“Through mindfulness we can see clearly how we create and intensify suffering through unconscious identification with instinctual or deeply conditioned reactive patterns of thought, emotion, and behavior triggered by stress. These stress reactions happen so rapidly that they are nearly imperceptible until we deploy mindfulness to become aware of them. We can also see clearly, through mindfulness, how we can decrease and even eliminate the suffering of automatic stress reactivity by simply misidentifying with it,” writes Alpers.
The experience of formal meditation allows us to directly experience the way we, as humans, are wired for suffering through language and cognition. By the same token, it shows us that our minds are also capable of overriding automatic reactions through mindful awareness and skillful responses. Over time, mindfulness practice makes a different, more skillful mode of being and relating possible.
4. Way of Being and Relating to Experience
Through the practice of formal mindfulness meditation practice, we learn to embrace each moment with curiosity, openness, and acceptance. We learn that by experiencing each moment without judgment or striving, we can reduce emotional and physical suffering. We see that the happiness and inner peace we experience through mindfulness practice are remarkably stable because they are not dependent or contingent upon external circumstances. For most of us, this is an entirely new way of relating to our thoughts and feelings. In fact, it is a new way of experiencing life overall.
“Embracing mindfulness meditation as a discipline of practice creates the potential for a profound shift in our way of being and relating to life. Attachment to preferred outcomes and views is increasingly replaced by heartfelt curiosity, openness to experience, and appreciation and gratitude without preconceived expectations or judgments,” writes Alpers.
For more about clinical applications of mindfulness meditation, check out Mindfulness Meditation in Psychotherapy.
Part 2: What to Do When a Client Is Participating in Self-Judgment?