Adapting Mindfulness for Conservative Christian Clients

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Adapting Mindfulness for Conservative Christian Clients Fernando Garzon, Psy.D. AACC Webinar, Tuesday, May 31, 2016 fgarzon@liberty.edu http://works.bepress.com/fernando_garzon/ fgarzon@liberty.edu Liberty University

Introduction

What Are We Going To Do? Mindfulness? Concerns? Ethics? Adaptations? Clinical aspects

Compassionate, purposeful awareness Open, Non-judgmental, Accepting of Thoughts, feelings, impulses, and/or behaviors, in the present moment (Shapiro, Carlson, Astin, & Freedman, 2006) Mindfulness Defined

Mindfulness Defined II Open presentmoment awareness (Shapiro, Carlson, Astin, & Freedman, 2006)

Core Elements Attention: On purpose regulating attention to the current moment. This increases one s perception of thoughts, emotions, sensations, and behaviors as they arise Attitude: Maintaining a stance of openness, curiosity, and acceptance without self-judgment toward inner experience. Applying a nonjudgmental attitude toward the self and others Intention: Ask the question of why you are deciding to practice mindfulness. Find personal meaning in the exercise (Shapiro, Carlson, Astin, & Freedman, 2006)

Mindfulness as an Empirically Supported Treatment Lowered Stress and Overall Well-being (Goyal, Singh, Sabinga, et al., 2014) Lowered Anxiety and Depression: (Hofmann, Sawyer, Witt, & Oh, 2010) Lowered Anxiety and Stress: (Chiesa & Seretti, 2009) Enhanced Emotion Regulation: (Menezes, Pereira, & Bizarro, 2012)

Buddhist roots Primary Christian Concerns

MH Professional Ethical Aspects: Why respond to these concerns? Avoid value imposition Treat clients with multicultural sensitivity Garzon & Ford (In Press)

Religiously Accommodative Treatment Religiously accommodative treatment seeks to increase therapeutic effectiveness through adapting or adjusting empirically supported interventions as needed to incorporate the worldview of the client respectfully in treatment (Tan, 2013).

Religiously Accommodative Treatment 2 Decreases resistance Increases treatment adherence Increases homework compliance

Primary Concern: Buddhist Roots

Secular Mindfulness Worldview

Secular Mindfulness Breath Meditation Example

Christian-Adapted Breath Meditation

Christian Worldview Additions I God is with us in our present moment experience. Theological principle: God s immanence

TRUTH

Christian Worldview Additions 2 God is relational with us in our present moment experience

Surrender as a Religious Coping Strategy Surrender to God is a religious coping strategy that focuses on actively yielding personal control of life stressors to God. It promotes a paradoxical experience of perceived control through acknowledging personal limitations in control over life stressors (Cole & Pargament, 1999; Wong-McDonald & Gorsuch, 2000).

Another Description of Surrender Let go and let God take control (Tan, 2011) Not learned helplessness

Serenity Prayer as an Example of Healthy Surrender God grant me the serenity to accept the things I cannot change [through yielding them to You], the courage to change the things I can [through Your strength], and the wisdom to know the difference.

Are there other principles we can add to mindfulness?

Lovingkindness Meditation Seeks to cultivate Self-acceptance Self-compassion Compassion for others Siegel (2010)

Why?

Secular Lovingkindness Meditation Script Start by repeating quietly to yourself, May I be happy, may I be peaceful, may I be free from suffering. Just repeat the phrase, intending or wishing this for yourself Eventually your mind wanders gently return your attention to the phrases, May I be happy, may I be peaceful, may I be free from suffering once you ve directed compassionate intentions towards yourself, you can try passing it on to others It s usually easiest to begin with someone who is a dear friend or relative May you be happy, may you be peaceful, may you be free from suffering. (Adapted from Siegel, 2010, pp. 84-85)

Adapted Lovingkindness Meditation Script See handout, Christian-Adapted Lovingkindness Meditation Version 1

Adapted LK Meditation Second Example See handout, Christian-adapted lovingkindness meditation version 2

Adapted Loving Kindness Meditation Differences Secular LK Intentions Sending well-wishes to the self Personal foundation Adapted Prayer Receiving God s kindness towards us Biblical, theological foundation

Grace Photo by Naypong. Published on 05 November 2014 Stock photo - Image ID: 100296179

Grace includes God s love God s compassion God s acceptance Self-acceptance

Teaching Clients Grace Scriptures (e.g., Romans) Books/audiobooks Grace Walk by Steve McVey Grace by Max Lucado Websites https://gracewalk.org/ Pastoral referrals Consultations

Lovingkindness Comparisons II Secular LK Meditation Wishing, kind intentions Sending Decision for selfacceptance, compassion & othercompassion Christian LK Meditation Prayer Receiving, interceding Receiving God s grace, mercy, love, & acceptance for me through faith & giving it to others

Christian Classics on the Present Moment Abandonment to Divine Providence, Jean-Pierre de Caussade The Practice of the Presence of God, Brother Lawrence Letters by a Modern Mystic, Frank Laubach Present Perfect: Finding God in the Now, Gregory A. Boyd

Brief Christian-Adapted Mindfulness Strategies Breaking worry and rumination cycles Quick Christian-adapted Mindfulness Exercises (See handout)

Christian-Adapted Quick Exercises A B C

Adjustments Connect fully with ourselves God in our present moment experience

Sample Questions & Background Lord, what are You doing around me right now? Lord, what is Your purpose for me in this present moment? Lord, what are You wanting to do in me in this moment? Around me? Abandonment to Divine Providence, Jean- Pierre de Caussade

Sample Questions & Background Lord, how can I express love to you in this present moment? The Practice of the Presence of God, Brother Lawrence Or another question that works Collaborate with the client to choose the question that works for her

Handling Potential Client Reactions

During the Meditation Monitor client non-verbals Posture shifts, facial expression changes (tension increasing, frown, etc.) Check-in as appropriate What s happening right now for you?

Potential Reactions Positive Positive with some noting of inner criticisms Lots of inner criticisms A negative God image God hates me is angry with me, etc.

Addressing Reactions to Christian Lovingkindness Meditation Some inner criticisms or lots of inner criticisms Immediacy ACT cognitive defusion strategies Exploring roots of self-judgment Scriptures on God s grace

Addressing Reactions to Christian Lovingkindness Meditation 2 Negative God image (God hates me, is angry with me, etc.) Parents, caregivers Church environment Scripture exploration, forgiveness, and meditation (God s mercy, grace, love, etc.)

Diagnostic Reactions Panic-like reaction Deep breaths Reorienting to the room Processing the experience to identify the underlying concern

Diagnostic Reactions 2 PTSD abreaction/flashback Rapidly reorient to the room Invite the client to attend to external stimuli Look at me. What are three other things you see in the room? Touch your nose Stand up, walk around, etc.

Key Points Ethical and clinical mandate for religiously accommodative treatment Adapting mindfulness to the Christian worldview is possible to make it more accommodative

Key Points 2 Accommodations God s immanence (presence) Surrender of control to God Incorporating Biblical context for terms (Breath example) Grace foundational for lovingkindness, and selfacceptance

Key Points 3 Monitor the client during the meditation Ways to handle different client general reactions Ways to handle different client diagnostic reactions

Resources Christian mindfulness online course by Richard Johnston, http://www.christianmindfulness.co.uk/about.html

References Chiesa, A., & Serretti, S. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. The Journal of Alternative and Complementary Medicine, 15, 593-600. doi:10.1089=acm.2008.0495 Clinton, T., & Ohlschlager, G. (2002). Christian counseling and compassionate soul care: The case for twenty-first-century practice. In T. Clinton & G. Ohlschlager (Eds.), Competent Christian counseling (Vol. 1). Colorado Springs, CO: Waterbrook Press.

References Cole, B. S., & Pargament, K. I. (1999). Spiritual surrender: A paradoxical path to control. In W. R. Miller (Ed.), Integrating spirituality into treatment: Resources for practitioners (pp. 179-198). Washington, DC: American Psychological Association. Garzon, F. & Ford, K. (In Press). Adapting mindfulness for conservative Christians. Journal of Psychology and Christianity, 35 (3).

References Goyal, M., Singh, S., Sibinga, E. S., et al. (2014). Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357-368. doi:10.1001/jamainternmed.2013.13018 Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62(3), 373-386.

References Siegel, R. (2010). The mindfulness solution: Everyday practices for everyday problems. New York, NY: Guilford Press. Tan, S.-Y. (2011). Mindfulness and acceptancebased cognitive behavioral therapies: Empirical evidence and clinical applications from a Christian perspective. Journal of Psychology and Christianity, 30(3), 243-249.

References Tan, S.-Y. (2013). Addressing religion and spirituality from a cognitive-behavioral perspective. In K. I. Pargament, (Ed.), APA handbook of psychology, religion, and spirituality: Vol. 2. An applied psychology of religion and spirituality (pp. 169-187). Washington, DC: American Psychological Association. Wong-McDonald, A., & Gorsuch, R. L. (2000). Surrender to God: An additional coping style? Journal of Psychology and Theology, 28(2), 149-161.