Mindfulness-Based Stress Reduction

July 29, 2014 By Susan O'Grady 4 Comments

The Present Moment and Transformation

Research reported in the respected journal Science, in an article titled “Just think: The challenges of the disengaged mind” by Timothy D. Wilson et al. (345, 75 [2014]), presented results summarizing 11 studies where participants were first given an electric shock; all participants admitted that the shock was unpleasant, and said they would pay to avoid it. Researchers then asked the subjects to sit in the empty room and entertain themselves with their thoughts without cellphones, iPads, or other distractions. There were only two rules: you can’t get out of your chair, and you can’t fall asleep. Participants did have the option to press a button and receive a shock again.

The mind is its own place, and in it self

Can make a Heav’n of Hell, a Hell of Heav’n.

John Milton, Paradise Lost

Very much to the researchers’ surprise, the study found that 70% of the men and 25% of the women chose to shock themselves instead of just sitting there with their thoughts—remember, for no more than 15 minutes.

Researchers ran the test in a lab with college students, but also with older subjects (recruited from churches, farmer’s markets, etc.) in their homes, and they tried to replicate the study with a wider sample of people minus the electric shock. They found that these folks also had difficulty sitting still for 15 minutes alone to entertain themselves with their thoughts. Over half the people admitted to cheating by using their phones. The majority said that hated the experience—it was boring.

What is going on here? Why is it so hard to entertain ourselves with our thoughts that people will actually resort to painfully shocking themselves just for something to do? Why not just stay in the moment and wait it out? Partly, reflecting back and looking ahead are just human nature, something our big brains allow us to do and a big reason for our evolutionary success. Because we can think ahead and formulate goals, or review the past and learn from it, we can accomplish stunning achievements like writing novels, building bridges, and curing diseases (not to mention more ordinary but still essential accomplishments like saving for retirement). But that’s not the whole story.

While being past- or future-minded can have benefits, it’s clear that mindfulness—staying in the present moment—offers essential benefits as well. The present moment is the only one that truly exists. It’s only in the present moment that we can feel peace, fulfillment, and harmony. And it’s only in the present that we’re free to choose. That’s why people meditate and why so many religious traditions include some kind of mindfulness exercise.

But researchers in the study found that even subjects who had experience with meditation and mindfulness found it only slightly easier to sit still without distraction. I’ve found this in my own practice. When I explain mindfulness to my psychotherapy clients, they understand the concept and its value on an intellectual level, and may even experience a sense of pleasurable release during some meditations. Even though my clients have come to me for help in dealing with life’s burdens, and even though they get good results from meditating, it’s still not easy for them to practice mindfulness regularly.

So, what comes up for people when they sit alone with their thoughts? We experience restlessness, discomfort, boredom, and irritation. Sitting in stillness, letting moments come and go and staying with the quiet space, gives room to encounter the self. We come face to face with our anger, our envy, our jealousy and our pride. Those feelings are unpleasant and it is easy to want to be quickly rid of them. Switching the channel in our mind to a diversion such as a show, a game, or a piece of chocolate cake takes us temporarily away from the difficult emotion. We don’t want to feel like a jealous person, for example, because that gives way to other feelings such as guilt—which makes us feel worse. Our self-concept takes a beating when we give it time in the quiet moments.

But if we are to enlarge our Self and be fully alive, we have to face the darker sides. As Goethe writes in “The Holy Longing”:

And so long as you haven’t experienced this: to die and so to grow,

you are only a troubled guest on the dark earth.

To be at home on earth, learn to sit with yourself in the present moment.

May 17, 2014 By Susan O'Grady 2 Comments

How Wisdom Emerges from Body-Scan Meditation

Mindfulness Meditation: Using the Body Scan as a Focus

Body-scan meditation focuses deliberate attention on the body without judgment or wanting anything to come from it. This isn’t a traditional relaxation method; people may feel peaceful, but they can also feel antsy, impatient, irritated, and hungry. That’s the point: You can experience these feelings, thoughts, and sensations without needing to take them further. Just notice, and then move on to the next part of the body.

With physical pain, for example, our thoughts might go something like this: “My back hurts, that muscle ache could be a spasm or what if it is bone cancer, maybe I should have an MRI, or maybe I need to go to a chiropractor, but that could mean I have to go three times a week, how will I get off work? My wife is going to be mad at me for spending the money, but then, damn that! If I’m hurting, then I need to get out of pain. She has no business keeping me out of the doctor’s office. I deserve to spend money on me sometimes. Just like when I was a kid, and my mother didn’t take seriously the pain in my arm, and it was broken! I went for weeks before she took me to the doctor… ”

The thoughts go on like that. Before you know it, you’re fuming; your body is more tense than when you began. You feel irritation not only at your wife, but your mother, the medical system, the ACA, and your insurance company. You probably feel sorry for yourself. All that strong emotion gets internalized into your pores, your muscles and sinews, and your heart. Your focus on your body ended ten minutes into the 45-minute practice: all you can think about is getting up and googling “back pain.”

A mindful alternative might go like this: “My back aches, oh, okay. It hurts now, that is how it is right now.” And then you rejoin your yourself, and think, “Noticing my right shoulder…noticing the feelings present there…I bring my attention to my right arm, noticing what is there to be felt…” At the end of the body scan, you open your eyes and realize that you have stayed with the practice for most of the 45 minutes. Your mind wandered, but you didn’t end up becoming angry with your partner, your mother, the medical system, and your poor luck.

Living with all our emotions can be difficult. It’s not uncommon for feelings to be transformed into physical sensations that can very possibly develop into an illness. You didn’t cause the illness, but being in prolonged or frequent physical and emotional turmoil puts the autonomic nervous system (ANS) into a constant state of over-arousal, a kind of hyper-drive that leads to difficulty sleeping, tense muscles, fretting, and worry.

In his poem fragment “Eternity,” William Blake wrote about the elusiveness of joy:

He who binds to himself a joy

Does the winged life destroy

He who kisses the joy as it flies

Lives in eternity’s sunrise.

Happiness studies show that no one is happy all the time. In the same way, wisdom is not always with us. We have moments where it all comes together, and then it disperses again. Focusing on the body with awareness is a way to allow wisdom to emerge without trying.

How does wisdom enter in? In the second, alternative, body scan you notice the pain in your back, move on, and finish the practice. You’re more rested because you didn’t get attached to any one thought. Then sometime later in the day, you do a kindness to yourself. You think, “I’m feeling some ache in my back; I’ll listen to my body over the next day and see if I should pursue it further. But for now, I’ll take care to not overdo the wedding, and to come inside and rest.”

That is wisdom. It’s not Socrates, or Jesus, or Buddha; it’s your own wisdom that emerges because of your kindness to yourself, and because you didn’t let yourself go down the rabbit hole of your thoughts.

Below is a thirty-minute Body Scan Mindfulness Meditation. It is one of the first meditations used in Dr. Kabat-Zinn’s Mindfulness-based Stress Reduction class (MBSR) and is also a core meditation used in Mindfulness-based Cognitive Therapy (MBCT). It is best done laying down, with your eyes closed.

Body Scan Mindfulness Meditation

September 21, 2013 By Susan O'Grady 2 Comments

How to Survive a Rip Current of the Mind When Practicing Mindfulness Meditation

Ruminations and Worry Make Meditation and CBT Difficult

Recently during a visit to Hawaii, I read a pamphlet on ocean safety that described how to survive a rip current. They can travel 1-8 feet per second, meaning that in an astonishing 8 seconds, you could be carried sixty-four feet out to sea! The instinct is to fight the rip, which only makes it worse because fighting something that powerful is exhausting. After exhaustion comes panic, and in gulping for air, swimmers choke on seawater.

In mindfulness training, we talk about letting thoughts pass away like waves in the ocean. But what if your mind gets caught in a rip current? When the waves are so turbulent that they produce the conditions ripe for a rip?

Surviving a rip current depends on doing something that is contrary to instinct. The key is not to fight the current but to understand it and go with the flow—while at the same time, swimming across the strong current, parallel to the shore. Find a spot where waves are breaking on the shore, and let yourself be carried back to the beach by the same ocean that took you away. If you are unable to swim diagonally to the shore until the waves carry you back, then relax and let the current carry you out: it will eventually lose strength and, if you have conserved your energy, you can swim back.

The same instructions can be applied to mindfulness-based cognitive therapy. Many people come to mindfulness meditation, or Mindfulness-based cognitive therapy (MBCT) or stress reduction (MBST) depressed, anxious, or dealing with panic disorders. Asking them to sit still and silently focus on their breathing is an enormous task. We talk about letting thoughts pass away like waves in the ocean, but what if your mind gets caught in a rip current? Often, the thought stream is too strong for the breath to anchor them, and MBCT clients get carried out to sea by their ruminations and worries.

When the mind gets carried away in a panicky current, it feels as if there is no escape. At those moments, the urge is to give up, even to quit the practice. So, when feelings threaten to overwhelm you during meditation, turn to wisdom learned from the sea.

Remember that a rip current doesn’t pull swimmers underwater; it carries them away from shore in a narrow channel of water. When your mind begins to ruminate, think of the thoughts as a channel, not the whole ocean. That channel can be overcome by allowing yourself to relax and accept the strong pull. Fighting it will wear you out. Notice where the shore is, pay attention to the flow of the water as it moves to the shoreline, and think of your body as the shore, grounding you. You are solid and firm. Ruminative thinking, like the rip current, will lose its strength eventually, and you can return your focus to your breathing. Each time you resist your instinct to fight the overwhelming thoughts and just accept them, you will be training yourself to be a stronger and smarter swimmer.

How to Survive a Rip Current

Remain calm, do not panic. Should you find yourself caught in a current that’s taking you away from where you entered the water, remember that panicking will only tire you.

Go with the flow. Do not attempt to fight the current. You will almost always lose the battle. Swim across or perpendicular to the current’s direction.
Wait until the current releases you. It will.
Swim parallel to shore and then make your way in.

From KORC (Kauai Ocean Rescue Council)

May 4, 2013 By Susan O'Grady 1 Comment

How Mindfulness Can Reduce Stress

In 1979, Dr. Jon Kabat-Zinn founded the Stress Reduction Clinic at the University of Massachusetts Medical School—the oldest academic medical center-based stress reduction program in the west. In response to inquiries about the clinic’s eight-week course, Dr. Kabat-Zinn wrote Full Catastrophe Living (1990), a the seminal book on mindfulness practice that has spawned numerous offspring, including mindfulness-based cognitive therapy (MBCT), dialectical behavior therapy (DBT), and acceptance and commitment therapy (ACT.) Mindfulness practices have made their way into schools, prisons, business, hospitals, and health clubs. Psychologists and researchers have explored combining cognitive therapy and mindfulness to help depression, anxiety, and medical problems. Given the ubiquitousness of the practice, it is important to understand what it is, and what it is not.

I have always considered the title of Dr. Kabat-Zinn’s book unfortunate. The title suggests that life is catastrophic, but the book is really about living well with the ordinary stresses of life. In his introduction, Dr. Kabat-Zinn tells the reader why he choose the title:

I keep coming back to one line from the movie of Nikos Kazantzakis’ novel Zorba the Greek. Zorba’s young companion turns to him and inquires, “Zorba, have you ever been married?” to which Zorba replies, “Am I not a man? Of course I’ve been married. Wife, house, kids, everything…. the full catastrophe!”

But despite Zorba’s responsibilities and multiple roles, he lived his life with gusto, very much in the moment. “’Just now I’m thinking of the chicken and the pilaff sprinkled with cinnamon,’” he tells the narrator. “’Everything in good time. In front of us now is the pilaff; let our minds become pilaff. Tomorrow the lignite will be in front of us; our minds must become lignite! No half-measures, you know.” Whether considering the pleasurable dinner or the difficult work, Zorba gave his mind to what was in front of him, never just being a spectator of his life.

We all have stress. As Michael Baime, director of the Penn Program for Mindfulness at the University of Pennsylvania Health System, put it recently:

“Stress doesn’t go away, ever. That’s why we call it stress management rather than stress elimination…in practicing mindfulness you create a world where you experience depth, meaning and connectedness. You see joy and sadness more fully and settle more deeply into an authentic way of being.”

Learning to Live With Stress

There are no avoiding daily hassles, relationship conflict, money worries, and health concerns. Yet by living side by side with our stress, we come to know ourselves more deeply. In mindfulness practice we learn to sit with uncomfortable feelings in a non-judgmental way and thereby develop the ability to tolerate the difficulties of life with more equanimity. The practice of observing our thoughts without getting wrapped up in them gives us the ability to bring insight to thoughts, feelings, and perceptions. By bringing our focus back to our breathing each time we notice our minds wandering, we learn to stop ruminating and obsessing, which will eventually help in reducing symptoms of anxiety and depression.

August 29, 2012 By Susan O'Grady 3 Comments

The fullest experience of the adventure of life: Eleanor Roosevelt, Blogging, and Mindfulness

I just returned from Rhinebeck, NY, where I took an intensive professional training course in Mindfulness-Based Cognitive Therapy (MBCT) for the Prevention of Depression Relapse. The five-day course was developed for health-care professionals who already have experience with mindfulness-based approaches.

Many years ago, I studied Mindfulness-Based Stress Reduction with its developer, Dr. Jon Kabat-Zinn. Since that time, research has continued to demonstrate the effectiveness of mindfulness training in treating many forms of emotional difficulties. Offspring treatments that involve mindfulness as a major component to their treatment protocol include Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Mindfulness-Based Cognitive Therapy (MBCT).

Taking a course in MBCT gave me the opportunity to study with one of the major researchers and writers in the field. It was given by Zindel Segal, PhD, and Susan Wood, MSW, LCSW. Dr. Segal is the author of Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse, 2002, The Guilford Press.

While the course was valuable and added to my skills in teaching this treatment approach, the highlight of the trip was my excursion to Val-Kill, the unpretentious, comfortable home of Eleanor Roosevelt. Just down the road in Hyde Park, NY, stands the opulent estate of her husband, Franklin Delano Roosevelt. Ms. Roosevelt created her separate home in a style that reflected her sensibilities, not those of her husband. Set among trees and brooks, the house contains simple furniture and cozy, intimate rooms.

I was fascinated to learn that Eleanor Roosevelt was a kind of pioneering blogger extraordinaire. She wrote a daily letter to Americans that came to be called “My Day,” one of the most popular syndicated columns of the time. She wrote her column six days a week, often dictated in any free moment she found. She published over five hundred words per column, at least six days a week for 26 years from 1936-1962. Personal as well as socially relevant, her work communicated her thoughts, joys, and intimate concerns.

As a beginning blogger, I have wondered about my urge to write. In a previous post, I talked about how this form of writing allows me to take my many years as a psychologist and put words to this experience that can go beyond the confines of my confidential private office. Social media has provided a means for anyone to make his or her thoughts and opinions public, taking journaling to a new level—but not an unprecedented one, as I saw by Eleanor’s example.

Pleasant and Unpleasant Events Calendar

I often suggest that my clients journal. Collecting thoughts and feelings by observing them and taking the extra step to write them down allows insights to emerge. In MBCT, one of the first homework exercises is to write a daily note about a pleasant and an unpleasant experience that occurred during the day. By noting the thoughts, feelings, and sensations associated with such experiences, we bring mindful awareness to daily life. This can allow us to experience and appreciate the moment simply as it is, without adding further elaboration in the form of wishing, dreading, or judging. It is often our mental elaboration that triggers rumination, a common symptom in depression. We can begin to realize that even unpleasant events can be tolerated. Bringing awareness to each situation, whether we label it good or bad, is an important step in learning to relate differently to them. This takes practice. And curiosity.

The Fullest Experience of the Adventure of Life

As Eleanor Roosevelt writes in You Learn by Living: Eleven Keys For a More Fulfilling Life, “There is no experience from which you can’t learn something. When you stop learning you stop living in any vital and meaningful sense. And the purpose of life, after all, is to live it, to taste experience to the utmost, to reach out eagerly and without fear for newer and richer experience. . . . The experience can have meaning only if you understand it. You can understand it only if you have arrived at some knowledge of yourself, a knowledge based on a deliberately and usually painfully acquired self-discipline, which teaches you to cast out fear and frees you for the fullest experience of the adventure of life.”

Being attentive to thoughts and writing them down takes discipline. When keeping a journal (or a thought record of daily events, or writing a blog) our life experience is enlarged and enriched. For people struggling with depression, being able to notice even slightly positive things during the day allows them to see that such events are already there for them. For some, it may be noticing the song of a bird, or the stars on a clear night—these simple experiences are always within reach, but for someone who struggles with depression, they go unattended. Writing is a vehicle of self-expression.

References:

Roosevelt, E. (2001). My Day: The best of Eleanor Roosevelt’s acclaimed newspaper columns, 1936-1962. D. Emblidge (Ed.) Cambridge, MA: Da Capo Press.

Roosevelt, E. (2011). You learn by living: Eleven keys for a more fulfilling life. New York: Harper Perennial.