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A Letter from Hugh G. Byrne, PhD

Our lives revolve around our habits; studies show that almost half of our behaviors are habitual rather than intentional. Some, like brushing our teeth or putting on a seat belt in the car, are obviously helpful. Others, like eating or drinking unconsciously, driving aggressively, procrastinating, or spending hours online, can be much more of a problem.

When severe violations of safety, trust, or vulnerability occur, including outright threats to survival, humans are wired to shut down higher-order neural functions and fight, flee, or freeze in order to survive the threat. Clients suffering from post-traumatic stress are faced with the dilemma of figuring out how to carry negative personal history in the present moment without letting it dictate or control their behav­ior.

Mindfulness techniques are often thought of as being synonymous with present-moment-awareness interventions; however, while the two are clearly related, they are not one and the same. Mindfulness interventions are basically a form of attention control training, and, yes, clients have to be able to control their attention to make much headway in a present-moment-awareness intervention.

The core dilemma of post-traumatic stress is how to carry painful personal history forward in life. If clients use fragmented attention and avoidance to cope with what has happened, living a vital life is all but impossible. The alternative is to carry the objective reality of the trauma without the all-encompassing negative self-stories that result from the mind’s misguided sense-making operations.

In therapy sessions, lack of genuine curiosity about where the client is coming from, unrealistic or incongruent expectations, and failure to approach the whole person, not only the pathology exhibited, can significantly impact the effectiveness of therapy. That’s why mindful communication, or interpersonal mindfulness, is so important.

Often therapists and clients fail to understand each other. The same way that the bedside manner of a doctor significantly affects the compliance and trust of the client, the various barriers to communication—lack of genuine curiosity about where the client is coming from; unrealistic or incongruent expectations; and failure to approach the whole person, not only the pathology exhibited—can significantly impact the effectiveness of therapy. Often clients do not fully understand the clinician’s explanation of what is needed and are unable to follow the advice given.

Sometimes emotions are seen as a sign of weakness and irrationality, but this perception couldn't be further from the truth. They are essential to being rational (Ciarrochi, Chan, & Bajgar, 2001; Ciarrochi, Chan, & Caputi, 2000; Ciarrochi, Forgas, & Mayer, 2001). They’re a way of seeing how events in the world relate to our values, needs, and desires.

Imagine feeling totally lost with a client. The client has just disclosed an extremely painful story, and you feel stuck about how to respond. Then you get defensive because you don’t know what to do next. What would be your strategy here? Would you break eye contact and instead look at your clipboard and pretend to be making some notes? Would you paraphrase what the client told you just to buy time? Would you get up, walk to your whiteboard, and draw an ABC diagram to avoid the pain you feel in acknowledging the client’s emotional distress?


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