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Course Presenter(s):
Author(s): Gary Buck, PhD | David Lukoff, Ph.D. | (click author name for biography)




Course Description: This course looks at the possible uses of mindfulness as an aid to parenting and within the life of a marriage and family. The focus is on current research on prenatal mindfulness, mindful parenting, mindfulness in marriage and couples therapy, and mindfulness within the culture of a family as well as in family therapy.

 

Introduction

Perhaps it is not surprising that the pioneer in the field of mindful parenting is the one and the same Jon Kabat-Zinn who developed Mindfulness-Based Stress Reduction (MBSR). In 1997, Kabat-Zinn, together with his wife Myla, a childbirth educator, who are themselves the parents of three children, published Everyday Blessings: The Inner Work of Mindful Parenting, (Hyperion Books, 1998). Their book, about which Daniel Goleman, author of Emotional Intelligence, exclaimed “At last an emotionally intelligent guide for parents,” set the stage for the interest in the uses of mindfulness in the context of families. Since that time, the applications of mindfulness in family life have gradually grown, with programs being developed in various contexts. Today there is the beginning of a body of research literature focused on family-related mindfulness interventions, as well.

Boegels,  Lehtonen, and  Restifo look at the growing use of mindfulness in parenting programs as an effective strategy for both the treatment and prevention of childhood mental disorders. Noting the current shortage of good research on how mindful parenting might actually work. They propose six possible mechanisms as follows:

(1) reducing parental stress and resulting parental reactivity;

(2) reducing parental preoccupation resulting from parental and/or child psychopathology;

(3) improving parental executive functioning in impulsive parents;

(4) breaking the cycle of intergenerational transmission of dysfunctional parenting schemas and habits;

(5) increasing self-nourishing attention; improving marital functioning and co-parenting. 

(Boegels, S., Lehtonen, A., and Restifo, K. (2010) Mindful Parenting in Mental Health Care.)

Reviewing the available literature, the authors conclude that it is still too early to draw conclusions regarding how mindfulness positively affects parenting and call for more and larger studies. However their preliminary analysis seems to suggest that there is already some support for mechanisms 1, 2, and 6 above.

Below we will look at the research on how mindfulness interventions can be impactful within families in several ways. These include the special relationship during pregnancy and following birth between mother and child, the effects of mindfulness on parenting, improved relationships between parents, and the role of mindfulness as a shared experience including all members of the family.

Prenatal Mindfulness

 

Several studies have been recently conducted where mindfulness was taught to expecting mothers or mother/father pairs. In the first such study Vieten and Astin found that the 31 mothers trained in mindfulness experienced 20–25% less anxiety during their final months of pregnancy than those in the control group. (Vieten, C. and Astin, J. (2008) Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: the results of a pilot study.) In the second 2010 study, Duncan and Bardacke followed 27 expectant mother/father pairs who participated in a program called Mindfulness-Based Childbirth and Parenting. Again the quantitative results revealed statistically significant reductions in pre-birth anxiety and increases in both mindfulness and positive affect. Qualitative reports from the subjects showed benefits during the early period of parenthood as well. Such results suggest that mindfulness training for expectant mothers could possibly improve attachment outcomes for their children. (Duncan, L. and Bardacke, N. (2010) Mindfulness-based childbirth and parenting education: promoting family mindfulness during the perinatal period.)

 

Mindfulness and Attachment Theory

 

In fact, recently attention has turned to the relationship between mindfulness and attachment theory. In their 2012 article “Attachment Theory and Mindfulness,” Snyder, Shapiro, and Treleaven explore this topic. Attachment theory has shown that our early life experiences, especially with our most intimate caregiver, shape our expectations of relationships in the future. We learn how to relate to the world through our relationship with our primary caregiver. The style of relationship we learn depends largely on the ability of our caregiver to attune to us. If attunement is strong, a child will develop a secure way of being in the world. However if the caregiver is not so capable of attunement, various insecure attachment styles may be the result. The attachment, or relationship, style we develop in infancy stays with us and influences our ongoing life experience. Research suggests that while secure attachment results in cheerful, socially well-adjusted children, those with insecure styles are more likely to be unhappy, socially alienated, and have difficulty responding to adversity. The attachment style a child acquires in their early years from their own caregivers tends then to be the style they themselves employ later as parents and thus pass on to their own children. Attachment styles thus tend to be handed down from generation to generation. Snyder, R., Shapiro,S., and Treleaven, D. (2012) Attachment and mindfulness.)

Yet the good news is that it is possible later in life to reverse an insecure attachment style. According to Daniel Siegel, an expert on the neurobiology of mindfulness, one factor that promotes this shift is self-understanding, something that is a central benefit of mindfulness practice. Through the cultivation of mindful introspection, it is possible to develop increased self knowledge, compassion for oneself and deepened self-acceptance, a process that could be called self-attunement or “earned security,” leading to a healing of a parent's own attachment wounds and a more secure attachment style going forward, one that she/he is then able to impart to her/his own children. (Siegel, D. (2007) The Mindful Brain,  p. 204ff.)

 

In fact, as Siegel notes, the neurophysiological effects of mindfulness practice are similar to that of secure attachment. (Siegel, D, The Mindful Brain, p. 132.) Because becoming a parent is a challenging time when a new parent’s own attachment styles become particularly obvious, it is also a time when mindful awareness can heighten self-knowledge leading towards the transformation of attachment style. A more self-attuned parent is more likely to effectively attune to a young child leading to a more secure attachment style for the child as well.

Mindful Parenting

 

This theoretical perspective on mindfulness and attachment theory is implicit in the model of mindful parenting offered by Duncan, Coatsworth, and Greenberg. Detailed in an article published in 2009, their model for mindful parenting takes a prevention-oriented, family-focused, mental health approach to parenting grounded in mindfulness training. They describe mindful parenting across five dimensions of the relationship between parent and child as follows: “(a) listening with full attention, (b) nonjudgmental acceptance of self and child, (c) emotional awareness of self and child, (d) self-regulation in the parenting relationship, and (e) compassion for self and child.” They especially emphasize the value of this approach parents during their children’s transition between childhood and adolescence. For their full article see Duncan L., Coatsworth, J., and Greenberg, M. (2009) A model of parenting:Implications for parent-child relationships and preventive research.)

However to date, few studies have been conducted on mindful parenting interventions. Those that have been had somewhat mixed results. Singh et al. have conducted a series of small pilot studies involving teaching mindfulness to mothers of children with various challenging mental health issues. In their first such study, published in 2006, three mothers of autistic children were given mindfulness training. According to the authors, “Results showed that the mothers' mindful parenting decreased their children's aggression, noncompliance, and self-injury and increased the mothers' satisfaction with their parenting skills and interactions with their children.” Singh, N., et al. (2006) Mindful parenting decreases aggression, noncompliance, and self-injury in children with autism.)

These same researchers published a second study a year later with four parents of children with developmental disabilities who were also aggressive and lacked social skills. The results were similar to those of the previous study, yet with one additional positive result: an increase in positive interactions between the developmentally disabled children and their siblings. Singh, N., et al. (2007) Mindful parenting decreases aggression and increases social behavior in children with developmental disabilities.)

Lastly, in a 2010 article, these researchers describe their work with mothers of children diagnosed with ADHD. They found that when they gave mindfulness training to two such mothers, the compliance of their children to their parents’ instructions and requests. Then, when similar training was given to the children, an even greater improvement was found. Improvement persisted through their follow-up evaluations. It should be noted that in all these studies no attempt was made to teach the parents new parenting strategies or to influence the children’s behavior in any way (apart from the mindfulness training the children with ADHD were given.) The changes can thus be attributed simply to the mindfulness skills gained by the parents (and by the ADHD children). Singh, N., et al. (2010). Mindfulness training for parents and their children with ADHD increases the children's compliance. )

In another study of families with children diagnosed with ADHD, this one conducted in The Netherlands, van der Oord, Bogels, and Peijnenburg trained both parents and children in mindfulness. They compared teacher and parent ratings of child behavior before and after the intervention. Parents’ ratings showed significant improvement in both their children’s ADHD behavior as well as in their own. However, while the teachers did note statistically significant increases in classroom attention, they reported no appreciable change in the students’ classroom ADHD behaviors. (van der Oord, S., Bogels, S., and Peijnenburg, D. (2012) The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents.)

 

Published in 2006, a study by Blackledge and Hayes used a 14-hour experiential group workshop format to introduce Acceptance and Commitment Therapy (ACT), which incorporates mindfulness to 20 parents (15 mothers, 5 fathers) of children diagnosed with autism. The found modest improvements in parental levels of depression, psychiatric symptoms and psychological distress when compared tothe participants' scores on measures for these factors taken three weeks before the workshop and then 3 months after. And as seems often to be the case where mindfulness-based interventions such as ACT are used, the benefits were greatest for those parents whose pre-workshop scores were near or above the clinically significant level. (Blackledge, J. and Hayes, S. (2006). Using acceptance and commitment training in support of parents of children diagnosed with autism.)

However not all mindfulness research involving parents trained in mindfulness have shown positive results. In 2005 Raelynn Maloney published her study of a 12-week intervention called Mindful Parenting Program given to 12 recently divorced parents with preschool-aged children. While the parents all showed increased levels of mindfulness after the program when compared with their starting levels, improvements in their relationships with their children were not observed. Nonetheless the program was well-received by parents who reported it to be quite valuable. (Maloney, R. (2005) Cultivating mindful parenting during marital transition: An initial evaluation of Mindful Parenting Program.)

Mindfulness and Marriage

 

Another context in which mindfulness can have an effect on families is its use with couples. Barnes et al. in a 2007 study showed that naturally higher levels of mindfulness, called trait mindfulness, predicted for greater ability to handle stress in romantic relationships. On the other hand, state mindfulness, or mindfulness in the moment, was associated with better relationship communication skills. (Barnes, S., et al. (2007) The role of mindfulness in romantic relationship satisfaction and responses to relationship stress.)

 

Wachs and Cordova studied 30 married couples to examine the relationship between mindfulness and various aspects of the experience of being married. They found strong relationships between mindfulness and “relationship health and stability … increases in satisfaction and affectionate behavior, …(and) greater inter-partner harmony” (p. 478). According to research results these positive benefits seemed related to the heightened skill in relational emotional repertoires, which the authors hypothesize is due to the ability of mindful individuals to “closely watch their feeling states and potentially become newly tolerant as even negative feelings, such as anger, are observed to come and go of their own accord when they are not elaborated upon by suppression or rumination.” In addition, those stronger in mindfulness had stronger “empathy, improved ability to identify and communicate emotions, and (better) handling of anger” (p. 478-9). (Wachs, K. and Cordova, J. (2010) Mindful relating exploring mindfulness and emotion repertoires in intimate relationships

Carson, J., Carson, K., Gil K., and Baucom, D., have developed a mindfulness intervention for couples which they call Mindfulness-Based Relationship Enhancement (MBRE). They tested their intervention on a group of 44 couples, none of whom were experiencing significant marital distress at the time of the intervention (i.e., a non-clinical sample). 22 couples were given the intervention while the others served as a control group. The MBRE intervention they used was a manualized adaptation of Jon Kabat-Zinn’s MBSR. The authors describe their adaptations as follows:

(a) greater emphasis on loving-kindness meditations, with a particular focus on one’s partner;

(b) incorporation of partner versions of yoga exercises, …

(c) mindful touch exercises … ,

(d) a dyadic eye-gazing exercise …,

(e) application of mindfulness to both emotion-focused and problem-focused approaches to relationship dif?culties; and

(f ) the context for practicing various mindfulness skills, both in-session and at home, was tailored to bring couples’ relationships into focus.

(Carson, J.,et al., (2004)  Mindfulness-based relationship enhancement, p.479.) Group discussions also had a couple-focused orientation. According to the authors the intervention was ef?cacious in (a) favorably impacting couples’ levels of relationship satisfaction, autonomy, relatedness, closeness, acceptance of one another, and relationship distress; (b) bene?cially affecting individuals’ optimism, spirituality, relaxation, and psychological distress; and (c) maintaining bene?ts at 3-month follow-up (p. 471). As is often the case with mindfulness studies, those participants with the most frequent mindfulness practice showed greater positive effect. In fact, the researchers also reported that “analyses of diary measures showed greater mindfulness practice on a given day was associated on several consecutive days with improved levels of relationship happiness, relationship stress, stress coping ef?cacy, and overall stress.” (p.471)

A qualitative research study conducted by Pruitt and McCollum involved asking seven advanced meditators how meditation had affected their intimate relationships.  The meditators identified four qualities that they attributed to their mindfulness practice that were beneficial to their intimate relationships:

1. greater awareness of body and emotions,

2. ability to disidentify from emotions and thoughts,

3. greater self-acceptance and acceptance of others, and

4. more compassion and lovingkindness both towards oneself and towards others.

Here again we see evidence of self-attunement or Siegel's notion of “earned security,” a shift in attachment style that can have a positive effect on parenting. (Pruitt,I. and McCollum, E. (2010) Voices of experienced meditators: The Impact of meditation practice on intimate relationships.)

Mindfulness with Families

 

At The Still Quiet Place, a Menlo Park, CA non-profit, Amy Saltzman and Philippe Goldin have developed a mindfulness curriculum for groups of parents and their children. They describe their program and report on their preliminary research results in a chapter entitled "Mindfulness-Based Stress Reduction for School-age Children" in Greco, L. and Hayes, S. (2008) Acceptance and Mindfulness Treatments for Children and Adolescents. The program is an adaptation of MBSR For specific program details, see Saltzman and Goldin’s chapter above.

The authors conducted research on their program with a total of 32 “self-referred, non-clinical” families, 24 of whom received the mindfulness training program and 8 of whom were waitlisted to provide a control group. Saltzman and Goldin measured five areas: attention, emotional reactivity and regulation, anxiety, depression, and metacognitive functioning. Compared with the waitlist group, both parents and children showed improvement in their ability to “direct their attention in the face of distractions that usually induce conflict” (p. 155). Parents showed mood improvements in both depression and anxiety while children did not. Both age groups showed increased metacognitive capacity, especially in the areas of self-judgment and self-compassion. While both parents and children showed decreased emotional reactivity the change was stronger for the parents than for the children. The intervention taught mindfulness in both formal practices, such as mindfulness of breathing, and in informal everyday activities, such as brushing one’s teeth. Analysis of the impact of these two distinct aspects of mindfulness practice revealed that formal practice was the strongest factor in improving attention while informal practice was more critical when it came to reducing depressive symptoms.

Mindfulness in the Context of Family Therapy

 

So far there is little literature on the uses of mindfulness in the context of family therapy. The one resource available currently is a book chapter by Quintilliani that consists of a case study of mindfulness-based family therapy with a family dealing with a combination of stress, anxiety and chronic pain. He describes his integration of such mindfulness practices as mindful breathing, the body scan etc., into family therapy sessions, and reports a reduction in overall family stress, clearer roles, better boundaries, increased family harmony and more effective family rituals. There were also reductions in symptoms for individual family members with, overeating issues, chronic pain, and ADD. (Quintillani, A. “A family case study on mindfulness-based family therapy for chronic co-occurring disorders: Chronic stress, chronic anxiety, chronic pain,” in Atwood, J. and Gallo, C. (eds.) (2009) Family Therapy and Chronic Illness )

Where We Stand

 

While the research to date is promising, there is the need for extensive additional research into the potential of family-based mindfulness interventions to heal family dysfunction as well as to improve the lives of healthy families.

Programs

 

Spirit Rock Meditation Center in Woodacre, CA, a Buddhist meditation center offers a Family Program which incorporates the teaching of mindfulness in a Buddhist context to children, adolescents, and their parents, Their program involves classes, daylongs, and, each summer, their annual Family Retreat.

Lesley Grant, a pioneering Waldorf-inspired educator in San Anselmo, CA, has developed a community-based family mindfulness program, Marin Mindfulness Cooperative, that incorporates early childhood education together with mindfulness classes for parents and their older children. To learn more about Grant’s program visit her website at

Resources for Mindful Parenting

 

The Mindful Parent website.

The Garrison Institute report "Mindful Parenting: Conceptualization and Measurement" on the current status of mindful parenting. The Garrison Institute describes itself as follows: “Founded in 2003, the Garrison Institute is a non-profit, non-sectarian organization exploring the intersection of contemplation and engaged action in the world.” They focus on both social and environmental issues.

Myla and Jon Kabat-Zinn’s "12 Exercises for Mindful Parenting."

Psychology Today blog by Jonathan Kaplan, PhD: "Urban Mindfulness- Letting Go of Expectations: A Lesson in Mindful Parenting"

Julia Kantor, MFT, describes her own experience of being in a mindful parenting group and its impact on her family culture.

Books

 

Parenting Your Anxious Child with Mindfulness and Acceptance, by Christopher McCurry, PhD.

Parenting Your Stressed Child: 10 Mindfulness-Based Stress Reduction Practices, by Michelle Bailey, MD

Mindful Parenting: Meditations, Verses, and Visualizations for a More Joyful Life, by Scott Rogers.


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True/False Comprehension Quiz

QuestionAnswer
An early pioneer in the field of mindfulness for families was Daniel Goleman.
Reducing parental stress and related parental reactivity and improving marital functioning are among the most promising mechanisms to describe how mindful parenting works to prevent clinically significant childhood mental health disorders.
So far research on prenatal mindfulness for parents has been focused exclusively on expectant mothers.
Research shows that a parents’ own attachment style is not likely to be passed on to their children.
In one study, when mindfulness was taught to the parents of autistic children, those parents whose pre-intervention scores for depression were high showed the most positive benefit from the intervention.
So far there is almost no research literature available on the topic of mindfulness in the context of conjoint family therapy.
In a study of experienced meditators, an increased ability to concentrate following mindfulness practice did not have a positive impact on their intimate relationships.
At present there is a robust body of research supporting the efficacy of mindfulness interventions in various family-oriented contexts.

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