Stepping Up

Repost from December 2012

It’s impossible to write a blog about mental illness without confronting the violence that has descended on this country all too often.  Too many innocent victims have fallen at the hands of too many offenders to set the issue aside.  My heart bleeds for the victims lost and the loved ones remaining.  Nothing written can take away the pain of the survivors.  But a call to action may help to prevent such crimes from continuing.

Bored to Tears

Repost from September 2013

Just a few days ago I realized I was bored with the internet and my mobile devices.  Together they have contributed to my font of trivial knowledge.  But it has been a very long time since I delved deeply enough into a topic to fully understand it, or to contribute to it with original ideas.  And perhaps most important, I have been losing my sense of nuance.  All discourse seems to fall on one side or the other.  Intellectually I have been anything but mindful.  In fact, the constant barrage of information, updates, and check-ins, and the 24-hour availability of me and everyone I know have turned me into a cognitive fight or flight machine.

I'd Rather Be Fishing?

I’m not the fishing type. Sure, the idea of standing in running water in the mountains casting flies sounds wonderful.  But I live in the city and like it.  And I don’t like fish.

However, for the last week I’ve been obsessed with fly-fishing.  My wife, daughter, and I spent a weekend in the Berkshires, and we’ve all been caught up in the idea of leaving the city and retiring to a rural area.  At least I have.  My wife is more partial to beaches.  My daughter is three.  She wants to be wherever she is.  I’ve always been drawn to the imagined solitude of rural life:  Farms, pastures, groves of trees, rivers, lakes, and fly-fishing.  Yes, I’m hypomanic right now.

Our Fear of Silence

Repost from January 2013

The cultivation of mindfulness requires periods of focused attention.  Many proponents of mindfulness maintain that this is best developed through seated, silent meditation.  So, while I’d like to investigate how to focus the attention, we must first consider our relationship with silence.

Whether in the center of a city or deep in a forest, the cacophony of sounds around us makes it apparent that true silence is impossible.  Composer John Cage wrote music that included long periods of silence.  When the musicians stopped playing, concertgoers were quickly confronted with the shuffling, shifting, and coughing sounds in the concert hall.  So what is silence?  I like to think of it as the absence of intentional sound.  Intentional sounds are the things we turn on such as TVs and iPods, the words spoken or heard in a conversation we are engaged in, music we make such as humming or tapping, and the noise of tools, keyboards, or other objects we are interacting with.  Sounds that remain are unavoidable.  So silence is when we are purposefully quiet.  For many of us, this can be unsettling.

The Medical Model

Reposted from November 2012

While I believe mindfulness meditation has been the keystone to my recovery, I still think of it as an adjunct therapy.  I couldn’t manage mental illness as well as I do now if I did not meditate.  But I acknowledge that the medication my doctor prescribes and the therapy visits I have with him are crucial as well.  Only through the consistent application of all three therapies am I well.

Mindfulness meditation is currently all the rage, and it works.  But I am wary of its proponents who claim it can treat (or even cure) mental illness by itself.  Meditation is a powerful tool when used to decrease stress and increase well-being.  But if we are to maintain that mental illnesses are biochemical malfunctions of the brain and nervous system, then we must allow room in treatment for medicine.  Therapy also has a long history of positively impacting the lives of those challenged by psychiatric illness.  Meditation, when added to more traditional and well-tested methods of treatment, can help a patient successfully manage a challenging life.  I, and so many others like me, am proof of that.

Anxiety and Society

The primary job of the American consumer is to manage anxiety.  Whether confronted with choices of excess or sustenance, balancing a dizzying array of options with limited financial resources, the classic economic problem, has resulted in a society of people pre-occupied with managing stress and its related discomforts.  Connectivity and its string of constant updates have led a certain status to novelty.  The constant effort to be relevant, witty, insightful, or on-trend, or at least not mundane, adds a knowing sense of “not good enough – does anyone really care?” to our increasingly tangential social interactions.  We used to confine our choices to what we knew was available, and we used to confide our opinions in a trusted few.  Now the world is our market and our audience, although I fear many fret that no one is listening.  The ease with which we can inquire, inform, and impress (or disappoint) is boundless.  We buckle under the pressure to be exceptional individuals with networks who care.

How Guided Meditation Can Become a Distraction

Reprinted from April 2013

I come from a long line of seekers, my mother’s side of the family known for trying on various spiritual traditions in a search for truth.  My mother herself has been experimenting with meditation recently, and has tried several forms of guided meditation.  The one that has worked best for her is Oprah Winfrey's and Deepak Chopra’s 21-day meditation challenge on the computer.

Last week she wanted to share with me a meditation she finds beneficial.  It was a busy day at her house, with much of the family in and out, so we escaped to her office to follow the guided instructions.  While I am glad so many people are following this program and finding relaxation in meditation, I found it too distracting to be truly mindful.

Challenge Yourself

In my last post I mentioned a contemplative practice based on Lectio Divina, the meditative practice of “divine reading.”  It can yield creative insight into challenges that confront us, and help us work out where we sit in relation to key questions or ideas that influence our lives.  I’d like to present it here.

Rejecting or Embracing the Sacred

I recently taught a class in creative contemplation that was based on Lectio Divina, or divine reading.  It is a practice undertaken by contemplative Christians and monks in which one completely surrenders to the voice of God as inspired by a line of scripture.  I have no real allegiance to Christianity, other than my upbringing, and presented the practice in a completely secular course.  Much modern meditative and contemplative forms are presented this way.  Centuries old sacred traditions stripped of theology and much underlying philosophy as a means of adapting each to a stressful, material world.  Sort of like insisting that prayer without an object or spirit to pray to will bring about a miracle.  The act, not the deity, holds the influence.  In my busy life in the city this means poses no problems.  But I spent the weekend at my parents’ house in the mountains, very quiet, and found the entire secularization of sacred traditions troubling.

I'd Rather Shock Myself

A much cited study from researchers at the University of Virginia and Harvard (actually a survey of 11 studies) has found that most people, across all age groups, would rather not sit alone in quiet with their thoughts.  The majority would opt for some distraction or point of focus outside of their own mind over six to fifteen minutes of silent contemplation.  In one of the studies, two-thirds of the men and one quarter of the women preferred to give themselves a mild electric shock over sitting alone in silence, even in their own homes, for a few minutes.

Another study has found that 56% of people in the United States cannot simply sit and watch TV without engaging with other digital media.

It as also been found that an ambient noise level of about 70 decibels (the hum of the neighborhood coffee shop) boosts creative thinking more than silence does.

The Dark Night

I've received many benefits from my meditation practice.  Yet, as I've written in some of my most often read posts, I'm skeptical about the vast positive claims the proponents of mindfulness meditation make.  It truly can't be this good for everyone who undertakes it.

Today many teachers with little depth of understanding of the challenges meditators can face are leading students into practices that, while often very positive and relaxing, can lead a troubled mind to very dangerous places.

Meditation on a Friend's Suicide

A very close friend of my wife recently killed herself.  The experience has been gut-wrenching.  I wrote a post the day after we received the news.  It has been published on PsychCentral.

You can read it here.

It's Not That I've Stopped Thinking

I’ve often attributed my success in managing bipolar disorder to the meditation practice I added to my treatment regimen years ago.  While there’s no doubt that the noticing involved in meditation has helped me head off major episodes of mania and depression, I changed something else in my life at about the same time I began to practice.  This adaptation may have equal weight in my wellness.  What did I change?  I stopped reading fiction.

Meditating With Purpose

If mindfulness is the sharpening of one’s ability to notice, then perhaps this noticing can be applied to the subtle changes in thoughts, behavior, and emotions that precede or come concurrently with the onset of a mood change or a psychotic episode.  One changes as one enters any psychiatric episode.  Noticing these changes can enable the individual to take whatever steps are necessary, and effective, to head off a debilitating psychiatric break.

The MBSR Police

Mindfulness-based Stress Reduction (MBSR) was first presented 36 years ago by Jon Kabat Zinn in the Pain Clinic of the University of Massachusetts’ Medical Center.  Since then, tens of thousands of patients have benefited from mindfulness training by taking classes that adhere to, and classes that are similar to, the MBSR program.  Today, variants of the program have sprung up at leading medical centers worldwide.  This has led many to wonder how should mindfulness be best taught as a medical intervention, and by whom?

On Not Corrupting Mindfulness

I just received the June issue of Mindful Magazine (yes, there is a magazine devoted to mindfulness).  Inside the front cover is a full-page ad for a clothing company called Best Dressed Monk, Attire for the Mindful Man.  I honestly thought it was a joke, but it’s not.  Mindfulness has truly entered the commercial space.

Unfortunately, it’s entered the political space as well.  All too often, proponents of mindfulness wrap the practice up as a world changing force that will bring forth an emergence of a politically progressive agenda.  As if one must think GMOs are always bad or income redistribution is always good to be truly mindful.  Of course, sustainability is a good thing, and self-interest serves society better as enlightened self-interest, but none of this has anything to do with being mindful.

In fact, if mindfulness is truly to be defined as nonjudgmental awareness, proponents of mindfulness must be accepting of all points of view.

Addressing Reactivity and Its Impact

I recently presented to a large group of Direct Support Professionals, people who support individuals with behavioral challenges.  I have conducted similar workshops for family members of those with serious mental illness.  We talk about stress management, self-protection, and the limits of compassion.  We meditate together.  But the topic that always garners the most interest is how the supporters’ own reactivity, or fight or flight response, can precipitate negative behaviors in the individuals they support.

What If It's Not The Stress After All?

A lively debate has begun in the stress management community over Kelly McGonigal’s Ted Talk in which she presents research that indicates it’s not stress that is damaging, but instead one’s attitude toward stress that dictates the damage done to one’s health by stressful situations.  To put it bluntly, stress doesn’t kill people, thinking that stress is bad kills people.  Volition over physiology.

Can we all be so wrong?

Mindfulness and Anxiety

Here's another post you may have missed that emphasizes the positive effects of meditation.

From August 2012.

Anxiety disorder is much more than being very nervous or edgy.  In anxiety, a person will report an unreasonable exaggeration of threats, repetitive negative thinking, hyperarousal, and a strong identification with fear.  The fight or flight response is kicked into overdrive and physical symptoms such as rapid heartbeat, high blood pressure, and digestive problems often join with the cognitive challenges that anxiety disorder presents.  In General Anxiety Disorder (GAD) and Social Anxiety Disorder (SAD) the symptoms become so severe that normal daily functioning becomes impossible.

Mindfulness and Hypomania

I've written quite a bit lately about the overselling of mindfulness, yet I continue to practice and to teach.  I'd like to repost the following to illustrate something that I think mindfulness is very good for.  Something that can help those who, like me, struggle with bipolar disorder.

From March 2013

I wrote in a post titled Discipline and Diagnostics that one of the benefits of meditation to a person with a mental illness is the ability to detect episodes early.  Well, I’m in one.

It’s been hard to sit at all, let alone for the thirty minutes I do each day.  I find myself agitated and fidgety.  My thoughts are all over the place.  This is not unusual during meditation, but in taking note of the subjects of my thoughts, I can see hypomania creeping in.  I’m thinking of buying stuff.  I’m thinking of trading stocks.  I’m thinking of another career change, discarding good ideas for more exciting, if undoable, ones.  All of my thoughts are about getting and doing.  Anything.  Right now I feel smarter, more creative, and more energetic than I usually do.  That might be dangerous, but that’s what I’m feeling, and that’s what I encounter during meditation.

Too Stressed to Meditate

For the past couple of years, meditation has been easy.  I’d put in some hard work over the previous decade and had found a place of stillness each time I took to the cushion.  Sure, sometimes what I met as I observed my mind was difficult, but my practice had become productive and indispensible.  I spent the last two years as a stay at home Dad of a toddler.  I did all of the Dad, and much of the Mom, stuff.  I managed the house, cleaned (badly), cooked (very well), arranged activities and play dates, and did what I could to keep the family satisfied.  None of this was easy, but my daughter napped every day.  And while she napped I had a solid thirty-five minutes to meditate, without fail.  I taught a couple of classes each week, and led a Wednesday night drop-in meditation group, but that was more rewarding and fulfilling than taxing.

Then, all of it came to an end.

Maybe It's the Discipline

Mindfulness works as a therapy to increase impulse control.  While the results of practice are well-researched, the neurological mechanisms are indeterminate.   Something about mindfulness practice actually changes the cortical make-up of the brain.  Why this happens is not yet known.  It could be the focused attention or the release of judgmental thoughts.  Or, it could be the discipline.

Judgment and Low Expectations

Certainly, the people closest to you want what’s best for you.  They want you to be safe, secure, and, if possible, happy.  Sometimes they want these things for us even more than we want them for ourselves.  This is loving, caring, and compassionate.  And it can be a burden that holds us back from our true potential.

When It Seems Like Work Isn't Working

I've always been an advocate of, if at all possible, staying off of disability insurance and working.  In fact, I believe that true wellness is not possible without the productivity and relative independence that come from work.  I've written about the benefits and the challenges of those of us with mental illness finding and keeping a job.  But one thing confronts many who have a gap in their resume due to a prolonged illness.

Underemployment.

Drop-in Meditation Groups

On select Thursdays in January and February I'll be presenting mindfulness meditation workshops in Center City Philadelphia.  They are sponsored by The City of Philadelphia Mural Arts Program and its Community Wellness Partners in support of a Community Wellness mural being painted later this year.  The events are free and details are on the Philly Wellness page here.

Every Wednesday evening I lead a meditation group in Old City Philadelphia.  Beginner and experienced meditators are welcome, donations are accepted.  All of the information is at www.meetup.com/quietthenoise/.  People from the meet up group and others from the community attend, and we usually have a pretty good group.  Join us if you're in the area.

A Downside to Mindfulness

I write so much about the benefits of mindfulness that I have to fess up when I come across a study that reveals negative effects.  This hasn’t been too taxing because there are so few resources painting mindfulness as having any deleterious effects at all.  But recent research out of Georgetown University does just that.

It turns out that mindfulness can inhibit implicit learning and implicit memory.

Just Breathe

Mindfulness is either on the cusp of something great, or risks becoming the latest self-help fad to perish from oversimplification.  It has, without a doubt, improved my functioning with bipolar disorder.  In working with others, I have seen similar results.  And while research specific to meditation and bipolar disorder is scarce, the effect of mindfulness on other mental illnesses is well documented, and positive.

But it’s not so easy.