What is Mindfulness-based Therapy?

Overview: What is mindfulness?

Defining Mindfulness

At its most basic, mindfulness is a way of purposefully noticing the present moment without judgment. It is made up of three elements: our direct experience of the present moment, our awareness of this experience, and our acceptance of it.

Mindfulness is both a skill and a behavioral practice.

As a practice, mindfulness is the act of purposefully noticing the present moment without judgment. Meditation is ONE way to practice mindfulness, but not the only one.

As a skill, mindfulness is the ability to observe the ongoing unfolding of experience with detachment and non-reactivity. The capacity to be more mindful in daily life can only be attained through a regular mindfulness practice.  Meditation is a common mindfulness practice for developing this mindfulness capacity, but not the only one.

3 Elements of Mindfulness

Where does mindfulness come from?

The concept and practice of mindfulness is derived from Buddhist philosophy and tradition, evident in the Four Noble Truths & Eightfold Path.

To understand the Four Noble Truths, it can be helpful to differentiate between pain and suffering. Pain happens when we break our arm or lose a loved one. Suffering happens when we want that pain to go away. While physical and emotional pain is inescapable, we can be freed from suffering.

The Four Noble Truths

  1. Suffering is part of life.
  2. Suffering comes from our attachment: our desire to have (craving) and the desire not to have (aversion)
  3. There is a way out of suffering.
  4. Suffering can be overcome by following the Eightfold Path.

The Eightfold Path

In Practice:
What is mindfulness-based therapy?

Mindfulness-based therapies integrate mindfulness meditation techniques with more traditional Western forms of psychotherapy, such as Cognitive Behavioral Therapy.

The use of mindfulness in therapy is part of a broader trend in utilizing mindfulness techniques for the purpose of physical and mental health. First emerging in the 1980s & 90s, interest in the therapeutic applications of mindfulness grew exponentially in the 2000s and gave rise to a family of mindfulness-based interventions for mental health. (Figure is from Black 2014, p489.)

Mindfulness was first applied to psychotherapy by Jon Kabat-Zinn in the 1990s to develop a treatment for chronic pain called Mindfulness-based Stress Reduction (MBSR). Since then, it has been integrated with Cognitive Behavioral Therapy to aid in relapse prevention for depression and substance use disorders.

Other well-known cognitive behavioral therapies that utilize mindfulness-based interventions include Dialectical Behavioral Therapy (DBT) for borderline personality disorder and Acceptance and Commitment Therapy (ACT), often used in the treatment of depression and anxiety.

In Theory:
How does mindfulness help?

The General Idea

Mindfulness reduces suffering by changing our relationship to it – especially to aversive experiences, such as physical or emotional pain. It helps with mental health by decreasing our aversion to negative emotional states and increasing our ability to cope with them.

Mindfulness creates a pause between a distressing experience and our reaction to it. It creates freedom from our attachment to feel or not feel a certain way. As our reactivity decreases, our freedom to choose our response increases.

The Specifics

Mindfulness helps by reducing our aversion to unpleasant experiences

A key insight derived from the Fourfold Path is that our aversion to negative experiences, such as physical and emotional pain, adds to our stress and increases our suffering. That is to say, our suffering from something like chronic illness is exacerbated by our nonacceptance and desire to avoid its symptoms. This secondary source of distress is sometimes called the “second arrow.” Mindfulness reduces our aversion to emotional pain by both (a) decreasing the amount of stress it causes us and (b) increasing our ability to tolerate it.


Mindfulness reduces our aversion to emotional pain by decreasing our stress response. By cultivating a non-judgmental attitude of acceptance toward distressing phenomena, we alter maladaptive thought patterns that only add to our suffering. For example, many women dislike experiencing the emotion of anger. But they unwittingly add to the unpleasantness of the experience by shaming themselves for feeling it. By showing us how to notice and separate judgmental thoughts (“I shouldn’t be angry”) from our immediate experience (“this is what anger feels like”), mindfulness prevents judgmental thoughts (the second arrow) from adding fuel to unpleasant emotions (the first arrow).




In addition to helping decrease the overall level of stress, mindfulness helps by increasing our ability to tolerate it. We have a natural tendency to want to avoid unpleasant experiences, such as emotional pain. Mindfulness, by contrast, encourages us to stay engaged with unpleasant experiences, thus increasing our ability to tolerate and manage them. By teaching us to focus on a single thing at a time in the present moment, mindfulness skills help to soothe overwhelming emotions. By enhancing our ability to accept the distress caused by unpleasant experiences, mindfulness reduces our reactivity and our need to comfort ourselves through unhealthy behaviors like emotional eating, substance use, or lashing out at our loved ones.

Through the practice of mindfulness, we increase our awareness of the emotional triggers, habitual patterns of relating, and automatic reactions that may be keeping us stuck. We develop the ability to separate ourselves from our thoughts, feelings, and urges long enough to create an opportunity to choose how we will respond. In this way, mindfulness is a readily accessible coping skill that increases our confidence in our ability to manage distressing emotions when they arise. When we no longer need to hide from our emotions, we can do what is necessary to heal them.


Black, D. S. (2014). Mindfulness-Based Interventions: An Antidote to Suffering in the Context of Substance Use, Misuse, and Addiction. Substance Use & Misuse, 49(5), 487–491. https://doi.org/10.3109/10826084.2014.860749

Chiesa, A., & Serretti, A. (2014). Are Mindfulness-Based Interventions Effective for Substance Use Disorders? A Systematic Review of the Evidence. Substance Use & Misuse, 49(5), 492–512. https://doi.org/10.3109/10826084.2013.770027

Published by Elizabeth Quiros

Elizabeth is a professional counselor specializing in psychotherapy for adults recovering from childhood trauma and dissociative disorders.

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