Copyright

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This edition published by HarperThorsons 2014

Text © Michael Chaskalson 2014

Illustrations © Nicolette Caven

Cover photograph © Flint/Corbis

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Michael Chaskalson asserts the moral right to be identified as the author of this work

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Contents

Cover

Title Page

Copyright

Praise for Mindfulness in 8 Weeks

Introduction: Mindfulness Is Everywhere

Box 1: A Small Digression into History

Box 2: Mindfulness-Based Cognitive Therapy

Box 3: How Did the Course at the Heart of This Book Come to Be Formulated?

Box 4: The Effects of Mindfulness Training

Week One: Automatic Pilot

Box 1: The Raisin Exercise

Box 2: Unhelpful Automatic Routines

Box 3: The Body Scan

Box 4: If I Had My Life to Live Over

Box 5: Tips for the Body Scan

Box 6: Stream 1 Home Practice for Week One

Box 7: Stream 2 Home Practice for Week One

Week Two: Mindfulness of the Breath

Box 1: Postures for Meditation

Box 2: Mindfulness of Breathing Meditation

Box 3: Four Key Skills

Box 4: Mindful Attitudes

Box 5: Stream 1 Home Practice for Week Two

Box 6: Stream 2 Home Practice for Week Two

Box 7: Pleasant-Events Diary

Week Three: Mindfulness of the Body Moving

Box 1: The Old Lady and the Fish Basket

Box 2: Change Takes Time

Box 3: The Three-Step Breathing Space

Box 4: The Physical Barometer

Box 5: Approach and Avoidance

Box 6: Empathy and Body Awareness

Box 7: Narrative Mode, Experience Mode

Box 8: Stream 1 Home Practice for Week Three

Box 9: Stream 2 Home Practice for Week Three

Box 10: Unpleasant-Events Diary

Week Four: Managing Reactions

Box 1: The Two Arrows

Box 2: Instructions for Walking Meditation

Box 3: What Is Stress?

Box 4: Mindfulness of the Breath and Body

Box 5: Mindfulness of Sounds and Thoughts

Box 6: Choiceless Awareness

Box 7: The Neurophysiology of Stress

Box 8: Stream 1 Home Practice for Week Four

Box 9: Stream 2 Home Practice for Week Four

Week Five: Letting Things Be

Box 1: Another Way of Being with What Is Difficult

Box 2: The Guest House

Box 3: ‘Sitting with the Difficult’ Meditation

Box 4: Relating to Aversion

Box 5: Using the Three-Step Breathing Space to Cope with Difficulties

Box 6: Stream 1 Home Practice for Week Five

Box 7: Stream 2 Home Practice for Week Five

Week Six: Recognising Thoughts and Emotions as Mental Events

Box 1: Mindfulness and Mental Proliferation

Box 2: Mindfully Relating to Thoughts

Box 3: The Cookie Thief: A Parable

Box 4: So Why Don’t Zebras Get Ulcers?

Box 5: Unhelpful Patterns of Thought

Box 6: Using the Breathing Space to Work with Thoughts

Box 7: Stream 1 Home Practice for Week Six

Box 8: Stream 2 Home Practice for Week Six

Week Seven: Taking Good Care of Yourself

Box 1: What If There Is No Need to Change?

Box 2: Stress – and Its Effect on Kindness and Compassion

Box 3: Mindfulness and Compassion

Box 4: Stress Indicators and Action Strategies

Box 5: Nourishing and Depleting Activities

Box 6: Stream 1 Home Practice for Week Seven

Box 7: Stream 2 Home Practice for Week Seven

Week Eight: Living Mindfully

Box 1: 21 Ways to Stay Mindful at Work

Further Resources

Further Reading

Notes

List of Searchable Terms

List of Audio Files

About the Author

Acknowledgements

Permissions

About the Publisher

Praise for Mindfulness in 8 Weeks

This book is a real joy ... Michael has laid it out clearly, succinctly and approachably. It’s a wonderful mix of clear, practical guidance and sound scientific evidence. Read this book, follow and practise the guidance, and enjoy the fruits!

Rebecca Crane, Director, Centre for Mindfulness Research and Practice, Bangor University

Before I met Michael I thought I knew all there was to know about my thoughts. I was wrong.

Eight weeks on I knew a feeling of space and calm. The internal chatter of my mind was there but not so demanding or noisy. Instead, I was just enjoying a new sense of seeing the world as it is rather than as the setting for my own thoughts.

David Sillito, Media and Arts Correspondent, BBC

This book provides a highly accessible way for people to learn mindfulness, experience its potential to relieve suffering, and cultivate joy, compassion and wisdom.

Willem Kuyken, Professor of Clinical Psychology, Exeter University

Mindfulness in Eight Weeks is a clear, practical and wise companion as you embark on the journey of transformation outlined in the book’s programme. With its balance of scientific knowledge, detailed meditation instructions and tips on how to bring mindfulness into daily life, it is indeed a trustworthy and accessible manual as, step by step, you change your mind and change your life.

Vidyamala Burch, Author and co-founder of Breathworks CIC

A great book for both novices and those familiar with mindfulness practice – I highly recommend it.

Mark Williams Co-Author of the bestselling Mindfulness: A practical guide to peace in a frantic world

The ideas and practices discussed here truly change lives.

Dr. John Teasdale Co-Author: Mindfulness-Based Cognitive Therapy for Depression

As we campaign in Parliament and in government to raise awareness of the benefits of mindfulness training more generally, I hope this new book will open many more eyes to the great benefits that are so readily available with mindfulness practice

Chris Ruane MP

Introduction

Mindfulness Is Everywhere

When I first started practising mindfulness in the UK back in the 1970s, very few people outside of Asia had heard of it. Now it’s everywhere. TIME Magazine devoted a recent cover to it, US congressmen and British Members of Parliament are vocal about its benefits, public courses abound, there are widely respected programmes available for schoolchildren and young adults, the US Marines are building it into their training, top corporations offer training in it to their employees, scientists study its effects (there are around 40 peer-reviewed scientific papers on the theme published every month) and NICE, the UK’s National Institute for Health and Clinical Excellence that advises the UK National Health Service on appropriate treatments, recommends an eight-week mindfulness course as a front-line intervention for certain conditions.

Almost every week another mainstream publication, a magazine or newspaper, carries an article that speaks of the popularity of mindfulness and its apparent benefits, and there seems to be an unending stream of books about it.

So Why Another Book?

Because it’s one thing just to read about mindfulness and quite another thing to practise it. The aim of this book is to support you in its actual practice. You can use the book as a do-it-yourself manual for learning mindfulness in a structured way or you can use it to supplement the teaching on a teacher-led eight-week mindfulness programme. You can also use it simply to find out more about the approach and to try some of the ideas and practices for yourself.

The book is built around an eight-week mindfulness course that is a combination of the two most popular and widely researched mindfulness approaches – Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). However you use this book, you will get the most from it by actually trying out some of the mindfulness practices taught here over a period of time.

My intention is for this book to be practical and – as much as possible in this medium – experiential. Although I will refer from time to time to the considerable scientific research into the effects of mindfulness training and I will be discussing some of the theory that underlies the approach, all of that is intended to support and illuminate the actual practice of mindfulness. The true meaning of mindfulness emerges ultimately from its practice and that is something you have to do for yourself. In the end, it is only by practising some of the methods of mindfulness that you can discover their real significance and begin to share in the very considerable benefits that they offer. Those benefits are really considerable – so many and various – and are accessible to people in a wide variety of contexts.

I teach mindfulness in many different settings these days. My associates and I run public self-enrolment eight-week mindfulness courses in London and elsewhere. We also bring programmes like the one outlined here to people in organisations – banks, Internet companies, media organisations, financial and professional services companies, the UK’s National Health Service and so on. I work with large groups or one-to-one with senior staff. I’ve taught people working at senior board level in large global organisations and I’ve worked in a space littered with potting compost teaching a course to the staff who run a plant nursery alongside clients who have learning difficulties. Sometimes we teach the full eight-week programme, sometimes we deliver a shorter introduction. We teach Mindfulness for Leaders courses and we teach mindfulness for general staff. But, however or wherever we teach, the basic premise of the work remains the same: when you’re more skilled at working with your mind and mental states things go better for you and for those around you.

After training in mindfulness myself for around 40 years now, and teaching others for much of that time, I feel I can say this unequivocally – mindfulness works.

How to Use this Book

The heart of this book is an eight-week mindfulness training course, and that is reflected in its structure. Each chapter comprises instructions for a particular set of practices that you can engage in that week. The practices are cumulative and follow one another in a particular order – building from week to week.

The core course material is laid out in one consistent style. All the other material – apart from the home practice – can be thought of as somewhat optional reading. These breakout boxes are marked with different icons:

The icon tells you that a box contains instruction and guidance that are necessary for the course.

The icon shows that the box contains ideas that I’ll be referring to as the course unfolds.

The icon shows that the box contains a description of the set home practice for this week.

The icon lets you know that the box marked by it contains useful information that is not absolutely necessary for you to know as you follow the course. Read it if you’re interested, or skip it if you’d rather.

The icon tells you that the box contains a poem or a story that further illustrates some of the points being made in that chapter.

I have also provided downloadable audio materials to support each week’s mindfulness practice. These can be found at www.mbsr.co.uk/mp31.php. There are two streams of daily practice that you can follow. The first stream follows the home-practice pathway of ‘classic’ MBSR and MBCT in suggesting that you do at least 40 minutes of home practice each day. Most of the research findings showing significant changes as a result of engaging in MBSR or MBCT have been based on a daily practice programme similar to this.

If you’re using this book as part of a teacher-led group-based eight-week course, do follow Stream 1 home practice unless your instructor suggests otherwise.

Having said all that, I’m aware that undertaking 40 minutes a day of home practice, especially without the support of a group, can be a real challenge. For that reason I’ve devised a second stream of practice. Stream 2 home practice takes no more than 20 minutes each day and may be useful for those who are using the book alone to guide their mindfulness training and who don’t have regular access to a teacher-led group.

The daily practice programme for each week of the course is laid out at the end of the chapter for each week, and Stream 1 and Stream 2 home-practice guidance is clearly delineated.

Finally, if you’re using the book as part of a teacher-led course, you’ll get the most from that course if, once you’ve read this introductory chapter, you leave any further reading until after you have participated in that week’s class with the teacher. Try to avoid reading ahead – it can undermine the effects of the work you’ll be doing on the course itself.

Home Practice is Essential

As you’ll see from the outcomes described in the book, with regular daily mindfulness practice real changes are possible. What is on offer here is a significant increase in your level of well-being and personal effectiveness. I’m personally committed to teaching mindfulness and I’m inspired to do that because I see real changes taking place from week to week in the people I work with. It’s not always a smooth journey. There are ups and downs and we tell people on our public courses that engaging in the stress-reduction courses we offer can sometimes be stressful. After all, for many people these days finding 40 minutes a day to fit in the practices really isn’t easy. But practice is what this is all about and, if you commit to your stream of practice and do it with whatever regularity you can muster, real change can follow.

And here’s the really wonderful thing: as you set out on your journey into mindfulness you don’t have to try to change yourself. In fact, striving after results can inhibit the process. All you have to do is engage in the practices – again and again and again – and change will begin to emerge. Over time, some people find that, once they have begun to experience for themselves the attitude of kindly self-acceptance that lies at the heart of this programme, they want to engage in further processes of development which build on that foundation. In the ‘Further Resources’ section (see here) I discuss a few of the many options that may be available, but for now the main thing is simply to engage in the practices described for each week. As best you can, put aside any idea of getting them right or doing them perfectly. That striving attitude is perfectly normal, it’s part of our being human, but in this context it just gets in the way.

Don’t strive to get the practices right. Just do them.

And here’s another great thing. On this course you’re completely liberated from any obligation to enjoy the practices. Sometimes you may enjoy them, sometimes you may not. That’s not the point. You don’t need to enjoy them to get the benefit – but you do have to do them.

What Exactly Do We Mean by Mindfulness?

Mindfulness is not the same thing as meditation. Meditation, especially ‘mindfulness meditation’, is a method of practice whose outcome is intended to be greater mindfulness.

Mindfulness is the quality of awareness that comes from paying attention to yourself, others and the world around you in a certain way. Jon Kabat-Zinn (of whom more later) speaks of it as the awareness that arises from paying attention on purpose, in the present moment and non-judgementally.

Let’s look at that in more detail.

Mindfulness Involves Paying Attention on Purpose

The act of choosing to pay attention is rarer than you might at first think. Even as you’re reading these words, how attentive are you? For most of us, the act of reading is fairly automatic. An impulse moves us to pick up a book, we open it, begin to read ... and all the while our attention flits.

This is neither right nor wrong – it’s just how we are, and even as you have read just these few pages so far, part of your mind will quite naturally have wandered off many times to engage with other things that call on your attention. Maybe part of your mind spent some time turning over a problem at work or at home. Maybe you thought for a bit about some of the tasks on your to-do list right now. Or perhaps something you read sparked a memory and an image from the past came vividly to mind. Maybe you began to think about your next meal and you ran through a quick inventory of one of your kitchen cupboards.

As I said, none of this is right or wrong. It’s just how our minds work. And when we’re mindful we bring a much clearer intentionality and awareness to the process of paying attention. When we’re mindful, we choose – to some extent at least – where our attention goes. We pay attention on purpose.

Mindfulness Involves Paying Attention in the Present Moment

Our attention wanders and much of the time it wanders off into the past or into the future. Sometimes there are elements of anxiety or regret involved in this. We may look to the future with a kind of anxious anticipation for what is to come, maintaining an uneasy alertness by constantly scanning the future for the challenges it may bring: encounters with other people we must prepare for, tasks we need to tick off our list – stuff coming our way. Or we may find ourselves constantly reviewing the past, especially the things we regret. There might even be some unconscious sense that by doing so we’ll be better prepared for the future.

Perhaps there are evolutionary processes at work here. Maybe we’ve survived as a species and become the planet’s top predators in part because we’re good at doing these things. But there is a price for this and that price may be the whole of our lives. If your attention is always in the future or always in the past, right now you’re simply not here. Right now, you’re not fully alive.

When you’re mindful, your attention stays in the present moment. Right here, right now.

Mindfulness Is Non-Judgemental

This doesn’t mean that we don’t make judgements when we’re mindful, or that we stop discerning what is appropriate at any time from what is inappropriate. That would be simple foolishness. But think of what we mean when we speak of someone being ‘judgemental’. A thesaurus gives these synonyms: critical, hypercritical, condemnatory, negative, disapproving, disparaging, pejorative. Quite a list.

The non-judgemental attitude of mindfulness, on the other hand, is neither condemnatory nor prejudicial. There are two dimensions to this.

Firstly, there is what we might think of as a wisdom dimension. This involves letting what is the case be the case.

Much of the time we may feel, instinctively almost, unwilling or unable to do this. We can put huge amounts of mental and emotional energy into refusing to allow things to simply be as they are. ‘They shouldn’t be like that!’ ‘It shouldn’t be like this!’ ‘I ought to be somehow different ...’ But things really only ever are as they actually are. However right, however wrong, however just or unjust, desirable or undesirable – they are as they are. And it’s only ever when we can allow this to be fact – that things are as they are – that choice can begin to open up for us. When we let what is the case be the case, whatever it is, then we can begin to choose how to respond to it. What shall we do about what’s showed up right now? What would be the most appropriate next step for us and for the situation as a whole?

When we can’t let what is the case be the case, then we’re stuck. We’re already rooted in a defensive posture of denial and we’ve closed down the possibilities for a more creative engagement with the situation. The wisdom element in the non-judgemental attitude of mindfulness opens up the possibility for a more wholehearted creative response to the situations we find ourselves in. It allows for more creative choices.

Then, there is a compassion dimension to the non-judgemental attitude of mindfulness. Here, to some extent at least, we still our inner critical voice.

For much of the time, many of us find that we run a kind of inner critical commentary on our experience. Sometimes that commentary can be directed at ourselves – ‘I’m not good enough.’ ‘I don’t measure up.’

How many of us actually think we’re thin enough, good-looking enough, smart enough, fit enough, strong enough, witty enough, rich enough, clever enough, fast enough ... anything enough?

Sometimes we turn that inner critical commentary on others – on their appearance, their intelligence, their emotional appropriateness and so on. Sometimes we run critical commentaries on our immediate environment – somehow or other, in one way or another, things just aren’t right. Nothing is quite as it should be. Nothing, ourselves included, is quite enough.

The compassion element in the non-judgemental attitude of mindfulness allows us to rest simply with things as they are – at least to some extent. We allow ourselves to be ourselves, we allow others to be who they are, and we rest a little bit more at ease with life as it actually is – with a bit more kindly acceptance towards ourselves, others and the world around us.

The quality of acceptance that emerges from mindfulness training isn’t simple passivity, however. It’s not that we passively allow the world to roll over us, or that we stop making ethical judgements. Far from it. Mindfulness training might even enable you to be more appropriately assertive. It might sharpen your capacity for drawing ethical distinctions. But all of this can be done with wisdom and with kindness.

With mindfulness training you begin to develop a greater capacity to allow what is the case to be the case and to respond skilfully and appropriately with a warm open-heartedness.

Box 1: A Small Digression into History

This book is based on a completely secular approach to mindfulness training. It is for people of any religion or none. For 2,500 years, however, the ideas and practices at the core of the approach were found almost exclusively in Buddhist monasteries in Asia. So far as we’re aware, the Buddha was the first person in history to use the idea of mindfulness as we use it in contemporary mindfulness approaches. He taught a number of mindfulness practices and other methods for developing and sustaining mindfulness and he spoke at length of the immense benefits that are on offer from engaging in those practices. That approach and a body of teachings and practices that came from it lived on in a wide variety of Buddhist monastic contexts in Asia but, for 2,500 years, people outside of Asia knew almost nothing about it.

Towards the end of the nineteenth century that began to change as European explorers, scholars and colonial administrators began to discover and translate into their own contexts some of what was going on in Asian monasteries. At first, only a tiny handful of these took up the practices for themselves, and the penetration of mindfulness approaches into European and North American culture was slow and gradual. But it built steadily and received a boost in the 1950s with the emergence of the Beats – poets and writers like Allen Ginsberg, Jack Kerouac and Gary Snyder, who began to publicly advocate the practice. It received more of a boost in the 1960s and 1970s with the psychedelic movement, when people like myself – hippies and wannabe hippies – began to get involved. But mindfulness practices were still largely to be found only in Buddhist contexts.

Towards the end of the 1970s, however, a very significant shift took place. Much of this comes down to Jon Kabat-Zinn. Jon had trained as a molecular biologist and was working as such at a hospital near Boston – the University of Massachusetts (UMass) Medical Center. In his student days he had come upon Buddhism and had established a regular daily meditation practice. Apart from his work at the hospital, he also taught yoga. He engaged with his scientific work, but two other questions kept bothering him. One question he expressed as ‘What shall I do with my life? What kind of work do I love so much I would pay to do it?’ The other was more to do with the patients who came to the hospital.

He saw that people came to the hospital because, in one way or another, they were suffering. But how many of them, he wondered, left the hospital with that suffering resolved? In discussion with physicians at the hospital he came to the conclusion that it was maybe something like 20 per cent of patients. What, he wondered, was the system offering to the other 80 per cent?

While on a silent meditation retreat in 1979 these two streams of questioning resolved themselves in a ‘vision’ lasting maybe 10 seconds, which Jon describes as an instantaneous seeing of vivid, almost inevitable connections and their implications.

He recognised in that moment that the way he was working on that retreat on his own mind and mental states might have enormous benefits for the people who came to the hospital with their suffering. He saw that it might be possible to share the essence of the meditation and yoga teachings that he had been practising for the past 13 years with those who might never come to a Buddhist centre, and who would never be able to discover that essence through the words and forms that were used in such places. He resolved to try to make the practices and the language used to describe them so commonsensical that anyone might benefit from them.

Jon persuaded the hospital authorities to let him and his colleagues have some space in the basement, and there they developed what soon came to be known as the eight-week Mindfulness-Based Stress Reduction (MBSR) programme. He and his colleagues worked to develop a contemporary vocabulary that spoke to the heart of the matter without reference to the cultural aspects of the traditions out of which those practices emerged.

Jon had trained as a scientist and knew the value of research, so he and his colleagues researched the patient outcomes of their programme and, bit by bit, what is now a very considerable body of research evidence into the efficacy of the training began to emerge. At the time of writing there are many thousands of peer-reviewed scientific papers investigating the effects of mindfulness training. If you’re interested in these, you’ll find an extensive database of them at www.mindfulexperience.org.

It soon became clear that MBSR training enabled people to deal much better with chronic pain. They also became more adept at managing the various stressors that accompanied whatever issues had brought them to the hospital. The research indicates that the programme is successful at helping people deal with difficulty and, at the time of writing, more than 20,000 people have completed the eight-week course at UMass itself. More than 740 academic medical centres, hospitals, clinics and freestanding programmes offer MBSR to the public around the world, and interest in mindfulness training has continued to build as it has become increasingly apparent that it is not only stress and chronic pain that are positively affected when you learn to work with your attention in a different way.

Biological changes started to show up in the research as well. One early instance of this was the finding that, among patients who came to the hospital for treatment for psoriasis, the symptoms of those who engaged in the MBSR course alongside that treatment cleared up around 50 per cent faster than the symptoms of patients who didn’t. What this seemed to show was that what people were doing with their minds, the work they were doing with their attention, was actually changing their bodies.

The understanding of the way in which mindfulness training affects us biologically received a further boost when neuroscientists began to investigate its effects.

Part of this story goes back to 1992, when a small group of neuroscientists led by Professor Richard Davidson and helped by Alan Wallace, a Western Buddhist scholar, travelled to Dharamsala in the foothills of the Indian Himalayas on a kind of neuroscience expedition. They took with them an array of what was then cutting-edge scientific equipment: laptop computers, electroencephalographs, battery packs and a generator. They wanted to meet some of the Tibetan Buddhist hermit-meditators who lived in the hills above the town and they hoped to recruit from among them a cohort of expert meditators – people who had put in tens of thousands of hours of meditation practice. The neuroscientists wanted to study the pattern of their brain activity. They were particularly interested in the habits of thinking and feeling they exhibited when not meditating. If these demonstrated that the subjects had unusual habitual traits, these might reflect enduring functional changes that had occurred in their brains as a result of their mental training.

This first foray simply failed. To begin with, the yogis were unimpressed by what seemed to them to be the scientists’ uninformed and naïve perspectives on meditation. ‘We seemed like primitive Neanderthals to them,’ explained Alan Wallace, who helped to facilitate the encounters.

In the end the scientists got no usable data from that trip. But they’d made a start and, with the Dalai Lama’s help, in 2001 a number of maroon-robed Tibetan Buddhist monks began to make their way to Davidson’s Laboratory for Affective Neuroscience in Madison, Wisconsin, to meditate with EEG caps stuck on their already shaven heads. These were ‘Olympic-level athletes’ of meditation, with many years of intensive practice behind them. The results were astounding. The expert meditators exhibited patterns of brain activity never before measured by science. We’ll look in more detail at some of these findings in Week Three. They’re particularly interesting because from them scientists were encouraged to investigate what changes might show up in people who had no previous meditation experience and who took up an eight-week mindfulness training course. Here, they found (and research continues to find) highly significant changes in the patterns of brain activation – and even changes in the brain’s physical structure – that follow from just eight weeks of mindfulness training.

Box 2: Mindfulness-Based Cognitive Therapy

A significant event in the development of secular mindfulness training came about in 1992 when three distinguished cognitive psychologists – Zindel Segal, Mark Williams and John Teasdale – were asked by the director of a clinical psychology research network to develop a group-based therapy for the treatment of relapsing depression.

Significant depression is a highly disabling condition. Besides emotional pain and anguish, people who are depressed also experience levels of functional impairment comparable to those found in major medical illnesses – including cancer and coronary heart disease – and a World Health Organization projection suggests that of all diseases depression will impose the second-largest burden of ill health worldwide by the year 2020.

Roughly one in 10 of us in Europe and North America will experience serious depression at some point in our lives. In some parts of the population that is more like one in four. What is more, when people have had three or more serious episodes of depression there is something like a 67 per cent chance that their depression will relapse.

Back in 1992, the two treatments that seemed to be most effective in treating people with relapsing depression were one-to-one cognitive behaviour therapy (CBT) or maintenance doses of antidepressants. Both of these are relatively expensive. Not everyone is comfortable taking the drugs and they can have unwanted side effects. And not everyone can have one-to-one CBT – there is a limit to the availability of trained therapists. Coming up with an economically viable and effective group-based intervention therefore seemed urgent.

To understand the approach Segal, Williams and Teasdale took, and why they took it, it will be helpful to consider a scenario they outline in the first of their books – Mindfulness-Based Cognitive Therapy for Depression.

Mary has just come from work. She’s tired and she looks forward to spending her evening relaxing in front of the television. However, there’s a message on her answerphone. Her partner is going to be late getting back from work. She gets angry and feels disappointed and upset. Then she starts to recall other occasions that month when the same thing happened. She begins to imagine that her partner may be being unfaithful to her. She pushes that thought to one side but it comes back with even greater force when she imagines that she has heard some laughter in the background of his voicemail. Nausea comes up – and it doesn’t end there. Her mind rapidly starts to conjure up images of an unwanted future – solicitors, divorce courts, having to buy another home, living in poverty. She feels herself getting more and more upset as her anger begins to turn into depression. Her mind throws up images from the past when she was rejected and lonely. She ‘knows’ that all their mutual friends would abandon her for him. Tears flow as she is left wondering what to do. Sitting in her kitchen she asks herself ‘Why does this always happen to me?’ and she tries to work out why she always reacts this way.

Mary experiences a whole avalanche of thoughts, feelings and sensations. It is not just the negative matter that caused her to be upset, however, nor is it just the way she found herself trying to deal with it. Instead, it’s as if a whole mode of mind – a complex configuration of moods, thoughts, images, impulses and body sensations – was very quickly wheeled into place in response to the situation. This mode of mind includes both the negative material and Mary’s tendency to deal with it by ruminating.

Like Mary, people who are vulnerable to depression can put much of their time and energy into ruminating about their experience – ‘Why do I feel the way I do?’ Thinking about their problems, their sense of personal inadequacy, they turn things over and over in their minds trying to think their way to solutions and to ways of reducing their distress. But, as Segal, Williams and Teasdale point out, the methods they use to achieve that aim are tragically counterproductive. In fact, when you’re low, repeatedly ruminating – thinking about apparently negative aspects of yourself or of problematic situations – actively perpetuates rather than resolves depression.

What seems to happen is that, at times of low mood, old habits of thinking switch in relatively automatically. That has two consequences: firstly, thinking now runs in well-worn grooves that don’t lead to a way out of depression; secondly, this way of thinking itself intensifies the depressed mood – and that leads to further rumination. In this way a series of self-perpetuating vicious cycles can cause mild and transient low mood to very quickly degenerate into severe, disabling depression.

As Segal, Williams and Teasdale saw it, the task of relapse prevention was therefore to find a way to help patients disengage from negative and self-perpetuating rumination when they felt sad or at other times of potential relapse.

While they were pursuing these questions, John Teasdale, who had long had a personal interest in meditation, was reminded of a Buddhist talk he had attended several years before where the speaker stressed that it is not your experience itself that makes you unhappy – it is your relationship to that experience. This is a central aspect of mindfulness meditation, in which you learn – among other things – to relate to your thoughts just as thoughts. In other words, you learn to see them just as mental events, rather than as ‘the truth’ or ‘me’.

John recognised that this way of ‘decentring’ from negative thoughts, of standing ever so slightly apart from them and witnessing them as an aspect of experience rather being completely immersed in them as the whole of experience, might be a key.

But how could you teach people to do that?

An American colleague, Marsha Linehan, who was visiting John Teasdale and Mark Williams at the Medical Research Council’s Applied Psychology Unit in Cambridge, provided a vital clue. Besides telling them of her own work in helping patients to decentre, she pointed them towards the work being undertaken at UMass by Jon Kabat-Zinn. Looking into his work, they came upon this piece from one of Jon’s books:

It is remarkable how liberating it feels to be able to see that your thoughts are just thoughts and that they are not ‘you’ or ‘reality’ . . . The simple act of recognising your thoughts as thoughts can free you from the distorted reality they often create and allow for more clearsightedness and a greater sense of manageability in your life.

Segal, Williams and Teasdale made contact with Kabat-Zinn and his Stress Reduction Clinic at the UMass Medical Center, began to engage in various ways with his programme and, based largely upon it, formulated their own eight-week Mindfulness-Based Cognitive Therapy (MBCT) programme. Although similar to Kabat-Zinn’s Mindfulness-Based Stress Reduction (MBSR) in many ways, MBCT contains elements of cognitive therapy and theory that address the specific vulnerabilities and exacerbating factors that make depression recurrent.

MBCT itself was originally specifically designed for those vulnerable to depression. Subsequently, variants of it have been developed to help with a wide range of issues: obsessive-compulsive disorder, disordered eating, addiction, traumatic brain injury, obesity and bipolar disorder among others.

When it comes to depression, the results of several large-scale randomised control trials suggest that, for people vulnerable to relapsing depression, a course of MBCT might more or less halve the rate of relapse and, if relapse does occur, those who have trained in MBCT appear to experience it less severely.

Box 3: How Did the Course at the Heart of this Book Come to be Formulated?

My Own History with Mindfulness

I come to this work from a Buddhist background. Born in South Africa and unable to reconcile myself to the apartheid regime, I left there at eighteen and settled in England. Driven to find a framework of values I could depend on and an understanding of how the world worked, I took up a degree in philosophy at the University of East Anglia in Norwich. But that didn’t really fulfil my need. In my final year, though, I had the good fortune to meet a committed practising Buddhist who had come to town to establish a Buddhist centre. He taught me to meditate and that changed everything. I committed to spending the rest of my life devoted to meditation, study, retreat and eventually to teaching others.

I lived sometimes in retreat centres, sometimes in city-based residential Buddhist communities, and gradually came to teach and to publish books on Buddhism (using my Buddhist name – Kulananda), and I thought that was how my life was going to go. For several years I took a kind of digression into the world of business. With a number of Buddhist friends I came to establish a ‘right livelihood’ fair-trade company that dealt in handicrafts from developing countries. The company came to be quite successful in time. At the peak of its success it employed around 200 people, had sales of around £10 million a year and gave its profits – often substantial sums – to various Buddhist charities each year. But running a business turned out not to be what I really wanted to do with myself and in 1988 I returned to a life based more in teaching, studying and meditating.

By 2002, however, more than 25 years after my first introduction to meditation, I began to feel the need to make another change and I looked about for a form of training that would build on my existing skills but which would allow me to earn a living in the world. I thought about training in psychotherapy. After all, I’d had many years doing informal pastoral counselling. Searching one day on the Internet, I came upon a master’s degree programme that was being run at Bangor University in Wales. The programme had originally been founded by Professor Mark Williams, one of the founders of MBCT, with the intention of training up a number of people who could begin to bring mindfulness into various clinical settings. That seemed like a marriage made in heaven to me. I joined the programme and graduated from it in 2006.

Reading Mindfulness-Based Cognitive Therapy for Depression – one of the set texts at Bangor – was a profound revelation for me. Here, for the first time, I saw the coming together of two great streams of tradition: Buddhist psychology, which implicitly informs much of what is found in that book, and Western psychology, founded in the tradition of scientific method, which explicitly informs it. Traditional Buddhist psychology, at its best, is founded on a detailed and scholarly investigation of the elements of experience revealed by a collective endeavour of deep introspection over more than 1,000 years. Plunging in meditation into the depths of their own minds, the founding scholars of Buddhist psychology provide us with profoundly valuable insights into the mechanisms of consciousness and the functioning of perception and experience. Western psychology at its best, on the other hand, brings a highly sophisticated scientific method and a well-developed scientific community to its investigations.

In Mindfulness-Based Cognitive Therapy for Depression I saw the first beginnings of what might be achieved as these two streams began to inform one another. I was deeply inspired by the way the authors illuminated some of the inner psychological processes at work in the client group they were concerned with. When we understand the processes that drive us and that make up our experience, we have a much greater chance of freeing ourselves from their unconscious grip. The intersection of mindfulness and Western science, I saw, opened up huge possibilities for human development and human freedom.

Besides relishing the psychological acuity I was discovering, I was also deeply inspired by the explicitly secular nature of the trainings offered by MBSR and MBCT. Ever since discovering mindfulness and related practices for myself I have held a passionate conviction that they offer something deeply lacking in contemporary society. Here, at last, was a vehicle for getting some of these practices and their benefits out into the wider world without any strings attached. I love the freedom and openness of that offering. You don’t need to be a Buddhist or subscribe to any religious framework to get these benefits now. What previously had been taught mainly in Buddhist centres and similar locales could now be made widely available for anyone to try.

While finishing my training in Bangor I had the great fortune to be introduced to John Teasdale, one of the founders of MBCT, who lives – as my wife and I do – in Cambridge. John and I took the mindfulness programme I’d been working with in Bangor, a hybrid of MBSR and MBCT, and tweaked it more particularly towards stress. We then spent some time teaching that programme, along with our colleague Ciaran Saunders, in public courses held in Cambridge. We made video recordings of each taught session and in between sessions the three of us would meet up, replay the recording of ourselves teaching, and comment on what we saw one another doing: what worked and what didn’t work so well. That was one of the richest learning experiences of my whole engagement in the process of mindfulness teaching.

Soon after graduating I was invited to join the team of mindfulness teachers at the Centre for Mindfulness Research and Practice that is located in the School of Psychology at Bangor. I’m now an honorary lecturer there and for many years taught a module on the master’s programme as well as co-leading mindfulness teacher-training retreats.

In 2006 I founded a mindfulness training company, Mindfulness Works Ltd, and with my associates I have since led many public courses in London and elsewhere based on what I learned at Bangor and developed with John.

But my interest in the world of work and business never went away and I’ve found myself increasingly drawn into that field. Part of this is because of what I keep finding on my public courses.

The sense I get from the public MBSR courses I lead is that, for a very large proportion of participants, the greatest source of stress and distress in their lives comes from what they encounter each day at work. I am convinced that, if we can train more mindful leaders, if we can help to create more mindful workplaces, we can have a huge impact on the overall levels of well-being in our society.

I wrote a book on this theme – The Mindful Workplace – and have come increasingly to teach in workplace and leadership contexts, as well as continuing with the public courses. More recently I have become an adjunct professor at IE Business School in Madrid, where I am honoured to be part of an extraordinary faculty teaching an executive master’s in positive leadership and strategy (EXMPLS), which has mindfulness training at its heart. We draw in a high-powered student body from around the world and I’m deeply moved each time I meet the students to see the changes that their deepening engagement with mindfulness practice brings about.

Box 4: The Effects of Mindfulness Training

It is because mindfulness works that it’s being found in so many different contexts these days. The variety of approaches and applications is extraordinary. NICE, the UK’s National Institute for Health and Clinical Excellence that advises the UK National Health Service on appropriate clinical provision, recommends it as a front-line treatment in instances of relapsing depression. The United States Marine Corps, on the other hand, has found that it helps soldiers remain mentally flexible, cognitively clear and emotionally appropriate under pressure. Some people use mindfulness to help them manage chronic pain and there is good research evidence for its efficacy there. Others come to it because they want to be more focused and effective at work, or because they want to be more resilient, or more empathic.

In whatever way or for whatever reason you come to mindfulness training, there is now a large body of evidence that shows that with just eight weeks of training really substantial changes are possible.

There is a considerable and growing body of research evidence around the effectiveness of mindfulness training these days. Peer-reviewed research papers are currently emerging at a rate of around 40 per month. I won’t try to sum up all of that evidence here, but the UK’s Mental Health Foundation commissioned a report which examined the health benefits of mindfulness training. Their 2010 Mindfulness Report noted that evidence coming from mindfulness and well-being research shows that mindfulness confers significant benefits on health, well-being and quality of life in general:

 According to the report, people who are more mindful are less likely to experience psychological distress, including depression and anxiety. They are less neurotic, more extroverted and report greater well-being and life satisfaction.

 They have greater awareness, understanding and acceptance of their emotions, and recover from bad moods more quickly.

 They have less frequent negative thoughts and are more able to let them go when they arise.

 They have higher, more stable self-esteem that is less dependent on external factors.

 They enjoy more satisfying relationships, are better at communicating and are less troubled by relationship conflict, as well as less likely to think negatively of their partners as a result of conflict.

 Mindfulness is correlated with emotional intelligence, which itself has been associated with good social skills, ability to cooperate and ability to see another person’s perspective.

 People who are mindful are also less likely to react defensively or aggressively when they feel threatened. Mindfulness seems to increase self-awareness, and is associated with greater vitality.

 Being more mindful is linked with higher success in reaching academic and personal goals.

 Practising meditation has repeatedly been shown to improve people’s attention, as well as improve job performance, productivity and satisfaction, and to enable better relationships with colleagues, resulting in a reduction of work-related stress.

 People who are mindful feel more in control of their behaviour and are more able to override or change internal thoughts and feelings and resist acting on impulse.

 Meditation practices more generally have been shown to increase blood flow, reduce blood pressure and protect people at risk of developing hypertension; they have also been shown to reduce the risk of developing and dying from cardiovascular disease, and to reduce the severity of cardiovascular disease when it does arise.

 People who meditate have fewer hospital admissions for heart disease, cancer and infectious diseases, and visit their doctor half as often as people who don’t meditate.

 Mindfulness can reduce addictive behaviour, and meditation practices generally have been found to help reduce use of illegal drugs, prescribed medication, alcohol and caffeine.

Neuroscience Research

We also know that mindfulness training has a significant impact on how the brain is shaped, wired and activated. After just eight weeks of mindfulness training we know from separate studies that one might expect:

 increased brain grey-matter concentration in areas connected with sustained attention, emotional regulation and perspective taking;

 increased cortical thickness;

 decreased amygdala activation: the amygdala is a key component in the brain’s threat-detection system – when it is less active you feel more at ease with yourself and others;

 increased activity in the left prefrontal cortex and less activity in the right prefrontal cortex: the ratio of left to right prefrontal activation is a good predictor of overall happiness and well-being – if the left prefrontal is more active then you’re likely to experience higher levels of well-being;

 increased working-memory capacity: working memory is the system that actively holds information in the mind to do tasks such as reasoning and comprehension, and to make it available for further information processing. Measures of working-memory capacity are strongly related to success in the performance of complex cognitive tasks. It is also a key component in emotion regulation and it is reduced by acute or chronic stress.

The skills that emerge from mindfulness training are gradually beginning to be recognised as crucial life skills. Really, we should all have learned them at school and it is deeply heartening that programmes for schoolchildren and young adults, like .b and the programme developed by my colleagues at Bangor University, are beginning to find their way into schools. Most of us missed that chance, but thankfully it is never too late to learn.

I sometimes begin my programmes by asking how many people in the room think that regular physical training can be crucial for their health and well-being. Everyone puts up their hand. I then ask how many people think that regular mental training can be crucial for their health and well-being. Most people put up their hand, a little more tentatively perhaps. I then point out that, had I asked the physical-training question to a general audience at the end of the nineteenth century, very few would have raised their hand. And, indeed, even as late as 1970, when the New York City marathon was first run with 127 entrants, of whom fewer than half completed the course, it was thought that only a few thousand people in the United States had the capacity to run a marathon. In 2010, 44,829 people finished – a world record for a marathon race – and every year tens of thousands of potential entrants are unsuccessful in the lottery for starting places.

There has been a paradigm shift in our cultural attitude to physical fitness.

We are now on the brink of another paradigm shift. We are beginning to recognise the importance of what we might think of as mental and emotional fitness and to see how we can train to build this.

When you’re more skilled at working with your mind and mental states, things go better: for you and everyone around you.

Before Beginning the Course

You will read about a number of different mindfulness practices in each chapter of this book. If you’re using the book as a do-it-yourself manual for the eight-week course, it would be best to do the practices in the order in which they are described.

To that end, it would be good, if you can, to read the book at a time when and in a place where you’re less likely to be disturbed. It would also be good to be able to engage in some of the meditations in the order in which they are taught. Some of the time, where indicated, you might want to put the book aside and take the time to listen to the particular audio material for that part of the course. The track name and its timing are shown at the appropriate place in the text.

Since you’ll be doing different meditations from time to time, it will generally be good to have access to an upright chair, rather like a kitchen or dining chair, or a meditation bench or cushion if you want to meditate sitting on the floor. I’ll say more about the postures for sitting meditation when we come to that part of the course.

For Week One, beginning in the following chapter, there are two other items of equipment you’ll need.

There is the option for doing one of our meditations lying on the floor, so you might want to have a rug or mat handy for that.

And our first meditation is going to be an eating meditation. But we’re not going to eat very much – just one raisin in fact – and I’ll be providing fairly detailed guidance on how to do that as an eating meditation. So if you’re going to read on, now might be a good time to go and find yourself a raisin. If you don’t have one handy, a very small section of any fruit or vegetable that you can eat will do instead.

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