Mindfulness and CBT

 

Hello. I’m Dr Brun. If you haven’t met me before, I’m one of the Drs at Elmham surgery. 

I’d like to talk to you briefly about some helpful tools and techniques that can help you if you’re struggling with anxiety and low mood.

You may be watching this as a follow on to another short talk I’ve done. Or perhaps you’ve spoken to me or one of my colleagues and we have advices you consider if these tools could be helpful for you. 

I’d like to start by explaining what mindfulness is and how it can help you. This is only a short over-view. There is a lot more help and advice on line about this as well as through various organisations, charities and websites, a few of which I’ve outlined at the end. 

So what is mindfulness?

Mindfulness is a helpful tool which has been practiced for hundreds of years, to help reduce anxiety, be more peaceful and help us cope better with difficult thoughts, feelings and challenging situations. 
It essentially stops us getting caught up in our thoughts and rushing through life without stopping to notice much. We can easily zone out, ‘switch into autopilot’ or ‘be miles away’ and not notice or listen to what’s going on around us. And often when we are ‘miles away’ or ‘in autopilot’ our anxious or low thoughts and feeling quickly appear.  Mindfulness teaches us to live in the present. To be more aware of the world around us, of sights, sounds, feelings, textures and tastes. 

If you’ve watched my short talk on anxiety you may remember I gave the example of a postman arriving at the door. Imagine you’re at home, overwhelmed with anxious thoughts and feelings that are whizzing through your head. Suddenly the door bells rings and the postman arrives asking for directions to another house. You stop, think, explain carefully where he needs to go and chat briefly to him. Perhaps you notice the colour of his uniform, his accent, the mud splashed on the side of his van. He thanks you and off he goes. During that couple of minutes, most people would find their anxiety lessens a little. That’s because you’ve come out of ‘autopilot’, no longer ‘miles away with our thoughts’ but back to the present, to the here and now. That’s a very simple example of mindfulness.

There are a few simple exercises you can try to help you live more mindfully.

Firstly. Try becoming more aware of your body senses. Perhaps try this whilst you’re outside walking. Notice the feel of the wind of the cheeks, it’s temperature. Notice the sound of the birdsong, children playing, your steps on the ground. Look at the trees, a dog being taken for a walk. Notice the berry bushes as you walk past. Look at the little veins on the leaves and the shiny texture of the berries. 
Perhaps you might try this whilst you’re eating. Slow down, smell the food first. Let it gently touch your lips and notice it’s texture. Move it round in your mouth picking up all the different aspects of its taste, its bitterness, sweetness, saltiness. Try this before swallowing it. Mindfulness doesn’t have to take lots of time. Try it as part of everyday chores and activities. Perhaps whilst having a shower, noticing the feel of the water on your skin. Notice the beauty and colour of the bubbles, the smell of the soap. The more you practice it, the easier and more natural it becomes and the less frequent and powerful the anxious or low thoughts are at constantly popping into your mind. 

Secondly, try some simple body awareness and relaxation exercises. Try focusing on your breathing. This is helpful for many reasons. Firstly it is mindful, focusing on the here and now not worrying about the future or thinking back to the past and regrets. Secondly when we are anxious, our fright light and fight response kicks in, which I’ve spoken about before. This can make our breathing shallow and fast which can make us feel more anxious. The opposite response in the body is called the ‘rest and digest’ response. This allows us to relax, recharge and digest our food better. Deep slow breathing is a helpful way of allowing this response to kick in. Try breathing in slowly while counting to 8. Be aware all the time you do of the feel of your breath as it makes it’s way through your nose, down your airways and into to the lungs. Feel your chest expand slowly. If you like you can imagine it going all the way through your body to the tips of your toes. Now slowly breathe out, counting to 8. Feel it slowly coming back out again, making it’s way out of your lungs, your chest settling down again, the movement of air through your mouth. You may be able to slow this down to counting to 7 as you breath in and 11 as you breath out but this can take some practice. Mindfulness also involves paying more attention to what is happening inside us as well as around us. It involves being more aware of our body, noticing, without becoming completely absorbed in, our thoughts. 

Imagine you’re stood at a busy railway station. There are trains arriving and departing from and to various different destinations on lots of platforms. It’s a busy place. Now imagine those trains all represent anxious or low thoughts; thoughts such as “I’m useless and never going to amount to much” “something bad is going to happen to those I love” “what if I never make new friends in this new area” “what if my panicky feelings actually mean I’ve got a dreadful disease and I’m going to die”. It’s easy to become all consumed with these thoughts and allow to take hold in our minds. That’s abit like boarding one of the train and riding it where ever it goes. Mindfulness teaches you to stand at the station and just obsever and name the trains without getting on. For example; “oh here comes the thought that I’m no good again,…it’s just a thought, it’ll pass” or “here comes the anxious feeling, the racing heart and now that thought again that I’m going to die…it’s my flight firght fight response again, it can’t harm me, it’ll settle”.

Sometimes naming our thoughts and feelings allows us to step back from them and helps to reduce the hold they have on us. 

Keeping a Thought Diary

I talked briefly in my short talk on anxiety about keeping a thought diary. This is helpful exercise which is often used as part of a process called CBT – cognitive behavioural therapy. 

It’s a practical way to log and then look at your thoughts and feelings relating to a situation that may make you feel anxious, low or uncomfortable. The benefit of doing this, is that it can help us to better understand the link between our thoughts, feelings and body sensations and how they influence us. Particularly when they are unhelpful. It’s best to download of the free thought records or diaries from the internet (again, resources listed at the end). There are a series of prompts to help you reflect. It involves noting what happened, our feelings,, unhelpful thoughts we have and why, then thinking of evidence against the unhelpful thought and thinking of a more realistic or just neutral thought then how it makes me feel.

Here's an example:

  1. I leave my house and see someone I know walk on the other side of the road but they don’t say hello to me or even look at me. 
  2. I feel sad. Rejected. Worthless. 
  3. My thoughts may be; no one likes me, I have no friends, I’m going to be lonely forever.
  4. I do have friends and people enjoy my company.
  5. Perhaps they just didn’t see me. Perhaps they are having a bad day and didn’t feel like talking. Perhaps this is nothing to do with me at all, but more to do with them.
  6. I feel a bit better. Not so low and worthless. 

This is a very simple example. There is lots more help that you can get from different types of talking therapy. What I’ve tried to briefly illustrate is that our thoughts and feelings can, if we let them, have a strong and negative impact on our lives but this can be challenged with some simple techniques that have been shown time and time again to really help. 
I’d encourage you to self-refer to wellbeing if you’d like some more support in this area. You may also like to explore the resources I’ve listed at the end. 

Good bye