I’ve just completed a six-session course in mindfulness. It was specifically aimed at helping me manage my pain, but I’ve found it applies to pretty much everything in my life.
I’ve been seeing counsellors etc for a long time. They’ve always talked about mindfulness. But I’ve never been taught it quite the way Dr Elena Moran has just taught me. She’s a neuro-psychologist who specialises in pain management. I was lucky enough to see her for free through the Nelson pain clinic. (If you have a clinic in your town, you can ask for a referral through your GP).
Dr Moran teaches with resources developed by Dr Bruno Cayoun, the Director of the MiCBT Institute in Tasmania. MiCBT stands for Mindfulness-integrated Cognitive Behaviour Therapy.
When I have encountered mindfulness in the past, it’s been couched as focusing on your breathing/”the present” in order to relax.
This didn’t work for me for a number of reasons. One, I was trying to employ it when I was super distressed, at which time focusing on my breathing makes things worse for me. Two, trying to use it to “relax,” wasn’t helpful, because I don’t want to relax. I want to get on top of my day and my feelings without becoming slow and sleepy. And three, “the present” as a concept didn’t mean anything to me.
Dr Moran’s approach was different from the start. She focuses on the physical as much as the mental. She said to me I needed to be exercising at least an hour a day (which I am still not managing but it’s a goal). Mindfulness works a lot better if you’re also exercising.
We had six sessions, because that’s how much I could get for free through the PHO, but it was enough time to run through the course and give me space to practice each new skill in between.
The first step for me was getting Mindfulness of Breath under control. I practiced first with Dr Moran and then with a CD created by Dr Cayoun.
(There’s a step before this on the CD, which is Progressive Muscle Relaxation, but I’d already done quite a bit of that, so we skipped it. It’s really helpful if you have trouble getting into a space for mindfulness though).
As I said, the difference here is you’re not being told to relax. In fact, you are expected to sit upright and remain alert and attentive the entire time, which I struggled with so hard. The tape is only about 18 minutes, but sitting like that is really painful for me, and my mind is like a hyperactive caged animal. But that’s the whole point. I was learning how to not react to the pain – to see it, but not break down because of it. And how to keep bringing my mind back to awareness of my breath, no matter how many times it scampered away.
This is something I can *mostly* do when I’m distressed, as it’s also not asking you to taking long, deep breaths or anything – it’s just asking you to look at the breath without judgement.
Once you’ve kinda started to understand that bit – I’m not going to say once you’re good at it, because I think that’s going to take me years – you can start doing the Body Scan. This bit is where you’re doing mindfulness progressively focusing on each part of your body. No matter how much the pain or wandering thoughts distract you, you just bring yourself back.
The word Dr Cayoun keeps using is “equanimity” – non-reactiveness. You have to view the sensations, whether they are physical or emotional, as just that – just sensations that rise and pass away. I am very bad at equanimity. I have pain, I cry out. I get emotional, I cry out. So I’m learning to try not to do that. It costs a lot and most of the time it doesn’t achieve what you want it to.
After you’ve been doing the Body Scan long enough you get to do the Symmetrical Scan, which is the same thing, but you focus on both sides of the body at the same time. Again, it’s really hard to do, but it activates both halves of your brain.
Dr Moran explained to me about how our brains are hardwired into the same thought patterns. And pain sensations are the same. It’s like a road you’ve walked over and over until it’s got an easy rut in it; you can do it with your eyes closed. Mindfulness is stopping at the entrance to that road and saying “I don’t have to go down here. I can take the other route.” Eventually, your brain will make that decision to head down the new route for you. You’ll rewrite the road. But the only way of doing that is practicing a LOT.
Finally, Dr Moran taught me what’s called Loving Kindness mindfulness. This one’s about compassion for the self and others. It helps me deal particularly with emotional situations (like when I’m losing my temper). I can actually relax during this one and just focus on my breath and on remembering that everyone has their path, including me.
(Selfcompassion.org is a good resource for this sort of thing too, though it’s not MiCBT-based I don’t think).
I also learned a few other skills during the sessions, which aren’t necessarily standard. One of the most useful things we worked on was my sleep pattern. I’ve always had trouble sleeping and now with my pain, it’s only gotten worse. Dr Moran said that I had to stay up until I was completely exhausted, then go to bed. No naps, and no doing anything in bed but sleeping. And, regardless of how much I’ve slept, I have to get up at the same time each day. It’s a pretty tough routine, but it helps.
I also learned a thing called a ‘bi-polar exercise’ which is another mindfulness practice you can do to help cope with situations that cause anxiety. The idea is that, several times before you actually do the thing causing the problem, you sit down and, after doing mindfulness of breathing, you first picture the worst thing that could happen. I know, it sounds awful, but it’s meant to increase your tolerance. So you picture the worst thing for five minutes, then you go back to mindfulness of breathing for five minutes – then you picture the best thing that could happen for five minutes. You let yourself imagine the best possible outcome. Then you go do the thing. Again, it’s tough. And it’s helping.
I can’t recommend mindfulness enough, really. Now that I’ve finished the programme, I’m still doing each of the practices every day. I hope I can keep that up.
If you to know more you can email Dr Moran, or call her: 027 206 6848.