Archive for May, 2011

May 19, 2011

Living with pain

by Dave P.

I’ve been having a pretty severe pain in my knee for the past week or so. I don’t remember banging it on anything or straining it, but it hurts like hell — especially after I’ve been sitting for a while and then get up and walk. I played a tennis match a few days ago and played with the pain. It was the only break in the rainy weather we had for a while and I wanted to take advantage of it.

A few minutes ago, our dog came into my office looking like she wanted to go outside. As I got up, I grimaced a bit from my knee pain. But then I decided to just accept the pain as an interesting sensation. As I walked down the stairs, I observed the pain without judging. It was just there. And as soon as I did that, my suffering diminished. I was still stiff and it didn’t stop me from limping (we can’t control our autonomic reflexes), but it was no longer excruciatingly painful.

When we’re in pain, much of the suffering comes from rejecting the pain. If we accept it, we eliminate the fear and anger. We relax. The muscle tension that causes much of the pain subsides and we suffer less.

Jon Kabat-Zinn introduced the practice of mindfulness for treatment of chronic pain back in 1979. He calls it Mindfulness Based Stress Reduction or MBSR, and it has been effective in treating chronic pain and anxiety. Today, there are mindfulness treatment and learning centers around the world.

May 19, 2011

Living in the present

by Dave P.

Have you ever noticed how some people seem to live mindfully as just part of their nature? You don’t see worry in their eyes or sadness. They’re content in whatever they happen to be doing. That is what it means to be alive. It’s not about the mountains we climb or how much money we make; it’s about living in the present.

Many of us spend our days preoccupied with the future. You hear people counting the days until the weekend when they can finally get away from work. On the weekend, they cram as much “living” into two days as they can, as if their days of freedom are numbered. Others are able to relax on Saturday but on Monday, they become preoccupied with going back to work.

At times, our vacations are the only break we get from the stress of work. If we get enough time off, we can actually immerse ourselves in the present for a few days and relax. Many people head to the beach to be able to just sit back and watch the waves roll in and then roll back out.

We don’t need the beach to be able to attain that level of contentment. We can achieve it through the practice of mindfulness at almost any time of the day no matter where we are. Even the most menial tasks can become enjoyable.

For example, rather than feeling excruciatingly bored when entering data into a spreadsheet, be mindful of your work. Imagine yourself as an efficient, well-oiled machine working with the precise accuracy of a mechanical watch.

If you have trouble focusing on the task at hand, divide your attention between your work and your breath. Observe the cool air flowing in through your nostrils and the warm air flowing out while you are working. This will keep the extraneous thoughts at bay and keep you in the present.

Living mindfully creates a feeling of equanimity and contentment. It can make work enjoyable and improve your relationships.

May 6, 2011

Thought Stopping Techniques

by Dave P.

by Dave Pollack

“I can’t believe I said those things at the office party last night! Everybody must think I’m a total idiot! I’m never going to hear the end of it and everybody at work is going to hate me!”

You lay awake in bed, tossing and turning, afraid to face the coming day. The next morning, you feel horrible from not having slept. Your eyes are bloodshot, you’re not thinking clearly, you’re in a bad mood, and you want to call in sick but you can’t afford to miss any more time off.

And so, you go to work, expecting the worst. But it turns out, what you said was no big deal. You weren’t the focus of everyone’s attention and hardly anyone noticed if you said something inappropriate or “stupid.” So you wound up making yourself miserable for nothing.

Worrying can become habitual. It might arise out of some genuine crisis. Maybe the company bully set his sights on you and made your life miserable. Afterwards, you started blowing any little snide remark or conflict out of proportion and you felt like the whole world had turned against you. Your relationships deteriorate and you begin to hate getting out of bed in the morning. You’ve become miserable and you’re making everyone around you miserable with all your complaining. You lose your comfort base. You snap at the slightest provocation. Your habitual worry turns into insomnia. Your friends no longer want to be around you. Your world is falling apart because you can’t stop those damned obsessive ruminations and maladaptive thoughts. You need help.

So how do you stop obsessive worry and ruminations? There are several methods and they can be used individually or in conjunction with each other. They do take a bit of self-discipline, though. You would think that it would be easy to control your own mind, but it’s usually quite difficult – at least in the beginning. We seem to derive some kind of satisfaction from rehashing events in our minds, which makes it difficult to stop.

Many people who suffer from insomnia have a hard time shutting down their minds when trying to fall asleep. Unless you’ve suddenly thought of a cure for cancer or have an idea that would make a perpetual motion machine possible, your thought doesn’t need to be processed when you’re lying in bed trying to sleep. Thoughts related to work can wait. Ruminations and worry can definitely wait for another time.

The cognitive approach to thought stopping can be effective in stopping the unwanted thoughts. When a thought pops into your head, ask yourself, “Do I really need to process that thought? Is that an important thought or am I just needlessly obsessing over something that doesn’t really matter? If it’s an important thought, does it need to be processed right now while I’m trying to sleep or can it wait until tomorrow?”

You can make a note to yourself to think the thought the next day after you get up. If you’re laying there worrying, tell yourself that right now you’re going to sleep, but you’ll be sure to worry about it in the morning when you get up. Make a note to yourself to worry, just in case you forget. Chances are, when you look at the note the next day, you’ll realize that whatever it was anything worth worrying about in the first place.

You can also do a cost/benefit analysis on your thought. What do you gain by thinking that thought? What do you lose? Sometimes thinking a thought has no positive value other than you gaining some kind of satisfaction from thinking it. Obsessing over things creates anxiety. Living in the present creates peace and equanimity. When we ruminate about someone who has done us wrong in some way, it doesn’t hurt the other person but it definitely does us harm, so what’s the point?

Ruminations often have their roots in self-loathing. You’re mad at yourself for allowing someone to do you wrong. You didn’t defend yourself the way you think you should have. So you go over the event over and over, perhaps imagining a different outcome.

The only way to get over a bad experience is through forgiveness. Forgive yourself for not defending yourself. Forgive the other person for causing you distress. That’s not to say you should become passive and let everyone pick on you. On the contrary, if you are at peace with yourself, you have a better self-image and can more easily defend yourself. And when you like yourself, people are less likely to pick on you. Bullies tend to go after those with low self-esteem.

After doing an analysis on a few maladaptive thoughts, you can simply tell yourself “It does me absolutely no good to process that thought and it actually makes things worse.”

Some unwanted thoughts will inevitably reappear, even after you’ve made the deliberate decision to not think about them. There are thought stopping techniques to stop them in their tracks before they’re fully formed.

One way most commonly recommended by therapists is to issue the “stop” imperative as soon as the thought begins to form. You can also visualize a stop sign. Another common method is to pinch yourself or snap a rubber band on your wrist when the thoughts start.

Then again, if you’re upset that someone treated you with disrespect and then you start yelling at yourself or hurting yourself, that might not make you feel any better. But there are other techniques at your disposal.

Bob Newhart did a funny skit in his TV series. On his show, he played a psychologist and a woman went to him for advice on how to get over her fear of being locked in a box. His advice was to “stop it. Just stop it.” Here’s a link to the video on YouTube.

While that’s not quite the same as issuing the “stop” command, a little humor can go far in diffusing negative emotions. When an unwanted thought appears, just imagine Bob Newhart telling you to “stop it.”

Another technique is to visualize your thought being sucked into a vacuum cleaner. You could also imagine zapping it with a Taser gun or perhaps it being eaten by a Pak-Man character. Or perhaps imagine a swashbuckler fighting the thought with his sword. You could visualize a Martian zapping it with a ray gun. Add some sound effects to your visualizations for more comic effect.

Humor can be extremely effective in weakening the negative emotions connected to your memories. The memories that are most vivid and most easily retrieved are the ones with the strongest emotional content. That’s why most people can remember where they were when they heard about the 9/11 attack or perhaps the Kennedy assassination, for those who are old enough to remember that.

We are most at peace when we’re living in the present – not rehashing past events or worrying about the future. People often go on vacation to clear their minds by sitting on a beach somewhere or camping out in the wilderness. We can do the same thing any time of the day by practicing mindfulness.

Many Buddhists practice what they call metta or loving-kindness meditation. It’s treating yourself with love and being fully in the present, usually focusing on your breath. You observe the sensation of the cool air passing in through your nostrils and the warm air flowing out. It gives you an object of focus and since your breath is always with you, you can be mindful of your breath at any time and any place.

You can also divide your attention between your breath and the task at hand. If you find that you can’t concentrate on a book you’re reading or a movie you’re trying to watch because of incessant ruminations, try observing your breath while engaging in those activities. When the extraneous thoughts subside, put your full attention on the task at hand. If the thoughts come back, return to dividing your attention between your breath and the task.

Many people have experienced good results with visualizations. Imagine yourself at a beach, the gentle waves rolling in and out, seagulls flying overhead… Or you could imagine yourself getting a massage or walking through a rainforest where you’re surrounded by vegetation and beautiful streams. There are many books dedicated to visualizations alone and you can find guided visualizations on the web and in media outlets.

A technique known as EMDR (Eye Movement Desensitization and Reprocessing) has been effective in treating PTSD (Post Traumatic Stress Disorder). Originally, EMDR consisted of visualizing the traumatic event and at the same time, moving your eyes rapidly back and forth. The theory is that it stimulates both sides of your brain at the same time and that weakens the emotional connections to your memories.

EMDR machines have been developed to stimulate both sides of the brain using sounds through earphones and vibrations through vibrating objects that you hold in your hands. You simply visualize the troubling event while hooked up to the device and the emotional content is weakened.

Thought stopping techniques can demonstrate their efficacy almost immediately. For severe problems with a racing mind or ruminations, it may take days or even weeks to get the problem under control. It does work, though, and the practice of thought-stopping along with meditation and mindfulness can actually change your brain chemistry so that your natural state of mind is one that’s relaxed and content.

May 6, 2011

Mindfulness – Right Focus

by Dave P.

by Dave Pollack

The Molly Lama

Every morning at about 9:00, I take our dog Molly out for a walk around the neighborhood. Molly is a German Shepard/Chow mix – a beautiful, feisty (at times a bit goofy looking) animal. I’ve gotten into the habit of practicing mindfulness on our walks and it sets the tone for the rest of my day.

This morning was sunny and mild – in the mid 50s, but windy. We’ve been having a windy spring here in Denver this year. Part of global climate change, I guess.

So Molly and I left the house a little after 9:00. As usual, she was anxious to explore the neighborhood. She ran down the walkway from our front porch and yanked me forward when she got to the end of her retractable leash.

“Hold on, Molly,” I told her. She looked down the street with a big smile on her face, tail wagging, as if to say, “Oh, boy! We’re going for a walk!” Dogs derive so much pleasure from the simple things in their lives. They live almost completely in the present, although I think she dreams of chasing rabbits when she sleeps.

As we started off on our walk around the neighborhood, I focused on my breath flowing in and out of my nostrils. It was windy and I observed the sensation of the cool air on my face and hands. The sun was beginning to heat the ground and occasionally a bit of warm air caressed the exposed parts of my body. So many things to be mindful of on this splendid morning in Denver.

The whistling from the steady breeze overpowered the traffic sounds from the busy street a few blocks away. Our neighborhood is a little oasis in Denver proper, with its two story houses and majestic, half-century old trees lining the streets. The sounds of traffic typically seem like an invader into our peaceful community, but on this day it was inaudible.

Molly suddenly started barking frantically as she lunged from the sidewalk into the street. I pressed my thumb down firmly on the leash brake to stop her progress, but she was already a good ten feet into the road. A German Shepard sat peacefully on the other side of the street – the object of Molly’s aggression. I backed up in a tug-of-war attempt to pull her out of the street with everything I had. At about 70 pounds of muscle, she’s a handful.

Just then I saw a van speeding down our side of the street directly towards Molly. I spun my body around, pulling on the leash. The van came within a foot of hitting Molly and continued down the street without slowing, seemingly oblivious.

“Damn it Molly!” I yelled, pulling her back to the sidewalk.

“Sorry about that,” came a voice from across the street. The owner of the well behaved German Shepard stood next to his dog, obviously concerned.

“That wasn’t your fault,” I replied, angry with myself for not being vigilant of my companion.

Molly is generally fairly well behaved, but she sometimes lets the Chow in her come out and can be a bit aggressive – never towards people, but often towards other animals. She likes to play by jumping on the other dog. That’s just her disposition. When the other dog responds in kind, the two have a good-ol’ time wrestling and play biting. Sometimes the other dog gets agitated, though, and they wind up fighting. She also goes after squirrels, rabbits, skunks (she’s gotten sprayed a few times), and I need to be mindful of her while we’re out on our walks. It’s not difficult to anticipate her moves. An attack is always preceded by an intense stare and a crouched stance, and generally, all that’s required is a firm “no” and my thumb on the leash brake to stop her from getting out of control. To do that, though, requires my mindfulness to be focused on her.

So this was a good lesson for me. While it’s important to be mindful, what’s also important is what we’re mindful of, especially when it involves the people and animals we love.

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May 3, 2011

Obese People Can Suffer from Social Anxiety Disorder Due to Weight Alone

by Dave P.

A new study from Rhode Island Hospital researchers shows that obese individuals with social anxiety related only to their weight may experience anxiety as severe as individuals with social anxiety disorder (SAD). The findings directly conflict with the criteria for SAD in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). The study is now published online in advance of print in the journal Depression and Anxiety.

The new research from Rhode Island Hospital, led by Kristy Dalrymple, Ph.D., evaluated a group of individuals who were seeking clearance for bariatric surgery. The researchers identified three separate groups: 135 individuals diagnosed with DSM-IV SAD; 40 individuals classified as “modified SAD” who experienced clinically significant social anxiety related to weight only; and 616 individuals with no history of psychiatric disorders.

In their study, both the SAD and modified SAD groups were rated as having poorer social functioning as an adolescent compared to the no disorder group, but there was no difference between the SAD and modified SAD groups in this respect, with similar results found in social functioning over the past five years. In addition, the SAD group was rated as having more time out of work in the past five years due to psychopathology or emotional reasons compared to both the modified SAD group and the no disorder group.

Results also showed that those in the modified SAD group experienced more disruption in their social life and were more distressed about having social anxiety in the past month compared to those in the SAD group. Dalrymple says, “We found it particularly interesting that the modified SAD group reported greater levels of disruption in social life and distress about their social anxiety compared to the DSM-IV SAD group. This suggests that although our modified SAD group had social anxiety that was related to obesity only, their level of impairment was significant.” She explains, “It could be that for individuals in which anxiety is related only to obesity, the change in social life functioning is more recent due to weight changes, and therefore, more distressing than for individuals who have experienced more generalized forms of social anxiety over a longer period of time.”

Read more…

May 3, 2011

Scientists Discover Anti-Anxiety Circuit in Brain

by Dave P.

Stimulation of a distinct brain circuit that lies within a brain structure typically associated with fearfulness produces the opposite effect: Its activity, instead of triggering or increasing anxiety, counters it.

That’s the finding in a paper by Stanford University School of Medicine researchers to be published online March 9 in Nature. In the study, Karl Deisseroth, MD, PhD, and his colleagues employed a mouse model to show that stimulating activity exclusively in this circuit enhances animals’ willingness to take risks, while inhibiting its activity renders them more risk-averse. This discovery could lead to new treatments for anxiety disorders, said Deisseroth, an associate professor of bioengineering and of psychiatry and behavioral science.

The investigators were able to pinpoint this particular circuit only by working with a state-of-the-art technology called optogenetics, pioneered by Deisseroth at Stanford, which allows brain scientists to tease apart the complex circuits that compose the brain so these can be studied one by one.

“Anxiety is a poorly understood but common psychiatric disease,” said Deisseroth, who is also a practicing psychiatrist. More than one in four people, in the course of their lives, experience bouts of anxiety symptoms sufficiently enduring and intense to be classified as a full-blown psychiatric disorder. In addition, anxiety is a significant contributing factor in other major psychiatric disorders from depression to alcohol dependence, Deisseroth said.

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May 3, 2011

Scientists Identify Genetic Risk for Major Depression

by Dave P.

ScienceDaily (Apr. 27, 2011) — A new study reveals a novel gene associated with major depression. The research, published in the April 28 issue of the journal Neuron, suggests a previously unrecognized mechanism for major depression and may guide future therapeutic strategies for this debilitating mood disorder.

Major depression is a psychiatric disorder that is responsible for a substantial loss in work productivity and can even lead to suicide in some individuals. “Current treatments for major depression are indispensible but their clinical efficacy is still unsatisfactory, as reflected by high rates of treatment resistance and side effects,” explains study author Dr. Martin A. Kohli from the Max Planck Institute of Psychiatry in Munich, Germany. “Identification of mechanisms causing depression is pertinent for discovery of better antidepressants.”

While is likely that a combination of genetic and environmental risk factors contribute to major depression, identification of risk-conferring genes has been challenging due to the complexity of the genetics and the considerable environmental factors associated with the disease. Dr. Kohli and colleagues performed a stringent genome-wide association study of patients diagnosed with major depression and matched control subjects with no history of psychiatric illness. They identified SLC6A15, a gene that codes for a neuronal amino acid transporter protein, as a novel susceptibility gene for major depression. The finding was confirmed in an expanded study examining over 15,000 individuals.

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