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Therapists lately have been all about “mindfulness.” 

Dialectical Behavior Therapy— one of the few successful treatment modalities for helping people with Borderline Personality Disorder lessen their self-harm behaviors— has made “mindfulness” a popular buzzword within the mental health community in the last twenty years. 

Look at the self-help section of any book store, and you’ll see “mindfulness” prescriptions for most maladies you can think of. There’s mindful eating; mindful anxiety reduction; mindfulness for those suffering depression. 

Mindfulness has become particularly fashionable in the trauma treatment community, possibly because it is almost the literal antithesis to dissociation. 

All “mindfulness” implies, in itself, is allowing yourself to be present in this very moment, without judgment, just experiencing what you’re experiencing. The upshot of mindfulness is supposed to be that, if you remove regret about the past or anxiety about the future, and just focus on what’s happening in the here and now, you can remove much of the extra emotional baggage that makes living so difficult, and bring you resourcefulness to doing whatever is on our plate, right here, right now, with less pressure and more potential enjoyment. 

Don’t get me wrong— I’m all for mindfulness when it’s the tool to use. 

Sometimes it totally is helpful and practical to live in the present moment. To remove expectations and  regret, and just experience can be a productive experience, if we’ve mostly been beating ourselves up about the past or fretting about the future. 

The thing is…sometimes mindfulness isn’t the tool to use. 

In fact, living too emphatically in the present moment can sometimes create more problems than it solves, particularly if the present moment is painful or overwhelming. 

Understand, I kind of come at this from a biased point of view. Most of the people that I work with are, at least initially, experiencing a great deal of pain, right here, right now. They’ve been through traumatic events that have for the moment crippled their ability to function, relate, and experience. For the moment they feel too depressed to breathe. For the moment they’re so anxious they feel like they’re jumping out of their skin with every passing second. 

Advocates of mindfulness would no doubt counsel such patients to approach their pain with an open, curious, non-judgmental attitude. Which, I think, is an elegant, measured way to approach pain, certainly. 

It’s also enormously impractical for many people who are suffering, and who simply don’t at the moment have the psychological bandwidth for openness, curiosity, and non-judgment. They’re in pain and they want to get out of pain. 

I don’t particularly want to tell a person in overwhelming pain to treat this moment like it’s the only reality. 

I want to focus them somewhere else. 

I want their focus to be on a past time when they felt at ease and confident. I want their focus to be on a future time when they’ve overcome their struggles, and they’re feeling good about the work they’ve done. I want their focus to be on an alternate universe in which it’s even POSSIBLE to not feel what they’re currently feeling. 

In short, I think what some people need is not necessarily “mindful” use of their senses to try to sink further into their experience of the current moment. Rather, I think what some people need is use of their imagination, to create a better moment that maybe used to exist or doesn’t yet exist— and, once the brain is heading in THAT direction, we can get about making a practical plan to bring those better moments into reality. 

When I talk about the use of imagination and creating “alternative universes” for us to escape into, I’m not talking about dissociation. 

Dissociation isn’t a use of imagination. 

When you dissociate, you’re still with the pain; you’ve just sent a different part of yourself out to experience the pain. That’s not a creative use of our brains; that’s cruelty to the part of yourself that has been shoved to the forefront to deal with the scary or painful situation. 

What I’m talking about is forming a hypothesis. 

I’m talking about hypothesizing a better moment— what that might look like, what that might feel like, what that might be like. 

When you give the brain something to shoot for, a picture to develop, it’s THEN that the brain starts planning and scheming to get from here to there. Not before. 

Thus if we just stay “mindfully” present in our current, painful moment— the brain isn’t going to get kicked into gear to problem solve or set goals. It’s not going to provide you with a cascade of motivating neurotransmitters and hormones. 

Again, hear me clearly: if mindfulness is a helpful tool for you at times, absolutely use it. I am not, in this blog, making the case that mindfulness is the “wrong” tool to use. If you benefit from a tool, use it. Use the hell out of it. 

I do want you to have on your radar screen, though, the mindfulness is only one tool— and, just like any tool, it’s not the right tool for any and every job, or for any and every patient. 

Don’t forget about your imagination. 

One thought on “Mindfulness: useful…except when it’s not.

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