Today I have the honor of bringing to you the author of the new book, The Mindfulness Solution: Everyday Practices for Everyday Problems. Ronald D. Siegel, Psy.D. is an Assistant Clinical Professor of Psychology at Harvard Medical School where he has taught for the past 25 years, a Board and Faculty member of the Institute for Meditation and Psychotherapy, and a long-term student of mindfulness meditation.
Dr. Siegel is also co-editor of Mindfulness and Psychotherapy and coauthor of Back Sense: A Revolutionary Approach to Halting the Cycle of Chronic Back Pain. He maintains a private clinical practice in Lincoln, Massachusetts and teaches internationally about mindfulness and psychotherapy and mind-body treatment.
Today, Dr. Siegel talks to us about how we can work with mindfulness to support us with stress, anxiety, and depression.
Elisha: Ron, in your book you talk about working with mindfulness as a path toward befriending fear and even seeing our sadness or depression in a new light. Can you tell us how this works?
Ron: Mindfulness practices are turning out to be useful for dealing with a remarkably wide range of psychological difficulties, including both anxiety and depression. This raises an interesting question: What might these problems have in common? Might mindfulness practices be addressing this common factor?
A bit of a war broke out among the researchers and clinicians writing the latest version of the DSM—the diagnostic manual used by mental health professionals. It was a war between the lumpers and the splitters. The splitters said that the major limitation in our current diagnostic system is that we’re mixing apples and oranges — we need more diagnostic categories to more accurately identify psychological problems. The lumpers said, “that’s crazy, you’re missing the forest for the trees. You’re ignoring what so many problems have in common.” So the splitters said, “oh yeah? What do they have in common?” And the lumpers said, “experiential avoidance.”
What do they mean by “experiential avoidance?” It’s the natural tendency we all have to pull away from painful experiences. And it turns out that indeed this is something that both anxiety and depression have in common.
While many people struggling with anxiety see their worried thoughts, rapid heartbeat, muscle tension, and other signs of physiological arousal as the problem, most mental health professionals realize that it is actually our maneuvers to try to get rid of anxiety that are at the core of most anxiety disorders. For example, if someone has a fear of public speaking, flying in airplanes, or catching germs from public restrooms; it’s not the fact that these situations provoke anxiety that’s the problem, it’s the fact that the person starts to avoid speaking in public, flying, and using the restroom that’s the problem.
I once heard an astronaut being interviewed by an actor who was going to play him in a movie. The actor wanted to get inside the astronaut’s head so he could play him faithfully. He said, “how were you able to get the courage to fly in those untested aircrafts—I would’ve been scared shitless.” The astronaut said, “of course, I was scared shitless every time I went up. Courage isn’t about not feeling fear, it’s about doing what makes sense anyway.”
Mindfulness practices train us to develop this kind of courage, to approach difficult experiences instead of trying to avoid them. By practicing being in the present moment, whether that moment is pleasant or unpleasant, calm or threatening, we develop the ability to bear feelings of greater and greater intensity. As we develop this skill, we become able to face a wider range of life challenges with confidence— knowing that we can bear the anxiety that may arise. Since so much of problematic anxiety involves fear of fear — worrying that a given situation will make us anxious — paradoxically, this approach in the long run makes us much less anxious. So instead of trying to “calm down,” mindfulness practices give us the courage to be with our anxiety when it arises, allowing us ultimately to be much less afraid.
I outline a number of specific exercises that we can use to develop this sort of courage in the chapter on worry and anxiety in The Mindfulness Solution. You can also learn many of these online at www.mindfulness-solution.com.
Interestingly, depression has a lot in common with anxiety. I often ask psychotherapists what they think is the difference between sadness and depression, and they come up with a variety of answers. Sometimes they suggest that depression lasts longer than sadness. But I point out that it’s perfectly possible to feel sad for days in a row and yet be quite depressed for just a few hours. Then they suggest that sadness arises in response to external events, while depression comes from the inside and has a life of its own. But I remind them that we can get very depressed after a misfortune such as the loss of a job or relationship and yet can feel sad without apparent cause.
Finally, after some discussion, they come to the conclusion that sadness feels alive and fluid and is an essential part of living a full life, while depression feels dead and stuck and gets in the way of living. This realization leads to another surprise: by helping us really be with sadness (and other emotions), mindfulness practice can keep us from getting stuck in depression.
We see here again how a psychological problem involves experiential avoidance. As long as we’re trying to not feel sad, angry, or some other emotion, we tend to shut down and not feel much of anything at all. And our body is in a constant state of stress as we tense up trying to keep these feelings at bay. This stress contributes to the difficulties with sleep, appetite, concentration, and interest that are so often a part of being depressed.
Mindfulness practices, by training us to open to our full range of emotions in the present moment, work against this depressive pattern. They help us to come alive in each moment.
Another way that mindfulness helps us to work with both anxiety and depression is by loosening our belief in our thoughts. Both difficulties involve a lot of painful thinking. In anxiety we worry about the future, in depression we may regret the past, or be full of negative, self-critical thoughts. Since mindfulness practices involve bringing our attention back to sensations in the present over and over, stepping out of the thought stream, they help to loosen our preoccupation with negative thoughts, making it easier not to believe in them so much.
The Mindfulness Solution and www.mindfulness-solution.com also contain a variety of exercises that can help you to experience difficult thoughts in a new light, thereby loosening the grip of either anxiety or depression.
Thank you so much for your insight Ron! Stay tuned for Ron’s upcoming interview on Friday, May 28th exploring mindfulness as a means to working with procrastination and how he uses it in his own psychotherapy practice.
To the readers: As always, please share your thoughts, stories and questions below. Your interaction here provides a living wisdom for us all to benefit from.