What is mindfulness-based therapy?

Mindfulness-based therapy is an approach that cultivates a particular kind of attention — kind, curious, and nonjudgmental — toward one's own experience. Within a session, therapist and client practice this attention together, sorting through thoughts, judgments, reactions, and felt experience to clarify what each calls for. Over time, the client learns to extend the same quality of attention to themselves.

How is meditation related to therapy?

Meditation and mindfulness-based therapy share an underlying capacity: the ability to be present with one's experience without becoming flooded by it or fleeing from it. Meditation cultivates this capacity through formal practice; therapy enacts it within the relationship between therapist and client. The two can complement each other, but neither requires the other.

How does mindfulness help with difficult emotions?

Many emotional experiences are not within direct conscious control. Trying to suppress or override them often deepens suffering. Mindfulness offers an alternative: learning to relate to difficult feelings with care and curiosity, which helps clarify which feelings call for action and which call for presence and attention. Over time, this practice reduces the secondary suffering that comes from judgment and isolation.

What does mindfulness have to do with relationships?

The same kind of attention that mindfulness cultivates internally — sustained, nonjudgmental, curious — is also what allows us to stay present with another person who is suffering, without becoming flooded or withdrawing. In this sense, mindfulness is not separate from relationship; it is the practice that makes meaningful relationship possible, both with others and with ourselves.

A Kind of Attention: Mindfulness, Relationship, and Therapy

May 8

Written By Nate Torrence

Do you know the feeling when you’re sharing something important to you, and you look up to see someone paying rapt attention? Eye contact, leaning towards you?

The feeling when you look up to see someone glazed over, clearly absent?

The feeling of flow state, fully absorbed into something you love?

The feeling of sitting on the couch with a show on and your phone out, half watching, half scrolling?

The feeling of trying to work, and finding it impossible to focus?

Have you heard a child calling out on the playground “Dad! Mom! Watch this!”

Attention is important.

This is how I was taught to meditate:

Find a comfortable seated position and close your eyes. Be still.

Pick a spot between your upper lip and nostrils. Look for a place where you can feel the sensation of your breath as you inhale and exhale from your nose.

Once you have found the spot, try to allow the breath to move naturally, letting your attention rest on the spot you have chosen. Set your intention to pay attention to the full breath: the beginning, the middle, the end, the pause, and the next beginning.

After some time (often not much time), your attention will drift elsewhere. Noting a sensation in a different part of the body, a sound, you might shift your weight or scratch your face, a thought will intrude. You may begin making a task list, reviewing a memory, worrying about the future.

This goes on for some time, until you notice what is happening.

In this moment, you are faced with a fundamental truth about our experience: we are not in full control of our thoughts, emotions, and behavior. In the same way that an internal organ performs its function automatically, there are emotional, cognitive, and behavioral processes that are playing out without our conscious direction.

I sit down and try to meditate. I am present with the breath for a short time, then I begin thinking about an argument with my partner. I rehash the conflict, thinking about what I might have said, feeling a similar feeling to what I experienced during the conflict. I notice that my attention has drifted, I become frustrated with myself.

“I can’t focus on my breath for even a full minute? This is supposed to help me feel calm and centered and instead I’m upset. I’m failing. If I can’t accomplish this simple intention, how am I supposed to be able to do anything else?”

I become increasingly frustrated, and notice the impulse to get up, thinking “this is a waste of time.” I get up and rush into some task or distraction.

I can understand this experience to be entirely outside of my control: “Meditation isn’t for me, I can’t do it. It just makes me frustrated.”

I can understand this experience to be entirely within my control: “If I just try harder, I will sit and be able to keep my attention perfectly aligned with the breath as long as I intend to.”

Both of these framings come with a cost.

In the first, I lump together something that is unchangeable: (I do not have perfect, unchanging control of my attention) with a habit, a pattern that can change: (I respond to myself with judgement and criticism when I notice that I drifted from my intention). This misunderstanding robs me of possible agency.

In the second, I try to change something that is unchangeable, which will lead to frustration, judgement, and giving up.

The truth is that my attention will drift. This is unavoidable. A mind doing what a mind does. I have no more control over this process than whatever my pancreas is up to at the moment. All I can control is how I respond when I notice that the drift has occurred.

Phenomenon outside of my control, response. This is where the relational analogy becomes useful.

A friend comes to me, clearly upset. I don’t like that they are upset, because I care for them. Being close to them while they are in this state also causes discomfort for me. I want the feeling to end for my sake and for theirs, but I can’t immediately change their state. I can only choose how to relate to it.

I could become anxious about my friend’s anxiety, becoming upset myself. This would be an understandable response, but would make it difficult for me to care effectively for my friend. I got too close to their feeling, became absorbed into it.

I could dismiss or avoid my friend, which might provide relief for some of my discomfort. This would be an understandable response, and would likely leave the friend feeling unsatisfied, and could damage our relationship.

In order to learn the kind of care that would be most useful, I must learn to stay present with them, without becoming flooded or fleeing the experience. Staying close enough to offer a kind, curious, nonjudgemental attention.

This is not easy.

It requires me to attend and relate to my own responses and reactions, to sustain my attention through discomfort, to be curious and flexible as I go through the trial and error process of learning what this particular person in this particular state needs from me.

If I can slow my pace, stay calm and present, it is likely that the friend will experience some degree of comfort and relief.

You may be able to recall an experience of offering or receiving this kind of attention in a moment of suffering. These experiences are meaningful, and deepen the relationship.

This is the capacity that one cultivates through meditation. The ability to be both the offerer and receiver of this kind, curious, compassionate attention, to see a state clearly and learn the kind of attention that will be most deeply satisfying to different elements of the experience.

This does not replace our need for relationships with others, but it can deepen and enrich the quality of our relationship with ourselves. Some suffering is inherent to the human experience, but this practice of attending and relating can free you from the added suffering of isolation and judgment. It offers instead the possibility of a kind, compassionate presence alongside the suffering, which can make it more tolerable, and make more room to experience the full spectrum of emotion.

This is how I understand my role as a therapist.

Within the bounds of the session, my intention is to offer this kind, curious, nonjudgmental attention to the client’s experience. Together, we partner to ask “what is this?” in response to their experience, sorting through thoughts, judgements, reactions, behaviors, and felt experience. This sorting is of vital importance, as the different elements of experience are in need of different kinds of attention. By engaging in this practice together, the client gains experience receiving this attention, and over time learns to offer this kind of attention to themselves.

An example:

A client could share “my partner is so annoying,” and note the impulse to shrug and say “well it is what it is” or “I’m going to break up with them immediately.” They might share a judgement like “I’m too irritable” or “they are lazy and inconsiderate.”

This rush to resolution is common when we have uncomfortable experiences. It is difficult to notice a feeling like anger or irritation and slow down, saying “this is a strong feeling. I don’t know what it means, let me approach it, ask it to say more.” Staying in this open, nonjudgmental stance requires tolerating uncertainty for a time. I don’t know exactly what I’m feeling and why I’m feeling that way, and I’m unsure how to respond.

What begins as a tight, undifferentiated clump can begin to expand. “My partner is so annoying” becomes “when I see the socks on the floor, I feel stress. When I feel this stress, it seems like they caused this stress in me, which means that they were trying to cause this feeling in me, or they don’t care about causing this feeling in me. When I feel uncared for in this way, the experience is magnified because I felt similarly uncared for in situations with my family growing up. It feels like I am right back in that painful situation again, and I can’t escape it.”

With this expansion comes many new possibilities. I can open up to my partner about my experience when I see the socks on the floor, so that they might better understand my experience. I can ask about my partner’s experience, to confirm or challenge my assumption of what is happening in them. I can become curious about the older pain that comes up when this happens, to learn how to offer care and attention to the ways that my past shows up in my current felt experience.

What begins as irritation becomes an opportunity to learn to care more effectively for myself and for others.

This is the promise of this practice, in meditation, in relationship to others, in therapy. If I can cultivate and apply this kind, curious, nonjudgmental attention, I will be able to learn to care more skillfully for the parts of my experience that I cannot change or control, and to take action in the areas of my life where I have the agency to effect change.

It is an alternative to grasping for the certainty of “everything will be ok” or “everything is doomed,” offering instead a path towards learning to tolerate the uncertainty of “it will keep changing, and eventually end, and I trust in my capacity to feel and care for my experience, no matter what comes.”

If you are interested in learning more about individual or couples therapy, email me at therapy@natetorrence.com or schedule a free phone consultation.

If you are curious to learn more about meditation, I would recommend exploring the offerings of the Cambridge Insight Meditation Center. They offer in person and online programs for all levels of experience. Their website also features a beginner’s reading list - a great entry point into meditation and mindfulness.

Nate Torrence