An Introduction to Mindfulness Meditation Cognitive Behaviour Therapy

As I do some rewriting and additions to this piece three and a half years after first writing it in the fall of 2015 and have put more and more distance between my present self and the self that went through the worst of what many consider to be the most difficult to deal with psychiatric disorder (bipolar type I) and, it turns out, Chronic Traumatic Encepholapathy  (from about a dozen concussions earlier in life), along with major anxiety disorder and borderline personality disorder along with being homeless through a Canadian winter, I can look back with some added perspective as to how I not only managed to get through all of that but actually continue to handle my mental outlooks, moods, mental states, cognitive abilities, abilities to handle life's difficulties and so on in a much improved fashion. 

I have to be clear that one does not - at least at my age and for how long my brain has been a "bipolar brain" (and all the rest) - simply "stop" being bipolar. Chronic Traumatic Encepholapathy is an (as yet) incurable degenerative brain disease that doesn't exactly go away on its own either. All the potential forces those can give rise to (and they infamously powerful) are and will always be there, they always must be managed. A bipolar brain (the real ones, not the tragically misdiagnosed ones) and one with CTE is always going to be prone to certain reactions to life's stress and stressful events. It is never going to be easy to manage. There is always going to be potential for being blown way off the rails by life events and stressors outside of one's control. This is true of all long term disorders. 

Reflecting back, there was certainly no one magic bullet or even strategy that made the difference in learning to better manage the horrors and intense emotions and reactions my mind could produce so I need to think hard on what exactly made the biggest differences (aside from the basics of my Positive Difference Making Fundamentals). 

In various previous posts, I've talked some about thoughts and the power they have over us and while there is certainly more than just thoughts involved with major psychiatric disorders, there's no denying that how our thoughts are generated, what thoughts we have, and the directions our thoughts will steer our minds and lives is a very significant factor driving mental states and moods. 

Aside from thoughts are our "instinctive" reactions to life events, triggers, others' words and actions towards us and so on but even many of our own reactions arise out of our own thoughts, mental models and ingrained thought processes. (I'm going to have to leave reactions for a future post, and it is when we begin to study our reactions and how and why we react certain ways that understanding just how very autonomous our subconscious "zombie programs" are will really come to the fore).

And of course tied to both our reactions and thoughts are our emotions. 

So I'm going to go ahead and declare that it's a pretty safe bet that in rearranging my mind, moods, reactions, impulses and so on to create a more mentally stable, emotionally resilient and healthy me, learning to deal with my thoughts ranks pretty close to the top of the list of how I turned so many things around. 

Now, if someone had told me during the worst of my mental states that it was "just thoughts", I'd have been the first to freak out and scream "this is more than just thoughts!!". And my experience at the time was that it certainly seemed to me much more than "just thoughts". It felt for all the world that I was in the grips of something very, very powerful (and in a very real sense, I was). However, as I learned more and more about the neuroscience of thoughts and the power of thoughts and how thoughts could cascade into creating the stress and anxiety and resultant stress response system spikes that were causing my worst melt downs, I had to begin to admit to myself and come to accept that so much of what was driving my mental states was thoughts and their power (and I think I'll need several more key posts to further convince you the readers of the power your thoughts have over you), the question became how to control them. 

Thoughts, as I'm sure many of you who battle mental health disorders are aware, don't just go away because we ask them to. If only it were so simple. Thoughts are all generated by specific brain regions and networks (neuronal groups and the wiring networks that connect them, something I introduced in Chapter One - Neuroanatomy 101 and in this post introducing neuroplasticity) and it is part of our disorders that these "brain loops" (as I like to call them) become too dominant and ingrained in our overall brain functioning. 

Changing our thoughts, therefore, means changing brain regions and brain wiring, something that is known not to be easy. I liken it to a professional golfer trying to change his golf swing, even someone as great as Tiger Woods. To learn the new swing they have to also learn to "forget" the old swing for it is the old swing (which they are changing because it is now producing poor results) that will just naturally and automatically come back when they step up to a ball and initiate a swing. And they have to "overwrite" the old swing with a lot of conscious effort and repetition of the new swing. It's difficult because it requires breaking down old wiring networks and building new ones (this is what neuroplasticity is all about, folks). Even for a great athlete with top notch coaching it takes a great amount of work.

And it is exactly the same with thoughts, emotions, reactions and behaviours that could arise from those; like breaking any old habit we no longer want and building new habits, it takes a lot of conscious effort to be aware of what is now undesired, what we want to replace it with, and the efforts to implement and ingrain the new habit. 

The trouble with something like thoughts or emotions is that they have been so much a part of us, and likely so much a dominating part of us, we're hardly aware that they're even there, much less how much power they have over us and the damage they are doing to us. And we're almost certainly not aware that they don't have to be there and dominate our minds and lives so much.

As I've said numerous times previously in this blog, I stopped at nothing and investigated everything in looking at how to recognize and deal with mental health disorders of all kinds. As well, I attended and took part in several kinds of therapy and group therapy (including being introduced to the very excellent Core Program (1)) so in several different ways and through several different sources and at different levels, I came to understand Cognitive Behaviour Therapy and mindfulness meditation and somehow, though I no longer precisely recall how, the subject of this post - Mindfulness Meditation Cognitive Behaviour Therapy.

Mindfulness Meditation Cognitive Behaviour Therapy (or mindfulness based cognitive behaviour therapy) has got to be one of the most cumbersome, unwieldy and syllable laden expressions ever devised to describe something that's actually more straight forward than would seem. So before we get too far, we'd better unpack just what exactly all that means. 

I was actually practicing this before I came across the term, read what it was about and realized, "oh, that's what I've been doing" but understanding better what I'd already been doing did help me to improve my practice of it. I'll get to how we're going to approach the practice of <deep breath> mindfulness meditation behaviour therapy in a minute but first let's break it down and remove some of the mystery and what I'm going to assume is a bit of an intimidation factor.

Mindfulness Meditation has its roots - of course - in meditation, a mind training practice that itself originated in Hinduism and Buddhism healing and spiritual practices nearly 2,500 years ago. Mindfulness meditation - to quote:

relies on techniques of mental training that suggest non-judgmental awareness of here-and-now mental or somatosensory* experience positively influences accurateness of perception and acceptance of one's own life experiences. The mindful practitioner thus amalgamates a focused attention component with a non-judgmental attitude of openness and receptivity when trying to pay attention to and non-reactively monitor the content of present-moment experience. 

[* "somatosensory" is a term which in this context distinguishes physical experience from mental experience]

Cognitive behaviour therapy is a form of long standing and often very successful psychotherapy that arose out of combining the principles of cognitive and behaviour therapies. Cognitive refers to our thoughts and mental patterns, and behaviours to our reactions to life around us or the actions we habitually take. CBT is designed to help us work through our thoughts, behaviours/actions, and feelings (emotions) and to understand their relations to each other within us. Its goal is to help us gain more control over all three aspects and to hopefully build more optimal thoughts, behaviours (or actions/reactions) and emotions that are more adaptive to our life situations. It is designed to bring these all into more harmony within us - which, I can assure you, can go a long ways in settling down a great deal of the inner turmoil and conflict we experience and which has such an unsettling effect on our overall mental states and peace of mind.

[image acknowledgement]

This illustrates what we were looking at above - how our thoughts, feelings/emotions and behaviours/reactions all tie together. I early on recognized the benefits of CBT, however the trouble was that I in no way could afford a one on one therapist skilled in teaching and applying CBT. Group therapy can be effective but the problem is finding a good group that is affordable and within convenient distance of where one lives. 

For the vast majority of those suffering mental health disorders, finding therapy of any kind, let alone therapy that is personalized and effective is extremely challenging, if not downright impossible. 

Which is the situation I faced - I not only could not find therapists trained and able to deal with my complicated and difficult case (2), in no way could I have afforded it even if I could (though again, I did find some groups at various times which were beneficial in some way or another at the times). 

So what to do?

I very early on in my race to discover ways to manage or overcome mental health disorders starting at the beginning of 2013 began to come across many ties between the study of the brain and meditation, chiefly that meditative practices could change the brain in very important and positive ways. As I started looking more into meditation, I came across the concept of mindfulness meditation. As I was already studying the neuroscience of consciousness and various means of "altering" consciousness, I grasped the fundamentals of mindfulness meditation quite quickly but at the same time I could see and sense this gulf between how "normal" practitioners practiced it and how we peeps with poor mental health could utilize it. This is a beef with me with meditation and yoga; two very useful practices made overly complicated, too advanced and difficult for the majority of people to gain from. 

So setting aside all what you may have read or learned elsewhere about mindfulness meditation, I'm just going to get to how I combined mindfulness meditation and CBT and further, how I learned to do them on my own without too much complication and difficulty.

To better understand how I approach mindfulness I'm going to ask that we have another brief look at consciousness. Regular readers will recall that we looked at consciousness in the previous posts An Introduction to Meditation and On Consciousness, Thoughts and Meditation. In those posts I likened consciousness to our computer screens and speakers and just as those peripherals display only a small portion of what your computer is capable of (through its own programs, memory stored and what it can bring in through the Internet) for you to work on at any one time, consciousness is like a "screen" or "working plate" created by our brains at any one time out of all of what our brains are capable of producing through our senses, our brains' programming and the vast amounts of memory stored there. 

It is also necessary to recall that our brains often, or maybe always, don't give us much choice of what is put up on our "awareness plates" or consciousness. It is also necessary to recall that our brains keep vast amounts of inner activities outside our conscious awareness (and thus we're not aware of what's causing so many of our behaviours that are driving us batty and which we'd like to change). 

So we're going to learn how to better manage our "conscious plates" or "conscious computer screens and speakers" and we're going to do that with mindfulness meditation, or at least my version of it. And with mindfulness meditation, we're going to tie it in to CBT and thus learn how to better manage our thoughts, behaviours, and feelings/emotions. 

I must tell you up front that this is no small task. I said above that I learned how to do it without too much complication and difficulty but by that I mean the actual practice of it needn't be complicated or difficult. This does not mean, however, that the mental work we must do is easy. We need to be aware of that and understand that it's not going to be easy because if we do that, we are less likely to become discouraged when we find that it can be tough. We are far better able to cope with difficulty (generally) if we know up front what to expect and how to deal with it (and we'll be learning techniques and the belief that we can deal with it). 

Now, without further ado, here we go. 

In the four years since first writing this I have done a great deal more study into consciousness of the human mind and subjective conscious experience (a good deal under the direct tutelage of renowned consciousness authority Bernard Baars), I have come to think of mindfulness meditative CBT differently, especially the "cognitive behaviour therapy" part. I think of it more now as "consciousness behaviour therapy" as it is our conscious experience that we must change and work on. 

As for what we have to do, I use it as a time set aside to specifically examine my thoughts, feelings and ongoing events in my life. I also think of it as a way to let my mind to slowly wake up in the morning in ways that I am paying close attention to. 

Mindfulness CBT takes a certain amount of bravery when you have the sort of thoughts that come with psychiatric disorders like bipolar and suicidal depression so let's keep that in mind as well. And with that in mind, lets just go ahead and give ourselves permission to be brave, to believe that we can do this, even if for only a short period of time each day. And like other forms of meditation, it is quite alright to do it only for short periods of time to begin with. I certainly started out with short periods but after I began to make some noticeable headway, I found I could stretch out the time I did mindfulness CBT longer and longer. 

I'm a morning person so in the beginning I tended to do mine first thing in the morning when everything was quiet and we do want quiet, undisturbed time to do this (and I realize what a challenge this is for many, especially for the parents out there among you). Since then (early 2014, about five years ago at the time of this rewrite) it's become a more natural thought process and I can apply it almost anywhere at any time. For you to start though, let's assume though that we can find some quiet time. 

Now, here's what we're going to do - and this is the scary part - we're going to allow all and any thoughts to come into our consciousness. But - and just for this period of mindfulness CBT - we're not going to judge them, we're not going to try push any aside; we're going to allow them to come in. But because we put ourselves in a brave state of mind and we're in a safe quiet place, this is going to be okay, if only for a short period of time. 

If you're like I was (and can still sometimes be), you're going to have an enormous number of possibly very disturbing thoughts vying for attention. But we're not going to pay attention to any particular thoughts just yet. And we're going to think of our mind like our computer screen metaphor and our thoughts as things that are popping up on that screen. 

As we saw above, the point of CBT is to learn how to examine and deal with our thoughts, behaviours and feelings (along with core beliefs and values), but today we're going to look at and just focus on thoughts, though we're also going to start examining the emotions that can come with our thoughts. Our minds can produce a lot of thoughts, in our cases often of the nuclear grade negative variety, so obviously dealing with our thoughts is an overwhelming and frightening sounding proposition. But again, we're going to give ourselves permission to be brave about this. And we're going to start to learn the concept that whatever our thoughts are, they are just thoughts. This will be very hard for many of you (and it certainly was for me) but again, for just this brief period of mindfulness CBT, that's how we're going to think of them. 

Now - and here's the important part - we cannot deal with all our thoughts at once; this is a big part of what drives us crazy, after all. So what we're going to do is to now begin to pay more mindful attention to our thoughts. We're going to lie here quietly and just sort of see what thoughts are going on.

They'll be swirling around, each trying to push the other aside. Or as one reader referred to it in a comment at the end of the post talking about bipolar and empathy (and empathy in general), the "blender in my head".  Through this tornado of thoughts, some are going to start to be more dominant. So what we're going to do is pay attention to the dominant ones and we're going to choose just one or two. 

Now, if I can get you to imagine your mind as being like that computer screen metaphor of ours, this is what we're going to do. You're going to imagine that our thoughts are like the tabs and various programs on your computer screen and that you have a mouse in your hand. Now, with that mouse, you're going to start "clicking" the "X" on the "tabs and programs" of thoughts to "close" the thoughts and feelings we don't want to look at just now.

So we've chosen a thought or two we want to examine more closely and all the others we're going to "close" in our mind, just like closing tabs, browsers, photo images or whatever else we might have open on our computer screen at any one time so that we can focus on just a few things without other distractions or bogging down the computer speed. 

This will not be easy at first. Like pop-up ads, many of these unwanted thoughts and images are going to pop up again again and again as soon as we close them. But for this period of Mindfulness CBT we're going to be persistent, just stick with it and mentally just  keep "clicking" on them and visualize them disappearing from your inner screen. 

I'll ask you to just imagine that for a few moments - clicking on unwanted pop-ups and tabs and so on and closing them. Now imagine doing that with thoughts in your mind and having the same power to close them.

Now, let's focus on the few thoughts we've chosen (and here's where general meditative practice begins to pay off - when we chose to focus on one or a few things and disregard others, those others will begin to naturally fade into the background). These thoughts we chose could be about anything - anything. They might be how we think of ourselves, our bodies, our situations. They might be about our jobs and money. They might be about our future. They are undoubtedly scary and worrisome. But, for this time at least, we're not going to feel afraid of them. 

I'll also ask at this time to please bear in mind that this takes practice and the first attempts will probably not go well. And that is perfectly one hundred percent okay and normal and I'll ask as well that you give yourself permission to forgive yourself if you don't nail it on your first try. 

Okay, so now we have a thought or two to examine and we're going to start questioning the ones we've chosen. There's quite a process for this, and I'm going to have to write a separate column for how this works, but I want for now to start with this idea and process of questioning our thoughts. I want to start with the idea and process of questioning whether these thoughts really have to be there at all, I want to start with the idea and process of questioning the very truth of these thoughts and ideas that are plaguing our minds and lives. 

As an example, let's start with a very common one - that we're ugly, we're bad people and nobody wants to be around us and that everyone hates us. For this time, during our mindfulness CBT session, we're going to challenge the truth of these thoughts. 

This will be very, very hard for many of you. For these thoughts have been so much a part of our inner landscape that they have become an "undeniable truth". Furthermore - and this is a "buggy" way the human brain works - when we get a "truth" like this in our minds, our brains will actively search for "evidence" to support these "truths". But for now we're going to question that. 

And to do this, I want you to actually question them. Try it! Just ask yourself, "Hhmmm, is that really true?" And of course your mind will immediately leap to provide all kinds of "evidence" that of course it's true. But we're going to be very stubborn here. We're going to keep pushing back on these thoughts and "evidence". Let's start with something easy like "nobody likes us". Really?? Nobody?? Nobody?? Not a single solitary person on the whole planet likes us? Seven billion people on the planet and not a single one likes us? Really?? 

Now, if we start questioning this and asking if this is really true, we may well find that it's not. If we start thinking through it, we may find that it's not as true as we thought. Now it may be true that we may not exactly be popular, but we'll find that it's not exactly true that "nobody" likes us. 

So we'll just go ahead and focus for a few moments on thinking of people who like us, or who don't mind us too much or even, to start with, who don't "hate" us. It might only be one. It might be five. It could be any number. What we want is to see evidence that counters our "belief" that "nobody" likes us. 

Now, as we examine the truths of our thoughts, it's also important to learn acceptance of some of our more unpleasant thoughts and truths behind them and - AND - to take ownership for them. Very, very, very important. For when we learn to take ownership of something, we give ourselves the power to do something about it. And if we have that power, we can change it. 

So now that we have identified a thought we don't like, and furthermore the basis for that thought and what's true and not true about the basis for it, let's try to think of some simple daily courses of action for what we can do about it. If we are troubled by feeling, or perceiving, that we are not popular, what are some daily actions we can do to change that? (I'll let you think on this for yourself, as exploring this will quickly stretch the boundaries of this post too far). Just remember the formula above in that thoughts and supporting behaviours must be in alignment so we must create better behaviours that will support our better thoughts and better thoughts to create our better behaviours. 

We can also use this time as an opportunity to start working on black or white thinking and the belief that everything has to be painted in stark either/or colours such as someone either "likes" us or "hates" us. We can start to think that maybe there are all kinds of shades or that there are different aspects to how people feel about us. Maybe they like us in this way but not so much in that way. 

We can start to question the black and white thinking about our very selves. Are we really "bad" people or maybe we're just bad sometimes? Maybe we're not "bad" but just do bad things sometimes.We can start to separate "us" from our behaviour (a classic therapy technique).

And so it will go as we look through and examine our thoughts and feelings about and reactions to our mental states and experiences of the world around us. 

We're not going to turn around our thoughts, feelings about any one aspect of ourselves or our reactions to the world around us in one session but we're going to start chipping away these long held "truths" about ourselves, these thoughts and ideas about ourselves that we are just convinced are "self-evident". As well, we're going to start learning more about common cognitive distortions and working through those.

And more importantly, we're going to start establishing the habit of creating the time and mental space to work on mindfulness meditation CBT. Way back when I wrote out my positive difference making fundamentals, I wrote that I worked on creating better habits. This is one of those. This was perhaps the most important new habit I created. 

For as I've written before, if we don't learn to work on our thoughts, to change our thoughts, we will be their bitch; they will mess us up.

So, before I go, a brief recap of what makes up mindfulness meditation CBT:

Mindfulness: This simply means paying mindful attention to what we are doing and in the case here, paying mindful attention to our thoughts.

Meditation: This is a tool we use to channel our focus on to specific things. Practicing simple meditative techniques like those in an introduction to meditation. We use it in practicing mindfulness in the sense of to what we are mindfully paying attention. 

Cognitive Behaviour Therapy: These are methods and tools for changing our thoughts and behaviours. It is generally done with a therapist working with you - and this is great if you can find one who's good (not a given) - but we're going to start learning how to do it on our own. 

Method: set aside periods of time each day that are quiet and you will not be disturbed to allow yourself to mindfully examine the thoughts and beliefs that are predominant at any one time. Learn to question the truth and validity of these thoughts and beliefs. Learn to reframe them. This time of mindfulness CBT can be just a few minutes to start, up to half an hour, an hour or more. 

Lastly, I want to remind that this is not easy work. But then again, nothing worthwhile doing is going to be easy. Now pay attention to that word "worthwhile". Many of us will have issues with this idea of "worth" and being "worthwhile", for one of our dominating thoughts and ideas are probably that we're not "worth it". 

It is now been five years since I created this program for myself and started regularly practicing it. In that time it has become an ingrained natural habit, a default mechanism that kicks in after I go through a difficult life or mental (and often both at once, of course). It is this process that is always the core to bringing myself around and moving forward as positively as possible. And this is the ultimate goal with a practice like this - make it a daily habit that comes to you naturally. Further mastery comes from more consciously deliberate sessions of examining our core values, beliefs and goals and making sure our thoughts, behaviours and emotions are in alignment with those. 

So here's a little bit of homework for you today. Practice believing that you are worth the work. Yes. You are worth it. Yes. You. Are. 

 

(1) While I'd come to see the Core Program as an excellent resource, unfortunately the facilitator I had leading the 8 week therapy program was very poor and I gained little from it at the time. That said, many of the things I'd learned I'd later see I'd begun to subconsciously use, so I think being exposed to it despite the poor facilitator made a difference in the long run.

(2) At one point from the fall of 2012 into the spring of 2013 I was extremely fortunate to work for free with a therapist who specialized in suicidal danger through the University of British Columbia's psychology program (the sessions and the relationship with that therapist in training ended, however, with the end of that school term). Though I'd been told I was welcome to register for free therapy again the following fall, when I tried to do so I was told that because my case was so difficult they did not feel comfortable having me see any of their therapists.

Focus (or the lack thereof)

I've been having a bitch of a time writing lately. I've no shortage of topics to write about - dozens of posts for this blog, ideas I have for my neuroscience blog and my Worldly Bush Ape blog (which is where I put my more op/ed pieces), along with various works of fiction I started but ... 

Focus. I can't focus. 

This only came to me this morning when I couldn't sleep. Yes, this is also related to having difficulty in focusing. 

This is going to be very familiar to any of you who deals daily with living with a psychiatric disorder - the dreaded scatterbrain feeling. Mind all over the place, first over here, then over there. This is the big priority. No wait, it's that. No, no, no, it's none of that, it's this new thing that's just popped up. Ghah, shit, no. Can't do that until X, Y and Z are taken care of first. Oh, wait! Look at this cool video someone posted on YouTube! Oh! So 'n' so is pinging me on Messenger. I'll just chat for a while. 

Okay, now back to work. What was it I was doing again? Aaahh, right, it was this project. Oh, shit, the cat's made a mess. Now where was I again? 

Oh fuck, I'm exhausted. No, can't sleep, must at least get started on this. I'll make some coffee. Shit, look at the kitchen, what a mess. I gotta straighten this out at least a bit.

Okay, now where was I? I had a good idea going there, now where the hell did it go? You know what? I think I need some fresh air. I'll go for a walk first. 

Phew, that felt good. Oh! Look at all the notifications I got! I'll just check those quick while I relax a bit after my walk. 

Then - just as I'm about to finally sit down to start getting something done - the dreaded brain fog descends. Nothing moves. Okay, just lie down a bit. Try to read. Stare at the same page for ten minutes, nothing gets absorbed. 

And on and on it goes. Days, then weeks and then into months. 

A year or two years ago, I'd have been in a great panic by now and probably on the verge of a massive suicidal breakdown. I am one of drive and ambition. I'd gotten so used to my mind working at a great pace (the great manic year of 2013 when I wrote hundreds of thousands of words, most of which came to me seemingly like magic out of thin air). I have great dreams for Taming the Polar Bears. I have books I want to write. I have photography projects I want to complete. I want to leave all this as a legacy to my daughter of who I was. I therefore find it very difficult when things grind on like this without any productivity. I find it gets enormously frustrating. 

If nothing else, I've moved on from allowing it all to plunge me down the rabbit hole so badly like in the past. Nonetheless, my own internal generated pressure begins to mount. Darker and darker thoughts begin to percolate and dominate. My mind gets more and more out of touch with my goals and ambitions. Ideas that seemed so clear not long ago seem distant or like dissipating mists. Things begin to break down. 

I'm sure this all sounds quite familiar to many of you. Bipolar minds can especially be like this because of the enormous amounts of mental activity they create and at times wildly varying mental states (bubbling optimistic energy here, dark melancholy there, much in between). 

So let's have a look at what's going on.

The basic issues are:

• difficulty in focusing and maintaining attention
• that ever delightful "scatterbrain" feeling
• brain fog (brain freeze, mental mud, mental molasses, etc)

The first issue probably sounds to most people like a condition for which there is either a three or four letter acronym. According to some literature, this condition and bipolar very often go hand in hand and it certainly has with me, especially during my worst periods. This is a topic I generally don't go anywhere near. I have my own views on focus and attention issues but if I've learned one thing in nearing three years of researching and writing on mental health issues and the brain, if you want to be a lightening rod for angry comments and being vilified, dare challenge anything about this condition. It seems I can talk about and challenge any other mental health disorder, but this one is off limits. So I just don't go there (though who knows, I might some day).

Attention and focus is controlled by a network of brain regions, the most important of which are in the frontal lobes (the details of this will have to wait for another day and a dedicated post). One thing I learned very early on in my research about the brain was to do with its "energy economy". In times of stress, the brain will generally redirect energy to key core regions that are more vital for our survival (which are the more primitive areas of our brain). The frontal lobes are the first to get energy scaled back when the brain reallocates energy due to stress so poof, there goes most of the essential areas of the brain for regulating focus and attention. 

The brain, as I've said numerous times in my posts on the brain, is the single biggest energy consumer in our body, taking up a whopping 20 percent of all reserves (while accounting for only perhaps 1 to 3 percent of our total body weight). When energy from caloric intake runs low, the brain also reallocates energy to core regions, once again dialing back energy to the frontal lobes and other (what it considers to be) "non-essential" circuits and regions. Poof again.  

So, with that in mind, what (I ask myself) have I been going through lately? Starting from early June, mega stress involving living arrangements and moving (long story, but for me these are major stress and anxiety triggers). I've found a new arrangement but at this point it is looking neither stable nor long term. As well, it's shared accommodations and getting used to living with other people and the noise has been stressful and difficult to adjust to (though I've been doing everything to put my best foot forward). 

For a wide variety of reasons, I've been eating like shit or not eating at all, having totally fallen off the wagon of my good eating habits (not terrible, mind you, I'm not eating junk or fast food, but certainly not as good as it needs to be). 

So, high stress, grinding anxiety (asides from bipolar, borderline personality disorder and major depressive episodes, I met all criteria for major anxiety disorder and social anxiety disorder as well) and piss poor eating habits. I can virtually guarantee you that that's going to challenge the ability of anyone to focus and maintain attention to tasks. That's going to challenge the ability to think, period.

Which takes us to the scatterbrain feeling. My mind can be a cacophony of snippets of songs, past conversations (from anywhere from those that took place that morning to some from decades ago), wild ideas, dark and distressing thoughts, ideas of all kinds coming and going in a constant revolving door, imagery of all kinds, haunting voices, visions of past mistakes and so on sometimes swirling around like the vortex of a roaring tornado. When it's all going full blast, you couldn't shoehorn an important task in there to focus on to save your life. 

Stress and anxiety are the big culprits here. Stress and anxiety (which is sort of a subset of stress that becomes chronic) have this troubling propensity to do a couple of things to our thought processes. One, in times of stress the brain is disposed to start "rapid firing" looking for answers, looking for things in our minds and memories that might help. Unfortunately, and here we go back to that "energy economy" thing again, higher cognitive areas and better emotional control areas tend to get deprived of energy and go "offline", while more primitive subcortical regions get higher priority. And these lower regions are exactly where more panicked thinking originates, where memories of past mistakes are stored and emotions are generated. It all adds up to creating the kind of chaotic cacophony of thoughts and mental messiness described above. 

I write about sleep and the brain here, but without making you go over there (though I quite recommend it), I can tell you that neuroscience has been uncovering tremendous amounts of evidence for how important sleep is to brain function and for memory consolidation. Chronic lack of sleep will greatly impact sharper brain function and contribute to scattered thinking. Sleep too has been an issue for me recently (more in a minute). 

If it's not rapid fire scattered thoughts and mental chaos, it's mental mud. You can't think, you can't read, you can't process anything. Memory seems inaccessible. Very, very disconcerting, I can tell you (and for those who know what I'm talking about, I don't need to tell you). If not downright terrifying. You're also going to tend to feel clumsier and process sight and sound slower. Every freaking thing seems overwhelming. Getting out of bed seems like a monumental task. This used to be guaranteed to send me into a panic. 

To understand this, we need to go back to energy (the whole universe is about energy and so it is with our brains). Now we must look deeper than short term caloric energy intakes, and even beyond that provided by sleep. We need to look into the very "energy engines" of our cells - mitochondria. For those of us who are bipolar and have been through many cycles of mania and depression (or during the depressive phase of any cycle, be it the first or the umpteenth one), or those who have been living with long term chronic anxiety and/or depression, we are going to have suffered damage to our mitochondrial function. 

I write about this in quite great detail in a three part series starting here (links to parts two and three are at the bottom of that post). Mitochondrial function is something I've looked very deeply into in order to understand the chronic fatigue that has come with living with bipolar for so long (and following the mother of all manic-depressive cycles). We needn't get into great detail here, but to understand times of mental molasses, let's have a brief look. Mental functioning of all kinds means neurons communicating with each other on massive scales (remember, you have somewhere around one hundred billion neurons, all with important jobs to do in your noggin and mental processing). Mitochondria are absolutely essential for every step in the processes of how neurons themselves function and in how they communicate with neighbouring (or even distant) neurons to form thoughts, call up memories (or create new ones), and process every single thing your brain must do (including coordinating physical movement and visual and auditory input, which is why something as simple as even holding a conversation or reading a book is so challenging).

So with mitochondrial dysfunction, everything the brain must do is going to grind to a slow crawl, focus and concentration will suffer. 

Now, on to a personal note. 

While I manage all my conditions drug free, there are times when I do need something. Stress and lack of sleep are the two main factors that will prolong and exacerbate the crippling fatigue that I live with. So sometimes after a particularly stressful time or event (like being evicted from my previous residence because of my condition and the resultant big move to another town and starting over yet again) and if sleeplessness is getting to be more than I can handle on my own, I know it's critical that I do something to really rest up and "power sleep" for a few weeks. It is during that time that I will temporarily go on the anti-psychotic Seroquel. There are no good drugs in my very well researched and founded view, but I know from prior experience with Seroquel that it will knock me out in the evening and let me sleep through the night so that I can get some essential restorative rest and sleep.

The trouble with it - and this is one of its numerous side effects for many users - is that it leaves me with a persistent grogginess through the day (especially in the morning) which in my case at least, also has been contributing to the brain fog and mental mud. 

The several week period I'd set aside to use it to help recuperate has passed and I've been trying to go off of it but, for the first time, it's been proving very difficult and sleep has been very hard coming without it (I've been on it for far too short a time to being going through true withdrawal, however).

So this has been a factor for me as well. 

Add it all up and I've been having a bitch of a time writing or focusing or reading or accomplishing anything mentally. 

Meditation has been demonstrated to greatly help with sleep, focus and concentration and improved mental states but I haven't been doing that either. 

So no wonder I've sort of fallen apart lately!

The good news is that I have been getting out for lots of walks or long hikes in nature. No question things would be even worse if I weren't at least getting a good amount of fresh air and exercise. 

So what to do? (the sixty-four thousand dollar question, after all).

It's pretty simple, really (do not, however, mistake simple for easy). 

For one, I must not allow myself to panic about it. This is a lesson I've learned over and over and over again. Whatever a difficult situation or crisis is, panicking is like throwing jet fuel on an already burning fire. Easier said than done, however. But this is where all my study pays off, plus by now lots of experience with going through this numerous times in the past few years. I know that if I do things right and get back to all my basic fundamentals, my mind will come back, focus will improve, my better mental functioning and somewhat improved energy will return. 

Two, and you regular readers have to know that this is coming, I have to rededicate myself to my Positive Difference Making Fundamentals. That means making more effort to stay in the now and the day, getting back to my various (and very simple) meditative practices, devoting more mental bandwidth to practicing my approaches to spirituality (and I can't tell you what a difference simply focusing on gratitude can make to one's mental states). 

Three, get back to my nutritional basics, starting with simply having a nutrition and brain energy packed fresh fruit and vegetable smoothie every morning and get away from the crap that's been creeping into my diet again (like the all you can eat fish and chips I had the other day. Yummy, yummy, yummy, but so not good for my mental states and energy). 

Four, and this very difficult in our 24/7 connected world, reduce the amount of unnecessary "input of data" most of us allow into our brains (and thus minds). Another thing I've repeated and tried to hammer home is that in no way did our brains either evolve for or adapt to the kind of sensory input we subject them to in today's modern world. So turn off the news of distressing events that you have no control over, reduce the amount of online interactions that are overtaxing your abilities to reasonably handle and probably reduce the amount of interactions in your "real" (read: not online) day to day life. I understand that reducing all this input can create a paradoxically uncomfortable "hole" in what occupies your mind but this is precisely what I designed my music therapy programs for (calming, soothing brain building "sensory input"), my brain training exercises and daily mindfulness practices of simple things that Need to be Done around your home (from cooking and baking to simple cleaning and so on). 

Lastly, and probably the hardest of all for me - patience. I know the downward spiral took time and it'll take time to get the spiral going back up. But I know good lifestyle and diet habits will always work, even if I get a bit grumpy sometimes about having to practice them. I've searched the world over looking at how to restore mitochondrial function and the best I can find is what I've listed - rest, rest and more rest, as much quality sleep each night as possible, better nutrition and fresh air and light (not strenuous) exercise along with regular meditation (to calm stress). And as my brain health improves with better diet, habits and sleep, my focus will improve, the mental chaos/scatterbrain will diminish greatly and the brain fog will lift (for the most part).  

Brad's Brain Training Exercises: An Introduction

Like anyone who's suffered with severe and recurring depressive episodes - and probably especially those of us who go through bipolar depressive episodes (which for various reasons that I'll get to in a separate post some day are more intense) - my mind used to be a horror show of negative thoughts, very bad beating myself up self-dialogue, cognitive distortions, black and white thinking, very dark and negative future projections and much else to do with "thoughts" and our inner mental world.

This is why I emphasize so much what consciousness is and what it's made up of - what I often refer to as our "conscious experience". Thoughts are a huge part of how our brains both "communicate" to us as part of our conscious experience and create our realities.

In the fall of 2013, I was deeply and badly struggling during the early parts of a massive and mind crushing depressive phase that was part of the mother of all manic depressive episodes. At the same time I was really beginning to fathom and grasp the neuroscience of thought and of the incredible power that thoughts can have in our minds and mental states. I was beginning to learn to examine my own thoughts and the roles they played in my mental states and it was at that point that I knew I had to work on my thoughts. That fall was also when the fatigue started absolutely hammering me and I was left with being unable to do much else than to spend most of my days just sitting staring out the window.

I also was beginning to deeply understand how much of our moods and mental states are driven by our own reactions to those very thoughts and to life around us. I understood that a great deal of what we needed to do was to "retrain" our brains to react differently not only to our own thoughts but to life events, circumstances, challenges and even to our own desires, wants and goals. And not only to retrain our brain's reactions to our thoughts but to create different thought patterns altogether.

The question then became how to do this.

Through the study of neuroplasticity, I was quite familiar with the principles and benefits of online brain training games and could grasp their potential but a) I'd quickly become wary of the claims made by sites such as Luminosity and b) I'd tried some and quickly realized that these were not what we mental health peeps needed.


What we needed was something that'd help us work on:

- distorted thoughts such as black and white thinking, cognitive distortions and negative self-dialogue

- learning self-compassion and forgiveness

- dark thoughts about the future

- letting go

- more confident decision making

- creating better perseverance and resilience

- creating better reactions to difficulties

- creating more positive inner dialogue

- our reactions to our own selves and the challenges of life


Along with much else along these lines.


As well - and I can't emphasize how important this is - I knew that I needed something to keep my brain and mind occupied and distracted during the worst of the fatigue because what I discovered during those dark times was that if we don't find ways to keep our mind occupied when we don't have the energy to do anything else, it creates particularly fertile ground for our minds to run amok and for demonic dark thoughts to dominate.

Not only that, I very, very well understood the dangers of losing my higher cognitive abilities due to the fatigue if I didn't train and exercise my brain in some way when I was really hammered with the all encompassing mental and physical fatigue.

No available brain training exercises I looked into did anything like that.

So I designed my own.

My brain training exercises work on multiple levels if approached and practiced correctly.This post is going to give an initial outline on how to approach them, establish further how and why they work, and how to apply the lessons learned to real life situations.

For "games", I just used the standard solitaire games that come with Windows OSes but I apply the same techniques when doing crosswords and then I began applying the same processes to virtually everything I do (the ultimate goal). You could use anything you like, as long as it's at least somewhat mentally challenging, holds your interest and keeps you engaged. You could actually apply the same principles we're going to learn here to any hobby you like - cooking (a favourite of mine), playing an instrument, woodworking, you name it!

I talk with a lot of people privately (both in real life and online) about what I've been through, what I've accomplished to overcome and stabilize very advanced Type I bipolar disorder, Borderline Personality Disorder, major anxiety and massive suicidal depression and how I did and continue to do it all without medications or any ongoing professional help. Most marvel at what I have done and can do (granted, the people that tell me this are those who deeply, deeply understand mental health issues and the struggles and challenges. "Normal" people - those who are mentally healthy or have never really gone through the worst aspects of long term mental health difficulties - don't get it at all). I get a lot of interest in wanting to know how I did it.

Looking back on it, I feel very strongly that my brain training exercises made the biggest difference (and I use them to re-enforce many of my Positive Difference Making Fundamentals). Now, if we go back to Neuroscience in Focus - an Introduction to Neuroplasticty and what we began to learn there, we can see that when we are trying to change deeply ingrained mental patterns such as very negative self dialogue or negative self-image (very closely related, of course), what we in fact have to do, is "rewire" actual brain circuits and this takes time and repetition and this is what exercises like I introduce here are designed to do.

So let me try introduce my approach.

Brain Exercise:

Assuming we're starting as I did with the solitaire card games we're all familiar with, the most important thing to keep in mind for the best approach and for best results is that we must not think of them as "games", we must think of them as puzzles.The brain loves puzzles. Human brains evolved to solve puzzles and find solutions, to seek patterns in apparent chaos and so on. So right away, the appropriate mental approach and attitude is that you are giving your brain puzzles to solve. This is a form of exercise for the brain, just as Pilates is for the body. A huge part of my concepts for better mental health is exercising the brain; the principle being that a brain that works better and more efficiently and that taps into the brain's higher cognitive powers is going to lead to less overwhelm and negative results in life situations. A better exercised brain is going to solve problems better leading to a smoother life and less stress and all of this is going to by course of nature lead to better mental health. Make sense?

I have lots of other ways that I exercise my brain - I read a lot of challenging material, I poke at different languages, I do a lot of music therapy (please refer that post as an introduction) and so on - but the following are the exercises that I do most and work at the most.

Now, not only are we going to exercise our brains by giving it puzzles to solve (crossword puzzles also work well and I often use them in lieu of card based puzzles), we're going to work on our mental processes and states as we do so.

As a Distraction and Change of Focus:

Puzzle solving games can be a great distraction technique.

Distraction, or changing one's focus, is a classic and powerful method taught by many psychologists for dealing with emotional overwhelm, periods of anxiety, racing negative thoughts, etc. So the games can at once give one's mind a different focus while also giving it something challenging and engaging to do.

There are times when one is getting pummeled with overwhelm and a breakdown feels imminent that some sort of distraction is vital. I just like to do my distractions with something with purpose (and we will feel less guilt as well if we feel we are actively trying to do something beneficial and purposeful). I also do a lot of mindfulness activities like cooking or baking, accompanied - of course - by music therapy (please see this introduction to music therapy and this post on some of the neuroscience of music therapy).

Correct Mental Approach:

It is critical for the brain training games to be most effective (results will of course vary) to approach the games mindfully; that is, to pay close attention to what one is doing and not just mindlessly move cards around (or whatever is involved in solving the puzzle). To that end one must also take a goal orientated approach to the games. There are multiple goals one can set. The most obvious goal is to win the particular game one is currently playing (or about to start). But there is much more than just winning individual games. There are long term goals (winning ten games, achieving a certain winning percentage, finishing a game within a set time limit and so on). As well, one should take the goal of aiming for constant improvement.

As it is not possible to win all the time, losing can feel quite discouraging and even frustrating. Feeling discouraged or frustrated with losing is perfectly natural but a) these are also automatic reactions we want to change and b) if one takes the approach of using each game as an opportunity to improve or to learn then no matter what, one can always take something away from each session.

If you're not feeling discouraged or frustrated by losing then perhaps you don't have enough desire to win, something that itself must be changed. This, I find, is not uncommon among those who've been beaten down by life for too long. However, by winning, we needn't necessary think of winning as the ultimate goal, or winning at all costs, but as always trying to attain the best possible outcome for ourselves out of whatever situation we face. For some of you I know it means learning that you deserve the best possible outcome.

Just a brief note on the "winning attitude" before we move on. Looking back on the many challenges I have faced in the course of the last several years - especially being homeless through a Canadian winter and related ongoing basic housing challenges - training myself through these exercises to always look for the best possible outcome no matter "the hand that I was dealt" was easily, in my mind, the biggest difference maker out of these brain training exercises. I've been dealt some pretty crappy cards the last few years and in constantly training myself through the exercises to always look for the best possible outcome no matter what and not just throw in the towel or "fold", it's just something my mind tends to do automatically no matter how bad I feel at first in a given new challenge.

Okay, now bearing the mindfulness approach in mind (and the following section), you the brain trainer need to understand that the pace at which you play is probably going to be quite slow to start. Actually, I'll state that it should be slow to start. This is an important part of mindfulness; going very slowly, paying close attention to each step, paying close attention to one's mental processes, inner dialogue and so on. Taking this approach while solving the puzzles is going to start training your mind to do this with other tasks you perform as well.

Using the Games as a Mental Exercise:

These are exercises that, if approached and practiced correctly, will target and exercise specific parts of the brain and brain networks, just as practicing a new golf swing does (or practicing anything in a focused and directed manner). These kinds of exercise are important for the brain – and for you – because it's very difficult to practice and change all the things outlined above (among others) under real world conditions, just as it is for an athlete to learn new skills in game conditions. That's why athletes practice daily in private controlled conditions - so they can master new skills or strategies before entering the arena of competition. My exercises give you the opportunity to work on things like cognitive distortions, negative self-dialogue, etc. in safe, focused, controlled and specific conditions.

In other words, the brain training exercises are like your own “practice field” and I (through these instructions and others to follow) am your personal coach (like a golfer even as great as Tiger Woods has a personal swing coach or a tennis player like Serena Williams has a personal coach). Like athletes, you can learn and master new mental skills and strategies before heading out into the arena of competition called Life.

Once one is making gains in a specific area, one can begin applying the new abilities in those “game conditions”; the real world day to day conditions of life. One may even notice that they are subconsciously beginning to change (IE: practicing new, more positive self-dialog without any conscious effort to do so), which would really be great!

Again, the exercises are designed to activate and strengthen specific brain regions and networks while weakening the connections in brain regions that have been overactive and dominating one's mental states, thoughts and so on. I will address the power of thought in a future post which will further bear out the importance of working on and making these changes.

Correcting Negative Inner Dialogue:

There are many things one can work on while solving the puzzles but the number one thing most people seem to want to start with is negative inner dialogue and self-criticism and I must agree this is a great – and very important – place to start because negative inner dialogue and that nasty self-critic has such an enormous impact on what we are consciously experiencing, our moods and mental health. Negative inner dialogue even shapes much about how we feel about and see ourselves (our self-image) and what we project to those around us. If we can change this, I can assuredly say that we can make profound changes and differences to our moods and mental states that will begin to change our lives along with how we and the world see ourselves. It's not a quick process, I must caution, but in time the difference can be striking.

Okay then, when we are performing almost any kind of mental task (or slow paced physical tasks), we are going to have a running dialogue going on in our head. We are going to use practicing the puzzle solving exercises to slowly change our inner dialogues by working to deactivate negative dialogue networks and to create, build and strengthen positive ones. Additionally, in doing so, we're going to start working on something I call Mindfulness Meditation CBT (which I introduce in this post) – becoming more aware of our thought processes and questioning them more and building alternate thought processes and reactions to situations.

So while one is going through the task of solving a puzzle, I'm going to ask that you become very aware of and conscious of your thought processes and inner dialogue. What I'm going to ask you to do is try to catch yourself saying negative things or running negative mental approach “programs” then pause to replace them with more positive ones. Replacing “can't” with “can” is just one tiny example. Replacing self-recriminating remarks like “you idiot! What a stupid move!” with dialogue that acknowledges the mistake with something like “oh shoot, that didn't go well. Hhhmm, now how could I have done that differently?”.

It's necessary to try and stop each time you catch yourself running a negative inner dialogue and really focus on the new dialogue, repeating it several times. Then – and this is very important – you need to follow up with actual action. If there was a mistake (you saw that you played a card wrong, for example), you need to slow down, examine what you could have done differently, then try it again or if you can't try it again, fix it in your mind how you might approach the same or similar situation next time. It's very important to align better inner thoughts with better actions; the two work best when re-enforcing each other (and this is indeed a cornerstone of CBT training - cognitive = the mental processes, behaviour = actions. CBT works to align these in healthy ways).

Also - very important to teaching ourselves better inner dialogue and reducing self-criticism - we're also going to start learning the habit of self-forgiveness and compassion. We can start learning to tell ourselves, "it's okay, it's perfectly natural to make a mistake". Because, in complete factual truth, it is perfectly natural to make a mistake, especially when we're worn down and stressed out. Retraining our brains to eliminate negative self-dialogue and the bitter inner critic is much, much harder if we don't, as we go along in these brain training sessions, learn to be more forgiving and compassionate towards ourselves in general - something I talk at some length about in this post on compassion and gratitude. This will also begin to apply to how we think of and talk to others as well. Change or improve this and I can one hundred percent guarantee that you will begin to notice an improvement in the relationships in your life. Improve the relationships in your life and your life begins to improve. Win/win, baby.

There are many other mental approaches and attitudes in our minds that we can retrain. Sometimes you may look at the cards (or whatever it is you're using to practice) and think, "oh crap, no way can I win this game". We can train ourselves not to "forecast" what might happen (especially in negative ways) and just learn the attitude to do the best we can, to make the best out of a bad situation and see what happens. I found that training myself to use this approach prevents me from shutting off possible solutions and instead helps me find solutions I may have otherwise missed.

I also found that when I trained myself not to jump to forecasting conclusions and not to either mentally give up (and only half-ass finish off the game, resulting in certain defeat) or just "throw in the cards" (literally or figuratively), that more and more games that at first appeared "unsolvable" ended up being - ta-da! - solvable! And - AND! - as this habit of not forecasting and jumping to conclusions and instead training myself to more calmly and mindfully work towards all possible best outcomes became more set in my daily mental make up, this new mental habit began to apply to real world situations and I got myself out of all kinds of pickles that I would not have otherwise done with the negative mindset that my mind had become in the years of my worst struggles (and of course at various points throughout my life).

There is much, much more but I'm going to leave it at this for now.

To get the relative optimal results, it is best that one practice daily (like practicing any new skills or keeping skills sharp). One must practice in a very focused and mindful way (which is actually a key part of the training and what is being trained in your mind). I'd suggest giving it a minimum of thirty minutes a day, at least to start. You can do it at set times (I often use them first thing in the morning to help wake up my mind and get it "on stream") or, as I've said, times when you feel too exhausted to do much else is when they can work as a good way to keep your mind occupied, or as a vital distraction or change of focus if you are beginning to feel overwhelmed by your own thoughts or some external stimuli. And I'd ask that you try to practice them purposefully and not think you're just screwing around killing time (which utterly defeats the benefits).

I always combine my brain training exercises with music therapy (again, introduced in this post). Combining my brain training approaches and the proven benefits of music therapy is very powerful.

It is my hope that this lays out a solid idea of what you can do to retrain your brain and thus so many of the undesirable mental models you'd like to get rid of or change. Again, I'd ask you in conjunction with what we learned in this post to take some time to reread the post introducing neuroplasticity where I begin to explain in a bit more detail the principles of how specific, focused and directed mental exercises can change the brain regions and networks involved in creating mental models that help drive depressive moods and states, both long term and short term.

Now the real cool thing about mental exercises like this is that when we begin to regularly exercise our brains in controlled conditions like this (again, just as athletes do to improve and grow), we in very deep and interesting ways kind of jump start the whole neuroplasticity processes in our brains (the deeper neuroscience on this is very interesting). And what this means is that once we "wake up" our brain's ability to adapt and grow in new ways, this can cascade into all kind of other new positive habit change, something Kelly McGonigal observed in the course of teaching thousands of Stanford students the science and methodology of habit change, which she documents in her book The Willpower Instinct. Which is why I concluded that doing these exercises regularly and daily made the biggest difference - because the better brain processes I trained into my brain cascaded over into so many other things I do and other areas of my life.

One last thing ...

As with all my approaches for attaining better mental health, my brain training exercises should not be taken in isolation or viewed as a "cure" or anything like that. This was and is just one part of my overall approach, one that includes lifestyle management, a specific diet, physical exercise and movement and much else (all of which I'm gradually getting to).