Savouring the Present Moment: Mindfulness of Pleasure, Enjoyment and Happiness

The most beautiful thing we can experience is the mysterious. It is the source of all true art and science. He to whom this emotion is a stranger, who can no longer pause to wonder and stand rapt in awe, is as good as dead: his eyes are closed.’ Albert Einstein, My World View (from a collection of philosophies of notable figures in 1931) Continue reading “Savouring the Present Moment: Mindfulness of Pleasure, Enjoyment and Happiness”

Lost in Oblivion – An Exploration of Adverse Meditation Experiences

(Please note this is a long blog post in order for me to do this subject justice. It’s likely to be of most interest if you have experienced adverse meditative affects)

Meditation is not all spa music, oxytocin, sandalwood and light! There can be stages that are like arduous rights of passage. A shamanic vision quest. There might be underlying mental health pathologies that mean that practice, or at least intense practice might be unwise. Continue reading “Lost in Oblivion – An Exploration of Adverse Meditation Experiences”

Getting Your Five a Day of TLC

I am a big fan of the short mindfulness practices that you can integrate into your day. Exercises like the STOP practice, the 3 minute breathing space and the self-compassion break. I often say to participants in our 8-week courses to try to get your ‘five a day’ of these short mini-mindfulness practices. A lot of people struggle to keep a consistent daily practice and these short practices can still strengthen your abilities in mindfulness, even if you are struggling to sit for 10 or 20 minutes daily. Continue reading “Getting Your Five a Day of TLC”

Behavioural Activation Part 6 – A Tool for the Future and a Promethean Act of Will

William James (1842 – 1910), the philosopher and pioneer of American psychology (teaching the first psychology course in the USA at Harvard) suffered bouts of depression throughout his life. At times they took what he described as a ‘Promethean Act of Will’ to overcome this ‘crisis of meaning’. BA is a tool that you can use for the rest of your life. At times it will be easy, for some people at times, it will require James’ Promethean Act of Will.

You may have times when you use BA more formally and write down an hour by hour daily plan. Other times you might use the principles to ensure you are giving yourself a balance of pleasant and mastery focused activities. You may completely forget about BA at times and then decide to come back to it if you notice changes in your mood.

These last two points are considerations for the future:

9. Prepare for lapses – Unfortunately for most people with anxiety or mood disorders there are likely to be lapses. When life throws new pain and losses at you, stress levels rise, or we stop looking after ourselves so well, then old brain pathways can resurface. Be ready for this and restart what worked as soon as you notice any signs of a lapse. Start planning BA and use your other tools as soon as you can. This was one of the key ideas of MBCT, the ability to detect the early warning signs of depression using mindfulness and to start to take care of ourselves early with BA.

10. Connect and get help – I have mentioned already that a number of these steps work better with friends or in groups. However, we have to watch for the tendency to ruminate out loud with another person. Can we instead put our attention on what they are saying, on their life? Can we do shared activities together rather than talk about our depression? It can be useful to talk to a professional therapist or a close friend or family member. But if it seems like we are going over the same unsolvable loops out loud, then try to switch into a problem-solving mode of what actions you are going to take, or observe and accept the thoughts whilst taking action with the other people.

Again, it’s worth noting that indigenous communities with lower levels of depression tend to spend almost every hour of the day with their friends and family. As they say in Dialectical Behavioural Therapy we need to do opposite action to what the emotion is telling us. So, try to connect with others and face to face connection is always best! Our blood pressure lowers and our heart rate variability improves when we are with friends, its how our nervous systems have evolved!

It can be really disheartening if we experience a lapse or a relapse in our symptoms. It can be important to contact our therapist right away or to connect with our support networks. Depression can resurface but if we continue to practice what worked and to open up with acceptance to these feelings and pursue meaningful activities, then we can recover again. As we develop these skills in a lapse, we actually become more confident that we know what to do next time. Each time we experience these difficult emotions and develop the ability to focus on meaningful goal-directed actions with the people we love (willingly carrying these emotions on our backs), our confidence grows. We get stronger through these promethean trials, much like a right of passage. I hope you have found this series useful and feel free to share any thoughts or questions in the comments below.

Behavioural Activation Part 5 – Lets Get Physical – Activate Through Activity

If you look at many high functioning people who have experienced depression, you often find exercise is part of their recovery. The likes of Tim Ferris, Stephen Fry and world class endurance athlete Christopher Bergland all have credited exercise to helping them maintain and improve their mental health (if you do a little more research online you’ll find the list is extensive). Exercise has been found to have comparable effects to anti-depressant medication in a number of studies. Not to mention the fact that there are all of the additional health benefits of exercise.

But what if you can’t get off the couch, out of bed or think clearly enough to exercise? We all find it difficult to exercise at times, imagine how difficult it is when you are suffering from major depression and you can barely move. I have experienced this dark place myself and it feels like an Olympian feat to simply get moving! But we do have some agency in the painful abyss of depression. We can strengthen the ability to make healthy choices whilst carrying these Atlas-like emotions on our backs. This is where scheduling physical activity in your BA schedule can be so helpful and having the support of friends and family to get you moving. Here are a few other ideas that might help:

7. Start small and build up – Walking is a really useful tool here. The key is to start with a really small and gentle amount. This might even be walking round your house for 2 minutes. Then moving onto a 5-minute brisk walk, then 10 minutes round the block and upwards. Also try integrating exercise with things, you have to do in your day – like commuting, shopping or visiting friends.

Exercising with other people is even more powerful and if you get out in nature as well then you have the coup de gras. It can be beneficial to do a mixture of relaxing and slow exercise like yoga & tai chi and also more intense aerobic exercise & weight lifting. This combination can have a really positive impact on our mental health.

8.What if it’s boring – A lot of people find exercise boring, even when they are feeling well, so (as always) be kind and self-compassionate. If exercise is boring then you might not have found the right fit. What did you use to enjoy before depression? Think back to when you were a kid (a useful tool for filling your BA schedule more generally) and what games, sports, outdoor activities did you use to enjoy and can you add them back in? Connect with other people in groups. Get an exercise buddy to help motivate you. Sometimes (as long as we have the all clear from our doctor) boredom can be a sign that we are not pushing ourselves hard enough. We might need a bit more sweat to access the pleasant rewards of exercise. Its also important to congratulate yourself in your head for achieving your goal when you finish your exercise. Many people don’t do this last step and often berate themselves and go straight into negative rumination after exercise.

Can we use exercise to train our focus and concentration, either through mindfulness of movement and breath or even by listening to music or a favourite podcast? Every time our mind drifts away we notice and come back. Sometimes people use exercise as a time to ruminate, engage in self-criticism or to worry. Can we notice and accept these thoughts and bring our minds back to the present moment? You can use encouraging self-talk to help you as we have talked about in the previous articles. Just like an endurance athlete encourages themselves internally and thinks of their goals.

Some theorists suggest that the stress of living a modern life, far from what we evolved for in the Pleistocene epoch, is one cause of the rise in depression. Indigenous cultures that report much lower levels of depression tend to get 4 hours + of exercise a day (just by going about their day and living their lives) and middle aged and older individuals are built like Olympic athletes! Can we reclaim a bit of this indigenous antidepressant lifestyle by building more exercise into our lives? Alongside exercise, a healthy diet and sleep are incredibly important ways to take care of ourselves and build into our behavioural activation. We will look at these topics in future articles.

Let me know your favourite ways to activate yourself through exercise below?

Behavioural Activation Part 4 – Actions Speak Louder Than Thoughts and Emotions

Our feelings have evolved to hijack our attention, behaviour and motivational systems. At times this can be incredibly useful, even lifesaving. But there are times when the better-safe-than-sorry ‘smoke detectors’ in our brain produce feelings that drive behaviours that don’t help us! There is a level of sadness which can be useful in helping us to pause and reflect, to feel love and compassion or to appreciate the bitter-sweet flavours of our life’s banquet. But there is a level of sadness that pushes us into a numbness or painful states of depression that induce shutdown and social isolation. The pain can be unbearable, there are even common neural correlates in the brain between depression and pain. These agonising feelings can place real barriers to behavioural activation. Often, we need to do the opposite to what our feelings are telling us. We need to get up and exercise when our beds call soporifically to our exhaustion. We need to contact and connect with our friends when every impulse in us is saying to avoid them and retreat back to the cave. We have covered a number of useful tools for working with painful emotions in part 3 of this series, but here are two more ideas to put in the mix:

5. Fake it till you make it – as Mark Freeman says ‘focus on changing actions, not thoughts and feelings’. It’s much better to do your chosen BA actions focusing on what you are doing and trying as best as you can not to monitor how you feel. Excessive self-focus is a large part of the problem. Can you aim to have far more of your focus out on the world and the people you are with? You may very well feel awful when you first start BA, but can you improve your ability to function and concentrate whilst these difficult thoughts and feelings are in the background? Can that be your aim, rather than aiming to feel better?

It is likely it has taken months and years to build to this point of your depression. It might well take some time to break the patterns that led to it, so it’s far better to focus on achieving your goals and concentrating out into the world rather than whether or not you are feeling better. Do the activities you used to enjoy, or new activities that reflect your values even if you don’t feel like it. Having experienced depression, anxiety, depersonalisation and OCD myself, I know how difficult this is, but if we progress gradually then we can get better at changing actions with the heavy thoughts and feelings in the background.

6. Parallel emotions – Another useful concept that I found in the work of a number of expert’s (Mark Freeman ,Reid Wilson, Leslie Greenberg) is the concept that you can have emotions in parallel. There is space for depression and gratitude, anxiety and savouring. In fact, Greenberg (leading researcher and expert on Emotion Focused Therapy) has found that to transform painful emotions they need to be activated alongside positive emotions. Can you learn to accept or tolerate the emotion whilst your concentration is on something enjoyable or satisfying? We really can train this skill of concentrating on gratitude, savouring and flow even when our concentration feels weakened by depression. I found flow to be particularly useful here as we just need to (i) focus (ii) have goals with clear feedback, and (iii) have a balance between our skill and the challenge (not too easy or too hard).

The key is not to battle with our painful emotions. We can use different tools to help us tolerate and then accept our pain but we need to try and develop them alongside our pain, not to battle with it. You might also find my article the acceptance spectrum useful for ideas on managing challenging emotions.

Behavioural Activation Part 3 – The Internal Saboteur

Its official – there are parts of us that are not in our own corner. In the clasp of depression this can show up as an internal voice or feeling that sabotages our efforts to make positive changes. It might be that heavy thick feeling of pain or it might be the voice telling you that ‘this isn’t working and you’ll never recover’. Many modern approaches to psychotherapy see the brain as made up of different systems or competing parts. In evolutionary psychology this model is called the modular mind. It’s even reflected in our language when we say ‘part of me wanted to do x’ or ‘I’m in two minds about y’. We even see it explored in literature like Dr Jekyll and Mr Hyde. Unfortunately, this layered network of different evolutionary stages can overreact, misfire or even turn on ourselves as the inner critic. These competing parts can have a large role in depression. So, what do we do to cope with this internal sabotage?

3. Talk to your self – I’ve mentioned the power of compassionate self-talk before on the blog. Just think of an endurance athlete and what they say to themselves in their heads to push through the pain and focus on their goals. In many ways this is a close replica of the depressed person. It is often an endurance event to get through the day. Use self-talk to both help concentration and motivation.

Emergency service drivers are taught to narrate their driving to help them concentrate when they are sleep deprived. You can do the same here: gently and kindly narrate what you are doing. Narrate each step and congratulate yourself when you achieve each step. Be the compassionate coach that Mary Welford describes.

There are studies that show that using self-talk can enhance your abilities in many areas, even finding lost items. So, use this skill to help you function when you are struggling. You can slow down the self-talk if you are struggling to concentrate, you can even talk to yourself out loud if you are in the right place for that. Its highly likely you will have the negative inner critic voice there as well, aim to have these voices running in parallel (rather than competing). Can you listen to your own positive, compassionate self-talk while the critic continues in the background? Can you focus more attention on the kind voice than the critic? It’s a skill that can be trained so it is unlikely to produce miracles right away, but give it time. You are strengthening this skill each time you try.

4. Dealing with rumination/negative thoughts – its widely acknowledged that negative ruminations feed depression. They will come up as you do BA. As in the point above try to let them be there as you focus on your kind self-talk and the actions you are taking. You might try to use the 3-minute breathing space from MBCT. Or you can label what you are feeling and remind yourself of your values (for example to be happy and health, to support and love others, to enjoy life etc).

Can you try to accept your negative thoughts and not fuel them with further rumination? Instead keep bringing your attention back to what you are doing and focusing on your goals. This is just like meditation; in the beginning of practice you need to keep returning your focus to your breath, until eventually you can stay focused on the breath while your negative thoughts float past in the background. The spotlight of attention is on what you are doing. The volume is turned up on thoughts that aid performance and the critic is turned down.

Also, choose some activities that help you break negative rumination cycles. Have an enjoyable and engaging book to hand, using the language systems of our brains can help to quieten the rumination cycles. Play fun computer games, do puzzles or sudoku, do sports, talk to people about things other than your ruminations. Even better, do activities outdoors with other people.

 

Why not give these tools a try and let me know what you think?

We will cover some tools in the next article which focus particularly on the emotional feelings that can challenge the BA process.

Behavioural Activation Part 2 – Why You Need More than Common Sense

As I wrote in part 1 BA is a common-sense approach to mental health. The problem is when you are in the depths of depression and anxiety the logical common-sense part of your brain is inhibited. You also struggle to hold on to the positive experiences in this state. In fact, at times your brain actively seems to resist them. Professor Richard Davidson elucidated this in his brilliant bookThe Emotional Life of your Brain’. Davidson describes that in comparison studies, depressed patients report the same level of positive emotion in response to pleasant stimuli. The difference is in the half life of these positive emotions. In the control group these positive emotions increased as the subjects reflected and savoured the experience, whereas, in the depressed individuals the positive emotions dropped away sharply. This was reflected in the brain region related to reward and pleasure, the nucleus accumbens. The ‘notes’ of pleasure in the brains of depressed patients were trailing off far quicker than in healthy controls. I think anyone who has experienced depression will relate to this, there are moments of happiness and pleasure, but these are often followed by even deeper lows as you lament for what slipped through your fingers. Sometimes these highs are so subtle that they even go unregistered, so the depressed person is tricked into believing there is only the darkness.

There is also the lack of motivation or the paralysis of fear to deal with. You literally can’t get yourself to think, move or act in a positive way. You might even know what will help you but your body doesn’t seem to move or your overwhelming thoughts convince you that nothing will help or you don’t deserve recovery.

Many theorists posit that depression has an evolved function. In the days of our ancestors this mood state would induce you to go back to the cave to rest and avoid danger. Or it might mean that you kept a lower status in the group so that the dominant members of the tribe would not attack you. Is it perhaps a mechanism that in smaller dose’s can be beneficial, but is not designed for our modern world? Is depression triggered by an overactive physiological response to the everyday stresses of modern life? These theories make sense to me. Perhaps we can use them to help us be kind with our harsh inner critics and cut ourselves some slack. After all, it is not our fault that we have tricky brains.

So, what can you do when you are depressed and want to utilise BA? As MBCT states ‘In depression, we have to do something before we are able to want to do it’. Over the next series of blogs, I’m going to describe 10 tools that have helped me. Needless to say, it will always be most effective to do BA under the guidance of a trained professional.

 

  1. Divide and conquer – The science of procrastination has a lot of transferable tools here (see Prof Timothy Psychl brilliant book for more details). Divide every task up into smaller and smaller chunks, until it seems possible. At the extreme end of the scale, getting out of bed and going downstairs for breakfast could be divided into multiple steps, each one being focused on in turn. Start small in terms of changes, with one or two new items added to your schedule a day (or week). Start with the simpler tasks and build up to anything more challenging.

 

  1. Put it down on paper – As discussed in the first article, BA is typically recorded hour by hour on paper. It really helps to write the plan down and focus on each hour rather than the potentially overwhelming full day or week. Generate and write down your list of pleasure and mastery activities that reflect your values and goals.

 

These first two points work in partnership. Putting our plans down on paper helps us to divide and conquer. But what happens when your thoughts and feelings resist this process? We will take a look at tools to work with our tricky minds in the next article.