A-Z of mental health
Information and advice on a huge range of mental health topics
A diary of mindfulness, week four - staying present
Posted Tuesday 16 October 2012
In the fourth in her series on mindfulness and depression, Clare blogs about staying present and identifying negative thoughts for what they are.
I've been writing a diary of my experiences of an eight week Mindfulness Based Cognitive Therapy course. You can see a list of the themes for the weeks, and a link to weeks one to three here.
Week four - staying present
Over the last week, I have been noticing and recording pleasant and unpleasant events as part of my homework for the course. Like before, I had to try and record the event itself, my bodily sensations, my emotions and my thoughts.
One of the things I found most interesting about recording unpleasant events was how the leader of the course had explained that we didn’t have to have ‘totally dreadful’ unpleasant experiences. Some of the experiences we record could be only ‘mildly unpleasant’ or even quite neutral.
I realised that pleasant and unpleasant events and experiences could be on a much more subtle scale than language enables us to describe. By taking time to become more aware of an unpleasant event and all the sensations and thoughts that came with it as it happened, I felt I was further getting to know my own mind.
I also found doing the breathing space three minute meditations three times a day really refreshing. It felt a bit like a ‘reset’ button, enabling me to step out of whatever was going on at the time. The instructor gave us a great metaphor for what the breathing space can do. Imagine we’re caught in a downfall of rain. Many of us will rush for shelter. We’re glad to be out of the rain for a moment - we hope it will stop so we stand undercover for a while. It becomes apparent we’re going to have to go back out into it - to face the thing we’re trying to avoid.
We could respond by going out into it cursing the rain, disliking the feeling of being wet, getting upset about how it is always raining - all of which is adding to our discomfort. Instead, another option is to stand there in the shelter, aware of the sensation of being a bit wet but not clinging to the hope the rain will stop. We can focus more closely on the rain itself and how it looks and splashes.
Taking brief shelter, or doing a breathing space, will not stop the ‘rain’, but can help us take a step back for a moment and change our experience going forwards.
For next week's homework, we were encouraged to combine these two activities - using the breathing space as a coping mechanism whenever we experienced unpleasant events. All the practice we had becoming more aware of pleasant and unpleasant events as they happen meant that we would be better able to identify the times when the rain was falling and a breathing space meditation might help.
The thoughts, emotions, sensations and behaviour interaction
In the feedback discussion around some of the homework, we got into further discussion about the interaction between our body sensations, our thoughts, our emotions/feelings and our behaviour. We talked about how these feed into each other if we are not able to take a step back using a breathing space meditation.
One of the course leaders gave one example of such an interaction. We wake up with particular bodily sensations, perhaps tired and achy and immediately start to think and ruminate, ‘I don’t think I’ll get anything done today’ and so on to ‘I’m useless, this will never change, another wasted day’. Unsurprisingly, these thoughts lead on to emotions and feelings of frustration, sadness, disappointment. We might feel depressed and irritable. This influences our behaviour - we cancel everything that day, we stay at home, we can’t sleep - and so next morning we have more tired and achy bodily sensations to deal with.
As I mentioned in my first blog, this is much more common among those who have been depressed in the past - we have more learned reactions and associations with moods or bodily sensations which means we slip more easily into the rumination and the spiral. They also said that a large percentage of people who end up being diagnosed with depression initially present to their doctor with aches and bodily pain. This is the part of the vicious circle that we more easily feel we can get help with.
At first, I could understand how thoughts and emotions interact, but struggled with the idea that bodily sensations could affect mood. But soon I realised that actually I had a really strong personal example. When I have the bodily sensation of ‘fat’, full or bloated, the feeling of my clothes on my body, especially if they are tight, can act as a trigger for thoughts about weight. ‘I’m fat’, ‘I’ve eaten too much again’, ‘I’m disgusting’. These then cause me to feel emotions of sadness, frustration and irritability with myself.
Learning to take a breathing space when I initially have that sensation helps me to identify the sensation for what it is, a transient bodily sensation, often after a meal or before my period. I can then stop myself going into the automatic spiral of rumination about it. Usually, when we have an uncomfortable feeling or bodily sensation, our mind tried to find a thought to hang it on - if instead you concentrate on the feeling itself, it stops the rumination having a chance to get in.
‘It’s not the right time for the moon’ - staying present
Next, our instructor talked about the moon. When we see the moon in the sky at night, we wouldn’t react by saying, ‘Oh no, it’s not the right time for the moon now.' Neither would we say ‘Ah the moon, I love the moon, I wish it was here more often.' The moon just is. If we say anything, it would be ‘Oh, there’s the moon.'
An interesting parallel was made here with our mind and how we react to events. We have a tendency, once we have become aware of an experience, to either chase after it (attraction) or to try and avoid it (avoidance). These can all start the rumination spiral as they involve a judgement about the type of event (pleasant, neutral or unpleasant) and then further thoughts. These can be either something like, ‘I hate this, I need to stop feeling like this, I can’t feel like this now’ or ‘this feels great, why don’t I feel like this all the time, I wish I did.'
We end up not being able to separate the initial experience from our judgement and thoughts about them. Staying present aims to take away judgement or expectation about events by neither becoming too attached to them, nor attempting to avoid them, but just experiencing the event as it is in the moment - ‘there’s the moon’ or ‘here is that sensation of feeling fat I sometimes get’.
The territory of depression
A further way of helping us get our heads around this section of the course was the next part of the session. This felt more like a basic education about depression, to help people recognise the territory of the illness and to see it as a whole. We were given a list of negative automatic thoughts that often appear in depressed people. I can only find an example of this online that links directly to CBT - but it was this sort of thing. Some of the examples that I recognised were;
- ‘I feel I’m no good’
- ‘My life is not going the way I want it to’
- ‘I’m so disappointed in myself’
- ‘What’s wrong with me?’
- ‘Something has to change’.
I’m sure you can come up with lots more. Part of the point of looking at this list was to see these thoughts as a much a part of depression as more physical symptoms such as fatigue or loss of appetite. It’s too easy to see feelings of worthlessness or other automatic thoughts like this as a personality failing rather than a symptom of depression.
Another point was to help us recognise the enemy. Mindfulness is helping us to become more aware of our minds and what they are doing. So when we become aware of these thoughts appearing, instead of believing them and spiralling into further thoughts and rumination, we can just identify them for what they are - ‘there’s that thought about something being wrong with me again’ - and perhaps take a breathing space to reconnect us with what is actually going on in the moment. This way we move away from acting as if they are true.
A radical new relationship
As we came to the end of the midway point of the course we were still also regularly practicing the body scan and longer meditations. We were learning to be more aware, to stay in the present rather than trying to avoid or becoming more attached to sensations. We were learning to ask questions of ourselves - ‘How are things right now?’, ‘What is going on in my mind right now?’, ‘What is going on in my body?’ Next session we would be introduced to what was described as a radical new way of relating to unwanted experience.
Clare
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.
14 Comments
-
One of the dangers of mindfulness is that we are not judging thoughts. However maybe it's good to be angry at the bankers?
Nick Clegg, although unpopular at the moment perhaps, used to do Transcendental Meditation (I'm not a fan but it has some similarities in regards to us transcending some of our reactions to thoughts, and therefore our emotions). He eventually gave up because he too realised that it is good to be annoyed at things that we SHOULD be annoyed at.
Mindfulness is the new opiate of the masses. I did the 8-week course (MBCT and MBSR) long before it became a fad. I have definitely seen it's downside for society. It might make the individual feel better but it can be destructive to society.
It might be good to develop some awareness of it's negative side! Also mindfulness teachers rarely mention that it is a potentially dangerous process for people going through a severe bout of depression. It can release a lot of suppressed emotions which could trigger a serious breakdown. Also people shouldn't practise meditation or mindfulness too much. Look up 'Zen sickness' to find out what some ancient masters knew about this process.
I'm not saying don't do mindfulness. It IS amazing. However be aware of the societal dangers as well as personal dangers.
-
Another good blog post, well done Fostress I am doing mindfulness at the moment as part of dialectical behavioural therapy for borderline personality disorder, still trying to come to grips with it really. When I tried to learn it a few years ago it was a bit of a disaster as I got chucked out the group and sectioned but I'm trying not to let that put me off (as I had a lot going on at the time and don't think it was specifically the mindfulness that caused problems). So far I liked looking at some candles exercise as I like candles, also I did some mindful knitting as homework which I enjoyed although my mind did tend to wander. Sometimes in the guided meditations though my mind goes to very dark places but I've been told this is normal at first and it should improve with practice.
-
Mike, interesting thought, and I agree in so far as it ties into the banal, individualistic, apolitical "happiness" agenda that is so promulgated at the moment. But I think action is perhaps better motivated by compassion and a sense of justice, rather than the white heat of anger.
-
That's interesting Mike - I'll have to read more about the potential societal dangers. I am not sure I agree that MBCT acts as an opiate to the masses at the moment but it's always good to read more. I also know that we were told that it is not for people who are in the midst of a depressive episode - it's designed as a maintenance programme to help prevent relapse. It's good to emphasise this though, as you say.
I would disagree that MBCT says we should try and avoid being annoyed or angry at anything or to 'transcend' our emotions and therefore push them to one side. Even though it uses some elements of mindfulness, I think it is more grounded in reality that some purely meditative practices.
I think it's aim is to help us better understand when our annoyance/ negativity about something is a result of depression, and when it is a result of something that we can change in the world. It helps us to take a step back from the experience of being annoyed or angry and so be in a better position to decide what to do about it.
As I understand, MBCT would say that if someone susceptible to depression is experiencing a feeling of annoyance or anger, they might well judge it - 'this is a negative feeling, here I am feeling annoyed again, I shouldn't be like this, I'm a bad person for getting annoyed so easily' and then try and push it away or let this spiral of negative thoughts move them away from the original feeling of annoyance and into more general negative thinking. MBCT suggests you to stay with the feeling of annoyance or anger and not try to push it away or let it cause other judgements or thoughts. This way, you are more able to take action on the feeling or thought itself without your mind being clouded by other negative and unhelpful judgements and thoughts.
The next four blogs in the series deal more with how we take these concepts and ideas of mindfulness and CBT and use them to act in the world - will be interesting to know what you think.
-
An excellent piece, although it would be brilliant to include some mindful physical exercise such as Tai Chi in courses like this. Otherwise it can be a bit 'top heavy'! By observing how we use the body we can greatly influence our physical health and as this is inseperable from our mental health would prove very useful
-
Hi Diana,
Yes, we had some people in the group who were finding the meditations difficult because they ended up finding their minds went to really dark places. At this stage the leaders encouraged them to keep on trying to pull their focus back to awareness of their body or breath. Later they talked about approaching and staying with the difficult experiences - but I am not sure if this is the same approach as you would take in DBT - glad you've got someone to support you there who can tell you how best to approach it.Candles seem to be a great way of focussing the mind - and they are generally really calming I find. Someone also suggested that it can be good to light a candle while you are doing a meditation as a way of signalling to yourself 'this is my meditation time now'.
Thanks so much for reading :) -
Great writing.
A point to ponder..
In a comment above you write:
"The next four blogs in the series deal more with how we take these concepts and ideas of mindfulness and CBT and use them to act in the world "
I've lived with depression for 35 years and I'm finally getting better doing the Oxford Mindfulness 8 Week Plan. I'm getting better because after 35 years I'm giving up trying to use "concepts and ideas...to act in the world". Each day I do a little mindfuling, letting go of concepts and ideas, and I seem to naturally react better to the world. The minute I get into my head and try to "understand" mindfulness I lose aliveness. As Werner Erhard said, "Understanding is the bobby prize". -
Hi Sussex,
That's a really good point - we did do some mindful exercises and walking as part of the course - but I didn't add it into the blog as they were already getting very long and I didn't know quite how to describe the exercises we did in a brief way. They seemed quite similar to what I understand of Tai Chi - steady long movements and holding positions. I definitely agree that they would also be useful though, as sometimes it can be harder to bring that awareness to your body when it is still.
We were also recommended to try and be mindful of any exercise or movement we were doing in our day to day lives - I try and focus on the movement of my body and breath when walking and running now.
Thank you.
-
I really can't understand why MIND is giving so much blogg space to this sort of thing. Yes, some people think they benefit from it, I suggest many would not have a clue what its all about. I feels to me like one of those middle class fads that come along,(like drinking bottled water do you remember that)? I suggest you start giving as much blogg space to the need for proper housing, welfare, and social justice. These in my opinion are just as (if not more) important to stable mental health. How many more weeks of this?
There thats me not pushing away my annoyance but thinking about it and channeling it positively as I take deep breaths.
-
Hi Concerned Citizen - I'm sorry you haven't found the series on mindfulness helpful so far. As you say, lots of people do tell us that they've found these sort of techniques really helpful in helping them to stay well. We know that not everyone can access these sorts of therapies, and hope that they can still find some tips to take away from the posts.
Of course, the issues you mention are vitally important and we try to cover a range of topics in the blogs. Recently, we've also been reporting back on the party conferences and publishing stories that demonstrate why we need excellent crisis care everywhere.
If there's a topic you'd be interested in covering for our blog then we'd love to hear from you, just drop us a line on digital@mind.org.uk
-
Hi Mindfuling - great point - MBCT is all about interacting directly with the experiences we are having, without letting thoughts and ruminations get 'in between' and lead us into negative spirals and depression/anxiety. Is your course purely Mindfulness based or does it have the cognitive therapy element too? So glad you are getting a lot out of it :)
I've been thinking this through and we do also talk about taking positive action as part of MBCT - not necessarily action that one would think the thought or experience dictates but more informed action based in what we know about ourselves.
To use the example in the blog above - if I have the feeling of tightness of clothes and bloatedness, I usually let thoughts and judgments straight in - 'i'm fat, disgusting, I always eat too much, I'm worthless' and end up feeling frustrated, low and angry. An uninformed action to this feeling of lowness might be to think 'right, i'm going on a diet, until I lose this much weight I am just ugly and useless' and to stop eating. In a sense it feels like this action is connected to the original feeling.
However, if I can take a moment to step 'out of the rain' and be more mindful of the experience I can think, 'OK I am feeling bloated and tight, and here are those thoughts about being useless I get when I feel this way.This is a transient sensation'. This helps me stop the rumination and to be in a better position to decide on a skilful response or positive action based on what I know makes me feel better.It is this sort of relation between our experiences and actions which I think MBCT encourages :) Thank you for asking me to ponder that - very useful!
-
Hi Concerned Citizen,
I echo Eve that I am sorry you haven't found them helpful - but I agree with her that a lot of people have and it is a good chance to help people get a sense of what it involves without having to attend a course - while these courses are sometimes being prescribed on the NHS now, they can be difficult to access for everyone.
But I would say that the good thing about the internet and websites is that you can publish a whole range of things and cater to loads of different needs. After all, Mind publishes a blog every day of the week as well of loads of other website content and campaign reports. People who find these ones helpful or interesting can read them and perhaps gain help and understanding and people who don't can ignore them.
This series is not replacing posts on any of the other issues you mention - which I would agree with you are fundamentally more important to universal human welfare and wellbeing. They are just sitting alongside them for those who are interested :)
-
Dear Eve,
I understand what you are saying and do not dispute this. reporting from party conferences is in my opinion a generalisation which does not give the emphasis on a certain subject such as the one above.
last week I read on your blog a number of people expressing how the emphasis on recovery and staying stable made them feel guilty and estranged. Many express pressure and stress in being cajoled into getting better or else to hide their true condition. I've heard it described as like having a cop in your head. And they were glad that others expressed what they were feeling too in describing their daily lives. According to mind over 80% of people with mental health problems are dependent on the state for their income. When you think of all the hassle, stress and anxiety that goes along with this I would have thought it would make it a priority for any representative body. All the blogs on welfare and social justice seem to get the biggest response here along with decent and fit for purpose services.
Clare Foster,
I'm not trying to belittle anything you are doing but in regards to your comment inferring that all kinds of issues get a fair amount of blog space I have to disagree. I say this as, I have not seen another subject on this blogg get and 8 week run as your has.I suggest mind asks its participants what other subjects they would like to see (if any) have a an 8 week run. No pressure just a suggestion as I was asked for. I would like to see welfare and social justice in light of mental health get a proper airing. I would like to see someone like Oliver James say (he of affluenza) who I don't fully agree with all the time do a series on what he thinks about mental health and social justice and the systems we have. Again just a suggestion.
Clare, best wishes for the future and I'm glad that others are getting help out of your blog.
-
Hi Concerned Citizen
Sorry if I was generalising in mentioning our reports from party conferences, I meant more that we try to cover a range of different topics in our blog. Benefits and welfare and the difficulty of coping with such an unfair system is certainly a priority - http://www.mind.org.uk/blog/filter/benefits%20and%20welfare
At the moment we’re encouraging our supporters to share the Hardest Hit coalition’s Tipping Point report, and email their MP to alert them to the shocking statistics about how much disabled people are struggling under the current system - http://www.mind.org.uk/news/7600_tipping_point_for_welfare_cuts
I agree that putting people under pressure to recover will leave them feeling guilty, and unable to talk about how bad they’re really feeling. Having said that, people also tell us that current mental health services and benefits/welfare often don’t give them the support they need to stay well, or build their resilience, and that’s something we need to take into account too. The blog can be a good place to share things that have helped people to cope, as well as their stories.
We do ask that comments stay on-topic to the original post, so we won’t be publishing any more around benefits/welfare. Thank you for your suggestions, and do email us at digital@mind.org.uk with any more feedback.
Commenting is now closed.