Mindfulness in Cognitive Behavioral Therapy

Twenty or thirty years ago, classic cognitive behavioral therapy didn't have much to say about the eastern concept of mindfulness. Over time it kind of snuck in by the stress reduction back door. Now it's all over current approaches such as acceptance and commitment therapy or dialectical behavior therapy.

Why is mindfulness so important? Because focusing on the future or the past intensifies painful emotions. “What-if” thoughts about the future make us anxious. Judgmental and regretful thoughts about the past can trigger depression, shame, or guilt. Shoulds—thoughts that focus on what we or others should have done differently—create anger or depression. Staying in the present moment is an antidote to future- and past-oriented thoughts that can get you in trouble emotionally.

Mindfulness targets two of the transdiagnostic factors that lie at the root of emotional disorders: the maladaptive coping strategies rumination and experiential avoidance. Because rumination is almost exclusively focused on the future or the past, mindfulness of the present moment reduces ruminative thinking. Mindfulness addresses experiential avoidance by allowing you to observe the way emotions rise, crest, and slowly diminish. This is a huge shift from maladaptive coping strategies that involve trying to numb or suppress emotions.

Mindfulness is crucial to emotion regulation for another reason too. It helps you see your emotions as only one part of the present moment. Whether you’re happy, angry, sad, or whatever, the emotion is just a single aspect of your current experience. There are so many other pieces of the present moment, including what you see, what you hear, what’s happening in your body, and what you’re tasting, smelling, and touching. Emotions are important, but they’re not your total experience.

When painful emotions occur, you can use mindfulness to observe them without getting swept off your feet. Just watch as the emotion unfolds and label it: "Anxiety..depression...anger" and so on. Name the emotion, and if it has any shadings or nuances or is a mixture of emotions, give yourself room to describe what you’re feeling and everything you notice as fully as possible.

Don’t block or resist the feeling. Let it be whatever it is and as strong as it is. Every emotion is like a wave; it will intensify for a while and then gradually subside. Don’t amplify the feeling, hold on to it, or analyze the experience, and don’t judge the emotion, or yourself for having it.

As you observe any given feeling, you’ll notice action urges—an impetus to do something. For example, anxiety typically makes you want to withdraw, and anger typically makes you want to attack. Just let yourself watch the emotion and notice the action urges without acting on them.

The point of mindfully watching your emotions is to let them be what they are—feelings that come and go—and to live in the full context of all of your experiences. You’ve experienced countless emotions in your life. You’re like the sky, and they are like the weather. The weather keeps changing, but the sky remains constant. And although the weather of emotions sometimes seems powerful and overwhelming, if you observe your emotions you’ll see that they inevitably change and evolve into your next emotional experience.

It’s particularly helpful to use this exercise when you notice that you’re trying to avoid your feelings. Remember, this is precisely what makes them stronger and more enduring. Instead of running away, turn around and use mindfulness to observe that particular wave of emotion. Each time you face a difficult emotional experience, particularly when feeling it in the context of your breath and body and the world outside yourself, you’re taking a step toward acceptance. You’re also giving yourself the gift of the present moment.