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The Mindfulness Cascade       


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1) Calmness is allowed (not actively pursued) as an antidote for overstimulation. There are techniques that require a certain amount of practice in order to achieve this goal. As previously mentioned: Relaxation has been considered a universal psychotherapeutic remedy as the monotherapy of the pain therapist. We could almost say that it has been added to the drinking water in the pain practices. Autogenic training or progressive muscle relaxation support overall relaxation.


In MBPT, we employ meditation in order to allow calmness. In more precise terms, this is a concentrative meditation, an observing, focusing meditation that uses an inner or outer phenomenon as its object. This is explained in more detail in the section of meditation, but it must be practiced in a course and – above all – at home. Breath meditation is especially suitable because, among other reasons, breathing is a prime example of an automated process that can be converted into a self-control process at any time through our own intervention.



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(2) Through the activation of an “inner observer” (perception component), automated behavior is raised into consciousness and the path is smoothed for disidentification. This is because we perceive that the various patterns of behavior and thought can be observed and also changed. So they are not identical with our “self”, which can observe and change them.




(3) The step of awareness prevents drifting into the past or future, anchoring our attention in the here and now (attention component).




(4) Disidentification creates an inner distance and prevents us from identifying with our perceptions. The part of the pain intensification that arose due to identification with perceptions, feelings, and thoughts goes away as a result.




(5) Acceptance means the avoidance of judgment and analysis. In contrast to wide-spread opinion, this is an active process that is difficult to achieve without previous disidentification. It means a non-judgmental, benevolent, and accepting basic attitude.




(6) Equanimity is incompatible with rejection/aversion on the one hand and wanting to possess/being entangled on the other hand. As previously mentioned, many negative states of mind can be traced back to the one or the other of these two “mind poisons”. With the development of equanimity, these states are ended.




(7) Letting go is the last step of the mindfulness cascade. What are we letting go of? Answer: the state of being entangled in pain-associated thoughts, feelings, and emotions. Through the elimination of these intensifiers, the suffering related to pain will be considerably decreased.



The mindfulness cascade can be divided into two phases and a switching process. The initial phase consists of the first three steps. It is quite suitable for making us aware of automated behavior.

The switching process consists of the fourth step: disidentification. It puts an end to the false equation of ourselves and our feelings, thoughts, and perceptions – which makes it possible for us to gain an inner distance to these phenomena.


Since attachment and rejection are such fundamental properties of our human mind, phase II (the last three steps of the mindfulness cascade) is also required. It serves to neutralize these tendencies and supports the development of equanimity, which allows us to let go of our entanglement in the pain-intensifying states of mind.


Consequently, the best possible result is achieved: We are no longer overstimulated, we let go of our entanglement in negative states of mind, and we give up our automated reaction patterns. This is how we gain self-control and an entirely new degree of freedom as a result.


It must be possible for patients to examine results. But caution is advised! It would be a major error to want to use the pain itself as a monitor in a form that measures the success of our own mindfulness practice by whether the pain has subsided or disappeared. If we do this, then mindfulness would be used for a purpose (intentionally), but it does not “work” like this. The gauge of success must not be the intensity of the pain but our own state of mind. We can use the following three questions to test it:


Inner calmness: Am I stable in the state of inner calmness and balance?


Openness: Am I open, ready to see and learn, and willing to follow attempts at solutions that are counter-intuitive?


Acceptance: Can I stop wanting to get rid of the pain?


These three questions can be used for a quick test to see whether we respond to pain situations through unconscious, unmindful, automatically responding actions or through conscious, adaptive, and mindful behavior. (More extensive tools for self-testing are listed in our Freedom in Pain book.)


Copyright Dr. Peter Tamme and Dr. Iris Tamme

Last update: September 21, 2012