Internal or External? Rethinking Mindfulness in Clinical Work
According to Mindful.org, mindfulness is the “basic human ability to be fully present… and not overly reactive or overwhelmed.” Psychology Today calls it “returning to the present moment.”
My definition, up until last week?
Sitting in the lotus position.
Hands on my knees.
Light humming optional.
Channeling Julia Roberts in Eat, Pray, Love.
I taught mindfulness techniques to my grad students — but rarely used them with clients.
Mindfulness? Not my thing.
And then a twenty-minute conversation changed everything.
The Question That Shifted Everything
This person asked me:
“Where is your focus?”
My sarcastic internal answer was:
On this conversation… obviously.
But the real questions were deeper:
Are you here right now?
Are you heart-centered?
Are you internally focused?
Or is your attention on the external world?
Ouch.
Because in that moment, I was listening… but also waiting for a sales pitch.
And keeping an eye on the clock.
And thinking about my next client.
When my ego recovered, I shut down all screens.
And something shifted.
Pause for a Minute — Where Are You Focused?
Right now, where is your attention?
Your to-do list?
Your next session?
Your notifications?
Your fatigue?
Your stress?
Your social media scroll?
Most of us live externally focused — pulled toward noise, responsibilities, and the constant pressure to keep up.
But the definition that finally resonated with me?
The one from Jon Kabat-Zinn:
“The awareness that arises from paying attention, on purpose, in the present moment and non-judgmentally.”
That’s mindfulness.
Mindfulness as Ethical Practice
Mindfulness isn’t about meditation.
It’s about intentional, wholehearted presence.
It’s:
Listening in the moment
Noticing your internal world
Being aware of your self-talk
Managing your emotional reactions
Remaining connected to the person sitting across from you
Yes, ethically, we strive to do this with every client.
But we’re also human.
There are days we are:
Exhausted
Distracted
Anxious
Crispy
Stressed about home life
Overwhelmed by external noise
On those days, being fully present requires effort… and awareness.
Because when your internal world goes unnoticed, your clinical presence is impacted — whether you see it or not.
Why Internal Awareness Matters
Your internal state influences:
How you interpret your clients
How you view your role
How compassionate you can be
How patient you feel
How you maintain boundaries
How you handle stress
How you show up
Mindfulness helps you reconnect with the internal space needed to practice wholeheartedly.
It’s not about perfection.
It’s about awareness.
If perfectionism or emotional overwhelm keeps pulling your focus outward, the Perfectionism Workbook can help you reconnect with your grounding truths, challenge internal pressure, and return to presence.
If you’re ready to dig deeper into your story and start showing up as your most authentic self, therapy can help.
I offer online therapy for helping professionals, busy professionals, and therapists who are ready to reconnect with their worth and live with greater balance and clarity.
Learn more about online therapy with Melissa Russiano or schedule a free consultation to see if we’re a good fit.
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