6/18/2011

NEW "WILD MOODS" BOOK RELEASE

A collected volume of The Wild Moods has just been issued, edited, culled, and in many cases, re-written, with a new introduction. It is divided into three sections (there is a sample article from each section below):

Inspiration
Context
Exercises

The book's 42 articles are spread across these three sections, and address the challenge of understanding, containing, and ultimately overcoming anxiety and depression.

You can purchase a copy for from here.

4/20/2010

INTRODUCTION: A Wily Kindness

My experience has been that when you are really effectively dealing with depression and anxiety, what you're doing is a kind of wily kindness. Much of the suffering in these states (i.e., the often linked states of depression and anxiety) comes not so much from their natures, as from how we struggle with them. They're like arm wrestling a rose bush--if you enter the game, you're going to end it bleeding.

Wily kindness is looking at your own experience without hostility, but also without blinders. With just the kindness, you often will lack the motivation or energy to actually get things done in your life. And with just the wily, you might be able to punch through the anxiety/depression, but underneath the hatred and struggle with, the lack of acceptance of, these states is causing you deep suffering.

I remember hearing an interview with an environmental activist who had been imprisoned in Arizona. She talked about the struggles of prison life, and about her own growth in the midst of it. The quote that has stuck with me for all these years is, "I've learned to love people who I cannot trust." The same could be said of skillful management of anxiety/depression, because the claims made by these states are deeply untrustworthy. And yet to hate them because of the ignorance of their claims is to jump right in with the roses--there's no winning that fight.

What are these claims? They usually go like, "The world is empty." "You're not worthy (of happiness, of love, of companionship, of grace, of joy)." "There is danger everywhere, so if you want to survive, be small!" "You can't possibly do..." "Be exposed and you'll be eaten." "No one loves you." "There's no way to solve your suffering." "It's all hopeless and you'd better just face it." Often they'll be phrased as "I...," but it's really anxiety and/or depression that is speaking, we just get confused about us not being the same as these states.

So with wily kindness, you practice recognizing that these messages are simply false (in the beginning, this takes faith on your part, and supports from others to help you believe this). But you also hold onto the fact that if you hate these states, because of this falseness, you are making more suffering for yourself.

This, admittedly, is a bit tricky, because if you've suffered with these states for a long time, particularly if beginning in childhood, then you've likely learned that the only thing keeping you from deep depression and anxiety is fighting them tooth and nail. But to move towards actually resolving and dissolving anxiety and depression, you have to learn to approach them with kindness, not animosity. Tall order? Only if you haven't yet experienced it. Once you really feel how different it is to sit with these states in watchful acceptance, and then act on them with the kind of attitude you'd take towards a beloved if wayward child, then it becomes clear how your strategy of struggle comes at a cost.

As an experiment (and an experimental attitude is extremely important in mastering these states), you can try the following exercise. (Though if you start getting overwhelmed, stop the exercise and do whatever is soothing to you. When you're overwhelmed, it's not only painful, but you can't really work. Be gentle).

1) Get physically comfortable.

2) Feel whatever depression/anxiety current is accompanying you (as thoughts, emotions, and physical sensations).

3) Start with the phrase, "Depression/anxiety, you are not my enemy," saying with as much conviction as you can find.

4) Notice if there are changes in your state (again, as thoughts, emotions, sensations).

5) Change the phrase and see if you can find something that feels truer. (For example, "Depression/anxiety, though you are difficult companions, I choose not to
fight you.")

6) Keep doing this till you find something that rings as believably as you're going to find (for some, it might be "I'm willing to consider that I'm not totally the same as these experiences...which suck!"--that's fine, as long as it's the truth for you).

4/01/2010

INSPIRATION: The astounding climb (pt.1): A meditation on development

A very old and dear friend had a healthy, bouncing baby boy, now two weeks old. I had the great honor of being with him and his wife a few hours after the birth, when, despite the various upheavals of his arrival at the hospital, a deep stillness underlay all the family visitations and the coming-and-going of medical personnel.

That stillness has not quite continued; the new parents are on a growth curve of learning to interpret "waahhaaahhaa!" and how to deal with sleep in two hour chunks. It all seems to be progressing fairly typically, with what appear to be standard amounts of happiness and pain.

Never having spent so much time around a newborn, what it has unexpectedly surfaced is a deeper appreciation--not of the particular struggles of individuals, which I already have a deep empathy for, but of the "impersonal" struggles of human beings. Looking at this little being, with his animatronic-like movements, his inability to focus, his language of a half-dozen nuanced cries, his out of control body functions--it gets me reflecting on what a climb it is for life qua life.

Think about Mars. Maybe there were some microbes in the distant past, or maybe even now, buried under a vast plain of dust and rock. But there are no grasses, no trees, no insects, no mice. It's like a sterilized Mojave, with texture. Here in my own neighborhood, there must be 50 different trees, and hundreds of different species of other plants and critters. Yet this planet was a barren as Mars at one point, and all of the incredible diversity has arisen from a browner colored rock-and-dust.

What a climb. What intense dramas have played out just to create a mammalian body that could support cognition of a rudimentary sort. That could allow the base for the emergent psychological world, and its dramas. All this, all the inconceivably vast play of energy and form over ungraspable spans of time, has localized in the form of my friend's newborn, in his raucously "bodied" phase.

Holding him, and knowing something about human pains and struggles, it's quite moving to imagine the vast effort that has formed him, and the efforts that will be called from him to even develop the basics, of language, movement, relationship. And then the personal struggles on top of that, finding meaning, purpose, love. Falling on your face and trying to make sense and use of it.

With this nascent being, this arc of effort is particularly poignant, and is easily forgotten or missed when looking at an adult, with all the clouds of language and personality. But my ability to type on this keyboard has a few billion years history, at least. Pretty astounding when you think about it.

6/01/2009

CONTEXT: The Intolerables

Why is it that in some areas of our lives, no problem, we flow around obstacles like an cork on a river, and other areas, we're an iron anchor? Why do we get stuck? And why do we get stuck, where we get stuck?

In my work with couples, we talk about"The Intolerables," those places where we dig in our heals and refuse to budge. With one person, their Intolerable might be around their partner's messiness. Another, around not getting a certain amount of sex or intimacy. A third, not having enough time alone. The Intolerables are not just preferences, which are simply statements of desire; instead, they are conditions in the world (relationship, career, mood states, etc.) which must be met or else there is a severe defensive reaction.

What these reactions are will vary from person to person, but they are all defensive. One couple I worked with, when the husband pushed to hard for his opinion to be heard, his wife at some point fell over her level of tolerance and snapped shut emotionally, often withdrawing to her study for a whole day. In another couple, the man, when asked for emotional contact, would quickly begin threatening physical violence.

Preference implies a certain flexibility: I'd like to go to the museum, but there's other things we could do that would also be o.k. But intolerance implies a line in the sand: cross this mark and there are dire consequences. "I'll go this far and no farther," is the voice of intolerance.

So, if the Intolerables are demarcated by a (relatively) sudden drop into defensiveness...what then is being defended? Take a minute to check in around one of your Intolerables. What marks the edge of your tolerance, and what happens when you reach it? What are you feeling as you go over that edge? What are you thinking; or, what story are you telling yourself about the situation, such that you feel you need to go into a defensive posture? (And here, attack is seen as the more active form of defending.)

In my experience, the Intolerables boil down to those areas where we feel our self is being threatened in a big way. This isn't a sticks and stones situation; these "thou shalt nots" are about life and death.

The defenses of the self, the guards on the castle walls, react when the alarm bell rings, when the self seems under attack. The type of reaction--retreat, attack, pulling up the drawbridge, going invisible, any of the myriad ways of defending--is determined by a person's character and past history, as is the conditions under which the alarm goes off.

For instance, Sarah grew up with an alcoholic father who was normally withdrawn, but could fly into violent rages at unpredictable times. She could handle her husband's irritation OK, but when he ramped up to anger, it crossed a line for her and she would start stonewalling, withdrawing emotionally more and more until she'd threaten divorce. Even if he was owning his anger, and voicing it appropriately, for her it triggered memories (which means, her neurological system was being activated in a similar way to when she actually was faced with a rageful father--i.e., there's something very real being experienced) that made her feel profoundly threatened.

Or take Benjamin, whose mother was depressed and unavailable for most of his early years. With his wife, who had a tendency towards depression, he could take about a week of her gloomy moods. But after that, he would feel less and less tolerant and sympathetic, and quickly move towards despair and thoughts of how his wife didn't love or care about him. At two weeks, he would start entertaining ideas of leaving (this option of "radical separation" almost always goes along with one's Intolerables).

So what are the solutions?

There's two ways to go with the Intolerables: management, making the situation conform to these "requirements"; or, letting go of the "requirements."

Now, the first we're all pretty familiar with. You could probably do a full assessment of your successes and failures in these terms: what are my Intolerables, and how have I designed my life and relationships to conform to them? And there's a lot to be said for being able to get one's needs met in the world, no doubt about that. The problem with the Intolerables, though, comes from the rigidity of reaction to what is perceived as "not to be tolerated."

For most people, the "letting go" response to the Intolerables is much less familiar. But, to my mind, and it is what makes any system--whether a relationship to others, or to life in general, or to one's own moods of depression and anxiety--more flexible and resilient.

This is the harder, but ultimately more rewarding path. The Intolerables are markers of where we believe we cannot survive reality, and since reality always, in the end, wins, these places are sites of deep suffering. In fighting for the maintenance of our "selves," our self definitions, we are like brick walls in the surf. The ocean doesn't stop, and our rigidity in meeting the endless waves means we are pounded by the inevitable, over and over...and over...

To learn that we can actually survive what now feels intolerable is, ironically, to allow ourselves (actually, "our selves") to be broken. Meaning, to resist the urge to defend, to stay present to the reality (our wife's withdrawal, our husband's anger, our own depression), keeping engaged, and asking, "Have I been destroyed?"

The trick, though, is to ask the question without then jumping to trying to answer it. You toss it out there and then just look, staying in that questioning space. As if it were less a question and more of a prayer, open and without panic.

What you'll notice in doing this is that, because the question (if you stay with the openness long enough, not collapsing into defensiveness, contraction) of "Have I been destroyed" is seen as a simple, "No," then there's a fundamental change. "Intolerable" turns into "preference." You'd prefer you husband not be angry--it's annoying and takes energy to deal with--but you know deep down it's not a matter of life and death. And from that lack of panic you stay present, and are able to work skillfully with what's in front of you.

5/08/2009

CONTEXT: Review of MBCT: Mindfulness Based Cognitive Therapy for Depression


Mindfulness-Based Cognitive Therapy for Depression is a very interesting new-ish modality for treating chronic depression in adults. It was created by three researchers and clinicians (Segal, Williams, and Teasdale) who received a grant to develop a treatment to address the high relapse rate among sufferers of depression. According to statistics cited in their book, patients with no history of depression had a 22% chance of having another major depressive episode; those with a history of at least 3 depressive episodes face a 67% chance of having another. Depression seems to be "etched in" to a person's psyche/body over time with more experiences, and this proneness to relapse is what MBCT was developed to address.

Essentially, MBCT is an application of Jon Kabat-Zinn's Mindfulness-Based Stress Reduction work at the University of Massachusetts, which focused on the use of mindfulness practice (i.e., meditation) with patients suffering from chronic pain. Kabat-Zinn's work shows that for these people who have had little success with conventional pain management, the internal work of mindfulness practice substantially helped in dealing with pain.

So the authors of MBCT worked with Kabat-Zinn in specifying MBSR for training chronic sufferers of depression in skills that prevent relapse. Their own research shows in people with 3 or more episodes, MBCT cut the relapse rate in half (over the 60 week follow-up period). Apparently, they hit on something.

MBCT consists of a mix of mindfulness practice, of practicing a mere noticing of sensation (vipassana practice), as well as certain thought-tracking techniques from cognitive therapy. It is taught as an 8 week class that focuses on skill acquisition, rather than on psychotherapy per se. Groups are from 8-12 people, a size that tends to pull away from the tendency for it to become group therapy. It's really about learning and practicing skills.

Is it spiritual? Not explicitly, neither in design or execution. It really is mindfulness applied to healing and not transformation. Kabat-Zinn's research shows that mindfulness practice does have specific health benefits; it does make for a stronger mind and body. In the context of MBSR or MBCT, it may bring someone into a deeper relationship to Spirit (whatever word you wish to use here), but the context is not intended for that and there is no spiritual context given to encourage that insight.

So it's a curious application of age old wisdom to the healing arts. Buddhist teachers that I've known have poo-pooed such modalities as MBCT, as rather shallow, or even making matters worse by making the ego (the false sense of a separate self) more entrenched. And on the other side, medical researchers are showing that it really does have positive health effects. It's where the two traditions--spiritual and medical/healing--are hashing it out most directly these days.

Perhaps what the "medicalization" of mindfulness practice is showing is the limits and strengths of these different approaches to health. This would be Ken Wilber's argument, that in order to experience ultimate reality, you need to be attuned to spiritual dimensions of life--the insubstantiality of ego, the pervasiveness of consciousness, the oneness of essence. But if your goal is more limited, then the results will be more specific and more confined (as with MBCT--the authors make no claim that it will bring one to enlightenment). Or as he has said, "Give unto Freud what is Freud's, and unto Buddha what is Buddha." That strikes me as a very sane way of seeing it.

5/01/2009

EXERCISES: The Magic Well: Letting the universe answer the questions (for a change)

Have you noticed asking questions of yourself, like, "Am I good enough," or, "Is this all useless," and then wondering why the answers are so elusive?

A colleague who traveled in Asia for a while once told me this story:

I was in Thailand, in the North where there was a lot of fogged in days, at least up in the mountains. My mood was really getting affected after a while. I was bummed out much of the day, and noticed myself walking around the forest thinking, 'Why can't I shake this malaise?' The question repeated over and over, and I'd struggle with it like a Zen koan, and just feel worse that I was apparently too stupid to figure out the answer.

Then one day, walking back from a dismal hike, coming through the gate of the village I was living in, I asked the question again, but for some reason it seemed to actually come out as a question. The difference was like, 'Hmm, I wonder what's keeping this in place?' Which may sound similar, but there was a part of me that came online, a rational, data-driven place that, when it showed up, backlit what had been going on. That I'd been actually saying, 'I'm miserable,' but in the cloak of a question. When the cloak dropped off, the answers came quickly and without a lot of struggle. Like, 'Oh, duh, it's been foggy and I always get low when there's not enough sunlight. And I'm eating poorly and am far from home. Oh!' And then the solutions came quickly and with that clarity I could actually take action. But it required getting clear what was a question, and what was me saying, 'Ow!'"


So, what's this about? Basically, perseveration and rumination are two of the forces that drive and support anxiety and depression. Like my colleague's question, they often take the form of asking questions that aren't really questions at all. These are sentences that do, indeed, seem to end with a question mark, and yet are not actually taken up as real questions, meaning, as inquiry which goes through a process towards either being answered, or being tossed out as illegitimate questions. That's how real questioning happened. The problem my colleague illustrated is when we think we're in that process, but are actually asking questions that in actuality are statements of feeling combined with a fear-based desire to find a little control.

These, then, are questions without answers, because they are not actual inquiry. And this is the dilemma, that when we forget what we're actually doing (stating a feeling and desire vs. practicing inquiry) is not questioning, then when we don't come up with an answer, it's taken as a sign of danger. Then we try "asking" again, trying to find a way to feel safety and control, and with no solid answer coming, we zip around the track yet again. And depending on the question, it's naturally going to be either depressing or anxiety provoking to not come up with an answer or solution.

There are a few ways out of this loop, and I'll offer an exercise below for one way, emphasizing acceptance and openness. I'm calling it the Magic Well, as it's a visualization involving...can you guess?

Closing your eyes, imagine you are in a safe, protected field of grass. It's sunny, mild, a pretty nice place to be. (Change the place if you need to, so long as the felt-sense is one of comfort and safety/peacefulness.)

Now, you see an old fashion well there a little bit in front of you. It has stones around the edge (you won't fall in). This is a magic well, but you have to read the plaque on the side to understand what kind of magic.

So, what you need to do is think of a question you want answered, and imagine it as having form, and resting in your upturned palms. Whatever feels like it's natural form, pretty or not so pretty, it's all fine.

Now, with your question formed, you walk up to the well and read the plaque: "This is a magic well, magic because it will answer your question. However, it answers on it's own schedule. Your job is to ask, and then step back with an open patience. It's job is to answer."

The well is deep, and you step forward and tip the question gently off your hands to drop down into the darkness. Now you step back and practice the patience of waiting, knowing that eventually, and appropriately, the answer will return to you.

Good work!


For some people, this exercise feels like a relief; for other, letting go of the question, giving it over to the universe, or a deeper part of ourselves (however one thinks about where it goes) causes anxiety. Any reaction is fine. This is an exercise in asking a question differently, and implicitly in developing trust that the answer is known already, in oneself, in the ether, in the Big Mind, in our nervous systems, and that openness will provide the information better than insistence.

Notice that, in the example of my colleague, his shift in questioning led to a more active problem solving stance. But it started with an openness of questioning, a real curiosity or wondering. The Magic Well is asking with a big openness, allowing something larger to do the answering.

So experiment with what approach seems to work with which question (radical openness, problem solving, etc.), but keep in mind that the starting point is opening to getting a real answer, and that you don't initially know what it will be, but trusting (more and more!) that it will be OK.