Mindfulness is a grossly misunderstood concept, not unlike many other concepts in psychology. This chapter is not sufficient to cover everything there is to know about mindfulness, so, I am going to try to crunch the information for you in a more digestible package. Simply put, mindfulness is focusing your attention in a non-judgmental or accepting way on the experience occurring in the present moment (Kabat-Zinn, 1994). It is an awareness of the present moment experience with acceptance (Germer et al., 2005). Mindfulness is the state of being able to focus on the task at hand with attention and awareness, without letting other factors cause a distraction i.e., present moment awareness (Behan, 2020). This is to be achieved non-judgmentally, non-critically. Let me explain the individual components.
First, mindfulness is about being in the present moment – having present-moment awareness. Where does your mind reside? In the past, regretting mistakes, feeling guilty, longing for things that are over? Or, does it reside in the future, worrying about things that have not happened yet and may never happen? Or does your mind truly reside in the present, focusing only on the current task with complete dedication? If your mind resides anywhere but in the present moment, and you do not recognize it enough to bring it back to the present, you are not being mindful.
Second, mindfulness is also about being in the present space – having present position awareness. Even if you are in the present, where is your attention? Are you trying to study while your attention is towards the television playing in the other room? Or are you trying to finish some work while your attention is focused on your manager having a conversation with your colleague? So, not just present moment but also present position awareness is important.
Third, there are seven attitudinal foundations of mindfulness as given by Jon Kabat-Zinn, the foremost authority in mindfulness and the developer of the Mindfulness Based Stress Reduction (MBSR) program. The seven foundations are non-judgmental attitude, patience, beginner’s mind, trust, non-striving attitude, acceptance, and the attitude of letting go or non-attachment (Kabat-Zinn, 2013). I shall also briefly discuss how you can use them to deal with your Harm OCD. The seven attitudinal foundations of mindfulness are as below:
1. Non-Judgmental Attitude: Mindfulness requires you to have a non-judgmental attitude towards your thoughts. When you practice mindfulness, you may begin to notice that your mind is being judgmental. You may have thoughts such as ‘this is boring’, ‘I can’t do this’, ‘I am bad at this’, and so on. The objective of mindfulness is not to try to stop the judgment, but just observe that it is occurring and notice how you feel about it. Like, when you do a mundane chore, such as washing the dishes, you may feel bored and may either not want to do it at all or do them hastily to get it done with. In that moment, if you are aware that you are feeling bored, and your mind wanders, you can try to bring it to the present moment and focus on doing the job better. In the context of your Harm OCD, when you have an obsessive thought, notice if you find yourself saying, ‘this is an evil thought’ or ‘this is a vicious thought’. When you notice it, try to shed the judgment and make an attempt to classify it as just another Harm OCD thought (neither good nor bad).
2. Patience: When you learn to practice mindfulness, you need to learn the valuable art of patience. There are no magic pills in recovery and the process takes time as it is a new skill you are learning. Your brain needs to develop the habit of doing the right thing and that will be possible only through practice. Whether it is ERP that you are practicing or mindfulness itself, the key to mastery is repetition and patience. You may make mistakes and you may often fail in your objective. But with patience, you will begin to get better at the practice. For example, if you want to learn juggling, it will require a lot of patience on your part. Unless you are gifted, you may not be able to learn juggling without patience and repeat practice. In the context of your Harm OCD thoughts, have the patience to recognize that you will take time to accept the thoughts without needing to do your compulsions. Learn to resist your compulsions repeatedly to overcome Harm OCD.
3. Beginner’s Mind: Mindfulness also requires you to learn to have a beginner’s mind. When you engage in routine activity, you work on auto-pilot and allow your mind to wander, without actually noticing the details. For example, you may not be able to recollect the pattern of the wallpaper in your house without needing to look at it again, as you may not have observed it very closely. However, when you do something new, your mind may be more focused on the task. For example, if you have never seen a mobile phone before and one is handed to you, you may look at it with curiosity and attention. This curiosity and attention is referred to as the beginner’s mind and is an important attitude for mindfulness. It allows you to fully absorb what is happening at that moment. It is as if you are looking at something with the eyes of an alien who finds the experience new. In the context of your Harm OCD, when you have an obsessive thought, you can activate the beginner’s mind and ask yourself mindfully – what am I experiencing as I am getting this thought? Observe the fear, observe the discomfort. Observe the push of the obsessions and the urgency to do the compulsions. Learn what to pay attention to, and learn what to let go of.
4. Trust: An important foundation of mindfulness is trust – the trust that you build in yourself. Trust that tells you that you can handle this situation yourself and do not need external crutches. You need to look into yourself when a situation arises. You interrogate yourself. You determine the validity of the thoughts and feelings yourself. You learn to break away from the thoughts yourself. If you get thoughts of harming your cat, you recognize that they are just stray thoughts. That these thoughts are being fed to you by someone else, namely your Harm OCD. You learn that even though the thoughts originate in your brain, it is indeed another entity that is responsible, and not the core you. You learn to delink from the thoughts and do not integrate them into your reality. When you trust yourself, you don’t need any external reassurance about your intentions. You do not need your thoughts to be validated by others. Instead of believing what your Harm OCD tells you blindly, you trust your core self to do the right thing.
5. Non-Striving Mind: The next important attitudinal foundation of mindfulness is of the ability of being non-striving. Being non-striving means not attaching your efforts to an immediate outcome. Being non-striving means putting in the efforts towards a goal but not being in a rush to measure progress with each step taken. Sometimes it may seem like there is no progress being made but you continue to put in the efforts because that is the right thing to do. For example, if you have a baby at home, you feed the baby and give it right care. But every time you feed the baby, you do not measure its height or weight and be disappointed if there is no change. Even if there is no visible change, you do not give up. You do not stop feeding the baby. The goal is to turn the baby into a strong grown up, which you realize will not be achieved in a day. Thus, you care for the baby in a non-striving manner, and eventually, you begin to see the baby growing up. In the context of your Harm OCD, when you practice ERP, you may try to do so with the intention of relieving your anxiety immediately. But that is a state of striving. It may prove to be counterproductive when despite trying your best your anxiety does not go down. But if you practice response prevention without attaching the goal of immediate gratification to it, you will get better at it and eventually your efforts will start showing results.
6. Acceptance: Acceptance is one of the pillars to recovery which we shall be exploring later as well. However, acceptance is also one of the attitudinal foundations of mindfulness and deserves mention here. Acceptance is a state of no-resistance, when you do not idly wish that things were different. When you idly wish for something to be different but do not do anything about it, you are neither accepting the situation nor making it better. Acceptance is the understanding that the situation is the way it is and that if you do not resist it, deny it or resign to it, you may be able to deal with it better. With complete acceptance, you can build the commitment to make a change for the better. In the context of your Harm OCD, when you get an obsessive thought, you accept it by recognizing that you have Harm OCD. Accept that it has happened often in the past, it has happened again, and it will happen in future too. Acceptance of the thought will prepare you for the next step – to effectively resist your compulsions.
7. Non-attachment: There may be many moments in our lives that we may want to hold on to. Pleasant thoughts, feelings, memories, we choose to hold on to more. But if there are unpleasant thoughts, feelings, experiences or memories, we want to get rid of them as they cause distress. Developing the attitude of non-attachment is important to becoming more mindful. Non-attachment refers to observing the experience every moment without assigning it meaning and without either clinging to it or shunning it. Reinhold Niebuhr summed it up beautifully in the serenity prayer – Father, give us courage to change what must be altered, serenity to accept what cannot be helped, and the insight to know the one from the other. In the context of Harm OCD, non-attachment refers to understanding that if there is a distressing obsessive thought, it will pass too. So will the relief experienced after doing the compulsion. In a state of non-attachment, you may not shun the obsessive thought or crave the satisfaction of having done the compulsion.
These are the attitudinal foundations to mindfulness and how they relate to your Harm OCD. Table 2.7.1 gives a quick look of how these foundations relate to your Harm OCD. Be sure to refer to it when you have obsessive thoughts and want to mindfully deal with them.
Table 2.7.1: Attitudinal Foundations with Harm OCD
|Attitude||Response to Obsession|
|Non-Judgment||‘Hmm, this is another obsessive thought that I am getting’ (neither good nor bad)|
|Patience||‘This will take time to go; it will not go away immediately’|
|Beginner’s Mind||‘What am I experiencing in my thoughts? What am I experiencing in my body?’|
|Trust||‘I can handle this myself. I do not need reassurance from others on this’|
|Non-Striving Mind||‘Let me not pressurize myself to be rid of this immediately; let me do what I can’|
|Acceptance||‘This happens often, this has happened again, this will happen again in future’|
|Non-Attachment||‘This will pass too, let me not hold on to it’|
There is a psychometric test provided as PT3 in the Worksheets for Harm OCD file – the Mindfulness Attention Awareness Scale (Brown, & Ryan, 2003). “The trait MAAS is a 15-item scale designed to assess a core characteristic of mindfulness, namely, a receptive state of mind in which attention, informed by a sensitive awareness of what is occurring in the present, simply observes what is taking place” (Brown, & Ryan, 2003). Take the test to note your mindfulness. Higher the score, the better you are at being mindful.
To-Do: Complete PT3 – MAAS provided in ‘Worksheets for Harm OCD’
To-Do: Practice mindfulness with your obsessions using these attitudinal foundations