Gerry Gajadharsingh writes:
“The word “Mindfulness” is often misunderstood, both by clinicians and patients. When Mark Williams, emeritus professor of clinical psychology at the University of Oxford, lectures on it to enlightened audiences, he always clarifies. All those illustrations of people on top of mountains, looking blissed out, he says mildly, “give the impression that this is mostly about clearing your mind. And it’s not.”
Williams, 70, likens mindfulness to sitting on a riverbank watching your thoughts and feelings flow past, and choosing which you want to engage with and which you don’t. You’re seeing the patterns of the mind.
His colleague Dr Danny Penman says “If you’re in chronic pain, your mind knows what to expect from the pain, so it doesn’t actually have to pay attention to the incoming data from the injury. It just essentially recreates the pain in your mind.” The actual pain varies moment to moment, “but because the brain is running a simulation, you only ever experience the peak pain”. When you start to pay attention to it, “you notice the peaks and the troughs. It makes it easier to live with.”
Prior to his work in mindfulness, William’s research focus was depression and the suicidal mind — and, he says, it’s partly because mindfulness teaches you to gain distance from your thoughts — to see them as “mental events passing in the mind” — that it’s so potent against depression, which involves getting tangled in a lot of negative thinking from which it’s hard to escape.
When depressed or suicidal people felt despairing, if they were trained in mindfulness techniques, Williams says, “They could stand back from their thoughts and say, ‘Ah, now I see what’s happening.’ ” Mindfulness was able to uncouple the sad mood from suicidal ideas. “So, people might still feel sad, sometimes they might still feel suicidal, but — rather like the pain example — it doesn’t all then get enmeshed and start escalating.”
It is almost impossible for most people to think about nothing. The focus of mindfulness is also to pay attention to internal bodily feelings, such as breathing and posture, and where we hold tension within our muscles. This can often help us move from the constant thinking that most of us do, and help our brains move into a more relaxed state. Physiologically, this helps us move from a state of “constant alert” where the stress or sympathetic part of our autonomic nervous system is constantly upregulated into the more relaxed or parasympathetic part of our autonomic nervous system.
Mindfulness techniques are often a mixture of relaxed breathing and meditation or visualisation techniques. However, many people find meditation or visualisation difficult, especially when their brains are constantly thinking. I tend to find it more useful to teach people to adopt a more relaxed, breathing pattern, and then to try meditation or visualisation.”
https://www.thehealthequation.co.uk/monitoring-heart-rate-variability-hrv/
https://www.thehealthequation.co.uk/breathing-therapy-and-techniques/
An Oxford clinical professor and a meditation expert tell Anna Maxted how to do it right and – help chronic depression.
The Instagram version of mindfulness has us fooled. We think it’s all yoga poses on white beaches. In fact, it is clinically proved to be effective in treating severe depression, yet its reputation remains on a par with crystal healing.
Mindfulness is so misunderstood that even when Mark Williams, emeritus professor of clinical psychology at the University of Oxford, lectures on it to enlightened audiences, he always clarifies. All those illustrations of people on top of mountains, looking blissed out, he says mildly, “give the impression that this is mostly about clearing your mind. And it’s not.”
I’m sitting in a quiet room in an Oxford college with Williams, who co-developed mindfulness-based cognitive therapy (MBCT) for prevention of relapse in depression, and Dr Danny Penman, a meditation teacher and author. We’re here to discuss their latest book, Deeper Mindfulness: The New Way to Rediscover Calm in a Chaotic World. (Their first, Mindfulness: Finding Peace in a Frantic World, was a million-copy bestseller.)
Who better to clear up any confusion? Mindfulness is about clear-sighted awareness, says Penman, 56. “It’s essentially paying full conscious attention to whatever is going on around you and inside you.” So, noticing your thoughts, feelings, emotions, as well as what you can see, hear, smell and feel. He adds: “It’s a state of mind that is cultivated by paying attention. And we very rarely do that.” Usually, we’re swept along by our thoughts.
Williams, 70, likens mindfulness to sitting on a riverbank watching your thoughts and feelings flow past, and choosing which you want to engage with and which you don’t. You’re seeing the patterns of the mind. This brings calm, but also insight. Another tenet of mindfulness is being kind to yourself and others. (Williams, who lives just outside Oxford, texts in advance to ask my sandwich preference, and Penman — coming from Bristol — emails to warn of train delays.)
Penman in particular is a convincing advert for the power of mindfulness to help manage chronic pain. Though I confess I’m sceptical, and almost annoy Williams by joking about its ability to lessen the agony of childbirth. Penman says with a laugh: “I know it sounds so glib!”
But mindfulness worked for him when, in 2006, he had a paragliding accident, smashing into a Cotswolds hillside from 30ft up. “The lower half of my right leg was driven through the knee into my thigh.” As the pain hit — “the most astonishing pain you could imagine” — he used a simple meditation learnt at school to gain control of his breathing.
During his month in hospital, he practised visualisation meditations — “I needed a positive view of where I was going to be in a year, two years . . .” His recovery was estimated at 24 months, but he was better in five and a half. “As soon as you relieve the stress and anxiety, which is what those meditations did, your whole body’s healing process is allowed to do its work,” he says. What it did for him led him to contact Williams.
Turns out mindfulness can alleviate pain because of how the brain works. “If you’re in chronic pain, your mind knows what to expect from the pain,” Penman says. “So, it doesn’t actually have to pay attention to the incoming data from the injury. It just essentially recreates the pain in your mind.” The actual pain varies moment to moment, “but because the brain is running a simulation, you only ever experience the peak pain”. When you start to pay attention to it, “you notice the peaks and the troughs. It makes it easier to live with.” He adds: “The pain you experience is absolutely real. I don’t want to downplay that.”
Plus, as Williams notes, most people don’t experience pain as purely “intense sensations from the body”. Rather it’s an amalgam of intense sensations, plus “thoughts about it like ‘I can’t stand it, how long is this going to go on?’ and feelings of frustration, helplessness”. It becomes “a glob”. But if you use mindfulness to step back — “oh, that’s a thought, that’s an emotion, that’s the intense sensation” — you dismantle the glob, so the pain becomes more workable.
Prior to his work in mindfulness, William’s research focus was depression and the suicidal mind — and, he says, it’s partly because mindfulness teaches you to gain distance from your thoughts — to see them as “mental events passing in the mind” — that it’s so potent against depression, which involves getting tangled in a lot of negative thinking from which it’s hard to escape. “Realising you don’t have to follow the thoughts, you don’t have to get tangled up in them, can be very powerful,” he says.
Even so, it seems astonishing that a mindfulness-based course can conquer the monster that is depression — until he explains. “We found in our early research at the MRC Cognition and Brain Sciences Unit in Cambridge that people when they are suicidal can’t see their way to solve problems.”
Much of that difficulty comes from “an over-general memory” — an inability to be specific about their past. If asked to think of an event when we were happy, most of us could recall a specific day. Depressed or suicidal people tend to say, “Oh, times when I’ve been with friends.” If you’re suicidal, this worsens your despair.
Why? Because if, say, your relationship has ended and all you can think is “ ‘when I was with Bill, it was all right’ and Bill’s left you — that’s it. There’s nothing you can do,” Williams says. Whereas a specific memory, “ ‘I remember going with Bill to the cinema, then we met friends, had a coffee’, has given you Bill, who’s left you, but it’s also given you the coffee, the friends, the cinema. So, you’re more likely to be able to navigate your future.”
When depressed or suicidal people felt despairing, if they were trained in mindfulness techniques, Williams says, “They could stand back from their thoughts and say, ‘Ah, now I see what’s happening.’ ” Mindfulness was able to uncouple the sad mood from suicidal ideas. “So, people might still feel sad, sometimes they might still feel suicidal, but — rather like the pain example — it doesn’t all then get enmeshed and start escalating.”
Even if we are well, mindfulness can be invaluable because it enables us to gain perspective, Penman says. “It gives you a little bit of extra space to make better decisions.” Nowadays we tend to overburden ourselves, Williams adds, and everything can accumulate until we’re in a “driven state” (distracted, judgmental, emotional, off balance, reactive, avoidant, joyless) — and then not tasting our food, ignoring our kids.
There’s good reason for this. The mind, as Williams explains, is clever at “devaluing distractions” to help us to focus. This, brilliantly, is why procrastination always makes a job less appealing. Even a neutral task like returning a library book will acquire an unpleasant tinge if you put it off. Mindfulness helps you get back into “being mode” — or at least prompts you to ask (as your children knock on your study door but fail to recognise you), “is this what I’d intended to be doing right now?”
Deeper Mindfulness contains an eight-week programme that includes meditations clinically proved to be highly effective at treating anxiety, stress, depression, exhaustion and enhancing quality of life. But even if you weren’t to do a single meditation, the science of how the mind works is instructive (OK, it’s an arse-kicker).
I’ve stopped multi-tasking as I don’t want “a shallower mind”. And anyone keen to preserve their ability to focus should develop a “spotlight of attention” they train on one thing at a time. Constantly switching from this to that erodes your attention span and — because of the effort needed to “inhibit” the mind’s focus on the task just left — is mentally draining.
To demonstrate, Williams and Penman suggest timing how long it takes you to count to 11, then recite “Mary had a little lamb”. Then try interweaving both: “One — Mary — two — had — three — a” etc. Thanks to the “switching cost”, it takes longer.
The book also introduces the “deeper” mindfulness concept of “feeling tone”, or vedana. Penman explains it rather poetically. “At the moment that the unconscious mind crystallises into the conscious mind, there’s this very, very small space where your mind categorises everything as either pleasant, unpleasant or neutral.”
So. A baby smiles at you. Pleasant. You see litter. Unpleasant. “There’s nothing we can do about that initial sense of ‘pleasant’ or ‘unpleasant’,” Williams adds. But, Penman says, that primal sense is a tipping point. “If it tips one way, it tends to trigger negative thoughts, feelings, emotions, sensations; if it tips the other, they will be more positive.”
Usually we’re unaware of this “feeling tone” as a trigger, and of the way we react to it. We find ourselves pushing away unpleasant thoughts and it creates mental turbulence. Or a pleasant feeling dissipates and we feel flat. Williams says, “You get pushed and pulled around by this sense of ‘pleasant’ or ‘unpleasant’ ” without understanding why.
But if you become aware of that moment where a “feeling tone” is created, you can alter your response. I try it. Hours after I realise, I need to replace my car (boring, expensive), my 16-year-old tells me something tedious about school and I snap. It dawns that the car issue is sloshing around in my head — unpleasant.
So, I mindfully name the car-prompted feeling tone souring my mood — “unpleasant”. Then I say, “It’s OK not to like it.” Doing this cuts out a lot of mental complexity, Williams says, “because when we’ve had a distressing memory or experience and we’re ruminating about it, we get drawn into solving the problem or rehashing it in our minds”.
Mindfulness isn’t about accepting the unacceptable, and you still might need to rationally process a problem, he adds. Though if not, or if it can wait, simply saying “no action needed right now” can be freeing. Words to invoke when your thoughts start spinning at 3am. It feels as if mindfulness is a superpower available to all of us.