An accidental form of control: when mindfulness produces happiness ACTing Well, Living Well iv

I’ve had some success while working with a man I’ll call Peter.  He’s got chronic pain, and has been incredibly fearful of what it might mean – in fact, you’d probably call him a classic catastrophiser because each time his pain flared up he immediately thought it was something like cancer and he would rush off to his GP or the Emergency Department to have it checked out.  Luckily any scans he’s had haven’t shown anything operable because I’m sure with the amount of distress he was been experiencing, he would have been able to persuade a surgeon to operate had there been anything odd-but-common found.

We’ve been using mindful breathing as a way to get in touch with the sensations, emotions and thoughts that occur to him, and especially ‘making room for’ the thoughts his mind has been telling him of needing to check his body for symptoms, for the nauseous feeling he gets when his mind starts to worry, and for the painful sensations that he experiences throughout his body.  It’s been a real learning experience for him to find that he can be willing to experience these symptoms without judging them, and, as seems to happen for many people, he’s been finding that they disappear or reduce over the five minutes or so we do the exercise.

Now this is a trap for young players and older ones too.  While it’s nice to find that sometimes mindfulness can produce peace, relaxation and calm – that’s not the point of being mindful!  The point of being mindful is to be open to experience whatever happens.  And for those people who do experience a reduction in negative emotions, sensations or thoughts, the very reduction can begin to form a subtle type of control.  The thinking goes something like this

“I feel uncomfortable.  Quick! I’ll do some mindful breathing – and then that feeling will go!”

Sounds a lot like ‘experiential avoidance’ – although perhaps slightly more effective than running around keeping busy to avoid the negative feeling, or trying very hard to ignore the feeling, or perhaps catastrophising.

Why would we worry about this?  Does it really matter if someone does start to use ‘mindful breathing’ as a way to reduce symptoms?

Well yes.  There will be times when even though the person is using mindful breathing to ‘sit with’ something negative, the negative experience doesn’t reduce, doesn’t fade, and may even increase.  That’s not the point of mindfulness – it’s about accepting whatever happens, allowing it to be there AND CONTINUING TO COMMIT TO ACTIONS that move in valued directions.

The problem with hoping that mindfulness will reduce symptoms or thoughts is that when it doesn’t reduce these, the temptation can be to feel distressed – and stop the mindfulness.  And after stopping the mindfulness it can be very difficult to carry on doing the actions that will ultimately enact values.  That wonderful mind can kick in and accuse the person of ‘being stupid’, ‘wasting time’, ‘doing this dumb thing that doesn’t even work’ – this usually brings more negative emotion along for the ride, and ultimately doesn’t help.

So what to do?

I’m still learning this, but I think I’m going to mention that mindfulness is about allowing what will be to be.  And being ready to carry on with valued actions despite this.

I think this might be one of the hardest things to do – I’ll let you know how I go!

Practical techniques of mindfulness

I’ve been looking around at quite a few different ways to learn and practice mindfulness. There are heaps and I realise that I’m just dipping my toe in water that has been flowing for many hundreds of years really.

If the essence of mindfulness is to be fully present, then most of us have probably achieved this at various times in our lives – that sense of ‘flow’ or the moments when body, mind, spirit and any other bits of the human self integrate without recalling the past, without predicting the future. To deliberately re-create this, especially during more challenging times, is what I want to consider today.

I mentioned a day or so ago that for some people, explaining the how and why is much less successful than plunging right in. I think I am biased in terms of preferring to understand the ‘why’ before I do things… Perhaps something that is distinctive in this therapy is the experiential elements – it really is important as a therapist to know how and to practice mindfulness, so that it’s a lot easier to explain and guide another person into it. Now I’m not the only person who has said this: Dr Chris Walsh writes about this in his paper on Practical Techniques in a section called Why mindfulness instructors need their own practice. He says ‘To teach an experiential skill (to coach) requires some mastery of that skill…experiential information is often conveyed non-verbally. This can be done skilfully if the instructor carries the information at an experiential level, within the body…This makes it easier to learn by modelling, just as a rock climbing student might do with an instructor.’

So…what can we do to learn?

My first steps for myself were to learn to be mindful of my breathing. It’s an ancient zen practice to meditate breathing – to achieve complete focus only on the breathing of ten breaths. Try it now – to completely focus only on breathing in, breathing out – without distraction, without mind chatter including labelling or naming sensations, without the thoughts taking off…

Now the mindfulness part of this is to notice the thoughts wandering and gently allow them to float away while returning the attention to your breath again.

Being a very visual person, I use imagery for myself a lot – so images like the thoughts are wrapped up in a bubble, floating in the air…. or thoughts are simply blowing away from me…. or are falling onto floating leaves in a stream… or drifting down like leaves from a tree….or feathers…

Most of my images are from nature, but other images I’ve experienced using include sitting in a train, allowing the thoughts to be falling far behind as I move onward…being in a boat, watching the thoughts floating away on the wake….thoughts being part of a machine, being taken in and being processed, coming out the other side on a conveyor belt and moving far away…

I usually spend a few minutes actively ‘managing’ my thoughts using imagery, then my focus on it’s own returns to my breath.

To guide my focus on my breath, I notice my breath in my body. The cool air coming in my nose, and down my throat, becoming warmer as it moves deeper into my body – the warmer air coming out of my nose and moving the tiny hairs of my nostrils. The movement in my body as the air fills my lungs, tightening pressure on my belly against my clothing as my lungs are filled, relaxing as I breathe out. Awareness that my breath out is often longer than my breathe in, that my breathing is ‘coming from’ my belly button…

And usually I become aware that I am naming these experiences, and allow my mind to name them then return to just feeling them rather than naming them. Being gentle rather than critical, taking my time so my mind and body have no coercion or force or requirement to do anything – rather, just allowing it to occur and noticing it as it happens.

A words I associate with this practice is ‘curiousity’ or ‘inquiry’ or even ‘exploring’, but not in an active sense, just in a floating sense.

A killer for mindfulness is to expect a certain emotion, feeling or result. That’s like expecting it to be something that it hasn’t yet achieved. My preparedness to receive what happens is the key to using this process. Sometimes I do feel incredible peace and connection, other times I feel detached, or as if I’m a spectator. Still other times I leave feeling energised or ready for action, while at other times I feel ready to fall asleep. What will be, will be and what happens, happens… That is at the heart of the practice, to just allow space for something or nothing to occur, and just be.

Sometimes while sitting with an experience during this breathing practice I can feel emotions welling up (and I have seen this with other people I have coached). Again, this is something that can just be allowed to happen then subside – emotions never stay forever, unless we are trying to edit them or restrict them or focus in on them. Allowing the emotion (fear, sadness, anger, loneliness) to rise then fall so we go with it, and accept it as part of our experience, makes it less powerful and it passes on.

Distraction in the learning stages of meditating is very common. Again, I’ve used imagery for myself, other times I have just said to myself before I start that I will hear noises or feel sensations and that they are there but will just help me appreciate the moment. So I allow them to be heard, then gently return to the breath. Sometimes just being aware of the space between each sound or sensation, or distinguishing between different sensations on different parts of my body can allow them to be felt then my mind returns to my breathing.

I have used prepared scripts, pre-recorded onto CD or MP3 player, and sometimes used music (mainly ambient sounds from nature or bells). This is great initially I think, but over time it can become the focus and be a sort of prop that interferes with the process of being fully present. So perhaps it’s something to use in the beginning, but later can be used occasionally to keep the experience fresh. The mindfulness can be brought into every day activity like brushing your teeth, or getting into the car and putting the keys in the ignition, or even while washing dishes and doing laundry.
For some good examples, Chris Walsh has made some great suggestions, with references to refer to.

I particularly like Chris’s description of ‘Urge Surfing’. This is a method to reduce the ‘feeding’ of an urge by either trying to resist it, or attending to it and actually doing it. Essentially it follows exactly the same format as I’ve described above for emotions and sensations, by sitting with the impulse or urge, allowing it to build by gentle acknowledging it as a thought, then perhaps defining it, or perhaps letting our attention return to our breath and noticing any changes to the urge or sensation throughout the cycle of the breath. Chris recommends five cycles of breathing – I think it doesn’t matter how long it takes! I can see application of this in exposure therapy, and I know I have used it myself without realising that was what I was doing! You know when you really want to scratch an insect bite? And can’t? And you can allow that feeling to pass… and it does…

Finally, this is a great site with a wonderful paper by Ruth Baer summarising the conceptual and empirical features of mindfulness training. Enjoy.

And for some koan to consider as you meditate? Try these… they are ancient.

Control or acceptance?

I’ve been reading a wee bit of ACT, acceptance and commitment therapy recently. I’m trying to find a relatively simple way to explain ACT to my patients, many of whom just don’t do reading, and prefer living life in a practical way, rather than an intellectual or even spiritual way. I’m not sure I’ve found an explanation that works terribly well yet.

So this is my attempt at a ‘simple’ explanation of ACT – and I’m keen to hear what others think of it!

The first step in ACT seems to be about recognising that the previous attempts we have made to control our thoughts and feelings about a situation seem to fail. Or they need an awful lot of energy. Or they compromise other important things in our lives. I can’t remember who described it as ‘creative helplessness’, but it is a great term!

The second step is to acknowledge that we have emotions, and that they don’t respond well to either being ignored or to be focused on. But emotions are part of us, and are present when we make judgements about a situation.

It’s natural to make judgements about things – this is how we simplify our lives, by making up ‘rules of thumb’ about how we think the world works based on what we’ve experienced, been taught, or seen happen to others. And the rules we live with we just don’t seem to revisit unless we have to.

Some of us are very rigid about our rules – the world just is this way, and there is no other way… others of us are more flexible and recognise that much of life is chaotic and random, and although we would prefer to have life happen in a much more orderly way, often it doesn’t. It seems that people who live according to the second way are more able to accept situations than people who live according to the first.

So if we’ve lived rather orderly lives, where everything happens the way it ‘should’, we may be secure but our world gets rocked when something unexpected happens. And perhaps some of us are more fundamentally able to be flexible about this, while others of us are not, but it seems that people who can work out a way to flow with an unexpected situation deal with it rather better than people who strongly want it to follow the rules. People who can deal with the unexpected deviation from a script also seem less emotional about it – happy when good things happen, but not awfully distressed when bad things happen.

So what I think mindfulness does is provide a way for us to flow with a situation by enjoying things that move in a direction that we ‘want’ but also allowing us to flow with a situation that doesn’t move the way we want by releasing our emotions, giving them some space to be – then recognising that they soon dissipate.

The tools that mindfulness uses, instead of being incredibly ‘talky’ involve lots of imagery and metaphor – which works really well for a visual creature like me – but I’m not so sure that it works as well for practical types. Mindfulness uses words like ‘gentleness’, ‘flow’, ‘moving with’, ‘openness’ and so on… Not that easy to describe to my practical blokes who are more familiar with a spanner than a book!

Some of the tools of mindfulness are awareness of breathing (not control), awareness of sounds (not naming them), awareness of sensations (not judging them), visualisation (such as putting judgements into ‘bubbles’ and allowing them to float away).

I wonder how I can translate this into ‘blokespeak’!

So my focus for this week’s series of posts is attempting to find some ways to help practical people understand how to become ‘mindful’ rather than ‘judgemental’, work with emotional flow rather than cognitive labelling, and finding out what is important and whether what happens is allowing what is valued in life to occur.