Recently I had a group of medical students for a seminar at Bournewood Hospital. Our usual meeting place was taken so I walked over to the Khan Building where our alternative space was also occupied. Since it was a nice day, we walked outside for our meeting and as we were approaching the picnic tables, I said, “This may be a funny beginning to our time together, but you might just notice the experience of walking—your feet on the ground, your arms, the motion, the breeze…”
We arrived, I asked their experience, they reported it and no one thought it was weird. This was mindful walking and everyone knew what mindfulness was.
Not so nearly 19 years ago when I first came to Bournewood. Mindfulness has since become quite a common term and increasingly integrated into medicine and psychiatry since the Stress Reduction and Relaxation Program (now the Center for Mindfulness) was founded at the University of Massachusetts Medical Center by Jon Kabat-Zinn in 1979.
At the Bournewood-Caulfield Partial Hospitalization Program which has been operating since 1998, we have integrated mindfulness practice into dual diagnosis treatment as one of the four components along with recovery, psychotherapy and medicine. Recovery means you are not alone as so many of our patient feel when they are admitted to our program. Psychotherapy is about understanding a problem and taking responsibility for it. The “problem” often entails the pain of life not going the way we would like and approaching the conflicts around facing the pain, our problematic habits and growing up. Medicine is for symptom relief. These three components help a person reach a state of calm, feeling less ashamed, thinking more clearly and taking an interest in the problem instead of avoiding it.
Mindfulness practices bring an immediacy to treatment that encourages individuals to live one moment at a time—more in the body than in the head—and learning to respond to experience instead of simply reacting. Mindfulness means bearing something in mind which we all do but often do not sustain. It is not about being perfectly focused, but more in remembering and being willing to return our attention to the present moment when it has wandered.
This training provides individuals who come to us with a powerful set of tools to ground in the body which decreases the power of troubling thoughts and enables a greater capacity to be with experience or distract from it if it is too painful. Mindfulness shows us the difference between pain and suffering. Pain is “it’s unpleasant” or “it hurts.” Suffering is the reactivity to pain or “I wish it were different.”
Of course, we want to be free of pain, but if someone comes to us, generally their strategy is not working.
Mindfulness is a wonderful accompaniment to recovery, psychotherapy and medicine—as we say “four pillars of treatment.” It becomes a foundation for living. Then, treatment is not only about getting rid of symptoms in order to feel better, but of approaching life with greater curiosity, courage, joy and active engagement.
Dr. Peltz is the attending psychiatrist at the Bournewood-Caulfield Center in Woburn, MA; and the author of “The Mindful Path to Addiction Recovery.”