March 6, 2012 • By Suellen Fagin-Allen, LMHC, Mindfulness Based Approaches / Contemplative Approaches Topic Expert Contributor
Perhaps you are troubled by periodic depression or “feeling down.” You’ve experienced first-hand the lack of energy, the feelings of inertia, guilt, and sadness, the disturbances of sleep, appetite, and sexual drive, the sense of longing for the meaning and purpose you once felt life held for you. You’ve tried to snap out of it, but it’s not that easy. And the worst thing about it may be that it seems as though it will last forever. Maybe your highs and lows are a bit more than just normal ups and downs. Your feelings of mild euphoria and expansiveness are exhilarating, but eventually you come crashing down and life turns dull and gray. You’re tired of the cycle and wish you could just “even out.”
For some, medication is a partial answer. As a psychotherapist, I’m not licensed to practice medicine, and it’s beyond the scope of my expertise to state definitively who those people are. I do often recommend a medication consultation for those bothered by depression, mania, or bipolar who’ve not been able to manage without significant disruption to their lives.
That said, much research out there suggests that talk therapy, on its own or with medication, is more effective at treating difficulties with mood regulation—especially depression—than medication alone. My approach to talk therapy, as you may have guessed if you’ve read previous blog posts of mine, is based strongly on a mindfulness perspective, and mindfulness practice has much to offer those having difficulty regulating moods.
A basic tenet of mindfulness is the impermanence of everything—and, by extension, that because of its impermanence we needn’t think of our present moment’s experience as being a fixed state. Think about it, and you may agree. The itch you felt a moment ago has gone away, without your even needing to scratch it. The thought, “I need to buy milk at the grocery store” has been replaced by “I hope to finish that report tomorrow!” Anticipation of having a great time at the movies with friends gives way to sadness over the loss of an important relationship that ended years ago. Thousands of thoughts come and go as they will in a day, each accompanied by its own feeling—happiness, relief, annoyance, joy, anticipation, disgust, or combinations of them. Change is perpetual, and the only aspect of living that truly is constant is that we are always existing in the present moment, which will shift into thousands or millions more present moments as time goes by.
One of my most successful interventions with clients having difficulty with mood management is an exercise based on recognizing the impermanence of our thoughts, emotions, and experiences. Similar exercises are utilized by practitioners of dialectical behavior therapy, a popular and effective treatment for people with so-called borderline personality disorder (BPD), which has roots in problematic early experiences with caregiver attachment. Clients with BPD typically had caregivers who behaved erratically—at times loving and nurturing, and at others abusive and neglectful. These children never knew what to expect and learned that extremes were normal. They wanted to trust but knew it wasn’t safe to do so in their early environments. That knowledge, unfortunately, is carried over into adulthood and now wreaks havoc in all aspects of life because of their inability to pilot their emotional ships on an even keel. Their task in therapy is to learn to even out their extremes and learn to live “in the middle” and to trust their inner Wise Mind. One way to accomplish this is through practice, deliberately shifting back and forth between emotional states, reinforcing their ability to be in control of how they feel instead of being so reactive to everyone and everything around them.
Not everyone should try the following exercise. If you have a history of trauma, are prone to excessive rumination, feel “out of control” or feel very, very depressed, seek the guidance of a trained mental health professional to help you decide which treatment modalities are best for you.
If you do want to give it a try, then sit quietly in a comfortable, private, and familiar area. Fix your gaze on a soothing object—a candle, a painting, a plant—and begin to breathe slowly and deeply, into and from your abdomen. (For those with breathing difficulties, this exercise can be done without the emphasis on deep breathing, too. The important thing is to feel safe and to be able to quiet the mind.) Establish a comfortable breathing rhythm, and then focus on a recent event, person or situation which has troubled you or perhaps just the feeling of heaviness, lethargy, and emptiness that is currently pervading your thinking. If you’re prone to hypomania instead, take a look at the feeling that accompanies the upward escalation of your mood. Examine the feeling thoroughly, not judging, just investigating. Ask yourself, what is this? Then identify it and name it: sadness, sadness or giddiness, giddiness. Now, switch to a time when you felt differently or to an event you‘re anticipating. Describe it to yourself in detail: where is it, who is there, what’s happening, what time of day is it, what is the weather like? What are you feeling? (Notice that I use the present tense because it’s important to actually sense yourself being in that moment!) Name the feelings: joy, peace, happiness, being in control, or whatever they are, and allow yourself to deeply feel them because you are really there, in that experience. Practice gradually switching back and forth between the two feelings. When you are comfortable realizing that the desired feeling is as strong as the other and that you now can envision and embody both, gradually return to the present, assuring yourself that each feeling is equally possible and equally real. With regular practice, this gets easier.
A wise philosopher once said that if we’re unhappy in the present moment, we have only to wait for another moment to arise, bringing with it the opportunity for and the reality of change. Mindfully envision feeling better and more in charge of your feelings. I’ve done it. Chances are you can, too!
Source: http://www.goodtherapy.org/
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