Mindfulness in treatment

What we use it for

We use mindfulness-based elements as part of treatment. It is particularly relevant for:

• Stress, where the body has to learn to come back down again
• Recurrent depression, where it prevents relapse
• Anxiety, as training in tolerating bodily sensations without fleeing from them
• Trauma — but with caution here: too much inward-directed attention can be overwhelming if the system is not yet stable enough

How it fits into our work

We do not offer mindfulness courses as such. We have the methodology and its techniques integrated into the treatment.

That is not a concession. It is a description of what ISTDP actually does — because the method largely works with the same material, just under different names.

Mindfulness trains the ability to stay with an uncomfortable experience without immediately doing something about it. That is, word for word, the same as anxiety regulation and affect tolerance in ISTDP — just done live in the room, with the discomfort that is actually at stake, instead of as an exercise.

The difference lies in what happens next. ISTDP does not stop at changing the thought pattern. It goes after the underlying feelings that set the pattern in motion.

Rumination is rarely a random bad habit. It is usually a way of keeping something at a distance that is too much to feel. Remove the worry without touching the feeling, and the system often finds a new way of doing the same job. That is why we work on both at once.