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Research question: does mindfulness practice help in managing depression?

Background here and here.

Method: Libby undertakes an 8 week NHS Mindfulness Course for Recurrent Depression and does what she is told.

Mindfulness course session 1 of 8: Beginner’s mind and the raisin
raisinfruitThe group (of 12, mostly with long-term recurrent depression like me) did introductions etc. then we were each given two raisins to examine intently with our senses, as if encountering raisins for the first time. It is surprising how much flavour you can get from one raisin, and for how long. I almost couldn’t manage the second one :)

We lay on mats on the floor for a body scan – concentrating on sensations in the body from toe to head. I really struggled with restless legs. Also nodded off a couple of times; it seemed to go on forever. Homework is to do this (to a CD) every day, which is as well because I was a long way off ‘present’ throughout for this first attempt.

I thought I might feel calmer after the session, but I was pretty calm beforehand and did not notice any difference. Despite still not having much of a clue how this is all supposed to work, I feel less sceptical than I thought I might. Mostly this is down toRuby Wax’s belief in mindfulness for depression. Thus my mindfulness motto is henceforth Waxo confido (“in Wax I trust”)

Below is a record of my homework.

Mindfulness course session 2 of 8: being fully present 
Ironically, given the topic for this week’s session, I was fully absent. I stayed at home to look after Raisin (my dog), who is recovering from a serious injury.

According to the course handouts, the session covered ‘dealing with barriers’ – specifically, the automatic tendency to experience everything in the light of an expectation or judgment about its meaning.

So if we are not careful we automatically think things are good or bad, or not what was wanted etc, giving rise to automatic thought patterns about what needs to be changed, done, fixed etc. I am not sure I understand why this is a problem – the handouts suggest it limits the freedom to choose what, if any, action to take.

However, applying this not judging to the body scan practice (introduced last week, and continued as daily homework), is helpful. I have really struggled to concentrate on following the CD, and often, to stay awake.  Now I know it’s OK to lose concentration or fall asleep.

Jon_Kabat_ZinnThe course notes give a number of quotes from the granddaddy of Mindfulness, Jon Kabat-Zinn‘s book Full Catastrophe Living.

Above all, we are cultivating the key attitude of kindness…towards the practice, our experience and above all towards ourselves.

The session then looked (if it followed the course notes!) at the mindfulness of breathing – using breathing as a focus of attention.

Daily homework this week: body scan with cd; 10-15 mindful breathing;  record feelings associated with a pleasant event; mindful routine activity. My efforts are in the spreadsheets below.

Am I any closer to understanding what mindfulness is all about and how it might help me? Possibly. This sentence from the course notes was useful:Our aim in the programme is to be more aware, more often. 

It is true, as I learnt from Ruby Wax, that if I am focusing all my attention on snowflakes falling (for example), the worry and frantic thought in my head shuts right up for a minute. And that’s good. Waxo confidio and all that.

 

Mindfulness course session 3 of 8: mindfulness of the body in movement and of the breath
This session was to develop awareness of sensations in the body and how feelings affect us physically. We should turn towards discomfort and unpleasant sensations that arise in our body, be fully aware of them and not label them.

cushionWe looked at posture for sitting meditation – erect and dignified: ‘the physical expression of the inner attitudes of self-reliance, self-acceptance, patience, and alert communication we are cultivating’. The 10-15 minute practice seemed to last forever, and was agony. 

Much more pleasant was the ‘three minute breathing space’ which is a way to shift out of automatic pilot and by bring yourself into the present moment with awareness (what am I feeling?), gathering (focus on breath), to expanding (awareness of body, immediate environment and beyond).

This week’s helpful comment from the course notes: the key skill in using mindfulness-based cognitive therapy is to maintain awareness in the moment. Nothing else.

We looked at mindful yoga – mindfulness practice that involves moving the body. I found it much easier to stay mindful when I was in motion.

Homework was to practice mindful movement and sitting meditation with the cd provided; to do the three minute breathing space exercise 3 times a day; and to record unpleasant events daily.

 

Mindfulness course session 4 of 8: staying present
mugWe began with mindfulness of sights and sounds – looking with beginner’s mind at a mug on the floor, and then focusing on sounds happening around us. Luckily the chap in the corner wasn’t asleep snoring at this point, because that would have been difficult.

We did some more on the three minute breathing space; using it get out of automatic pilot and then choosing whether to return to the situation we were in, or to do something else.

Homework for the week was daily sitting meditation, three minute breathing space 3 times a day plus whenever we wanted to get out of automatic pilot.

 

Mindfulness course session 5 of 8: allowing/letting be
I felt very low for this session and all the preceding week, and hadn’t managed more than a couple of breathing space exercises for homework.

We started with a long sitting meditation and were asked to focus on something that had given us difficulty during the week, and the physical sensation recalling it produced. I was empty and numb, but I can see the point of doing this when I feel better. Of turning towards the feeling, exploring it, accepting it and thus removing its potency.

We watched some videos to drill in this idea of acceptance, including this old film of Jon Kabat-Zinn teaching mindfulness for dealing with chronic pain.

Homework is full sitting meditation daily and plenty of three minute breathing space exercises.

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