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Mindful : February 2018
When mindfulness is developed and practiced while a person is feeling emotionally stable, it may increase their ability to navigate difficult situations or emotional upheavals in the future. better than usual care,” Kuyken says. He explains that depression makes some- one more likely to react to life’s setbacks with negative, judgmental thinking, which can lower their mood and trigger a new episode. Mind- fulness helps create mental space around these thoughts, enabling people at risk to observe, with kindness, the patterns of the mind that might otherwise drag them down. He shared the example of a former client. “She was a young mother who was pushing her toddler son on a swing. It was a happy moment, but then a thought popped into her head: ‘I don’t deserve to be happy, and this happiness won’t last.’ We all have thoughts like this, but for someone who’s vulnerable to depression those shards of negative thinking can quickly spiral into a whole bunch of other negative thoughts, associated emotions, and behaviors.” For this woman, he says, the thoughts came in the form of “I’m a rubbish mother” and the internal thrashing that typically followed. Prior to MBCT, he says, going down that path “might have led her to do a ‘duvet dive’ and hide away from the world,” resulting in more rumination and furthering the downward spiral. Instead, she was able to recognize the destructive pat- tern forming—what she called “wrecking-ball thoughts”— and take a sideways step, allowing the thought to pass through her mind without being knocked over by it. Zindel Segal, one of the creators of MBCT, agrees. “Qualitative analyses show the core takeaway from MBCT is I am not my depression. That the self is bigger than that. “That’s a source of liberation, because they can choose how they want to act, rather than running to the first solutions that the mind offers, which can often be reactive,” he adds. “Their symptoms may not reduce to zero, but their well-being and resilience increases as they develop a different relationship to them.” There’s a time and place for mindfulness For the great success mindfulness, and MBCT in particular, has shown for helping people with a history of depression to avoid or lessen the impact of those depressive dips, there are equally strong caveats against using the practice when you’re in the throes of an episode. “It’s very hard to sit and do formal meditation practices when you’re depressed,” Segal says. “The executive control networks of the brain are often compromised when you’re in an episode of depression, and it’s difficult to engage.” In other words, when the world goes dim and life feels bleak, your brain might not have the bandwidth to be a kind, nonjudgmental observer to its own thoughts, or to grasp the bigger picture. Susan Woods, a psychotherapist and mindful- ness teacher in Vermont, goes further: “If some- body is in a major depression episode, mindful- ness is useless. There’s just no energy there, no ability to concentrate for any length of time.” Even if a person with depression is able to engage with meditation, there is a risk that heightened exposure to the unpleasant symp- toms of their illness, experienced while paying mindful attention, could actually increase their fear and aversion, triggering a reactive spiral of deepening low mood. “There is some evidence that vulnerable people exposed to mindfulness can have quite unsettling experiences,” says Kuyken. “That makes complete sense,” he says, because when people are depressed, the mind “can be quite dark and scary.” Also, if depression seems more to do with a person’s life situation, rather than their inner patterns of thinking, feeling, and relating, they may need assertive action more urgently than meditation. “If someone is in circumstances of tremendous adversity or abuse, they first need to get to a place that’s safe,” adds Segal. “If your house is on fire, you need to get out.” A mindful exception There are exceptions to every rule, of course. I learned to meditate toward the end of a two-and- a-half year major depressive episode, and it was the key that released me from a prison of con- stantly fighting my inner demons, a pattern that kept them running rampant. However, by the time I started practicing, I had already undergone intensive psychotherapy, beg un to make much- needed lifestyle shifts, and understood some of → To watch a video demonstration of the 3-minute breathing space practice, visit mindful.org/ breathingspace 46 mindful February 2018 mental health