We live in a world filled with material wealth, live longer and healthier lives, and yet anxiety, stress, unhappiness, and depression have never been more common. What are the driving forces behind these interlinked global epidemics? Professor Mark Williams examines the neuroscience of mindfulness in this short video.
Erica Crompton, Daily Mail: Meditation is sitting around trying to think about nothing and letting out the occasional ‘ommmm’.
They do lots of it in India and in parts of Islington where they eat granola, too. OK, those are sweeping statements but you catch my drift.
I’m open-minded, but if you had asked me a few years ago whether I believed meditation could be an effective treatment for serious mental illness, I would have laughed. However, that is exactly what some of Britain’s mental health experts now believe.
It has been almost a decade since I was first diagnosed with paranoid psychosis, a type of schizophrenia. It’s not as dramatic it sounds – I’ve seen a psychiatrist about once every three months since I became ill, and my medication is managed by the GP.
I needed to go into hospital once, for a week. I take an anti-psychotic drug called amisulpride. I’d rather not be dependent on tablets but if I stop taking them, I feel unwell again.
It happened just recently. I ran out of pills before the weekend and thought I would be fine to wait to see my doctor on Monday. By Sunday, anxiety had begun to creep up on me. My illness makes me feel I’ve done something terribly wrong, although I’m not sure what …
Danny Penman and Mark Williams: The gloomy days of January can be the most miserable and stressful of the year, but it doesn’t have to be this way. If you follow this ten step guide to destressing your life, then the next few weeks just might become the most serene and fulfilling ones of the year.
One step should be carried out on each of the next 10 days. They’re based on the ideas found in the international best-seller “Mindfulness: An Eight Week Plan for Finding Peace in a Frantic World.”
The book uses a program based on mindfulness meditation developed by us at Oxford University in the United Kingdom to relieve anxiety, stress, exhaustion and depression. Mindfulness has proved in some clinical trials to be at least as effective as drugs or counseling for dealing with these conditions.
The ten steps described in the article are:
Day 1: Eat some chocolate
Day 2: Go for a short walk
Day 3: Take a three-minute breathing space
Day 4: Do something pleasurable
Day 5: The intensely frustrating line meditation
Day 6: Set up a mindfulness bell
Day 7: The ten-finger gratitude exercise
Day 8: Do the sounds and thoughts meditation
Day 9: Reclaim your life
Day 10: Go to the movies
Some recent and ongoing research sheds light on how the experience of depression arises, and also squares with the Buddhist teaching on the hindrance of doubt (vicikicchā).
Buddhist meditation traditions speak of five hindrances to meditation. No, this isn’t things like throbbing knees or the neighbor playing his stereo too loud. The hindrances are five mental states or activities that “hijack” the mind and make it hard, if not impossible, for us to stay focused in meditation. The central one of these hindrances is doubt.
In English we use the word doubt to mean many things. We can talk about doubt in terms of a willingness to question, and a desire to seek the truth without taking ideas on board too quickly. You might be skeptical, for example, that there are in fact five hindrances to meditation, and want to know more about them. You might want to test out in your experience whether this model is valid and useful. And those are very useful responses. That’s part of the meaning of the English word doubt, but in Pali, the word vicikicchā is much more specific. It refers to a lack of confidence and clarity.
Doubt as a hindrance involves, on an emotional level, a collapse in trust. We lack confidence in ourselves, or we lack confidence in the practice we’re doing, or we lack confidence in others and in whether they have anything to offer us. At its mildest doubt can simply be a form of disgruntlement, disengagement, or confusion, but at its most severe it can be a crushing burden of depression.
Doubt has a more cognitive aspect as well. Accompanying the confused, critical, and sometimes depressed emotions are various kinds of disordered thinking. For example, we may be having a hard time with a task we’re working on — whether it’s meditation or something at work — and we generalize this into statements about ourselves (“I can’t do this … I’m not getting anywhere”) or about the task (“Meditation is stupid … this is pointless”) or about the world generally (“This isn’t fair … life sucks”).
Part of the cognitive distortion is that we’re temporarily unable to remember any counter-examples — times that we succeeded and when the task went well, and times when we experienced obstacles and difficulties and overcame them. We think of ourselves as trapped, and stuck, and can’t imagine any creative way out of our situation. The hindrance of doubt hijacks the mind — both our emotions and our thoughts — and leaves us feeling trapped.
The other day I was talking to a meditation student who is writing a novel, and he talked about the difficulty of actually finishing his writing. Being on the verge of completing a project, or being on the verge of a breakthrough, can often trigger doubt. Say the book isn’t popular; how are we going to deal with that? Say it is popular; we’re then faced with the problem of adjusting to a new self-view, and the dread of having other people’s expectations of future success to live up to. Sometimes it seems best just to delay completion.
The research I mentioned earlier, which is described in a New York Times article, illuminates the connection between the emotional aspect of doubt (at its most extreme, depression) and the cognitive.
People were given words, like “rejection” or “loved” and were asked to come up with one specific memory connected with the word. The word specific here meant an event that lasted less than one day.
For “rejected,” one participant answered, “A few weeks ago, I had a meeting with my boss, and my ideas were rejected.” Another said, “My brothers are always talking about going on holiday without me.”
The second answer was wrong — it is not specific, and it refers to something that took place on several occasions.
You can see how the second response is a generalization. It’s highly unlikely that the brothers in question were literally “always” talking about going on holiday without the participant who wrote that comment. Sometimes people will take one or two examples that happened on specific occasions, and generalize them into an “always.” Sometimes counter-examples will be ignored: the time the writer was invited to go on vacation with his or her brothers but wasn’t able to go, or chose not to go for some reason. Sometimes the generalization in these cases is built on a misunderstanding: the intent wasn’t to exclude, perhaps, but the joint holiday was based on an activity that the brothers shared (like rock-climbing) and that the writer didn’t. With doubt, all the nuance gets squeezed out of the experience, and we’re left with a tight, hard statement of hopelessness expressing doubt in the brothers (“they don’t care about me”) and oneself (“I’m not likable enough to be invited”) and even the world (“Nobody likes me”).
These over-general memories seem to be connected with the arising of depression and related conditions:
Scientists at the University of New South Wales in Sydney, Australia, assessed 46 firefighters during their initial training and again four years later, when all had experienced traumatic events like seeing comrades injured or killed. Those who could not recall the past in specific detail during the first assessment were much likelier to have developed the disorder by the later one.
Interestingly, Dr. Mark Williams, who is well-known for his research into how meditation can help with depression, has
induced an overgeneral style in subjects by coaching them to recall types of events (“when I drive to work”) rather than specific occasions (“when I drove to work last Saturday”). He found they were suddenly less able to solve problems, suggesting that overgeneral memory is capable of producing one symptom of depression.
Doubt is treatable. My advice to students when doubt arises in meditation is first to deal with their posture. When we’re feeling depressed the body usually slumps and the head drops, and this posture reinforces the feelings of depression. When we straighten up the body it’s harder to feel depressed. Remembering how the body feels when we’re full of confidence can help us change our posture and empower us by bringing confidence into our present-moment experience.
The next thing I advise is to cultivate a healthy distrust of our own stories. Just because we think something doesn’t mean it’s true. If we recognize the signs of vicikicchā — in the form of over-generalized thoughts and stories that disempower us — we can step back from them and not take them so seriously. Jack Kornfield has suggested giving this inner doubter a name. When you hear the nagging voice of doubt you can say something like “Thanks for your input, Betty. I’ll get back to you on that.”
I also suggest seeking a more balanced perspective by seeking the truth. “My brothers are always planning to go on vacation without me.” Really? How often? Twice? Three times? Is that really “always.” Is it a bad thing if they don’t invite me on a climbing trip given that I don’t climb? Have I ever invited them to go away with me? We need to be doubtful of our doubt.
“Meditation just doesn’t work?” Wait, is that true? Are there counter-examples? Well, I guess there are actually lots of times I’ve been on retreat and felt amazing afterward…
I’d expect that this research on depression and over-generalizing will end up by recognizing that depression is just the extreme end of a spectrum of doubt that starts with a mild lack of confidence, and that patterns of over-general thinking are the mechanism that get us from feeling just a bit “down” to a full-blown depressive attitude.
There’s good news in the article regarding how to circumvent this slide:
Williams has found that specificity can be increased with training in mindfulness, a form of meditation increasingly popular in combating some types of depression. Subjects are taught to focus on moment-to-moment experiences and to accept their negative thoughts rather than trying to avoid them. It may help by making people more tolerant of negative memories and short-circuit the impulse to escape them, which can lead to overgenerality.
We’re also told that:
Spanish researchers have reported that aging patients showed fewer symptoms of depression and hopelessness after they practiced techniques for retrieving detailed memories.
This is good news for depression sufferers, but it also shows other people how to maintain robust mental health: be specific in your recollections so that you don’t “talk yourself” into a depressed state of mind.
Danny Penman: Meditation is often touted as a panacea for all manner of ailments, from chronic pain to anxiety, stress and even depression.
Like most sensible people, I’d always taken such sweeping claims with a large pinch of salt. However, five years ago I learned the power of meditation for myself after an accident left me critically injured and in constant pain.
A freak gust of wind caught me off-guard as I was paragliding over the Cotswolds. One moment my paraglider was flying normally, the next its wing had collapsed, sending me tumbling into the hillside 30ft below.
I was struck with the most agonising pain imaginable. The bone in the lower half of my right leg had been driven up through my knee and into my thigh.
I could see the outline of my fractured shin bone sticking through the cloth of my jeans. I went into shock and my body was racked with violent uncontrollable spasms.
As I lay on the hillside, I remembered a form of meditation Read the rest of this article…
Over the years I’d used it to deal with the usual stresses and strains of daily life, but never in times of physical pain. But I knew that meditation (and self-hypnosis) had been used for pain relief and, as I lay on the hillside, in sheer desperation I tried them both.
I forced myself to breathe slowly and deeply, to focus on the sensations the breath made as it flowed in and out. I pictured myself in a beautiful garden and imagined myself inhaling its peaceful and tranquil air.
Gradually, breath by breath, the pain became more distant. It felt less ‘personal’, almost as if I was watching it on TV.
In hospital it became apparent how seriously injured I was — and just how effective a painkiller the meditation had been.
My leg was so badly broken that I would need three major operations. I also needed a newly invented device, a Taylor Spatial Frame, to be surgically attached to my leg for up to 18 months to repair the damage. Consisting of four equally spaced rings that encircled my lower leg, the frame looked like a cross between a Meccano set and a medieval torture device.
Fourteen metal spokes and two bolts connected these rings to the shards of bone inside my leg, and allowed the surgeon to move the fragments around inside.
Life with the frame was intolerable. Sleep was virtually impossible, and the pain was controlled with powerful drugs that left me washed-out and jaded.
I felt thoroughly wretched — anxious, irritable and highly stressed. So I decided to find an alternative way of coping with the pain and of maximising my chances of recovery.
I discovered the work of Mark Williams, professor of clinical psychology at Oxford University. He and his colleagues at the universities of Cambridge, Toronto, and Massachusetts had spent 20 years studying the phenomenal power of meditation for treating anxiety and even full-blown depression.
They had turned it into a therapy known as Mindfulness-Based Cognitive Therapy (MBCT) that was gaining the support of doctors and scientists. It had even been endorsed by the U.S. National Institutes of Health and in Britain by the National Institute for Health and Clinical Excellence (Nice).
One study, in the Journal of Clinical Psychology, has shown that it brings about long-term changes in levels of happiness and well-being, while a major study in Psychological Science revealed such changes help regular meditators live longer, healthier lives. It’s also been shown to be as effective as drugs for treating depression. In fact, it’s now one of the preferred treatments recommended by Nice.
A typical meditation session consists of focusing on breathing and the sensations it creates. This reduces the levels of stress hormones in the body which, in turn, enhances healing and boosts physical health.
It helps partly by teaching you to live in the present moment rather than worrying too much about the past or the future.
Faced with the evidence, I decided to try mindfulness meditation. I began each day with a ten-minute breathing meditation to calm the mind. At bedtime, I would meditate for 30 minutes while visualising a warm, white, healing light sweeping up and down my leg.
This simple meditation programme worked to an astonishing degree. My pain gradually subsided and I slashed my intake of painkillers by two-thirds. I also developed a more contented outlook, seeing my injuries as temporary problems that would gradually subside rather than as limb-threatening ones that might confine me to a wheelchair.
The MBCT is, I’m convinced, why I recovered in double-quick time: the leg frame was removed after just 17 weeks rather than the normal six to 18 months.
My progress astonished my doctors. Just after the final operation I joked with my surgeon that maybe my injuries hadn’t been as bad as I’d thought. He looked at me aghast and said: ‘Your leg was in the Top Five leg injuries I’ve treated with a Taylor Spatial Frame — and possibly higher.’
I still meditate for 30 minutes each day. So convinced am I by its benefits that I’ve written a book, with Professor Williams, that teaches mindfulness meditation.
And my recovery continues apace. Two years ago, at the age of 42, I took up running, and I’m currently hiking the 630-mile South West Coast Path in 50-mile sections. Given the severity of my injuries, that’s astonishing.
In what is being described as a ground-breaking school curriculum addition, the school’s pupils aged 14 and 15 are taking part in the courses designed by Oxford and Cambridge psychologists.
The school’s year 10 pupils’ “mindfulness” course, which will last for two months, is said to be one of the first in the country, which was designed to develop skills in concentration and to combat anxiety.
The school also reportedly said it showed teenagers the benefits of silence and helps them to identify certain “corrosive” mindsets that could lead to mental health problems.
The project is being jointly run with staff at Charterhouse and Hampton schools, which will soon introduce similar classes.
It is being lead by the Mindfulness Centre at Oxford and the Wellbeing Institute at Cambridge.
Richard Burnett, A Tonbridge housemaster who is leading the course, said the course demanded a “culture change” in the perceptions of silence for teachers and pupils.
“One of the things about schools is that silence is associated with power, the teacher tells the pupils to be quiet,” he told The Times.
“What you need to do is convey the idea that silence is a positive activity to be savoured and enjoyed.”
Prof Mark Williams, director of the Mindfulness Centre at Oxford, told the paper that Tonbridge was the first school to introduce a full meditation course in a practical rather than academic context.
“This is not about converting people to Buddhism, but showing there is scientific evidence that these practices are useful,” he said.
“So why deny them from being used?”
Andrew McCulloch, chief executive of the Mental Health Foundation, said that mindfulness training also offered the chance to take proactive steps to avoid depression and anxiety in later life.