Mindfulness practices can make such a profound impact on the seemingly small, everyday interactions in life – and this can add up to major positive changes for patients.
That’s why I asked my friend Elisha Goldstein, PhD to share some insights on using mindfulness in clinical practice. Elisha is a Clinical Psychologist in private practice, Co-founder of The Mindfulness Center for Psychotherapy and Psychiatry in West Los Angeles, and author of the upcoming book The Now Effect: How This Moment Can Change the Rest of Your Life.
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Every moment of our lives our brains are rapidly taking in information and making snap judgments, interpretations and decisions based on what we see, hear, smell, touch, and taste. Depending on how we’re feeling we’ll interpret it differently. I sent out a request to a popular person in the media to review my latest book The Now Effect: How this Moment Can Change the Rest of Your Life and I received silence. My mind started creating this story about how she thought I wasn’t worth her time. I started feeling angry, slighted and a bit hopeless.
A week later she got back to me saying, “Sounds great, let’s get something going.”
Even though I believed my thoughts represented reality, this was yet another lesson of the truth that our thoughts are not facts. A lot of us live without an awareness of this, operating mostly from a state of auto-pilot, sleepwalking through life. The good news is we can train our minds to become more aware of this automaticity, get perspective and tune into what really matters.
Here’s an example I often do with my own patients to illustrate why we don’t need to believe everything we think:
Scenario one:
You’re walking down the street feeling particularly depressed, heavy, and hopeless one day and see a friend walking by. The friend looks up at you, but just continues walking without saying hello.
What thoughts come to mind? How do you feel now?
Scenario two:
You’re walking down the street and feeling pretty well, you’re feeling light on your toes, warm, with a smile on your face. A friend walks down the street and looks up at you without saying hello.
What thoughts come to mind now?
Most people I do this with usually respond to the first scenario with some self-blame or self-judgment. “What did I do,” “He hates me,” or “I’m no good.” Most people respond to the second scenario with a curiosity about what is going on with the other person. “Is he having a bad day,” “that was strange,” or “I hope he’ll be ok.”
The fact is thoughts are temporary and fleeting and when we’re not feeling well, our minds become a magnet for negative thoughts and skewed interpretations of what is going on. When we start thinking and ruminating on these thoughts, they tend to create a snowball effect on the rest of our constitution. If we cling to exaggerated negative thoughts in our minds, (e.g., “he didn’t look at me, that’s because I’m fat, nobody likes me and nobody ever will”), this will certainly have an effect on how our bodies feel, bring on emotions of anxiety, sadness, anger, or others, make us feel like isolating and before we know it, we are either in a full blown depressed mood, a panic attack, or both.
You might say, “Well, I can’t help it, this just happens and I feel I have no control.” I would say that in that moment, you might feel that way because you are unaware of the cycle that is hijacking you. You are caught in the future worrying about the terrible things that could be, or caught in the past with memories and regrets of things you wish would have been different.
There might really be feelings of sadness, anger, or shame there. The moment you notice this is the moment you are sitting in that space between stimulus and response, a space of clarity and choice and that is The Now Effect. The more the now effect occurs, the more often you’ll start noticing it like moments of grace throughout the day.
In this space of awareness we can apply some mindfulness. Practicing mindfulness means to acknowledge the feelings that are there, not judge them as good or bad, but let them be. This may bring up healing feelings of self-compassion and calm as you realize how much you are suffering in the moment. When you notice self-judgments arise, you can label them as such, and gently bring your mind back to just being with the feelings that are there.
There is a more gentle, compassionate and healing nature to this approach than the usual cycle of self judgment and critical mind that we’ve been used to for so long. This is not to say don’t ever have judgment or think about the past or future, but to do it on your watch rather than letting your mind run off with it and deepening your suffering.
Here are 4 steps to increase your chances of breaking free from a downward spiral and experiencing the Now Effect:
- Intentionally be on the lookout for the mind snowballing or when you’re in a low mood. This will prime your mind to pop out of it more often.
- Bring awareness in that moment to how you are feeling. Name the feelings if possible.
- Think about how your interpretation of the situation may be influenced by the mood you are in.
- If you are feeling an uncomfortable emotion or pain, apply some self-compassion and do something pleasurable or kind for you that day. This will send the message internally that you care for yourself and allow for the discomfort to come and go quicker as it naturally would.
As you practice and repeat this with intention, like all things, it will start to become more automatic. In other words, rewiring a healthier and more mindful auto-pilot.
Please leave a comment below – have you tried any of these practices with your patients? What was the result?
As a therapst working in the field of addiction, i truly embrace the practice of mindfulness & bring it to my patients. Being in the NOW, opens us up for endless possibilities. I am sure your book will be a good source of inspiration.
Thank you for your article. I will order the book, add it to my library, and share the information with others.
I’ve practiced mindfulness for close to 40 years. It was very slow going at first and well worth the practice. I’ve also taught introduction classes. Feedback from many participants has been excellent.
Thank you.
Thank you all for your wonderful comments. For Patricia, Yes, agreed” grinning and bearing not the attitudes we want to bring with acceptance. It may be better than pure avoidance, but we want to espouse more of a warm and welcoming quality. I discuss this in The Now Effect.
Lynne, I’m not a psychiatrist, but I know many who use drug treatment as a last resort. However, sometimes meds can truly be skillful. There are many psychology programs that are now integrating mindfulness and psychotherapy, even mainstream ones. Some include itp.edu, ciis, UCLA, Harvard, Stanford, and many more.
Warmly,
Elisha
I would like to practice mindfulness and psychotherapy. I have an MD, and cannot decide whether I should pursue training as a psychiatrist or psychologist. Are there programs in the US in psychiatry that specialize more in mindfulness and psychotherapy, versus just dispensing drugs?
I love all you have to say. I think the next question, however, is to know when and when not to respond to unfair, hurtful situations. In a way, just accepting everything leaves one rather adrift in terms of having received the reactive treatment from others, particularly when they have authority.
I do not think it is a good policy to just “grin and bear it” through accepting everything. Maybe that is not true and I just have to learn how to do that more graciously.
Hi Elisa
Very simple way taming the mind without believing what we think is not always correct. I must certainly read this book
Much appreciated & Thanks a lot
12-steppers are fond of saying “Don’t believe everything you think.” This practice has been around for a long time– and many of us continue to need reminding and practice to do what we know works.
Thank you so much. You have put so well and so succinctly what I’ve struggled to impart to others. “THE SPACE between stimulus and response” sums up the work so well. I will definitely recommend your book!!
Thank you so much for these clear hints, they are so useful and easy to use as related to the usual day. I will post the 4 steps up to remind myself and to keep up with the Now Effect.
Thank you for your kind words Christine,
Radical Acceptance by Tara Brach is a wonderful book speaking to the effectiveness of accepting things as they are instead of reacting with aversion.
The Now Effect weaves mindfulness, psychology and science with practical ways and links to short videos if you like, to help you put this into practice in daily life. ~ Enjoy
love your examples. Am currently reading a bok called radical Acceptance of Everything aand I believe more acceptance assists me to master mindfulness. How do you feel aboutthis?
Thanks for this practical piece, and the reference to the book.
Hello everyone,
Thank you for your wonderful notes about the article and The Now Effect. May it be a source of clarity and positive change to you and the people you know. To answer some questions, Lily, my experience with Mindfulness and Psychotherapy has taught me that sometimes the best mindfulness is knowing when not to employ a formal practice. Meaning, the moment a person recognizes that they are overwhelmed to a high degree of anxiety is a moment of clarity. That is what I call The Now Effect. In this space of awareness they have a choice, and perhaps the best choice is employing what I call, “The Great Art of Distraction.” Helping clients know that it’s okay to get outside, go on a walk, or hold onto a ice cube as a way to come into the body and down from the automatic negative thoughts (ANTS) is perfectly fine.
I also like Jeffrey Schwartz’s thoughts around teaching people that OCD is a kind of Brain Lock that cycles scary thoughts and to say, “It’s not me, it’s the OCD” helps impersonalize it, putting us once again into that space of awareness, that choice toward a more skillful response. Of course, my response is limited as just a comment in this box, but I hope this was helpful in some way,
Elisha
Great application! Thank you for sharing it! I’ll put it to use today! Would love to have gotten into the mindfulness and psychotherapy program, but have had a difficult financial year (had to replace my home heater, my car transmission and my water heater within the last 8 months) and am trying to catch up. I’m wondering if in the future you might consider offering the program with a payment plan, whereby a person could incrementally pay for it? Many thanks for all you do!
Elisha,
I really like your style and ease in writing, making this material very accessible for a general audience. As a psychologist for 26 years, I approach the subject with great respect and teach and use mindfulness daily to children and adults in my practice. In my opinion, the way you illuminate the space between stimulus and response is very valuable and well done. I am the director of a wellness center and most of my colleagues use and teach mindfulness and I will share this with them. Thank you!
using mindfulness has been a foundation in all my work since I was introduced to it by Ruth! But for the first time I have a client for whom it doesn’t seem to work. He has severe anxieties, panic attacks, and OCD and he says that thinking about what he’s thinking keeps him in scary loops. I wonder if you might have some advice?
Many years ago I was shown relaxation and meditation. Over the time it has been my most-used tool as I teach new doctors how to meet with their patients. thank you for this very concise and useable reminder.
Thank you for this book! I teach my clients mindfulness as a path of self-loving and empowerment. This higher level of calibration has more “pulling” or magnetizing power to receive goodness into our lives.
Very clearly defined information! this matched what I was experiencing this morning. I became aware that I was being hijacked by my fear. As I began tapping with EFT on the side on my hand and followed my process of words with the tapping. I discovered my early attachment to neg images and an early belief that the universe is harmful. Who is creating this sensitivity I ask? I am was the answer as I tapping figoriuosly on my upper chest than middle chest and than lower chest. I was finally no longer caught in the cycle you spoke of and I understand what it mean’s and how it feels to be present in the now not the drama. Thanks you so much for languaging and seguence it so clearly.
Thank you for sharing this. we get so quickly caught up in scenarios that it is hard for most of us to stop, pause, and choose which way to move or think. And all it takes is staying in the Now, noticing what is going on choosing what’s next. When we are down in the dumps this isnt easy… we need to find some way of reminding ourselves in the moment.
Thank you for sharing this. I’m using mindfulness practices with me and often I forget I really can just be in the present moment. I’m at the beginning in my professional experience, and I’m still studying psychology at the university. With my own clients I’m proposing self-observation, especially on what they’re feeling but not what or how they’re thinking about what they’re feeling! That is a very important thing to remember. And even if now I’m judging myself… I’m taking a deep breath, and looking forward to discover my thoughts, now.