Archive for February, 2009

Stressed? You Can be Your Worst Enemy

Friday, February 27th, 2009

How many times during the day do we run away with stories in our heads that only serve to make us more tense or more frustrated with life. How many troubles do we have in our minds that never really happen? The following is a story I originally heard from author and teacher, Jack Kornfield, of a man that we may all be able to relate to:

John had been touring in Afghanistan and over time had developed a stress condition so severe that his commanding officer recommended him to take leave for a while. Part of the conditions for leaving was that he take an 8-week mindfulness course to deal with his stress. After 8 weeks, John learned how to become aware of the interaction of thoughts, feelings, and emotions that would cycle over one another and snowball him into a full blow stress reaction or a fit of rage. He was able to acknowledge when this was happening, bringing himself back to his breath and body, calm his nervous system, and respond differently. He was feeling pretty good about himself and his new way of relating to his stress and anger.

On his way home to see his family, he stopped at a super market to pick up some groceries. As he began to check out in the 12 items or less check-out line, there was a woman in front of him holding her baby. The first thing he noticed was that she had at least 15 items which started to irritate him. He began to think, “I can’t believe people do this, it is so rude, what is wrong with this lady.” As the fumes continued to rise he noticed to check out clerk and the customer beginning to coo at the little baby. This only made his blood boil more. Then the unthinkable happened. The customer actually handed the baby over to the check-out clerk who continued to coo and smile at the baby. “Don’t these people have any respect for other people’s time? I hate this.” John’s whole body was in a knot at this point.

Just when he was about to …

What's the Point of Life?

Wednesday, February 25th, 2009

Human beings are social creatures and we really need one another for support and survival in this world. Back in the day it was called a clan or a tribe, now it’s called community or social networks. Too often in the midst of our relationships one person says or does something that offends another and a spiral of hurt and grievance begins between the two. People get so boiled over with anger inside and make a choice not to connect or make amends with the other because “they don’t deserve it.” What we’re missing in this picture is that this grudge, this boulder of anger we’re carrying within us, is actually hurting us! It comes in the form of tension, irritability, shallow breathing, increased heart rate, and stress. While it may be too difficult to just ‘let it go’ right now, it may be a good idea to begin to see it a different way.

I have seen it now a number of times. “What was the last thing I said to him before he went out the door” she said on the day her boyfriend was killed in a tragic accident. We’re heard a resounding cry of this during 9/11. Why does it take something so severe as death or threat of injury to bring us back to our senses to what is truly most important…our connections. Lying on his deathbed the successful entrepreneur turned to his counselor and said “I had it all wrong. It’s not about the money, it’s about who you love and how you love them.” We could take some lessons from those who are in the last round.

When reflecting on this topic, it makes me think of the people in my own life who are still alive. Life can be so fragile and while at times I can think that we’re all immortal and will live forever, reality informs me that we all come and go in this life. The truth is, we just don’t know when that will be.

In an earlier blog, Ronald Pies, M.D. said, “having problems means being alive”. I’d like to add to that, “having …

Depressed? Break Out of Auto-Perception

Monday, February 23rd, 2009

This weekend I went on a hike with some good friends and during the hike we kept hearing sounds of frogs, ‘croak, croak.’ We looked in the water, on the ground and all around us, but we could not find these frogs. They sounded like they were right next to us. For a few moments we slowed down and I chose to close my eyes, open my ears and just listen. As I began to feel more present and let go of the expectation that the frogs needed to be in a certain place, I opened my eyes again and was able to shift my perspective and see the frogs, they were camouflaged against the rocks. It was amazing. All along they were there but my mind and eyes were stuck and couldn’t perceive them. It made me think: How many things in this world are we literally not able to sense because our minds get stuck in automatic patterns of perceiving or auto-perception?  How might this auto-pilot of perception contribute to our depression and anxiety, day to day?

Certainly, when a person is experiencing depression, the mind is often stuck in a cycle of rumination that not only interprets things from a negative lens, but expects negative things to happen and literally zeros in on the negative things that are there. Because of these prejudices and preconceptions about how things are, we can literally feel stuck in a box, unaware of new options that might support our mental health during this time. Doubts and self judgments about getting better run rampant, leading to the inevitable trifecta of depression “this is never going to get better, no one can help me, and I can’t help myself.”

Without being able to take a step back and examine the validity of these thoughts we just take them as fact, which leaves us feeling helpless and lethargic, leading to a self-fulfilling prophecy of not getting the support we need. Taking these negative thoughts and beliefs as facts limits the potential to make the important steps on the road to recovery. Henry Ford once said, “whether you believe you can or …

Feeling Grief Means Being Alive: 7 Tips to Help

Friday, February 20th, 2009

In a recent blog, Ronald Pies, M.D. wrote about an experience which left him fuming when a local pharmacy lost close to 50 years of “priceless” home movies of childhood summers and memories gone by.  That same day continental flight 3407 went down and the deaths of 50 passengers that day putting everything in perspective. He said “Having problems means being alive” and even though we may struggle in this life, being alive is something to be grateful for.

Days later I learned that a very good friend’s husband was hit by a bus and left in critical condition only to pass away shortly after. He was a great man with a sweet soul and a gentle nature. He loved his animals, his wife, and kids, and seemed to always have a smile for you when in his presence. When I heard the news, I initially felt resistance to the sadness as I had so much to do that day and didn’t feel like I had time to feel it. My body was starting to feel tense and I noticed irritability arising. A little thought arose, “maybe you should just take some time to feel this, the other stuff can wait”. I found a picture of him online and stared at it for a few moments and then I realized, “I need to feel this” and just let it be. After spending some moments letting the tears roll down, the tension and irritability melted away, I began to feel much more connected to myself and more compassion and empathy arose for my friend who lost her husband.

Mindful grieving informs us to allow ourselves to feel what is there, without judgment. For me, there was sadness there and I needed to nonjudgmentally acknowledge it, feel it, and let it be. It was important in that moment that I didn’t resist it or strive to make it any different, but just feel it as it was. Ronald Pies, M.D. wrote to us, “Having problems means being alive”, and I’d add “Being alive, means grieving loved ones who pass.” Grief is a natural part of the human experience.

While …

Turn on the Shower and Reduce Your Stress Today

Wednesday, February 18th, 2009

Supreme Court Justice, Oliver Wendell Holmes said, “What lies behind us and what lies before us are tiny matters compared to what lies within us.” Too often in our society we favor spending time in the past or future than in the right here and now. What is the cost? Habitual rumination on regrets into the past will sap your energy and open the doors for a barrage of self judgment that will keep you from living the life you want. Letting your mind cycle over worries about the future or potential catastrophes will leave you tense and potentially with a good case of irritable bowel syndrome (IBS). So many of us have so many imaginary troubles in life, most of which never happen. Learning how to be more present in day to day life is the process of falling awake, gently letting go of our giant self critics, and opening our eyes to the reality of what is really happening, right here, right now.

What would happen if instead of thinking about all the plans you had to catch up on while you were in the shower, you took a pause, and then brought your nose to the smell of the soap…and again, just exploring the scent of it with your nose…What would happen if you then brought your attention to just feeling the sensation of the warm water against your skin and the feeling of goose bumps that might be there from the contrast of coming in from the cold? Oh…then the mind drifts back again about who you need to call at work, why are you doing this stupid practice, the upcoming meetings, when you need to pick up your kids, what you need to buy for dinner, as you begin to speed up and the tension mounts. What would happen if you noticed this, said to yourself “there goes my mind again”, and then brought your attention back into the shower where you were right now. How might your experience be different? How might your mood be different when getting out of the shower? Would you be more or less reactive with …

Mindfulness and Addiction: Part 3

Monday, February 16th, 2009

This is the last blog in a 3 part series on Mindfulness and Addiction. This one is all about getting our hands dirty in practice when it comes to working with cravings and urges. Let me set the landscape. Dr. Alan Marlatt had a friend who was a surfer and also a cigarette smoker and no matter how hard he tried, he just couldn’t quit. Alan described this process of bringing attention to the breath while observing the physical sensations of the urge and watching them as they came and went. His friend said to him “It’s like you’re using the breath the surf the urge”. And so it was, urge surfing was born.

I had mentioned in an earlier blog that an urge is an impulse to engage in the addictive behavior and is expressed via physical sensations in the body. Cravings are thoughts or desires to engage in the behavior. An urge to engage in an addictive behavior can be seen as an ocean wave in that it starts small, gets bigger, crests, and finally subsides. The peak of an urge usually lasts somewhere between 20-30 minutes. Urge surfing teaches us to use the focus of our breath as a “surfboard” for riding the wave of uncomfortable thoughts, feelings, and sensations rather than the usual approach of try and avoid the discomfort of the urge by using.

Here’s how to do it:

  1. Find a place where you can feel comfortable and relatively undisturbed for a few minutes.
  2. Think of a situation where you feel like you might be in danger of engaging in your addictive behavior. If you have a severe addiction, you may want to choose something a little less triggering (e.g., email, internet surfing, etc…). Really imagine this situation.
  3. Begin to observe the thoughts, emotions, and physical sensations that are arising. You may notice desires to engage, or feelings of excitement or anxiousness, and even stiffness or tightening in the body. Just reflect on what is coming up.
  4. Now begin to shift your attention and engage with your breath. Breathing in and just noticing it coming in and breathing out and just noticing it going out of …

Mindfulness and Addiction: Part 2

Friday, February 13th, 2009


In the prior blog I wrote about the potential to use nonjudgmental present moment awareness (aka mindfulness) to become more attuned to triggers, cravings, and urges and help break the cycle of addictive behavior. I also used the caveat “this is easier said than done.” When struggling with addiction, it becomes all too common to switch onto auto-pilot with little to no awareness of the thoughts, feelings, and sensations that can tip you off balance and bring you to that next moment of grasping. In his research, Dr. Alan Marlatt, Director of the Addictive Behavior Research Center at the University of Washington, gives us insight into what is helpful to be aware of?

 Here are 3 things to bring more awareness to:

  1. Body-Feeling State – It helps to be aware of emotions and how they manifest in the body. Are you feeling a constriction in the chest due to anxiousness, salivation in the mouth due to excitement, or maybe tension in the body due to anger? It’s important to become aware of these emotions and instead of avoiding them through the next fix, we can learn to bring a non-judgmental awareness and curiosity to the actual feelings of them. In this approaching instead of avoiding, we cultivate compassion for ourselves.
  2. Addictive Thought  Styles – Common mind traps arise in connection with the body-feeling state. Do you notice any denial? “I don’t have a problem with my drinking” or “I just like to shop, I’ll pay off my credit cards later.” How about blaming – “It’s my wife’s fault that I smoke so much, she’s always on my back.” Rationalizing anyone? “I’ve worked really hard today and deserve this.” As soon as we bring awareness to these mind traps, we’ve stepped outside of them, are present, and are closer to being able to change our behavior.
  3. Negative Interpretations – When caught in an addictive cycle, we also usually engage in interpreting events for the worse which helps tip us off balance and become more susceptible to auto-pilot. For example, if the addiction is with alcohol, does a sip of wine mean you had a “slip” or is it a “full blown relapse”? If …

Mindfulness and Addiction: Part I

Wednesday, February 11th, 2009

In an age where our lives seem to be accelerating, our stress also naturally seems to be increasing. In addition to addictive behaviors potentially having a strong genetic link, it’s no wonder why so many of us are craving avoidance and escape. According to the U.S. Substance Abuse and Mental Health Services Administration, One in eight Americans suffers with addictive behaviors regarding drugs or alcohol and it costs society approximately 250 billion dollars per year.

When caught up in the cycle of addictive behavior, there is an inability to accept whatever is being felt in the present moment and the mind is constantly wandering onto the next ‘fix.’ In the present moment, distressing thoughts and emotions can feel like unwanted guests that we can’t seem to get away from. In our fight to avoid this distress, we actually amplify stress and uncomfortable emotions such as sadness, frustration, irritation, shame, or guilt. These uncomfortable emotions often kick us into a state of mindlessness or auto-pilot, where we’re unaware of our environment and more susceptible to triggers, cravings, and urges.

Victor Frankl, respected Psychiatrist and Holocaust survivor, once said:

 Between a stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.

Is there a way to slow time down to be more aware of that space and choice? In the addiction field specifically, Dr. Alan Marlatt, Sarah Bowen, and Neha Chawla, Psychologists and researchers at the University of Washington, are trailblazing a promising new approach toward addiction based on Jon Kabat-Zinn’s Mindfulness-based Stress-Reduction program, called Mindfulness-based Relapse Prevention (MBRP). While clinical trials on this approach are still underway, over 30 years of prior research in the field of meditation and addiction are very encouraging.

Whether our addictions have to do with alcohol, drugs, food, sex, gambling, emailing, or shopping, the addictive behavior is often preceded by some triggering event that sets off a flurry of uncomfortable thoughts, feelings, and sensations, leading to cravings and urges to engage in the addictive behavior. An important part of recovery is being able to recognize our triggers and how cravings …

Reclaim Your Mind, One Story that May Change Your Life

Monday, February 9th, 2009

When struggling with our mental health one thing we can all agree on is that sometimes our minds feel out of control and reactively judging or interpreting a situation may not only be inaccurate, but actually make us feel worse (see recent blog). Read the following scenarios and notice your initial response. When a recent date doesn’t call back, does that mean the romance is cooling or that the person has been busy? Does getting a speeding ticket mean the world is out to get you, or that you need to slow down? Is showing your emotions a sign of weakness or a sign of courage? Lack of awareness of automatic negative interpretations can keep us in a cycle that continually leads to anxious feelings and tense physical sensations. Mindfulness is a vehicle to slow things down and notice habitual tendencies to automatically interpret events in a negative direction and can remind us of other options. What might seem like a disaster may actually be a gift.

There is a story of a very wise old man in a village: Everyone in the village looked up to him and sought his advice. One summer day, a villager came to him in a state of panic, “Wise sage, I don’t know what to do, my ox has died and now I am unable to plow my fields. This is the worst thing that could have ever happened.” The sage looked him in the eye and replied, “Maybe so, maybe not.” In a state of disbelief the man returned to his family and proceeded to tell them how the sage was no sage after all and that he had lost his mind because surely the death of the ox was the worst thing that could’ve ever happened.

The next morning the man went on a walk to mourn his ox and in the distance saw a strong young horse grazing in the field. Immediately he had the idea that if he could catch the horse then his troubles would be over. He brought the horse back and realized how blessed …

Mindfulness, Mood, and Your Mental Health

Friday, February 6th, 2009

Every day we walk around taking in information and interpreting what we see. Depending on how we’re feeling we’ll interpret it differently. Here’s an example I often do with my own patients to illustrate the point. Picture scenario one: You’re walking down the street feeling particularly depressed, heavy, and hopeless one day and see a friend walking by. The friend looks up at you, but just continues walking without saying hello. What’s going on? Scenario two: You’re walking down the street and feeling pretty well, you’re feeling light on your toes, warm, with a smile on your face. A friend walks down the street and looks up at you without saying hello. What’s going on? Most people I do this with usually respond to the first scenario with some self-blame or self-judgment. “What did I do”, “He hates me”,  or “I’m no good”. Most people respond to the second scenario with a curiosity about what is going on with the other person. “Is he having a bad day”, “that was strange”, or “I hope he’ll be ok”.

This was an exercise to illustrate the point that even though we believe our thoughts represent reality, the truth is, our thoughts are not facts. They are temporary and fleeting and when we’re not feeling well, our minds become a magnet for negative thoughts and skewed interpretations of what is going on. When we start thinking and ruminating on these thoughts, they tend to create a snowball effect on the rest of our constitution. If we cling to exaggerated negative thoughts in our minds, (e.g., “he didn’t look at me, that’s because I’m fat, nobody likes me and nobody ever will”), this will certainly have an effect on how our bodies feel, bring on emotions of anxiety, sadness, anger, or others, make us feel like isolating and before we know it, we are either in a full blown depressed mood, a panic attack, or both.

You might say, “Well, I can’t help it, this just happens and I feel I have no control”. I would say that in that moment, you might feel that way because you are unaware …

Mindfulness & Psychotherapy

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Books and CDs by Dr. Elisha Goldstein:
Mindfulness Meditations for the Anxious Traveler: Quick Exercises to Calm Your Mind

The Now Effect: How This Moment Can Change The Rest of Your Life
A Mindfulness-Based
Stress Reduction Workbook

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