There was no MBSR class last week as our trainer was unavailable, but I wrote a fortnight ago on "Learning MBSR: fifth evening of the course - the value of 'difficult' practice sessions & of 'concentration'".  This evening we were down to six out of the nine of us who began the training together.  I do wonder whether using tools like "The session rating scale (SRS)" would reduce drop-out rates - it certainly does in one-to-one and couples work.  I'm currently using a slightly adapted version of the SRS in an "Interpersonal group" that I'm running and I think it is catching people who begin to lose a strong personal connection with the work of the group - it gives us an opportunity to re-look at why they're doing the course and how best they can get most value from it.  

Besides mentioning the possible value of the SRS, there are three other areas I'd like to touch on looking back on yesterday evening's class.  One is a comment about learning and the engage-reflect-engage loop.  Another is a further thought on "difficult" sessions and the development of determination, and a third is a metaphor that I think might be useful & fun - mindfulness as a "self-parenting class".  I'll look at the "self-parenting class" metaphor in a separate post, so here I'll talk firstly about the engage-reflect-engage loop.  A widely used illustration of this is Kurt Lewin's "Learning circle of experience" (sometimes erroneously attributed to Kolb).  Lewin argued for the value of experiential learning, so for MBSR this involves immersing in the practice and then taking time to look at what one can best learn from the experience (as I'm doing in this blog post).  Here in this particular MBSR course, we quite often seem to follow a pattern of a longish (45 minutes or so) initial practice followed by a detailed discussion between individual group members and the trainer about their experience of the meditation that we have just done.  A couple of things I appreciate about this are the way the trainer models a gentle, unhurried, non-judgemental curiosity about individuals' reports of their practice, and the recency of the experience providing a rich, multi-textured source of information to explore.  However it does seem that some participants are more ready to talk about their practice than others - as I guess in any class - and my personal experience is that can mean I lose some of what I could have learned from my own exploration.  I wonder if it would be helpful to get people initially to do a little writing after a long class practice session.  We could then discuss what we had learned in pairs, before bringing it back into the full class.  In this way everyone gets the fresh initial time just after the meditation to look more deeply at their own experience, but one also keeps the value of a more general group discussion.  I think providing a simple sheet to fill in can be helpful - asking, for example, about what struck the individual as most personally important for them to note about the practice they have just completed, what the main challenges were, and possibly what they now want to take forward into future exploration of mindfulness.  One could use these or other related questions, possibly even varying from week to week, and clearly giving people the option to ignore the questions if they want to and simply write about their practice in any way that they feel would be most useful for them.  I would probably show them a diagram of Lewin's "Learning circle" as orientation and give them question sheets (here are Word format and PDF file examples).

What about "difficult" sessions and the development of determination?  I've already talked a bit about the potential value of "difficult" practice sessions in the "MBSR: fifth evening" post.  Masicampo & Baumeister discuss this issue much more extensively in their paper "Relating mindfulness and self-regulatory processes" with its abstract stating "We share the ... enthusiasm regarding the usefulness of mindfulness ... interventions, and in order to facilitate the movement forward in this line of work we highlight two areas where the distinction between mindfulness and self-regulatory (or self-control) processes may require attention. First, there appears to be some theoretical overlap between mindfulness interventions and self-control exercise. Recent work (for a review, see Baumeister, Gailliot, DeWall, & Oaten, 2006) has shown that engaging in self-control exercises on a daily basis increases the general capacity for self-control, and that such an increase results in a variety of benefits for the self. Given the similarities between self-control programs and mindfulness interventions, we propose that mindfulness therapies may qualify as one example of self-control exercise ... ".  Giluk touches on this issue too in "Mindfulness, Big Five personality, and affect: A meta-analysis" with her comment "The primary purpose of this study is to provide a more precise empirical estimate of the relationship between mindfulness and the Big Five personality traits as well as trait affect ... Meta-analysis was used to synthesize findings from 32 samples in 29 studies. Results indicate that, although all of the traits display appreciable relationships with mindfulness, the strongest relationships are found with neuroticism, negative affect (both inversely!), and conscientiousness. Conscientiousness, in particular, is often ignored by mindfulness researchers; results here indicate it deserves stronger consideration."

I think conscientiousness & "willpower" are vastly important areas and I wrote a series of seven posts back in the summer starting with "Self-control, conscientiousness, grit, emotion regulation, willpower - whatever word you use, it's sure important to have it".  I went on to talk about how we might be able to increase our ability to "self-control" and to follow through on personally important, value-driven activities despite the cross-currents of more immediate thoughts & feelings sometimes trying to push us off course.  I give general background to this in "Self-control, conscientiousness, grit, emotion regulation, willpower - the importance of training" and then extend the discussion further with "Building willpower: it's like strengthening and nourishing a muscle".  I had what feels like personal experience of this way back in 1970 when I changed subject at university from Philosophy to Medicine.  Reading philosophy involved just the occasional lecture and a single one-to-one tutorial each week where we discussed an essay that I'd done.  A good friend bet me that I wouldn't last a term in Medicine.  He couldn't imagine how I would be able to adjust to "going back to school" in the sense of having to sign in for more lectures on a single day than I was having to attend in Philosophy over the course of the whole week.  It happened that, at much the same time as I shifted to Medicine, I also began daily yoga practice.  I'm very confident that the self-imposed discipline of practising yoga conscientiously every day hugely strengthened my ability to follow through on the many demands of reading Medicine.  And what are the implications for mindfulness practice and MBSR?  Well I'm very confident that responding to the challenging demands of an MBSR course is pretty impressive exercise for our "self-control" muscle.  To build strength in a physical muscle we need, at times, to push to the edge of what the muscle can achieve.  I suspect there is some parallel value in pushing some of the mindfulness exercises to the edge of what we can individually manage.  This is likely to be of considerably more value if I'm doing it autonomously, rather than having it forced on me by an external authority or doing it because I want to impress others.  It's likely to be most helpful to push myself out of interest, because it feels right to me - see some of the Self-Determination Theory (SDT) work on the importance of where our motivation primarily comes from.  So at this sixth evening of the course, I probably worked with more pain during prolonged sitting than I have done for quite some time ... to the extent of becoming a bit physically nauseated.  I know that some of this was driven by less helpful motivation like not wanting to shift position because I wanted to look like "a good meditator".  OK!  But some of it was driven more autonomously ... exploring how it is to be with pain rather than running from it.  For me, I think, genuinely helpful ... partly maybe as a mindfulness exercise, but partly also as a self-regulation challenge. 

It's an interesting lens, this one of exploring the overlap between mindfulness and conscientiousness/willpower/self-control.  Actually on current evidence, if you had to choose between having higher self-control or higher mindfulness, you would be sensible to choose higher self-control.  It is linked to so many good outcomes.  Examples include better academic attainment, better coping skills, less depression, better weight control, less risk of dementia, more stable relationships, and improved mortality.  Mm ... not a bad bunch of benefits!  Mindfulness and self-control are overlapping constructs.  Acknowledging that mindfulness training has helpful knock-on effects on conscientiousness & self-control is probably one of several useful lenses through which to understand how MBSR training produces its benefits.