Mindfulness is the primary acceptance strategy in CBT. It addresses parts of emotional experience that cannot be directly changed, like many of the spontaneous sensations, feelings, urges and thoughts that arise in emotional disorders.
- Anxious sensations, thoughts, and urges to avoid, escape and control
- Depressive self-criticism, regret, guilt, rumination, urges to avoid and escape
- Intrusive sounds, sensations and related emotional patterns that accompany Tinnitus and Hyperacusis
- Urges to pull, pick, tweeze, that accompany Trichotillomania
- Urges to overeat, use drugs, alcohol, porn, etc.
These experiences, distressing and disabling in themselves, can cause even more suffering by triggering avoidance and escape and by blocking the development of alternative, healthy responses.
Stepping Out of the Fire
With mindfulness you are accepting that for some areas of emotion there is no off switch, that the attempt to escape and control sensations, feelings, urges, thoughts, may only result in more suffering.
The solution provided by mindfulness is to soften the experience, turn down the volume. In this way you can more easily sit with fixed emotional patterns as they run their course. With regular practice you can come to observe feelings, sensations, urges and thoughts as neutral internal events. Strong emotions lose their power to drawn you into dark places, drive you toward destructive patterns. Think of mindfulness as stepping out of a fire, you still feel the heat, but are no longer consumed by the flames!
In CBT, mindfulness is used along with cognitive skills, exposure, and activation as part of an integrated treatment plan.