We’re halfway through 2017. Many of us made New Year’s Resolutions but we may not have adhered to them the way we wished. My first thought is to be gentle on yourself. We live in stressful times. It’s also worth considering where is the desire to change coming from? Was your original goal based on your own values and beliefs or from an external source and how has that impacted your decision-making process? Assuming you had or have a goal you’d really like to accomplish, when we do not achieve our goals we can end up feeling even more stuck in negative emotions. If there’s something you’ve been wanting to do, whether it is January or July, you might find these guidelines from the American Psychological Association helpful. Good luck!
As Dolly Parton’s character Truvy observed in the movie Steel Magnolias: “Laughter through tears is my favorite emotion.” Sometimes by being present to the sad things we can be more present to the joyful things as well. Crying can often be a skillful way to let one’s emotions out; if we keep those emotions inside too long it can have powerful adverse consequences. Tears can be healing. Researchers have determined that emotional tears contain proteins such as prolactin, which is also associated with reproductive health and breast milk production. It takes courage to share one’s emotions, and it can take courage to cry, to be vulnerable with another. Interestingly, humans are the only species that cry for emotional reasons. Some researchers believe crying exists as a bonding and communication method. Other scientists argue that crying represents a physiological response to a marked emotional shift, and that tears result because of the parasympathetic system after a fight or flight response. Crying is an important human experience, to learn more you can read this article.
When was the last time you got a really good night’s sleep? Sleep is so important for virtually every dimension of our lives, and it’s something we often neglect. Sleep helps with mood regulation, cognitive functioning, and our immune system to name just a few essential processes that sleep relates to. In fact, some researchers argue that sleep is the single most important factor for our health and wellbeing, being even more important that diet or exercise. Most adults need seven to eight hours of sleep per night but do not get the sleep they need. And children need even more sleep. It’s estimated that 50 to 70 million Americans have a chronic sleep disorder. This article by the American Psychological Association describes ways that people can achieve more and better sleep, and how psychologists can help. Let me know what you think and sweet dreams!
There are many forms of healing. In my work as a psychologist I often cite films, novels, music and other forms of art. Congruent with earlier research, a study by Bournemouth University and Queen’s University Belfast has found that music therapy reduces depression in children and adolescents. In this study children from ages 8 to 16 that received music therapy had improved self-esteem and a significant reduction of depression-related symptoms compared to children who received treatment without music therapy. The study also concluded that music helped teens have improved communication skills, and social functioning was improved in all the age groups that were investigated. You can learn more here.
Everything that is biological is psychological, and everything that is psychological is biological. The brain and body are one. Lowering stress and improving your mental wellbeing can significantly improve your physical wellbeing and lower your chance of contracting illnesses and diseases. Another example of this was found recently by researchers in Norway who were studying the link between heart disease and health anxiety. Study participants were followed over a twelve-year period and monitored for factors such as health, lifestyle, and education levels. And their anxiety levels were also closely monitored. Based on the data, this study concluded that twice as many study participants who had health-related anxiety developed heart disease compared to those who did not have anxiety. Even after adjusting for other cardiovascular risk-factors people with health-related anxiety had a 73% increased risk of developing heart disease. You can read more about this study here.
Dr. David Zuniga was recently featured in a series of videos on multiple myeloma for the WebMD website.
In Face the Fear and Find Support, Dr. Zuniga offers insight on coping and support.
How to Tell Others About Your Condition discusses communicating with caregivers and family members, including children.
Though these videos specifically target multiple myeloma patients and their families, they are relevant to all cancers and chronic or incurable illnesses.
Here’s an article that many of us can use. The idea of decluttering is not new, but interestingly we’re starting to generate research showing the health benefits of decluttering. This article explores the positive benefits of decluttering for mental health, including lowering stress and perhaps even increasing important dimensions of our life such as self-confidence and inner peace. You can read this article here.
I'm interviewed on religion journalist Eileen Flynn's blog on mindfulness, psychology, and parenting here.
The Buddha, Jon Kabat-Zinn, and Mindfulness-Based Cognitive Therapy: Personal Concerns Leading to New Therapeutic Innovations
According to the Pali Canon (the oldest collection of Buddhist texts) the Historical Buddha discovered and formulated mindfulness meditation as a result of wanting to overcome his profound fear of sickness, aging, and his inevitable death. Buddhist mythology describes the Historical Buddha as a rich, and somewhat sheltered prince. When he first comes in contact with people who are sick, aging, and have died he is terrified. And for the next 6 years of his life he tries the main spiritual and religious methodologies of his time, achieves great attainments, but never fully overcomes the raw terror of death.
Finally, he resolves to sit in meditation until he finds a way to cultivate equanimity with the fact that he will eventually die. And thus mindfulness meditation was created over 2,000 years ago. The Pali Canon described the Buddha as wanting to find a new way to deal with some of the universal givens of human existence (e.g. sickness, aging, and death). These Pali texts (Pali is a dialect of Sanskrit) were the first works to discuss mindfulness meditation, and one such Pali text that describes this meditative process in great detail is the Mahāsatipatthāna Sutta (Gotama, 1995).
Just as the Buddha was unsatisfied with earlier established methods of his day, Drs. Jon Kabat-Zinn, John Teasdale, Marsha Linehan, and Steven Hayes have all described how deficiencies in dominant forms of medicine and therapy led them to develop their leading contemporary therapeutic approaches that seek to utilize mindfulness, which was first proposed in the Pali Canon.
In my blog last week, I talked about how Marsha Linehan and Steven Hayes created Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT), respectively, based on their own personal spiritual interests, struggles, and dissatisfactions with established cognitive and behavioral approaches to therapy. And interestingly, personal influences also led to the clinical innovations of Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), which have become leading empirically supported treatments in biological medicine and mental health.
Hearing a lecture by Zen Buddhist priest Philip Kapleau while he was still a graduate student in molecular biology led Jon Kabat-Zinn to develop a life-long personal interest in Buddhist meditation and yoga, and to eventually create MBSR (Simon & Wylie, 2004). After attending a two-week vipassanā (mindfulness) meditation retreat, he returned to the hospital where he was working and created a program for chronic pain patients based on his meditation practice that eventually evolved into MBSR (Simon & Wylie, 2004). Kabat-Zinn believed that mindfulness could improve the treatment of chronic pain even when established medical protocols had often proven insufficient. Kabat-Zinn’s MBSR is designed as an 8-week course that typically meets once a week in a psycho-educational format with the introduction and practice of different MBSR techniques that he originally adapted from his own personal practice and conception of Buddhism and yoga (Kabat-Zinn, 1990, 1994). MBSR was not initially designed or intended to be a psychological intervention in mental health settings, but Kabat-Zinn’s approach came to strongly influence many leading therapeutic approaches that seek to integrate mindfulness into their therapy work (e.g., MBCT, DBT, ACT).
The founders of Mindfulness-Based Cognitive Therapy (MBCT), Drs. Zindel Segal, Mark Williams, and John Teasdale, initially had varying levels of personal interest in Buddhism before creating MBCT (Segal, Williams, & Teasdale, 2002). Professionally, they were moved to explore mindfulness for the treatment of depression because they were concerned about high rates of relapse for people who had used traditional treatments for depression. Of the three founders of MBCT, John Teasdale was initially the most personally interested in Buddhism, and he credits his personal interest in Buddhism as an inspiration for his clinical and research work (Segal, Williams, & Teasdale, 2002).
Segal, Williams, and Teasdale all share that they initially believed their training as psychologists would be sufficient for them to train others in the practice of mindfulness (Segal et al., 2002). They relate, however, that when they initially tried to teach mindfulness without having their own mindfulness practice their seminars were extremely unsuccessful, and they subsequently implemented Kabat-Zinn’s admonition that to teach mindfulness they must first have a strong mindfulness practice (Segal et al., 2002). Teasdale, Segal, and Williams (1995) defined their mindfulness approach as a new, innovative form of cognitive therapy serving to inoculate against the relapse of depression, and contrast their methodology against traditional cognitive therapy: “In the case of cognitive therapy, these alternative “views” probably involve more of an active “coping and controlling” stance than the views implicitly created in mindfulness practice (p. 38).”
Since its origins, Buddhism has been appreciated by some leading psychologists as a way to advance the discipline of psychology. In the early 1900s when the Buddhist monk Anagarika Dharmapala made his third visit to the United States and attended a lecture at Harvard delivered by William James, the seminal scientist urged Dharmapala to speak on Buddhism declaring, “You are better equipped to lecture on psychology than I” (Fields, 1992, p. 135). After Dharmapala spoke to Dr. James’ class, James declared to his students, “This is the psychology everybody will be studying twenty-five years from now” (p. 135). The work of Drs. Jon Kabat-Zinn, John Teasdale, Marsha Linehan, and Steven Hayes are perhaps examples of how James’ prediction that Buddhism would become the future of psychology may now be coming true.
Fields, R. (1992). How the swans came to the lake: A narrative history of Buddhism in America. Boston, MA: Shambhala Publications.
Gotama, S. (1995). Mahāsatipatthāna Sutta: The greater discourse on the foundations of mindfulness. In M. Walshe (Trans.), The long discourses of the Buddha: A translation of the Dīgha Nikāya (pp. 335-350). Somerville, MA: Wisdom Publications.
Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, NY: Delta.
Kabat-Zinn, J. (1994). Wherever you go, there you are. New York, NY: Hyperion.
Segal, Z., Williams, J. M., & Teasdale, J. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York, NY: Guilford Press.
Simon, R., & Wylie, M. S. (2004, November/December). The power of paying attention: What Jon Kabat Zinn has against “spirituality”. [Electronic Version]. Psychotherapy Networker. Retrieved August 1, 2013, from http://www.psychotherapynetworker.org/populartopics/leaders-in-the-field/521-the-power-of-paying-attention
Teasdale, J., Segal, Z., & Williams, J. M. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behaviour Research and Therapy, 33, 25-39.
Last week I wrote about Viktor Frankl and his existential approach to psychology. Frankl’s approach arose for him based on three years he spent in concentration camps such as Auschwitz and Dachau. Frankl’s father, mother, brother and wife were all killed; he and his sister were the only survivors in his family.
I think one reason Frankl’s theories and therapeutic approach have so much meaning for so many people is because he actually endured the unimaginable. And Frankl, a psychiatrist, spoke openly about human phenomenon such as art and love. In fact, he felt that art and love were vehicles to transform clinical problems (e.g. art and love help with things like depression, anxiety, trauma etc.). Sadly, we live in an era of increasingly brief, standardized, manualized, de-personalized therapy. Some of that is a function of insurance companies, and some of it is probably a function of our quick-fix desires of our wider society.
Frankl’s transformation of his personal suffering, and using his profound suffering to create a unique therapeutic approach made me think of other leading theorists and clinicians who have created a new form of therapy based on their own personal suffering.
Dr. Marsha Linehan created Dialectical Behavior Therapy (DBT; Linehan, 1993). DBT is now considered the therapy of choice for Borderline Personality Disorder. DBT is also being used successfully for other concerns, such as substance addiction.
Borderline Personality Disorder is a very challenging situation characterized by a history of intense, unstable relationships and life choices. Not long ago, Marsha Linehan, the “guru” of DBT had the courage to share that she herself had struggled for years with Borderline Personality Disorder and was hospitalized due to numerous suicide attempts and self-injurious behavior that included cutting herself, head banging, and burning herself (Carey, 2011). Linehan credits her Roman Catholic religious faith, prayer, and personal interest in Buddhism with enabling her to survive and create DBT (Carey, 2011; Robins, 2002).
Dr. Steven Hayes was a widely published, successful professor and researcher. But at the same time Dr. Hayes also suffered debilitating panic attacks that threatened his academic career. Hayes has stated publicly that an interest in Buddhist philosophy, meditation, and other forms of religion and spirituality helped him overcome his Panic Disorder and create Acceptance and Commitment Therapy (ACT; Cloud, 2006).
ACT was initially designed to primarily address anxiety-related symptoms and disorders. ACT has emerged to be used successfully for a range of diverse problems including chronic pain, substance abuse, obesity, cancer management, schizophrenia, psychosis, and PTSD (Bach & Hayes, 2002; Bach, Hayes, & Gallop, 2012; Gundy, Woidneck, Pratt, Christian, & Twohig, 2011; Walser & Westrup, 2007).
Drs. Frankl, Linehan, and Hayes each endured profound suffering. And each transformed their suffering to create influential therapeutic approaches. Their work demonstrates that out of profound suffering we can find ways to help other people. And sometimes, by helping ourselves, we can help others as well.
Bach, P., & Hayes, S. C. (2002). The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 70(5), 1129-1139. doi:http://dx.doi.org/10.1037/0022-006X.70.5.1129
Bach, P., Hayes, S. C., & Gallop, R. (2012). Long-term effects of brief acceptance and commitment therapy for psychosis. Behavior Modification, 36(2), 165-181. doi:http://dx.doi.org/10.1177/0145445511427193.
Carey, B. (2011, June 23). Expert on mental illness reveals her own fight. [Electronic Version]. The New York Times. Retrieved July 29, 2011, from http://www.nytimes.com/2011/06/23/health/23lives.html?_r=1&pagewanted=all
Cloud, D. (2006, February 13). The third wave of therapy. [Electronic Version]. Time. Retrieved July 29, 2011, from http://www.time.com/time/magazine/article/0,9171,1156613,00.html
Gundy, J. M., Woidneck, M. R., Pratt, K. M., Christian, A. W., & Twohig, M. P. (2011). Acceptance and commitment therapy: State of evidence in the field of health psychology. The Scientific Review of Mental Health Practice: Objective Investigations of Controversial and Unorthodox Claims in Clinical Psychology, Psychiatry, and Social Work, 8(2), 23-35. Retrieved from http://search.proquest.com/docview/928984322?accountid=10868
Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.
Robins, C. (2002). Zen principles and mindfulness practice in Dialectical Behavior Therapy. Cognitive and Behavioral Practice, 9, 50-57.
Walser, R. D., & Westrup, D. (2007). Acceptance and commitment therapy for the treatment of post-traumatic stress disorder and trauma-related problems: A practitioner’s guide to using mindfulness and acceptance strategies. Oakland, CA: New Harbinger Publications.