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Mindful Choices Therapy

















Are you struggling with stress, anxiety, food and weight issues, addictive or compulsive behaviors, or relationship problems?
In practice since 1977, we have developed a unique approach we call "Mindful Choices Therapy."  It's a program of mindful awareness, conscious choice, and intentional follow-through to lasting positive change. 





























We are highly experienced therapists, but more importantly, we are teachers and life coaches. Following an in-depth assessment, our clients achieve clarity on past and present life choices. We then collaboratively focus on specific choice areas and guide our clients in overcoming barriers and moving toward a high-level of well-being and personal effectiveness.
Our clients receive over 350 pages of "Mindful Choice" program materials, assessments, access to videos, and exercises. Based on their initial assessment and Mindful Choices Profile, they select choices to work on from among the following choice areas:





























1. Breath Awareness and Retraining. This means developing a consciousness of breathing patterns so that you are instantly aware of becoming “uptight” and are able to use your awareness of your upper-chest breathing as a cue to immediately employ a relaxation response involving diaphragmatic breathing. This step also involves literally retraining the way you breathe, developing a stress-reducing pattern of breathing that becomes more effective over time. Breath awareness is a basic relaxation and mindful awareness step, and foundational to all our Mindful Choices. It helps you activate “rest and digest,” rather than “fight or flight.”
















2. Beginning and Ending Your Day Peacefully. Begin your day with calmness, rather than anxiety and stress. Consciously and intentionally set the stage for moving through your day in “cruise mode,” with ongoing awareness of your intention to have a great day. Ending your day peacefully and settling in for a night of peaceful and revitalizing sleep is perhaps even more important than beginning your day well.
















3. Mindful Eating. Beginning with breakfast and incorporating healthy nutrition, mindful eating is about taking the time to slow down and focus on food in a pleasurable, non-anxious manner  without distraction. Not only is this the secret to healthy and enjoyable eating, but it also provides stress breaks at regular intervals during your day to reconnect with yourself and regain your balance. Your relationship to food is a metaphor for your relationship with your life. If you eat on the run, eat rapidly, eat junk food, multitask while eating, or are too busy for meals, be aware that this is how you are treating your life.
















4. Staying Present and Cultivating Mindfulness. This choice is about cultivating the all- important self-discipline of present-moment awareness. You can greatly enhance your well-being by cultivating mindfulness skills and even learning mindfulness meditation. For example, one mindfulness skill, frequently checking in with yourself, with your mind and with your body, is a vital step in cultivating the mindful awareness vital to effective stress and anxiety management.
















At least once an hour, if not more frequently, you can check in with yourself with what is known as a mind-body scan, taking stock of your anxiety and stress, your thoughts and feelings, and what’s going on in your body. You can use your awareness of your stress level as a cue to plug- in a learned relaxation response, calming and centering yourself, and readying yourself to move forward in a purposeful and intentional way, never losing sight of the importance of excellent self-care.
















5. Engaging in Self-Reflection. Engaging in self-reflection and dealing with negative self-talk and distorted thinking with awareness, acceptance, and realistic self-talk or diffusion is a key to transforming a life filled with stress, anxiety, and depression to a life that can be fully satisfying.
















6. Connecting with and Living Your Deepest Values. Knowing what’s really important is your compass. One of the most powerful ways we know of reducing stress, anxiety, and depression and becoming a calmer and more peaceful person is possessing a clear sense of your values and having an unwavering commitment to living those values.
















7. Intentional Relating. Actively connecting with those who matter most to you and with others in a purposeful, constructive, and satisfying way while masterfully managing conflict eliminates or reduces perhaps the biggest source of stress in our lives. At the same time, positive relationships are a key component of well-being.
















8. Physical Activity and Mindful Movement. Regular exercise that includes aerobics, strength training, and developing flexibility, along with gentle movement with peaceful thoughts and self-calming inner dialogue, are essential to effective anxiety and stress-management practice. Mindful movement is a way of connecting your body to your life in a most positive way.
















9. Develop and Utilize Your Mindful Choices Toolbox. You need regular activities that enrich, restore, revitalize, and re-energize your life and renew your spirit. For example, some form of meditation/relaxation/mental imagery or visualization helps maintain equilibrium and promotes overall well-being. Consider yoga, mindfulness meditation, Tai Chi, mindful journaling, and other practices for enriching your life. The list of possible tools is limitless. Whether meditation or gardening, the important thing is to have practices that enrich your life, revitalize you, and consistently contribute to high-level well-being.
















10. Self-Acceptance and Self-Compassion. This is perhaps the most important choice. Research indicates that people who are compassionate toward their failings and imperfections experience greater well-being than those who repeatedly judge themselves. Give yourself the same caring support you'd give to a good friend.
















It’s all about choices!
















Life is all about choices, and our ten Mindful Choices encompass virtually hundreds of choices you could make that are helpful not only in dealing with stress, anxiety, and depression, but perhaps more importantly, they dramatically promote personal mastery, well-being, and quality of life. The ten Mindful Choice areas reflect what we’ve learned from over three decades of providing psychotherapy, teaching future therapists, and life-coaching. Now that experience will work for you.

You can make choices today that will improve your life today. Making these choices a consistent part of your lifestyle and part of your core values will dramatically enrich your life—guaranteed!

Getting to those choices, however, requires mindful awareness of the present moment and acceptance of whatever you find there. It means noticing your thoughts, feelings, and images and the stories you tell yourself, without needing to avoid, distract yourself, judge yourself or others, or struggle against what you’re experiencing. It means having the ability to step back and calmly observe your thoughts, feelings, images, and stories, responding to them in terms of usefulness and workability, rather than being all caught up in trying to determine whether or not they are literally true. It means recognizing that your mind is constantly busy generating thoughts, helpful and unhelpful, and saying to yourself: “I’m noticing that my mind is telling me…,” rather than automatically accepting what your mind is telling you as absolutely true. It means having the flexibility to not automatically go with where your mind is leading you, but instead choosing to move actively in the direction of your values, and in the direction of choices that serve you well. It means not being dominated by habitual thoughts and beliefs, but having the power to choose an entirely different direction.

The following chart represents the Mindful Choices Model. We will walk you through the model from left to right.

Figure 3-1: The Mindful Choices Model for Moving from Life on Autopilot to Living on Purpose

The circle in the upper left portion of the chart represents situations you find yourself in, events that impact your life, either positively or negatively. Life is about continuously responding, reacting and choosing. Most events are routine and require only a routine response. Some events, however, set in motion mental activity leading to stress, anxiety, or depression, or habitual negative reactions. Your mind is not always your friend.

Whatever happens in your life is processed through a filter of your past learning and experience, beliefs you hold about yourself and the world, and attitudes you have formed over time. As a result, the thoughts, feelings, and images generated in response to your ongoing experience are often predetermined.

Also, you may tell yourself “stories” about what’s happening, stories which have more to do with your habitual interpretation of events than present reality. Some of these “stories” represent maladaptive schema, which are complex patterns of cognitive, behavioral, and emotional elements that usually start in childhood and reverberate throughout life. When schema are triggered by present events, you may find yourself responding with old and possibly dysfunctional and destructive patterns of behavior, along with disturbing thoughts and feelings from the past.

Often, automatic negative self-talk occurs at lightning speed, with instantaneous disturbing feelings. You may not be conscious of any thoughts or beliefs, but rest assured, your mind is telling you something, and you are responding.

This is a point where our model draws heavily upon acceptance and commitment therapy (ACT), particularly the work of Russ Harris, author of The Happiness Trap. The basic premise of ACT is you don’t have to do battle with negative thoughts, feelings, and images, and you don't have to distract yourself. Instead, you need to accept their existence without allowing them to dominate your behavior. You simply respond to them in terms of workability, rather than having to determine how true they are. The question is not whether or not the thought is true, but rather: “is this thought or belief useful?” You don’t have to struggle with them, and you don’t have to avoid them. You simply notice them, make space for them, and choose to move in the direction of your values. ACT is central to our work, and we will be referring to ACT concepts such as “fusion” and “defusion” throughout the book.

It all comes down to noticing, and remembering to slow down and notice.

Do you take time out of all of your doing to just be—and notice? Are you “mindful?”

What do you notice about your life? Are you self-aware? Do you notice your emotions? Do you know how you feel from moment to moment? Can you observe your own thoughts? Are you able to step back and observe your life in a calm and reflective manner? Are you fully present in the here and now? Are you mindful?

“How is life?” Bill begins most sessions with the same question. Many assume it's just small talk, but it's a serious question. Most of the people we see aren't happy with the state of their lives. It seems easier than ever before to feel stressed out and overwhelmed. We live in a high-stress society, and by all measures it seems to be getting worse. Most of us are running hard just to keep up amid ever-increasing challenges and pressures.

We're all familiar with the sayings, “Wake up and smell the coffee,” or “Stop and smell the roses.” These are sayings that have been around for at least 100 years, and no one knows for sure their origin. It seems some of us have always had a problem with moving too fast to really pay attention to what's happening in our lives, but these sayings seem to have special relevance most people in the twent-first century.

Much of our stress is self-generated, and largely unnecessary. Our Mindful Choices Model shows a pathway from the initial experiencing of events to either self-imposed “dis-ease,” or values-driven choices for overcoming stress, anxiety, and depression and achieving well-being. It’s the difference between living your life on autopilot, or living your life on purpose.

Mindfulness of the choice is the key. Cultivating mindfulness skills opens the door to being conscious and intentional and taking charge of your life.

The simple act of noticing is the turning point.

So, you constantly respond to events or situations, and you perceive those events through a filter of past learning, beliefs, and attitudes. You add thoughts, feelings, and images associated with the situation and add learned self-talk that is sometimes distorted or even irrational.

Yes, each of us can be irrational. Being human means you have a tendency to deny, distort, or falsify reality on a fairly regular basis, and particularly when you perceive things to be threatening to your well-being or sense of self.

Often, you are on autopilot, responding in a stereotypical way, and not realizing that your stress, anxiety, and depression often result from “cognitive fusion” with automatic negative self-talk.

Russ Harris in ACT Made Simple, a Primer on Acceptance and Commitment Therapy, states:

Cognitive fusion basically means that our thoughts dominate our behavior. In cognitive fusion there is no separation between thoughts and self, and thoughts are seen as absolute truth or commands that have to be obeyed. Defusion on the other hand means seeing thoughts as only thoughts, something your mind is telling you that may or may not be true, not a command that has to be obeyed, and not a dire threat.

At the very center of our chart is “noticing,” bringing the present moment clearly and mindfully into view, not judging but simply observing. Noticing isn't ruminating on the past or anticipating the future. It's simply checking in with yourself and being fully present in the “here and now.”

Without noticing, it's all too easy to get caught up in mindless automatic self-talk, much of it self-distressing and distress perpetuating. Noticing is a learned skill, opening the door to mindful awareness. It's the essence of mindfulness. No skill matters more.









    Figure 3-2: The Act of Noticing is the Essence of Mindfulness

Noticing with mindful awareness sets the stage for the process of “defusion” of negative self-talk. Once you are noticing your mind is telling you certain things, things that may be self-defeating or impractical, you are in a position to calmly realize your mind has given you a thought that is no more than a thought, and it doesn't have to be obeyed. You are free to decide what you really want, and you're free to make values-based choices.

For example, John has difficulty with his boss. When his boss is critical, John automatically says to himself: “I'm incompetent. I can't do anything right. I'm going to be fired for sure.” Consequently, John suffers from extreme stress and high levels of anxiety and depression. Suppose, on the other hand, John is well-practiced in noticing his negative self-talk. Further suppose John is able to take three deep breaths, take a step back from being “fused” with the negative self-talk, and instead say to himself, “I'm noticing my mind is telling me I'm incompetent, and it's only a thought. It’s not useful to me, and I don’t have to do anything with it.”

John is defusing automatic negative thoughts. He's able to consider whether the thoughts work for him or whether he would be better served by an alternative way of thinking. He's able to calmly accept the presence of negative thoughts, neither struggling with them or avoiding them. Instead, he's able to simply accept thoughts as only thoughts, making space for them, and moving ahead in a healthier direction based upon calm awareness, accurate information, and a clear awareness of values-driven choices.

Without noticing and diffusion, you may find yourself automatically responding to negative self-talk and caught up in an endless loop of self-imposed distress, living your life on autopilot.





Figure 3-3: Autopilot without Mindful Awareness and Values-Based Choices

The following chart illustrates “fusion,” or not separating yourself from your thoughts. Imagine being so caught up in automatic negative thoughts and self-talk that destructive or ineffective choices are made, choices that, in turn, reinforce old and erroneous perceptions, beliefs, and self-defeating behaviors. Our clients refer to this as “the Racetrack,” with distressing thoughts going round and round, picking up speed, and making disturbing thoughts increasingly likely.











Figure 3-4: The Racetrack and a Possible Solution

Noticing your distress within the context of self-calming skill and mindful awareness is the key. Both self-calming skill and mindful awareness are learned and practiced skills you can continue to improve upon.

So, want to get really good at noticing? Frequently take three deep diaphragmatic breaths and check in with yourself. Slow yourself down and take a moment to notice what you're telling yourself, and what you're feeling. Accept your thoughts and feelings without judgment, make room for them, and then consider your choices. Values-driven choices are made possible by being in a calm, accepting place, a place that allows careful reflection and choosing to live your life with full consciousness, clear intention, and what psychologist Rollo May referred to as “real freedom.”
















Choices, Good Ones and Bad Ones
















There are always choices. No matter what is going on, no matter what problem or life difficulty you are facing, no matter how much distress you are in, there are one or more of the ten Mindful Choices that can help. These are values-driven choices, and they will make a difference—guaranteed!
















However, not all choices work well for you, and you may find yourself making choices that help you feel better or safer in the moment, but greatly increase your stress, anxiety, or depression in the long run. Consider the following chart.












Figure 3-5: Values-Based Choices
















Some people remain on the racetrack, experiencing high levels of stress, anxiety, or depression. Many choose unhealthy “off-ramps.” Our program is all about cultivating mindful awareness, noticing, defusing, and then choosing to be actively involved in values-based choices. As indicated by the following chart, our ten Mindful Choices actually constitute sets of values. You may already embrace some of them. We invite you to consider the others. True values are always freely chosen from among alternatives. We will do our best to influence you to freely choose and act upon values implicit in our ten Mindful Choices.






















Figure 3-6: Living a Purposeful Life Based on Values-Driven Choices

As we have stated repeatedly, it’s all about choices. Our program is about helping you become very aware of present choices and consequences, and consistently make values-based choices. Our self-assessment helps you be clear on where you’re at. Self-calming skill and mindfulness training helps you break free from thoughts, feelings, images and stories that don’t serve you very well. Choosing and actively engaging in living your values helps you transform your life to a life truly worth living.

Our program is also about recognizing habits that you would like to change and guiding you through systematically “rewiring” your brain. Later, we will take you through a process we call “habitualizing,” a process of mindfully moving from negative autopilot to positive autopilot as illustrated by the following:









Figure 3-7: The Habitualizing Process for Developing Positive Habits
















Revolutionary in Its Simplicity
















Mindful Choices Therapy is transformational in five ways:
















  1. Our Mindful Choices Self-Assessment yields a profile where you can see at a glance your strengths, areas needing attention, and Mindful Choices you might like to focus on.
  2. A daily focus on specific Mindful Choices leads to being more fully aware of “opportunities” to make choices leading to major changes. Using our Action Planning Guides will result in steady improvement in selected choice areas.
  3. The ten Mindful Choices are interrelated and “Keystone” habits are developed that greatly influence positive habit development in other Mindful Choice areas as well. This means that when working on one Choice, you’ll probably see improvement in others as well. This will be especially apparent each month when you retake the full assessment. You will most probably find your overall score has improved, and you are further along on your Mindful Choices Roadmap.
  4. Noticing the thinking and beliefs associated with stress, anxiety, and depression creates an opportunity for growth. Training in mindfulness skills and the ACT skill of defusion paves the way for values-based choices—most probably the very same choices identified as needing attention in your Mindful Choices Assessment.
  5. Over time, developing a solid working knowledge of each of the ten Mindful Choices results in familiar and well-practiced positive coping skills being readily available. You’ll find you have a clear choice between old choices that don’t work well and values-based choices leading to greater  well-being and happiness.
  6. Together, you will find yourself moving from a life largely on autopilot to a life that is being lived on purpose, a life that is rich and satisfying.
















You are a work in progress. Don't judge yourself harshly if change takes time. It always does. The hardest thing about mindfulness is simply noticing the need to be mindful. When mindful awareness is followed by choice and practice, great changes happen—and that changes everything!
















Further Reading
















Harris, R. 2009. ACT Made Simple: An Easy-To-Read Primer on Acceptance and Commitment Therapy. Oakland: New Harbinger Publications.
















Harris, R. 2008. The Happiness Trap: How to Stop Struggling and Start Living. Wollombi, Australia: Exisle Publishing Ltd.