March 31, 2012

Saying No to Say Yes

Saying no isn't easy. Even if we already have a lot on our plate and already feel time-crunched, we say yes to supervising a new project at work, planning a friend's baby shower, organizing a camping trip, editing a colleague's grant proposal, teaching a weekly yoga class, joining a weekly pub trivia team, feeding the neighbour's cat, and volunteering at church. For various reasons--it's hard to say no to our boss and colleagues; we don't want to miss out on a cool opportunity; we don't want to disappoint our friends, partners, parents, or children--we often say yes to requests, opportunities, and activities when we might be happier or less stressed out if we said no.

I read a line a few days ago that I'm going to keep in mind the next time I'm having a hard time saying no:

Saying "yes" to more things that we can actually mange to be present for with integrity and ease of being is in effect saying "no" to all those things and people and places we have already said "yes" to.

This line (from Coming to Our Senses: Healing Ourselves and the World Though Mindfulness by Jon Kabat-Zinn) resonated with me because non-present is exactly how I feel on days when I've said yes to too many things. At the end of the day, even as I'm congratulating myself for being so efficient and productive, I usually realize that I missed something important that a client said, that I barely remember a conversation with a friend or colleague, or that I ate all three meals on the subway.

The idea that saying yes too often is really a way of saying no is great because it means that saying no is a way to say yes to established commitments and priorities. For example, say you and your partner have reserved Sundays for family time with the kids; when you're regretfully say no to brunch with friends, you can remind yourself that you're saying yes to your family. If you're supervising two projects at work or teaching two classes and you're receiving pressure to take on a third, you can remind yourself that saying no to a third class or project is a way of saying yes to the first two.

The next time you're having a hard time saying no to a request or opportunity, consider all of the things you'll be saying yes to. Let me know if if helps!

March 28, 2012

Mindfulness

Last January, I wrote about how mindfulness was taking the psychology world by storm. One year later, interest in mindfulness hasn't abated; if anything, it's grown--in my personal world, in the mental health field, and in Western culture at large.

What exactly is mindfulness again?

Mindfulness involves purposeful attention and awareness in the present moment, with acceptance and without judgment. Let's look more closely at the four key components of the definition, all of which overlap:
  • Being in the present moment: Being mindful means being present no matter what you're doing. It means that when you talk with someone, you listen and actually hear and respond to what he or she says, rather than thinking about what you did earlier in the day, or only half paying attention while you smile and nod automatically. It means that when you eat dinner, you actually taste and appreciate your food, rather than reading while you eat or fantasizing about dessert or about what you're doing later.
  • Awareness: Mindfulness means being aware of what's going on inside and around you, a kind of "waking up" to your life. The idea is that we sleepwalk through a lot of our days, without questioning our habits, routines, and reactions, and without noticing the impact they have on us and on the people around us. Mindful awareness means that when you find yourself doing something unusual or unhelpful, (e.g., eating when you're not hungry, drinking too much, overreacting to an innocent comment, avoiding your email inbox), you notice your behaviour and ask yourself "what's that about?"
  • Attention: Being present and aware requires focused attention. You can't be in the present moment if your mind is off in the past or the future, and you can't be aware of yourself, others, or your environment if you aren't paying attention. Part of being mindful is cultivating the ability to focus your attention on what's happening now. Minds naturally drift away from the present, but with greater awareness and with meditation training, you develop the ability to notice when your mind drifts off and the discipline to bring your attention back to the present. These skills are cultivated by guided meditation exercises that use various anchors (e.g. the breath, body sensations, sounds in the environment) to increase your capacity for sustained and focused attention.
  • Acceptance and non-judgment: In addition to being aware and attentive to what's happening as it's happening, mindfulness implies a kind of equanimity and acceptance of experience. The idea is that whatever's happening--pleasant or unpleasant--is already happening, and that struggling against the experience or labeling it as awful is unhelpful. We can develop equanimity in the face of any event or outcome by accepting the raw experience, rather than piling on layers of resistance and secondary emotions. Importantly, acceptance doesn't mean resignation; it doesn't mean that you have to accept everything that comes your way and never try to change or improve your circumstances. Rather, it means being aware and accepting of the facts. Accepting that your bus is late, that your partner forgot your birthday, or that you lost your job--rather than denying or resisting--frees up your energy and attention to decide what you want to do about it.
Mindfulness isn't a secret, special, or necessarily spiritual thing or something that happens only during meditation; rather, it's a way of being in everyday life, cultivated by daily meditation. An example of mindfulness meditation is sitting for fifteen minutes simply paying attention to your breathing or just observing sounds in your environment, without judging them or trying to change them. This type of exercise provides the opportunity to practice being aware, attentive, and accepting in the present moment, skills that sooner or later generalize into the rest of your moments, hours, and days.

March 01, 2012

Therapy Gold

Some clients come to psychotherapy because they are entirely non-functional and need help establishing the basics--routine eating and sleeping, and a reasonable degree of physical comfort, financial stability, and social support. Other psychotherapy clients are already highly functional and fairly content, but want help tweaking their life to achieve better relationships, a more meaningful career, or less stress.

Which type of client is more rewarding to work with? Is it better to slightly improve the already-good quality of life of high-functioning clients or to work with low-functioning clients who improve more slowly but whose progress, even if minimal, constitutes a huge improvement in quality of life?

I've always been partial to the idea of tweaking--of helping high-functioning clients meet their potential and achieve their stretch goals. But last week I had a therapy gold (term I made up in my post about friendship versus therapy) moment that changed my thinking somewhat:

I had a session with an extremely depressed client with a serious chronic medical condition. He was going through a flare-up in his condition and I expected him to report that his mood had plummeted correspondingly; however, when I asked him about mood, he replied that it was stable, good even. He reported that he had been using some of the strategies we had discussed in therapy and then said (and this is the therapy gold part), "I have more control over my situation than I thought I did."

After he left, I practically jumped up and clicked my heels! My singular therapy goal with this client been to improve his mood by instilling a modicum of hope and personal control; the serious joy I experienced at seeing this happen diminished my conviction that working with high-functioning clients is more rewarding.

NB: My cup of therapy joy ran over when, before the client left, I assigned him the What Went Well exercise.