0:02

Welcome to the Mind Dive podcast

0:04

brought to you by the Menninger Clinic , a

0:06

national leader in mental health care . We're

0:09

your hosts , dr Bob Boland and

0:11

Dr Keri Harrell Twice

0:14

monthly .

0:14

We dive into mental health topics that fascinate

0:17

us as clinical professionals and we

0:19

explore those unexpected dilemmas

0:21

that arise while treating patients . Join

0:24

us for all of this , plus the latest

0:26

research and perspectives from the minds

0:28

of distinguished colleagues near and far . Let's

0:31

dive in . Welcome

0:44

back to the Mind Dive podcast . We're really

0:46

excited today to be joined with Dr Willem

0:49

Keichen . Dr Willem Keichen earned

0:51

his PhD from the Institute of Psychiatry

0:53

, king's College London and his doctorate

0:56

in clinical psychology from the Salomon's

0:58

Clinical Psychology Training Program

1:00

. Dr Keichen learned cognitive behavior

1:03

therapy over two years as a postdoctoral

1:05

fellow at the Center for Cognitive Therapy

1:08

University of Pennsylvania and

1:10

the Beck Institute . From 1999

1:12

to 2014 , he worked at

1:14

the University of Exeter , where he

1:17

held numerous roles , including

1:19

heading up the doctoral clinical

1:21

psychology training program and leading

1:24

the clinical research group . Dr Kaiken

1:26

co-founded the Mood Disorder Center

1:28

and co-founded the Masters in Mindfulness-Based

1:31

Cognitive Therapies , and since 2014

1:33

, dr Kaiken has directed the Oxford Mindfulness

1:36

Center . So an absolute expert on mindfulness

1:38

and we're so excited to have you here

1:40

today . Thanks for joining us .

1:42

Right and a new book out , I believe .

1:44

Yeah , we're especially focusing in on your

1:46

new book Mindfulness for Life Right Absolutely

1:49

.

1:49

Well , welcome . Thank you . It's a privilege

1:51

to be on your podcast .

1:57

Thank you . So for starters , can you just tell us about your career .

1:58

So , far and just how you got interested in mindfulness . So I'm a research clinical

2:00

psychologist and all of my work has been

2:03

around the prevention of depression and

2:05

psychological approaches to the prevention of

2:07

depression , and actually

2:10

my interest in mindfulness predated

2:12

my work in this area . I was

2:15

working as a young postdoc for

2:17

the World Health Organization , traveling

2:19

all around the world . It

2:22

included traveling to places like Thailand

2:24

and India and I got

2:26

really interested in what could

2:28

we learn from places like that about

2:30

mental health and well-being and healthcare

2:33

, and we were developing a quality

2:35

of life measure that's actually still widely used around

2:37

the world . And I decided

2:39

to do a bit of research and I kind of got interested in

2:41

Buddhism and mindfulness

2:43

and started practicing retreats and having

2:46

a daily meditation practice and in

2:48

those days to have said that to one's boss

2:50

or in a professional setting would have

2:52

been professional suicide . A

2:55

few years later I went to a conference called

2:57

I think it was called East Meets West and there

2:59

were people there like Francisco Varela

3:01

, jon Kabat-Zinn , jon Teasdale

3:04

, and it was a place where people were

3:06

beginning to seriously think about what

3:08

can modern psychology and

3:11

contemplative traditions learn

3:13

from each other and for the benefit

3:15

of mental health and well-being ? And that's

3:17

where the kind of professional link came together

3:19

and since those days I've been doing research

3:21

around mindfulness-based approaches to preventing

3:24

depression .

3:24

Those days I've been doing research around mindfulness-based approaches to preventing depression

3:26

. I do want to quickly ask what the measure is the life

3:29

satisfaction measure ?

3:30

So it's called the WHO-QUAL , the World Health

3:32

Organization Quality of Life Measure , and actually

3:35

it was developed in North America . It's used a lot

3:37

in clinical trials and studies of that yeah

3:39

absolutely . It was a really

3:41

cool development because we sat in focus groups

3:44

with healthcare professionals and

3:46

patients in 15 different countries

3:48

, 15 different languages , first

3:50

understanding how people understood quality

3:52

of life and what the dimensions of quality of life

3:55

were , and then we went through a whole psychometric

3:57

validation and development of this measure

3:59

and it's held up really well over

4:01

the years .

4:03

I believe we give that to our patients here as part of their

4:05

outcomes . I think we do , yeah , which is really

4:07

cool . I will say again yeah , we want to focus

4:09

in on some of your work around mindfulness , and

4:12

I know this . You know our podcast is geared

4:14

towards mental health clinicians , so many

4:16

of the people listening will probably already

4:18

have thoughts about this , but

4:25

from your perspective , I wonder why . You know , how do you see mindfulness being

4:27

so integral ?

4:27

to mental health . Why is it an important thing to focus on ? Well , the way I define mindfulness

4:30

and think of mindfulness is it's kind

4:32

of a combination of awareness

4:34

and these

4:37

attitudes of mind , curiosity

4:40

and kindness and

4:42

open-mindedness . And

4:45

the third dimension

4:47

is something around , I think , ethics and values

4:49

. And so awareness on its

4:51

own isn't mindfulness . Awareness is

4:54

a very powerful capacity and it could

4:56

be used in all sorts of ways , including by a sniper

4:58

, for example . But

5:03

when awareness is linked to a sort of ethical basis and when it's imbued with these qualities

5:05

of what I call befriending

5:08

, if you like , it becomes mindfulness

5:10

. And I think a lot of what we

5:12

do in therapy is about

5:14

people's stories and people's narratives and

5:17

formulating those and thinking about

5:19

how we can treat whatever they present with , be that

5:21

depression , anxiety or anything else . But

5:23

I think what mindfulness is doing is it's adding to

5:25

that by actually thinking about how the mind

5:27

operates , how the kind of process

5:30

of the mind can generate states

5:32

of depression , states of anxiety , and

5:35

so I think of it sometimes as being a bit like links

5:37

in a chain , and what you're helping people to see

5:39

through awareness is those links

5:42

in a chain and the possibility

5:44

then , potentially of not of breaking

5:46

links in those chains . It's not necessarily about the story

5:48

I'm not saying that isn't important but

5:50

this is a different way of working with people

5:52

, and I my understanding is , when you look

5:54

at surveys now of psychotherapists

5:57

and mental health professionals , I think that it's almost like

5:59

a majority now are integrating some

6:01

of these ideas into their practice . But

6:04

one of the things that I think is actually

6:06

quite powerful is there's been a couple of trials

6:08

now where they've randomized

6:11

the therapists to mindfulness training

6:13

themselves , but the outcome has been

6:15

patient outcomes , and

6:17

what they found is that when therapists

6:19

have trained in mindfulness themselves , their patient

6:21

outcomes improve , and that's not

6:24

because they're teaching mindfulness . It's because they

6:26

are able to perhaps be

6:28

more present to their patients and

6:30

more able to regulate their own emotions

6:33

in the face of patients who might be quite

6:35

dysregulated , for example , and so

6:37

I think it has a

6:39

real adjunct role

6:41

alongside the work

6:43

that you and many of your listeners will

6:46

be doing , but it also has a really

6:48

, I think , crucial role for us as

6:50

mental health professionals as well , in terms of our

6:52

own work and our own well-being

6:54

.

6:55

Totally agree . So can you say a bit about the techniques

6:57

used in it ? I mean , probably a lot of people would know

6:59

, but still , of what sort of

7:01

things are taught in it .

7:03

So two things that I

7:05

think most mindfulness-based

7:08

programs will use

7:10

is what are called formal practices and informal

7:13

practices . And the formal practice

7:15

are things like body scan , mindful

7:17

movement , attention on the breath

7:19

, and these are sort of longer practices

7:21

, and the idea is that these are kind of like you

7:24

know , to use a physical exercise

7:26

metaphor these are ways in which one can

7:28

strengthen particular muscles , and

7:30

traditionally this is thought of as being

7:33

three parts . One is sort of focus and

7:35

attention being able to train our attentional

7:37

muscle , if you like , so that we can have a

7:39

bit more volitional control about where we place

7:41

our attention . Another form of practice

7:43

I think of as being like cultivating

7:46

different attitudes of mind . So

7:48

you're actually cultivating curiosity

7:50

, you're cultivating friendliness , and I think a lot of

7:52

our patients and actually many therapists themselves

7:55

, when they become aware of their mind , they

7:57

can see how self-critical they are , they

7:59

can see how they have this

8:02

kind of imposter syndrome often

8:04

, or they have this constant orientation

8:06

to threat and befriending the

8:08

mind enables people to actually have a different

8:11

relationship . So some of the practices are about cultivating

8:13

these attitudes of mind , and then the

8:15

third class , I think , are insight practices

8:18

, and this is about understanding . So , as

8:20

I was saying just now , about , for example , being able

8:22

to see that at the moment

8:24

in which we judge in that

8:26

process of the mind that something

8:28

is pleasant , unpleasant or neutral is a really

8:31

sweet spot , because that's the spot at

8:33

which we will either go into a ruminative

8:35

loop and potentially create something problematic

8:38

and on the counter side to

8:40

that , with sort of maybe something pleasant

8:42

, people can skate over that . There's nothing

8:44

to see here , nothing that needs paying attention to

8:46

, there's no threat here . It's not salient

8:49

, and I'll move on quickly . So that sweet

8:51

spot in mindfulness , when people see that they

8:53

have the potential to either go gosh

8:55

this is a pleasant moment , this is a

8:58

moment of connection with a loved one or

9:00

this is a moment of feeling calm

9:02

in nature and to learn to

9:04

begin to savor those moments . I think that's

9:06

a really important part of our work

9:09

. It's not just working with the psychopathology

9:11

, if you like , but also building up

9:13

the kind of positive valence system , if you

9:16

like , and so there's a so-called insight practices

9:18

.

9:18

Well , I'm thinking about too you

9:21

know , when I work with patients around

9:23

mindfulness , I tend to find the

9:25

awareness piece probably

9:27

comes the quickest , the easiest . It is the

9:30

non-judgment piece and

9:32

the kind of work around trying to consider

9:35

different states of minds and hold them more

9:38

, even at the beginning , more

9:41

neutrally . Can we think about it more neutrally

9:43

? That is so tough . Those cycles

9:45

were so difficult to break and

9:47

I know a few of my patients . When we're doing

9:49

this , even in vivo , we're doing it in groups

9:52

they're like this is so challenging

9:54

. It's so challenging to hold your own

9:56

mind with compassion . I think that's so

9:58

easy for people to do what

10:01

they've known to do , which is hold themselves with a lot

10:03

of harshness and criticism

10:05

.

10:05

I guess one of the things that I'm arguing

10:08

in the new book is that I think this

10:10

is a lifelong journey . You

10:12

know , I think what you've just described there is when people begin to

10:15

step back and see the mind . These

10:17

are long-held habits of thinking

10:19

and it can be a lifelong journey

10:21

, I think , to be able to stand back and change

10:23

one's relationship and diminish the power

10:26

of these ways of thinking

10:28

. Winston Churchill used to talk about his depression

10:30

as this black dog , and I think that's very skillful

10:33

in a way , because what you're doing is you're stepping back , you're

10:35

decentering and you're giving a name to

10:37

the depression . So it's out there and

10:39

more than that , like a black lab . A lot of

10:41

people love black labs , so you actually there's

10:43

so a different relationship one's developing

10:45

to . It's not like the bad thing that I have to somehow

10:47

cut out or get rid of , but it's something

10:49

that's part of my life that I can somehow befriend

10:52

. And I think for people maybe not for people with

10:54

a first episode of depression , but for people with recurrent

10:56

depression that can be a very skillful way

10:58

of changing their relationship to their thinking

11:01

.

11:01

I care a lot about gratitude and gratitude

11:04

practices , but whenever I teach them to

11:06

my patients , I try really hard to say something

11:08

along the lines of I want us to be thoughtful

11:10

about how we think about gratitude

11:12

, because so often for especially our folks with

11:14

depression gratitude's been used and

11:16

weaponized against them At times like

11:18

how could you be depressed ? Look at all you have to

11:20

be grateful for . So I've noticed a lot of my patients have

11:23

this sort of tendency when I say let's work on

11:25

gratitude , to say ugh

11:27

, they have this sort of frustrated response to it . And so

11:29

I feel like I say something kind of similar . You

11:32

know , along the lines of gratitude is as

11:34

well that we can always pull from , even

11:36

alongside our pain . It's not that we're

11:38

saying that one washes over the other

11:40

, or because you have gratitude or you

11:42

take time to notice things in your life that are

11:44

going well , that the other painful stuff

11:46

their grief , depression , sadness isn't

11:48

there . It's that we pay attention

11:50

to both and don't let sort of one wash

11:52

away the other . And again I found a similar

11:54

sense of my patients feel like , oh yeah

11:57

, I guess if it doesn't mean that , like I can't and

11:59

don't have these other painful feelings I can pay

12:01

attention to it with more open hands I

12:04

think it's very common , isn't it , for people to have

12:06

people with a history of mental health problems to have

12:08

, as you say , these kind of beliefs that

12:10

can invalidate the positive .

12:12

I don't deserve this . This is self-indulgent

12:15

, this is not acknowledging that the

12:17

difficult pieces . But if you can actually

12:19

bring that into awareness too and go gosh

12:21

, there's a thought that actually that

12:24

you , that your mind , is placing a thought

12:26

between you and happiness , wow

12:29

, and that's really . I remember . I remember

12:31

having a patient once , a young woman with children

12:33

and toddlers , and

12:36

she was with the toddlers and she started having this flurry

12:38

of thoughts about I'm no , you know , I'm

12:40

a terrible mom and I'm going to

12:42

screw up my kid . And we were sitting in a

12:44

class with other patients and

12:46

and she said , you know , I , I

12:49

started to use some of the practices that we've developed

12:51

and I saw these thoughts

12:54

as being like wrecking ball thoughts

12:56

, and everybody else in the class

12:58

had this kind of look of and this nod

13:00

of recognition . Yeah , I get those wrecking ball

13:02

thoughts too . And what was so interesting

13:04

about that metaphor is , of course , a wrecking

13:06

ball is strong and powerful , right

13:09

, but actually if you just step back

13:11

back , you can

13:13

see whoosh as it goes and

13:15

if you just don't interfere with it , it will lose

13:17

its power and its valence sorry , its

13:19

power , and it's kind of like its strength

13:22

. And that was her

13:24

journey and I think , um , you

13:26

know , in the book we we also talk about these

13:28

practices . I broaden it it , I have to say , beyond

13:31

gratitude and we call them appreciation

13:33

practices , because in the wisdom

13:35

traditions gratitude is just

13:37

a small part of what's sometimes

13:39

called sort of appreciation practices

13:41

. So I think in that family

13:43

there are . There's just hedonic

13:46

pleasure , but there is also

13:48

a sense of ease and

13:50

contentment . There is also

13:53

generosity and selfless generosity

13:55

, and

13:58

one of the practices that we use , that people love and is in

14:00

the book , is this reviewing the day practice

14:03

. So as you get to the end of

14:05

the day , maybe when you're in bed , you're about to fall asleep

14:07

and you just scan back through your day and go

14:09

, what from the day have I got

14:11

a sense of appreciation for

14:13

? It might be a moment of love , a moment

14:15

of connection , a moment of joy or something really

14:18

simple , like my first cup of coffee this morning

14:20

was amazing . Or you know

14:22

, I was just sitting in the other room

14:24

here and I've got in london is we've

14:26

got a lot of parakeets , and so the parakeets

14:28

are outside my balcony

14:31

eating and then all of a sudden a squirrel

14:33

came by , um , and it was

14:35

carrying its young from one nest to

14:37

another . And it's like there's little moments like that so

14:39

you can just look back on your day and

14:41

reflect on those and enjoy

14:44

them and savor them and actually so

14:46

they become like a you know , you're really

14:48

developing that ability to savor

14:50

and appreciate and at the same time

14:53

then opening up , was there anything from the day that

14:55

you felt didn't go so well

14:57

? Is what I learned from that

14:59

, but not with that kind of ruminative mindset

15:01

. But what can I learn from that ? And

15:05

then can I put that down and let it go . And our patients seem to just

15:07

, you know , really love those kinds of practices

15:10

because you're , in a way , you're retraining the

15:12

mind to change what

15:14

it focuses on and how it focuses on

15:16

things .

15:17

Sure , you know . Can you tell us like in your new

15:19

book you focus on the reality

15:21

that you know a lot of people drop their practice over

15:23

time . You know certainly people I've known , including both

15:25

colleagues , not just patients .

15:27

I thought you were going to say both you and me .

15:29

No well , I won't speak for you , you

15:31

just patience . I thought you were going to say both you and me no well , I won't

15:33

speak for you . You know , they kind of start

15:35

strong and they're very excited and stuff , and then it trails off . I don't know . What have

15:37

you learned from that ? Why do people drop

15:39

out of this if it's so helpful ?

15:45

You know , it's really interesting , isn't it ? And the same happens with

15:47

cardiac rehab , doesn't it People ? Have a real scare with a hard time . Why don't I ?

15:48

exercise all the time .

15:49

Yeah , why don't I exercise all the time ? Yeah , that's right , and they start off really

15:51

well and they drop it off . And I think what

15:53

we're learning is that

15:56

if you , you

15:58

know , one of the motivators for doing something like

16:00

practice is that you're suffering , right , you're

16:02

in a bad way , and you practice because you know it's going

16:04

to help you . And that's the same with the early days of cardiac

16:06

rehab . You had

16:08

a real scare and so you're going to do everything that the

16:10

doctors ask you to do . But

16:13

we've reframed how

16:15

we think about mindfulness practice and it seems to be

16:17

paying off . So what we're

16:19

doing is we're moving away from a metaphor

16:21

of , um , physical exercise . You

16:24

know you've got to go to the gym . Go

16:26

to the gym , you're going to get the strength

16:28

and this fitness and that's . There's

16:30

a kind of a validity to that . But actually

16:32

a lot of people join the gym and then the same

16:35

thing .

16:35

Well , gyms , that's where they make their money .

16:38

And so we're using two

16:41

ideas which seem I mean , the

16:43

research needs to be done but seems to

16:45

be working . The first is to

16:47

change one's relationship to mindfulness practice

16:49

to be more like it's

16:52

your best friend . And if

16:54

you think about the qualities of a

16:56

best friend , right , they're loyal , they've

16:58

got your back , you like hanging out with them

17:00

. You know sometimes they're a bit of a pain in the behind

17:03

. Give them that , because

17:05

actually you're lifelong friends and

17:07

you invest in them . You put energy

17:09

into them . Lifelong

17:12

friends and you invest in them . You put energy into them and when people think about their

17:14

mindfulness practice and indeed their body and mind , as being like their best friend

17:16

, this is something you want to invest in because it's

17:19

going to be there from this moment

17:21

to the moment we die . So this is

17:23

a relationship that will actually

17:25

support you through your life . And then

17:27

what I'd say is you start to build

17:29

in something so that it becomes

17:32

intrinsically rewarding , that appreciation

17:34

practice I was just talking about . People

17:36

don't go away and do that and go . That was fun and I stopped doing

17:38

it , and I think they do do that with the gratitude practice , by

17:40

the way , because for a while they go . Yeah , okay , I'm grateful for my

17:42

kids , I'm grateful for my dog , I'm grateful for my job

17:44

, I'm grateful for my health . It's like a checklist , but

17:47

if you're actually looking back to , the richness

17:49

of your day is like what I just described

17:51

with the parakeets and the squirrels . That's

17:53

unique , that's not happened any other time and

17:56

you know we were just sitting and watching and laughing

17:58

and um , it was . You know , it was extraordinary

18:00

. So you build in this sense of intrinsic

18:03

motivation and you link it to values

18:05

. So one of the things I do , for example

18:08

, is at the end of a year I look at my appreciation

18:10

list and I go gosh , that's really interesting . Pretty

18:13

well , consistently all the way through physical exercise

18:16

, and my daughter's has been

18:18

there all the way through , and

18:20

so I'm actually going to prioritize that

18:22

in my life . And then I think

18:24

people don't see practice as being

18:26

like the gym . They see it as this is actually

18:29

. This is is my life , and this is

18:31

a really rewarding part of my life and I

18:33

invest in it because I care about it in the

18:35

same way we invest in our friendships . It's

18:37

quite a subtle shift , but I think it's quite

18:39

a profound shift in a way , and certainly

18:41

it's the way I feel when I get on the mat every

18:43

morning , I get on the mat because this is

18:45

, it's like a friend , it's like a chance

18:48

to set for the day . I'm not doing it because I

18:50

have to , or I feel like I've got

18:52

some Zen monk with a stick behind me . I'm

18:54

doing it because it adds value to my

18:56

life .

18:57

Well , it's making me think . Actually , this whole

19:00

conversation is making me think about mentalizing

19:02

, and it is . I think there's a lot of overlap

19:04

in the mentalizing literature

19:06

and concept and mindfulness as a concept

19:08

. But you know , when I teach this to

19:10

my patients , I , you know , I say mentalizing

19:13

isn't a checklist , it's not something that we do as

19:15

far as , like , you do this , this and this and you're mentalizing

19:17

. It's a stance , it's a posture and it's

19:19

one where I try to cultivate that . It's a , it's a

19:21

way of being rather than as a . I'm

19:24

going to take the time to do it , and that

19:26

completely tracks with what you're saying

19:28

, that mindfulness is a posture towards

19:31

your mind . Yes , so there's practices

19:33

to , to get better at

19:35

that , like any other skill that ultimately

19:37

becomes a part of your life , like this is how I relate

19:39

to my mind yes , throughout the day

19:41

, with awareness , you

19:43

know , with , with compassion , with non-judgment

19:46

. That , again , it's not like I'm going to take this 40

19:48

minutes just to do a meditation

19:50

so that I can check off that I did mindfulness today

19:52

, but it's a , a noticing that

19:55

, again , I think , is hard to do .

19:58

It's hard to practice that , yeah , I

20:00

think it's a really nice way of describing and

20:02

I I try to encourage people

20:04

when they have their morning practice is

20:07

to end the practice with setting an intention

20:09

for the day . So so that's your

20:11

idea of mentalizing , right . It's not just that you're doing the practice

20:13

, you're saying all right , today's a day that's going to be really

20:16

busy and really quite stressful . Is

20:18

there a way I can keep a sense of being

20:20

anchored and grounded throughout the day ? And can I

20:22

just try and stay connected through the day ? And

20:24

I think that that works , you know

20:27

, particularly if you link it to the review of

20:29

the day at the end of the day , because then you're sort of , in a way

20:31

, holding yourself to account . I mean a nice

20:33

way . I would add one other thing to what

20:35

you said about mentalizing , because I think some people

20:37

sometimes have this idea that mindfulness

20:40

is a sort of very internal activity

20:42

and maybe even a selfish activity

20:44

. I've heard it described as , and I really don't

20:46

think it is . I think it's quite the opposite , because

20:48

what you were just describing is also

20:51

, then , how you're going to show up to your friends and

20:53

to your colleagues and to your kids

20:55

and your family members and whoever else

20:57

, so that internal how

20:59

we relate to ourselves is

21:01

also how we relate to other people , and

21:03

I've done a fair amount of research

21:05

on compassion and we developed this measure

21:07

of compassion which has got these

21:10

two scales compassion for self and compassion

21:12

for others . And what's very interesting

21:14

is that they're not as correlated as you think

21:16

they might be , and I think , particularly in our profession

21:18

, a lot of people are able to be compassionate to their

21:20

patients but not particularly compassionate to themselves

21:23

, and I think that's a recipe for burnout

21:25

. And I think the ability to have

21:28

genuine what you

21:30

described as mentalizing or friendliness

21:32

to our own inner landscape If

21:34

we have that , we're more genuinely

21:36

going to be able to show it , I think , to other people in

21:38

a long and sustainable way , and

21:41

that's why I think these skills are so very

21:43

important .

21:44

I tend to tell my patients and I don't know if you'd agree with this and , quite

21:46

frankly , I don't know if the research would agree with me , but anecdotally

21:49

I tell my patients that our self-compassion can

21:51

at times be our ceiling for our compassion

21:54

towards others . I think , cognitively , people

21:56

think I have so much

21:58

more grace towards other people than I do to myself

22:00

and I'm like but do you ? I don't

22:02

say it like that , but I'm like , do you ? Because

22:15

how can we really look at ourselves , our own bodies , our own minds , our own experiences , with such

22:17

hostility and then look at somebody else's where it's similar , and be like oh no , but it's fine . And again , maybe there is that like a at a level

22:19

that's more conscious . But again I think , like there is this my sense is a deep relationship between these things

22:21

that when we can get better at connecting

22:24

with ourselves through compassion , through acceptance , we

22:26

really do have more of an ability to show

22:29

up for other people in a way that feels so much more profound

22:31

.

22:32

I agree with you wholeheartedly . Mother

22:34

Teresa used to with

22:36

her nuns in Calcutta . She

22:39

used to spend , they used to spend several hours

22:41

before they went into the slums

22:43

of Calcutta in prayer and

22:45

prayer to develop a sense

22:47

of compassion for themselves . So

22:49

they were resourced to show

22:52

up and really show up right , because when you're

22:54

faced with that amount of suffering it's really difficult

22:56

to show up . So she was resourcing

22:58

her nuns in the same way . And I have to say

23:00

, when I do clinical work and I think this is maybe

23:02

why those trials

23:05

I was describing earlier , where therapists

23:07

with a mindfulness practice have better outcomes I

23:09

will sometimes sit and meditate

23:12

before a session and

23:14

bring to mind the patient and

23:17

bring to mind the client , and particularly the one

23:19

that I'm

23:21

feeling quite hopeless about , or I'm kind of hoping

23:23

maybe doesn't show up . Yeah right

23:25

, I will cultivate a sense

23:27

of compassion and care for them and it transforms

23:30

the way you're able to show up and be present for

23:32

people , I think clinically . So

23:34

I think the point you make is very well made

23:36

.

23:37

This is fascinating . You know

23:39

. We have a lot of people listening who are clinicians

23:42

and I'm curious , you know , what would you share with

23:44

them , especially if they're having patients who are struggling

23:47

starting with mindfulness

23:49

, or perhaps they're having trouble sticking

23:52

with it and stuff . What is their practical

23:54

advice ?

23:54

maybe even and it sounds like we've all had

23:56

this experience where the patient rolls

23:58

their eyes . They're like , yeah , we got to work on mindfulness . They're

24:00

like , oh , that's not gonna be

24:03

, that's not gonna help with my real life , real depression

24:05

or I've done that before and that

24:07

just doesn't help we hear that one all the

24:09

time , yeah , yeah what

24:11

? What advice might you offer to our clinicians

24:14

?

24:15

you know , I'm british and we , we're

24:18

really keen not to be self-promoting

24:20

, but I , I would . I would

24:22

recommend the book I've just written because

24:24

it's essentially , it's essentially

24:26

this , and I yeah , so it's

24:29

essentially an answer to this question and I

24:31

, I really hear what

24:33

you say about . I've tried that before

24:35

and it doesn't work . And I

24:38

, I never say this , but I , I think that

24:40

you know that's a bit like saying I've tried relationships

24:42

, it doesn't work . Or I've tried exercise

24:45

and it doesn't work . I've tried not smoking and it doesn't

24:47

work . I think you've

24:50

got to just somehow just like

24:53

, do some sort of jujitsu on that and move

24:55

past that . And I think the way to do it is to actually

24:57

use different language and

24:59

not talk about mindfulness

25:01

, but talk about the subcomponents of mindfulness

25:03

and what it is that might be helpful . I

25:06

mean , nobody's really going to say you know

25:08

, my ability to pay

25:10

attention , that's not important

25:13

, that doesn't work , I'm not interested in improving

25:15

that . Or my ability to regulate my

25:17

impulses , that's not

25:19

important , I don't care about that , I don't

25:21

want to learn about that , and I think

25:23

you know . If you so , I

25:25

think the book talks about this quite a lot , but it's how

25:28

you describe what it is

25:30

you're trying to teach someone

25:32

and that you remember what I was saying earlier

25:34

about these different practices for different functions

25:36

. It's like what is this person's challenge

25:39

and then how

25:42

do you make the practice bespoke

25:44

to their challenge ? Um

25:46

, so , somebody who might be very dissociative

25:48

you want some more grounding and anchoring

25:51

practices . For somebody whose attention

25:53

is all over the place , you might

25:55

want some focus practices and

25:58

very practical focus practices . And

26:00

for somebody who has problems regulating

26:02

their impulses and

26:04

you know and spend a lot of time on the internet

26:07

, I mean , I find this metaphor

26:09

really powerful . You know it's like would

26:12

you actually let somebody else

26:14

stock all the cupboards and the fridge

26:16

in your house and you just eat what's

26:18

exactly in front of you ? And that's what

26:20

you're doing when you're not managing your

26:22

attention . You're essentially saying I don't care what

26:24

comes into my mind , I'm just going to go

26:26

on TikTok or I'm going to go on news channels

26:28

, I'm going to let somebody else decide what

26:31

goes into my body or all goes

26:33

into my mind and most people . When you describe

26:35

things like that , you're not even using the word mindfulness

26:37

. You're saying you're coming with this particular

26:40

issue and , if you've understood it correctly

26:42

, this is what's happening for you , and here's a

26:44

practice I think could help , and you don't have to call

26:46

it a mindfulness practice , you can call it a practice

26:49

that is bespoke to that particular person's

26:51

challenge .

26:52

I really again . I so appreciate this

26:54

approach because it does feel particularly

26:57

useful for people who maybe have heard this word before

27:00

, have kind of given up on it and having

27:02

a different approach . I want to make sure

27:04

I say this I think your book's not quite

27:06

out yet .

27:07

No , it's coming out . I

27:09

think it's on the 10th

27:11

of September in the States .

27:12

Okay , so we almost have your book out

27:14

. You can look up Mindfulness for Life by

27:16

Dr Willem Kuyken and

27:19

again gosh . Thank you so much for coming and sharing

27:21

your wisdom with us and our

27:24

listeners .

27:25

Yeah , thank you , my pleasure

27:27

, it's been a really stimulating discussion .

27:29

Thank you Again . You've been listening to the MindEive

27:31

podcast . I'm one of your co-hosts , dr Keri Harrell

27:34

.

27:34

And I'm Bob Bowen . Thanks for diving

27:36

in .

27:37

The Mind Dive podcast is presented by the Menninger

27:39

Clinic . If you're curious about the professional

27:42

experiences of mental health clinicians , make

27:44

sure to subscribe wherever you listen .

27:46

For more episodes like this , visit

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wwwmenningerclinicorg .

27:51

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27:56

.