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Mindful preparations for working with depression

Your journey journal

We have now arrived at the work and practice part of our exploration together. You might find it helpful to have a folder or a journal that you keep to write in reflections on different exercises, or thoughts you’ve had during the day, or ways in which you might respond to things differently, or even note changes in your dreams. It’s like a personal log. You can also gather things along the way – pictures, poems or articles – to stick in it. We know that writing about our thoughts and feelings

reflectively can be very helpful to clarify them and can also provide insights. You will find there will be some days when you may want to write in your journal and other times you may not. Having a journey journal is, of course, only a suggestion, although I will be inviting you to use it in different ways as we go along.

First steps: mindfulness

On the road ahead we are going to explore how to work on thoughts, feelings and behaviors, to change depressed brain states. One of the most useful skills to help us in all these efforts is called mindfulness.1

In recent years researchers all over the world have dedicated a lot of attention to mindfulness and how it can help depressed people, and indeed all of us.2 The idea of mindfulness itself goes back thousands of years. Here we focus on mindfulness as a way of learning to pay attention, and hold attention in the present moment with a specific focus and with judgement. This it can bring new balance to our minds and awareness.3

Many of the great teachers of meditation point out that we only exist in this moment – we are a

‘point of consciousness’ passing through or in time. Our consciousness does not exist in the moment just gone nor in the moment yet to arrive – we only exist now. Mindfulness is learning how to bring us to be fully alive to the now of our conscious existence, the only place we actually exist. We can be so lost in the hopes or fears of tomorrow, or the regrets of yesterday, that we miss the moment now – we live in a remembered or imagined world, not in the world of ‘right now’. Of course, sometimes it is very important to reflect back and project forward, but when we do this we want to do it purposely rather than being automatically dragged there by depressed states, fears, angers or strong desires.

The word meditation actually means becoming familiar. For us becoming more mindful is to become familiar with the contents of our minds and how our minds work. Mindfulness also means becoming more aware and more ‘in’ one’s experience; to pay open or curious attention to the details

of one’s inner feelings and thoughts as they emerge in one’s mind. How many of us, for example, when anxious or angry, actually stop and pay attention to where this feeling is in our bodies, what our voice sounds like, what part of our mind is now issuing the instructions to our thoughts and bodies; what are our key thoughts and fears? How often do we stand back and practise observing what is actually happening in our minds? Mostly we don’t, and our brain patterns and emotions are just ‘doing their own thing’. Mindfulness is learning how to change this ‘being caught in the automatic-ness’ of the unpleasant emotions and moods.

Yourself and consciousness

Let’s think about ourselves as existing as a point of consciousness ‘in this moment of time’.

Consciousness of this type can be regarded like water. Water can contain a poison or a medicine, can be clear or muddy – but water is water – it is pure and is not what it contains. So too with our

consciousness – it can be filled with joy, anxiety, anger or depression but consciousness itself is not those things. Learning to recognize yourself as a point of consciousness and distinguish this from the content (your moods, feelings and thoughts) can be helpful. A key to help us is learning about our attention.

Learning to attend

Mindfulness is a way of understanding our attention. The attention can be located as an act of choice.

For example, if I ask you to concentrate and attend to the big toe on your left foot, you will suddenly notice sensations from that part of the body. If you now switch your attention to the top of your head, you will experience different sensations. Our conscious attention can be thought of as a spotlight that moves around. It is learning how to direct that spotlight, via our attention, which is key to

mindfulness.

Mindfulness is therefore about the clarity of observation. Let’s try an example of eating an apple mindfully. First, you would look at the apple, and note all of its colours and textures. Hold the apple in your hand and feel the quality of its skin. Don’t rush, spend time observing. When your mind

wanders from your focus on the apple (as it very easily can), gently bring your focus back to it. In this exploration, you are not judging the apple, you are simply exploring its properties. Then you take a knife, and maybe peel the apple, or cut into it. Once again, notice the effect that you have on the apple, the colour and texture of the fruit beneath the skin. Take time to really observe. Next, you may take a bite of the apple, and now you are going to focus on the senses of taste and what the apple feels like in your mouth. Chew slowly, feeling the texture in your mouth, noticing how the juice might stimulate your saliva and how it feels in your mouth. As you chew, notice how it becomes more mushy. As you swallow, pay attention to the sensations of swallowing. All focus is on the apple.

So we have explored the apple visually, by touch and feel, by smell, texture, and by taste. If we had dropped the apple, we would have been able to hear what it sounded like. In this interaction, there is no judgement, there is only your experience of your interaction with the apple. This is mindful attention, being in the activity, rather than distracted from it by other thoughts, and exploring all aspects of the activity to the full.

Notice how your mind can wander: ‘These are not good apples, where did I buy them from; I ought to eat more fruit; actually I don’t like apples! Oh damn, I cut my finger!’ If you are depressed you might have thoughts like, ‘What is the point of this, it doesn’t solve my problems’ – thoughts that will

put you back into stimulating depressed patterns in your mind. One reason for doing these exercises is to practise shifting out of patterns of thinking and focusing that increase rather than diminish

depression in our minds. The mind can ‘rest’ in this moment.

Mindfulness is important because most of our lives are spent doing one thing and thinking about something else, and we are never fully ‘in this moment’. Our minds are constantly distracted. Take driving, for example. We can get home and realize we can’t really remember how we got there, because our minds were full of a hundred and one other things. If something unexpected happened, such as a group of naked motorcyclists zooming past us, our attention would have been alerted, or if the driver in front of us suddenly put on their brakes, our attention would be focused again. But this is not savouring the moment; this is being brought to alertness for a specific reason. Mindfulness is about being in the moment.

Soothing rhythm and mindful breathing

We are now going to use the same idea as mindfully peeling and eating the apple, but this time

focusing on our breathing. Our breathing will become a central focus around which we will do some compassion-focused exercises later. Learning how to breathe mindfully will be useful when we come to do these exercises. The key here is simply to practise without worrying if you are doing it right, correctly, adequately and so forth. These thoughts are common and understandable but they are

distractions. If they arise in your mind, simply notice them and call them ‘your judging and evaluative thoughts’, smile kindly to yourself and bring your attention back on task.

To start with, find somewhere you can sit comfortably and won’t be disturbed. Place both feet flat on the floor about a shoulder’s width apart and rest your hands on your knees. Keep your back

straight. Look down at about 45 degrees – or if you prefer close your eyes – whatever you find best for you. You may prefer to sit on the floor, or cross-legged on a small meditation stool. Find postures that are comfortable for you but not slouched. Sometimes lying flat on the floor can be helpful, if that is the most comfortable position for you to start your work. In my CD, which covers aspects of this book, there are ideas that you can listen to.4 The idea is not to become sleepy but to develop a certain type of alertness, focus and awareness. I will, however, explore a set of relaxation exercises with you later in this chapter.

Gently focus on your breathing. Breathe through your nose. As you breathe in, let the air come

down into your diaphragm – that’s at the bottom of your ribcage in the upside down V. Place a hand on your diaphragm and notice your hand lift and fall with your breath. Feel your diaphragm – the area underneath your ribs – move as you breathe in and out. Do this for a few breaths until you feel

comfortable with it and it seems natural and easy for you. Next place your hands on each side of your rib cage, as low as you can. This is slightly more awkward because your elbows will be pointing outwards. Now breathe gently. Notice how your rib cage expands against your hands outwards, your lungs acting like bellows. This is the movement of the breath you’re interested in; you feel your lungs expanding. You want a breath to come in and down but also expand you out at the sides. Your

breathing should feel comfortable and not forced. As a rough guide, it’s about three seconds on the in-breath, a slight pause and three seconds on the out-breath. But you must find the rhythm that suits you.

As you practise, replenish most of the air in your lungs but not in a forced way.

Notice your breathing, and play around and experiment with it. Breathe a little faster, or a little slower, until you find a breathing pattern that, for you, seems to be your own soothing, comforting rhythm. There will be a breathing rhythm that feels natural to you, and as you engage with it feel your

body slowing down. It is as if you are checking in, linking up, with a rhythm within your body that is soothing and calming to you. You are letting your body set the rhythm and breathe for you, and you are paying attention to it. Rest your eyes so that they are looking down at about 45 degrees. You may wish to close your eyes, but notice that sometimes if we do that we can become very sleepy. Spend 30 seconds or so focusing on breathing, noticing the breath coming through your nose, down into the diaphragm, your diaphragm lifting, your chest gently expanding sideways, and then the air moving out, through your nose. Notice the sensations in your body as the air flows in and out. Stop reading this book, and focus on that for 30 seconds (longer if you like) and sense a slight slowing with your

breathing. Some people find that focusing their attention on just the inside of their nose, where the air comes in, can offer a helpful attention focus. Try it and see.

You might notice how your body responds to this breathing, with feelings of slowing and feeling slightly heavier in your chair. If you’ve done the exercise you may notice how the chair is holding you up. However, some people can find these first stages quite anxiety provoking, and don’t actually like them. For those who do not like the breathing bit, you can practise mindfulness by holding your

attention on something in the way we did above with the apple; choose something like a flower, a tree or the sky. Hold your attention there and if you mind wanders, gently and kindly bring it back. Don’t worry at all if you find the breathing tricky (many people do) and we can do the compassion exercises in later chapters without doing the mindfulness breathing. Nonetheless, it could be useful to practise, so that even if you can only do a few seconds and gradually expand over the days that would be

helpful too. The sensations in the body can be difficult for some people – so practising and coming to feel comfortable with the sensations can help.

Wandering and grasshopper mind

Assuming all went well, you may have noticed that actually, although it was only 30 seconds or so, your mind may have wandered off. You may have had thoughts like ‘What’s this about? Will this help me? Did I do my job correctly yesterday? Where did that pain in my leg come from?’ If you practise for any length of time, distracting discomforts are very common. You may have heard various things outside the room; your attention may have been drawn to the postman pushing letters through the

letterbox, the traffic outside or whatever. The point about this is that our minds are indeed very unruly and the more you practise this short breathing exercise and the longer you extend it, the more you will notice how much your mind simply hops about all over the place. When you first do this kind of

mindful focusing, it can be quite surprising how much your mind does shift from thing to thing. This is all very normal, natural and to be expected. We need to train the mind, and the only thing that is

important in this training is not to try to create anything. You are not trying to create a state of

relaxation. You are not trying to force your mind to clear itself of thoughts – which is impossible. All you are doing is allowing yourself to playfully and gently notice when your mind wanders and then with kindness and gentleness bring your attention back to focus on your breathing. That’s it. Notice and return. Notice the distractions, and return your attention to your breathing. Notice how often your judging mind tries to get in on the act with thoughts like ‘Am I doing this right; is this helping me; am I relaxed now?’ Just notice these thoughts and return your attention to the breath. The act of noticing and returning your mind to the task at hand (in this case the breath) are the first steps to becoming

mindful! In other words, the exercise is simply an exercise where we learn to focus attention. You are not trying to achieve anything. If you have a hundred thoughts, or a thousand thoughts, that doesn’t matter. All that matters is that you notice and then, to the best of your ability, gently and kindly bring

your attention back to the breathing.

If you practise that ‘attention and return’, ‘attention and return’, with gentleness and kindness you may find that your mind will bounce around less and less. It may become easier. Remember, you are not trying to relax as such. All you are doing in this exercise is noticing that your mind wanders and then return it to focus on your breathing. Notice and return, and each time it wanders, that’s fine; don’t get angry with it, kindly bring it back to the focus of your breathing. It can also help if you allow

yourself to smile when you notice the wandering mind. Develop an attitude of gentleness and kindness to your wandering mind.

This exercise of mindfulness is allowing yourself some time where you focus on your breathing and for your mind to come back to that single focus. You may take an interest in how much of a

grasshopper (or kangaroo) mind you have, but at all times try not to condemn your wandering mind, always be gentle, always kind. Notice and return. If you have thoughts that you are not doing it right or that it cannot work for you, then note these thoughts as typical intrusions and return your attention to your breathing.

Some people like to go on and have a focus for their attention, such as a candle or a flower

(concentrative meditations). Again the issue here is learning how to enable one’s attention to focus, without it being cluttered with various thoughts, reflections, concerns, worries and so forth; or if it is, to notice this as ‘thoughts arising’. Another variation is to have a mantra, which is a word or phrase to focus on in one’s mind. Some people think you need to be given your mantra whereas others

believe you can choose one for yourself such as ‘om’, ‘peace’, ‘calm’ or ‘love’. The key word should have meaning for you, and ‘feel calming’.

Applying the principles of mindfulness

You can use mindfulness in many different ways. Another aspect of mindfulness is to become more fully aware of each moment we are in. For example, while eating, you may practise really focusing your attention on the taste and texture of the food, chewing and eating slowly. Waiting for a bus or lying in the bath or while out walking, really focus on where you are. If walking, focus on the

movement of your body. Notice how your feet lift and fall in coordinated action; how the foot comes down from heel to toe as it hits the ground; how your arms move and your breathing flows with the action. In mindfulness we can focus on the thought, ‘I am walking.’ Or focus you attention on what is around you. The idea is to help your conscious mind focus on where you are ‘right now’ – using all your senses – noticing the colours, the sounds and the textures.

A pleasant place to practise mindfulness is in the bath. Often when we relax in the bath we allow

A pleasant place to practise mindfulness is in the bath. Often when we relax in the bath we allow