Thursday, February 28, 2013

When Mindfulness Isn't Helpful

Meditation:  Yes. Wonderful.
Hatha Yoga:  For sure, who can live without it?
Controlled breathing: A life saver.
Guided body focus: Best thing for you.
Containing, holding, focusing only upon depression, anxiety, or anger: Maybe think about drawing the line when this particular intervention is making you sick.

At least don't feel badly that you have failed the class, can't get all cozy with your negative emotions. Because that's the goal, understand, oneness, full acceptance. Mindfulness.

Tell yourself that it isn't your fault if you can't befriend your sadness, if you hate the training, if you aren't getting any better and want to run away, to be anywhere else than in that room full of mindful people.

Who could blame you?  Attending to pain won't  magically bring on peace, certainly isn't nirvana, not for every deep sufferer. It just isn't.  Fine, let's qualify. It works for some, certainly not all of us.

There, I've gone public about something that has bothered me for a long time. I held them in, my mixed feelings about this part of mindfulness, getting close to the pain, because I like the rest of the therapy, and I know that pain does lift and when it does, nobody tends to notice.  So say hello to unhappy moods because they have a shelf life. They also spontaneously regenerate, which is a shame, but it''s called being alive.

The mindfulness therapists will surely tell me I have it wrong, will spleen me for what is to come, but it is worth the risk, shouting to the blogosphere, reaching out and yes, relating to the confused and the angry, the still depressed and even more anxious, those who have plunked down their five hundred dollars to take the 8-session class, if not go on a weekend retreat.

But I'm giving you permission to Just Say No, to say I'm Not Doing This. To say, This Was Okay Until Now, But You've Crossed the Line asking me to lean into my bad feelings.

Lean into the pain?  You want to know who else leaned into the pain?  Aaron Swartz. He killed himself a little over a month ago.

Saying No! when told to embrace depression, anxiety, etc., should empower more than one somebody, and that process, asserting feels good.  Assertiveness is one of our more successful emotional management strategies, tried and true.

No question, each of us gives negative emotions their due in our lifetime. There is no escaping or denying, and those who battle their feelings regularly have spent countless hours in their presence, mostly fighting them, wishing they would go away. It makes a certain amount of sense, therefore, that changing one's attitude, which is what mindfulness is really all about, is worth a try. This is like any other behavioral technique or strategy, in that it deserves a try.

Rather than run, rather than medicate, if we get into it a little, feel the sadness, the anxiety, the anger, it will lose its power. Stop fighting it, it can't kill you unless you let it. Ironically, we tell alcoholics and drug addicts to do this all the time because using is truly hiding, avoiding emotion. So for them feeling is educational.  We tell addicts, Stay with it, feel badly for a change. It won't kill you and it won't mess up your life like substances does.

Staying with a bad emotion might not kill you, but staying in a bad marriage probably won't, either. That doesn't mean you should.

And then there's Aaron.

It is very unlikely, working with a professional mindfulness therapist, that you would do anything self-destructive in the process of getting well. Aaron had severe mental illness; he needed more help than he had, or he simply couldn't take it any more, that spontaneous regeneration. The mindfulness trainers who have trained with the best, and who hasn't, are setting themselves up if they know how seriously mentally ill their trainees are and still pretend it will all be okay. Close your eyes.

No matter, for those who are not severely distressed, it is still possible to feel like a big loser, a huge loser when making the mark feels impossible. If the sadness, anxiety, the anger is no better when you embrace it. If you feel like exploding or imploding while focusing on the pain and don't feel a whit better when it is all over, it is likely that you will feel worse.

Are you not embracing it enough?  Are you a poor embracer? If it feels worse because you are giving it your undivided, your full attention, worse isn't what you are looking for; it's not the goal. Less is.

Theoretically, the major disorders are compounds of negative thoughts and feelings. That's all. Sadness is just a feeling, no more no less, anxiety and anger, too. Emotions are realities like every other reality, anything else that grabs our attention. Hanging out with them should be seen in that light, a fleeting reality. One long moment.

Except that hanging out in this reality, watching pain, hurts a little more than say, watching a sunset or maybe visiting someone, holding someone's baby.

I prefer the sunset. The baby.

You could say that cognitive behavioral therapists who recommend distraction, the sunset, Modern Family (television), taking a walk around the block, or doing a crossword puzzle over embracing the pain are chicken. We also like anesthesia for surgery.

A patient says to me:
 Like I don't know what it is like to be consumed with anxiety?  Every day of my life I suffer from anxiety. And they want me to invite it in?  Makes no sense. I tried and it made me feel even crazier than usual.
Nice.

I recall being a young therapist, a hundred years ago. The patient is crying and I am saying, "It's okay, cry. Crying is good. You have a lot to cry about." And the patient continues, throughout the visit, weeping, and it won't let up, and she won't get up off the floor at the end of the visit, won't leave, continues to sob, and I have to call an ambulance to take her to the hospital.

Wouldn't it have been better if I would have taught her to manage her sadness? Would it have mattered? I think so. I'm pretty sure it would have been better if I had guided her to disengage from the pain, not embrace it.

Of course, I'm not a mindfulness teacher and hope to hear from someone who can clarify for me. But one thing I know. Give me a good distraction, a good procrastination, a good rewrite or a new script, a napkin full of obsessive thoughts, a hand on the heart, a phone-a-friend or any one of the hundreds of emotional management strategies we can all think up with only a little imagination, any day.

therapydoc







18 comments:

lynette said...

i enjoyed reading your take, it is refreshing. i took a mindfulness class at the world-renowned center for mindfulness originated by jon kabat-zinn. at the time, i was struggling with the loss of my dad (which was huge) and with a very difficult marriage. i suffer from major depressive disorder in conjunction with severe anxiety (this predates the life issues mentioned).

i found that the meditation practices exacerbated my anxiety to such an extreme level that i became afraid of trying to meditate. focusing on my breathing when my anxiety attacks were all about feeling like i couldn't breathe was awful.

i cope well in general with MDD and anxiety, and have been invited to speak at patient panels by my doc about my coping skills. for me, the best thing i can do is get engaged. get busy. vacuum. get out of the house, meet people (i don't have issues with social anxiety at all). cook, write, dance, sing. these work for me. they are still mindful, as long as i remember to be in the moment. i can do yoga, but it has to be flow yoga, where i am in motion.

mindfulness is more than one mode. but for me, the current trend does not work.

Graciewilde said...

Darn! your robot proofing stuff just ate my comment - I will look for an email on your site and try again later - after I watch my frustration for awhile....
In a nutshell, I very much appreciated your post. Maybe you could do comment moderation instead of the robot thing to avoid spam? I know spam is an issue...

GracieWilde said...

I read your post on Mindfulness a few minutes ago and wrote a comment - the one that was eaten by the robot killer thingy -
I just wanted to say that I very much appreciated what you wrote. I have been familiar for a long long time with the theoretical concept of mindfulness but have only recently decided to actually step into the experience. I wish I could remember exactly how I phrased the comment that was entirely eaten by the robots but enough to say that putting, say, sadness over there and just letting it be is something I am willing to try on - for awhile anyway. I am someone who wants to DO SOMETHING about everything that gets in my way. This is new territory for me b/c it says, don't do something. Just let it be there. Interesting. What I liked is that you give me permission to say, okay, nice experiment - maybe it will be useful, maybe it won't. Mindfulness is not necessarily not the end all and the be all but it's okay to try it out --
Thanks.
I always look forward to your posts --

therapydoc said...

I hate the capcha robot whatever it's called, too I'll try an experiment, but something tells me it's not going to be good.

therapydoc said...

Sorry friends. Without capcha I get way too much spam. Experiment failed. It's back on.

Mound Builder said...

I read your post on mindfulness just now. I'm not a mindfulness therapist, but I have practiced yoga for nearly 26 years. And that term 'mindfulness' and the practice of mindfulness are part of that, as it of more formal meditation practice. I hadn't thought of mindfulness as leaning into pain (of whatever sort), more like the opposite. That is, you are supposed to notice how you feel--physically, spiritually, emotionally--but you're not supposed to stay focused on any state of mind. Rather, it comes, it goes. You don't push it away, you don't draw it closer. You observe it but you don't fixate on it because fixating on it, grasping to hold onto it means that it dominates you.

I think the same thing about states of mind like extreme anger. Why try to stay stuck in that state of mind? And for goodness sakes, why vent it to others? I used to hear, a long time ago, that anger had to be expressed--angrily, that you had to get the feelings out and yell and scream and carry on. Seems like a recipe for causing emotional harm to others, to me.

But the idea of mindfulnes is not to allow those states to give you power. You notice that you feel angry and then you return your mind to your breathing, for instance. You notice over time that your mind moves from one thing to another (sometimes), and you learn to be able to choose what you spend time with, and that you can always return your mind to your breathing.

But I can't say that I've ever heard anyone, in 25 years of yoga practice, suggest that you're expected to cry and cry and cry, as if that's being mindful. I don't get that at all.

DorleeM said...

I'm glad you're sharing the other side of mindfulness... while I generally love practicing guided meditations, I definitely went through a stage when I had to stop (the feelings and anxiety that were emerging had to be dealt with in therapy and were too powerful to be addressed with on my own).

I remember feeling very confused by my negative reaction (nothing I had read/heard seemed to confirm that one may experience this) and therefore, it probably took me longer than it should have to put 2 and 2 together that I needed to stop meditating for awhile (thereby prolonging my suffering needlessly).

Mindfulness can indeed be incredibly helpful but it is not always appropriate... the bottom-line is that we need to learn to listen to our gut feeling about whether something feels like it is good for us.

therapydoc said...

Thank you Moundbuilder and Dorlee,
That's most of it, MB, noticing the anger and returning to breathing. But there is a stage in mindfulness in which one wholeheartedly stays in the emotion, rides it out, so to speak. That's the part I don't think is always healthy, and Dorlee, sounds like you agree.

Anonymous said...

as a survivor of trauma in my family of origin, i have tried many kinds of therapy over the years. meditation and mindfulness based practices seem good, but often i end up experiencing what my judging mind labels as 'failure'. part of the way i survived was dissociation...and i don't do it automatically any more but the brain mechanisms for regulating attention are flukey now - sometimes too much attention, sometimes not enough - and still an internal part who is a guardian and does not want any other "part" to stop being busy!so, mindfulness can be either allow awareness of incredibly strong painful stuff or self loathing at my 'failure' to 'do it right'.

Syd said...

I like the idea of working through the feelings but not letting them work me over to the extent that I am lost in them. Feel the feelings but not stay stuck is the kind of mindfulness that I like. Again, this is Al-Anon speak in which I accept that I have character defects but don't celebrate them. And some anger is protective but spewing it at others isn't helpful.

Anonymous said...

I respectfully disagree with the idea that there is a stage of mindfulness training where one leans into emotion. I mean... I don’t doubt that somewhere someone says that but I don’t really think it’s true. I have 15 years of yoga, several years of Vipassana (Theravada Meditation), and 4 years of DBT under my belt—that’s what I speak from.

The idea of leaning into emotion sounds like a misreading of the second foundation of mindfulness—mindfulness of feeling tone—which is really not so much the emotion itself but one’s reaction to it—pleasant, unpleasant, or neutral. I’ve never encountered an instruction about leaning in—only instructions about watching and riding. In some lineages, instructions about labeling.

In DBT, which is mindfulness-based therapy, leaning in is explicitly laid out as suffering... as in pain is only pain but suffering is holding onto pain or pushing it away. There’s talk of having a “teflon mind.” Leaning in is viewed as unskillful and there are specific instructions about how to avoid doing it.

That’s not to say that I don’t have sometimes have quams with the way some mindfulness teachers come to mental health issues—I think distracting techiniques, particularly around trauma, aren’t always given the thumbs up they deserve. I suspect this is some of what you’re talking about.

What DBT did for me is take my pre-existent background and basic world view then teach me basic things that I didn’t know—like safety first. And my emotions matter. And this is how one soothes one’s self. Allowing oneself to be overrun is not openness, not loving (a good dose of alonon learning in that one)—then back to DBT for the instructions on exactly how to be assertive.

DBT was like life does have instructions and finally I had screwed up so badly the universe gave up and handed them over. I still struggle but I can keep myself safe, and I have the shelter of a structure to turn to. I didn’t get that from mindfulness alone....

My other quam is around safety. Mindfulness trainings just aren’t equipped to deal with it. So for years I was hearing that I just have a human mind—I am no different than anyone else. Stand on your head and don’t believe your thoughts, blah blah. Meanwhile, I was saying—no—something is really, really wrong. It wasn’t terribly different than victim blaming. And I was too dissociative to put my finger on what was going on... It took a good mental health professional to help me recognize and get out of a bad situation. So I’m not saying mindfulness is the cure.... .......but without it I can’t imagine having achieved this much healing.

Anonymous said...

I wrote in last night but I've been thinking this over and I have one other point to add--philosophical nuance (or foundation...) about the what/where the "self" is-- not so easy to talk about because the way I need to say it here is ultimately not the way it's seen in the end.... but.... With the idea of "leaning in" to emotion, which I already said, from my point of view, is a misunderstanding, there seems to be an idea of merging with the emotion-- being lost in it--being identified with it. Whereas in mediation teachings you are only the watcher-- the container-- the space through with universal experience (thought, emotion, pleasure, plain) passes. You watch with neutrality...theoretically... or all the neutrality that you can muster and there a lot of tools. If you start to get lost in the emotion or thought you are watching you have lost mindfulness (until the later stages of mediation...). The instruction is return to grounding-- the first foundation--mindfulness of body (your seat, your breath). And there's a lot of strength building too that goes on through metta (loving-kindness) meditation, which is often described as the second wing of a bird-- mindfulness and metta-- without both wings the bird can't fly. Metta is the antidote to fear-so really grounding--loosing grounding is the trouble with "just feel it." It's also the first of the brahmaviharas- or prescribed safe resting places for the mind. There is also sympathetic joy, compassion, and equanimity. And there are also reflections on the vicissitudes of life-- I can't recall them all but stuff like fame and ill repute, gain and loss, pleasure and pain.... So mindful awareness sits within a frame. As a sort of aside, this all goes to what I find to be the most fascinating distinction between eastern and western thought-- in eastern thought thought and emotion fall on the side of material (not spirit). My understanding of western thought, especially post-enlightenment, puts thought and emotion on the side of the spirit. Those are vastly different starting places.

therapydoc said...

Anonymous, I can't thank you enough for your explanations. I'm going to cut and paste and think about this. I really appreciate it.

seo glaze said...

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Anonymous said...

I ran across this:

http://www.huffingtonpost.com/ron-purser/beyond-mcmindfulness_b_3519289.html?utm_hp_ref=fb&src=sp&comm_ref=false

And thought back to your post. It adds something to the discussion.

Anonymous said...

Thank you for this... I so needed to hear this. I am seeing a therapist who is pushing mindfulness at me as The Cure and it isn't working for me. I have a lot of stuff to deal with and looking at the 'negative emotion' or pain, not judging it, just noticing it, is driving me crazy!! I have never felt so stressed out!!! On top of everything else I feel like I am 'failing' mindfulness! :*(
It isn't the cure all for every emotional issue, I know it's good for a lot of people, but not everyone!

Anonymous said...

The thing that finally drove me away from mindfulness was the idea that my feelings are "just feelings", and that there is no point to having feelings, and eventually you must return to a state of inert equanimity. I began to dissociate because I was splitting myself into two people, the one experiencing emotion and the one condescendingly observing it. I became suicidal and self-destructive, and am still trying to undo the damage.

Oh, and unconditional, passive acceptance of everything that happens to you--INCLUDING SEXUAL ABUSE--was bad for me, too.

Anonymous said...

To me it seems like mindfulness is like a controlled form of dissociation. You are splitting off the emotions from the experience, so that you just observe them, you don't become them. Emotions have a very short half-life, and will evaporate quickly if not attended to. You don't turn your emotions off (numb out), or distract yourself by going somewhere else in your head, but you don't let them take you over, either.

That said i find it too difficult to use mindfulness as a sit down for 10-20 minute exercise, but i do use those techniques as a quick coping skill when i need it, but only until i feel grounded again and can go on with my day.