Omega: Your work has been funded by the National Institute of Mental Health and the Canadian Institutes for Health Research. What have you learned in working with and training professionals in the mental health world?

Zindel: It’s been really interesting that some of the initial requests we made of professionals have been embraced with increasing acceptance.

For example, when we first started to do this work (and I think one of the first workshops we ever did was at Omega in 2002 or 2003), we asked people who were coming into the workshop to tell us whether they had their own personal practice of mindfulness.

Some of the participants found it a little bit odd because for other workshops in mental health training, you're not asked to develop or have your own practice. But it's very central to our teaching that people are able to practice and then use that practice to observe and work with their own emotions.

But increasing, over the years, this has become a nonissue. The people who come into the workshops now have their own practices. They understand how and why that's important. I think it really enriches the kind of learning that they do and the kind of experiences that they have.

Omega: What personal practices do you recommend for clinicians interested in using mindfulness tools with their clients?

Zindel: I think not worrying too much about being perfect but starting somewhere is important. Start with a commitment to some regular form of practice. Make a commitment to sit for 10 minutes a day. Find resources that can support you by listening to teachers guiding you through mindfulness meditati practices.

I think it's really hard to start on your own and feel like you have to figure it all out. Guided mindfulness meditations can be found in the CDs that come with The Mindful Way Through Depression or The Mindful Way Workbook. There are also lots of apps out there that offer similar content, such as 10% Happier.

Then see if you can add to that informal practices of mindfulness where maybe you pay attention to eating and noticing taste or taking a shower in the morning and noticing either hurrying or just how the water feels on your body or what the shampoo smells like.

Omega: You designed the Mindfulness-Based Cognitive Therapy (MBCT)professional certification program for the Mindfulness-Based Professional Training Institute (MBPTI) at UC San Diego. Tell us about some of the program components. 

Susan: We support and strengthen the idea that when you're teaching an MBCT program, you need your own mindfulness meditation practice because that's what you're teaching from. It’s the platform, and because of that, you're not using your clinical skills in quite the same way.

We look at what the clinician is encountering through their own mindfulness meditation practice, how they embody that, and then how that translates into facilitating the skills and the modules of the MBCT program. It takes time because we have to encourage our very well-trained professionals to learn how to facilitate the MBCT program rather than using it as just another psychological intervention. It's very different.

Omega: You’ve said the heart of bringing mindfulness into a clinical setting lies in encountering modes of mind that often characterize mood disorders, while simultaneously learning to develop a new relationship to these modes. How do you work with clinicians who may be fearful about directly experiencing these modes of mind?

Susan: The difference between somebody who has encountered a major depressive disorder or high levels of anxiety, and the clinician who has encountered moments of high anxiety and perhaps profound sadness, is an interesting edge.

Mindfulness meditation practice allows us to develop a different relationship to sometimes quite high levels of emotional and cognitive dissonance. If someone who's coming to teach the MBCT program has not found a way to work with those mind and mood states during their own practice, they are going to encounter moments of high frustration, moments of profound sadness, and high levels of negative thinking often directed toward one self. They may experience high levels of criticism. This is part of life, right? The meditation practice gives us a platform from which to view it.

We train clinicians in MBCT in a boot camp style, from seven in the morning to nine at night, and then we put them back into the practice. They really have to sit with a lot of the questions and discomfort that's coming up for them.

It's a real container for engaging in their own mind and mood as they go through the training. Can they tolerate sometimes quite difficult material that is showing up? Do they have a sense that the person sitting in front of them has the ability to weather this and that they have what they need? It's a very profound change for our clinicians.

Omega: What kind of personal practices do you recommend for clinicians interested in using mindfulness tools with their clients?

Susan: I suggest finding time first thing in the morning before the day gets started to spend between five and 10 minutes sitting quietly and focusing on the body and breath. I also suggest, if they're not already doing it, to try some kind of meditative movement. I think meditation and mindfulness go hand in hand. I also suggest authors John Kabat-Zinn and Sharon Salzberg.

Ultimately, it’s like getting started with swimming. You can talk about it as much as you like, but until you get in the water, you don't know how to do it. So, I recommend five to 10 minutes of meditation practice every day as a wonderful way to get started.