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 Moving through emotional pain towards what's most important: One of of my favorite strategies for staying balanced and getting out of my head

Moving through emotional pain towards what's most important: One of of my favorite strategies for staying balanced and getting out of my head


Guest post from Dr. Natsumi Sawada, Registered Psychologist (originally published here).

Dr. Natsumi Sawada is a psychologist in private practice in Vancouver, B.C. Natsumi is passionate about using psychology to help people live meaningful, peaceful, connected, and joyful lives. For more of Natsumi's transformative tips check out her blogFacebook or Instagram


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A central feature of one of my favorite therapies, Acceptance and Commitment Therapy (aka ACT) is the idea that identifying our “values” and moving towards them even when we are experiencing emotional pain is crucial for psychological health and wellbeing.  

What are values? They are the things in life that are most important to us. They are what we want our lives to be about. They are different from goals in that they are not things that we can achieve or complete and they are not future destinations. They are the the things that are most important to us in life and in the now. Examples might be: Helping, creativity, our relationship, emotional closeness, caring for others, kindness, independence. One way to tap into your values is to ask, “Who or what is most important to me?” I will write more on identifying values in an upcoming blog post.  

So why move towards values even when we feel terrible? 

Well, ACT proposes that pain is an inevitable part of being human (or sea slug for that matter). To experience physical and psychological pain in the form of difficult thoughts, emotions, and sensations is to be human. It is not pathological, abnormal, or something to be changed. Our lives cannot be separated from pain. We inevitably experience loss and disappointment; feel sadness, anger, fear, guilt, and shame; experience self doubt and self judgment. We don’t often recognize that everybody suffers especially in the Instagram era when all we see is everybody else’s glowing faces and smiles on our screens while we struggle through the slop. But the idea that everyone is happy is bogus. The truth is, every person feels emotional pain and will feel pain throughout their life. Values are important because moving towards them orients us and give life meaning (and all the positive things that come with it). If we want to create meaning in our lives we cannot wait for the skies to clear because being human can at times be a little like living in Vancouver in November.  

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This sounds grim but it’s actually great news because to be psychologically healthy we need to experience positive AND painful emotions. For one thing, it’s natural to feel painful emotions. Imagine you never felt sad or afraid. I don’t think I need to explain why that would problematic. Painful emotions and thoughts serve important protective functions. We need to experience fear, sadness, and guilt to function in the world and to be human (more on this later). Some people argue we need to embrace this vulnerability that we all share, to connect with and be of service to others. Some research even suggests experiencing too much positive emotion is bad for our health and well being. It can cause us to engage in more risky behavior, impede our performance, and hinder our ability to empathize and take others’ perspectives (something that is crucial for good relationships). Research also suggests pursuing happiness can do more harm than good because the more people pursue happiness the less they seem to experience it. See this article for more. So forget the “don’t worry be happy" stuff. Ideally we have a little of both.  

However understandably, humans don't like to experience pain (and don’t even like to experience the possibility of future pain) so often when we experience it we struggle against it like a fish on a hook and line. We think about it, we worry about it, we dread it, we anticipate it, we question it, we obsess about it, we try to mentally problem solve our way out of it. A large part of the war we fight against our painful mental experiences (such as sadness, anxiety, anger, worries, doubts, obsessions, rumination) often takes place in the form of a why question: Why can't I be happier? Why me? Why am I so weird? Why am I messed up (or insert another insult of your choice here)? Why does life have to be this way? Why is everybody such a [bleep]?  

According to ACT, while this is a totally understandable response to pain, this mental war is problematic because whether you experience a little psychological pain or what seems like a lot, the struggle against it makes things so much worse; It creates pain 2.0 otherwise known as suffering. This is similar to an idea found in Buddhist philosophy, illustrated by the story of the two arrows:  

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“…When touched with a feeling of pain, the ordinary person sorrows, grieves, and laments, beats his breast, becomes distraught. So he feels two pains, physical and mental. Just as if they were to shoot a man with an arrow and, right afterward, were to shoot him with another one, so that he would feel the pains of two arrows…”   

The idea here is that when we experience pain (it could be physical pain as described here or emotional), we often react to it by fighting against it. We feel anxious and we get mad at ourselves for feeling this way, we feel sad and we feel ashamed, we feel depressed and we ruminate on the question “what is wrong with me?” and then ruminate on the answer, “you are deficient.” This causes us to, in effect, shoot ourselves with a second arrow: We add suffering to pain.  

One goal of ACT is to teach us how to reduce this suffering by learning to let go of the automatic habit of shooting the second arrow when we experience pain and instead move towards our values. Rather than getting caught up in the net of pain and suffering, we engage with and move towards what's important to us even when we feel pain. The idea is that we can experience painful mental events such as sadness or anxiety or the thoughts, “I can’t do it” or “I don’t want to” or “I’m a failure”  AND we can go on bike rides, work in the garden, do our work, paint a picture, act in a loving way, meet a friend, and do other things that create meaning and value in our life. The experience of a painful mental event cannot stop us from doing these things. The idea in ACT is that we recognize these thoughts and feelings with mindfulness AND then we move towards what's important to us with pain in hand.  

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Does it sound hard? It can be! The experience of sadness for example can organize our whole being to want to lie in bed, cry, eat cheetos and ice cream, surf the internet mindlessly for hours, and ruminate about what went wrong. Does this mean this is our only option? No. As difficult as it might be we can mindfully recognize our emotions with kindness and then, with the same attitude of love and care, ask ourselves, “Does acting on my urges take me farther from or in the direction of who or what is most important to me?” We can then do our best to take a small step towards what is important. It is not always easy but with a lot of practice we can learn how to do this. We can learn how to respond more flexibly to emotional pain instead of always going with the knee jerk reaction of resisting it, hiding from it, smothering it, and turning it into suffering. Some of the mental skills that can help us learn to do this are mindfulness, self compassion, and distress tolerance. I will talk more about these skills in future blog posts.    

I’m writing this post because I find this idea of moving towards values with pain particularly valuable and I use it a lot in my own life. When I feel despair, sadness, or anxiety, for sometimes what seems to be no reason at all, one of the most helpful things I've learned to do is to mindfully take note of the emotion and accompanying urges that arise in me, remind myself of my values, and encourage myself to take one tiny step in the direction of my values.  

For example, if I feel despair I might notice the urge to listen to sad music, lie in bed and watch Netflix, or ruminate about the things that are not going well for me and what I’ve done wrong. However, while understandable, these behaviors are designed to numb or escape pain and take me further from my values of learning and teaching, caring for others, developing my skills as a psychologist, being an engaged and loving partner, and creative expression. So, I do my best to notice these emotions and urges with kindness, acknowledge how painful they are, and then if all goes according to plan, I take a tiny step in the direction of my values. I repeat TINY. This is crucial because when we feel anxious or down even “small” steps can seem overwhelming. My tiny step might be washing the dishes in the sink, reading a page of a book, going for a walk around the block, or send a half dozen friends a cat meme (someone usually responds). Although it’s important to note that the point of moving towards values is not to get rid of pain, I sometimes find that after I have made a move towards my values, my difficult emotions loom less large or sometimes even pass. And, at the very least I’m sad but at least I’m sad AND I went for a walk and took a step towards health.  

If you want, try this out for yourself. Write down a few of your values and the next time you find yourself caught up in painful thoughts or emotions, see if you might remind yourself of some of your values and ask yourself the question, “Does acting on these mental experiences or thoughts take me closer to or farther away from what is most important to me?” If the answer is farther you might ask, “What tiny step might I take towards my values?” If this seems really difficult get in touch with a counsellor or psychologist for help. 

It's important to note that what feels tiny to me might feel microscopic to you or it might feel huge. Take a step that feels tiny to you. It might be doing five jumping jacks or washing three dishes or it might be reorganizing your house or running a marathon.  Meet yourself where you are at. The main point is to take a tiny step towards your values, notice that you did it, and see what happens next and repeat. Let me know what happens.  

3 simple mindfulness practices for coping with difficult experiences and emotions in day-to-day life

3 simple mindfulness practices for coping with difficult experiences and emotions in day-to-day life

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Cultivating mindfulness through regular meditation practice has been shown to produce numerous benefits over time. It reduces stress, anxiety, and emotional reactivity and increases focus, well-being, and compassion. However, meditators sometimes grapple with the question of how to tangibly apply mindfulness skills in day-to-day life, particularly in moments of stress when we notice our buttons are being pushed or we’re edging towards emotional reactivity. It’s not always clear how to take mindfulness from the meditation cushion into the activities of daily life. It’s also no surprise that being mindful in moments when we are dealing with a difficult person or event can be more challenging than being mindful when we are peacefully and comfortably seated on a meditation cushion!

There are a few short practices that are well suited to integrating mindfulness into day-to-day life in order to reap the more tangible and immediate effects of stepping out of automatic patterns of reactivity and grounding ourselves in the present. Weaving these practices into your day in moments of calm can help you go about your daily activities more mindfully and may help prepare you to use mindfulness skills when you encounter stressors. This may interrupt the cascade of negative thoughts, emotions, and actions that sometimes seems to happen automatically in moments of stress or emotional discomfort.

These different practices share elements but also have important differences. Try them and see what works best for you!

1STOP

This practice is helpful when we find ourselves caught up in ruminative, worried, or otherwise “busy” patterns of thinking or in destructive urges and impulses. It can help us notice our mental state, ground us in the bare facts of the present moment, and insert a pause between our thoughts, urges, and impulses and impulsive (and sometimes harmful) behavioural responses.

The acronym STOP serves as a reminder of each step.

1. Stop what you are doing. Freeze and do not do anything.

2. Take a few deep breaths and step back from the situation. You can continue this deep breathing for a few minutes while paying attention to the sensations of breath in your belly.

3. Observe what is happening inside of you and in your environment without judging or evaluating. Observe the bare sensory qualities of your present moment experience. What is your body doing? What thoughts, feelings, and body sensations are you experiencing? What is happening around you? What sensory information are you receiving from the environment?

4. Proceed mindfully and with compassion. Act with awareness of what you are doing and how it will affect yourself and others. Proceed with compassion for yourself and others.

There are a few variants of this practice but the intention of each is similar. To read more about psychologist Elisha Goldstein’s version of STOP visit http://www.mindful.org/stressing-out-stop/

2RAIN

Psychologist and meditation teacher Tara Brach teaches this practice. It is helpful for when we feel overwhelmed by painful feelings such as sadness or despair and difficult thoughts of insecurity or unworthiness.

The acronym RAIN serves as a reminder of each step.

1. Recognize what’s going on inside you by acknowledging the thoughts, feelings, and sensations that are present. You might label these experiences by saying to yourself, “sadness is here”, “pain is here”, “self-critical thoughts are here”, etc.

2. Allow the thoughts, feelings, and sensations that are already present to simply be there. Often we react to difficult thoughts and feelings by judging others or ourselves, numbing ourselves to our experience (e.g., by overeating, abusing alcohol, mindlessly surfing the internet). Allowing means willingness to be with these experiences. Allowing also involves noticing if there is an urge to resist difficult thoughts, feelings, and sensations and intentionally relaxing our resistance. Note that allowing does not mean that we agree with our self-critical thoughts or like our painful feelings. It means being willing to observe and make room for what is already present. When we are willing to allow our difficult thoughts and feelings to be as they are, we may be less likely to react in impulsive and destructive ways intended to reduce our discomfort. We may therefore be more able to choose a wise and skilful course of action. Paradoxically allowing may therefore reduce suffering in the long run.

3. Investigating with kindness means bringing a gentle and discerning curiosity to our experience in the present moment. You might investigate whether the emotion or thought that is present shows up in the body (e.g., a lump in the throat, clenching in the jaw, a knot in the stomach, tension in the shoulders or arms), the qualities of the sensations you are experiencing (e.g., tense, throbbing, prickling, solid, fluid), and the area of your body that is occupied by the sensations. You might also notice if resistance to the present experience shows up in the body (e.g., a tightening around the lump, a twitching sensation, an urge to move). Investigating with kindness means bringing compassion and curiosity to difficult experiences in the moment and observing them without jumping to change or “fix” them.

4. Non-identification means not fusing our sense of self with limiting thoughts, difficult feelings, and uncomfortable sensations. This means recognizing that our awareness in the present moment can hold more than just our difficult thoughts and feelings and that we are therefore not defined by these experiences (e.g., sadness, fear, anger, pain). Difficult emotions are shared by all human beings and are simply showing up in the wider field of our awareness in this moment. Non-identification also means recognizing thoughts as mental events rather than “capital T truths” about what needs to be acted upon, fixed, or changed.

For more on RAIN visit http://www.tarabrach.com/articles/RAIN-WorkingWithDifficulties.html

3. Three minute breathing space

This exercise is taken from Mindfulness Based Cognitive Therapy (MBCT). It is a quick and simple way of taking mindful pauses throughout the day and maintaining continuity in our mindfulness practice. It is also helpful for interrupting automatic (i.e., habitual) and unhelpful thinking patterns that can sometimes spiral into negative moods and destructive behaviours. It integrates two types of meditation (open-monitoring and concentrative) as well as the practices of acceptance, attentional switching, and letting go. The following instructions are from Mindfulness-Based Cognitive Therapy for Depression by Segal, Williams, and Teasdale, 2002.

Step 1 - Becoming aware

Start by adopting an erect and dignified posture. Then, if possible, closing your eyes and bringing your awareness to your inner experience by asking “What is my experience right now?”

 What THOUGHTS are present? As best you can, acknowledging thoughts as mental events, perhaps putting them into words.

● What FEELINGS are here? Turning toward any sense of discomfort or unpleasant feelings, and acknowledging them.

  What BODY SENSATIONS are here right now? Quickly scanning the body to pick up any sensations of tightness or bracing, acknowledging the sensations.

STEP 2 - Gathering your attention

Redirecting your attention to the physical sensations of breathing in the abdomen.

Feeling the sensations of the abdomen wall expanding as the breath comes in and falling back as the breath goes out. Follow the breath all the way in and all the way out, using the breathing to anchor yourself into the present.

STEP 3 - Expanding your attention

Expanding the field of your awareness around the breath so that it includes a sense of the body as a whole, your posture, and facial expression. If you become aware of any sensations of discomfort, tension, or resistance, taking your awareness there by breathing into them on the in breath. Then breathing out from those sensations, softening and opening with the out breath. As best you can, bring this expanded awareness to the next moments of your day.

A video of Mark Williams guiding the three minute breathing space is available here


Natsumi Sawada is a clinical psychologist in Vancouver, BC. Learn more about Natsumi here.

The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogs, podcast, follow @connectepsychology on Instagram or @ConnecteMTL on Twitter, or like us on Facebook.


Mindfulness: An Introductory Guide

Mindfulness: An Introductory Guide

By: Dr. Natsumi Sawada, Clinical Psychologist
Guest post from the Mindfulness and Meditation Blog blog.natsumisawada.com

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WHAT IS MINDFULNESS?

Mindfulness is a particular state of awareness cultivated through intentional practice.

WHAT IS PARTICULAR ABOUT THIS STATE OF AWARENESS?

1. It is focused on the present moment.

Our awareness is usually caught up in thoughts about the past or the future. We therefore cruise through life on autopilot unaware of what’s actually happening now in our minds, bodies, and all around us. Sometimes being caught up in thoughts about the past or future can be helpful because it allows us to remember, learn, and plan. 

However, the downside is:

1) We miss out on what’s actually happening now.
2) We get caught in disappointment about the past or worry about the future, which can lead to depression or anxiety. We don’t need to actually experience threatening events to be scared or stressed – we can simply imagine past or future threats. 

Practicing mindfulness means intentionally bringing awareness to the present moment over and over again. It’s about noticing what’s here now.

There is a sense in which all that actually exists is the present. Both the past and the future only exist now as thoughts, concepts, or stories.

The present moment is filled with joy and happiness. If you are attentive, you will see it. - Thích Nhất Hạnh

2. It is embodied and sensory.

Mindfulness is a type of knowing through awareness of what we are experiencing with all of the senses (smell, touch, hearing, sight, taste, proprioception, interoception) as well as the mind.

We are often caught up in experiencing the world almost exclusively through our thoughts/intellect/concepts:

Example: This is delicious, this tastes horrible, she’s beautiful, he’s stylish, this room is ugly, he’s talented, I like this, this is not as good as that, etc.

However, we don’t spend much time experiencing what is actually coming to us through our senses.

Example: Experiencing the texture of fabric, noticing light hitting a particular object, vibrations hitting our eardrums, the rise and fall of the pitch in a piece of music, the rush of an emotion bubbling up inside our chest.

When we practice mindfulness we cultivate awareness of present moment experience though all of our senses at a pre-conceptual level. Sometimes I like to ask myself, how would I experience and get to know about a particular experience if I were a dog or a small child without concepts such as rude, ugly, stylish, and beautiful? What is here for my senses to experience?

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Out beyond ideas of wrongdoing and rightdoing, there is a field. I’ll meet you there. - Rumi

3. It can be characterized by five key attitudes.

a) Non-striving/acceptance:  This means noticing subtle forms of resistance such as wishing things were different or tensing up or bracing against a difficult experience and intentionally and repeatedly cultivating acceptance and a willingness to be with what is happening by coming back to noticing, acknowledging, and experiencing how things are in this moment at a sensory level. 

Example: Becoming aware that you are rushing though a task you don’t like and telling yourself how great it will be to be done. Then, choosing to let go of thinking and gently redirecting awareness to the sensations in your body allowing yourself to open up to these. Then, noticing the information coming through all of your senses in this very moment.

b) Non-judgment/beginner’s mind: This means noticing when we’re intellectualizing, judging, conceptualizing, or telling “stories” about something based on our past experience and instead choosing to bring our awareness back to the present and to explore what we are experiencing, with curiosity, as if we are experiencing it for the first time.

Example: Noticing you are telling yourself a story about (i.e. thinking about) what it will be like to do something you have experienced before (e.g. meeting a certain person, eating your favorite meal, experiencing a particular emotion) and choosing to come back to explore this with curiosity, using your senses in this very moment.

c) Letting go: This means noticing when your mind is getting carried away with stories or thoughts about how things are, were, or should be. Letting go means intentionally coming back to the present and your body even when these stories are very compelling (they usually are).

d) Non-doing/being: This goes hand-in-hand with acceptance. We are almost always trying to do, change, or achieve something. Mindfulness is about intentionally being with what is here now. Simply being.

e) Patience/kindness/compassion: When your mind is carried away with stories, thoughts, or judgments acknowledging that this is simply what all minds do. Gently, kindly, and compassionately bringing your mind back to the present over and over and over again. Mindfulness does not imply constant, fixed awareness of the present. It is the intentional and gentle act of bringing your awareness back.

For more on mindfulness check out this introductory talk by Jon Kabat-Zinn (at Google):

 
 

Natsumi Sawada is a clinical psychologist in Vancouver, BC. Learn more about Natsumi here.

The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogs, podcast, follow @connectepsychology on Instagram or @ConnecteMTL on Twitter, or like us on Facebook.