therapists. All these components and how they should be used are described
extensively in Linehan’s book. A core element of the therapy is the training in
mindfulness skills, which is the first and basic module of skills training. The other
modules are: emotion regulation skills, interpersonal effectiveness skills, and distress
tolerance skills. In these last three modules the mindfulness skills recur and are applied
to special problems. These skills are psychological and behavioral versions of
meditation skills found in Eastern spiritual practices. There are three ‘what’ skills and
three ‘how’ skills.
The first ‘what’ skill is observing: attending to events, emotions, and other
behavioral responses, without necessarily trying to terminate them when painful or
prolong them when pleasant. What a person learns here is to allow herself to
experience with awareness whatever is happening at the moment, rather than leaving
a situation or trying to terminate an emotion. A person learns surrender to the given
moment, acceptance without resistance. The second mindfulness ‘what’ skill is that
of describing events and personal responses in words. The ability to apply verbal labels
to behavioral and environmental events is essential for both communication and
self-control. It prevents one from being blindly driven by emotions and events. The
third mindfulness ‘what’ skill is the ability to participate without self-consciousness.
It means entering completely into the activities of the current moment, without
separating oneself from ongoing events and interactions. The quality of action is
spontaneous: the interaction between the individual and the environment is smooth
and partly based on habit.
The other three mindfulness skills have to do with how one attends, describes, and
participates; they include taking a non-judgmental stance, focusing on one thing at
the moment, and being effective. Taking a non-judgmental stance means taking a
non-evaluative approach, judging something as neither good nor bad. The second
‘how’ is learning to focus the mind and awareness in the current moment’s activity,
rather than splitting attention among several activities or between a current activity
and thinking about something else. The third ‘how’, being effective, is directed at
reducing the client’s tendency to be more concerned at times with what is ‘right’ than
with doing what is actually needed or called for in a particular situation (Linehan
1993b:63).
In many techniques used in all the modules of the skills training we see the
previously explained dialectics at work. Radical acceptance of one’s own situation, of
pain, anger, being in the moment as it is, without judging, inevitably brings about
change.
Nishitani and LinehanIn this paragraph we will compare Nishitani’s Buddhist and Linehan’s
psychotherapeutic paths.
194 CHRISTA W.ANBEEK AND PETER A.DE GROOT