Mindfulness & Mental Health: Introducing DBT

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Mindfulness is no longer just for practitioners of Zen and Buddhism but has moved into the mainstream Mental Health counseling. It has become one of the primary techniques employed among many therapists and coupled with meditation has shown tremendous amounts of improvements in otherwise non-responsive patients. As science furthers more and more we are seeing them recognize the benefits of Zen in daily practice. As NAMI (National Alliance on Mental Illness) describes it, “While the combination of therapy and medication is crucial to recovery, the addition of self-awareness tools and skills can also be beneficial. Whether you are just beginning your recovery or are further along on your journey, the holistic practices can be an excellent complement to therapy and medication.”

While many treatment programs employ the use of mindfulness, I will focus on DBT (Dialectical Behavioral Therapy) in my analysis. So what is DBT? “Dialectical Behavior Therapy (DBT), is a comprehensive cognitive-behavioral treatment that was originally developed to treat chronically suicidal individuals suffering from borderline personality disorder (BPD). DBT has been found especially effective for those with suicidal and other multiply occurring severely dysfunctional behaviors. Research has shown DBT to be effective in reducing suicidal behavior, psychiatric hospitalization, treatment dropout, substance abuse, anger, and interpersonal difficulties,” (behavioraltech.org). So what exactly does all that mean? It is a non-judgmental way of the patient accepting that they have a problem with how they think, and rather than judge it, they can make changes to make their thinking more balanced using mindfulness as one of the primary techniques.

What is mindfulness within this context? The best and simplest definition I have come across is, “doing one thing at a time, in the present moment, with your full attention, and with acceptance,” (DBT Made Simple). This can be further broken down into two parts for the patient. First, awareness and focusing on the present moment. The second part is acceptance, and this is the part that seems to be overlooked. This requires not judging what you are doing mindfully. A large percentage of patients respond well to this primarily, in my opinion, because they are taking control of their mind. Most patients, as is the case with most people in general spend far too much time in the past reliving negative things and mindfulness is a way to put a stop sign up to this harmful cycle.

How is mindfulness employed? There are a multitude of ways this is employed in your everyday life, but I will briefly cover seven of them:
1. Counting breaths. Count your breaths up to ten. One on the inhale and two on the exhale and so on. When you find your mind has wandered, simply return to counting your breath without judgment.
2. Observing sounds. Sitting silently focus your mind on any sounds which you hear: the sound of your breath, the traffic outside, the air-conditioner, etc. When you catch your mind wandering, take note of it without judgment and return to observing sounds.
3. Observing an object. Pick an object, any object. Examine the object with all of your five senses. Touch it. Smell it. Take note of any sound it makes when you move it. When you mind wanders, simply bring your attention back to the object.
4. Observing your thoughts in a cloud. Also could be called labeling your thoughts. You imagine yourself lying in a field of grass looking up at the sky. In each cloud is a thought and as it floats by you label what kind of thought it is without judging yourself for having that thought. For instance if you think this is a stupid exercise, that would be an anger thought. If you think how will I pay my house payment next month, that would be a worry thought.
5. Focusing on a thought. Pick a meaningful thought or short sentence and focus on the thought as you breathe. For instance if you think wise as you breathe in and think mind as you breathe out. When your mind wanders return to your thought without judging yourself.
6. Being the gatekeeper to your mind. This is more simply observing your thoughts. As a gatekeeper would watch people coming through a gate, you will simply experience and observe each thought as it passes over you without judging it. Experience thoughts and emotions as they come to you, do not try to block them. When your mind wanders or you feel yourself trying to stop thoughts simply return to the practice of observing them without judging the thoughts or yourself.
7. Being in your body. Quietly sitting, focus on the different sensations you experience in your body. For example, the feel of your bottom on the chair or your arms against the armrests. Take notice of any emotions you might be feeling, such as worry over a presentation you have at work next week. When your mind wanders simply return your thoughts to your body without judgment.

Mindfulness: I’m too busy and other excuses…

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The practice of mindfulness takes patience and dedication and the litany of excuses not to practice are endless, but I will attempt to debunk a few of the more common ones.

“It makes me more anxious”

Some people, especially people with anxiety issues, find practicing mindfulness increases their anxiety.  This is an understandable reaction, but not enough to give up on the practice.  It is often found that the exercises focusing on breathing cause the most anxiety.  Simply focus on the non-breathing focused exercises to begin and once you become comfortable with mindfulness practice come back to the breathing exercises.

 I just can’t do it

What exactly does the person mean by this?  Is it just too hard?  Are they having difficulties concentrating?  Do they believe to be successful thoughts and feeling never intrude?  Many people say they can’t do it when they just mean it is really hard.  Truth is practicing mindfulness is a hard skill and the only way to get better is to keep pursuing it.

I don’t have time

This is one of the simplest problems to fix.  You can practice mindfulness anytime, doing anything.  If what you mean is you don’t have time for formal practice, let me remind you some of the exercises only take a few to ten minutes.  It is better to spend 10 minutes fully dedicated than an hour half-heartedly.  Try setting aside 10 minutes in the morning to practice mindfulness.

I can’t stay focused

Mindfulness is simply about staying in the present moment with acceptance.  Please throw any other expectations out the window.  The object of practicing mindfulness for many is to feel better.  It is with this in mind that we reach a paradox.  To feel better you must practice mindfulness, but if you focus on feeling better you have trouble staying focused on mindfulness.  So throw away the goal while practicing mindfulness and you will achieve that goal.

I fall asleep

Some people find they drift off when they practice mindfulness.  If the person has trouble sleeping this can be a good thing, simply practice mindfulness of part of your preparing for bed routine.  There are several factors to consider if this is a common issue:

  • Do you need more sleep? If you are sleep deprived your body will want to take advantage of this quiet time.
  • Is there a better time of day to practice? If at the end of the day you are always exhausted, simply begin practicing in the morning.
  • Did you eat a big meal shortly before practicing? Watch out for a food coma!
  • Is there a different position you can try? If you practice mindfulness lying down, simply try it is a sitting position.
  • Are you closing your eyes? Keep your eyes open while practicing.

You have to plan for the future

Some people believe that practicing mindfulness means you never consider the past or the future.  This simply is not the case, but you may be able to do those things mindfully whereas you do not currently.  Often planning for the future isn’t planning at all, but instead it is worrying.  Mindfulness actually helps you in planning for the future by keeping you grounded in reality of the present moment.

The Sixteen Bodhisattva Precepts

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THE THREE TREASURES

  • Taking refuge in the Buddha
  • Taking refuge in the Dharma
  • Taking refuge in the Sangha

The Three Pure Precepts

  • Do not create Evil
  • Practice Good
  • Actualize Good For Others

 The Ten Grave Precepts

  • Respect life – Do not kill
  • Be giving – Do not steal
  • Honor the body – Do not misuse sexuality
  • Manifest truth – Do not lie
  • Proceed clearly – Do not cloud the mind
  • See the perfection – Do not speak of others errors and faults
  • Realize self and other as one – Do not elevate the self and blame others
  • Give generously – Do not be withholding
  • Actualize harmony – Do not be angry
  • Experience the intimacy of things – Do not defile the Three Treasures

Mindfulness Training

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Other than meditation how should I practice mindfulness?

 Walking Practice

  • “Kinhin” is Sanskrit
  • Slowly walk, a step on a three count
  • “Walking not in order to arrive, but just to walk.” ~ Thich Nhat Hanh

Chanting

  • Mantras or whole Sutras are chanted
    • Attunes the mind and body

 Bowing

  • Expression of respect or veneration
  • Greeting, thank you, or to take leave
    • Palm-to-palm, slight bow from the waist
  • Gratitude
    • Bow at waist, drop to knees, forehead to floor
  • Prostrations
    • Full Body Bow
      • “The act of unself-conscious prostration before a Buddha is … possible under the impetus of reverence and gratitude. Such “horizontalizings of the mast of ego”cleanse the heart-mind, rendering it flexible and expansive, and open the way to an understanding and appreciation of the exalted mind and manifold virtues of the Buddha and patriarchs. So there arises within us a desire to express our gratitude and show our respect before their personalized forms through appropriate ritual”  ~ Phillip Kapleau

Zen Practices of Mindfulness:

  • Akido
    • A dynamic defensive activity involving body movement and sparrinh with a short staff or sword.
  • Brush Painting
    • The fully engaged process of tapping and releasing energy to create an especially powerful composition.
  • Haiku
    • A seventeen-syllable poem (3 lines of 5-7-5) capturing the essence of a subject.
  • Ikebana
    • The arrangement of flowers in a spiritually and aesthetically satisfying manner.
  • Karate
    • A weaponless form of self-defense aimed at disarming an opponent or rendering his hostile motions harmless.
  • Kyudo
    • A form of archery combining spiritual and physical training.
  • No Drama
    • A style of theatre aimed at the direct communication of experience and emotion.
  • Pottery Making
    • An approach to making pottery that conveys special respect for the materials and process.
  • Shakuhaci
    • The playing of a bamboo flute in harmony with the breath and the emotional force moving the breath.
  • Tea Ceremony
    • An especially graceful and aware preparation of tea and management of the tea-partaking interchange between host and guest.
  • Zen Gardening
    • A meditative approach to creating, tending, and enjoying a garden

What Is Meditation?

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What is meditation?

“Meditation is a conscious effort to change how the mind works. The Pali word for meditation is ‘bhavana’ which means ‘to make grow’ or ‘to develop’.”
~ Buddhanet.net

Well that was an easy and painless post… not quite. What really is it? How do you do it? What different types are there? I get so many questions about this subject when it comes up that I am a practicing Zen Buddhist. Let’s hope what follows will make it a little more clear as we briefly cover these questions while discussing five different types of meditation. I practice Zazen, so it is the one I know the most about but I have experimented with the other forms and am pretty familiar with all of them to a degree.

First, how do you meditate? All of them in general have the same basic form:
1. Sit comfortably in one of the following positions (The uppermost being the most ideal, but whatever is comfortable):
a. Full Lotus (legs crossed with each foot resting on the opposite thigh)
b. Half Lotus (legs crossed with one foot resting on the opposite thigh; the other foot on the floor)
c. Burmese (thighs spread so that the knees are resting on the floor and both feet are close to body)
d. Kneeling with a cushion or bench
e. Sitting in a chair (feet flat on floor and the back away from back of the chair)
2. Spine straight.
3. Head up.
4. Hands in proper mudra.
5. Eyes slightly open and unfocused.

Zazen
This is the form of meditation I personally practice and is practiced by Zen Buddhists and means “just-sitting”. The goal is to free the mind of ANY kind of thinking. Beginners are often suggested to follow their breath or count their breaths. This helps in allowing you to clear the mind.

The Soto school of Zen practices what is known as shikantaza, which means “nothing but sitting.” While the Rinzai school practices Zazen and Koan study. “Koans are a paradoxical teaching question or story designed to confound linear, rational thought, and therefore to help condition the mind for enlightenment” (Essential Buddhism by Jack Maguire) The koans serve as a meditation catalyst and not purely the focus of the meditation.
For a more detailed explanation watch the following video by the late great John Daido Loori of Zen Mountain Monastery describe Zazen:

I will briefly discuss the other forms of meditation:

Samatha Meditation
Translated as calm abiding meditation practiced by Theravada school. You focus the mind on something in particular: observe the breath at the tip of your nose, sound of the rain, sound of traffic, etc. Additionally some focus on a virtue such as compassion or loving-kindness.
Vipassana Meditation
This is what is known in this country as insight meditation and is practiced by the Theravada school. Your primary focus is on your own thoughts and feelings.
Mantra MeditationUse of a power laden syllable or series of syllables, such as Om. You use a constant still repetition such as the more complex myoho-renge-kyo (glory to the lotus sutra).
Visualization Meditation
This form of meditation is practiced by the pure land school. You mentally envision an image, often a Buddha or a particular bodhisattva.

In an upcoming post I will cover ways to be mindful besides meditation in your everyday life and your spiritual practice.

 

Buddhism: The Four Noble Truths

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  1. All life is suffering.
  2. The cause of suffering is desire.
  3. Suffering can be ended.
  4. The way to end suffering is the Noble Eightfold Path.

Commentary:

All life is suffering.  

The common translation of the Sanskrit word duhka is suffering.  It also has several other translations including: unsatisfactory, imperfection, bothersome, incoherence, and possibly most importantly impermanence.  These words are important to keep in mind while considering the Four Noble Truths.  It basically comes down to we are mortal, hence we age, get sick and die eventually.  You must also consider the fragility of our possessions and the instability of our relationships, fortunes, moods, thoughts and convictions.

The cause of suffering is desire.

Desire.  The cause of suffering is desire.  One can simply rationalize that upon reading those lines.  To fully understand it in a Buddhist context you must consider the word desire comes from the Sanskrit word trishna, which also means thirst and craving.  Additionally the concept in Buddhism of no-self is important here especially how it breaks away from the Hindu concept of a self that is passed on in a soul-like form from one lifetime to the next.  This touches on the break in how Buddhists consider you are reborn from one lifetime to the next with some casual influence depending upon your past life, whereas Hindu believe in reincarnation with the soul being passed on between lifetimes.

Why is this important?

The Three poisons are: greed, anger, and ignorance which all feed into desire and the urge to win, or to overpower.  Buddha’s teaching was the self does not exist as a spiritual entity, but is the name given to a temporary personality made up of five important factors.  Buddhism taught these factors or aggregates are: matter (eyes, ears, nose, tongue, body and mind), sensations (raw data of these senses), perception (naming of the sensations), Mental formation (best summarized in the Buddha’s words, “We are what we think.”), and consciousness (awareness of the perceptions).  From which you can conclude, “suffering exists, but not the sufferer” as Buddhaghosa did in the fifth century.

Suffering can be ended.

This is the good news, which moves us on to four with little explanation needed.

The way to end suffering is the Noble Eightfold Path.

  1. right understanding
  2. right thought
  3. right speech
  4. right action
  5. right livelihood
  6. right effort
  7. right mindfulness
  8. right meditation

This is not a list that can be broken down and followed in a linear path.  Most people will find right speech much easier than right thought for instance.  It may be the most difficult.  I will explain the Eightfold Path in an upcoming post in detail.

“Someone whose faith is not grounded in reason is like a stream of water that can be led anywhere” ~ Tibetan Proverb