MIndfulness Based Cognitive Therapy for Depression

Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse by Zindel V. Segal

My rating: 4 of 5 stars

In Mindfulness Based Cognitive Therapy for Depression, the authors bring an Eastern approach to managing the increasingly common issue of depression. Just last week, an article in the news proclaimed that 1 in 10 Americans are on antidepressants , and that most of them do not seek therapy in conjunction with pharmaceutical treatment. This is unfortunate. "Antidepressants drugs do not provide a long-term cure. Their effects do not outlast their use." They can be instrumental in keeping a depressive episode from becoming severe, but it is important to do therapeutic work as well in order to change the way the brain is functioning. This is where MBCT has proven itself successful.

It turns out that "negative thinking could itself cause a depression… [and] could certainly maintain the episode once it started." This tendency to ruminate on negative feelings does not help, and is in fact, counterproductive. Unfortunately, people in depressed states have a tendency to do just that, which can feed their feelings of hopelessness and despair. Rather than feeding or fighting these feelings, MBCT helps people develop a new relationship with their thoughts.

Mindfulness based practice teaches people to watch their mental and somatic processes intentionally and non-judgmentally. This observation can help people to understand that their "thoughts are not facts." As Jon Kabat-Zinn explains, "It is remarkable how liberating it feels to see that your thoughts are just thoughts and that they are not 'you' or reality." In fact, a core skill of MBCT is "to teach the ability to recognize and disengage from mind states characterized by self-perpetuating patterns of ruminative, negative thought." This invaluable skill teaches people how to direct their attention and to reduce the amount of energy they expend in these self-defeating habits.

Although there are definite benefits to mindfulness based practice, it is important to remain non-attached to outcome. It is "easy to believe deep down that success is achieved when we are with the breath and failure occurs when the mind wanders." In fact, one of the most useful ideas in this book was the concept that "it is just as valuable to become aware that the mind has wandered and to bring it back as to remain fixed on the chosen object of attention." In our goal-oriented culture, it is easy to fall into the trap of self-judgment, even while meditating. One can become overly concerned with whether they are 'doing it right' as they internalize the 'God-as-Judge' meme. This is why it is so important to approach this work with a sense of acceptance and self-compassion. Even long-time meditators have wandering thoughts. They just have developed a different relationship with them. They are aware that "just because your thoughts are compelling, doesn't make them true." Once we understand this truth, we can stop identifying so strongly with our thoughts. This can take the charge out of our inner critic and help us tune in to a different channel that supports and nurtures our growth and healing.

Understanding that it is the process of returning to the breath itself that helps us remember to return to a grounded and centered state in times of stress. This practice of returning is the most useful thing I learned in this book.

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The Mindful Path of Self-Compassion

The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions by Christopher K. Germer

My rating: 4 of 5 stars

Love says, "I am everything."

Wisdom says, "I am nothing."

Between these two my life flows.

~ Nisagradatta Maharaj

Our culture teaches us that happiness depends on external circumstances, but that is not really the case. In The Mindful Path to Self Compassion, Christopher K. Germer, PhD., states that 2/3 of people without chronic back pain display the same structural dysfunction as those experiencing pain. In another study, job satisfaction was found to be a predictor of developing low back pain. Buddhist psychology instead teaches that it is our relationship with our pain that is the problem, and that acceptance may be a more effective strategy than fighting against our troubles. "What we resist, persists."

Germer offers simple and effective strategies for changing our ingrained habits of resistance. Mindfulness meditation is neurological reprogramming that helps us cultivate a calmer and less reactive state. Since "Neurons that fire together, wire together," we can practice paying attention to what we are doing. This allows us to be more intentional in our lives on many levels. By practicing intentional attention in formal sitting practice, we can develop habits of mindfulness that can serve us in times of stress and difficulty.

Having meditated before, I was surprised to feel how different a consistent Metta practice could make me feel. Practicing being kind to myself has transformed my relationship with other people as well. I find myself more able to be present. Even better, I am remembering to judge myself less when I make mistakes, and to help stop others from beating themselves up as well. I think Germer said it very well: "Give yourself the attention you need so you don't need so much attention." This frees up our energy to be more present for others, and lets kindness move through us to do good work in the world. After all, "[t]ransforming relationships with others starts with us; it is an inside job."

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Learning Is What We Do

Humans can't help but learn; it is what we are built to do. Every experience, every word, every thought and every action trigger physical patterns of activity in our bodies and brains. Patterns that are repeated become more persistent, habitual, and long-lasting. This can create a situation in which we feel molded by our world, trapped by our jobs, and lost in our patterns of relationship as we replay old patterns as if by instinct.

This view lacks one vital component: the power of intention. Intention is movement of intelligence through the system, looking for ways to order and understand experience. This intelligence works whether we harness it or not, which is evidenced by the dysfunctional coping strategies adopted by people across all ranges of activity. Whether challenged physically, emotionally, or mentally, humans do the best they can under a given set of circumstances. This is an essential tenet of William Glasser's Choice Theory, as is the idea that if we developed better tools we could make more effective and beneficial choices in our lives.

This theory maintains that, "for all practical purposes, we choose everything we do, including the misery we feel." He goes on to demonstrate that this is, in fact, the only thing we really do have control over, and that by investing energy in developing these skills we can move towards a healthier and happier life. Choice theory provides wonderful tools for discovering ways to move with ease in our relationships with others. We can own our impact on our world, and learn to navigate our way such that we ease conflict around and within us by really tuning in with attention to our experience.

This is as true on a physical level as it is on an emotional one. We adapt to our experiences, such as injury and repetitive strain and also to the emotional conditions of our internal environment. As our bodies reconfigure themselves around the activities and states we experience, we lose track of good functioning and consider our stress and tension to be the baseline normal.

Again, this can be remedied by education. From a Somatic viewpoint, our much myofascial pain comes from lack of full embodiment due to somatic amnesia. Pain causes people to withdraw attention from the injury, which removes that region from conscious control. This causes painful patterns to coalesce into habits. Instead of running from our discomfort, we can invest attention to our process and use intention to reconnect with the lost parts of ourselves. As people learn to direct their attention to their experience, they can tune in to their inner wisdom and understanding. This knowledge can tell us what our bodies need, if a situation is healthy or if communication is authentic and real. Our senses can tell us so much about our experiences, but we need to invest energy in learning how best to use them.

We can use this knowledge to chart a healthier course through life. We can discover if our chronic pain is telling us we need to find a different livelihood, or that a relationship needs attention in order to heal. We can listen to what people are really saying, and be more intentional in our interactions. We can create space that supports all of our needs, and put our monkey minds to use in creating a life worth living.

5/21/2011