Kathleen Kawamura, PhD Clinical Psychologist
Kathleen Kawamura, PhDClinical Psychologist 


Mindfulness refers to the practice of observing without judgment your present moment experience. The present moment can be thoughts, feelings, or physical sensations you are experiencing internally, or it can be the sights, sounds, smells, tastes, and sensations from the world around you. As a skill, it means being able to observe what the mind is doing with information that is being presented by the brain.

With regards to emotional distress, whether it be fear, sadness, guilt, or anger, mindfulness means recognizing when your emotions are beginning to spiral and rather than immediately reacting, choosing to observe, even if just for a moment, your experience as it unfolds.

By sitting with and observing your uncomfortable emotions and all the thoughts, physical feelings, and urges that come along with it, you will have more space to respond in a way that does not add more pain and suffering to your experience.

Mindfulness is effective because attempts to ignore, escape, or fight emotional distress in any way often makes it build up and grow stronger. A saying is, “What you resist, persists.” In comparison, mindfulness is about floating with the feelings of distress, riding the wave, and allowing it to pass through.  

The idea of mindfulness can seem frightening to those who are already feeling overwhelmed by the intensity of their emotions and have the protective habit of shutting out distressing thoughts, feelings, or physical sensations. It can also seem impossible to those whose minds stubbornly latch on to regrets over the past or fears of the future.

Despite these challenges, mindfulness is a skill that has been shown to have many benefits for emotional distress and can be developed gradually with time and practice. 


A nonjudgmental awareness of the present moment can allow you to see more clearly, rather than through the cloud of emotional distress, which will allow you to make decisions accordingly.

By observing the rise, crest, and fall of your emotional distress, you are able to watch and wait, which also gives space for it to slowly dissipate on its own.

As you watch and wait, you may also notice urges to avoid or escape the discomfort of emotional distress but will be better able to choose to respond more flexibly, rather than reacting automatically or unconsciously in ways that contribute to more problems.

In addition, mindfulness can help put your distress, meaning validating that you are experiencing an important and distressing reality in your present moment, but that it does not have to define your total experience in this world. 

In neurological terms (see the section on the brain in Understanding Anxiety), mindfulness refers to processes occurring in the cortex (the thinking brain). In fact, mindfulness has been shown to be related to increased activity in the cortex rather than decreased activity in the amygdala (the emotional brain).

This suggests that in anxiety, the amygdala still sends out an alarm, triggering the fight or flight system, but with mindfulness, the cortex is able to send messages to dampen the amygdala response and the accompanying fight or flight response, which then can allow the relaxation response of the parasympathetic nervous system to unfold.

In essence, mindfulness limits the fuel that is added to the anxiety and keeps from further igniting the anxiety response. This is in comparison to the anxious mind that is typically focused on past failures or future threats that amplified anxiety.

It may be challenging in the beginning but as new neural connections are being made and developed, the brain is being trained to change your relationship to the present moment and to your experiences of distress. 


Mindfulness often starts with learning how to focus on the breath because breath awareness can lower baseline anxiety, helps with anxious breathing, is easily accessible, and increases awareness of one’s body, allowing the mind and body to reconnect.

Breathing is also rooted in the now, not in the past nor in the future, and thus focusing on the breath is training your mind to focus on the present moment. Anxiety is constantly trying to pull you away into the questions of “what if” whereas breath awareness anchors you in the “what is.”

Mindfulness can also include focusing on thoughts, sounds, tastes, or an entire experience. Mindfulness practice can be done in short 3-minute sessions and can be done throughout the day in a variety of settings - while brushing your hair, while waiting in line, while eating, while washing the dishes. 

Mindfulness is a process where you pull yourself out of autopilot and learn to re-experience life in the moment. Simple yet profound.

Each time your mind wanders from your breath or from your sensations, you have an opportunity to gently teach your mind how to refocus by observing your mind being pulled, allowing for the pull, and then gently guiding your mind back to your point of focus and allowing the thoughts to pass through without getting caught up in them.

Mindfulness is a conscious decision to act differently, to try something new just for a moment, to not give in to anxiety’s pull, to disengage from anxiety, to accept uncertainty, and to come back repeatedly to the present moment.

Mindfulness is not a natural process of the mind, especially during anxiety, but this ability to recognize the wandering mind and return to the present moment can be strengthened over time and with consistent practice.


Mindfulness has been a powerful addition to cognitive behavioral therapy. Mindfulness Based Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT) have both shown positive effects in treating a variety of mood disorders.

Brain imaging studies have found mindfulness practice to be associated with changes in brain structures associated with learning, memory, and mood regulation. 


There are several attitudes that are central to mindfulness:

1) Non-judging

It is a powerful habit of our minds to constantly categorize our experiences as good, bad, or neutral/boring. Mindfulness teaches us to be more aware of the constant pull to judge or evaluate our experiences and encourages us to step back and observe our experiences without judgment.

During mindfulness meditation, you might be able to recognize evaluative thoughts such as, "This isn't going to work. I can't do this right. I'm so bad at this. This makes me uncomfortable," or "I enjoy this. I hope this doesn't end," or even, "This is boring."

When you notice the mind judging, there is no need to stop it, but instead observe the judging quality of the mind and label it as judgmental thinking. It is important not to judge the judging, but simply note that it is present.

By learning to recognize these judgments, you will be better equipped to notice them when they come up in your day-to-day life or when you're feeling overwhelmed. Evaluative judgments that come with emotional distress might be, “I shouldn’t be feeling this way, I must be weak” or “I should be feeling happier, I must be damaged.”

The belief can be that self-criticism will prompt us to feel how we “should” but in actuality, it is impossible to stop normal, natural, hard-wired emotions that often make sense given the situation.

Instead, by telling ourselves our feelings are bad or that our problems are going to get worse and that we won’t be able to cope, the intensity of our emotional distress increases and so do the feelings of urgency to escape them.  

Mindfulness can help you learn how to step back and shift to observing, "What is happening now? I am having thoughts that this is dangerous. I am feeling my heart racing. I am wanting to turn around and escape. How shall I respond?" This shift from immediately reacting to mindfully observing is an important part of managing emotional distress.

2) Patience

Patience refers to being aware of the internal rush to get through one moment to the next, especially to quickly avoid or escape those experiences you might evaluate as painful or uncomfortable, and instead, practicing the art of waiting. Patience means allowing the present moment to unfold as it will and sitting with your urges to try to control a situation that may be outside of your control.

With regards to anxiety, this means cultivating patience towards your mind and body. It means accepting an anxious mind or a reactive body, knowing that recovery is a process that takes time.

Patience requires a level of kindness and compassion for yourself and for others.

3) Trust

This refers to trusting yourself, including your feelings and your ability to see clearly what is happening to you. It means trusting that your abilities to observe and respond to your mind and body will develop over time and that you are the best person to know what is going on inside you and around you.

Trust means taking risks for a greater purpose or to reach other important goals in life. It means stepping back from frantic attempts to control emotional distress knowing that it comes with certain risks such as feeling worse or that it may not work.  

Trust means taking the risk of letting go of control and increasing your faith in your ability to cope. This might be based on your past experiences of coping with adversity or imagining how you might cope with challenges in the future.  

4) Present Focus

Present focus is about keeping our emotions grounded in the present moment and allowing each moment to unfold moment to moment. It means engaging directly in an experience as it is happening in the present moment, without focusing on comparisons to the past and without expectations for the future.

Present focus also means trying to see the present moment with a clear and uncluttered mind that is open to new possibilities. Focusing on the present moment can help keep us from adding a layer of pain to the distress that already exists.

A beginner’s mind can also be used as a way to disengage with anxiety and instead engage with the present moment sensations of smell, touch, taste, or sound similar to a child experiencing the first smell of a flower, the first feel of rain, or the first taste of an orange where each moment is unique.

5) Non-striving

Those experiences we judge as good we become attached to, want more of, and do not want to lose, whereas those experiences we judge as bad, we feel an aversion to and want to avoid them or get rid of them.

Both are about reactively changing our situation whereas non-striving is about allowing whatever is happening to happen so that instead of striving for an outcome, you learn to see and accept things as they are at least in this moment – the good, the bad, and the ugly.

Non-striving means letting go of expectations of good or bad, liking or disliking, pleasant or unpleasant, and allowing the experience be what it is. By letting things be, you have a better chance of letting go.

This is all important for anxiety because the harder you try to get rid of it, the more powerful and elusive it becomes whereas by stepping back and accepting things as they are seems to loosen anxiety’s hold.

6) Acceptance

Acceptance means being aware of and acknowledging the way things are in the present moment. In comparison, we often waste energy denying and resisting what is already a fact. We try to force situations to be the way we like which only creates more tension.

Acceptance is a willingness to see things as they really are at least in this moment without trying to impose ideas about what we “should” be feeling or thinking or seeing.

Acceptance and Emotional Distress:

With regards to painful emotions, acceptance means coming to terms with uncertainty and discomfort. It means that regardless of how you feel about it, uncomfortable emotions are an unpleasant part of your reality at this time, that your fears may be causing you suffering, and that those fears may or may not happen.

Acceptance does not mean you are satisfied with things as they are, that you don’t care, or that you have to stop trying to change things for the better, rather it means recognizing that the pain may be temporary, there may be hope for a better future, and you are learning to manage it more effectively.

Serenity, Courage, and Wisdom: 

There is a saying that we need “the serenity to accept the things we cannot change, the courage to change the things that we can, and the wisdom to know the difference.”

This means that there may be situations in life that we have to be at peace with, but life is not about resignation and succumbing to challenges in our lives, as it also involves courage to move towards reasonable change, working with what we have, and facing difficulties that challenge.

Wisdom comes in learning when it is futile to try to control a situation versus when change is possible - when to work on acceptance versus when to gather courage to seek out change. Usually, it is about a flexible balance between the two.

Acceptance of the Past and the Uncertain Future:

Acceptance of the past is related to understanding the impact experiences from your past have had on your current situation, grieving any losses, and then shifting the focus on the present. We cannot change the past, but we can try to minimize the impact it has on us now.

Acceptance of the future is related to tolerating uncertainty about the future and knowing that you are making strides to create a better future for yourself and that you are developing the skills to assist you when the future does not turn out quite as expected. Acceptance of the future is patience, taking it one step at a time, and seeing life as a process.  

Guided Mindful Practice:


Click here for a selection of audio guided mindfulness practices for beginners: https://www.mindful.org/meditation/mindfulness-getting-started/


Click here for a 5-minute mindfulness exercise: Meditation audio https://www.oxfordclinicalpsych.com/view/10.1093/med-psych/9780190686017.001.0001/med-9780190686017-appendix-5



5-minute Mindfulness Exercise


Some people find this mindfulness exercise to be uncomfortable, especially if they’ve been in the habit of avoiding their emotions or distracting themselves from uncomfortable sensations. Mindfulness is a practice that can be cultivated, though, with regular practice, so that it becomes easier to sit in stillness and easier to observe without judgment.


If you notice that your mind has wandered or that you’ve been judging your experiences, that’s great! Mindfulness about noticing, and then without judgment, bringing your mind back to your point of focus. It is the practice of constantly noticing and bringing back, and not necessarily about staying focused or clearing the mind.


The goal of this mindfulness exercise is not to feel relaxed. The goal is to learn a new way of being, observing your thoughts, physical feelings, and emotions in a nonjudgmental, present-focused manner.


  1. Find a comfortable position sitting up or lying down.
  2. Inhale, pause, then exhale all the way, emptying your lungs, allowing your body to go loose and limp. This full exhalation will create a vacuum that will pull a deep breath into your abdomen. If you notice your body holding tension in certain areas, allow the muscle to relax so that you can rest comfortably.
  3. Notice your breath. Notice each inhalation and exhalation, notice the pause in between. Be aware of the sound and feeling of your breath against your lips and nostrils. Notice the rise and fall of your body with each inhalation and exhalation. Observe your body breathing itself naturally and automatically. Focusing on your breath is a way to ground yourself in the present moment.
  4. Now shift your attention to your body, how it feels to be sitting or lying down and of the sensations in your hands and then your feet. Focus on your physical sensations and describe them in a matter-of-fact manner, rather than judging and evaluating them or changing them. Simply notice with curiosity.  
  5. Now notice the thoughts that come to mind. Notice if the mind jumps from topic to topic, or notice if the mind latches on to some other thoughts. Simply notice the actions of the mind without forcing it one way or another. If you find yourself being swept away by your thoughts, just acknowledge it and bring it back to a place of observation. You can label your thoughts, as in “thinking, planning, judging, noticing, resisting….”   
  6. Now shift your attention to your how you’re feeling. Notice your emotions. Notice how they might fluctuate or change from one to another. Notice if the emotions come in waves, rising, cresting, and falling. Notice any emotional reactions you might be having to the emotions. Simply observe the feelings without judgment and without trying to change them in any way.  
  7. Now slowly bring your attention back to the room, wiggle your fingers and toes, take in a long, deep, slow breath and whenever you’re ready, gently open your eyes.
  8. Practice this mindfulness exercise once a day for a week. In the beginning, it can be easier to use a guided audio mindfulness meditation.

Mindful Awareness in the Presence of Uncomfortable Emotions

After you’ve practiced the above exercise for about a week, you can begin to incorporate this practice into your daily life, during those times you may experience uncomfortable feelings of emotional distress.

The goal here is to be able to pause at a moment when emotions are starting to build and then creating space for you to make a conscious choice about how you’d like to respond.

By being aware of your thoughts, physical feelings, and emotions, you might be better able to step outside of your emotional experience so that you can make a decision that is more in alignment with the present moment or with your greater goals and values.

  1. Ground yourself in the present moment by taking in a long, slow deep breath and becoming aware of your presence in the room.
  2. Notice your thoughts….notice your physical feelings…notice your emotions….notice what you’re doing right now and what you feel like doing.
  3. Ask, “How shall I respond?” Check in to see if your response is consistent with what is going on the in present moment rather being based on the past or the future. Check in to see if your response is in alignment with your greater goals and value.
  4. Practice any time you feel an uncomfortable emotion beginning to rise up. Know that this will take regular practice, like building up your muscles, until it starts to feel like an automatic response. 


  • Full Catastrophe Living by Jon Kabat-Zinn
  • Calming Your Anxious Mind: How Mindfulness and Compassion Can Free You from Anxiety and Panic by Jeffrey Brantley
  • Peaceful Mind: Using Mindfulness and Cognitive Behavioral Psychology to Overcome Depression by John McQuaid and Paula Carmona
  • Unified Protocol for Transdiagnostic Treatment of Emotional Disorders by Barlow et al.