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Write a synthesis which integrates your personal experience of mindfulness practice with the rationales which underpin the use of mindfulness as an approach in contemporary settings.

This essay integrates my personal experience (physical, mental and emotional) of undertaking an established mindfulness-based learning programme in relation to the rationale which underpins its use in contemporary settings.

It investigates my personal understanding of how the shift in awareness from an unconscious, emotionally reactive state (automatic pilot) (Crane, 2008) to a more responsive conscious state of present-moment awareness (mindfulness) (Kabat-Zinn, 1994) is cultivated and provides physical and mental health benefits (Williams & Penman, 2011) that validate the use of mindfulness based approaches and interventions in contemporary settings (Crane, 2008) like healthcare (Baer, 2006; Didonna, 2009), education (Williams & Kabat-zinn, 2011), workplace (Baer, 2006; Goleman, 2003; Kabat-Zinn, 2003) and conflict resolution (Goleman, 2003; Kabat-Zinn, 2004; Nauriyal & Drummond, 2006).

Mindfulness/Sati (Pali), historically known as The heart of Buddhist meditation (Thera, 1962) is part of the core teachings of the Buddha known as Dharma (Sanskrit) meaning the way things are (Gunaratana, 1992; Hanh, 1998; Nanamoli & Bodhi, 1995). They point to the inevitability of suffering (dis-ease), stress the importance of its recognition, of identifying its root cause, description, development/deployment of pathways to free ourselves from its influences, collectively named the Four Noble Truths (Fig 1) (Hanh, 1998; Kabat-Zinn, 2005; Thera, 1962).

Fig 1(Hanh, 1998)

The basis for the mindfulness practices of all Buddhist schools, The Satipatthana Sutta consists of four foundations to free us of suffering (liberation), mindfulness of body, feelings, mind (mental state) and dharmas (mental events), all having the same aim: to be aware of what is (Thera, 1962; www.dhagpo-kagyu.org, 2001).

The contemporary Western psychological mindfulness tradition however, asserts that Buddhist Dharma at its core is, truly universal, not exclusively Buddhist and neither a belief, an ideology, nor a philosophy (Kabat-Zinn, 2003), emphasising the non-judgmental, present-centred nature of mindfulness, bare attention (Kabat-Zinn, 2003) necessary to better enjoy the present moment (Wallace, 2006).

The modern definition of Mindfulness (Kabat-Zinn,1994), paying attention in a particular way: on purpose, in the present moment, non-judgmentally has been refined to form three co-emergently arising axioms, On purpose, the axiom of intention (I), Paying attention, the axiom of attention (A), In a particular way, the axiom of attitude (A), called the IAA Model of Mindfulness (Fig 2) (Shapiro, Carlson, Astin, & Freedman, 2006)

Attention

Intention

AttitudeFig 2(Shapiro et al., 2006)

Kabat-Zinn (2004) asserts that a mindful state requires the development of 7 interdependent attitudes (pillars):- non-judging, patience, beginners-mind, trust, non-striving, acceptance and non-attachment that strengthen the ability to rest in the mindful state when accompanied by commitment, self-discipline and intentionality.

The recent explosion of interest and use of Mindfulness-based interventions/approaches (MBIs, MBAs) is based on nearly 2 centuries of curiosity regarding Eastern philosophical, religious and medical/scientific thought by westerners (McCown & Reibel, 2009) and a gradual melding of those within clinical practice since the 1940s (Speeth, 1982) (Fig 3).

Fig 3 (CMRP, 2012)

An increase in number of scientific papers and use of the term mindfulness since 1990 (Williams & Kabat-zinn, 2011) (Fig 4) coincided with the publication of Jon Kabat-Zinns Full-Catastrophe Living, a manualisation of the Mindfulness Based Stress Reduction (MBSR) programme, devised at the University of Massachusetts Medical Centre, as an evidence-based practice for safe new avenues of research and practice in academic medicine and psychology (Dryden & Still, 2006)

Fig 4(Williams & Kabat-Zinn, 2011)

This first universally adopted MBI , MBSR, arising from Kabat-Zinns integration of yoga and Buddhist meditation (Kabat-Zinn, 2004) and wish to help medical patients who were falling through the cracks of the health care system through insufficient or unsuccessful treatment (Kabat-Zinn, 2005), was initially offered through a free Stress Reduction clinic to help patients and staff cope with stress, anxiety, pain and illness (Kabat-Zinn, 2004).

This 8 week course consisting of a weekly 2 hour group session and 45 minutes of daily personal practice (Kabat-Zinn, 2004), informed the structure of the foundation year course of the Masters in Mindfulness at Bangor.

The overall outcomes of participating in this learning programme are, to

1. develop awareness through formal (body scan, sitting meditation, mindful movement) and informal mindfulness practice (cultivating present-moment awareness in daily life (Crane, 2008), 2. cultivate kindness, curiosity, and a willingness to be present with unfolding experience (Williams, 2008),

3. discover the universality suffering, learn to recognise/step out of the patterns that perpetuate/deepen it and developed insight/new perspectives which enable personal transformation (Crane, 2008). I explored these 3 elements (Crane, 2008) through the 2 modes of mind that underpin the rationale behind modern mindfulness-based approaches, doing and being (Williams, 2008); doing where my mind dwells mainly in the future and past, thinking and analysing, and being where I experience the direct, immediate, intimate present (Segal, Williams, & Teasdale, 2002).

Both modes have 7 aspects (fig 5). Each aspect forms the basis for a course session aimed at cultivating and embedding doing mode within daily living (Williams & Penman, 2011).

Doing mode Being mode

1. Automatic pilot /ruminationConscious choice

2. AnalysingSensing

3. StrivingAccepting

4. Seeing thoughts as solid & realTreating them as mental events

5. Avoidance Approach

6. Mental time travel (past /future)Remaining in present moment

7. Engaging in Depleting activitiesNourishing activities

Fig 5(Williams & Penman, 2011)

Kabat-Zinns original concept, developed and adapted under the umbrella of Mindfulness Based Approaches (MBAs), is classified by Didonna (2009) as Mindfulness-Based Interventions for Specific Disorders (Depression, Anxiety, Addictive Behaviour, Chronic Pain Management etc.) and Specific Settings and Populations (Individuals, Inpatients, elderly, carers, professional training etc.)

Suitable learning/teaching models have been formulated that meet modern academic requirements to train MBA facilitators. The training programme I engage in is structured around such a model, consisting of three interlinking layers integrating the doing and being aspects of learning (CMRP, 2012) (Fig 6).

Fig 6(CMRP, 2012)

This model embodies a single day teaching structure; Immersion in direct experience, Observation regarding immersion/teaching and finally Integrating immersion and observation with rationale, science/neuroplasticity (Arden, 2010; CMRP, 2012; Didonna, 2009; Hanson, 2009; Nauriyal & Drummond, 2006) and Buddhist Background, resulting in a learning system/methodology/delivery process promoting the development of the 7 attitudes within the learning experience, informed by a teaching process/delivery embodying these attitudes (McCown & Reibel, 2009).

The CMRP course initially emphasises paying attention to aspects of the internal and external world and becoming grounded, by learning to pay sustained attention to a single thing, intentionally (being mind) (Williams, 2008; Williams & Penman, 2011).

Through this process I recognise when I act without conscious intention/awareness of the present, (Crane, 2008) and developed an understanding of how automatic pilot is both beneficial and harmful (Williams & Penman, 2011); beneficial when engaging in familiar learned complex tasks like driving or typing, but harmful when applied to processing emotional experience (Crane, 2008).

These initial experiences verified how little conscious control over the unaware, harmful aspect of doing mind I had (Williams & Penman, 2011), confirming why learning to disengage from harmful doing mode and entering present centred being mode is central to the programme (Williams, 2008; Williams & Penman, 2011).

The second half of the course focussed on my learning to widen awareness and recognise when harmful Doing mode is triggered, for me develop responsive, skilful strategies when overwhelmed (Crane, 2008; Williams & Penman, 2011) and see thoughts as passing mental events while cultivating acceptance, compassion and empathy towards myself and others (Siegel, 2011; Williams & Penman, 2011).

I began this learning process resting within anticipation, acceptance, openness and trust, essential qualities for developing a mindful state (Kabat-Zinn, 2004), when the sudden sound of Tingshak cut through my rumination (Kabat-Zinn, 2004) and switched my attention (Shapiro et al., 2006) to hearing/listening/being mode (Baer, 2006), signalling the start of a practice session.

Following the practice guidance, I made conscious choices regarding what to and where my attentional focus should be directed (Crane, 2008; Kabat-Zinn, 2004; Williams, Teasdale, Segal, & Kabat-Zinn, 2007), cultivating my capacity to be mindful (Williams et al., 2007) and finally resting in choiceless awareness (Kabat-Zinn, 2004; Segal et al., 2002; Williams et al., 2007), until the short session ended.

A more vivid experience of the benefits of engaging with my senses mindfully was invoked during the raisin exercise (Didonna, 2009; Kabat-Zinn, 2003, 2004; Santorelli, 1999).

Focussing/connecting with each of my senses (Kabat-Zinn, 2004) within narrow concentrated attentional focus (doing mode) (Williams & Penman, 2011) instantly reduced my ruminating (Williams, 2008), reminding me of how much living is lost through dwelling in autopilot (Williams & Penman, 2011).

Feeling joyful, I rested in choiceless awareness (Williams et al., 2007), observing attention move between direct sensory experience and mental consciousness within a field of awareness bigger than thought alone (Williams & Penman, 2011), a receptive state that left me open to new experiences, like the completely unexpected crackling of the raisin in my ear that invoked the freshness of beginners mind (Kabat-Zinn, 2004).

An everyday object, a 'lowly insignificant fruit that I tend to eat by the handful while doing something more important (Williams & Penman, 2011), confirmed that bringing mindfulness to any activity (eating, teeth cleaning etc.) transforms it into a kind of meditation (Kabat-Zinn, 2004).

Recognising the mental shift from ruminating, analysing and overthinking (doing) to experiential discovery (being), (Segal et al., 2002) revealed the reason the raisin exercise begins the programme and why it is an excellent introduction to mindfulness for those who are depressed (Segal et al., 2002) or anxious (Kabat-Zinn, 2004).

Even more profoundly, it transformed this everyday sensory experience from simply focussing (Williams & Penman, 2011) into an ability to see things unfold moment by moment, a central tenet of the mindfulness programme (Williams & Penman, 2011)

Systematically bringing my attention/awareness to the unfolding sensations in and on each part of my body during the body scan developed this ability further, (Williams & Penman, 2011) through falling awake rather than falling asleep (Williams & Penman, 2011).

Being fully aware of my experience as it is (Williams & Penman, 2011) I direct and sustain my attention (Kabat-Zinn, 2005), deliberately engage, disengage and move from narrow to broad focus fulfilling the practice intention to develop attentional flexibility (Crane, 2008; Williams & Penman, 2011).

My attention, however, is sometimes caught, rumination setting in until awareness dawns, reminding me to focus on my body through belly breathing (Williams & Penman, 2011) and re-establish attentional stability before redirecting my attention to my body part of choice (Crane, 2008).

Directing my breath towards sensations or body parts was initially challenging, but tasting the difference between thinking/analysing and sensing mind while being profoundly relaxed (Williams & Penman, 2011) eventually enabled me to sense the itching or direct pain etc., even if disliked and settle into the non-striving / accepting present-moment experience intended (Crane, 2008).

Moving and directing my attention from a big toe-like narrow focus, to a broad full body attentional awareness (Crane, 2008) was less challenging, particularly while resting in this deeply relaxing, highly aware, restorative, meditative state (Kabat-Zinn, 2004).

I initially resisted (avoidance) (Shapiro et al., 2006) unguided practice because agitation, distraction, time stress and anxiety surfaced (Kabat-Zinn, 2004), but persistently returning to timeless present centred practice (Williams & Kabat-zinn, 2011) slowly eroded the driven nature of these feelings (Kabat-Zinn, 2004), reaffirming Kabat-Zinn's (2004) adage that you dont have to like it, just do it.

Through resting within choice and intention (Williams & Penman, 2011), I realised that the background felt meanings which guide my thoughts, emotions, speech and actions are expressed through my body (Crane, 2008) and that recognising/approaching them can relax body and mind, reduce fear and pain, aid in coping with illness (Kabat-Zinn, 2004) and help with depression (Segal et al., 2002) This beautifully simple practice is re-integrating my mind and body into a powerful and seamless whole (Williams & Penman, 2011) enabling me to identify less with my thoughts, emotions and sensations, seeing them more as mental events within my field of awareness (Crane, 2008).

I discovered new and spontaneous avenues of exploration within this practice that gradually gained acceptance (Williams, 2008), making it more enjoyable and fulfilling, by applying the habit breaking/releasing technique of adopting different positions, times and places to practice (Williams & Penman, 2011).

Practicing mindful movement, although mainly enjoyable and fulfilling, surprised me. I discovered that I was flexible enough to carry out some exercises but my body shape and health condition limited some of my movements (Williams & Penman, 2011), as is the case with the elderly, hospital patients and those living with pain (Didonna, 2009).

This gave rise to louder body sensations and a more concentrated attentive grounding in awareness (Williams et al., 2007), preventing recurrence of physical problems caused by habitual unconscious tensing of previous stressful mental states (Kabat-Zinn, 2004; Williams et al., 2007; Williams & Penman, 2011), weakening my tendency to avoid unpleasant internal experiences arising during the practice process (Williams et al., 2007) enabling the process of body/mind re-integration to continue (Williams & Penman, 2011).

Awareness of moment by moment information regarding body parts (proprioception), strength (kinaesthetic) (Kabat-Zinn, 2003; Teasdale, 1999) and choice of movement (interoception) (Crane, 2008; Kabat-Zinn, 2003; Williams, 2008; Williams et al., 2007), led to the realisation that my experience is underpinned by a single mind scale that simply registers experience as positive, neutral, or negative, acting as my internal barometer (Williams et al., 2007), a profoundly powerful and significant early warning system, that allows me to defuse problems before they gather momentum (Williams & Penman, 2011).

The employment of one early warning practice tool, the 3 Step Breathing Space (Crane, 2008; Williams et al., 2007; Williams & Penman, 2011) initially felt like a condensed version of a Tibetan Buddhist Mahamudra tradition shamata meditation technique (Thrangu, 2001). This mini-meditation however, expands on the technique while condensing the core elements of the programme into the three steps of becoming aware, gathering/focussing and expanding attention (Williams & Penman, 2011), providing a bridge between longer mindfulness sessions and daily living and a useful tool to maintain a flexible, compassionate, mindful attitude whatever occurs (Santorelli, 1999; Williams & Penman, 2011).

This major shift from doing to being mode (Kabat-Zinn, 2004; Williams et al., 2007) combined with the new and fresh experience of mental flexibility (Kabat-Zinn, 2004; Shapiro et al., 2006; Williams et al., 2007) dissolved the preconceptions of I know this, Ive done this etc. (Crane, 2008; Didonna, 2009), reminding me to approach practice with a fresh/open mind (Kabat-Zinn, 2004; Williams & Penman, 2011).

This practice refreshes and relaxes my striving mind and reduces body tension, useful when managing difficult situations (Segal et al., 2002). It brings an awareness that helps me step out of and relate to difficulties differently (Williams et al., 2007), even dissolving potentially destructive habitual reactions before they emerge (Williams & Penman, 2011), crucial in relapse prevention for depression etc. (Didonna, 2009) .

Applying the foundational attitudes (Kabat-Zinn, 2004) within the breathing space and the 45 minute meditation sessions as I follow the directions to contract (concentration/narrow) and expand (mindfulness /panoramic ) (Speeth, 1982) my focus within my field of awareness (Teasdale, 1999) has refreshed, enriched and deepened my practice experience (Kabat-Zinn, 2004).

I now approach my thoughts with warm acceptance, friendliness, patience and kindliness (Crane, 2008; Didonna, 2009; Segal et al., 2002), observing (decentre/repercieve) (Crane, 2008; Didonna, 2009; Shapiro et al., 2006; Williams & Penman, 2011) and letting them go (Teasdale, 1999), skills used in MBIs for a wide range of psychological disorders and some severe medical problems where clinically relevant/effective (Baer, 2006; Cullen, 2011; Didonna, 2009)

Ive noticed that my mind-scape is ever-changing, from the being-feeling tones of dawn practice to the more frantic doing-feeling tones of daily busyness (Williams & Penman, 2011) and that each mind state brings a new take on reality, with none being complete or final (Welwood, 2000), as in the changing emotional reality of my destructive emotion, anger (Goleman, 2003b).

Initially, anger dominates my field of awareness and due to emotional entanglement (Welwood, 2000) eventually affects my lower back, shoulder or neck and creates tension behind my eyes, affirming Kabat-Zinn's (2004) Paradigm that patterns of thinking and feeling etc. influence my health.

But, by turning towards (approaching) this anger with compassionate mindfulness (Williams & Penman, 2011) and letting go of the judgement and story lines, I transmute it, experiencing it as naked living presence (Welwood, 2000).

A recent event clearly demonstrated the benefits of consciously making this modal change (Teasdale, 1999) resulting in the 7 foundational attitudes arising from within the mindful state (Kabat-Zinn, 2004).

Wheelchair bound and unable to walk I had to be reliant on others. This induced

Apprehension and anxiety what will others think? (Segal et al., 2002; Williams et al., 2007)Self-judging (self-talk)How stupid to get in this situation! (Williams & Penman, 2011)clarity/insight/beginners mind the a-ha moment(Kabat-Zinn, 2004; Welwood, 2000)Acceptance! There's nothing you can do (Segal et al., 2002) Non-striving,Just sit and relax (Kabat-Zinn, 2004)Be patient (Kabat-Zinn, 2004)Curiosity Let's see how this feels (Segal et al., 2002)Openness "soften" my response(Segal et al., 2002) Trust in the experience, (Kabat-Zinn, 2004)in those caring for you right now, (Arden, 2010) Non-striving/relaxyou can't go anywhere on your own, (Crane, 2008; Kabat-Zinn, 2004)Let go. (Kabat-Zinn, 2004)

Joyously letting go, accepting and sharing this mindfully with those in the same situation felt like an act of hospitality (Santorelli, 1999), offering the possibility of relating to others in the same way, with the realisation that working with whatever is present is enough (Santorelli, 1999).

Applying this to my everyday activities verifies this, transforming them into something more vivid, real, fresh, insightful and calming (Kabat-Zinn, 2004) that changes my mind mode from the feeling there's 'something that has to be done before we do the next thing' (discrepancy based processing) (Williams, 2008), to inducing patience and non-striving within them (Kabat-Zinn, 2004).

Mindfulness is a mainly solitary, deeply personal, internal learning process (Crane, 2008) but the interface between fellow group members and exploratory dialogue facilitated and stimulated by someone experienced in the learning process (Crane, 2008) helped me cultivate a more non-reactive, non-judgmental attitude toward others, objects, events and ideas (Carroll, Lange, Liehr, Raines, & Marcus, 2008; Kabat-Zinn, 2004).

It also revealed and emphasised the normality of shared experience and suffering (Santorelli, 1999), a shift in perspective and attitude that proved a potent and important part of my learning/development (Crane, 2008).

Our diverse backgrounds offer us a great deal to work with as we explore our humanness (Crane, 2008) within a safe and positive learning environment (Santorelli, 1999) through discussing individual (vertical inquiry) and shared experience (horizontal inquiry) (Bernstein, 1999), leading to a more refined understanding of the learning process that lies at the very heart of mindfulness based learning approaches (MBLAs) (Crane, 2008).

Directing my attention appropriately (exteroception) (Segal et al., 2002; Speeth, 1982) while these interactive discussions unfolded enhanced this process (Shapiro et al., 2006; Speeth, 1982), revealing my true feelings and reactions/responses to their content and emotional undercurrent (Shapiro et al., 2006; Speeth, 1982).

The intensity of my reactions during inquiry/dialogue as I became caught in my emotional vortex sometimes surprised me (Williams & Penman, 2011), led to regret, a lowering of mood and my inner critic blaming me for not meeting my expectations (Williams & Penman, 2011).

However, the unfolding of this process has made me more respectful and tolerant, able to speak more freely and openly, more supportive and appreciative of individual input, aware of others difficulties (empathise) (Santorelli, 1999; Shapiro et al., 2006; Williams & Penman, 2011) and able to facilitate a healing relationship through lively collaboration and mutual transformation (Santorelli, 1999) aided by tutors who have explored the territory we are led into (Crane, 2008).

The result is, I have befriended myself (Santorelli, 1999; Williams & Penman, 2011) become self-caring, embrace nurturing activities, have improved health and a more enjoyable life, the main aim and intention of mindfulness-based programmes (Kabat-Zinn, 2004).

Through regular mindfulness practice I have become more aware and awake (Crane, 2008; Santorelli, 1999) and experience my thoughts, thought processes, feelings, emotions, reactions and the physical effects of mental processes on my body more vividly, as Siegel, Germer & Olendzki in (Didonna, 2009) affirm, and reduced the power of stress reactions and their hold, changing the way I see myself , my life and the world (Kabat-Zinn, 2004).

My experience of the practices, concomitant with the scientific and psychological rationales and evidence is, that they are a very powerful and effective set of learning and clinical tools (Carroll et al., 2008; Crane, 2008; Didonna, 2009; Grossman, Niemann, Schmidt, & Walach, 2004; Kabat-Zinn, 2004; Segal et al., 2002; Williams & Penman, 2011) when combined with an understanding and application of the foundational attitudes (Crane, 2008; Kabat-Zinn, 2004; Shapiro et al., 2006; Williams et al., 2007).

They help me relate more directly to my mind (Williams et al., 2007) and to the dynamics of peer to peer, intergroup, student/tutor and daily life interactions (Kabat-Zinn, 2004), reminding me that we are all students and that learning and growing are life-time engagements (Kabat-Zinn, 2003).

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