The Sanctuary: Present-Moment-Awareness and the Clinical Benefits of Being There

Mindfulness techniques are often thought of as being synonymous with present-moment-awareness interventions; however, while the two are clearly related, they are not one and the same. Mindfulness interventions are basically a form of attention control training, and, yes, clients have to be able to control their attention to make much headway in a present-moment-awareness intervention. As far as present-moment-awareness interventions are concerned, we regard the ability to focus and sustain atten­tion on what has shown up in the present as a means to an end, which, leads us to the bigger question: What is that end?

But when clients enter into present-moment awareness, they aren’t suddenly, automatically healed from whatever ails them. Once the problem of attention control is solved, the real fun begins! What clients will immediately make contact with is the full gambit of private experiences that were previously inaccessible or systematically avoided. This is what everyone who has ever meditated knows all too well. You can get as quiet and focused as you can possibly imagine, but that doesn’t mean your mind will shut up. While for many of us the typical problem is having a very busy mind that won’t shut up, for clients it’s having a very busy mind that won’t shut up, combined with major, emotionally salient life experiences that haven’t been integrated in a cohesive, healthy way. Once the client can control attention, the problem becomes what to do with the material that’s showing up in the field of present-moment awareness.

In their book, Inside This Moment: A Clinician’s Guide to Promoting Radical Change Using Acceptance and Commitment Therapy, Kirk Strosahl, PhD, and Patricia Robinson, PhD, emphasize, “Our approach to utilizing present-moment-awareness interventions in therapy doesn’t require clients to meditate, as is a common practice in some therapeutic approaches. We also don’t assume that radical change is dependent upon how long clients are in therapy. Our goal is to help clients enter into the space of present-moment awareness, make sustained contact with feared content, and use top-down attention resources to reframe and expand the psychological meaning of the present-moment experience.”

In this sense, change triggered by present-moment-awareness interventions is a qualitative rather than a quantitative event. Not surpris­ingly, we see clear and obvious clinical benefits associated with focusing on and utilizing present-moment-awareness interventions in therapy.

First, there really isn’t a role for the busy mind in the space of present-moment awareness. Busy mind is only capable of representing the past and future perspectives, whereas present-moment awareness involves being present, here and now, without interference from competing symbolic perspectives. Typically, when we have clients enter into the space of present-moment awareness, busy mind immedi­ately attempts to pull them into a symbolically derived perspective of the past or future. Assuming clients learn how to tame this beast, they can create an accessible space where busy mind’s activities are largely irrelevant. We like to call this “the sanctuary.” When people are in the sanctuary, they are able to simply be aware of what they’re aware of, nothing more, nothing less. When clients are stressed-out, the sanctuary offers respite from the endless negative chatter of busy mind.

Second, present-moment awareness is the only place where people can experience the immediate products of the interface interplay between their inner and outer worlds without interference from the symbolic activities of busy mind. We like to remind clients that emotions are never wrong, and they are never accidental. They are the result of thou­sands of years of evolution, and it makes no evolutionary sense whatsoever to argue that they’re bad for a person. Emotions are good for people; they’re a powerful form of feed­back about what’s working in life and what isn’t. Practicing present-moment awareness allows clients to absorb the information in their emotions, rather than getting lost in the mind’s evaluations of emotions and directives about what should be done about them. In reality, nothing should be done about the way you feel except to feel the way you feel. Contact with this form of nonverbal intelligence often allows clients to over­ride the directives of the mind and behave in new, flexible, and effective ways.

For more about the clinical use of present-moment-awareness, check out Inside This Moment by Kirk Strosahl, PhD, Patricia Robinson, PhD, and Thomas Gustavsson, MSc.