The MBSR body scan in clinical practice

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ISSN: ISSN 1868-8527

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Mindfulness
ISSN 1868-8527
Volume 4
Number 4
Mindfulness (2013) 4:394-401
DOI 10.1007/s12671-013-0212-z
The MBSR Body Scan in Clinical Practice
Samuel J.Dreeben, Michelle
H.Mamberg & Paul Salmon

1 23
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MINDFULNESS IN PRACTICE
The MBSR Body Scan in Clinical Practice
Samuel J. Dreeben &Michelle H. Mamberg &Paul Salmon
Published online: 7 April 2013
#Springer Science+Business Media New York 2013
If one thing, O monks, is developed and cultivated, the
body is calmed, the mind is calmed, discursive thoughts
are quieted, and all wholesome states that partake of
supreme knowledge reach fullness of development.
What is that one thing? It is mindfulness directed to
the body…
Anguttara Nikaya 2010,p.9
Introduction
The body scan is a somatically oriented, attention-focusing
practice first introduced into clinical practice as part of
the Mindfulness-Based Stress Reduction (MBSR) pro-
gram. Developed by Jon Kabat-Zinn, the MBSR program
brings together a range of techniques and practices uni-
fied by a common theme —that of cultivating mindfulness.
Mindfulness is defined predominantly as moment-by-moment
attention focused in the present, in a nonjudgmental manner
(Kabat-Zinn 1990). Described as a “clinic, in the form of an
8-week course”(Kabat-Zinn 2003,p.149),MBSRhasbeen
adapted for various clinical populations, including individuals
with eating disorders (Kristeller and Hallett 1999) anxiety
(Kabat-Zinn et al. 1992), cancer (Speca, Carlson, Goodey &
Angen, 2000; Lengacher et al. 2009), chronic pain (Kabat-
Zinn, Lipworth, & Burney, 1985) and fibromyalgia (Sephton et
al. 2007). MBSR was also the inspiration for a well-validated
clinical intervention for depression: Mindfulness-Based
Cognitive Therapy (MBCT), developed by Segal, Williams,
and Teasdale (2013).
The MBSR program typically consists of an introductory
informational meeting followed by eight, 2½-h group meetings
with an all-day retreat on the weekend of the sixth week
(Kabat-Zinn 1990). Participants are expected to commit to
45 min of home practice, 6 days of the week for the entire
8-week program. As the first formal home practice, the body
scan is frequently participants’initial encounter with mindful-
ness. Though the body scan serves as a foundation for all
subsequent practices in the MBSR program, it has received
remarkably little individualized attention. This relative lack of
theoretical exploration may be an artifact of what McCown,
Reibel and Micozzi (2010) note as a tendency of MBSR
scholars to favor sitting meditation over other forms of prac-
tice. Whatever the reason, little has been written on the body
scan in terms of its background, unique clinical contributions,
and prospects for expanded clinical use. In this article we
consider each of these facets in turn, with the intention of
locating the body scan in the broader spectrum of clinical
psychology practice.
Body Scan
In practice, participants begin the body scan by sitting or lying
in a comfortable position. The instructor (live in class, then on
audio recording at home) slowly guides the participants’atten-
tion through the various regions of the body. Kabat-Zinn has
described the practice of the body scan as a “sweeping”
(Kabat-Zinn 1982,p.36)ora“zone purification”of the body
(Kabat-Zinn 1990, p. 87). Kabat-Zinn’s meditation teacher, a
chemist by training, used the metaphor of a circular furnace
slowly scanning a bar of metal, temporarily melting each
segment while pushing impurities to the end of the bar. The
body scan practice has elsewhere been described as an “affec-
tionate, openhearted [and] interested”attention to the body that
can be practiced at various speeds and levels of precision
(Kabat-Zinn 2005,p.250).
According to Drummond (2006), Kabat-Zinn’sbodyscan
was originally based on U Ba Khin’ssweepingpracticeand
S. J. Dreeben (*):P. Salmon
Department of Psychological and Brain Sciences,
University of Louisville, Louisville, KY 40292, USA
e-mail: sam.dreeben@louisville.edu
M. H. Mamberg
Department of Psychology, Bridgewater State University,
Bridgewater, MA 02325, USA
Mindfulness (2013) 4:394–401
DOI 10.1007/s12671-013-0212-z
Author's personal copy

Hatha Yoga meditation. S.N. Goenka, a Burmese-trained
Vipassan a teacher, was U Ba Khin ’s long-time student and
primary lineage holder (Srinivasan 1996). Goenka (cited in
Hart 1987) has indicated that his teachings are based in the
Satipatthana sutta’s observation of bodily sensations
(Drummond 2006). The body scan may have been influenced
in much the same way. Kabat-Zinn (2003) has pointed to the
Satipatthana sutta (in addition to the Anapanasati sutta)as
constituting the core teachings of mindfulness, with mindful-
ness of the body being the first of the four foundations of
mindfulness. Relatedly, current Vipassana teachers (e.g., at the
Insight Meditation Society and Spirit Rock) discuss both
suttas when leading a similar type of scanning practice to
stabilize attention and shift focus from being lost in thought
during insight meditation.
As individuals begin body scan practice, they are often
confronted with thoughts about success and failure or pleasure
and discomfort (Segal, Williams, & Teasdale, 2013). These
cognitions may relate to sleepiness, physical discomfort, atten-
tional lapses, or emotional unease. Segal, Williams, and
Teasdale (2013) encourage instructors to use these experiences
as teaching moments, accentuating the participant’sattention
to these thoughts and feelings. By gradually shifting the inten-
tion of the practice from performance to simple attention, the
practitioner may begin to cultivate a more detailed awareness
of emotional, cognitive, and physical experience.
In traditional Buddhist practices, once attention is stably
focused on bodily processes such as physical sensations or the
flow of breathing, the practitioner can begin to notice the
transitory nature of experience as well as the mind’stendency
to judge each sensation (Sayadaw 1994). Experiencing pe-
riods of uninterrupted sensory awareness can highlight the
extent to which the mind engages in automatic evaluative
thought. Having noticed the mind’s tendency to judge, one
can in turn notice the attachment to or rejection of specific
bodily sensations, becoming increasingly aware of the mind
as intermediary interpreter.
Intimate knowledge of bodily experience, without judging
or reactivity, is further assumed by Buddhist psychology to
lead to an acceptance of impermanence —the body will
fall ill, decay and die. As a consequence, the meditator’s
identification of self with body may be reduced with practice.
This cognitive shift of dis-identification, we argue, is an inte-
gral aspect of the body scan as practiced in MBSR. McCown,
Reibel, and Micozzi (2010) explain that this dis-identification
also extends to separating present moment experience from
stories or opinions about the experience. Through separating
stories about the present moment from the experience of
“present-moment happening,”MBSR participants cultivate
the ability to be flexible and to maintain perspective as they
perceive their inner experience and the world around them.
Kabat-Zinn (2005) similarly points out that the body scan’s
embodiment of two ways of representing meditation —as a
technique (which implies a goal) and as a way of being —can
contribute to reducing the mind’s tendency to fallinto dualistic
thinking.
The popular caricature that Buddhist psychology rejects
the body in favor of enlightenment is directly contradicted
by the body scan. The practice makes clear that the body can
be and is used as a vehicle to stabilize the mind and as a way
to eliminate Dukkha, or suffering. Olendzki (2010)illustrates
this process when he writes:
The reason [mindfulness of the body] is effective is that
the mind can be aware of only one thing at a time …over
time, as the practice of mindfulness of the body develops,
one can actually have multiple consecutive moments of
sense awareness uninterrupted by ‘thinking about’what
one is sensing. To those who habitually think too much,
this is experienced as blissful relief. (p. 89)
The body scan, in effect, provides the pedagogical basis
of all the practices introduced later within both the MBSR
and MBCT programs. By providing participants an oppor-
tunity to experience the automaticity of judgmental and
narrative thinking, the impermanence of thoughts, and the
flexibility of attention, it provides a thorough introduction to
mindfulness in practice. If participants experience even a
moment of “blissful”sensing without thinking, they may be
more prepared and motivated to begin meditation and yoga
practice. In addition, the inquiry which follows each MBSR
practice in class entails just these skills of directing attention
nonjudgmentally. As they learn this first practice in the
MBSR course, participants develop an attitude of explora-
tion, which serves as a shared foundation for teachers and
students in future inquiry discussions. Finally, having been
introduced to kind, patient attention to the body early in the
course sequence, participants are better equipped to attend
nonjudgmentally to their direct experience as they begin the
more physically engaged mindfulness practices.
Somatic Attention in Clinical Practice
Just as various lineages employ scanning practices, many
clinical interventions use some form of explicitly attending
to the body. In reviewing these stand-alone clinical prac-
tices, we may begin to consider ways in which the body
scan might fit into the canon of Western somatic psycho-
therapy techniques.
The body scan is markedly less action-based and goal-
oriented than the most widely known Western-based somat-
ic practices. For instance, in Progressive Muscle Relaxation
(PMR), the therapist instructs the patient to notice sensa-
tions involved in tensing and relaxing specific muscle
groups, sequentially, with the purpose of training the patient
to bring the relaxation response more fully under conscious
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control (Jacobson 1938). PMR shares with the body scan a
progression of attention through different regions of the
body. It also shares with the body scan a de-emphasis on
labeling emotional reactions. However, unlike the body scan
in which attention is continually re-directed to the body,
PMR requires that participants should “let the power go
off”in all the muscle regions until thinking has ended
(McGuigan and Lehrer 2007, p. 75). More importantly,
PMR differs from the body scan in that muscles are actively
engaged and released rather than simply observed. This
important difference means that PMR is more focused on
the participant’sdoing —cognitively and physiologically —
rather than being. In contrast, the body scan directs awareness
to the noticing of how one is in the moment, rather than
aiming to accomplish any task, however subtle. Lastly, PMR
has the declared goal of achieving relaxation or reduced
anxiety as its end, whereas the body scan is based in the
non-striving attitude characteristic of mindfulness practice.
Schulz’s Autogenic Training (AT) also shares the body
scan’s focus on the body. However, it is based heavily on
imagery and aims to alter body sensations (Linden 2007).
For instance, a person practicing AT may aim to lower her
heart rate (HR) or warm her arms. Again, an important
difference between the body scan and other Western somatic
therapies lies in the difference between doing in order to
achieve something, rather than simply noticing one’s current
state of being.
Similarly, hypnotherapeutic inductions frequently move
attention through the body as a means of shifting an indi-
vidual into a hypnotic state. Again, this differs from the
body scan in its goal-directedness and use of non-body
imagery. However, the body scan’s traditional use of the
present participle and slow speech patterns is quite similar to
hypnotic inductions. Notice the language in this segment of
a hypnosis induction: “The muscles around the right elbow
and forearm becoming loose and comfortable. And all the
muscles in the hand letting go, letting go…. Completely
letting go”(Karlin 2007, p. 137). As discussed in our close
examination of Kabat-Zinn’s“languaging”(Mamberg,
Dreeben, & Salmon, 2012), similar phrasing is a core part
of the body scan. In both cases, language is used to encour-
age a particular type of experiential focus; however, the
body scan does not elicit striving toward a particular state.
Arelated—but somewhat distinct —clinical approach
derives from humanistic psychotherapy, in which a number of
therapeutic modalities have incorporated elements of somatic
awareness. Gendlin (1981) developed Focusing based on
developing clients’perceptions of the felt sense of an emotion
in their bodies. In this technique, an individual first notices the
physical sensation of an emotion, and then gives a “handle”to
the emotion by labeling it with a word. This differs from the
body scan in both the use of labels and the attention directed at
a felt emotion, rather than sequential regions of the body.
Gestalt therapy also uses attention to somatic sensations as a
central feature of therapy; for instance emphasizing awareness
of gestures, breathing, voice, and facial expressions (Perls
1973). Much like the body scan, the use of non-evaluative,
sustained attention to the body in Focusing and Gestalt
Therapy may function to reduce reactivity to negative physical
states and shift focus to present moment experience.
Charlotte Selver, the founder of Sensory Awareness in
the U.S., influenced a wide range of psychological practi-
tioners, including Fritz Perls, Erich Fromm, and Alan Watts.
Her therapy focused specifically on the body, often in con-
junction with movement, touch, or other sense perceptions
such as noticing the effects of gravity. Her instruction, like
the body scan, encouraged directing awareness through the
body, cultivating a familiarity with the entirety of the body
(Littlewood and Roche 2004). Selver’sworkinSensory
Awareness has found its way into mindfulness practice via
teachers such as Ruth Denison (Boucher 2005).
Compared to western somatic practices such as PMR and
AT, the body scan is markedly less action-based and less
goal-oriented. PMR and AT both involve active manipula-
tion of inner states, such as tensing and releasing muscles to
attain relaxation. These techniques intentionally bring about
changes in state, rather than foster experience of the body as
it is. By emphasizing attending to the body and its functions
without the practitioner having to do anything, the body
scan fosters a distinction between awareness and bodily
reactions, as well as acceptance of the body as it is. It also
encourages adaptive attitudes with which to approach the
body (e.g., curiosity or kindness).
In sum, the body scan shares certain features with other
somatic therapies incorporated in western psychotherapy,
while contributing a distinct quality. The MBSR body scan
remains unique due to its focus on non-striving awareness
without doing, and its roots in Buddhist psychology.
MBSR Body Scan as Yoga
The body scan is normally conducted lying supine on a floor
or mat, comparable to the Savasana pose in Yoga. Savasana
is treated in yogic texts as a particularly challenging pose.
This is because of the demands it places on steady, inwardly
focused attention, which in part is attained by taking phys-
ical activity out of the equation: very little conscious control
is needed to maintain the posture, in contrast to the mental
challenges involved, not the least of which is staying awake.
Seen from this perspective, the body scan is intimately tied
to Yoga, by virtue of establishing a vantage point from
which to observe internal sensations. However, there are
differences between these two practices, as well. In Yoga,
savasana serves as a vehicle for stabilizing attention that is
not necessarily somatically focused, but rather puts one in
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touch with a state of being that transcends the physical
world (Iyengar 1966). In a way, savasana presages death,
quite literally —it is translated as the corpse pose —and
implicitly fits in a much different framework than that of the
body scan, which is undertaken within the context of the
assertion “…as long as you are breathing, there is more right
with you than there is wrong”(Kabat-Zinn 1990, p.2). In
effect, the body scan brings the practitioner into intimate
connection with sensations of being alive. Here is one point
where the effects of the body scan and the yoga asana
appear to diverge.
In both the body scan and savasana, the body makes
more complete contact with the physical world —in the
form of a mat or floor —than in any other posture. When
standing, for example, our point of contact is through the soles
of the feet, resulting in a certain precarious postural state that
requires minute, non-conscious moment-by-moment skeletal
and muscular adjustment needed to sustain what from a dis-
tance appears to be a static pose.
Novice yoga practitioners begin developing awareness of
movement by observing the body during gross physical
motion. Over time, they become increasingly attuned to
more subtle postural shifts and their resulting sensations.
As a natural lead-in to yoga practice and the MBSR pro-
gram, the body scan helps cultivate awareness of the wealth
of distinct somatic sensations. This is in contrast to the
common experience of only noticing physical reactively
when something unusual happens, typically negative. Once
the practitioner has learned to develop this sensitivity, in-
structions such as “pivot on your right hip”begin to make
sense, because of acquired sensitivity to subtle propriocep-
tive and kinesthetic feedback generated by movement.
So, in one sense, although yoga is formally introduced in
session 3 of MBSR, in reality it begins with the body scan in
session 1, due to the close physical correspondence with
savasana. One could go further, and say that simply the act
of moving into and out of the body scan comprises a fairly
complex series of movements that are closely associated with
yoga. Getting down on the floor is in fact a highly complex
sequence of actions, beginning with establishing the intention
to move and culminating the moment one finishes making
contact with the floor and is able to completely let go and
release any sense of effortful action. (Returning to an upright
position is the reverse of this, and likewise requires enactment
of a very different —and highly complex —sequence of
movements resulting in assumption of a seated or standing
position.) Mindful Yoga is full of instances where apparently
simple movements are enacted with careful attention; in fact, it
is the quality of attention, rather than the movement itself, that
is paramount. In MBSR, these sequences provide an opportu-
nity for careful attention to one’s automatic judgments about
bodily movements, limitations and sensations. The body scan
provides practice with this attentional style well before mindful
movement is introduced. It highlights embodied awareness,
inherently based on sensation; it is not merely a mental exer-
cise that uses the body as an object.
Clinical Research
In this section, we summarize the existing research on the body
scan which falls into four general categories: (1) physiological
effects, (2) intervention applications, (3) correlations between
body scan practice time and psychometric variables, and (4)
clinical case studies.
Physiological Effects of the Body Scan
Ditto, Eclache, and Goldman (2006) compared the physio-
logical effects of body scan meditation, PMR, an audio
recording control group, and a quiet sitting control group.
They found that over a 20-min recording period and following
4 weeks of daily practice, the body scan group had a signifi-
cantly greater increase in Respiratory Sinus Arrhythmia
(RSA), a measure of parasympathetic activity reflecting heart
and breathing rate synchrony, than PMR, the audio recording,
or sitting groups.
In a study of MBSR for women with fibromyalgia, par-
ticipants listened to a 20-min body scan before and after the
8-week program, while HR, skin conductance level (SCL)
and peripheral (finger tip) temperature (PT) were measured
(Lush et al. 2009). Mean SCL was significantly lower during
the post-program body scan. Additionally, following MBSR,
SCL had significantly lower initial values and declined more
rapidly during the recording, suggesting lower sympathetic
activation and reduction during the body scan. Although other
factors in MBSR may have contributed to this pattern, the
body scan likely contributed to the observed practice-specific
effects.
Body Scan as Clinical Intervention
Although the body scan is a facet of many mindfulness-based
clinical interventions (e.g., MBSR, MBCT, Mindfulness-Based
Eating Awareness Training [Kristeller and Hallett 1999],
Mindfulness-Based Relationship Enhancement [Carson et al.
2004], Mindfulness-Based Art Therapy [Monti et al. 2006],
Mindfulness-Based Mind Fitness Training [Jha et al. 2010],
Mindfulness-Based Relapse Prevention [Bowen, Chawla, &
Marlatt, 2011]), it has received little attention as a stand-alone
or complementary treatment. One notable exception is a series
of studies by Ussher, Cropley and colleagues comparing the
effects of the body scan to various smoking cessation tech-
niques. A pair of studies found that a modified version of the
MBSR body scan was as effective at reducing withdrawal
symptoms and desire to smoke as isometric exercise (Ussher,
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Cropley, Playle, Mohidin & West, 2009;Ussher,Doshi,
Sampuran & West, 2006). Cropley, Ussher, and Charitou
(2007) also examined the effects of a modified body scan on
withdrawal symptoms and cravings in overnight abstinent
smokers. Compared to an educational audio recording control
group, participants who listened to the body scan reported
reduced irritability, restlessness, and tension, as well as a di-
minished desire to smoke. There were again no significant
differences between the two conditions, while both proved to
be more effective than an educational audio recording.
Although these studies tested a briefer body scan as a stand-
alone intervention for a very specific application (smoking
cessation), they suggest that the body scan may have value as
an independent clinical resource.
Practice Time and Psychometric Variables
One of the most consistent findings in the MBSR literature
is a preference for the body scan, as measured by practice
time, compared to other core practices. In the study of
Shapiro, Brown & Biegel (2007), student therapists in
an 8-week MBSR program reported spending more time
practicing the body scan (on a minutes/week basis) than
they did sitting meditation or hatha yoga. In a pre-
deployment military sample of Mindfulness-based Mind
Fitness Training, the body scan and breath awareness
were reported as the most frequently used practices (Jha
et al. 2010). Tacon, Caldera, and Ronaghan (2004)
reported that women with breast cancer participating in
an MBSR program preferred both somatic practices: yoga
(50.6 %), and body scan (42 %), followed by sitting
meditation (7.4 %). At a 3-month follow-up, yoga remained
the top preference (50 %), followed by the body scan
(29.2 %), and sitting meditation (20.8 %). Finally, Carmody
and Baer (2008) found that participants in a mixed MBSR
group practiced the body scan 31–35 min/day, as compared to
16–20 min/day for both yoga and meditation.
In addition to tracking body scan practice time, Carmody
and Baer (2008) also correlated these values with pre-/post-
changes in psychometric measures. Body scan practice time
was positively and significantly correlated with decreased
interpersonal sensitivity and anxiety, and increased well-
being, non-reactivity to inner experience, and observing skills.
Lengacher et al. (2009) similarly correlated practice time with
pre-/post-changes in an abbreviated MBSR program for
breast cancer survivors. In this study, body scan practice
time was correlated with significant improvements in trait
anxiety, depression, perceived stress, emotional well-being,
and aggregate mental health. Although it is unclear what
mediating factors may be at work, or precisely what these
outcome measures communicate, these studies collectively
suggest that body scan practice is positively correlated with
mental health.
In the papers reviewed thus far, the body scan is used as an
indicator of patient engagement and as an outcome measure,
with little attention paid to the activities (cognitive, affective
and interpersonal) employed during the body scan itself. We
turn now to clinical self-reports describing the effectiveness of
the body scan.
Clinical Reports and First-Person Studies
There are several reports of participants’experiences with the
body scan (Ott 2002; Finucane and Mercer 2006; Williams,
Duggan, Crane & Fennell, 2006;Smith,Graham,&
Senthinathan, 2007). These papers include accounts of people
who reported the body scan being useful for distress tolerance
and stress reduction, as well as coping with chronic pain,
generalized anxiety disorder, depression, and epigastric
disturbances.
The many narratives provided by Finucane and Mercer
(2006) provide a particular wealth of first-person accounts
about the body scan from MBCT participants. One of their
participants describes the personal benefit of their body scan
practice by contrasting it with PMR, stating:
…when you are doing (progressive muscle) relaxation
you are sort of concentrating just on muscles or different
parts of your body but it's outside your body but I felt the
[body scan] meditation was going inside the body …as
if I've got into the root, is probably the best way to
describe it. And I can get right to the nucleus of it and
I can feel it. (p. 7)
As experienced MBSR instructors know, not every
encounter with the body scan is positive. For instance,
a woman with a history of childhood sexual abuse found
that the body scan made her aware of "horrible feelings
through my body that I had never felt before" (Finucane
and Mercer 2006, p. 7). This is not unlike an MBSR
participant described in Full Catastrophe Living, whose
memories of childhood sexual abuse and guilt over her
father’s death surfaced as a result of sensations she
experienced during the body scan (Kabat-Zinn 1990,
p. 79–80). However, she persevered with the body scan
and found that her physical and emotional pain decreased
substantially. To further emphasize the variety of possible
experiences, Finucane and Mercer describe another par-
ticipant with a history of childhood sexual trauma who
had a very positive experience with the body scan, and
continued to practice it several times a week even at
3 months follow-up. Such reports are a reminder that
the body scan itself is a neutral stimulus to which prac-
titioners bring their own reactions, whether positive or
negative. They also reinforce the importance of under-
standing a client’s history and relationship to their body
before embarking on this intervention.
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Neuroimaging
Finally, some neuropsychological studies are beginning to
focus on body scanning, as well. Goenka’s adaptation of
U Ba Khin’sbody sweeping practice has been employed
in neuroimaging studies showing structural changes in
practitioners. A study by Holzel et al. (2008) reported
higher concentrations of gray matter in the left inferior
temporal gyrus, right anterior insula, and right hippocam-
pus in long-term meditators compared to non-meditating
controls. In a study with the same participants, the left
inferior temporal gyrus was also significantly more acti-
vated during body-focused meditation; additionally, the
concentration of gray matter in this region was also
correlated with amount of practice time (Holzel et al.
2007). Greater concentration of gray matter in the right
anterior insula corroborates a similar finding with insight
meditation practitioners (Lazar et al. 2005). The right
anterior insula is generally considered to be related to
interoception and awareness of bodily feelings (Holzel et
al. 2008). Thus, while research on the body scan is in its
infancy, it shows promise both as a clinical practice
alone as well as an integral element of MBSR.
Clinical Application
The body scan has been widely practiced within the context
of MBSR and other mindfulness-based interventions for
over 30 years now. It is our opinion that it is clinically
useful and needs to be researched as a unique clinical
practice if we are to deconstruct the effective components
of MBSR and related mindfulness-based interventions. To
inform research and clinical use of the body scan, we
propose the following applications of the body scan in
traditional clinical settings:
(1) To help explicitly establish the connection between
physical sensations and emotional labels. Most patients
can say very little about what is going on internally, and in
general have minimal sensitivity to inner states. The body
scan provides a means of establishing a deeper sensitivity
to sensations, as well as a vocabulary for conveying
physiological experiences, that may previously have been
missing or absent.
(2) In psychotherapy, to aid in identifying somatic corre-
lates of cognitive activity and coming to understand
that modifying either one may potentially impact the
other.
(3) Re-directing attention away from stressful “time travel”
cognitions to “here and now”sensations. Such re-directing
may be particularly helpful with patients who dissociate or
ruminate excessively.
(4) To encourage noting and appreciating affective states
(Davidson 2010) using non-reactive language that is
descriptive rather than diagnostic. For example, rather
than saying “I’m depressed,”clients with mood disorders
may benefit from explicit re-framing and encouragement
to state experiential correlates such as “my breath feels
heavy and labored.”Further, the body scan helps the
practitioner move past static characterizations of the self
(“I’mdepressed”), in favor of more momentary sensa-
tions of the breath or body.
(5) Keeping in mind that many MBSR participants (and
psychotherapy clients more generally) have physical
problems, the body scan can be a tool for positive re-
framing by bringing attention to the fact that whatever
difficulties may be going on in one’s body, there is
much that is working properly.
(6) Avoidance is a common obstacle to therapeutic
progress —avoidance of thoughts, avoidance of feelings,
not being willing to make contact with experiences
that are, or have been, prematurely labeled as aver-
sive. Some people are so entrained into avoidance —
perhaps habitually so —that clinicians need to em-
ploy a very gradual, gentle means of guiding them
into making contact with the object of aversion. The
reason for using the body scan to initiate this process
is that much of avoidance involves cognitive activity,
and by initially focusing on somatic sensations the
therapist can establish a sort of phenomenological
“beach head”from which further contact with corre-
lated cognitive events could be initiated. If clients are
avoidant or fearful of emotional experience, it may
also provide an opportunity to experience emotions as
somatic events, independent of evaluative cognitions.
Introduced early, and practiced throughout the MBSR
curriculum, the body scan encourages awareness and
acceptance of inner states, whether positive, negative or
neutral. It is a unique practice, differing from most
somatic-based clinical techniques because of its consistent
emphasis on awareness in the present, rather than on
future (or even immediate) change. Although largely
overlooked in research, it has been a central feature of
mindfulness-based practices for many years. The time has
arrived for researchers and clinicians to consider seriously the
unique contribution of the body scan in both MBSR and
clinical practice.
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