Integrating Mindfulness in Mental Health Recovery

In the recovery community, there is a growing awareness that the conventional system and the "disease" model of care has let us down; at times, it has chronically disempowered mental health clients, many of whom end up in the peer community seeking answers and help. At the same time however, perhaps paradoxically, it should also be acknowledged that the mental health system does many good things for people in recovery; tremendous things actually, in many ways. In learning to self-advocate and become more self-directed, people in recovery must work harmoniously and cooperatively with the conventional system to optimize recovery. I personally try to see that although the system is broken (and is changing, albeit slowly), there are nonetheless good people doing great things, it is important to focus on utilizing existing resources that are helpful, and learn to trust its helpers as much as possible.

Many criticisms of the conventional system do exist, and disempowerment unfortunately still does occur at times, and peers must be aware of it when it does. There are a number of reasons: documented instances of traumatic dehumanization; a lack of empathy and sociocultural awareness among some (but not all) conventional helpers; a systemic focus on deficits and weaknesses instead of on strengths or on amplifying wellness; an approach of "fixing" problems instead of healing or facilitating change; non holistic approaches to mental health; an over reliance upon psychiatric drugs and on pathological labeling; and finally, a hierarchical, and at times even authoritarian approach. It is clear how all of this can surely contribute to substantial feelings of disempowerment. It is also clear that these influences have helped birth the recovery movement.

With that said, one may ask, what can peers in recovery do to become more self-empowered and independent, rather than dependent, or disempowered? The first principle of recovery, as defined by the Substance Abuse and Mental Health Services Administration (SAMHSA) is that recovery is self-directed. The peer community and the Recovery Learning Communities (RLC's) are designed to help those in recovery become more self-directed, and to develop self-help skills for recovery. One simple yet profound self-help skill is the practice of mindfulness meditation. Mindfulness is a holistic, non-drug, self-directed, strengths-based approach that can be done by anyone, no matter what stage of recovery he or she is in. Mindfulness is a practice of paying attention, being in the moment in a special way, with nonjudgmental awareness. It is about minimizing – even if only for a few minutes at a time -- the distractions of modern living, including the sensory stimulation, technology and information overload, the excessive and at times unrealistic expectations and constant pulls from all directions perpetually experienced in modern life. Sitting in meditation is merely one (though very important) aspect of mindfulness, however, the practice of mindfulness is actually about learning to embrace life each moment more fully in a centered way in body, mind, and spirit. Mindfulness has been practiced in various ways for thousands of years in global cultures, and is now expanding rapidly in the Western mental health field, regarding both practice as a self-help tool and in terms of scientific research.

How does being present and paying attention more deeply aid in recovery? Very simply -- life is happening now, and opening up and experiencing it, awakening to the precious present, is potentially very healing. For example, coinciding with recovery are often feelings of low self-esteem that are connected with guilt and shame, rumination, constant feelings of angst, and worry about how things could or should be, e.g., "If only I had done this..." or "What if things were like this...? or "What if I had become like this...?". This type of thinking is rooted in attachments to a past which cannot be changed or to a future which does not yet exist, or rooted in an inability to embrace the now. A key is relaxing into one's own being, trusting self and others, and learning to embrace positive emotions and positive interpersonal connections. It encompasses learning unconditional self-compassion, e.g., no matter what one has accomplished, how much stuff one owns, how attractive or slim the body is, or anything else – in the here and now.

Some people see this as a defeatist attitude, as though it is resignation about things that cannot be changed, which is simply not true. We are constantly in a state of both being and becoming, but unless we learn “being,” then becoming -- envisioning and creating a new future -- remains perpetually difficult. There are many things we can change about ourselves, some more difficult than others; yet discriminating between the two, what can and cannot be changed, is critical. Constantly challenging oneself with realistic and hardy goals is unquestionably important, yet simultaneously living in the present and learning the art of relaxing into and accepting "what is" is crucial to happiness. This is much different than helpless resignation. The process is not about fixing, fixing is what the conventional system seems bent on doing. We may need to fix some aspects of our situation, yet the whole of who we are does not need fixing, we are complete. This is a foundation of the practice of mindfulness.

Mindfulness’ use in mental health is built upon a foundation of brief tools for managing stress more effectively, self-awareness, and handling difficult emotions. A central idea is the utilization of brief practices, not necessarily long, advanced meditations. It is increasingly being used in the conventional mental health field as well. Current burgeoning therapies include Dialectical Behavior Therapy (DBT), Mindfulness Based Cognitive Therapy (MBCT), Acceptance and Commitment Therapy (ACT), Mindfulness Based Relapse Prevention Therapy (MBRP), and Mindfulness Based Stress Management (MBSR) among others. Many new self-help skills are being introduced all the time, juxtaposed with ancient time-tested practices. The good news is you don't have to wait for a therapist or other professional to teach you mindfulness. Although there are many involved techniques and practices, at its essence, it’s truly simple. You can begin with simple practices now, and use them any time during your day.

A Guided Mindful Journey Let’s begin together on a guided mindfulness experience: Close your eyes, sit comfortably in your chair but also be straight and align your body. Take a few moments to relax and quiet body, mind, and spirit. Turn your attention let go of all the external stimuli. Take a deep breath and release it slowly. Now, take another deep breath, release slowly, and sigh as you release. Next, allow the breath to breathe itself, recognizing there is no right or wrong way to breathe, breathing is truly organic. Although you can consciously intervene in the process, the breath is primarily controlled by your body’s innate wisdom, associated with the autonomic nervous system.

Once again, simply notice the breath breathing itself. Feel your breath like the ocean, envision you and your awareness resting like a leaf on top of the water. Gently allow the breath to move in an out with the ebb and flow of the water; simply notice as it moves, again, a leaf floating atop the gentle, moving water. Now, become aware of your inner reality -- tune in to feelings, thoughts, sensations happening inside of you, any thoughts or feelings from your day. Just let them be, let go, no need for struggle. Allow difficult feelings to move on by, release feelings of tension or anxiety, fear, or pain. Notice any difficult feelings toward self, let them be; let go. Peace and tranquility are now permeating your being. Allow everything to be as it is, with no need to resist. And, as you let go, amazingly, paradoxically, you also become increasingly centered and more in control of your own vital energy. You are in the present, you are living mindfully, you are whole and complete as you are.

It is very empowering to take time each day to do this, to nurture your spirit, and to make a regular commitment for self-care practice. The art of self-compassion, in a sense, self-parenting, is an important step to healing emotional trauma and wounds. So, whether or not the “system” has let us down, we each can, little by little, begin taking back control of our own minds, and our well-being. The reason that such practices have been used for thousands of years, and now like wild-fire in the mental health community is because they work. A few minutes of inward attention practiced consistently can do wonders for self-esteem, an overall state of calmness, and self-efficacy.