A Mindfulness Response: Thoughts & Feelings

Acceptance of self

Acceptance and Self-Compassion

            The Mindfulness Response noted that others often feel embarrassed and discuss shared humanity, which does not imply failure. Using self-kindness, the group discussed how much pressure the word “should” has. The group determined that the thoughts were false.

Self-compassion: I can use the self-kindness skill and become more patient with myself. I can accept that I am learning and growing each day.

            The Mindfulness Response addresses negative thoughts by observing them with a non-judgmental attitude, being aware of and understanding them, and creating a space for self-reflection. The participants' knowledge that thoughts can be false enabled them to choose a new reaction.

            After talking with the group, one participant recalled being shy as a child. The group pointed out how the participant has grown and changed. The validation from the group helped transform this negative thought and brought awareness to the participant.

Thought Journal with CBT

Negative thought Cognitive Distortion Feelings that I have

I should know better "Shoulds" embarrassed, dumb

            The Mindfulness Response taught participants about shared humanity and how everyone experiences negative thoughts and strong emotions because we are humans. One participant discussed being kinder and changing their self-talk.

Mindfulness:

            The participants practiced mindfulness and learned to acknowledge and accept their symptoms. They were encouraged to write down ruminative thoughts and bring them to therapy. This helped them gain inner knowledge by noticing and observing thoughts and reactions. Once aware of this, they used different skills to manage distress.

Self-Kindness:

            Participants learned to become nonjudgmental about themselves and their symptoms, allowing them to be there. They practiced nonjudgment by refraining from labeling symptoms or labeling themselves as “stupid.” Participants learned to view the symptoms as separate from themselves and to be patient with the process.

Common Humanity: 

            Support from a team was encouraged so that team members could feel a sense of community and connection with one another. The group discussed how participants do not do this alone and need a support person to listen and do reality checks. The group discussed how others have the same feelings and symptoms as you. Free support groups, such as NAMI.org or the Depression Bipolar Support Alliance (DBSA), were discussed, and how building a community of supportive people helped to maintain stability.

The Mindfulness Response, Self-Compassion, and the Thought Journal

            The Mindfulness Response uses self-compassion to help diffuse difficult emotions and moods. When symptoms arise, self-compassion is added to help lower the distress. One participant noted that the thought journals helped explain the process and that self-compassion made it more manageable. People with recurring serious mental illness can develop anxiety or depression once symptoms return. Participants reported feeling disappointed when symptoms return, as they are aware of the skills from many therapies and treatment programs.

I feel like I am moving backward.

I took one step forward and two steps back.

I was here before, and I still can't believe I'm back.

            Apply self-compassion to the thought journal to reach a neutral thought. Self-compassion helps diffuse confusing emotions, thoughts, images, and sensations. By not judging ourselves, we learn to be more patient and forgiving of ourselves for our mistakes.

Thought Journal with Self-compassion

What I remember from childhood: _____________________________________

Do I still believe this today? __________________________________________

Participants attempted to replace negative thoughts with neutral ones if they experienced difficulty.

Notes were brought to therapy for further discussion. This was difficult for some participants, but others encouraged them by mentioning their positive attributes.

Self-compassion: I can become a new person and develop new thoughts about myself that are distinct from my childhood experiences. I don't need to keep old messages from childhood. I can create my own.

Neutral or Satisfying Thoughts

I can accept myself.

I can write a grocery list.

I can do chores.

I can take a shower.

I am ok.

I am safe and grounded.

I accept the situation for what it is.

It is what it is.

I am focusing on the present.

I have experienced one hundred paranoid thoughts, and I am safe.

I have had one hundred worried thoughts that people would judge me in social situations, and no one did.

The neighbors do not have time to come to my home and insult me. They are doing chores and have more important things to do than think about me.

I worried and checked the locks and doors one hundred times, and nothing happened.

            The group discussed ways to change and neutralize negative thinking patterns. Participants who had difficulty were instructed to try to make grounding statements if they were unable to formulate positive ones. The group discussed how to gain insight into past problems and recognize that they can serve as opportunities for growth. The group discussed how it takes time to learn from some hard life lessons that have improved their lives.

Self-Kindness I can be patient with myself. I am learning new skills.

The group discussed how self-compassion helped relieve tension. The discussions centered around how important it was to identify their negative thought patterns or cognitive distortions. Participants said, “I can never be happy,” or “My voices criticize me and will not leave me alone.”  The group reminded the participant to be patient and that others may also experience the same symptoms. The group recognized that the symptoms and depressed mood make people think they will never be happy. Participants were encouraged to acknowledge and not judge the negative thoughts and critical voices. The group practiced staying present and grounded, taking slow, deep breaths to clear the mind.

Transform Negative Thoughts

The Mindfulness Response focuses on the middle ground or a neutral point to move the negative thought into an affirmation. The group discussed changing thoughts and how it requires practice for several hours. The participants related the negative thoughts to their psychosis symptoms and critical voices.

Symptom The voices criticize me and yell at me.

Negative Thought I am such a loser. The voices tell me I am too.

Mindfulness Response It's a symptom, not my real thoughts.

Neutral Thought Other people experience depression and negative thoughts, not just me

Affirmation I can get support from my therapist and learn new ways to

manage the symptoms.

            Some participants reported feeling happier when they gave to others through volunteer work, donations, and conversations. The group noticed that small acts of kindness help our moods and improve our community. The group talked about building a community of supportive people through a hobby, a religious organization, or a support group.

Different Amounts of Happiness

            The Mindfulness Response aims to meet a person where they are, and some participants noted that happiness is not easily found. To help group therapy members overcome negative thoughts, a neutral area was created where individuals felt okay and safe. Happiness was divided into smaller segments, thought of as a fast food restaurant or a movie theater, with different sizes: small, medium, and large.

            The group discussed how to find different types of happiness. First, participants were asked to try to reach a neutral zone. The group had to ask members about their general activities to see what they appreciated. They did produce neutral or small amounts of happiness for their list of three good things (Seligman, 2005). Participants with multiple symptoms had trouble identifying positive things.

Discussions of happiness included small, medium, and large amounts, pleasant experiences, and three good things. The group discussed small, lovely things they noticed daily while trying to find the good in their lives.

            Negative thoughts or cognitive distortions tend to stick to us just as burrs stick to clothing. Traumatic events are stored in the brain and encoded in multiple areas, making it more difficult to forget them. Positive experiences tend to slip away from our memory. The group was encouraged to write down pleasant and positive experiences.

Neutral or Satisfying Thoughts

It is ok to do: _____________________________________________________________

I feel safe and content to do: ______________________________________________________

I feel good with: _____________________________________________________________

            The group discussed what comforted them when they experienced negative thoughts and symptoms of psychosis. They discussed living at home with their family and feeling safe and comfortable. They spoke of supportive people, such as friends or family who listened, their therapist or doctor, and feeling that they were trulyheard. They discussed how they felt valued by others, leading to happiness.

Positive Thoughts and Happiness

Smaller Amounts

What are some small, enjoyable things that I have done? _____________________________________________________________

Listen to music, rest, be with friends or family, be with a pet, walk my dog,

and watch the sunrise or sunset. Listen to birds while walking outside. Feeling the breeze on my face _____________________________________________________________

_____________________________________________________________

Medium Amounts

What are medium-sized events or hobbies that I enjoy? _____________________________________________________________

Going for a bike ride with a friend or family, going for a walk in the park, going to a movie, doing arts and crafts, sports, singing, dancing, or being with friends.

_____________________________________________________________

Large Amounts

What is a large amount of happiness for me? _________________________________________

Going to a concert, a birthday party, or a wedding. Being with friends, laughing, and playing board games.

_____________________________________________________________

Positive Thoughts, Happiness, and Enjoyable Activities

Small: _____________________________________________________________

Medium: _____________________________________________________________Large: _____________________________________________________________

            The group felt better when they shared their difficulties. Participants felt a sense of relief and created a change. The atmosphere in the room became calmer and more relaxed. Trying to get into a happy mood was difficult for many, and for some, it was impossible.

             Group conversations asked others how to lower their stress level and depressed mood. Participants explained how they got stuck in depression and had low energy and low motivation. The group recognized and acknowledged symptoms and discussed being patient with the process.

            One person said that friends told them to try to smile, and then they would feel better, but it did not work. The group talked about stigma and that they felt worse when people told them to try to cheer up. They spoke of frustration and felt the friend was not listening to them.

            Just buck up

            Just do it

            Pick yourself up by your bootstraps

            One participant told the group how they helped them escape a funk. They thanked the group for sharing their ideas and giving them hope. The group considered pleasant activities on a spectrum to see where they had trouble when they felt content, and what was a happier event.

Pleasant Activities and Events

            The group discussed how being content or satisfied was “good enough” for happiness. Participants explained how different degrees of happiness can occur. They compared sad moods to feeling content and being grateful for this. Other participants agreed that feeling satisfied is a healthy state to be in.

Trying to reach the neutral zone and not putting pressure on oneself to be happy every day was not realistic. The group discussed the USA culture that attempted to sell products to make them feel satisfied, but that was just the sales pitch.

            Changing a mindset or an attitude takes patience, time, and understanding. Once there, a person can feel relief from intense symptoms. Moving further into happiness and positive affirmations may require more self-reflection and tolerance of troublesome symptoms.

            Pleasant experiences (Segal, Williams, Teasdale, 2013) were cultivated in the group. Just as a person raises a garden and tends to it daily, our positive thoughts and focus need attention.

            The group focused on replacing negative thoughts with neutral ones. They discussed the pleasant experiences they had had on a day-to-day basis. Practicing these skills daily helped them develop a new habit of noticing pleasant events. The group practiced observing the five senses as they ate, using this time as a mindfulness activity. The use of the five senses helped participants find pleasant experiences and sensations.

Three Good Things

            Group therapy discussions attempted to identify three positive things and utilize positive psychology, but participants struggled to find pleasant events in their past week. The group discussed the possibility that a range of scenarios could lead to this outcome. The group learned to recognize and appreciate positive or satisfying events through mindfulness practice.

            The group learned to use self-kindness with their thoughts and become non-judgmental towards themselves and others. This meant they did not criticize, insult, or swear at themselves. Once they could do this, they applied it to others and could identify three good things.

            The group tried to do Three Good Things (Seligman, 2005) each time they met. They were reminded to watch birds and listen to their calls, to notice the colors of leaves and changes of the seasons. Other ideas include spending time with friends or family, listening to calm music, reading a book, eating a tasty sandwich, petting a dog or a cat, enjoying the aroma of a spaghetti dinner with garlic toast, listening to a rainstorm, or watching clouds.

Three Good Things

1. _____________________________________________________________

2. _____________________________________________________________

3. _____________________________________________________________

The Mindfulness Response taught participants to observe negative thoughts and pay attention to how they affected their mood. This was considered an essential part of self-care. Practice questioning and challenging negative thoughts helped neutralize them. One participant mentioned feeling part of a community due to the support from providers, friends, and the group. Once the distress from thoughts decreased, the participants began to notice three good things. The use of gratitude helped participants learn to view problems in a different light. One participant discussed how they changed their life by utilizing the skills and using gratitude to understand the importance of their relationships with others. The group validated the response and stated that it was highly valuable to them.