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Book Review: A Mindfulness Guide for the Frazzled by Ruby Wax

A Mindfulness Guide for the Frazzled

Book Review

Ruby Wax- A Mindfulness Guide for the Frazzled

Ruby Wax is known to me firstly as a comedian and more recently a Master of Mindfulness based cognitive therapy. It is because of the latter and her potential to reach the masses that I wanted to review her book, to help others decide whether it is a worthwhile read and me whether to stock it in my client library.

She writes with an easy style and you are soon drawn into the ideas of mindfulness. She is keen to teach the physiology of the brain (neuroscience) to help us understand that our behaviours and emotions are natural animal responses to the need to stay alive. The evolution of the brain is described very simply. She switches from humour to personal experience to science and back again. This might be engaging for some and keeps those not interested in the science bits motivated to continue reading. I found the science stilted and her style more forced, she acknowledges help with these passages from the experts which I can see is reflected in the prose. The humour is nice, although I am not sure whether it is a distraction some times.

The second section of the book is about applying mindfulness and how to use mindfulness with your children. There are some simple ideas to encourage an open and non-critical relationship with our family members. She clearly speaks from experience as a mother and a daughter and highlights how things are often easier said than done. This may be interpreted as don’t bother if you think it will fail which possible undermines some of the messages she wants to put across. However the message is simpler, you cannot fail just try, but try regularly-daily.

Frazzled fron coverIn the middle of the book is a stand-alone 6-week Mindfulness programme. It introduces the reader to familiar practices of meditations, for example the Body scan and the 3-minute breath. I was introduced to a lovely one focusing on listening. The practices show how to access our body, thoughts, senses and emotions in the present, through simple exercises set out week by week. There are questions after each practice to help you notice what might have changed or been different from your usual experience.

Part way through the book Ruby puts  ‘mindfulness’ on hold and shares a  moving journey about her own sufferings that happened during the writing of ‘Frazzled’. This makes the book all the more personal, and perhaps shows in that the latter section of the book seems to me a bit less dynamic or humorous than the first.

Finally she describes a retreat she went on. Retreats I guess are a bit like having children, you really cannot know what it’s like until you have done it. Her experience is heart-warming, real, and genuine.

I would recommend this book to the curious,  to those who love Ruby, and to those with anxiety looking for help through mindfulness. It is for a secular audience not the expert, although she does list her references and resources for those interested.

It does not touch on the spiritual or loving aspects of mindfulness these are more associated with Buddhism, and neither to does it claim to. To conclude  this is an easy read for those looking for an introduction to Mindfulness.

A Mindfulness Guide for the Frazzled by Ruby Wax

Mindfulness Meditation for Novices; sharing personal experience- Part 1

I am a middle aged mum (and incidental a psychotherapist) who wants to spread the word about Mindfulness. However the media hype is something that might put any novice off. I hope to provide a fresh and personal perspective.
I am not a Buddhist, I hold no particular belief about God or Allah, or paganism. I do believe that our busy world has taken our attention away from what it is to be human; what it is to have an inner sense of being OK; a belief that we have the skills to live our lives as best we can; that we are all OK, even if we sometimes feel otherwise. I hope to inspire mindfulness meditation for novices who are curious but don’t know where to start or anxious about doing it wrong.
I would like to say that I  agree with many of the supporters of Mindfulness, who feel there is potential to change how we respond to cultures different to our own, we often respond because of feelings of threat. We have a tendency to live our life based on fear. We make decisions to avoid harm or to minimise risk. I am not advocating risk, far from it, I notice how we have a strong need to plan, to stop bad things happening. We don’t believe we can manage should a bad thing happen; and we think, by planning, we can prevent the inevitable bad thing happening. I want to say, we are not fortune tellers! We have no idea what will happen in 2 weeks.

A spare pair of knickers in case I wet myself laughing

A spare pair of knickers in case I wet myself laughing

When was the last time you packed a spare pair of knickers because you anticipated wetting yourself laughing? It is far less often that we plan for unexpected joy.
We do not give ourselves space to experience the moment that is now. We allow the past or the future to disrupt now and that then generates feelings that may be difficult to contain.

We are in such a hurry to get on to the next task, to finish, to move on. To move on to what? When will it all be done?

Mindfulness Meditation for Novices-Wakening up to new possibilities

Mindfulness Meditation for Novices- Where to start?

Why do you want to do mindfulness meditation? This is not a miraculous cure for dissatisfaction, anxiety or depression. It will not change you directly, mindfulness is about being you, or awakening; being you in a way that is different, not preoccupied with thought.

You may have heard how mindfulness can help your mental health. Mental health issues may arise because we lose ourselves in thought, they become our reality, and the thoughts might trigger behaviours and we end up suffering in a way we do not like. Mindfulness can help and you can access some tailored support through your GP.

Or you may be intrigued, mindfulness meditation it is a new fashion after all. Great.

If you have already started reading or listening to meditations they often describe having an ‘intention’. This means; be clear why you are meditating. Identify your intention for yourself and also in relation to others. You will be reading this or considering Mindfulness because of something, a new possibility you see for yourself. It is worth thinking about this, either writing it down or telling someone. As your experience of mindfulness changes so will your understanding of the intentions you make, and these evolve. Mine are evolving all the time as I learn what ‘being awake’ feels like. ‘Being awake’ is the term often used by Mindfulness writers, I understand it to mean being conscious of every little moment, rather than being ‘in your head’ on ‘auto pilot’.

Lost in thought, we cannot remember where we put our keys

Lost in thought, we cannot remember where we put our keys

You may have those moments when you cannot remember locking the front door, or where you put your keys? These daily jobs are done on ‘auto pilot’ if we were totally conscious in these little activities things would not get lost.

We are often ‘lost in thought’ and the formal meditation practice is about noticing this, and providing us with an opportunity or even training to be able to separate ourselves from our thoughts.

Mindfulness Meditation for Novices-Trying to understand intentions

My understanding of Mindfulness is still very basic. There are some useful resources listed that might help you.

As a novice, I am finding it hard to understand ‘intentions’ as used for Mindfulness meditation. Here is my attempt at explaining intention, intentions are not goals or targets.

Initially I wanted to use Mindfulness in my work. So my intentions were about ‘learning’ and experiencing it. This was not the best way to start, as mindfulness is a lot more than a technique. I could compare it to learning to love, or learning to fear. Being Mindful is learning to be present, and ironically it is not until I started doing it, that I realised what this meant.

My early intentions were about changing me. This is a common intention to have, and it is not really what it all is about. It is more subtle. It might help comparing a goal with an intention, a goal might be ‘I want to be kinder’ whereas an intention is ‘I intend to give kindness’. As we become more ‘awake’, we notice our kindness and how kindness is already part of who we are, or we might notice others’ kindness and so learn what it is to be kind, or how it feels to experience kindness. We become more aware of kindness, and ‘kindness’ changes from being something that is ‘out there’ to strive for, to something ‘in your heart’ something already present; already available to give. I think this sounds exciting.

I suggest you give Mindfulness meditation a go. If you are suffering quite badly with a mental illness it is advisable to talk to your doctor first.

I share more of my journey in part 2

Resources

Books

  • Wherever you go there you are by Jon Kabat-Zin (2004)
  • Mindfulness: A practical guide to finding peace in a frantic world By Mark Williams and Danny Penman (2011)

For anyone interested in the science behind mindfulness-

  • The practical neuroscience of Buddha’s Brain, happiness, love and wisdom. By Rick Hanson with Richard Mendius (2009)

Websites

Emma Dunn Counselling and psychotherapy

Thoughts and Anxiety -Using Psychotherapy and Mindfulness to alleviate fretful thinking

Thoughts and Anxiety

Anxiety often manifests itself as poor eating, irritability due to poor sleep, and an inability to concentrate. First line treatment addresses these manifestations. Anxious people are encouraged to exercise to become physically tired; eat regular meals and to make lists  to feel less over- whelmed. These are useful for symptom alleviation but without identifying the cause there is potential for anxiety to continue. The link between thoughts and anxiety is not being addressed in these treatment. It is understanding the cause that will ultimately decrease the symptoms of anxiety.

Anxiety might be interpreted as a reaction to a real situation. Do you believe anxiety is a reaction to a real situation?

Have you ever considered your thoughts and anxiety as one problem?

The Neuroscience of Anxiety

Emma Dunn Counselling and Psychotherapy

Summary of the brains response to a threat

The stress response is the same whether there is a real threat to our physical safety or a perceived one. An area in our brain called the amygdala is the warning bell that makes us physically alert through a cascade of hormone and nervous reactions. One of the hormones released is cortisol, which further alarms the amygdala so it becomes even more alert to negative stimuli. Meanwhile, another area of the brain, the hippocampus, becomes less responsive. The hippocampus normally provides a control over the amygdala such that positive experiences are noticed as well as the negative ones and we can weigh up rationally what is the best action to take. The more often we are stimulated by anxious reactive thoughts the more readily we get to a state of alertness and vigilance, and less able to keep calm and rational. We attune into (implicit) memories that are not quite clear ‘the sense of something bad going to happen’; thoughts and reality become inseparable, we become less able to access reality, which might appropriately be remembered as as ‘when such and such happened, I was concerned but it all worked out in the end’.

Thoughts

Thoughts and Mindfulness

In the context of Mindfulness there are 3 types of thinking

  • Active-Useful, essential for planning, doing, reaching our goals
  • Flow-thoughts occur but are not judged, they pass by.
  • Fixed-unhelpful patterns of thinking, not usually based on reality.

Mindfulness aims to help us move away from fixed thinking to flow thinking and active thinking.

It is useful to remember that

  1. Thoughts are not facts
  2. We are not our thoughts

We are then in a better position not to let thoughts and anxiety dominate our thinking and behaviour.

A useful way to notice whether a thought is an unhelpful one is whether it creates an emotion, or whether it is helping or not, that is enabling you to do a task or stopping you from doing a task by relating to the past or the future, rather than the present.

Psychotherapy and Thought

Psychotherapy is about understand the workings of the mind, and bringing it into awareness. It is about recognising behaviours that are based on past experiences, and understanding that we do not need to repeat behaviours and thoughts, especially those that cause unhappiness.

The implicit memories that were mentioned earlier, it is these that psychotherapy can help unravel and challenge.
An example
As we grow up we often maintain the beliefs, behaviours and thinking patterns that were familiar to us as children, when they are out of awareness, as adults they can prove to be unhelpful. An innocuous example might be that as a child ‘greediness’ was discouraged. So little Billy, to please his mum would take the smallest bun when offered a plate of cakes. As an adult Billy’s wife offers him a plate of buns, obligingly he takes the smallest, not wanting to be disliked for being greedy, Billy’s wife is upset thinking Billy does not like her cooking. There is something in Billy’s wife’s belief, behaviours and thinking that feels rejected if someone doesn’t accept what she offers.

These actions can be so ingrained that we believe them. Billy believes he is greedy if he takes a big bun and his wife believes she is rejected because he didn’t take the biggest one. These are fixed thoughts. The reality of the situation has not been made explicit, spoken about. In a state of anxiety further implicit memories may be stored (remember these are not based on reality). Billy’s implicit memory might be is that he upsets his wife by eating buns, his wife’s that Billy doesn’t like her cooking. A tiny event reaffirming a whole set of thinking and anxiety based on past experiences not relevant in the present.

Through psychotherapy Billy will gain an understanding that perceptions of greediness are individual. He will identify with his own physiological experience about what it is for him to be greedy, or even whether greediness is an unhelpful experience that represents for him an interpretation of poor self-worth (i.e. he doesn’t deserve a big cake because his mother will not love him, and as an adult, his wife will not love him if he has it) He will become aware through dialogue that explaining why he makes certain choices can avoid future misunderstandings, and stop the perpetuation of irrational decision making. He will learn that other people, including his wife, experience his behaviours in their own way, not necessarily how they were intended.

Psychotherapy and Mindfulness

Thoughts and anxiety can be inseparable. Through Mindfulness practice there can be an awareness of our thinking, noticing spiralling sequential thinking sometimes pulls us away from reality into a repetitive story of stress, and worry; Mindful practice enables us to begin to slow down fixed thinking, replacing it with flowing thoughts.

Psychotherapy acts as an adjunct helping us to notice actions and behaviours that are based on habit, or implicit memories, and previously out of our awareness. It therefore helps us to modify our behaviour and take greater control, strengthening explicit memory formation and the role of the hippocampus, enabling rationality informed by experience.

Thoughts and anxiety lose their grip on each other. Thoughts become focused based on reality, and our physical arousal is appropriate based on actual threat or excitement.

We learn to make our thoughts explicit to help identify reality from ‘make believe’. Relationships improve and anxiety decreases.

Further information about mindfulness can be found below.

If you think counselling can help you please look at my website Insightfulness or visit Counselling Directory or British Association for Counselling and Psychotherapy where you might find some helpful resources.

Resources

Books

The practical neuroscience of Buddha’s Brain. By Rick Hanson, with Richard Mendius

Mindfulness; a practical guide to finding peace in a frantic world. By Mark Williams and Danny Penman

Web Sites

The Mindfulness Project

Oxford Mindfulness Centre

Counselling Directory

British Association for Counselling and Psychotherapy

Counselling can be for anyone.

It is interesting how counselling is associated with mental ill health. Nick Clegg at the Liberal Democrats conference (2014) promised to increase spending on mental health, and there is frequent debate about putting mental health spending on a parity with that of physical health. I however, am not debating whether your mental health is sub-optimal and you ‘need’ treatment, I am proposing that just like we indulge our body, we should perhaps be a little more attentive to our mind/soul/spirituality.

I could google the cost of a spa break, or how much we spend on wasted gym membership. Or I could start on the cost of teeth whitening, facials, liposuction, a touch of Botox, these are accepted behaviours, which incidentally, are not inexpensive, that are used to help us ‘feel good’ about ourselves. Behaviours which we do regularly and then need to do them more frequently for the same benefit and then up-grade, and repeat the cycle.

We attend to the body, the shell, our physical form. This is how we see ourselves in the mirror, and it is important. Our acceptance of this picture in the mirror, is often conditioned by a view that society gives us regarding what is aesthetically pleasing. Some of us our more bound by this view than others, and constantly need to pay attention to how we look in order to feel ‘acceptable’ and ‘accepted’ to others and ourselves.

I recently was introduced a group ‘Health at Every Size’ one article caught my eye, Weight Science: Evaluating the Evidence for a Paradigm Shift . This article demonstrates how powerful non-health based influencers have been on defining what a ‘healthy weight’ is. This has not been challenged enough by scientists and health professionals.

The general dissatisfaction of our ‘form’ that many of us have is not a ‘mental illness’ and yet it impacts on our relationships, our ability to get satisfaction from social events, our enjoyment of holidays, because it results in us  carrying an anxiety about how we see ourselves and also how others see us.

Then there are those of us who despite having a good quality of life, the family we aspired to, the regular work promotions good physical health who feel guilty that despite this they do not feel satisfied/happy. We wonder ‘what is the point’. This is not ‘mental illness’ yet impacts on our relationships our potential to do well, and our overall enjoyment of what we have.

Another group of us carry a sadness (which may be experienced as anger or frustration), it is associated with an aspect of the world, people, society, animal or human welfare, our environment, things that are ‘not good’, for example war, pollution, famine, global warming. Often we have little control of this as an individual but feel as a race/ species uniting we can have greater influence, so endeavour to put energy into this. This sadness can be overwhelming, it has a moral or ethical feeling and is hard to ignore. This is not a ‘mental illness’ yet impacts on our relationships, and our satisfaction with our own life journey.

These issues can slip from being motivators to de-motivators, we may feel like a failure, or unlovable, or even worthless, or insignificant. Not a mental health problem, but nevertheless leads to low mood.

Many of us with strong social networks, good communication skills, and who trust those that love us and are close to us, can share these doubts well enough to grow through them and understand themselves better.

Those that are not so fortunate may find their support through counselling. Counselling provides an unconditional space to explore what is that makes us who we are, counsellors generally believe that we are all ok, exploring the things we don’t like about ourselves can be done safely and without fear of judgment. Allowing reflection and opportunity to see things from a fresh perspective.

The benefit of doing this is often felt immediately; having the space to be who we truly are and explore our defences and anxieties in a contained consultation with a stranger who has no vested interest is liberating.

You may even want to try counselling just for the experience!

 

 

The Johari Window and Improving our Understanding of our Patients

Joseph Luft and Harrington Ingham in 1955 created this ‘Window’ concept to understand how individuals work  within teams and to improve productivity, communication and collaborative working. It is frequently used within counselling to explore self awareness.

It is a metaphor for displaying ourselves, drawing on ideas of visibility and transparency as well as curtaining off areas to keep them protected from on lookers who may mean harm.

I wonder if this tool can also be used to understand the complexity of the patient presenting to their doctor or Health Care Professional (HCP)?

The Open Quadrant

The transparent two way picture.

This is what the patient is willing and able to show to their doctor. But what is it that the doctor believes they are being shown? And what are they willing to see? The picture is quite a simple discrete one, I believe that too often the view for the doctor and HCP is the illness and  treatment for which their patient has been diagnosed. This is not necessarily so for the patient, their presenting picture; what they make visible, may be quite different, not even on the radar of the doctor or HCP. For example they may be showing as an anxious parent unsure of their ability to provide for their children, a highly paid business man who is in denial  ‘not very ill at all’. So  despite this quadrant being ‘open’, and that our patient willing to disclose some of them self, is the same picture being seen by the doctor? Is the doctor, only looking to see a patient with an illness, not a person?

The Blind Quadrant

This area is designed to represent what the other person can see but the patient themselves cannot see. I have  interpreted this slightly differently to emphasise the knowledge the HCP or doctor has about the patient because of their illness.

This area is saturated by the doctor’s knowledge about the patient’s diagnosis, prognosis, and expected complications. So they see, or focus on their own intelligence and ‘dump’ it on the patient. Whether they are able to tune into other aspects of the patient ( not their illness) such as their bravado, courage, or fear,  would provide potential for an improved empathic relationship. Do the blind and open quadrants merge, the patient becoming the illness, detached from the person?

Perhaps the doctor too is being blind?

The Secret Quadrant

This is describing the things the patient is keeping well guarded and hidden from the HCP or doctor who will be completely unaware of them.

An acknowledgement by HCP’s that they in fact are not being presented with the whole of their patient and the patient is concealing aspects of themselves may be useful. It may be relevant to reflect: what is my patient hiding from me?Is this related to their illness?  The situation, environment? Am I being presented with the whole person? How can I facilitate openness? What impact will this have on concordance? Self management?

The Hidden Quadrant

Neither the HCP nor the patient knows what is hidden. But by providing space to explore the potential for understanding how the patient’s illness is impacting on relationships, behaviours and emotions will only serve to increase the potential for our patient to modify their behaviour  to help them reach the potential they hope for themselves. So facilitating the exploration of anxiety, poor sleep patterns, bad dreams and other negative characteristics may prove beneficial for physical health and the relationship between patient and HCP/ doctor,  and patient and their illness.

Johari-Window-Medical-Model

I would just like to conclude that there are missed opportunities within the NHS care settings that deny the patient the opportunity to be truly known by health care professionals such as doctors, who claim to wish to do patients no harm and yet understand very little about the patient they wish to avoid harming.