Trauma-Informed Mindfulness: Guidelines for Effective Helping

Sam Himelstein, in a podcast interview with David Treleaven, discussed the principles for teaching mindfulness that he has developed over more than 12 years working with teens impacted by trauma.  His principles and related guidelines have relevance for anyone using mindfulness to help people who have experienced trauma. 

Besides his discussion in the interview mentioned above, Sam provided a blog post that addresses the guidelines explicitly.  The principles and guidelines (together with examples from real cases, teaching material and  practical exercises) are explained in depth in his forthcoming book,  Trauma-Informed Mindfulness for Teens: A Guide for Mental Health Professionals.

Guidelines for effective helping of people impacted by trauma

The guidelines developed by Sam Himelstein provide clear and consistent actions that can be taken by anyone helping people impacted by trauma:

  • Do no harm – this is a fundamental guideline informing the others.  Through research, study and practice of trauma-informed mindfulness practice, we can be more aware of potential harm and have the tools to do the best we can to avoid further harming the person suffering from trauma.  Sam mentions two resources that he draws on, The Meditation Safety Toolbox and Chris Willard’s Guidelines for Ethical Teaching of Mindfulness.
  • Avoid prescription about “meditation logistics” – people who are impacted by trauma are often unable or unwilling to start with formal meditation.  Sam urges us to avoid being inflexible through insisting on a set posture or closed eyes when initiating our helping interaction.  This requires letting go of the structural prescriptions of our own meditation training.  It is important to recognise that the people we are helping will be in a “different space” but can still develop mindfulness (inner and outer awareness) with processes other than formal meditation.  We need to acknowledge that mindfulness is more than just meditating.
  • Establish safety – it is critical that the person we are helping feels safe.  If they do not feel safe, they may experience re-traumatisation.  In addition to physical safety, this involves relationship and emotional safety through developing trust, being authentic and being prepared to modify our approach to suit where the person is at.  A more involved aspect of safety is what Sam calls cultural safety developed through “intersectional awareness”.  This requires an awareness of our implicit biases when dealing with people who have characteristics different to our own, e.g. gender, ethnicity, religion, age, sexual preference, disability or “class”.
  • Employ somatic practices first – this involves recognising the role of body memory in trauma and being cognisant that cognitive approaches commenced too early in the intervention can exacerbate the situation for the trauma-affected person.  Sam indicated that he often uses deep breathing exercises and basic somatic meditations.
  • Understand the “window of tolerance” – relates to a personal zone within which a person is able to effectively employ their cognition to “receive, process and integrate information”.  If a person is outside their window of tolerance than are unable to engage effectively in talking, telling stories or undertaking meditation practices.  Sam suggests that a sign of this “intolerance” is the person’s inability to use language, e.g. unable to formulate complete sentences or follow a line of discussion.  He recommends the book Trauma and the Body, as a resource for understanding the “window of tolerance” and learning about somatic approaches to trauma healing.

Reflection

As we grow in mindfulness through meditation practices, research and reflection, we can develop our awareness and understanding of the sensitivity of trauma-impacted people to formal meditation.  This requires that we become more aware of the “window of tolerance” and develop our capacity to pay attention to the signs that someone we are working with is not coping with our processes.  Associated with this, is the need to build the relationship through establishing safety and trust.  Employing somatic approaches will be more effective if we have experienced their utility ourselves as part of our own mindfulness practice and experience.   The more mindful we become, the better we will be able to help people impacted by trauma – for one thing, we will be able to let go of our assumptions and become more aware of our biases.

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Image by enriquelopezgarre from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Trauma-Informed Mindfulness: Principles for Effective Helping

Sam Himelstein has specialised for more than 12 years in using mindfulness to help teenagers impacted by trauma.   In a podcast interview with David Treleaven, Sam explained in depth his approach to teaching mindfulness to teens affected by trauma, as well as the evolving principles that shape his practice. While his focus is primarily on teens and educating others to work with teens, his approach and principles have relevance to anyone who is using mindfulness to assist people impacted by trauma (or anyone who is teaching mindfulness where a participant is a trauma sufferer).  He has developed his principles through ongoing reflection on practice.

Sam is a psychologist and youth worker and the author of A Mindfulness-Based Approach to Working with High-Risk Adolescents and the forthcoming book, Trauma-Informed Mindfulness for Teens: A Guide for Mental Health Professionals.  He is also the founder of the Center for Adolescent Studies.

Principles for trauma-informed mindfulness practice

In discussing his approach to working with teens impacted by trauma, including incarcerated youth, Sam identified several principles that guide his practice:

  • Avoid “adultism” – the assumption that as an adult you are superior to teens and have a lot to teach youth and they have very little in the way of wisdom to offer.  Associated with this false belief, is the assumption that you know best what is good for them – implying that they should learn from your teachings (that you try to impose on them).  This also involves recognising the wisdom they gained in their transition to a teenager. [You can also test your assumptions when working with adults – do you assume that they have no insights into the nature and practice of mindfulness?]
  • Work from where they are at – do not begin with formal meditation as they are unlikely to be ready for this.
  • Focus on relationship-building – consciously build trust in every aspect of your interaction, as their level of trusting others will have been severely damaged by their trauma experience(s). 
  • Assist teens to become comfortable with “sitting with themselves” and exploring “inner awareness”.
  • Be genuinely curious about what is happening for them and what they are doing to cope – bring an open mind to the interaction.  It can be helpful to identify and test your own assumptions before interacting.
  • Develop your own mindfulness continuously – your inner and outer awareness – and learn to let go of “ego” and the need to control the process.

Reflection

When teaching mindfulness to adults and youth, we need to be aware of the possibility that they may have been impacted by trauma(s) in their life.  Being conscious of the principles employed by Sam will help us to demonstrate sensitivity, build trust and relationships, and work at their pace – rather than to a pre-ordained progress schedule.  It will be imperative for us to grow in mindfulness – becoming fully aware of the assumptions we bring to the teaching/interaction, letting go of ego and the need for control, and genuinely engaging with curiosity, humility and openness.

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Understanding Trauma and Post-Traumatic Stress

In the previous post, I addressed the need for trauma-sensitive mindfulness.  One of the observations of David Treleaven mentioned in the post, was the need for meditation teachers to develop an awareness of, and sensitivity to, the presence of people who are experiencing, or have experienced, trauma.  Failure to do this could lead to mindfulness activity that generates trauma stimuli leading to re-traumitisation.  Being trauma-sensitive means understanding the signs of post-traumatic stress as well as having the presence of mind to modify mindfulness practices to take account of people’s needs in this condition.

Recognising the signs of post-traumatic stress

Trauma results where a person experiences an overwhelming amount of stress that exceeds their ability to cope and deal with the emotional fallout from that experience.  The effects vary with each individual and the nature of the traumatic event. Traumatic events can include the loss of a sibling or parent through death, separation from a parent at a young age, a life-threatening car accident or terrorist event, separation and divorce, a house fire, physical or sexual abuse or a natural disaster.

This variability in the nature and impact of traumatic events, and the individual’s reluctance to disclose through shame or the need to comply with an authority figure, means that it is often very difficult to ascertain whether a person has suffered from trauma and is experiencing post-traumatic stress disorder (PTSD).  According to several reports, up to 20% of people who experience a traumatic event together will experience post-traumatic stress disorder.

Trauma can impact a person’s thoughts, emotions, perceptions, level of arousal/reactivity and mood.  It can be reflected in behavioural change such as avoidance of a person or location, inability to sleep or sleeping too much, reliving the trauma through nightmares or flashbacks or withdrawal from social contacts or work colleagues.  The attendant emotions could be depression, anxiety and feeling unsafe.  Thoughts of suicide can also be one of the signs of post-traumatic stress disorder.

The role of memory and embodiment

Peter Levine, in an interview with Serge Prengel, discussed the role of memory in trauma and post-traumatic stress disorder.  Peter is the author of the book, Trauma and Memory: Brain and Body in Search of the Past – A Practical Guide for Working With Traumatic Memory.  His book is ground-breaking in that he highlighted the role of “implicit memory” and showed how to treat trauma sufferers by accessing the “complex interplay of past and present, mind and body”.  He termed his methodology, “somatic experiencing”.

In the interview, Peter stressed that we have several different forms of memory and the ones that are particularly relevant to trauma are episodic or autobiographical memories, emotional memories and procedural or body memories.  Episodic memory, also termed “defining moments” by Serge the interviewer, though low in emotive content are nonetheless impactful. For example, Peter describes a teacher who acted as a mentor to him and instead of blaming him for poor judgement encouraged him to learn and explore his curiosity.  Other mentors in his life as he progressed through his studies modelled similar behaviour.  This, in turn, led him to a career choice as a professional mentor – so the episodic memory acted as a “trajectory” for his progress in life. 

Emotional memories, on the other hand, “though further out of the realm of awareness” are “very powerful and compelling” and shape how we behave in our life.  Some interaction from the past is encoded with a very strong emotion such as sadness, anger or fear.   The emotional memory can interfere with a current relationship when something or somebody acts as a reminder of the past interaction so that we can be overwhelmed with either a very strong negative or positive emotion. 

While emotional memories operate at a deep level, body memories are deeper still.  At one level, they have to do with the acquisition of motor learning and skills, e.g. riding a bike.  At another level, they are determinants of our approach or avoidance behaviour.  Peter gives the illustration of coming across a former classmate more than 30 years after their schooling and finding that he had a strong desire to approach and reconnect with him.  The classmate had been his protector at school when other children tried to bully him – hence his approach behaviour.  An example of avoidance behaviour conditioned by body memory is when someone who has previously experienced sexual abuse actually freezes when touched by a loving partner.

David Treleaven reinforced the relationship between trauma and body memory when he stated in his video presentation that “the respiratory system is intimately connected to our sympathetic nervous system which is totally tied to traumatic stress”.  He pointed to two books by Babette Rothschild that highlighted the close connection between trauma and body memory, The Body Remembers and Revolutionizing Trauma Treatment.   David also explained further why meditation exercises such as mindful breathing can activate trauma stimuli.  He drew on the differentiation between exteroception (body’s perception of external stimuli received through the senses) and interoception (sensing conditions within the body such as deep breathing or tightness of the chest).  Normally exteroceptors and interoceptors integrate (e.g. the external sensation of viewing a sunrise is matched with the internal sensation of a warm feeling in your chest and a sense of looseness in your hands and legs); with trauma sufferers, “the relationship between interoceptors and exteroceptors can go awry”.

Peter Levine emphasised the need to recognise that we have a “fluid identity” – while our identity is shaped by the past, and the interplay of multiple events and interactions, it is possible to gently, but surely, release the embodied memories and progressively unearth the richness, power and sense of connection of an identity not locked into painful memories.  He has dedicated his lifework to training individuals and professionals in understanding the role of the different memories and in learning to use his trauma treatment methodology, somatic experiencing.  Other professionals, through an understanding of the mind-body connection, employ somatic meditation to assist trauma sufferers.

Reflection

We can grow in mindfulness as we develop an awareness of the role that memory plays in our own thoughts, emotions, moods and behaviour and learn to recognise the signs of post-traumatic stress in others.  As we develop this heightened awareness, we can make appropriate modifications to our meditation teaching and deepen our own meditation practice and reflection.

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Image – Sunrise over the water, Wynnum, Brisbane

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Understanding Trauma-Sensitive Mindfulness

David Treleaven, through his doctoral dissertation and subsequent book, has raised awareness globally about the need for trauma-sensitive mindfulness.  His book, Trauma-Sensitive Mindfulness: Practices for Safe and Transformative Healing, identifies three myths about mindfulness and trauma, discusses research-based case studies and offers clear options for the way forward.  His work is so critical to the teaching of mindfulness that Brown University has sought to integrate his work and findings into their Mindfulness Based Stress Reduction (MBSR) Course and the Search Inside Yourself Leadership Institute is exploring integration of David’s approach into their Mindful Leadership program.

Trauma and mindfulness

Trauma is described as “the experience of severe psychological distress following any terrible or life-threatening event”.  Many organisations and trainers/consultants/psychologists offer services, strategies and programs for trauma sufferers. Beyond Blue, for example, offers coping strategies and ways that friends and relatives can help someone close to them who is suffering from a traumatic event.

Mindfulness has become acknowledged as an effective way to deal with trauma.  For example, Boyd, Lanius and McKinnon (2018) concluded from a review of the relevant literature that mindfulness-based therapeutic approaches are effective in reducing the symptoms of post-traumatic stress disorder (PTSD).   They suggested that reduction in shame and self-blame could be key explanations of the efficacy of mindfulness-based approaches to PTSD.

David, however, warns that there are potential difficulties in using a mindfulness approach if practitioners are not sensitive to the interplay between mindfulness practices, beliefs about the universal efficacy of mindfulness and related messaging.  He points out that most people will experience at least one traumatic event in their life. So, in any one room of meditation participants, there is likely to be one or more people who are experiencing trauma in their lives.

David dedicates his life to making people aware of the need for trauma-sensitive mindfulness through his book, videos, podcasts and workshops. He articulates his concerns about a lack of sensitivity to this issue amongst meditation teachers by identifying three “myths” about mindfulness and trauma that can potentially create harm for trauma sufferers.

Three myths about mindfulness and trauma

David’s research with trauma sufferers and practitioners in the field working with people who have experienced trauma, has led him to identify three “myths” (widely held false beliefs) that impede effective and safe use of mindfulness approaches. The myths are powerful determinants of the behaviour of mindfulness teachers:

  • Universality – David describes this myth as “one size fits all”.  However, David’s experience is that for some people who have experienced trauma, meditation can activate trauma stimuli so that the person re-experiences trauma.  As Peter Devine comments, “The nervous system can’t tell the difference between that [reliving the trauma] and the original trauma”.
  • Certainty – this myth relates to the assumption by meditation teachers that they will know when a person has experienced (or is currently experiencing) trauma.  David cites a case of a very experienced meditation teacher who failed to pick up the cues that some of his trainees were trauma sufferers.  He maintains that there are some very subtle non-verbal cues that can signal the existence of trauma, but it requires sensitised awareness to detect them.  He suggests that two major impediments that get in the road of someone openly disclosing their experience of trauma are (1) feelings of shame and (2) compliance (felt need to conform to an authority figure).
  • Neutrality – the myth that breath is always neutral, with no emotive content.  David recounts the experience of one person who was traumatised by a violent parent when a child.  Focusing on his breath “reconnected with the need to hide”, caused him to re-live his trauma and led to increased anxiety.  So, instead of being a calming anchor, mindful breathing acted as a trauma stimulus.

Trauma-Sensitive Mindfulness: some strategies

David provides considerable detail, explanation and case illustrations of these myths in his book on Trauma-Sensitive Mindfulness and in a video presentation on The Truth About Mindfulness and Trauma, which was a promotional webinar for his course for practitioners on recognising trauma, responding to trauma and preventing the re-living of trauma during mindfulness practice.

In the video mentioned above, David suggests a range of strategies that address the limitations and potential damaging effects of the three myths:

  • Develop awareness about possible difficulties for people during mindfulness practices
  • Increase knowledge of, and sensitivity to, the signs of trauma
  • Provide space for people to experience different aspects of mindfulness practice and be ready to make modifications after asking, “What would work for you?”
  • Acknowledge at the outset that some people may have a very different experience to the calming effects of mindfulness meditation
  • Offer the opportunity for participants to approach you privately to have a conversation about their experience
  • Don’t reinforce the “shoulds” of mindfulness experience, e.g. avoid saying, “you should experience calm and peace”
  • Avoid “close and sustained attention to breath” as this may be a stimulus for re-experiencing trauma
  • Offer a range of options for people to practice mindfulness so that they can choose their own anchor for paying attention, e.g. breath, sounds, the sensation of the feet on the floor, feeling of the body on the chair or fingers touching each other.  According to David, Paula Ramirez, a Director of Breathe International, maintains that this choice of options gives participants a sense of agency (the opposite of a loss of control).

As we grow in mindfulness through our own meditation, research and reflection, we can become more sensitive to the needs of people who have suffered (or are suffering) trauma; be better able to respond to their needs; and also learn to adopt strategies that avoid re-traumatising participants in mindfulness training groups.

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

What Do You Do if Mindfulness Does Not Reduce Your Symptoms of Anxiety or Depression?

I was approached recently by a young man who was experiencing severe anxiety.  He was able to cope well with his work but had all kinds of difficulties coping at home, including endless self-doubts, negative self-stories and an inability to relax or concentrate.  He indicated that he had “tried everything’ – meditation, mindfulness practices and reflection. 

He found, for example, that “reflection” only resulted in his entertaining negative thoughts about himself and re-visiting his destructive self-stories.  So, reflection for him resulted in a downward spiral rather than a release from self-deprecation.

What does “tried everything” mean?

The first consideration is how did he approach these attempts to develop mindfulness and reduce his symptoms?  Given the young man’s level of agitation, it was likely that his efforts were somewhat frantic and unfocussed.  One could question whether he engaged in a sustained meditation practice in a focused way, e.g. working on his self-stories with the aid of a meditation teacher or meditation group.

One of the issues is that there are so many different forms of meditation that it is tempting to “try them all” and flit from one form to another, without addressing your specific needs or the causal factors of your depression or anxiety.  This is where a professional psychologist or dedicated professional group could help.  Organisations like Beyond Blue and the Black Dog Institute can help by providing knowledge, resources, group support, access to programs and advice in identifying a suitable medical practitioner, psychologist or psychiatrist.  Other specialist carer support groups can assist people who are experiencing anxiety or depression as a result of caring for someone who has a long-term need for care and support.

The Mental Health Care Plan

You may need medication and/or the aid of an allied health professional to overcome depression and/or anxiety. In Australia, there is a specialist form of help that can be accessed through your local medical practitioner, the Mental Health Care Plan.   You explain your symptoms and needs to a doctor who develops a mental health treatment plan with you.  This may include medication, referral to an allied health professional such as a psychologist and/or other forms of activity designed to address your specific mental health condition.  Medicare will provide rebates for visits to an authorised health care professional where the visits have been the subject of referral by a medical practitioner as part of a Mental Health Care Plan.  The number of visits covered by Medicare rebate is 10 (subject to a confirming review by the doctor after the first six visits).

Advancing our understanding of the causes of depression and anxiety

Johann Hari, in his book Lost Connections, highlights recent research undertaken worldwide that shows that anti-depression medication can be effective in the short term to reduce symptoms but that, in the medium to long term, it typically has to be increased and can reduce in effectiveness over time.  In his book, Johann focuses on the social factors contributing to the global rise in depression and anxiety and proposes solutions that support rather than replace medication treatments, although some people are able to give up their medication after a period of successful use of one or more of these alternative approaches.

Johann identifies seven social factors that contribute to the rise in depression and anxiety, all relating to a loss of connection.  He describes them as “disconnection from”:

Johann acknowledges the research that shows that in some instances a person experiences depression and/or anxiety because of their genes or a brain change brought on by some life experience (pp. 143-155).

Reconnection: alternative anti-depressant treatments

Johann describes several ways to reconnect to overcome depression and anxiety.  These include reconnecting with others, with meaningful work, with nature and/or meaningful values. He also includes chapters on finding “sympathetic joy” while overcoming self-obsession (Chapter 20), and a compelling chapter on acknowledging and overcoming childhood trauma (Chapter 21).

What I found particularly intriguing, as well as very practical, was a chapter on “social prescribing” (Chapter 17).  In this chapter, Johann highlights the work of the Bromley-by-Bow Center which combines a medication approach (where deemed necessary) with hundreds of social programs.  This medical centre is very different to most doctor’s clinics that you would normally visit, both in terms of the orientation of the medical practitioner and the physical environment.  The emphasis is on listening, not medication prescription, and treatment is strongly oriented to “reconnection” strategies such as a walking group, employment skills group, start-up support to establish your own business and a casual group focused on “Create Your Future”.

What further intrigued me was the effectiveness of one project described by Johann through the experience of Lisa, who was experiencing severe depression.  The project was the brainchild of Dr. Sam Everington who was concerned about the over-reliance on anti-depression medication.  Basically, he assigned some of his patients to a community project focused on beautifying a strip of bushland that had become overgrown and neglected but was a popular walk-through. 

The group of people experiencing depression, who had difficulty interacting with anyone and typically kept to themselves, eventually started having conversations, sharing their life histories and their personal mental health challenges as well as plans to beautify the bushland strip.  They had to learn about the seasons, plants and their nutrition needs and how to plant and cultivate different kinds of plants.  They took pride in their project and started to gain confidence and competence.  A moving story was that of a person who had initially presented as very angry and aggressive who went out of his way to help two people who experienced learning difficulties.  Eventually, the members of the group decided to do a Certificate in Horticulture.

Johann pointed out that this creative project addressed two major reconnection needs – reconnection with others and with nature.  It can also be seen that each of these reconnections reinforces the other.

As we grow in mindfulness, we can be open to new ways of dealing with depression and anxiety.  We can learn to reconnect with key elements in our life that induce mentally healthy living, including mindful connection to others, spending time in nature, being grateful for what we have (rather than suffer “status anxiety”) and being willing to show compassion towards others.

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Image by Henning Westerkamp from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Reasons Why Meaningless Values Lead to Depression

In the previous post I explored Johann Hari’s discussion of the research demonstrating that disconnection from meaningful values – expressed as obsession with materialism – leads to depression and anxiety. In this post I will explore the reasons why this occurs. 

Four reasons why meaningless values lead to depression

In identifying why materialism leads to depression, Johann draws on the research of Emeritus Professor Tim Kasser and his colleague, Professor Richard Ryan, one of the acknowledged world leaders in understanding human motivation.  Based on their work and his own research, Johann identifies four main reasons for the consuming sadness experienced by people who relentlessly pursue materialistic values that focus on extrinsic rewards (Lost Connections, pp. 97-99).

1. Damages relations with other people

The research shows that people who primarily pursue materialistic values experience “shorter relationships” that are of lesser quality than their peers who focus more on intrinsic values.  Materialistic-oriented people are more concerned about superficial things such as another person’s looks, their ability to impress others and their material possessions, than they are about the innate qualities of the person.  Their focus on external qualities makes it more likely to end a relationship because they invariably find someone who possesses these external qualities to a greater degree.  Their self-absorption also means that their partner in a relationship is also more likely to separate from them.  People who are out to impress others as their major motivator are very poor at reflective listening as they are more likely to interrupt and divert a conversation so that the focus is on them and their accomplishments.  Listening is the lifeblood of a sustainable relationship and has profound effects on the its quality.

2. Deprives them of the joy of being in the present moment

Because a materialistic person is always seeking more or pursuing an elusive goal over which they have no control, they are more likely to be frequently frustrated and disappointed.  They tend to be driven and impatient in the pursuit of their external goals and they experience time-pressures continuously. It is difficult for them to be fully engaged in the present moment and to experience the joy that derives from present awareness.  The researchers point out, too, that the pursuit of materialistic values results in the inability to experience “flow states” – being in the zone where you are hyper-focused and highly creative and productive. 

3. Become dependent on how other people think of them

Other’s opinions become the driver for the materialistic person’s words and actions.  They seek to gain positive assessment by others of their looks, their possessions (e.g. clothes and cars) and their income and social standing.  They tend to pursue relationships for what they can get out of them in terms of extrinsic rewards.  They can never be satisfied and often engage in attempts to outdo others.  The researchers point out that materialistic-oriented people are also more sensitive to feeling slighted, even when no slight is intended – because of their sensitivity to others’ opinions, they can more easily feel criticised and be hurt by seemingly harmless comments.  This can result in their being “on edge” all the time when with other people.  Their sense of self-worth becomes “contingent on the opinion of others” which, in turn, can lead to negative self-evaluation and self-deprecation.

4. Frustrates innate human needs

Tim Kasser observed that a core reason why materialism leads to depression is that it ultimately frustrates a person’s innate needs – needs such as the desire for meaningful connection with others; realising a sense of competence in their endeavours; a sense of autonomy and being in-control; and wanting to do, and achieve, something meaningful in their lives.  Depression and anxiety will grow over time when these real, innate human needs are not met.

We can choose how we spend our time and energy

Johann observes that time is limited and that our day is like a pie with defined parameters.  The way we carve up our day – how we allocate our time to aspects of our life – will significantly affect whether we realise joy and happiness or depression and anxiety.  If we can align the way we spend our time to the pursuit of meaningful values, we can experience mentally healthy states of positivity, joy, happiness and gratitude. The more time we spend on materialistic goals, the lower will be our “personal well-being”.

As we grow in mindfulness through meditation and reflection, we are better able to notice the impact that the pursuit of materialistic values has on our quality of life – our relationships, our joy, our sense of self-worth.  We will have a clearer idea of how well we meet our innate needs and how we can improve on their fulfillment.  Importantly, we will better understand the sources of our frustration and anger and be able to improve our self-regulation.  By developing mindfulness, we will more often experience the joy of being in the zone – of experiencing “flow states”.

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Image by KarinKarin from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Being Disconnected from Meaningful Values Leads to Depression

In previous posts I highlighted the relationship between depression and being disconnected from what is meaningful in terms of work and in terms of relationships with other people.  In this post, I want to draw further on the work of Johann Hari’s book, Lost Connections, by focusing on the loss of connection to meaningful values.

Being disconnected from meaningful values

In Chapter 8 of his book (pp. 91-105), Johann identifies a third social factor contributing to the rise of depression and anxiety – disconnection from meaningful values.  In this section, he draws heavily on the ground-breaking research of Emeritus Professor Tim Kasser who explored in depth how our cultural values contribute to the rise of depression and anxiety in today’s Western society. 

Tim was motivated in his search for meaningful values through the music of Bob Dylan and John Lennon and his own independent inquiry into the nature of authenticity while studying at Vanderbilt University, a learning institution committed to curiosity.  Tim was curious about the reason why there was such an increase in the incidence of depression and anxiety in today’s world.  He spent more than 25 years researching and working with colleagues to find the answers.

Tim drew on the work of philosophers and research by others that established that the stronger a person focuses on materialistic values (such as wanting more money and possessions and wanting to be viewed highly by others), the more likely they are to experience depression.  He conducted his own experiments as well and learned that those who gave priority to materialistic values experienced less joy and lived a poorer quality of life than those who primarily pursued meaningful values.  Johann describes Tim’s research projects in detail in his book, Lost Connections.

Materialistic values pursue extrinsic rewards

Philosophers have identified two different types of human motivation – extrinsic and intrinsic.  Extrinsic motivation seeks an external reward in the form of money, status, recognition or being liked and admired. Intrinsic motivation, in contrast, is associated with internal personal rewards that flow from undertaking something for its own sake such as working to make a difference in the world, developing meaningful and supportive relationships, showing compassion towards someone in need or playing an instrument for the sheer joy it brings.  Materialistic values focus on extrinsic rewards and do not add meaning to a person’s life.

Tim engaged 200 people in completing a “mood diary” over a period so that he could establish the outcomes for people who primarily pursued extrinsic goals versus those who pursued intrinsic goals.  He was startled by the results – people who focused on, and achieved, extrinsic goals did not experience any appreciable increase in happiness in their daily life, despite the extraordinary amount of time and energy that they put into pursuing those extrinsic goals (e.g. gaining a promotion, purchasing a new car, buying the latest smart phone).   In contrast, people who pursued, and achieved, their intrinsic goals were “significantly happier” and experienced a decline in depression and anxiety.  These people set goals such as improving the way they related to others and supported those in need.

Johann points out that we all pursue both extrinsic and intrinsic goals and the associated rewards.  However, the challenge is to achieve the right balance – ensuring that materialistic values do not dominate our lives and lead to depression and anxiety.  We are constantly confronted with the choice of whether we pursue an extrinsic goal or an intrinsic one – such as whether we stay longer at work and earn more overtime money or go home to our young family and enhance our relationships with our partner and/or children.

I was recently confronted with such a choice – the choice between an extrinsic goal and an intrinsic one.  I was asked to write a book on action learning and the extrinsic rewards offered were to earn money for the work, receive royalties on an ongoing basis and, in the process, make a name for myself by way of my “legacy”.  The cost for me was to give up writing this blog on mindfulness, as the book would be all-consuming – I would have to give up what I consider to be making a real difference in some people’s lives (including my own) in favour of realising some extrinsic rewards.  I chose to turn down the offer to write the book and to continue to research and write about ways to grow in mindfulness via this blog.  The challenge for me was to put an important intrinsic goal ahead of offered extrinsic rewards.

We can become consumed by materialistic values and the associated extrinsic rewards by spending more and more time and energy in their pursuit, despite their achievement providing less and less satisfaction.  People, for example, chase the next promotion and movement up the ranks and are often prepared to sacrifice their personal values and joy to “get there”.

Western society encourages and reinforces materialistic values

Our consumer society cultivates extrinsic values and advertisers persistently encourage us to have the better car, to look better, to buy eye-catching jewellery, to upgrade our home (in terms of size and/or location) and to attract admiration.  Porsche, for example, in promoting its latest SUV, the E-PACE, describes the new “luxury” vehicle as having “head-turning good looks” – reinforcing the “look-at-me” values of Western society. 

The selfie revolution is another example of our pursuit of “looking good” on social media.  Technologists have pandered to this trend by developing the “selfie drone” which has now morphed into the “dronie” that enables you to focus on your group and yourself and also to back away to highlight your location, thus providing that extra “WOW factor”.  Some selfie drones even let you upload your shots directly to social media – meeting our need for immediacy and convenience. Taking selfies, by itself, does not mean you are pursuing materialistic values – some people use selfies solely for their family album or to share with family connections. The problem comes when taking selfies consumes us and their sole purpose is to establish our (superior) “value” in the eyes of other people.

Each year at Christmas time, there is a rush to have the latest and best toys/games/technologies that are available – what was the benchmark last year is now superseded by something more costly and peer pressure reinforces the “need” for this purchase.  Our children thus become indoctrinated very early into the “must have’ social norms and lose sight of what really makes them happy such as the sheer joy of playing a game with friends in the yard or park.

Our culture drives the desire for extrinsic rewards to the point where our elected officials feel it necessary to misuse their positions of trust to increase their own wealth through corruption.  More than fifty wealthy American parents were recently charged with admissions fraud through a scam designed to get their children admitted to “elite” universities.

Johann points out that multiple studies show that depression and anxiety will be experienced by people who pursue materialistic goals relentlessly – irrespective of their age, social standing or economic means.  He argues that just as junk food creates toxins in our bodies, “junk values” produce “psychological toxins” that invariably lead to depression and anxiety (p.97).

Becoming mindful about our lives and our values

Tim Kasser, in an interview in 2016, encouraged us to reflect on how we spend our time and energy.  He suggested that we look at what we really value and how that is reflected in our life.  He asks us to seriously look at how we act out what we claim to be important in our lives and how well we make time for the things that are important to us.

As we grow in mindfulness through reflection, meditation and mindfulness practices, we can identify the ways in which our words and actions do not align with the values that provide meaning and happiness in our lives.  We can explore ways to make better use of our time, not to pursue materialistic values, but to pursue intrinsic values that provide lasting satisfaction such as making a difference in the world, being fully in the present moment and connecting meaningfully with others. 

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Image by KarinKarin from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Depression and the Loss of Connection To Meaningful Work

Johann Hari, author of Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions, was concerned about the extraordinary rise in the use of antidepressant drugs in America and the associated total focus on biological causes of depression.  He set about doing worldwide research on the social factors contributing to depression.  He was particularly interested in precursor events or situations that led to a person experiencing depression.  His research led him to identify nine social factors that were contributing to the alarming rise in the incidence of depression and suicide.  As the title of his book indicates, each of these social factors related to a “lost connection.”  He describes the first of these causal factors as “disconnection from meaningful work”.

Loss of connection to meaningful work

Johann’s research (and that of his colleagues) covered a range of people engaged in different kinds of work, usually at lower levels in organisations.  They found that certain job characteristics contributed to a loss of meaning for the worker.  This disconnection with meaningful work resonates with the Job Characteristics Model developed by Hackman and Oldham in the 1970s as a basis for the design of jobs that generated positive psychological states such as the experience of meaningfulness and personal responsibility.

Johann, drawing on his own research and that of his colleagues, identified several job characteristics in different contexts that contributed to the loss of connection to meaningful work and resulted in people experiencing depression:

  • Lack of control over work – research into the high incidence of suicide amongst staff investigating tax returns in the Taxation Office in Britain found that a key contributing factor was the lack of control over their work.  No matter how hard they worked, the pile of work kept growing and they could never get on top of it.  The ability to control the work environment and how work is done, known as “agency”, has been the subject of much research into what constitutes a psychologically healthy work environment.
  • Lack of feedback – in the previous research, another factor identified as contributing to psychological illness was the lack of feedback about performance of the job.  No matter how well or how poorly the work was done, there was no feedback received from supervisors or managers.  This led to a sense of the work and the worker being devalued.  The disconnection between effort and “reward” in terms of positive feedback contributed to people feeling “irrelevant” – they felt that they were not important or relevant to what the organisation valued.
  • Lack of discretion – research into the experience of depression amongst typists in a typing pool demonstrated that a causal factor of depression was the lack of the ability to make decisions affecting the work and the typists’ output.  The typists were totally disempowered because work was given to them with instructions on how it was to be done by people they did not know; they lacked understanding of what the documents involved or meant; demand was endless; and they were unable to speak to each other.  The work was thus experienced as meaningless and “soul-destroying”.  This research, along with other studies, highlighted the fact that people lower in organisations experience greater stress than those at higher levels who have a lot of responsibility because the latter have more discretion over what they do and how they do it.
  • Lack of ability to make a difference – the example given by Johann related to a worker in a paint shop who spent all day adding tint to base paint and using a machine to mix the contents to provide paint with the colour requested by a customer.  The repetitious nature of this task and the associated boredom contributed to the worker experiencing a lack of meaning because he did not make a real difference in people’s lives.  Hackman and Oldham had previously identified “significance” of a job as a key element for a psychologically satisfying job.  Associated with that was the degree to which a job provided what they termed “task variety” and “skill variety”.  Work without variation and with no perceived impact, can be experienced as mind-numbing and deadening and lead to depression.

The loss of connection to meaningful work can be addressed at two levels.  Organisations can develop greater awareness about what constitutes unhealthy work design and remedy deficiencies in the design of jobs.  Action learning interventions can be helpful in this regard and, in the process, build employee’s self-awareness and sense of agency.

Workers, too, can develop inner awareness about what in their work is impacting their mental health and causing depression. They can explore this awareness through meditation and reflection and identify ways to remedy the situation.  As they grow in mindfulness, they may be able to identify why they are procrastinating and not removing themselves from a harmful work situation.  Johann found, for example, that the worker in the paint shop really wanted to change jobs and had already identified what job would give more meaning and joy for him.  However, he was held back by his perceived need to achieve the external rewards of life – better income and a good car.  Through meditation and reflection, it is possible to become more acutely aware of the cost of “staying’ versus changing and to be able to cope with the vulnerability involved in changing jobs.

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Image by Gerd Altmann from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Carers Need Self-Care

Much of the focus in the resources on mindfulness is on ways to help people who are suffering from conditions that are debilitating such as mental illness or chronic pain.  Very little of the resources focus on ways to help carers in their role – ways to manage the physical and psychological toll of caring for someone else on a constant and extended basis.  Carers are the overlooked group – forgotten by others and themselves.

Carers: people who care and support others

Carers come in all shapes and sizes  – adults looking after ageing parents who may be suffering from Alzheimer’s disease; siblings caring for a family member who has a mental health condition such as schizophrenia, anxiety or depression; or anyone caring for someone suffering from a physical condition such as paraplegia, chronic pain or cancer.  According to Carers Australia, carers are people who provide unpaid care and support to family members and friends who have a disability, mental illness, chronic condition, terminal illness, an alcohol or other drug issue or who are frail aged.

The toll of caring

The “burden of care” can be felt both physically and psychologically.  The physical toll for carers can be excessive – they can become exhausted and/or accident-prone, suffer from sleep disorders or experience bodily symptoms of stress such as irritable bowel syndrome, chronic fatigue or related conditions like fibromyalgia. The physical toll of caring can be experienced as cumulative stress and lead to chronic conditions that adversely affect the carer’s long-term health.

The psychological toll of caring can also be cumulative in nature and extremely variable in its impact.  Carers can experience negative emotions such as resentment or anger, despite their compassion towards the person who is being cared for.  They can become extremely frustrated over the paucity of time available for themselves, the opportunity cost in terms of inability to travel or to be away for any length of time, the lack of freedom (feeling tied down), the lack of improvement in the condition of the person being cared for or the financial impost of caring (preventing desired savings/purchases or home improvements). 

Carers do not have inexhaustible personal resources – physical, psychological and financial.  They can suffer from compassion fatigue which can be hastened by emotional contagion resulting from close observation of, and identification with, the pain of a loved one.  Hence, carers can experience depression, anxiety or grief – reflecting the emotional state of their loved ones who are suffering.

The toll on carers has been the subject of extensive research.  For example, Emma Stein studied the psychological impact on older female carers engaged in informal aged care.  Sally Savage and Susan Bailey reviewed the literature on the mental health impact on the carer of their caregiving role and found that the impact was highly variable and moderated by factors such as the relationship between caregiver and receiver and the level of social support for the carer.

Being mindful of your needs as a carer

The fundamental problem is that carers become so other-focused that they overlook their own needs – their need for rest, time away, relaxation and enjoyment.  Normal needs can become intensified by the burden of care and the associated physical and psychological stressors.  Carers tend to neglect their own needs in the service of others.  However, in the process, they endanger their own mental and physical health and, potentially, inhibit their capacity to sustain quality care.

Carers can inform themselves of the inherent physical and psychological consequences of being a caregiver, particularly if this involves intensive, long-term caring of a close loved one (where feelings are heightened, and the personal costs intensified).  Mental Health Carers Australia highlights the fact that people who care for someone with a mental health illness are increasingly at risk of “developing a mental illness themselves”.

Self-care for the carer

One of the more effective ways that carers can look after themselves is to draw on support networks – whether they involve family, colleagues or friends; broad social networks; or specific networks designed for carers.  Arafmi, for example, provides carer support for caregivers of people with a mental illness and their services include a 24-hour carer helpline, carers forum, blog, educational resources, workshops and carer support groups. Carers Queensland provides broader-based carer resources and support groups.

Carers tend to go it alone, not wanting to burden others with “their” problem(s).  They are inclined to refuse help from others when it is offered because of embarrassment, fear of dependency, concern for the other person offering help, inability to “let go” or any other inhibiting emotion or thought pattern – in the process, they may stop themselves from sharing the load.

Carers could seek professional help from qualified professionals such as medical doctors or psychologists if they notice that they are experiencing physical or psychological symptoms resulting from carer stress.

Mindfulness for carers

Carers can use mindfulness practices, reflection and meditation to help them cope with the physical and emotional stresses of caregiving.  Specific meditations can address negative feelings, especially those of resentment and the associated guilt.  Mindfulness practices can introduce processes that enable the carer to wind down and relax – such as mindful breathing, mindful walking, mindful eating or using awareness as the default when caught up with “waiting” (a constant companion of the carer role).

Carers can employ techniques such as body scan to relax their bodies and release physical tension.  Deep, conscious breathing can also help in times of intense stress such as when experiencing panic. For people who are religious, prayer can help to provide calm and hope.

Dr. Chris Walsh (mindfulness.org.au), offers a simple mindfulness exercise for self-care by carers in his website article, Caring for CarersThe exercise involves focusing, re-centering, imagining and noticing (thoughts, feelings and bodily sensations).

As carers grow in mindfulness, they can become more aware of the stress they are under and the physical and psychological toll involved. This growing awareness can lead to effective self-care through social and professional support and meditation and/or mindfulness practices. Mindfulness can help carers develop resilience and calmness in the face of their stressful caregiver role.

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Image by Sabine van Erp from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Facing Up to Vulnerability

I am not a Buddhist.  However, I readily acknowledge that in the area of mindfulness I can learn from the oral tradition of the Buddha that has been passed down over more than 2,500 years through teachings and stories.  Tara Brach, practising Buddhist and international mindfulness teacher, shares one such story related to vulnerability, “I See You, Mara”.   Tara recounts that the Buddha when travelling and teaching often encountered a sense of vulnerability experienced as “fear of loss or rejection”.  His way to manage this fear was to name it and face it – he called the fear Mara (“the god of darkness”).  So, whenever he encountered such fear and sense of being vulnerable, he would say, “I See You, Mara”.

Facing up to vulnerability and naming our feelings

There are times when we feel intuitively that we should do something that would be helpful to others, but we become fearful and give into our sense of vulnerability.  For the Buddha, “Mara” epitomised this fear and vulnerability.  We could find our own name for this darkness that can overwhelm us and impede our ability to be intimate, creative or compassionate.  Whatever way we choose, the basic process involves naming our feelings when we feel blocked by a sense of vulnerability.  In this way, we can tame our feelings, draw on our strengths and reduce the inhibiting influence of feeling vulnerable

In a previous post, I discussed the genesis of our sense of vulnerability and offered a short meditation that Tara teaches to help us to open to our vulnerability in our everyday life.  However, we may be faced with a specific challenge represented by an opportunity to do something worthwhile for others and, despite the value of the proposed action, we find ourselves procrastinating out of fear of some adverse outcome.  On these occasions, we can face up to our procrastination self-stories and bring them above-the-line.

What can be helpful, too, is to explore whether there is an underlying adverse event (or series of events) that gave rise to our personal sense of vulnerability.  Have we experienced an occasion when we were deeply embarrassed, totally rejected or attacked for our ideas or efforts?  How is such an event playing out in our lives now?  In this reflection, we can relate our sense of vulnerability to its origins and our deeply held belief (however false), that a similar outcome will be experienced again if we challenge the “status quo” or advance ideas that are different to mainstream thinking.  This deeply held belief about adverse outcomes can immobilise us if it remains hidden and not exposed to the light of observation and reflection.

As we grow in mindfulness through meditation and reflection, we can become increasingly aware of the impact of our past experience on our sense of vulnerability, begin to name our underlying feelings and access ways to face up to being vulnerable.  In this way, we can progressively release our capacity for intimacy, creativity and compassionate action.

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Image by Quinn Kampschroer from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.