Therapeutic mindfulness

One of the most exciting developments in mindfulness over the past four decades has been its increasing use for therapeutic aims – to support people who are dealing with chronic health issues, life-threatening illnesses, depression, anxiety, trauma and a range of other physical and mental challenges. There are thousands of studies which validate the use of therapeutic mindfulness, and countless people have been helped by learning mindfulness as part of their treatment plan. From better pain management, improved immunity and decreased inflammatory response to improved mood, lower anxiety and improved relationships, there is clear evidence that mindfulness can be used therapeutically. It’s not a replacement for medical treatments, counselling or medication, but it can support these other therapies and enhance their effectiveness.

Unfortunately, this is also an area where mindfulness can do more harm than good, if it is taught by inexperienced practitioners to people with certain vulnerabilities. Learning mindfulness can initially increase our experience of pain, difficult thoughts and negative emotions, as we slow down enough to really become aware of them, and this can be unsettling. Even people who are not dealing with major difficulties are often quite dismayed when they start to meditate and realise just how frantically busy their mind always is, and how little, if any, time they actually spend in the present moment. With the right support and guidance from an experienced and trained practitioner, these early stages can be worked with and can lead to increased affect tolerance, personal growth and resilience. Often people learn mindfulness while also supported by counselling and/or medication, and this can be very effective. Yet, at the moment, anyone can call themselves a mindfulness teacher, whether they’re highly qualified, or whether they simply like the sound of it and are making it up as they go along (I’ve met a few people in the second category!). Mindfulness may also be contra-indicated for people who are experiencing psychosis, schizophrenia, or other conditions where dissociation may be present.

When taught by someone suitably qualified, therapeutic mindfulness has the potential to significantly shift our relationship to the difficulties of our lives. As we practise non-judgmental awareness, acceptance, beginner’s mind, letting go, we slowly and gradually learn to become less caught up in emotional reactiveness and unhelpful thought patterns. I’ve been teaching the eight-week Mindfulness Based Stress Reduction (MBSR) course for eight years now, and consistently, by week four or five, participants report significant shifts in how they are approaching the challenges of their lives. They describe being more calm, less reactive, less caught up in painful emotions, being able to see the bigger picture. They find they often have a choice of how to respond to difficulties, and they talk about exploring new and better options, which is very empowering.

Weekly practice idea:

Take ten to twenty minutes to sit somewhere quiet and notice your breath coming and going. When the mind wanders off, gently bring it back to the breath. What do you notice in your thoughts, your body sensations, your emotions?

Anja Tanhane

Looking at the bright side

‘Always look on the bright side of life…’

Eric Idle

Who can forget the group of criminals, crucified at the end of Monty Python’s ‘The Life of Brian’, cheerfully singing and whistling,

‘If life seems jolly rotten

There’s something you’ve forgotten

And that’s to laugh and smile and dance and sing.

When you’re feeling in the dumps

Don’t be silly chumps

Just purse your lips and whistle

– that’s the thing.

And…always look on the bright

side of life…’

There are indeed times when looking on the bright side of life is just plain ridiculous. Yet, as Jon Kabat-Zinn often says to participants in his MBSR courses, most of the time there is actually more right than wrong with us. This is not to gloss over suffering and challenges which are real and painful. However, just as mindfulness is about acknowledging the difficulties we face, it’s also about recognising the resources and gifts which are available to us in any given moment.

Some of these resources are external – perhaps we have friends and family who care for us, or we live in a civil society which is relatively stable, or we have food and shelter to nourish our bodies and protect us from the elements. Just these basics are more than hundreds of millions of people around the world are able to enjoy right now.

Then there are our internal resources – our gifts, wisdom, resilience, good humour and warmth. I’ve worked with people in hospitals or residential care who had lost almost everything, and yet they would smile with warmth when they saw a little kitten or young child come to visit. If we think about all the people we’ve met in the last few weeks, chances are that most were fundamentally friendly, decent and resilient. Not many people are completely cold and bitter. As for ourselves, we might have made a few mistakes in the past month, perhaps didn’t always cover ourselves in glory, but nonetheless we probably were often thoughtful and kind, and it’s likely we made some good choices along the way.

So there’s a lot to be said for looking at the bright side of life – perhaps not always, as the Monty Python song reminds us, but almost always!


Weekly practice idea:

Write down three external and three internal resources which you feel are in your life right now, and set an intention this week that you will notice times when you are drawing positivity and strength from these.

Anja Tanhane

Boys don’t cry

‘Now I would do most anything to get you back by my side.

But I just keep on laughing, hiding the tears in my eyes,

‘cause boys don’t cry.’

The Cure


Can you think back to a time where you sabotaged your chance at something which was important to you, such as a relationship or an opportunity, because you were hiding your ‘tears’ behind a fake smile? There are times for putting on a brave face, for not letting everyone around you know the exact minutiae of all your feelings. It’s part of being an adult, yet we can get into the habit of putting on a false smile to ourselves and to those close to us. There is something very vulnerable about tears, whether we’re actually crying or expressing our hurt and pain in some other way.

We can put ourselves under a lot of pressure to be positive – after all, positive people tend to be more popular, successful, healthy. And it’s true that a positive outlook on life does come with many benefits. However, there is a world of difference between a positive outlook which is based on reality, and the false good cheer we can feel compelled to resort to. To paraphrase the Ecclesiastes, there is a time to laugh, and there is also a time to cry. Participants in the eight week MBSR course often report becoming more comfortable with the full range of their emotions, rather than the narrow ‘approved’ range of emotions they might have allowed themselves before. At the same time, they talk about being increasingly able to take a step back in challenging situations, get a bigger-picture view, and to calm themselves down in the midst of challenging situations. Regular mindfulness practice will take some of the extreme edges off our emotions, but that doesn’t mean emotions aren’t still intense. In fact they may be experienced more intensely, and yet, at the same time, we feel less overwhelmed by them.

Grief which is not expressed can fester in our lives, like the worm in William Blake’s poem ‘The sick rose’:

O Rose thou art sick!

The invisible worm

That flies in the night,

In the howling storm,


Has found out thy bed

Of crimson joy,

And his dark secret love

Does thy life destroy.

Men in particular have often been brought up not to cry, and may not feel comfortable shedding tears. There are other ways to express grief, or at least to be present with it whenever it arises. Music can be especially powerful, and the best music is often tinged with sadness. It is helpful to know what our feelings are; how we can best live with them. Mindfulness helps us become more familiar with, and less anxious about, the full range of our emotional life.

Weekly practice idea:

What is your attitude to grief, to expressing when you feel hurt? Where do you sit on the scale between complete repression, and letting it all hang out (perhaps inappropriately at times)? Where would you like to be?

Anja Tanhane