KC MINDFULNESS

Thanks to visitors

Thanks to all visitors and those who are interested in mindfulness practice. I am currently on sabbatical and not offering training or psychotherapy services. Please contact the Center for Mindfulness at the University of Massachusetts Medical Center to locate an MBSR teacher or MBCT psychotherapist near you, if you are interested in learning more.

FAQs: Meditation, Mindfulness, Psychotherapy, and Buddhism

1. Is "mindfulness" the same as "meditation"?

"Mindfulness" is not identical with "meditation," but they are closely related. In the realm of mental health treatment and stress reduction, "mindfulness" is a way of training the mind to develop a different (and less reactive, less distressing) relationship with thoughts, feelings, and sensations. And this training is done through the practice of meditation. For a longer discussion about these two concepts and how they are related, click here.

2. Isn't there something religious about meditation? What if I am not religious, or not Buddhist?

The practice of meditation is common in many religious traditions. However, it has long been recognized that there are non-religious forms of meditation that can simply be considered attentional and awareness training methods. In the 1970's, Jon Kabat-Zinn developed his Mindfulness-Based Stress Reduction (MBSR) program, using a secular (non-religious) form of "mindfulness" meditation as the core intervention. Tens of thousands of people, of all faiths (or of no religious faith), have completed and benefited from the meditation training used in MBSR.

3. I don't think I can meditate. My thoughts keep racing, and I don't find it enjoyable.

Many people begin or attempt a meditation practice, believing that it will be enjoyable, and/or believing that in order to meditate, you must be able to stop thinking. Neither of these ideas is helpful. Meditation is about learning to compassionately observe all phenomena, including our own thought processes, feelings (pleasure, agitation, whatever they might be), and urges (such as the desire to move around, or to scratch an itch, or to get up from our seat and do something else). It's really not about trying to control or eliminate our thoughts, feelings, or urges. Meditation is a practice, much like practicing a musical instrument, or learning a new skill of any kind. It may or may not be easy, or enjoyable, but in the long run, it is very beneficial. For a longer discussion about these ideas, click here.

4. Why should meditation be a part of psychotherapy, anyway?

Psychotherapists (and researchers in psychology, psychiatry, and neuroscience) have begun to incorporate meditation into psychotherapy (and to do research on how that works), because training in meditation has been linked with: improvements in mood (depression); reductions in anxiety, and in compulsive or addictive behaviors; improvements in capacity to pay attention; and many other positive results. For more information about meditation, and research into the benefits of meditation, click here and here. Also, click here for a good explanation, written by Dr. Kalea Chapman on his blog.
 

5. What kinds of problems are addressed with mindfulness-based psychotherapy?

This type of treatment can be helpful for a wide variety of presenting problems, including symptoms of depression and/or anxiety; situational stressors (relationship, family, and job problems); behavioral problems (anger, compulsive behaviors). An initial consultation with a competent psychotherapist is essential, for determining what type of treatment might be best for you.

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Meditation: Sounds Great... But Not For Me??

Image by shankargallery via Flickr

Recently I was with a group of lawyers, hearing a presentation about mindfulness. There were about 20 or 30 lawyers in the room; they seemed interested and receptive, but perhaps still a bit skeptical, or puzzled, about how mindfulness and/or meditation might be helpful or even applicable to their work. One man raised his hand and put the question very simply and baldly: "But, we're lawyers!" He didn't elaborate on that comment/question (or was it an objection?), but I think most of us in the room had an idea of what he seemed to be saying, and it might be paraphrased, thus: Lawyers are trained to be critical thinkers. If we teach ourselves to be "mindful," might we also be giving up a large part of what makes us effective?

I think it's a very good question. It reminds me, once again, that meditation carries quite a lot of baggage along with it, part of which is the idea that it is a sort of fuzzy, or "touchy-feely", way to avoid reality. There is a pervasive caricature of the meditator as a blissed-out navel-gazer, off on a mountain top, away from the nitty-grittiness of ordinary life. And there are meditation methods that do encourage the cultivation of a sort of trance state... however, mindfulness meditation is not one of those methods. In fact, training in mindfulness, including meditation practice that places a strong emphasis on awareness and attention, is much more about waking up to what is real, than it is about avoiding, or ignoring, or running away from what is real.

Lawyers (and people in all walks of life!) need to have their wits about them, and they need to have the capacity to attend closely and accurately to all data being presented to them. They need to be able to engage in effective emotion regulation, so that they can remain effective, even in highly emotional and stressful circumstances. And they need to be able to live with the chronic stress that is the practice of law (and life) without self-destructing, getting sick, or hurting their own families, clients, and friends. Training in mindfulness, including the practice of meditation, can be helpful to people in any professional discipline or line of work; since I am a lawyer, myself, I am especially attuned to the ways in which mindfulness can be helpful to lawyers. I am personally aware of the types of stressors that afflict lawyers... I was a trial lawyer and lived (and sometimes suffered) with the intense emotions of trial preparation, being in trial, and the aftermath of trial.

"Mindfulness" just means learning to consistently pay attention to what is around and within us, and to do so clearly and non-judgmentally. Research seems to indicate that training and practice in mindfulness (including mindfulness meditation) results in lower levels of depression and anxiety; enhanced capacities for attention and emotion regulation; and improved capacity to resist the destructive effects of acute and chronic stressors. And there is nothing about any of this that involves getting blissed-out, or detached from reality. I recommend mindfulness training for lawyers (and mediators and judges) because I think it will help them to be more effective, less reactive, and better capable of dealing with stress.

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What is Mindfulness-Based Cognitive Therapy?

Image via Wikipedia

 

Very much like Mindfulness-Based Stress Reduction (MBSR; see the page about MBSR, here), Mindfulness-Based Cognitive Therapy (MBCT) is usually conducted in a group format, with 8 weekly sessions, each lasting 1.5 or 2 hours. There is also an all-day retreat, about half-way through the course of sessions. Participants are expected to engage in "homework" (see the page about homework, here) between sessions, which can consist of up to an hour of mindfulness practice and exercises, and some writing (and record-keeping) about their experiences.

MBCT may suitable and helpful for individuals who are experiencing a variety of uncomfortable mood (depression) and/or anxiety symptoms. An initial screening interview and orientation session is always scheduled before a potential patient is entered into a MBCT group. [Note: no participant is placed into a MBCT group without an initial screening to determine whether MBCT would be an appropriate form of treatment or intervention].

MBCT was originally developed as a method of preventing relapse, for people who have suffered from serious depression. The three psychologists who developed MBCT (Segal, Williams, and Teasdale) became convinced that there were ways to teach people to relate differently to the thoughts, emotional states, and physical sensations that sometimes precede a full-blown depressive episode. They believed that, by doing so, they could actually prevent the re-occurrence of depression (a very significant goal, since Major Depressive Disorder frequently is characterized by relapse). These scientists were well-versed in the prevailing model of cognitive therapy, in which people are taught to recognize and "restructure" inaccurate, counterproductive, and self-defeating thoughts; and they were also aware of Jon Kabat-Zinn's work with Mindfulness-Based Stress Reduction (MBSR). They were intrigued by the fact that the MBSR training model also teaches people to pay attention to their thoughts and emotional states... but without judging them, or trying to change them into something else.

Many psychologists and cognitive scientists have come to believe, based on emerging research, that it really is not possible to take a dysfunctional or inaccurate thought, and "re-structure" it, change it into a better thought, or substitute another thought for it. It is, however, possible to short-circuit the process of elaborating on one's thoughts and emotions, to minimize the "rumination," and the increasingly negative thought processes, that can spiral downhill into a full-blown episode of depression (or an anxiety disorder).  And it could well be that the success of the cognitive therapy model results not from “restructuring” one’s thinking, but from recognizing that “thoughts are only thoughts”; they are not necessarily “reality,” and not necessarily all that important…

MBCT is now being used (and researched) for individuals currently suffering from symptoms of depression, as well as for people who are troubled by symptoms of anxiety disorders. The patients in a recent study (found online here) by Ferrando, Findler, Stowell et al. ("Mindfulness-based cognitive therapy for generalized anxiety disorder") displayed "significant reductions in anxiety and depressive symptoms from baseline to end of treatment." The researchers concluded that "MBCT may be an acceptable and potentially effective treatment for reducing anxiety and mood symptoms and increasing awareness of everyday experiences in patients with generalized anxiety disorder (GAD)."

MBCT has also been successfully adapted for patients with Bipolar Disorder: In a recent study, the authors state that "The results suggest that MBCT led to improved immediate outcomes in terms of anxiety which were specific to the bipolar group. Both bipolar and unipolar participants allocated to MBCT showed reductions in residual depressive symptoms relative to those allocated to the waitlist condition...” This study, in the Journal of Affective Disorders (click here for the abstract), suggests “an immediate effect of MBCT on anxiety and depressive symptoms among bipolar participants with suicidal ideation or behaviour, and indicates that further research into the use of MBCT with bipolar patients may be warranted."       

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Workplace Stress, and Mindfulness

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Mindfulness-Based interventions help people who are living and trying to cope with the pain and the stress of difficult life circumstances. One of the most common (and very painful) stressors experienced in our lives arises out of the workplace.

I had breakfast a week or so ago with a friend who told me about his wife's experience with "The Boss From Hell." Let's just call her the "BFH." When the BFH arrived as the new supervisor at my friend's workplace, things immediately went sour for her (and she had been an excellent employee for years, a professional woman with outstanding performance reviews, and a lot of responsibility). Although she had always worked far more than her required 8 hours per day, all her movements in and out of the office were suddenly subjected to strict scrutiny. She had no leeway at all as to her arrival and departure times. She was given new assignments that would have been appropriate for an entry-level worker, but not for a person with a graduate degree in her field (she was ordered to make the rounds of her colleagues, every afternoon, to ask them if they needed anything copied or faxed). She was repeatedly raked over the coals by her supervisor, for not having done tasks that had never been assigned to her. I have written about this phenomenon of "workplace bullying" before (click here); recently I found some interesting new research  (click here), about what happens in a person's brain when this sort of disempowerment takes place:

It appears that if you cause a person to be placed into a position of “low power,” then that person’s cognitive functioning (capacity to make effective and sound decisions, for example) will be impaired, compared to the people who are placed into positions of “high power.” Here is an excerpt from the “Science Daily” piece about this research:

“New research appearing in the May issue of Psychological Science, a journal of the Association for Psychological Science, suggests that being put in a low-power role may impair a person’s basic cognitive functioning and thus, their ability to get ahead… In one experiment, the participants completed a Stroop task, a common psychological test designed to exercise executive functions. Participants who had earlier been randomly assigned to a low-power group made more errors in the Stroop task than those who had been assigned to a high-power group. Smith and colleagues also found that these results were not due to low-power people being less motivated or putting in less effort. Instead, those lacking in power had difficulty maintaining a focus on their current goal.”

This research is really not surprising, in light of prior research that has long indicated that, among primates, when an individual is eliminated from a powerful position, that individual experiences an impairment in the functioning of his serotonin system (serotonin is a neurotransmitter involved in many brain functions, including mood regulation). And, together, these lines of research would seem to demonstrate that adverse employment actions can cause workers to experience significant incapacitation: clinically significant depression, for example, and impairments in judgment and decision-making capacity. And this will likely have a negative impact on the employee’s subsequent performance on the job.

Accordingly, we can see more clearly what kind of biological effect the actions of a workplace supervisor can have on her/his employees. In situations (all too common) involving a workplace supervisor who engages in bullying-type actions with employees, the targeted employee will experience changes in his or her brain that will very likely be reflected in his/her mood and capacity to continue to work effectively. For example, supervisors who want to punish an employee might take actions such as: removing the employee from leadership positions; shifting job responsibilities around in such a way that the employee experiences a diminished sense of control over his/her workplace duties; or outright demotion. And I suspect that even seeing one’s colleague being treated unfairly might well cause co-workers to experience a feeling of fear and disempowerment, thus spreading the ensuing dysfunction even more broadly throughout the workplace. Common sense and life experience tell us that any of these actions will cause employees to have negative emotional responses; now, we can see a bit more about how the brain changes to produce these negative effects.

Mindfulness-Based interventions help people to learn new methods for coping with these after-effects of stressful events; they teaching people techniques by which they can use their own minds to change the pathways within their brains, thereby relieving much of the suffering that goes along with the traumas we experience in life.

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Wake Up!

Image from Flickr

I thought I would begin to feature some of the "pages" on this blog; below is my "Wake Up!" page, which I first wrote while I was teaching mindfulness-based interventions to graduate students at Avila University; it was intended to help them understand some of the reasons that meditation might help some of their clients, and also for them to use as a hand-out or instructional tool for clients:

WAKE UP!

To what’s going on

 

Around you

AND

Inside your head

 

If you pay attention to what is going on in your mind, you will find that there is a near-constant stream of chatter. Our brains seem to be talking, and engaging in commentary, all the time: sometimes about the past (“I really wish I had not done that!”), sometimes about the present (“this is really nice!” or “I hate this!”) and sometimes about the future (“I hope I get the job!” and “I am so scared that I will fail.”).

 

This “chatter” represents normal brain function; it is simply something that the brain does, when it is not occupied in deliberate problem-solving. The brain generates thoughts, emotions, impulses, and physical sensations. However, most of us are unaware of most of what the brain is “saying,” nearly all the time! Instead, we let it go on, chattering outside of our awareness, while we go off into autopilot. If we are not actively making an effort to pay attention, many of our complex behaviors (driving to work; walking down the hall to the mailbox; eating meals) occur while we are in a sort of autopilot state. This does not necessarily mean that we are functioning poorly (any outside observer would say that we are doing just fine); but if we are in that autopilot state, we clearly are not living fully. And we may also be putting ourselves at risk for various problems such as depression, anxiety disorders, and impulsive and compulsive behaviors (including addictions). We may find, upon reflection, that our lives simply are not what we would like them to be.

 

There are any number of patterns into which internal chatter might fall. For some people, brooding about the past is prominent. I might endlessly and repetitively recall and re-hash episodes from my past, critically judging my decisions and my behavior, maybe even wallowing in regret and self-hatred.

 

Another pattern involves the future: I might be a chronic worrier, constantly bringing into mind scenarios in which disasters and catastrophes will likely take place. This can be accompanied by a constant effort to problem-solve or problem-prevent: “What will I do if this happens? What if that happens? How can I keep either of those things from happening?”

 

One very important pattern that appears in all of our mental landscape falls under the heading of “habit.” We all are aware that we have behavioral habits; we also have mental habits. Our capacity to develop habits is, overall, a very positive thing; we could not function efficiently if we had to think through every step we take in life, constantly “reinventing the wheel.” However, the negative side of habit-formation is clearly evident, as well. Many of our habits would be readily identified as “bad habits.” Our brains are structured in such a way that anything that is repeated often enough becomes a sort of a preferred, or even “default” option. If I am accustomed to taking a certain route when I drive home from work every day, then it takes a certain amount of effort to change my route. That driving route has become a (benign) habit. By the same token, if I have begun a pattern of eating a bowl of Cherry Garcia ice cream after dinner in the evenings, then it will take some effort to refrain from eating it on any given evening, and I will feel a strong urge to buy more of it when I go to the grocery store.

These patterns, mental and behavioral, can lead to serious problems:

 

• Brooding contributes to depression
  
• Worrying contributes to anxiety disorders
  
• Habit makes unhealthy behaviors more difficult to avoid
  

 

The tricky thing about these patterns is that they tend to go on outside of our awareness. We can see the outcomes that naturally arise out of the patterns (in unhappiness and in behaviors we don’t like, but can’t seem to control); but we fail to see the mind-states that contribute to these outcomes. We tend to be mystified by our own behaviors and emotional states. We feel as if they are outside of our control.

 

But, what if we shift our focus away from the outcome to the cause? What if we begin to develop the habit of awareness of our own mental functioning (especially our thoughts, emotions, impulses, and physical sensations), and develop our capacity to detach from counterproductive patterns, before they have a chance to manifest themselves as significant problems?

 

As it turns out, we can exercise our human capacity for freedom by deciding to develop our ability to direct and re-direct our attention. Since we know that our mental habits are contributing to unhappiness in our lives, the arena for choice becomes situated within our minds. We can let these patterns continue to go on chattering, outside of awareness (in which case we have no control over them); or we can pay attention, so that when they are operative, we can gently detach from them, and redirect attention to something more worthwhile.

How do we do that? As Jeff Schwartz says, “Attention must be paid.” One way that many, many people have successfully brought a greater degree of freedom into their lives is called mindfulness practice, which is a sort of umbrella term that covers a variety of practices or types of meditation. This can involve formal, silent “sitting meditation,” sometimes for long periods of time; and it can involve “everyday” mindfulness, when we remember to pay close attention to a particular activity. For example: Washing the dishes, we deliberately notice all the thoughts, sensations, and emotions that arises during the period of time that we are doing that task.

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