Full Catastrophe Living is a 650-page practical guide on how to cultivate a mindfulness-based approach to life. It is very well written. I have long wanted to learn about mindfulness as an adjunct to other forms of psychotherapy. I read it slowly and took notes over the past six months during my sabbatical from work. This review is for myself as a way of summing up my thoughts on mindfulness. Please do not feel obliged to read it.
Mindfulness is defined operationally as the awareness that arises by paying attention on purpose, in the present moment, and non-judgmentally. Simply put, mindfulness is moment-to-moment non-judgmental awareness. In this book, Kabat-Zin provided a highly informative, comprehensive and practical manual on how individuals can live more fully in the moment. After all, the moment is the only time we have to live.
Mindfulness has positive effects on health and well-being. The book focused on the Mindfulness-Based Stress Reduction (MBSR) program conducted at the University of Massachusetts Medical Center as part of behavioral medicine or mind-body integrative medicine notably (but not solely) for individuals afflicted with chronic pain conditions. Treatment is an 8-session weekly program based on rigorous and systematic training in mindfulness, a form of meditation originally developed in the Buddhist traditions of Asia. The book abounds with encouraging stories of patients who have come to the end of their tether in their respective journey of seeking a cure for a range of medical and/or psychological conditions (heart disease, insomnia, chronic pain, depression, anxiety, etc.) but have found an alternative way of dealing with physical or emotional pain. For most, the improvement is significant and lasting.
‘Catastrophe’ in the book title does not mean disaster but rather ‘the poignant enormity of our life experience.’ We are reminded that our life is constantly changing and nothing is permanent. The question is how to adapt to a life of flux, the inevitable change we all encounter. The most salient idea is on the sacredness of the moment. Rather than worrying about the future or fretting about the past, mindfulness invites us to live in the present. Why? According to Kabat-Zin, ‘The only way we have of influencing the future is to own the present, however we find it. If we inhabit this moment with full awareness, the next moment will be very different because of our very presence in this one.’
The book is structured in five parts. Part I is ‘The Practice of Mindfulness’ and covers various forms of meditation: breathing, sitting meditation, body-scan meditation, yoga as meditation, walking meditation, loving-kindness meditation. I love the last form of meditation as it is about being kind first to yourself and then to others. Part II touches on ‘The New Paradigm: A New Way of Thinking about Health and Illness.’ It shows that our mind and body are intimately interconnected and completely integrated and that our beliefs, attitudes, thoughts and emotions can harm or heal. Part III is on ‘Stress’ and how we can respond rather than react to stress. Part IV focuses on ‘The Applications: Taking on the Full Catastrophe.’ It is an extremely helpful section on strategies for coping with time stress, sleep stress, work stress, people stress, role stress, food stress and world stress. We will each find here at least one stress area that has plagued us. We will also find some practical steps to de-stress. Part V, ‘The Way Of Awareness’ has tips on ways to keep up the formal and informal practice of mindfulness.
There are many features about mindfulness I like.
One of the most useful mindfulness practices I have discovered is breathing, which is the first step to (informal) meditation. The breath is the bridge between the body and our emotional life. The book recommends that we spend about 45 minutes a day doing a breathing exercise. Here’s how. ‘Focusing on the breath means becoming aware of the breath by feeling the sensations associated with it, and by attending to the changing qualities of those breath sensations. (For example, focusing on the breath as it flows past the nostrils or on the chest as it expands and contracts, or the belly as it moves in and out with each breath. The last is preferred as it tends to be particularly relaxing and calming in the early stages of practice.’ Beginners can start doing this first for 3 minutes and then 10 minutes a day. I tried this and liked how it made me feel more in tune with myself. The ability to regulate our breathing plays an all important role in enabling us to respond to situations in a calm and balanced manner. Kabat-Zin put it this way: ‘This is an extremely effective way to reconnect with the potential for calmness within you. It enhances the overall stability of your mind, even in very difficult moments, when you most need some stability and clarity of mind. When you touch base in any moment with that part of your mind that is already calm and stable, your perspective immediately changes. You can see things more clearly and act from inner balance rather than being tossed about by the agitation of your mind.’
Second, I appreciate the idea that mindfulness in daily life consists in ‘really doing what you’re doing’. We rarely pay moment-to-moment attention to the tasks, experiences, and encounters of ordinary living. Too often, we find ourselves doing several things all at the same time. I, for one, would be reading while I am eating. So I found it amusing that one of the earliest activities that the participants in the MBSR program are asked to do is to eat three raisins meditatively. They have to eat them one at a time, feeling the texture of the raisin between the fingers, noticing its colors and texture, paying attention to what they are actually doing and experiencing from moment to moment. It is interesting that some participants find themselves tasting a raisin for the very first time. The point is that eating (or conversing with a friend or any other activity) can be far more satisfying when we bring awareness to what we are actually doing while we are doing it. In moments of calm and alert attention, we are also more likely to gain insight into ourselves and our lives, which can lead to worthwhile changes.
Third, I like how mindfulness teaches acceptance and kindness toward oneself. The premise is that by intentionally cultivating acceptance, we are creating the preconditions for healing. Acceptance comes before change.
There are, however, tenets about mindfulness I have difficulty coming to terms with. It could be due to my limited understanding at this point in time.
My biggest difficulty has to do with its views on thoughts. The mindfulness-based approach adopts the view that we are not our thoughts. (I am inclined to think otherwise. Swiftly, Descartes comes to mind: ‘I think, therefore I am.’) The mindful way is to simply observe our thoughts as thoughts and letting them float away like passing clouds; we do not examine their content. Kabat-Zin says in his book, ‘The way to handle thinking is to just observe it as thinking, to be aware of thoughts as events in the field of your circumstances… Letting go is not a pushing away, a shutting off, a repression, or a rejection of your thoughts. It is more gentle than that. You are allowing the thoughts to do whatever they do as you keep your attention on the breath as best you can, moment by moment.’ In mindfulness, ‘we don’t try to censor our thinking, nor do we judge it as we observe it.’ Thoughts are not to be taken personally and are not to be taken as true. I find this mind-boggling. How can one’s thoughts not be respected as true? It is tantamount to invalidating what one has thought about. Do our thoughts not dictate how we perceive and interpret experiences as well as how we feel and behave?
What interests me most about mindfulness is how it is utilized in Mindfulness-Based Cognitive Therapy (MBCT). And yet, the description of MBCT is radically different from Cognitive Therapy. To quote, ‘The key to MBCT approach is to recognize that any efforts to talk yourself out of depression or fix it in one way or another through changing the way you think about things or feel about yourself, only confounds the grip. What is required is just what we have been exploring from the beginning: a shift from an attitude of ‘fixing’ what you think is wrong with you (one more misguided element of the domain of doing) to a mode of mind that is much more allowing and accepting, and simply aware.’ Awareness seems to be the end goal. Just be aware and accept the current state. However, I am uncomfortable with this approach. MBCT is different from Cognitive Therapy or Cognitive-Behavioral Therapy which works at examining the content of thoughts (i.e., are they true, safe, worthy of holding on to) and then restructuring or altering them (if needed) in ways that can shape our feelings and behavior for the better.
The emphasis in Mindfulness is on non-striving and self-acceptance. This is fundamentally related to the Way of Awareness called the Tao. To quote, ‘The Tao is the world unfolding according to its own lawfulness. Nothing is done or forced, everything just comes about. To live according to the Tao is to understand non-doing and non-striving. Your life is already doing itself. The challenge is whether you can see in this way and live in accordance with the way things are, to come into harmony with all things and all moments. It has nothing to do with either passivity or activity. It transcends opposites. This is the path of insight, of wisdom, and of healing. It is the path of acceptance and peace. It is the path of the mindful body looking deeply into itself and knowing itself. It is the art of conscious living, of knowing your inner resources and your outer resources and knowing also that, fundamentally, there is neither inner nor outer. It is profoundly ethical.’ This is the philosophy underlying mindfulness. It is a liberating to think that we are born whole and there is no need for striving or doing. We can just be. It is not a philosophy I embrace. I am a thinker and a doer. I consider myself a work-in-progress; non-doing does not seem a credible option. Yet, undeniably, mindfulness and its meditative approach to life has its value. Kabat-Zin’s book has persuasive empirical evidence to show that MBSR has greatly benefited those who are willing to practice the discipline of mindfulness. This is just the beginning of my exploration of MBCT. I plan to read more on it and hopefully I will understand it more fully.