In my 15 years as a therapist, I’m used to clients arriving with a specific target: a relationship problem, a painful memory, an anxious or catastrophic prediction, or a harsh inner critic. They usually want to change what they are experiencing. But real breakthroughs rarely happen by changing the content of our experience; they happen when we change how we relate to it. It’s not what I’m thinking, but how I’m relating to what I’m thinking that matters. It’s not what I’m doing, but how I’m doing it. Before I was trained as a clinician and learned mindfulness, this distinction had sounded like a technical, almost superfluous, unnecessary, and philosophical footnote. Now I know it may be one of the most clinically significant, but subtle insights I’ve learned across 15 years of professional and personal practice.
The “How” in Mindfulness
I first encountered this while studying and practicing mindfulness, originally in 2013 at Spirit Rock. Mindfulness is, as Jon Kabat-Zinn would say, the awareness that arises through paying attention on purpose, in the present moment, curiously, acceptingly, and nonjudgmentally. In workshops, attendees (including myself) often wanted to know what to pay attention to. They wanted content. In mindful practice, however, content matters far less than the quality of attention itself.
The mechanism most consistently linked to mindfulness outcomes isn’t relaxation, mental peace, or stress reduction. It’s decentering. Decentering is the ability to observe thoughts and feelings as temporary rather than true reflections of reality and self. In decentering, you are not changing your inner world. You are changing your relationship to your inner world.
As noted, the content of experience can remain exactly the same. What shifts is the angle of engagement. There is a profound difference between being trapped inside a storm and watching it pass from behind a window. In mental health work, we often exhaust ourselves trying to change the weather of our experience. But the secret to well-being isn’t changing the storm; it’s learning how to step behind the glass and observe.
This isn’t just one of my clinical observations; the research confirms this as well. Fuochi and Voci (2024) found that decentering suppressed the association between negative emotions at one point in time and negative emotions in the future, effectively interrupting patterns that would otherwise compound into greater distress. A separate study published (Wang et al., 2024) confirmed that decentering functioned as a significant mediator of the relationship between mindfulness and psychological suffering across both cross-sectional and longitudinal designs.
None of this is really about meditation or technique. It’s about something much more fundamental: whether we are inside our experience or able to watch it. Mindfulness training is thought to increase metacognitive awareness, the ability to decenter from one’s experience and view it as passing events, rather than to identify with it or believe it to be entirely truthful representations of reality. How you hold a negative experience is different from what it says. Most of us spend copious energy trying to change our inner lives and almost no time examining the stance with which we’re engaging with it.
The “How” in Therapy
In my clinical work, this shows up constantly. A client arrives convinced that if they could just resolve the right issue or reach the right conclusion, their suffering would lift. Often, what’s actually available to them isn’t resolution but a different relationship to the uncertainty itself. Process over content.
I primarily practice as an EMDR therapist. In EMDR Therapy (a mindfulness-based therapy), the client’s relationship to the trauma changes significantly as treatment progresses (not the factual, past traumatic events themselves). Zooming out to therapy in general, research has arrived at a similar conclusion. Decades of process-outcome data found that relational processes in therapy showed a significantly stronger association with outcome than the technical. A pioneer in this research, Dr. Sean Davis—one of my mentors from graduate school—consistently emphasized this paradigm shift in our training. The what of treatment, the particular model, reliably predicts less than the how of treatment, the quality of the relationship holding it. Over decades, repeatedly and seemingly intractably: the therapeutic alliance continuously emerged as the most robust predictor of outcome, across virtually all therapy models (Davis, Lebow, & Sprenkle, 2012; Saxler et al., 2024; Sprenkle, Davis, & Lebow, 2009).
This means that when I’m sitting with my clients, the type of therapy I’m applying matters considerably less than how clients feel I’m meeting them. As I wrote about previously, who your therapist is and how they show up with you matters much more than the model their model. Specifically this can come down to how safe, heard, and understood you feel with them, and the overall level of collaboration and productivity in the relationship over time (regardless of therapy model).
Mindfulness Essential Reads
Conclusion
What I keep learning as a clinician and daily meditator is that presence is a quality of attention, not a checklist. The task isn’t to eliminate negative experiences, thoughts, and/or feelings, but to notice what’s arising and then gently return attention to the present moment. That practice, repeated thousands of times, changes not just how you relate to yourself but how you relate with others.
Most of us spend our lives fighting a civil war inside our own heads. We often treat a negative thought like an intruder to be argued with, managed, or evicted. But what if the problem isn’t the thought itself, but the fact that we are fighting it at all? The invitation isn’t to stop caring about content. It’s to notice that you’ve probably been optimizing for the wrong variable.
What can you slow down and curiously observe today? What can you savor today?
