Today I bring you one of the leaders in the field who goes to the heart of the intersection between mindfulness and psychotherapy. Shauna Shapiro has co-authored The Art and Science of Mindfulness: Integrating Mindfulness into Psychology and the Helping Professions, with Dr. Linda Carlson and has published over 50 book chapters and peer-reviewed journal articles on the topic.  She currently leads mindfulness training programs for professionals nationally and internationally on the applications of mindfulness in the field of health care.

Question: In your book, you cite a huge rise in the last 10 years for National Institute of Health (NIH) funded research studies focusing on mindfulness-based therapies for stress, pain, and/or illness.  Can you tell us a bit about why you think there is such growing interest?

Shauna: In both research and clinical environments there is a rapidly growing interest in mindfulness-based approaches.  For example, searches of the scientific literature on PsychINFO and PUBMED using the same term, “mindfulness-based”, yield 260 and 115 published scientific articles, respectively.  And the enthusiasm of funders, grant peer reviewers and the scientific community has followed this trend:  In 2008 there were 44 funded studies in progress; this number has increased from zero in 1998 and only three in 1999.  I believe the interest and increased funding is due in part to the strong body of research conducted by pioneers in the field, such as Kabat-Zinn and Segal, Williams and Teasdale who provided a clear rationale and direction for future research.  I also believe that there is a cultural shift happening and a deep yearning for greater wholeness and health, for both patients and therapists. Mindfulness offers a simple and easily accessible path toward this – mindfulness offers enormous potential and possibility to the field of health care.  

Question: In your book you talk of three different ways mindfulness can integrate into psychotherapy. The first, the mindful therapist, the second, mindfulness-informed therapy, and the third you call mindfulness-based psychotherapy. Can you give us a rundown to what each is and the benefits of each?

Shauna: These three pathways of integrating mindfulness into …

Sharon Begley, science editor for Newsweek and author of The Plastic Mind: New science reveals our extraordinary potential to transform ourselves, just wrote an interesting article titled The Upside of Depression. In this article she reviews some recent research that basically flies in the face of the “Happiness” surge and says that depression is actually adaptive. In other words, it is part of our evolutionary make up.

How can this be?

She reviews an article titled The Bright Side of Being Blue, by J. Anderson Thompson at the University of Virginia and Paul Andrews at Virginia Commonwealth University who give a scientific argument that:

• Depressive rumination can be good because it allows for analytical thinking that can be important when coming up with a solution for depressed mood. This may be the case, but sometimes the mind’s anxious habit of looking for a solution is exactly what keeps us stuck in depressed mood. The ruminative anxiousness seems to pour kerosene on the fire. At times letting things be, rather than falling into the trap of always having to “do something” about it, is just what the doctor ordered.
• Depression tends to focus thinking. This is one of their findings, but it’s news to me. My experience is that people who suffer from depression feel more clouded and distracted with their thinking making it difficult to even pay attention to reading a magazine or book.
• Depression leads people to seek isolation and this can be good as it allows for the space to think about what might have triggered the depression in the first place and therefore find a way out. She goes onto quote a study citing the importance of writing as an expressive way to come out of depressed mood. This is absolutely true, however the reason writing might be helpful is because it allows us to get our thoughts out on paper and externalize them, taking away the emotional charge of our thoughts and laying to rest their need to swim or “ruminate” in our minds. I’m not sure it’s the isolation that is the key …
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There is a tradition on the Mindfulness and Psychotherapy Blog. Every Monday, I cite a quote or a poem that is related to mindfulness and psychotherapy in some way and then explore it a bit and how it is relevant to our lives. For me, quotes and poetry can often sink me into a state of greater understanding. So for today, here is a quote by Franz Kafka:

 “You can hold back from suffering of the world,

you have permission to do so,

and it is in accordance with your nature,

but perhaps this very holding back

is the one suffering you could have avoided.”

In a recent blog, Mindful Monday: A Note to the Severely Depressed–Don’t Try So Hard, author Therese Borchard wrote about her first hand experience with trying to get out of a depressed state through her bag of mindfulness and CBT tricks. What she found was the harder she tried and was unable to succeed the more her judgments about being a “failure” grew.

What her doctor’s told her was when you are in the eye of a depressive episode, “distract, don’t think.”

When we’re really depressed, the mind is searching for things “to do” in order to get us out. However, this is a trap, especially when we’re really depressed. The harder we try, the more stuck we get.

Why?

Because it’s a set up.

The moment we’re reaching for mindfulness practices as a means to an end, as a means in that moment to feel better, get out of depression, or achieve calm, is the moment our minds develop the rule: “If I don’t see any relief come from this, then I am a failure, or there must be something wrong with me.”

From then on, the mind becomes vigilant in looking for relief and every moment it is not found, is a moment that is laced with self judgment which digs us deeper into depression.

Also, with a depressive episode, the stronghold of automatic negative thoughts (ANTS) is so powerful in that moment that it is almost as if we …