Friday, January 2, 2009

"Terminating Reactions" --An Especially Malignant Form of the Internal Tyranny

Humans, like nearly all other life forms, are strongly motivated to avoid and escape from pain of all kinds. One manifestation of this among humans is the universal tendency to develop what I have come to call "Terminating Reactions (TR's)."

I define a "Terminating Reaction" as any automatic, habit pattern that tends to give us TEMPORARY relief from some form of physical, mental, and/or emotional pain or discomfort-- ranging from mild to very severe. In other words, a TR tends to REDUCE OR TERMINATE PAIN, in the most general sense of that word, for a relatively short period of time.

In the following video, I offer a brief introduction to Terminating Reactions and provide a broad overview of how they range from completely benign to highly pathological.

Friday, December 19, 2008

Mindfulness As A Powerful Way to Get Liberated from "Internal Tyranny"

By George Shears

During my 35-year career as a psychotherapist, I became a bit notorious in regard to what I called "The Internal Tyranny" and, especially, for the highly novel therapeutic approach that I invented to help my clients liberate themselves from it. I called this unique experiential approach "Provocative Psychodrama."

What I term "The Internal Tyranny"--or IT for short--is simply the entire vast array of negative (i.e., unskillful) automatic habits that we start acquiring in very early childhod and which tend to sabotage our happiness and personal effectiveness/success to varying degrees throughbout our adult lives.

These habit patterns go far beyond just our behavioral habits. The habits that trip us up most insidiously are mainly at the level of perception, thinking, feeings, and attitudes. They generally operate outside of our awareness and basically tend to cause us, in our adult relationships, to unconsciously replicate negative, emotionally painful experiences from our early childhood.

A simple aphorism I coined in an effort to capture the essence of this highly lawful, self-defeating propensity is: "As in childhood, so in adulthood."

That is, insofar as we run on automatic, so to speak, it's very likely that we will inevitably recapitulate some of these unskillful childhood themes. Not infrequently, in fact, this may happen over and over, much like a needle stuck in a particular groove of a phonograph record from the past.

About a century ago, Sigmund Freud observed this phenomenon in some of his clients, calling it the "repetition compulsion," but he did not seem to recognize it as being as common as it actually seems to be. My personal clinical observations with many hundreds of clients throughout my career convinced me that it is actually--at least to some degree--nearly universal.

Perhaps the most tragic aspect of these automatic negative habit patterns is that we tend to identify with them strongly and and construe them as part of our intrinsic personal identity, instead of recognizing them simply as impersonal habit patterns that operate much like software programs in a computer.

Not surprisingly, then, we actually tend to devote a lot of energy promoting and defending them in various ways. The key to getting free from these habits, therefore, is not only to recognize them for what they are--i.e. as simply a collection of automatic unskillful habits that we happened to fall heir to in large part during the innocence of childhood--but actually to disidentify, or decouple, from them as fully as possible.

Provocative Psychodrama is one very powerful way of doing so. It entails a structured, highly experiential therapeutic process wherein the therapist strongly and blatantly PERSONIFIES the client's Internal Tyranny and invites him/her to challenge it as fully and strongly as s/he chooses. This process typically and quickly becomes quite emotionally intense and tends to generate major emotional insights into, as well as marked disidentification from, the habit patterns that the client has previously considered to be part of his/her personal identity.

In some ways, however, the practice of mindfulness potentially offers an even more effective means of decoupling from the Internal Tyranny. It's also a method that anyone can utilize personally--at least to some degree--with or without the formal assistance of a teacher/coach/therapist.

By its very nature, mindfulness entails shifting into pure awareness and then observing, moment to moment, all of one's constantly changing experience, both internal and external.

This "formal practice" of mindfulness, as it is usually called, involves staying aware in this way over increasingly long periods of time. It's not uncommon, for example, in mindfulness retreats for practitioners to spend 12 to 16 hours a day in mindful awareness, observing objectively and dispassionately the endless array of mind/body phenomena that spontaneously arise into awareness.

This process, which is much like turning on a bright light in a previously darkened room, reveals the full spectrum of mental phenomena, including those that are obviously unskillful.

As just one small example, most people who engage in this process become clearly aware of how the mind, much like a dog chewing on a bone, tends to dwell on all manner of painful past experiences and, likewise, repetitively projects endless unpleasant future scenarios.

This process, when it is carried out persistently and consistently over time, gradually gives rise to deep and transformative insight--so much so that this formal mindfulness practice is most commonly referred to as "Insight Meditation."

The most central feature of this insight is that these internal habit patterns come to be recognized very clearly--not as one's "true identity," but rather in much the same way that various external natural patterns are recognized as being completely impersonal.

It is in this sense, then, that mindfulness provides a way to "externalize the problem." And once any problem is recognized as being "out there," so to speak, it tends to become much easier to deal with. Once it is recognized as being much like an external "enemy," so to speak, instead of as "myself," attachment to it tends to drop away spontaneously. This is much like letting go of a load of garbage that one has become personally attached to and has been hauling around throughout all of one's adult life.

Shinzen Young, one of my mindfulness teachers, likes to refer to this powerful decoupling process as "watching it to death."

In his recent book, The Mindful Brain, Dr. Daniel Siegel offers a clever acronym to represent this key process, utilizing the name of the well-known Jedi Master from Star Wars fame--YODA: "You Observe and Decouple Automaticity."

On this note, it's probably not too surprising that I independently conferred this same name, YODA, upon my beloved German Shorthair Pointer mascot. He's definitely the epitome of highly focused awareness and provides me with a constant reminder to be mindful.

Hopefully, this information will help to clarify the brief initial introduction to mindfulness that I have offered in the following video:

Research on Mindfulness--a Partial Overview

By George Shears


There is now a rapidly growing body of research that documents the marked effectiveness of mindfulness in many areas of psychology, neuroscience, and medicine. It has been shown especially to be a valuable means of stress reduction, as well as an exceptionally powerful method for coping with chronic pain and other forms of mind/body adversity.

Here’s a small sampling of this research that shows the diversity of problems and conditions for which mindfulness has been found beneficial: This research includes recent clear-cut documentation by Dr. Richard Davidson, Director of the Laboratory for Affective Neuroscience at the University of Wisconsin-Madison.

Using cutting-edge brain imaging methods, he has found that a group of people who went through the standard 8-week Mindfulness-Based Stress Reduction (MBSR) program showed “a significant increase in activity in the part of the brain responsible for positive emotions and traits like optimism and resilience—the left prefrontal cortex.”

You can learn more about his extensive research in this area by watching this video of a presentation he gave at The Wisconsin Academy.

A further video summary of some of this research is available here.

Another outstanding example of research in this area has been conducted by Dr. Phillipe Goldin, who is a post-doctoral researcher in Clinically Applied Affective Neuroscience in the Department of Psychology at Stanford University. He recently did a presentation at Google University on the “Cognitive Neuroscience of Mindfulness Meditation.” You can watch it by clicking here.

Dr. Daniel Goleman, by publishing his 1997 best seller, Emotional Intelligence: Why It Can Matter More Than IQ, underscored the crucial importance of many facets of mindfulness, although he did not explicitly use this umbrella term in referring to them.

Western psychologists, especially those who favor a cognitive-behavioral therapy approach with their clients, are increasingly applying mindfulness in their treatment programs.

One of the most well known and successful examples of this is the Dialectical Behavior Therapy Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, & Distress Tolerance, published in 2007.)

Another outstanding example of this is the recently-published book, Acceptance- and Mindfulness-Based Approaches to Anxiety by Susan Orsillo and Lizabeth Roemer.Several studies have documented the effectiveness of mindfulness in coping with chronic pain.

You can read a summary of one of them here.

Another research study has been reported very recently, showing that the practice of mindfulness meditation slows the progression of HIV.

It has also been shown to be helpful for people with fibromyalgia. (Although I did not do any formal research on this condition in the MBSR course I taught, there were a number of participants with fibromyalgia who reported that the mindfulness training helped them to cope with it more effectively.)

Here’s a report of a pilot study on adolescents with learning disabilities showing that mindfulness seems to lessen their anxiety, promote social skills, and also improve their academic performance.

A Brief History of Mindfulness

By George Shears

Mindfulness was initially introduced by Gautama Siddhartha, who was born as a prince about 2,500 years ago in a region that is now called Lumbini in Nepal. At the age of 29, he is said to have renounced his luxurious, royal life to become a wandering monk. About six years later, he is reputed to have achieved “full enlightenment” while sitting under the famous Bodhi tree.

Following that transformative experience, he became known as Sakyamuni Buddha—or, more simply, “The Buddha,” which means “The Awakened One.” He then spent the remainder of his long life (45 years) imparting his wisdom to vast numbers of followers, including both monks and laypeople. It is said that he once summarized his entire teaching in one short sentence: “I teach about suffering and the way to end it.”

Importantly, he did not represent himself as being any kind of god or divine being, but as simply being “awake.”The key form of meditation that he taught was called sati in the ancient Pali language that he spoke. In English, this word is conventionally translated as “mindfulness.”

He regarded it as the keystone method for what he called “awakening.”Mindfulness was first introduced in the western world around 60 years ago by a small number of Japanese Zen masters. For the next twenty-five years, it was practiced mainly by a relatively small number of their followers.

Then, in 1973, it was re-introduced in it’s original form by two Americans, Jack Kornfield and Joseph Goldstein. During the ensuing 35 years, it has evolved extremely rapidly and has now become mainstream in many ways.

During this relatively short time, it has evolved from being predominantly a method for spiritual development to becoming widely recognized and adopted as a purely secular skill—especially in the areas of psychology and medicine.

Dr. Jon Kabat-Zinn, who is now a Professor of Medicine Emeritus at the University of Massachusetts Medical School, has taken a strong lead in implementing this evolution. He is also the founder and Executive Director of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society in Worcester, MA.

He began teaching the Mindfulness-Based Stress Reduction program (MBSR) at the Stress Reduction Clinic in 1979. His work first became widely known when it was featured in Bill Moyers’ PBS Special, Healing and the Mind in 1993.

From that point onward, the MBSR program has been widely replicated in hundreds of hospitals, clinics, and educational settings throughout North America, as well as in other countries.

As a side note, it was my good fortune to be included in a week-long special MBSR training program by Dr. Kabat-Zinn and his colleague, Saki Santorelli, for health professionals in 1994. Utilizing this training, along with nearly 20 years of previous mindfulness practice, I then developed and implemented the first hospital-based MBSR program in Minnesota in 1995 and continued to lead it until I retired five years later.

Wednesday, December 17, 2008

Dr. Jon Kabat-Zinn--The Father of Mindfulness-Based Stress Reduction

The person who, arguably, has done more than any single other person to bring mindfulness into the mainstream in the U.S. and other Western countries is Dr. Jon Kabat-Zinn.

While earning his Ph.D. in Molecular Biology in the 1970's, Jon also immersed himself in meditative practice, including mindfulness. This led him to the vision of introducing mindfulness to chronic pain patients in a mainstream medical setting as a means of coping with unrelenting pain. He called it the Mindfulness-Based Stress Reduction (MBSR) program.

When I first heard of this project, I couldn't imagine that he would be successful in bringing such an alien approach to ordinary people who had absolutely no familiarity or interest in meditative mumbo-jumbo.

As it turned out I--along with a lot of other doubting Thomases--were proved to be dead wrong. Through Jon's passion and unrelenting dedication, this program gradually grew and became phenomenally successful.

It got a huge boost when it was featured in Bill Moyer's watershed PBS TV series, Healing and The Mind in 1993.

Since then, it has been cloned redundantly and has proliferated in hundreds of medical settings throughout North America and in other parts of the world as well. It's effectiveness as a means of coping not only with chronic pain, but with a myriad of other forms of physical/mental/emotional suffering, has now been strongly documented through a large body of research studies.



This video by Dr. Kabat-Zinn provides a wonderful overview of mindfulness and MBSR.


Friday, September 21, 2007

Mindfulness Meditation and Smoking Cessation

Stop Smoking Cigarettes By Applying
Mindfulness Meditation As A Strategy
By George Shears

Summary: Mindfulness is a powerful aid for anyone who wants to stop smoking cigarettes or any other compulsive habit. Although challenging, it's profoundly simple and has a huge positive payoff.

------------------------------------------------

For anyone who is a long-time habitual smoker, the challenge to stop smoking cigarettes is usually overwhelmingly difficult. As is well known, even for smokers who are successful in quitting, relapse rates are very high. In order to be successful, therefore, it's essential to utilize the most powerful long-range strategy that's available.

There's a strong argument to be made for including mindfulness meditation as one part of such a strategy. It can be very helpful in two distinct ways.

On the one hand, it can provide an effective means of coping with the intense symptoms of nicotine withdrawal and craving that inevitably arise with smoking cessation. There is now abundant evidence that this particular application, which is commonly called mindfulness-based stress reduction, provides a highly effective way to cope with all forms of physical pain, discomfort, or distress.

Secondly there's growing evidence that mindfulness, when applied consistently over time, can help weaken the subtle but powerful mental habits that underlie all compulsive forms of behavior and which make them so strongly resistant to change. There is now also solid neuroscience evidence that the consistent practice of mindfulness can actually alter the structure of the brain in measurable and seemingly positive ways, giving rise to increased equanimity and positive affect.

So what is mindfulness? Most basically, it consists in simply paying careful, moment-to-moment attention to all internal and external experience while simultaneously accepting it and allowing it to be just as it is, without judging or trying to change it in any way whatever. It is, in other words, a means of living fully, consciously, and non-reactively in the present moment, instead of reacting negatively, or getting attached, to current experience and/or getting lost in thoughts about the past or the future.

This tendency to get "lost in thought" is strongly habitual for most people. At the very least, it tends to deprive us of "capturing our moments"--i.e., of living fully in the present. Even worse, however, since much of our thinking is negative, it's a major root cause of what we commonly call "stress."

Since mindfulness training has been shown to decrease stress, which is known to be strongly correlated with both smoking rate and smoking relapse rates, there is reason to expect that mindfulness training might lower these two measures.

Mindfulness training has also been shown to decrease negative affect, which is a potent stimulus for drug-seeking behavior and smoking relapse. So, again, such training can reasonably be expected to have positive effects.

Some initial research studies have utilized mindfulness meditation in helping people stop smoking. In one of these studies, 56% of the subjects showed biologically-confirmed smoking abstinence six weeks after quitting. It was also found that "compliance with meditation was positively associated with smoking abstinence and with decreases in stress and affective distress."

These early results, then, along with the strong theoretical basis for the probable benefit of mindfulness training in smoking cessation, supports its inclusion in an effective stop-smoking strategy. This is especially true in view of its many other positive benefits

Monday, June 18, 2007

Mindfulness Based Stress Reduction--Some Basic Assumptions

1. The universe (or "Great Nature") is a constantly changing process.

2. At any point in time, however, it is just the way it is. There is absolutely no other way it can be. THIS IS IT!

3. We humans are seamlessly interwoven into the fabric of Great Nature. We are none other than Great Nature.

4. As such, we too are constantly changing, but at any point in time there is absolutely no other way we can be than how we are--including whatever we are experiencing in this moment.

5. To be consciously aware and accepting of this is skillful or wise--that is, in harmony with basic reality. To not recognize/accept it is to oppose reality. This inevitably creates suffering. This suffering is essentially a form of friction.

6. The more we are aware and accepting of how we are--that is, what we are experiencing in this moment--the less we suffer and the more we experience happiness and peace of mind.

7. When we experience pleasure, we tend to become attached to it and want it to continue.

8. When we experience pain--whether physical or mental/emotional--we dislike it and want it to end. We tend to resist it automatically, avoid it, condemn it and try to escape from it. All such attempts to escape from pain--whether gross or subtle--can be understood as "terminating reactions." They range from highly skillful to highly unskillful. Many of them develop into addictions. Automatic reactions to physical pain typically add to the pain. Observing such pain mindfully and learning how to "relax into it" can be a much more effective way to cope with it. The greater the resistance to pain, the more suffering is experienced. In principle, pain is inevitable, but suffering is optional. The following formula generally defines how pain, resistance, and suffering are inter-related: Pain X Resistance = Suffering.

9. Attachment to pleasure and aversion to pain causes suffering. Both are forms of resistance to a basic universal law--constant change or impermanence.

10. The human mind has two very different aspects or modes: A) Pure awareness (the unconditioned mind or "Big Mind")); and B) the mind of habit formations (the conditioned mind or "little mind"), including concepts, beliefs, assumptions, judgments, interpretations, images, attitudes, intentions, and feelings. Very importantly, the conditioned mind includes the construct or concept of an enduring self, with which we tend to be very strongly identified. Most of our energy is channeled automatically into sustaining, promoting and trying to protect this mentally constructed "I" or self. This is the basis for much distress and suffering.

11. The unconditioned mind of awareness is unchanging and always available. In order to be "in this mind," however, it is necessary to let go of all mental formations and to shift consciously into non-interfering, moment-to-moment awareness or "bare attention." Learning how to make this shift and to sustain it requires commitment and persistent practice. Through such practice, most people can develop this skill in high degree and, as a result, experience increased peace and fulfillment and much less suffering in their lives. Until it is developed, however, we continue to be strongly identified with, and at the mercy of the automatic reactive mind, suffering all of the distress that it entails.

12. Being aware, moment to moment, on purpose, without judgment (that is, without attachment or aversion) is to practice MINDFULNESS.

13. As long as we are able to shift into awareness--that is, to be mindful--there's more "right" than "wrong" with us. That is, we are in position to shift into "just being" and to experience the intrinsic meaningfulness that this entails.

14. This moment is the only time we have to practice and to live. To miss our moments is to miss our lives. THIS IS IT!