Clarifying the Construct of Mindfulness in the Context of Emotion Regulation and the Process of Change in Therapy

Several lines of research are converging on the idea that emotion regulation is an essential component of mental health and that problems of regulation are associated with a variety of forms of psychopathology (Cicchetti, Ackerman, & Izard, 1995; Davidson, 2000; Gross, 1998). Emotions involve changes in subjective experience, expressive behavior, and physiological responses; emotion regulation refers to processes that amplify, attenuate, or maintain the strength of these emotional reactions (Davidson, 2000; Gross, 1998). Emotion regulation difficulties can take a variety of forms. One way to regulate emotions is to avoid them. Hayes and colleagues (S. Hayes, Wilson, Gifford, Follette, & Strosahl, 1996) describe a type of regulation called experiential avoidance, which includes avoidance of emotions, thoughts, images, memories, and physical sensations. They acknowledge that avoidance can at times be useful, but this strategy becomes problematic when it persists even when costly, ineffective, or ‘‘life distorting.’’ Avoidance of negative experiences can involve distraction, denial, cognitive distortion, suppression, repression, substance abuse, self-harm, disengagement, dissociation, and even suicide. Avoidance can arise in response to positive experiences as well. For example, one can experience anxiety and disengage in the face of increasing intimacy in a relationship, or a person who is recovering from depression can become afraid of and avoid hope and positive experiences. Another problem of emotion regulation can involve getting preoccupied, consumed, or overtaken by emotions and experiences. It is important to know when it is no longer productive to engage. Overengagement can involve rumination, worry, obsessions, recurrent cravings and strong urges, and compulsive behavior. One can also get entangled with positive experiences, such as the ‘‘highs’’ associated with adventure, risk, challenge, or even success. For instance, Johnson and her colleagues are finding that those with a vulnerability to or history of mania tend to become overly engaged with positive emotion, which can set off a cascade of overconfidence and unrealistic goal-setting that can spiral into mania (Johnson, 2003). Addictions can be conceptualized as a way to both maintain the highs and avoid the lows of life (Marlatt, 1994). There is now substantial evidence that avoidance and overengagement with emotions are associated with worse psychological and health outcomes (Gross, 2002; Salovey, Rothman, Detweiler, & Steward, 2002; Segerstrom, Stanton, Alden, & Shortridge, 2003). It is less clear, however, what characterizes healthy engagement with emotions. The power of destructive and healing emotions is central to Buddhist teachings, and we have much to learn from the concept of mindfulness. Mindfulness training provides a way to cultivate emotional balance and decrease the hold of habitual patterns that obscure perception and impair judgment (Kabat-Zinn, 1990). The practice of mindfulness has been around for 2500 years but has only recently become a legitimate area of scientific inquiry. Although it is being adapted from Buddhist traditions, mindfulness integrates themes from Address correspondence to Adele M. Hayes, University of Miami, Department of Psychology, Flipse Bldg., 5665 Ponce de Leon Blvd., Coral Gables, FL 33146–0751. E-mail: [email protected].