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A diary of mindfulness, week one - automatic pilot
Posted Tuesday 25 September 2012
After 11 years on varying doses of Citalopram, I’m looking to cut down, hopefully completely within two years. As part of this, I’ve been thinking about tools and techniques I can use to make the transition easier, and to help me manage my mind to prevent further relapse into the recurrent depression I’ve experienced in the past.
I’ve come to recognise the main components of my ‘mental healthy toolkit’ as exercise and getting enough sleep, but smaller tools play their part too - my SAD light in winter, my diet (brazil nuts, bananas and dark chocolate are all supposed to enhance mood), my writing, my crafts and my garden.
But, I felt there was something missing. I wanted to try and better understand what might be happening to my thoughts and attitudes, how these interacted with my low mood and how I could respond. I've had some sessions of counselling and tried online CBT in the past - but never in way that felt like it was creating and sustaining any real improvement.
It was while exploring these options that I returned to the Mindfulness based Cognitive Therapy for depression course at the London Buddhist Centre in Bethnal Green.
One of the most important parts of the course was the way it developed - each week our learning and understanding from the previous week was built upon and expanded. Learning to use mindfulness in this way is not something we can just be told. It's something we have to experience and practice, week by week.
I guess this is a particularly important point to make here too. While I hope to give people a sense of what MBCT is - and possibly some new perspectives or insights, reading about it is no replacement for doing a course and getting the practical experience.
I'll cover each week as we did on the course. I wanted to recreate something of this sense of building and discovery that we experienced. I would encourage you to read the eight posts in order - and stay with them.
So let's get started with the first week.
Week one - automatic pilot
Before the course started, we all got an email preparing us - explaining that we should expect to do at least an hour's practice and homework each day. It also said that the course wasn't really suitable for people who are in the middle of a depressive episode - it's designed to prevent relapse. It sounded like a big undertaking, but I was keen to get started. It felt like I might be about to discover something new about how my mind works.
The group was a large one, thirty people or more, and we met in a basement room at the Buddhist Centre. With green cushions on the floor and artwork on the wall, it felt like we were very removed from the bustle of Roman Road outside. Some people were obviously really quite anxious about the next eight weeks and whether they could 'do it', whereas others, like me, just seemed unsure about what to expect.
The leaders explained that we would be exploring helpful ways of responding to automatic thought patterns that can lead to relapse into depression in three main steps; developing awareness, being with our experience and choosing how best to respond.
Something they really emphasised was that it can take time for you to really understand the point of what you are doing. They encouraged us to stick with it and come each week, even if at the time we don't feel up to it, or don't see the point.
I think this was a really useful thing to be encouraged to do. As the course starts, it isn't always clear exactly how it will help. In addition, for people with a tendency to depression, the encouragement to just do something, to just put one foot in front of the other without thinking about it and questioning it too much can be really helpful.
We started by looking at dried fruit! We were each given a cranberry and asked to spend time exploring how it looked, its texture and its smell as if we had never seen one before. We were asked to put it in our mouths and see what that felt like and then, finally, to bite it, to chew it and to notice how that felt, before taking the conscious decision to swallow it. Give it a go with your next mouthful of food. For me, this opened my eyes to my tendency to wolf my food, eating fast without really appreciating it.
After we had done this, we talked about how it felt to be more aware of the experience of eating. The course leader explained how the activity helped illustrate, in a really practical way, how much of the time we spent doing things on automatic pilot, just behaving mechanically without really being aware of what's going on. In automatic pilot mode, often it is as if while the body is doing one thing, the mind is wandering off elsewhere.
She explained how this ‘autopilot’ can be difficult if you have suffered from depression in the past - as bits of negative thinking are more likely to go unnoticed, and slip into well worn grooves of thought processes that lead to stronger feelings of sadness. By the time these really surface, they are much stronger and harder to deal with. Another important thing she said was that, by being fully aware of an experience and how it feels, you can actually change the experience - in terms of the cranberry, this made a lot of sense - I have never tasted such a cranberry tasting cranberry as that one!
However, it’s worth saying that during this activity, another part of my mind was saying: 'I'm sick of looking at this cranberry, let's get on with it.' Initially I thought I was doing something 'wrong' here - but they explained the point was not to have any particular experience, but just be be aware of whatever our experience was.
The main thing at this stage was to realise how much of life slips by without us really being aware of what is going on. Missing out on the good means life isn't as rich as it might be, and missing out on the bad means we're not in such a good position to take action and depression can creep up on us. How to take action is what would come later in the course.
Awareness of the body
We explored this awareness in another way in the next part of the session - this time focused on bodily sensations with something called the 'body scan'. This felt more like a meditation. We lay on our backs and were guided through a process of being 'aware' of each part of our body in turn. They explained that our minds would wander while we did this, but when we recognised this, we should bring them back to just focusing on part of the body.
It was a strange experience; it's incredible how easy it is for your mind to wander off into default grooves of thinking, even when you are trying really hard not to let it happen. I expected something like this to be relaxing, but in fact it was a real effort to keep the awareness focused on the body, and to bring the mind back every time I realised it had wandered off into other thoughts.
What was interesting was that I started to get a glimpse of the processes my mind goes through as it moves through thoughts. I'd suddenly realise I had lost it again, that my mind had wandered from the body scan to thinking of something else, to a low feeling. Then I'd think: ‘Well how did I get here?’ At this point I could start to trace it back and see how I often jumped from one thought, to a more negative one, to a worry about something else.
After the body scan - which took about 30 minutes - we discussed it in smaller groups, and then all together. One of the things everyone found it hardest to get their heads around was the idea that there was no right or wrong way to do it. It's so easy to think that there are rules to follow and a way of succeeding or failing at the activity.
In fact, what the leaders tried to explain was that doing it 'well' was not the issue - we're not even trying to relax and it's ok to feel bored, or uncomfortable, or for your mind to wander. It's how you handle this that is important.
For now, we were given a number of homework activities. We had to do the body scan every day - without expectations - and make notes on how we experienced it. We also had to choose one routine activity in our daily lives and make a deliberate effort to do it mindfully, in the way we ate the cranberry. I chose cycling to work. We also had to try and eat at least one meal a day in a mindful way.
Next week, we were told, we would still be focusing on the first part of the course - developing awareness - but this time the focus would be on automatic judgements. I'll be writing about that in my next post.
Clare Foster
Clare writes her own blog on mental health, relationships and online youth support. You can follow her on twitter @fostress. She works on TheSite.org for YouthNet.
Read Week two: automatic judgments.
12 Comments
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I wish sombody could help I have had depresion for some time i live in a lbeautifull place but feel alone I wake up in the morning cryingand I am now on tablets I do not want to go back to england but do not know what to do my husband has demensa I have a few freinds here but what do I do will it ever go away I used to be a happy person but now I feel people do not want to know me because of thishas any one felt the same and got better
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Hi Jane,
Sorry to hear you are having such a difficult time - but it's great you've reached out for some help and support. It's often really hard to even take that first step so well done. If it helps, I have been through some really difficult, low and lonely times in the past but I do feel much much better now. I use lots of techniques like mindfulness, and exercise as well as some medication to help me manage my mood and stop myself relapsing. So it is possible to get through really hard times - even if it doesn't feel like it now.It sounds like you are looking for some support from other people in similar situations to you - this can definitely help you feel less alone and help you make sense of what you are going through. Are you on Facebook? Mind has a great community of people based around this page - https://www.facebook.com/mindelephant - if you add the Mind Elephant as a friend you can chat to people who are in a similar situation to you on there and get some support and suggestions. Hope this helps a bit.
Hugs,
Clare -
Hi Clare,
I recently got into Mindfulness after a bout of depression and have found it incredibly helpful. I have only read stuff though and never been to a class. Thanks so much for sharing this, its great! Has helped me realise I'm doing it right and looking forward to reading your future posts!x -
dear Claire,
i found this very intresting and shall be looking forwrd to your next blogg on the subject of mindfullness.
I am going to look in the local libairy for books on the subject, I am having CBT at the moment and am on anti depressantants, I really want to slowly come off these and have tools to cope with life. -
Hi Julie - thats so good to hear. It's more than anything about practice I think and just keeping on having a go - good to hear you're finding it helpful :) Hopefully these blogs will help give you some extra practical suggestions as well as some of the background. Let me know if you find the future ones helpful too and do drop me a line if you have any questions or suggestions/comments. Best of luck!
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Hi Joan - glad to hear you found it interesting - it certainly can be a useful tool to help you manage depression. This link has some suggestions of books that you might find useful - http://mbct.co.uk/mbct-books/ - see if your library can order any of them in :) Hope you find something useful!
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Clare's link to mbct.co.uk is spot on, but as someone using these resources professionally, I would say that Mark Williams' Mindful Way through Depression is probably the most accessible to the most number of people with depression and anxiety, and has turned around the lives of many people in my experience. His Finding Peace in a Frantic World is a good accessible introduction for the majority of folks who are simply having a tough time in the world we live in. Jon Kabat Zinn's Full Catastrophe Living is ideal for those struggling with chronic disease/pain etc. Nice column, btw...
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Thank you Tim, that's really helpful :)
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Dear Clare I am on antidepressants and about to embark on a course of CBT. I was diagnosed with recurrent depression by my local CMHT and then left to my own devices as I was 'in remission'. It didn't take long before a relapse and I have just got round to getting CBT after a lot of 'NHS red tape'.
I am aware that I need to live in the moment and your blog has reinforced this and given me food for thought. I dread getting up and being on autopilot .....tomorrow I am going to try the body exercise and the food consumption theory...every idea helps. This has been my longest episode to date and it is so inspiring to know that things will get better. I look forward to reading your blogs and will follow you on twitter.
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Hi there Jenna,
Well done for navigating all the red tape and getting some CBT, I hope it helps. I think you're right with the idea that 'every little helps' - for me it feels like the best way forward is to build your toolkit of things that you know help, even if only a little bit each. Together they can help you manage and keep moving forwards until things feel easier. Keep practicing the awareness and body scan, and hopefully the later blogs will help you to develop and use these skills to help recognise those negative thoughts and stop them from spiralling out of control and causing further relapse.
I also find exercise really valuable - I run, but even getting out for a short walk can be calming and help to get those endorphins moving. I wrote a bit more about this here - http://fostresswrites.blogspot.co.uk/2012/06/running-stops-my-thoughts-running-wild.html.
All the very best - you're not alone :)
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My wife has navigated the red tape and has managed to get some CBT in a couple of weeks time. Given that she has had these inner feelings brewing for sometime now which has pushed us further and further apart, what can I practically do to help? It has got to the stage where I feel myself sliding into negativity as I see the person that I love moving away from me
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Hi Mark,
Good to hear your wife is getting some CBT - and she's lucky that you are looking for help to support her further. Managing mental ill health within a relationship, whether yours or your partners can be a real struggle - as it can feel as though it affects every part of your life. But there are things that can help.
It can feel like your wife as a person and the inner feelings she has that are caused by the depression are one and the same. I find it helpful to identify the 'depression' as something separate which you and her are together in fighting. Sometimes it can come along and make her feel or behave in a particular way - but by talking about it you can help recognise together that this is the depression talking. Being able to identify it like this and work out how it makes her behave and what kind of support she needs when it comes along can help you to separate the feelings and emotions it causes from your relationship itself.
For example, I get very needy when I am depressed - but as I have explained this to my partner, I am able to say "I'm feeling foggy and depressed today, it's making my head spin off in all sorts of weird ways and I am probably going to be a bit more needy than usual". In turn, he is able to support me, knowing that my behaviour is a result of depression and not caused by him.
Fundamentally, asking her how she feels and what she needs from you when she feels this way is the best way of finding out the practical support you can offer.
You might also find it helpful to read as much as you can about depression to help you understand what your wife is experiencing. Mind have some information here; http://www.mind.org.uk/help/depression_and_anxiety.
Later on in this blog series, I explore suggestions of how a partner can help you identify when you are relapsing and how they can help you take positive action to prevent it.
I hope this helps a bit. Best of luck.
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