Here is the second part of Paramabandhu’s excellent exploration of the lessons Buddhist techniques around meditation and mindfulness training can bring to the field of mental health – especially to problems with depression and addiction. Drawing on many years of experience as a consultant psychiatrist and Dharma teacher, here he takes questions on his previous talk and elaborates on the general theme. There’s a wide range of material opened up – and considerable detail about how we can actually go about applying these techniques to whatever challenges we face in your own lives. Essential listening.
Please note – the questions in this recording were made at very low levels. We’ve amplified and clarified where possible – but the general sound quality drops noticeably at these points. However, they are all now audible and, in almost all instances, questions are repeated by Paramabandhu before he answers.
Talk given at San Francisco Buddhist Center, 2006
Contents
01 Question-and-answer session – two books to reference on mindfulness; working with depression – discrepancy monitor and rumination
02 Knowing what you can and cannot change – considered action
03 Difficulty doing mindfulness work when actively depressed; noticing subtle shades of pleasant and unpleasant
04 Can mindfulness initiate depression? Stepping out of patterns of thinking; difference between rumination and ‘staying with’; body awareness
05 Over-active mind; 12 step program – something to actually do; expectations and suffering; having your experience – the truth as sometimes uncomfortable
06 Letting go of what you don’t have; relationship break-up; staying with unpleasant experience and not compounding it – the Buddha in the ‘Dart Sutta’
07 Not identifying with one feeling; sexual addiction; recovery from addiction and mindfulness practice
08 Rumination in the body; working with internal sensations; using metaphors to work with your mind
09 Psoriasis and mindfulness
10 What is meditation? A brief introduction and exercise – the ‘Three Minute Breathing Space’
To help us keep this free, please think about making a donation.
Should we be willing to answer some questions? Okay, maybe we should come back here then. Okay, maybe if you could just try to repeat the question too so we can hear it. Okay. Reference two books, one of which we might have out there, can you repeat with those? So the two books I refer to was Living With Awareness by Sankratjuta. And the other one is by Beku Analiel. And it's called, I don't know, but it's something about mindfulness anyway. Thank you. It's got a nice picture of one of the stone bridges from Sri Lanka. On the front cover. Thank you for translating those ideas in this idea of staying with your negative experience. Getting your difficult experience is a depression. And so there's a sort of a tension known sensing, which is, you know, we talk about these things sort of spiral. And so how are you going to do that without having that road? Okay, so how can you be with negative or difficult experience when you're prone to depression? I mean, I mean, I suppose the first thing to say is that this has only been shown to be useful for preventing recurrent depression in people who are currently well. So I think if you are at a particular point in time and very, very depressed, so that you can't go on with your daily activities, I think this sort of approach isn't terribly helpful. You need to do things like activate yourself, you know, do things, probably distract yourself to some extent. Yeah? However, if that isn't the case, then nevertheless you're not noticing a depressed mood coming on. I think the way to be with it is to investigate it. And I think particularly the body is very useful. So you can investigate what's that like in the body. Because basically what harms with depression is there's two things that tend to happen with depressed moods. It's what's called a discrepancy monitor. So people who tend to get recurrent depression have this tendency to compare themselves with, usually with some kind of ideal, and usually they come out not very well. If it's almost like it's sort of antennae looking for "Oh, I'm not doing that as well as I should be" sort of thing. And then the other thing is there's a tendency to rumination. And rumination is sort of going around and around a problem. And the idea of rumination, or why you do it, is because you're trying to solve a problem. And you're trying to solve the problem of why there's this discrepancy like, "So my mood's gone down. I'm feeling depressed. Why am I feeling depressed?" "Oh no, what's I doing? Is this something I'm getting depressed again?" "Oh dear, and the rumination, as I say, tries to solve it, but actually it makes the mood go down." And they've done little studies where they get people to do problem solving. And rumination comes out as being a bad strategy, basically. So you need to cut out of all that. So when we're saying that we're not staying with rumination, we're not staying with a discrepancy monitor. We're stepping out of that. But we can, as I say, particularly like the physical sensations. That like gives another way in of actually being with the experience without getting sucked into it. "Oh, I heard you just said, you know, there's something a little bit dangerous in a way because when you get depressed, you are with your thoughts or any length of time, and maybe you're giving them like very nice examples of something that embody. But if you have things in your life that are traumatic or cruel or like threatening or, you know, a lot of things that are not nice and they would cause one to be angry or depressed, they are outside things, you don't have control over, for instance. And some take action. I don't think sitting and experiencing yourself may not be in that moment, the thing you can do. The other thing is I would think that at some point you need to, like you said, regroup your thoughts. And when you said maybe it's true, if you're in a certain mood, this is not a good thing to do because you are with your thoughts and the point of those thoughts becoming dangerous to yourself. You know, there are thoughts that feed on, even if you intend this meditation to interrupt them, which is what I hear you say, that maybe that's good practice. But this investigation is very innocent and it sounds sort of innocent, like you investigated and you're conscious. You know, for me maybe I have to think I'm conscious and maybe I'm not, you know, maybe I'm on the conscious of something. Maybe I'm not conscious of other things because, well, I'm not sure. But, you know, in some place, like thoughts, they do become sort of your own enemy. You know, they race themselves, they feel like they're old. And what you said, if that was very interesting, that you do have to try to solve what it is. And maybe this is not the thing to do for everyone to know. I don't know. Can I pull out a couple of things from you? I mean, I think just spursal to reiterate, if you're in a really depressed mood, then doing mindfulness meditation isn't going to help. Yeah, because you need to activate yourself. So just to reiterate that. I think the second thing is you've also said that, you know, sometimes there will be real, you know, serious big events that have happened in your life and maybe are happening in your life. What I would say about that is, in a way, that comes to the fourth point about making wise choices. So, you know, there is a time for sitting meditation. There's also a time for taking action. I mean, in a way, you've got, if you're familiar with a serenity prayer, which I can't remember now, but it's something like basically knowing what you can change and knowing what you can't change and learning to be with what you can't change and taking action where things can be changed. But the point that I was making is the important thing about taking action in a way that it is considered rather than it's just a knee jerk or just a habitual thing which you may have tried many times before and hasn't actually got you anywhere. So you somehow need a new way of doing things. And I think meditation can offer a space which can allow those possibilities to arise again. But if you're in a reasonably okay sort of state of mind, so you're not just going to go further down a pit. Yeah. At least that we took the mindfulness thing that they had here for depression. I ran in a priest down, I mean, a priest in difficult depression for the last three years actually. And I had some inspiration about it because I didn't realize until I started the course that they didn't actually recommend it if you were in this particular place. If you were currently depressed, and I didn't know that when I signed up. But when I talked with my doctor, she said that actually if you see San Francisco, you see SF, that they were actually seeing that it is very beneficial for people who are actively depressed. And so I continued with it. But I do have to say that there were certain aspects of it that I still find extremely difficult to do because I am depressed. And one of those being, I mean, one of the things they have you do is a pleasant event, something whatever I came from what it is. Diary. Like a diary of things. And I can't even imagine what that is. I don't have a list because everything is very flat. So I can see abstract that and see, well, if you could imagine, if you have a sense of joy about one activity as opposed to another, it would be easy. Like I get their lists and I thought, are they out of their kind of makeup? I don't know. I know. What is pleasurable about? Like whatever this list was. I can't remember some of the things or so beyond words weird to me. I guess I'm just trying to say that for me as a person who is depressed, meditating, listening to the thoughts. I don't want to listen to those thoughts. I don't want to have anything to do with them because it's just like what you said, the rumination. Whether it's like a particular thing that recycles, I don't think that's what I experienced. It's just this endless chain of negative crap in my head that it's not a particular thought that has an endless loop, it's just a lie. I have a lot of trouble with the whole idea of meditation because I don't want to listen to those thoughts. I want to get away from them. I mean I sit down and listen to the CDs and I want to check out my hot food and skin because I'm sitting there listening to this stuff. Every once in a while maybe there might be a second where there's not this junk going on. I'll just take a book of the songs out there. First of all you mentioned the pleasant events, diary or calendar, I think it's for a two. Interesting, that comes straight from CBT. That's not a mindset, particularly. Actually that is used in CBT for depression. I didn't know what the examples were given. Actually if you do pay close attention to your experience all the time is varying degrees of pleasant unpleasant. Maybe not be whoopee, let's go and have a party pleasant, but there will be a variation. And in a way that's what you're trying to sort of notice. For two reasons, one because when you are depressed you tend to not notice even the very slightly pleasant things. So to actually just start to even a very slightly pleasant things can just change things a bit. It's very easy to fall into, it's all rubbish. So it can be useful. Another thing about that is again those shifting, unpleasant or pleasant can also be triggers to thoughts that can be useful to just be aware of. That was one bit and I forgot what I was going to say. Oh yes, well of course you want to get away from the thoughts and that's what we do. The trouble is always fleeing from thoughts is problematic. I mean I think this is where it's a question of practice and in a way building up. I think of it in terms of building up your muscles, your mindfulness muscles so that you can be with more and more difficult experience or more and more sort of continuously unpleasant experience. I mean just to give you a little example from my own life. When I first started meditating I was a medical student and I was doing my finals. I sort of sit and meditate I think. It's like going to ask me about this and I think of all the sort of horrible things that they could do. And I just get more and more anxious and I just gave up I stopped meditating. Because I was just getting more and more anxious in the meditation. And a couple of years later I was doing some more exams which is what happens in medical careers. And that's the same thing happening but what I noticed is that I was just able to oh yeah this is me getting anxious about the room. And I could let the thoughts be there without getting so identified with them as I had been before. So I've just been able to just get a bit more space around them to be able to make a difference. And I know similarly with other people who you know describe really persistent negative thinking. Although it's quite a battle actually it is possible to make a difference in terms of not getting so completely caught up with them and believing them. But as you say it's completely understandable you don't you know you've had up to the back teeth and of course in a way. It's sort of your immediate response is no I don't want to spend lots of time with them thank you very much. But as I say it may be a case of just sort of building up doing a bit of a time a little bit a little bit. What I was going to say on this kind of random building here example so yes when you've got some practice under your belt and you can get that distance that's a great thing. But in the short term I'm curious about how likely it is to actually do such a impressive state by doing mindfulness meditation. Even if you're well not impressed but you're just starting into this and maybe you get really going into it but I could kind of see how the thoughts and being aware of them and not trying to run away from them. If that's a risk I don't know I mean I know from what the search is that it's about preventing the occurrence. I mean sort of scientifically speaking I don't know I don't know from what I've read of the studies it didn't say x number of people were provoked into depression by the practice but then how do you know. The reason I kind of say this because with traditional CVT as I understand it it's about sort of intervening and having some kind of developing a response or a reaction to those thoughts. Whereas this is not about kind of logging back but it's about just taking it in and being with it. Well except that you see you're saying about being with the thought but actually the first thing you're doing is just practicing stepping out of them. Because you know as I said at the beginning you notice your mind's gone off somewhere you notice where your mind's gone you come back to breath. So you're actually practicing stepping out of those thinking and this is why it is so important because you're stepping out of rumination rather than staying with rumination which would be a sort of misunderstanding of the staying with bit. If you see what I mean. So the question is what's the difference between ruminating and staying with. So again I think what you're doing in staying with again I come back to this thing as a body so you're stepping out of habitual thought patterns and exploring your experience in a different way. So staying with in a way the sort of raw sensations particularly the physical sensations it just gives you another unglue. But you may speak before I know you can speak with you but when you say oh here I go being anxious about my sense again you let go of the thought that you're anxious about what they're asking you you're observing. Oh there I go again me being anxious and just observing. We'll just give you an example say for me or not on the being anxious so I might fall into ruminating about what am I going to be asked in this and start thinking about all of that. So what I've noticed is that actually I look my shoulders tensing up my heart beating faster I'm a bit sweating and I bring my awareness onto those aspects of my experience and that would take me out of the rumination but actually I would be staying with the experience so I wouldn't be trying to get away from it but I would be staying with it but staying with more sort of bodily rather than on a cognitive basis. It's too bad. Yeah I kind of think of this this idea of being attached might be caught up in the hole as opposed to sort of being able to step back and look at it but still feel it that's not what you're saying. Yeah definitely still feel it. My question was I had Tom also about UCSF's curriculum study on mindful space relapsed prevention just started about two weeks ago so while you're in town. So my question is you know I've meditated off and off for a few years and you know as other people have said you know just kind of sitting with your thoughts especially when you're not in a mood or whatever. My question is do you have any tips or suggestions around how to habituate this behavior to make it more relevant more exciting to still struggle with it. Some days I can sit for 40 minutes and it's no problem. Some days I can sit for like a minute. It's like this is not going to happen today I got to get out of here. So what specifically do you find difficult? Can you just say a bit more about what it is you find difficult? My mind is just going and I just can't break it back you know it's just I mean I've got so much on my mind it's just like you know where you know bills or whatever it's just stuff that comes up. Yes. My hunch and I may be wrong but it would be very common this is that somewhere there's an expectation that it should be easy that your mind should settle down. Maybe not but actually if your mind is going all over the place mind is going all over the place. I mean I sometimes do that my favourite thing is that I'm planning. My mind can do anything little plan so I can you know plan lists of lists and things like that. And in a way that sort of can be unpleasant but actually well that's just what my mind is doing and sometimes for me I just recognise that actually I haven't given enough time to sit and think. I need some thinking time. I'm in recovery and I go this steps actually and one of the things that I'm going to try to do is just strictly look for recovery and it didn't really work. So now I sort of use both the books and steps and the reason that somebody had suggested to me at one point and said well the steps could be something to do. There's like do this and do this and do this and do this and do this. And that kind of work for me and actually having incorporated it together you know not just sort of taking it verbatim but trying to make sense of myself. So the idea of having stuff to do is helpful as opposed to just sitting and kind of hoping something happens. So just a couple of more things on there so again hoping something to happen suggests an expectation where every time we have an expectation we're setting suffering up for ourselves. So we need to watch out for that and that's so so so easy to do that and all aspects of life not just in meditation. The second thing is it will be painful sometimes that is just the way it is because life is painful sometimes and you've got a choice you can either face it and in a sense deal with it or you can avoid it and it will deal with you. And actually what you're doing in meditation is you're having your experience and it's all yours it's no one else's. No one else can take it away from you it is your experience and that is going to be painful sometimes. So you know maybe sometimes you say well look I just I'm going to do something else now for a while I'm you know sure but I think if you're doing that it's good to do that conscious choice rather than an unconscious fleeing from experience which of course is what we do. Again it's kind of interesting with Kisa go to me. The Buddha didn't bring the baby back to life he didn't make a rosy ending he showed her the truth and the truth is sometimes uncomfortable. That's what I've been grappling with but quite some time now is these expectations of setting myself up and wanting things to be a certain way. The other night in a meeting such as this but more post-op oriented the hardest thing to let go of the things that you don't have and to be more specific with this and maybe to give an example and you can tell me if I'm right about this. About like like a relationship breakup in your heart set can you feel it you feel it in your stomach or your heart or solar reflexes right here. So rather than ruminating about the situation rather turning your energy to where it actually hurts in your body the stops am I correct in that. I think that is really good because again when we have something unpleasant happens our mind very quickly proliferates off and actually if we can stay with the raw unpleasant experience in a way that can be very helpful and you know cut through a lot of the unnecessary extra suffering. It's like the traditional analogy the Buddha talks of a sutta called the dark sutta where he basically says person gets shot by a dart and then they get shot by another one and actually the first dart is the unpleasant experience like somebody we love leaves us. The second dart is our rumination and bashing ourselves up about it. That's entirely optional although can be very difficult to let go of. So in a way just stick to the first dart and try and let go of the second dart. Yeah, first I just want to comment that one thing I found helpful is in terms of this little lightness how the behavioral thing is what I'm saying and I'm feeling angry. And I find my mind saying I am angry. I realize that you know my identity is totally fused with the emotion and it really helps me to say I am having a feeling of anger. So it isn't completely me. It is part of me that's having this feeling. It really helps mostly. I do sexual addiction counseling and I have these mindfulness because people have early recovery. I think it's kind of risky to say if you're having a sexual addiction impulse then sit with it. This can be very you know the cycle and it reaches a point where there's also a point in how we turn acting out on the impulse. So I mean I suppose you might explain this over the weekend but I'm really curious about what stage you know you would introduce this to someone who was recovering. Okay so when you can use it with addiction I mean I can't speak specifically for sexual addiction that's not an area I work in but I mean I specifically work with alcohol. What I found when I've run a few courses both at the centre and where I work and some people get it amazingly quickly and early on in their recovery. And other people have said back to me that they're just trying to do too many other things and it's all been too much at this point in their recovery. So I don't think there's a hard and fast rule from that point of view but I think the specific thing about would it in a way trigger the addiction. Again comes back to this question we had earlier about how do you be with in this case an urge to act in a particular way and again I think it comes back to you starting with you just stepping out of the experience and staying with it comes a bit later. I definitely find value in bringing awareness to the body and periods of some anxiety or some negative emotion going on. But how would you respond if your rumination is being expressed in the body? Body flow is repetitive disorder where it's you know it's very more resident of the body. Let me see so the question is if your rumination is to do with something about the body or is being expressed in the body? Like I have tricked the Romanian which is so it's already very resident in the body so bring awareness to the body. Okay, I suppose the first of all you know there's different parts of the body so particularly areas that's generally useful is sort of the chest to the belly and in a way more thinking of internal sensations rather than you know skin. So like if they're not in the belly for example or you know it's a heart beating fast. So there may be sensations that you're not paying attention to that you could usefully stay with that aren't related. That's just one way of being with it. There are other ways of being with it. So if you have repressive thoughts you can try using a metaphor. So you might for example think of your thoughts as being like a current and like a waterfall and just in a way stepping just behind the waterfall. So they're still going on you're not trying to stop and they're still going on but you're not getting wet so you're not getting caught up in them. Or it may be that there's some emotion that's not being fully acknowledged and so again what we sometimes on the instructions we have is this idea of opening to whatever you're feeling and if you find it helpful saying to yourself whatever's happening let me feel it. So again it's paying attention to a different area of your experience. I think that's probably generally true that you know if you're habitually paying attention to this bit of your experience you want to pay attention to that so you're putting your attention somewhere else. So when you brought up the waterfall example to Sam I think part of helping to separate from thoughts, feelings, experiences just like you were saying you know turning into I'm feeling this right now. I think that's one of the logical stories that is really helpful in creating this little picture that isn't about yes but it does help to separate and give it a different kind of thing. So metaphors can be very useful to change your experience a bit. Do you have any more specific information about techniques that have been used for that or that just one of the consequences of relaxing people every day? Well I don't know I haven't looked at it closely but from what I remember of the study is that people were doing the same mindfulness based stress reduction and I think they did it as far as I can remember they did a comparison between people you know sitting in those light chambers for treatment for psoriasis. And one lot of people were doing relaxation and one lot of people were doing mindfulness and the people with mindfulness as I understand it did better. Oh no I have a thought and I really can please get s's point but I was keen so I can tell me there was a particular technique. That would sort of make sense wouldn't it's trying in a way first of all notice that thought and actually not immediately act on it in a way trying to get a bit of space in between the thought and the option. I'm really really aware of that when I think of stress in between hours. No I think I really understand what meditation is because you didn't describe I know one thing I do I realize is that I breathe I breathe and I am aware of my breathing. I'm just aware of that often because I don't really place to go and so I kind of come back to that and it's kind of a soothing thing. But are you supposed to be mindful like are you only supposed to do it like where you're sitting and you're still or do you do it you know when you're in line or driving or how does that look I didn't quite understand how you are or you know how. Yeah so what is meditation I didn't go into that you're quite right and partly because we've got a weekend workshop which in a way is more practical on that even that is a condensed version of what we do if I was doing a course. However in brief if you remember I was talking about formal and informal practice so formal practice would be when for example there are lots of different meditations but one example would be you're sitting on a chair on a cushion you're not doing anything else but just bringing your attention on to your breathing. And then in your mind gets come off you notice what's gone to my debris but very importantly and usefully you can also do what's called informal practices which is just where you try and pay attention when you go about your daily life. So when I'm doing the course would do various things I could get you maybe one week to choose an activity like having a shower, taking on the garbage, something you do every day and just to pay attention when you're doing that just notice what your body is notice where your mind is. And then the other thing that we do which is really really useful is something called a breathing space which is like a mini meditation. You all do that just to end with there's a fine thing okay so breathing space it's got three steps and you can do it anyway you can do it something in line you can do it you know drive in the car whatever so first step just notice what's going on in your mind right now it's just as best you can. Any thoughts, any emotions, any feelings just whatever's going on. And having done that bring your attention onto your breathing so notice the breathing going in and out of the body maybe the rise and fall of the chest or the belly. And then expand your awareness out onto the body the third steps and noticing any physical sensations maybe the contact the chair or cushions any of the physical sensations you're aware of in the body contact with the ground. So that's the three minute breathing space call three minutes not because you literally have to do it for three minutes because it means it's not very long it's got three steps and it's very useful to do. So what I'd get you we're shooting the course is to do that three times a day or do it at pre-selected three times a day so you just get into the habit of noticing what's going on and stepping out of it during your routine life. Then to start using it to cope with difficulties so you notice you get upset about something you do a breathing space and the idea is that eventually you're getting a seamless mindfulness practice. So you're mindful all the time and still worth on it but it's a direction that you can helpfully move in with practice and is achievable to move in that direction. Thank you. (audience clapping)
