Mindfulness Based Treatment and Training
Notes for Presentation to the 9/11Trauma Team, St Vincent’s Hospital, NY., NY.

Mindfulness based practice is commonly used for stress reduction and to increase tolerance of distress and reduce the painful repetitive thoughts and feelings that occur following incidents of traumatic stress. 

The Buddhist practice of meditation which gives rise to mindfulness based treatment modalities is increasingly viewed as informing the leading edge of developments in contemporary psychoanalysis and psychotherapy. Regular practice of mindfulness meditation has been shown to enhance the development of meta-cognitive awareness or the observing ego. Establishing the observing ego is a maturational goal and a generally accepted goal of the psychotherapies. This ‘observing ego’ can function as an antidote to the ‘automatic pilot’ that drives so much of the behavior underlying mental illness. It is taken for granted that such behaviors arise from internal conflicts which may in turn be triggered by external stressors. The observing ego is the psychological function that mediates experience and can moderate the effect of experience on the psyche.

People who meditate don’t need scientists to tell them that meditation is beneficial. But contemporary research in cognitive science clearly demonstrates those benefits. Mindfulness based clinical practice is used in the treatment of a variety of conditions including Generalized Anxiety Disorder , Bulimia , Depression , Borderline Personality Disorder and Alcohol and Substance Abuse Recovery. 

Mindfulness is a practice that enables us to pay attention to the state of our being and allows a dialogue to begin between our ‘being’ and our ‘self.’ When we sit with our attention focused only on our experience of being in the moment we begin to notice that indeed our experience changes from moment to moment. This simple observation of experience is the foundation of psychological flexibility, the ability to tolerate distress and to mediate experience and the effect of experience in the mind. While we don't need mindfulnesss to achieve this, mindfulness meditation is a proven and useful method for developing the flexibility of mind that enables us to work with our own thoughts feelings and actions and loosen the hold of neurotic repetitive feelings.

For practitioners of psychotherapy, mindfulness training moves away from the notion of theory; leading to interpretation, then to insight towards the notion of experience-in-the-moment, leading to compassion and then to healing. However, it is important to note that meditation is not a clinical treatment but an aid to treatment. For many patients psychotherapy is successful because it enables them to lead a richer, fuller life despite the pain of their past. For the clinician, meditation offers the possibility of a way to be with patients that expands the framework of the treatment and allows that richer, fuller sense to emerge. Meditation then can offer the patient an answer to the question “If I am not my pain, who am I”?

Reading list:

Ordinary Mind: Exploring the Common Ground of Zen and Psychotherapy. Barry Magid. Wisdom Publications 2001

Mindfulness Based Cognitive Therapy for Depression. Z.V. Segal, J.M.G Williams, J.D. Teasdale. New York, Guilford 2002

Expanding our conceptualization of and treatment for Generalized Anxiety Disorder: Integrating mindfulness based/acceptance based approaches with existing cognitive behavioral models. Clinical Psychology: Science and Practice. 9, 54 – 80


Cognitive behavioral treatment of borderline personality disorder. M.M Linehan,. New York, Guilford. 1993

Buddhist Philosophy and the Treatment of Addictive Behavior. G.A.Marlatt, Cognitive and Behavioral Practice, 9, 42-50. (2002).

Equally Useless, review of Psychoanalysis and Buddhism: An Unfolding Dialogue. Ed Jeremy D. Safran, Wisdom 2003 by Barry Magid in Shambala Sun, May 2003.