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Wednesday, May 29, 2013

The Tao: Mindfulness-Based Cognitive-Behavior Therapy 05-30

The Tao: Mindfulness-Based Cognitive-Behavior Therapy

By Jenny C. Yip, Psy.D.

All things in the world come from being. And being comes from non-being.
–Lao Tzu

Tao, Jenny Yip, Mindfulness, Cognitive-Based Therapy

This is the essence of what we have come to know today as mindfulness. Learning to let go and be without thought, without judgment, without mind.

How do you let go? 

By being in the present moment. For many of us, that is easier said than done. Instead, we waste our time either ruminating over past mistakes or worrying about future catastrophes. 

We can’t change the past. So why live in it? 

There are no guarantees for the future. So why jump to conclusions?

 Of course it is intelligent to plan for the future. It is also smart to learn from our past mistakes. 

However, it is irrational to worry about that over which we have no control – e.g., the past and the future.

Living in the “now” allows us to be present, mindful, and experience the passing of time. 

Whatever emotion or thought you are experiencing, whether positive or negative, over time, has to pass. The moment you read these words has just passed. 

Try to hold onto it… you can’t. The moment you read THESE words has passed again. And so on and so forth. This is what is meant by “This too shall pass.” 

Every moment is moving toward the next moment. Being present in THIS moment as it occurs leads to mindfulness.

In Cognitive-Behavior Therapy (CBT), this is coined the “process of habituation.” The passage of time allows our triggered fight-or-flight response to exhaust itself.

Remember that classic saber tooth example? How long do you think your motors can keep you running or fighting? Until exhaustion or, as we call it in CBT, habituation occurs. Or until you become the saber tooth’s lunch. Whichever comes first.

So, if you are feeling anxious with fearful thoughts, this will pass.

 Similarly, if you are feeling joy with happy thoughts, this too will pass.

 Whatever it is, it has to pass. No one thing can ever be static. Everything evolves and passes. And time cannot be recycled. How do you attain mindfulness? 

There is no definitive “achievement” of mindfulness, especially when the essence of it is to empty your mind. Mindfulness is just a state of being.

Unfortunately, when dealing with anxiety, the worry and fear along with all of the other uncertainties keep you either in the past or the future, and this has a domino effect. One negative thought typically triggers another and another and yet another. And more often than not, these negative thoughts consist of cognitive distortions in various forms. Before you realize it, your mind is spiraling into a tornado of irrational thoughts. 

Because mindfulness requires you to be in the present, it allows you the opportunity to quickly identify these negative thoughts.

Imagine having the ability to stop a distorted thought in its track before it spirals out of control. Being aware of these mental connections allows you to interrupt negative thought cycles. The goal is to identify the cognitive distortions and revalue them to represent reality accurately.

 So when you are feeling anxious, instead of getting caught up in those negative thoughts of the past or future, just stay with the present moment. Rather than giving more meaning to the distorted thought than what it’s worth or appraising the unnecessary emotion with more value than it has, focus on the now to let time pass and habituation occur.

In my practice, there are a number of mindfulness methods I’ve integrated with traditional CBT. In the essence of time, I will review a few of the most concrete ones here:

Being mindful of the 5 senses: First and foremost, in beginning mindfulness meditations, I instruct clients to imagine viewing themselves from a bird’s eye perspective. The emphasis is to be mindful of each of the 5 senses (visual, auditory, olfactory, taste, tactile) individually, until the client is able to incorporate all 5 senses together.

 Many clients beginning mindfulness practice falsely believe that mindfulness meditation is a relaxing technique where your mind is free to wander off to Never Never Land. Unlike this popular belief, it actually takes concerted effort to empty your mind, and allow your 5 senses to absorb your surroundings thereby keeping you in the present. 

Try to take 60 seconds for a super quick mindfulness meditation, and you’ll realize just how easily your mind enjoys wandering off to another world. To assist in this training, clients are also instructed to practice mindfulness eating and mindfulness walking. The goal is to engage slowly in only one activity at a time, while being mindful of all 5 senses in the process.

Narrative writing: Narrative writing is a very powerful mindfulness training that incorporates the process of exposures. This exercise requires clients to write about their most feared situations. Exposures via writing require the highest level of cognitive functioning. 

Unlike visual or auditory processing which comes and goes, when we write, we make a concerted effort to mindfully process our thoughts before externalizing them onto paper. This is infinitely more effective. 

Even if a client exposes to a feared situation in vivo, s/he can avoid or escape the anxiety-provoking situation mentally. However, it takes much more effort to avoid when you have to be cognitive and mindful as you are writing.

 To increase mindfulness, the rules of narrative writing include:

1) staying in the present moment by using present tense;

2) using active versus passive verbs;

3) being as descriptive and detailed as possible.

The client is instructed to continue the narrative writing exposure and stay in the moment with whatever emotions or thoughts arise until habituation occurs.

The “oh well” approach: Finally, the “oh well” method encourages us to let go of those situations that are outside of our control which, I must say, occur more often than not. Certainty and control give us a false sense of security. 

Not only do we not have control over people, objects, and situations outside of ourselves, the truth of the matter is that we do not even have direct control over our own emotions or what thoughts enter and exit our minds. We only have control over our behaviors, which include our actions and reactions to those thoughts and emotions.

 If we are mindful of this fact and accept it, then we will not have a need to control those areas outside of our behaviors, and we will be able to let go of situations outside of our control. So, the next time you are stuck in traffic, “oh well” it since there is really nothing you can do in that very moment. 

Rather than working up a frenzy of one negative thought after another, just breathe and empty your mind. Let’s face it, those negative thoughts aren’t doing your mind or body any good anyways.

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