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Conscious Mindful Leadership: Uncovering Wisdom and Insight in Clinical Practice

By Heather Good, MSW, RSW

In our day to day lives and in our clinical practice, we come up against challenging situations. When we are met with a challenging situation, or if we have an interaction with a person that feels difficult, it is interesting to take a step back and explore our own inner and outer responses.

Often times, when we have the feeling we are unable to navigate difficult relationships, we are left feeling as if we want to throw in the towel, and sometimes we do. Sometimes feelings of helplessness lead to finger-pointing and blaming.

We end up relating to people as either obstacles that are in our way, or tools that support us in reaching our goals. As we begin to pay attention to our responses, we learn about the circumstances and situations that cause us to expand and reach out to others, and what triggers us and causes us to retract, become small, and critical. The impact of bringing a more conscious and mindful way of being to the world is that we expand our capacity for compassion. Mindfulness practices assist people to find their own solutions, gain insight, and to become empowered.

In this article, I will share a scenario where I used a mindfulness-based breathing practice with a client and I will discuss the benefits of this type of intervention.

To begin with I would like to define mindfulness. Although mindfulness has been defined by countless experts over the years, one of the definitions that I have come across that I find most clear is in Marlena Field’s (2005) Body-Centered Coaching: Using the Body as a Resource for Change.  Ms. Field writes, “In mindfulness, you are participating as an observer of your own behavior and cultivating that part of the mind that can impartially witness whatever you are experiencing- body sensations, emotions, impulses, thoughts or memories- without trying to control or direct what is being noticed.”

Research indicates that mindfulness has many benefits including helping people to be more compassionate and less judgmental.  As we all become more mindful, we operate with greater clarity, intuition and awareness.

Although I currently work as an educator and consultant, I also provide urgent mental health intervention/assessment in a hospital setting for clients who are in crisis. I would like to share my experience working with one particular young lady who was in her mid-twenties. She came into the hospital complaining of feeling purposeless, sad, and having low energy. This young woman, whom I will refer to as “Sue”, stated that she had not been feeling very great for a few months and that her work performance had been declining. She stated that her boss had talked to her about being unhappy with her performance at work and she stated that she was really upset about this, as she enjoyed her job and did not want to be fired.

She talked about some changes she had made in her life over the past few years that helped her to really discover who she is.  As I delved a little more deeply into her history, I learned that she had been using Ecstasy (only a few times) and Cocaine (only once, she reported). I wondered to myself about the impact of the drug use on her mood and difficulties. She told me that she did not think that the drugs were the cause of her problems. Sue was tearful and expressed feeling a lot of sadness, confusion and hopelessness. Because I sensed that this young woman was ungrounded and needing something to anchor her to the present moment, I asked her if she would be willing to try a breathing practice that would help her to stay calm in times of challenge. She shared that she would be open to this and stated that she had done yoga in the past and that it had been helpful to her.

It is very important to ask for the client’s permission to share with them a technique that will help them to get grounded. This allows the client to say yes or no, and to be in charge of their process.

Below is a version of a script that I use. Once you become comfortable, you may not need to read from a script and you can lead a practice intuitively. The italicized segments can be read to the client and the segment that is written in bold is for your own use. 

Mindfulness and Grounding Exercise

Explain this slowly:

I am going to take you through an exercise that will help you to focus on your breathing. We will take a little time to relax and get grounded, and as we do this exercise, I want you to pay attention in a particular way. If you notice a thought come into your mind as you breathe, notice it like it is a friendly visitor. Say "Hello...Oh there you are worry/stress/person/place or thing.”  Then you bring your attention back to your breath. I want you to practice this as many times as you need to in a manner that is accepting and non-judgmental.  I will lead you through this practice and there is nothing you need to worry about doing.

1. As we begin, sit comfortably and take a minute to plant your feet solidly on the ground- I invite you to gently close your eyes and relax the muscles of your face. - Pause- If you would prefer to keep your eyes open, you can do this, too, closing them when you feel comfortable. I may close my eyes, too, as we do this.
2. Take a posture that allows your spine to remain tall and pull your belly in slightly. - Pause-
3. Feel your shoulders relax as you place your hands, palm down, on your thighs.
4. Take a few breaths and feel any stress or tension drain out of your feet. –Pause-
5. Without changing your breath at all, imagine fresh clean air enter your lungs as you breathe in and out.
6. Now bring your focus to the sensation of the air on your nostrils as you breathe in and as you breathe out. - Pause- approximately 30-45 seconds of silence
7. Feeling relaxed and at ease, continue to observe the sensation on your nostrils as you breathe in and as you breathe out. -Pause-
8. If you notice any distracting thought arise, treat it as a friendly visitor, say hello, and return your attention to the sensations on your nostrils as you breathe in and out slowly.- Pause – 30 seconds to 1:30-
9. Allow the client to breathe- repeating the previous two points a few times- with space between the statements- this is used as a reminder to the client- and assists them to return to their breath, if they have had a thought that they have been following.
10. Although this practice can be prolonged for a couple of minutes you can build up time- for the first few times, 3-5 minutes for the entire practice will likely be enough.
11. Now I would like you to slowly bring your awareness back to your feet planted solidly on the ground, and to the sensation of yourself sitting in your chair. As you take a few deeper breaths, you can start to wiggle your fingers or your toes, slowly bringing your awareness back to the room. When you are ready, you can open your eyes.
12. There is no rush here:  allow the client as long as they need to become present before asking any exploratory questions. You can also tell them that there is no rush.

Debriefing

Now ask the client some general questions about what they observed as they did the breathing exercise. Approach this enquiry from a position of curiosity and ask them to do the same. Ask them to observe in a curious, non-judgmental manner what they are aware of and what they notice in their body, right now.

Give them space and time to answer this. Move very slowly, and continue asking them questions about what else they notice.  This assists the client to go deeply into sensations/ feelings and builds awareness.

If the person who you are working with has a difficult time noticing the nuances of what is going on internally, you can state what you observe. For example, when I worked with Sue, she noticed her shoulders were relaxed and felt she was sinking into her chair. If your client has difficulty with this, you can let them know that it is sometimes challenging to notice subtle energy. If you intuitively notice tightness or holding in an area of their body, you can ask an open-ended question such as, “Is there anything going on in your shoulders?” and see how they respond. Developing the inner observer is important as it helps people to tune into the innate wisdom of their bodies and it also assists with tuning into others.  

After telling me how she was feeling and what she was noticing in her body, Sue then told me that there was something that really surprised her. She stated that the entire time that she was breathing, she was aware of a little pill sitting in her awareness, outside of her brain, but near her head. When I asked what this was she said it was a pill of E (Ecstasy). She then told me that this surprised her. She stated that she had only used the drug a few times, but given that it was in her mind while she was doing this practice, it must be a problem. She was very surprised by this discovery: she then stated that she was going to quit using all drugs and alcohol.

When you think this process is complete, you can ask them if there is anything else that needs to happen or if there is anything else that they need.

Although I have used mindfulness and body-focused coaching with many clients, it is rewarding to see a client who is struck by a significant insight and is willing to take action to change. When I work with clients using mindfulness and body-focused approaches, the work is effortless and the results are significant. It often surprises me when a simple practice of building mindfulness brings such powerful results. In the past, I have found addiction work to be very challenging. Sometimes assisting clients to move from pre-contemplation to action can be a long drawn out process. Having Sue shift from pre-contemplation to action in a single session was amazing. Clearly this woman was ready for change and the intervention was provided at the right time. I saw her a few weeks later, and she looked radiant and healthy.

If you are a practitioner reading this, and you would like to participate in a study on the impact of using mindfulness in addiction treatment, I would love to hear from you. I can be reached at heather@goodcoaching.ca.

Heather Good, MSW., RSW, Principal of Good Coaching, is the author of Conscious Mindful Leadership: Your Path to Greatness in Work and Life, and is also a consultant, educator and coach/therapist, who facilitates mindfulness based training for groups and organizations. She also practices mindfulness and body-focused coaching in her own life and in her work with clients. For more information see: www.goodcoaching.ca

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