Clinical Handbook of Mindfulness (116 page)

mindfulness, says:

First, we become receptive to actually feeling the subtly changing sensations

in our bodies, so often overlooked in our daily lives. We become aware of our

physical location and movements, thereby bringing the mind and body to the

same place at the same time. It can be surprising to see how rarely the mind is

where the body is, here, in the present, instead of thinking about something or

somewhere else. Literally
embodying
mindfulness, we observe direct sensory

experience, opening all the senses – “sensing” – the non-verbal world of touch,

sound, sensation, smell, sight etc.”

(Kabat-Zinn, 2005)

These techniques that enhance sensory awareness, build the skills of mind-

fulness through actually being mindful. As mentioned earlier, mindfulness is

both the means and the end of our practice; what strengthens mindfulness

the most is the practice of mindfulness itself! For those new to this way of

working, here are some guidelines:

• Recognize that there is a learning curve. Mindfulness takes practice;

insight and compassion are experiences that cannot be forced.

• Your credibility comes from knowing first-hand the clarity and gentleness

that come from doing this practice patiently, over and over again.

• As you continue in your own practice of mindfulness meditation, insights

about the children with whom you work will likely occur quite spon-

taneously. You may find that your intuition becomes sharper and you

become more willing to trust it.

• The more you become acquainted with this process, the more you may

be able to creatively introduce it in appropriate ways to the children with

whom you work.

• Learn as much as you can from others who have done pioneering work in

the field.

Using
Scram
in Psychotherapy

A 12-year-old girl named Manouj was suffering from constant anxiety and

panic. Manouj’s family had emigrated to the USA shortly after her father

was released from prison, three years before. He was a political prisoner

for months, taken at gunpoint from their home while Manouj was at school.

Shortly before entering therapy with Trudy she had been visiting cousins in

the Middle East, and the war between northern Israel and Hezbollah broke

out. This triggered intense terror in Manouj.

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425

Manouj, told Trudy in tears, that she’s afraid to fall asleep because there

might be spiders in her bed, she’s afraid to eat lunch with her friends because

the taco might be poisonous, she can’t eat outside because an insect might

fall into her food. Salad reminds her of a poisonous plant and she might die

if she touches it. Even the food her mother has cooked for her might be bad.

The little spot on her T-shirt could be dangerous
. . .
She is sobbing as she tells

all this, in Arabic, with her mother as interpreter.

Trudy enters her world through mindful attunement to her feelings of fear

and sadness. Trudy names fear as a visitor who got its foot in the door when

her father was taken to prison.

Together, they practice
scram
when fear arrives:
Stop
and slow down,

calmly breathe through the fear, and remember fear is visiting. Wordlessly,

through her willingness to just come and be open, Manouj can attune to her

therapist and begin to act mindfully to change her relationship to fear.

Trudy shifts into an active internal practice of mindfulness and metta: her

attention is attuned to her experience and Manouj’s simultaneously. Trudy

deliberately suffuses the atmosphere with kindness, “holding” Manouj in her

stable presence. A mindful mentor can lend the strength of her ability to

be present with experience to the child; Manouj can begin to see how fear

can be there, she can feel anxious, without losing her own capacity to be

mindful. Fear doesn’t have to be in charge of her thoughts, feelings, and

choices.
Calmly
she can recover her balance and confidence.

As we sit and talk, Trudy checks in with Manouj; she reflects, in English

now: “The more I talk about it, the more fear goes away and the better I

feel.” Her voice is calmer, lower, and she is not crying anymore. Manouj is

relaxed now, body draped across her mom’s lap, her head resting on the

arm of the couch. Her mother, a sensitive meditator and attuned parent, is

quietly holding her. The room is peaceful and still. Trudy encourages her

mother to act with metta by holding Manouj and being silent, “as if you

are meditating.” Sitting still, they are all quiet together. Manouj seems to

be soaking up the peace that is palpable in the room. The session ends

this way.

A tear-stained and angry Manouj arrives at the next meeting, reluctant to

come in, hiding behind her mother. Manouj is upset, afraid that coming to

talk about her fears will make then come back, when she’s actually been

feeling less scared this past week. She despairs that it would happen again

from seeing Trudy and is angry with her mother for bringing her.

Fear was not around for much of her weekend. When it came back, her

mother remembered
scram
and brought Manouj on to her lap while she sat

quietly. Manouj feel asleep, held in the arms of her mother’s mindfulness

meditation, and, the next morning woke up free of fear again.

Trudy
reflects
aloud if fear might be trying to protect her from present

dangers – could fear be trying to protect her from growing up too fast? She

nods. From having to go to high school? From having her body change and

mature? Manouj tells her mother that she wishes she could just stop the

world, go somewhere for a while and then get back on.

Trudy teaches Manouj mindfulness meditation at this point, as a way to

stop and be very grounded in the present moment, able to observe fear’s

comings and goings. Manouj learns to be aware of her body sitting, of her

breath flowing rhythmically, in and out. When thoughts go through her mind,

Manouj can bring her attention gently back to the movement of the breath.

426

Trudy A. Goodman and Susan Kaiser Greenland

They sit together for 8 minutes, and Manouj gives a thumbs-up when fin-

ished. She was able to notice when her mind wandered away from what

she was doing, and to relax and feel peaceful as she practiced being mind-

ful of her breathing. Smiling and rosy, Manouj looks genuinely happy for the

first time.

Manouj arrives at our next meeting, glad to see Trudy and asks her mother

to go out for a walk, so they can be alone together. This is new. Being held in

her mother’s attuned mindfulness, with the guidance of her mentor, Manouj

is learning to hold and calm herself, too.

In the next session, Manouj imagines empathetically how difficult it must

have been for her parents when she was in so much emotional pain. She

describes how she is healing the past terror and loss of her childhood home.

“Moving to Los Angeles was a big shock for me. The story behind it and the

story after it makes me realize how strong I have become. If you get hurt,

you will heal,
. . .
as you realize what’s here and what’s there, your mind will

be strong, and become healthy, that alone will heal the wound. That is how

I got through (my fears), back to my real world.”

At the end of the session, Manouj acts mindfully! She stands on her head,

using her arms for support. It’s a wonderful metaphor for learning how to

handle her world being turned upside down with balance, self-efficacy and

confidence.

For over a year, Manouj was free from fear and anxiety. After around 18

months, Manouj became mildly anxious and Trudy saw her again. Her parents

felt Manouj’s anxiety was an internal problem of her own. They are not yet

willing to acknowledge how much their family’s past trauma and losses still

affect their relationships, to one another and to their new life. Until they find

a way to do this, Manouj may continue to be vulnerable to fear.

Guidelines for Working with Children

•
Mentoring and Embodiment

◦ Children learn to build their own mindfulness skills more effectively

when the adult
embodies
mindfulness. Having and maintaining an

established mindfulness practice is a prerequisite for this work.

◦ It is critical that the mentor has experience with the specific mindful-

ness practices that are being taught. Many have blown on a pinwheel

to teach children breath awareness, but to use the practice effectively

you must know how to apply it to different learning objectives – how

do you use the pinwheel to train focused attention? wide-open aware-

ness? to soothe the body? When used skillfully this one practices can

be used to help a child feel the experience of each of these qualities –

concentration, awareness, and calming.

◦ Mindfulness is relational, attuned, and connected. Sharing attention and

caring may strengthen both mentor and child’s capacity to access a calm

and clear state-of-mind.

◦ The benefits of practicing mindfulness take time and are not always

obvious. Patience is the heart of the process and developed by focus-

ing on the practice itself rather than a specific goal or end point. From

Lonnie Zeltzer: “It is precisely the moving away from the need to have

Chapter 22 Mindfulness with Children

427

results that often contributes to a lessening of the child’s suffering”

(Zeltzer, 2005).

•
Practices

◦ Mindfulness teaches children to note and label emotions. Noting is an

effective tool for becoming aware of emotions and being able to see

them as occasional visitors.

◦ Mindfulness games and activities can be framed in ways that are appro-

priate to various ages and developmental abilities, from pre-school

through adulthood.

◦ Because children often have relatively short attention spans and,

depending on their age, their memory may not be completely devel-

oped, we engage in reflective practices for periods of short duration

and repeat them frequently.

◦
Fun
is a key concept when practicing mindfulness with children. If the

activities are not fun and playful young children will resist them.

◦ Practicing mindful awareness may not be for everyone and it is not skill-

ful to insist that a child engage in introspective practices if she is not

comfortable doing so.

◦ Breath awareness alone is an extremely valuable tool for all ages, and if

taught correctly, it is in and of itself a practice of mindfulness.

◦ In a classroom setting it is virtually never appropriate for children to

drop into deep states of meditation or introspection. The mentor must

take care to monitor the students. If it appears that a child is having a

difficult time sitting still or is becoming sad, it is appropriate to gently

ease out of a reflective practice into a more active one.

•
Metta

◦ The use of mindfulness techniques to train children in attention is com-

plemented by training in kindness and caring (
metta
), and learning how

to include both oneself and others in a circle of compassion.

◦ Through compassion for self and others
embodied
by the mentor, a

child is show a process through which she can develop a new relation-

ship to her difficult emotions, built upon insight and courage.

•
Family Systems

◦ It is important that parents are informed about every aspect of your

work and are integrated as much as possible. We recommend a parent

meeting before and after mindfulness skills are taught to children. We

often give children prompts (or homework) at the end of a session and

it is helpful if parents participate in the home practice.

Conclusion

The playful acronym
scram
takes breath awareness further than calming the

body and mind. It charts a step-by-step mindfulness-based process to help

children free themselves from the often complex webs of tangled and diffi-

cult emotions that are a natural part of growing up.
Scram
invites children to

stop, calm
their bodies/quiet their minds, and
remember
to be mindful when