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Mindful : February 2018
PREPARATION Begin by deliberately adopt- ing an erect and dignified posture, whether you are sitting or standing. If possible, close your eyes. Then take about one minute to guide yourself through each of the following three steps: 1 BECOMING AWARE Bringing your awareness to your inner experience, ask: What is my experience right now? What THOUGHTS are going through your mind? As best you can, acknowledge thoughts as mental events, perhaps putting them into words. What FEELINGS are here? Turn toward any sense of emotional discomfort or unpleasant feelings, acknowl- edging their presence. What BODY SENSATIONS are here right now? Perhaps quickly scan your body to pick up any sensations of tight- ness or bracing. 3-Minute Breathing Space This short practice is taught and repeated throughout Mindfulness-Based Cognitive Therapy. It’s intended to help bring formal mindfulness practice into moments of everyday life. It’s considered the most important practice in the program. Adapted from The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness by Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn. Reprinted by permission of Guilford Press. Visit the authors’ website at www.mbct.com PRACTICE the ingrained mental and behavioral habits that were maintaining my low mood. Meditation was a vital piece of the puzzle—a practical skill that helped me discover the art of letting go—but I also remember how tough it was the first times I tried to sit and focus on my breath. It felt like I was going to explode from the intensity of the sensations inside me. It took a lot of commitment, a lot of support, and a lot of going gently for the practice to bear fruit. In the earlier phases of my illness, I doubt it would have helped so much. A few small-scale studies suggest MBCT can help people in the midst of an episode, but Segal notes the quality of evidence is low, and Woods points to the fact that the courses in these trials were often led by very experienced teachers, who were also specialists in treating depression. Kuyken shares their concerns: “ With vulnerable clients, teachers need to be well-trained and very skilled in how they teach mindfulness.” Because it’s so difficult for the depressed mind to discern what it needs, the best first step to wellness is professional support. A competent therapist can act as a g uide to skillful action, helping you form a treatment plan. This, accord- ing to Woods, is likely to include antidepressant medication, slowly building in self-care activities that can help stabilize and elevate mood, and cognitive therapy to help you understand and work with your individual triggers. There is mindfulness here, but it comes from the therapist as a wise, compassionate friend—much needed when you can’t locate your own inner compass. Once mood has stabilized, mindfulness training can be part of the plan. At this point, says Segal, a mindfulness-trained therapist might recommend a mindful movement prac- tice. Woods suggests short sitting practices, such as the three-minute breathing space (at right), to be practiced several times a day and at the beginning of a therapy session. After a few months of stability, it might be time to enroll in a group-training program, such as MBCT. Moving forward So, when depression is present, it probably isn’t the time to engage in meditation. However, there’s cautious optimism that when mindful- ness 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. In this sense, it may be a powerful buffer against the ups and downs inevitable in every life. 48 mindful February 2018 mental health