MINDFULNESS

Mindfulness is a state of being in awareness and paying attention to the present moment without judgement.  One notices what is happening and responds through choice rather than being driven by habitual reactions [1,2]. You intentionally observe and become aware of your subjective experience – your thoughts, sensations and feelings – without judgement or resistance. You can be mindful when eating, breathing, thinking, hearing, sitting, walking, and in many other ways.

Existing research supports mindfulness and mindfulness-based approaches such as Acceptance and Commitment Therapy (ACT) as being beneficial in managing anxiety, depression, chronic pain and other chronic medical conditions. Mindfulness-based practices can cultivate acceptance of chronic conditions, increase psychological flexibility and potentially also lead to better self-management [3-5]. The goal is to change a person’s relationship with an adverse experience or condition, rather than change or get rid of it [6]. An approach that focuses first on improving functioning as opposed to eliminating or controlling symptoms proves to be beneficial [7].

MY RESEARCH FINDINGS

When I did the research for my Master’s degree, one of the findings was that the use of mindfulness-based interventions can be effective in managing withdrawal symptoms. This has also been the feedback from many of the people I have supported, especially within the last 5 to 6 years.

Four of the participants in my research study reported that their use of a mindfulness practice and approach was the most effective coping tool during their withdrawal.  One was referred to a mindfulness course by her counsellor and another consulted a mindfulness practitioner. Two others were taught mindfulness techniques by their counsellors. One participant identified it as the only helpful aspect of his counselling experience:

“I would say the mindfulness training is the one thing that has been of great help. The contact doesn’t focus on trying to find a meaning in my symptoms, with my thinking, but rather on tools that allow me to accept and come to terms with it, and to allow me to accept the pain and be present with the pain. Those are things that have really helped with my general approach to all of this.”

One participant found her mindfulness course to be beneficial and says she now uses it as part of her self-care regimen. Another said she also used mindfulness to cope with the symptoms and continues to use it post-recovery:

“She showed me how to use mindfulness to deal with the symptoms and that really helped. For me, that was the most useful thing because I was able to stop fighting what was happening and to accept it, and now that I am better I still use mindfulness so it still continues to help me in day-to-day life. That and the reassurance were my life-savers.”

One participant said he was at first hesitant but later found it to be effective as a coping technique:

“He made me sit in the therapy room and pay attention to my breathing and the pain and the agitation and he told me to accept everything that was happening, to tell myself it was normal for anyone in my situation. We did a lot of those exercises. In the beginning I didn’t think it would work but after a while I would do it at home too and I was surprised at how much it helped me to cope with the symptoms.”

I thought I would share these narratives with you as they demonstrate that mindfulness can be effective as a coping tool during withdrawal and that it can be of benefit outside of the withdrawal context, in normal daily life.

THE PRACTICE OF MINDFULNESS

By sensing your breath, your body and your immediate environment, you remain fully present and aware, and mental distractions are effortlessly removed. Mindfulness is an excellent skill to practise when coping with withdrawal – a time when you may be prone to worrying thoughts about symptoms and recovery. It can be used to take a step back from your situation and to reduce the impact that withdrawal may be having on your life. It is also a valuable tool to use in everyday life.

Mindfulness Exercise

The following simple exercise will give you an idea of how mindfulness works. It is not used to stop the mind but it will help you to gently release any thoughts of the past or future and redirect your attention to the present moment by focusing on the breath.

– Find a comfortable position and close your eyes.
– Focus your attention on your breathing. Simply pay attention first to the sensation of your breath as it flows in and out of your nostrils.
– Feel your stomach/abdomen rise and fall as you breathe in and out (rising when you inhale and falling as you slowly release the breath).
– Continue to focus your attention on the flow and rhythm of your body as you breathe in and out.
– If thoughts enter your mind (as they probably will), gently acknowledge them and return your focus to your breath.

Do this for as long as you feel comfortable – for as long as it feels right for you. The more you practise, the more natural it will feel and the longer you will be able to do it.

You can further extend this basic exercise by moving your attention to the body as you breathe. Place your awareness on one area at a time and notice the sensations. Does it feel cold, warm, tight, sore, tingling? Simply observe, again, without judgement. Just be present. Then start listening to the sounds around you, with no analysis or thoughts. If you find yourself doing this, gently acknowledge and bring your focus back. All you need to do is listen. Then when it feels right for you, prepare yourself to open your eyes and slowly do so. You can then ground yourself by:

– Slowly open your eyes and look around as if you are seeing for the first time.
– Settle your eyes on an object for about 15 to 30 seconds. Don’t analyse or evaluate it; just observe it. As you do this, maintain an awareness of your breathing, your body and any sounds around you. Then let your eyes rest on another object for a minute or two, until you are ready to get up.

If there is one technique that will be useful for everyone post-recovery, especially if there were problems with anxiety, insomnia or any psychological issue, it is mindfulness. Try it and see. If you do, I hope you will enjoy it!

References:

1. Kabat-Zinn J (2004) Wherever You Go, There You Are: Mindfulness Meditation in
Everyday Life. Piatkus, London.

2. Burch V (2008) Living Well with Pain and Illness: The Mindful Way to Free Yourself
from Suffering. Piatkus, London.

3. Simpson R, Byrne S, Wood K, Mair FS, Mercer SW. Optimising mindfulness-based stress
reduction for people with multiple sclerosis. Chronic Illness. 2018;14(2):154-66.

4. Kuba, K. Weibflog G. Acceptance and Commitment Therapy in the Treatment of Chronic
Disease. Psychotherapie Psychosomatik Medizinische Psychologie. 2017;12:525-536.

5. Graham, CD, Gouick, J, Krah´e, C, Gillanders, D. A Systematic Review of the Use of
Acceptance and Commitment Therapy (ACT) in Chronic Disease and Long-Term Conditions,
Clinical Psychology Review. 2016:46:45-58.

6. Harris, R. (2009). ACT made simple: An easy-to-read primer on acceptance and
commitment therapy. Oakland, CA: New Harbinger Publications.

7. Graham, CD, Stuart, S, O’Hara, D, Kemp, S. Using Acceptance and Commitment Therapy
to Improve Outcomes in Functional Movement Disorders: A Case Study. Clinical Case Studies,
2017;16(5):401-416.