Reflections around Therapy and Well-Being
Habitual patterns of behaviour that don’t serve us well but are difficult to change are a common issue in therapy. In extreme form they can have an obsessive compulsive aspect or manifest as an addiction.
A workbook* for overcoming obsessions and compulsions, makes it clear that avoidance is a key component of OCD behaviour. The understanding is that the obsessive compulsive behaviour is an attempt to create a sense of security, albeit temporary and illusory. Underpinning this type of behaviour is an avoidance of the fear or anxiety that would arise if the compulsion was resisted. Moreover there may well be other feelings, perhaps out of conscious awareness, that might surface if the habitual pattern is confronted.
Mindfulness as a way of remaining present with our experience and as a tool to turn towards what we find difficult has become an important component in strategies to help with OCD. Overcoming the avoidance is crucial to the success of these strategies.
A tendency to avoidance may underlie other types of issue that people might seek help for such as depression, lack of self-esteem, or high levels of dependence in relationships. Often habitual patterns are not recognised as such but are seen more as just part of who we are. The underlying avoidance happens outside of conscious awareness.
A key part of the process of therapy is to allow uncomfortable feelings and experience, what we have shied away from and avoided, more into awareness,. Out of this greater self-awareness we develop more perspective on the ways we have attempted to control of our experience, and a greater sense of choice can become possible.
* The Mindfulness Workbook for OCD by J Hershfield and T Corboy
Cultivating a Sense of Embodiment
Often difficulties we experience are associated with being too much in our heads: caught up in obsessive patterns of thinking or being taken over by a critical inner voice.
Mindfulness practice involves turning towards one’s bodily experience and paying attention to it, cultivating a sense of embodiment. This is a way to reduce our tendency to mental preoccupation. It offers an avenue of exploration and also another way of being with ourselves.
Attending to our experience in our bodies, that is the sensations that are arising from moment to moment, we might notice the movement of our lungs and diaphragm associated with our breathing, a sense of our posture, the engagement of some muscles and relaxation of others, We might if we scan through our bodies notice that the feeling tone of sensations changes, more intense in some places, lighter in others.
We might then use this type of exploration to explore a particular state of mind. If our inner critic is active we can try to take our attention to our body and pay attention to the sensations and feelings that are associated with this critical voice. We might notice that a physiological process has been activated - a heightened state of arousal, the tensing of muscles readying for action. We might contact feelings of anger. We might then find other feelings associated with this state such as tearfulness and vulnerability.
A sense of embodiment contributes to a capacity to be with one’s experience even if it is difficult, rather than being overwhelmed by or numbing against it.
Our bodies participate in our emotional and mental life, even if we pay little attention to this. Developing our connection with our bodies can help us make sense of our inner world.
Mindfulness and Emotional Regulation
A key aim of therapy is to enhance a sense of emotional connection both within oneself and in relationships with others.
Many psychological difficulties have, as a component, various forms of emotional disconnection. These can range from a sense of not being in touch with feelings, an emotional flatness, to more obvious forms of emotional dysregulation such as panic attacks and excessive anxiety.
Mindfulness practice and therapy can over a period of time support a process of more healthy emotional connection.
Mindfulness involves bringing one’s attention to one’s experience in the body, not just the breath but at the same time, to the physical and feeling sensations, and to the emotional and mental states that make up one’s overall sense of being alive in each moment.
In directing one’s attention in this way, through what are called the interoceptive senses, one becomes over time more familiar and at home with this inner world of being and feeling
One benefit that can arise from this is a greater capacity to tolerate emotional distress when that is present.
A leading researcher into trauma, Bessie Van der Kolk, emphasises the importance of this capacity in coping with the states of emotional dysregulation that can arise from traumatic experiences.
In his view “you learn self-regulation by noticing, by noticing your distress and continuing to go on even though you notice it”*.
Over time, slowly, the capacity to bear difficult feelings increases, and as a result one can feel more alive.
*NICABM Treating Trauma Master Series- how to help clients tolerate dysregulation and come back from hypoarousal
Reading and Mental Health
A recent edition of Front Row on Radio 4 highlighted the potential benefit of reading as a resource in dealing with mental distress.
The presenter and several contributors talked about how particular books provided some protection and relief from the anxiety and mental disturbance they were experiencing in a period of their lives. The novels of P G Wodehouse and Agatha Christie were mentioned , also War and Peace and the Odyssey. The familiarity of the worlds these books conjured up and sense of order within them were part of their appeal. For some, knowing that there were other books in the same vein meant the safe space created could be returned to many times.
A psychiatrist who suggests reading to his patients stated that it was not about recommending particular books but for each person to find out what worked for them.
This illustrates the benefit of cultivating and being aware of resources in one's life. Activities, places, people, memories that one can find solace and comfort in. Resources which one can turn to when the challenges of living seem to be getting too much.
Click here for the Front Row podcast for October 10th.