It was my pleasure to speak to Dr Chris Walsh, an Australian mindfulness pioneer since the 1980’s and a respected psychiatrist. Dr Walsh has trained with leading Western mindfulness figures such as Jon Kabatt Zinn, Mark Williams, Kristin Neff and Daniel Siegal. Dr Walsh and I spoke about the darker side of mindfulness.
As with any area experiencing such strong growth, mindfulness is surrounded by myths and misconceptions. What is one that you feel particularly strongly about?
It’s used by business to make people work harder. It’s not so much a myth, it’s just the way it is being used.
People think it’s a relaxation technique. This is tricky to address. Mindfulness does help people to relax, but that’s not the main game. It’s about training your awareness.
You cannot count on mindfulness to make you relax.
If occasionally mindfulness doesn’t help you relax, you will feel that it’s not working and are missing out on an opportunity to learn to hold an unpleasant feeling. This can be destructive.
Mindfulness can bring out negative emotions, especially during the initial stages. How would you recommend that a person deals with that?
The first thing is to have a good teacher. It’s a delicate balance and it can be hard to know when to lean into the negative emotion and when to stand back from it.
The basic principle is that it is ok to feel challenged, but it’s not okay to feel overwhelmed.
With any kind of learning, including learning to be mindful, it is normal to oscillate between feeling comfortable and feeling challenged. If you’re never challenged, especially with something experiential like mindfulness or a sport, the learning isn’t in its optimal state. Getting overwhelmed in mindfulness is the equivalent of getting injured when training, and this sets back the progress.
I have a few tricks on how to deal with being overwhelmed during mindfulness.
- The feeling of being overwhelmed is most likely to occur when doing a body scan, especially when focusing on the chest and abdomen as this is where we tend to feel anxiety. I encourage people to find “safe places” where they are less likely to feel this anxiety: such as the resting one’s attention on the sensation of breath in their nose. Even this can be too much for some people.
- Awareness of sounds can also help, as the attention is then focused on something outside the body.
- Allowing oneself to move can also help to deal with the sense of being overwhelmed. In the Tibetan mindfulness tradition you can move; in the Zen tradition you are meant to be still no matter how much one’s knees hurt. This stillness doesn’t work for people with a lot of agitation. Doing walking mindfulness or exercising before doing mindfulness can help greatly. Some people think that this is an avoidance behaviour. I believe, it is taking a distance, while still still remaining present to the difficult experience.
- Sometimes it is okay to let one’s mind wander off. When I run classes with inpatients, I tell them that it’s okay to daydream if it gets too much. The important thing is: come back because this way you can learn what has changed. This is very empowering: we don’t always have to do something to change things. They change by themselves.
These tips work for patients with mental health issues, e.g. PTSD, as well as people with no mental health issues.
Have you ever had any experiences when mindfulness had side effects? The “decentering” in mindfulness may impact an individual’s concept of the “self”. There are anecdotal reports of some vulnerable individuals developing dissociation and psychosis after reading self-help books or attending seminars – and more recently after practicing mindfulness. Do you see any risks in “trying it at home” when it comes to mindfulness?
It is damaging when people use mindfulness to dissociate or disconnect in some way. Two patients I encountered were attached to ecstatic states.
The first was a man with a background of heroin and alcohol addiction. He was able to stay away from drugs and alcohol for 10 years and then relapsed – which is when he came to me. He told me he was using mindfulness to stay away from his addictions and meditated for 8 hours a day! Just before the relapse he got a job: this stopped him from meditating for 8 hours a day, and so he relapsed.
When I questioned him about his mindfulness practice, he told me that he would just got into a blissful state for 8 hours, never experiencing any negative emotions.
I asked him to deliberately call to mind some unpleasant experiences while practicing mindfulness and pay attention to how it felt in his body rather than holding on to these blissful states. The lesson here is to get comfortable with feeling uncomfortable. In Tibetan Buddhism, they talk about samadhi. It is a blissful state – and sometimes people get addicted to this state. Some people this is enlightenment, but the Buddhist teachers say that that’s a delusion, an unhealthy attachement to something.
The second case that comes to mind was of a man with schizophrenia. Many of my patients with schizophrenia derived a great benefit from mindfulness. This man was having a Kundalini experience, where energy was going up and down his spine. They talk about it in the Hindu tradition. He would go through this experience for many hours a day and it made him more delusional and psychotic. It was very hard to persuade him to do less meditation!
I wouldn’t’ call either of these experiences mindfulness, as they weren’t this open, non-judgemental states. This is why having a teacher is important: so that you can reflect on your experience and receive some guidance.
How should one go about choosing their mindfulness teacher?
There are no absolute guarantees. I am aware of some highly trained psychiatrists who teach mindfulness, but don’t practice it. They say they do, but by talking to them, you quickly realise they don’t: they have a kind of striving attitude.
For people with psychiatric conditions, it is better to have someone who understands both the Western and the Eastern traditions. If you have a teacher, a psychologist or psychiatrist, who comes from the Western tradition only, it is important that they practice mindfulness themselves. It’s important for a teacher to be able to tune into the problems that arise for people as they go through their mindfulness journey rather than sticking to a rigid program.
There is a one size fits all approach to mindfulness among the public at the moment. Do you feel that that it’s appropriate for someone to use an app or should they find a teacher?
In my classes, I have a handout that reviews the apps and advises my patients to beware of any apps that tell them what to feel or that they should relax. People can play with apps – it gives them experiential information that allows them to commit to go to a class. Some people learn a lot from the apps. I haven’t seen the good apps causing any harm. Headspace is quite good. Buddhify is great for getting past the idea that mindfulness only happens on a cushion and has lots of shorter meditations that people like. Insight timer has nice mindfulness bells and nice soundtracks. Some are a bit New Age-y, so people need guidance in choosing the right ones. iTunes U UCLA meditations are quite good too. I send people to my website as I have some soundtracks there.
What are your thoughts on transcendental meditation? It became commercialised quite quickly once it reached the West. Do you worry that mindfulness is headed in that same direction?
I did TM for a few years and found it helpful. I studied Buddhist meditation before that and it gave me the impression that the mind has to be completely quiet – which caused a lot of agitation. TM helped me to get past that as it involved returning to the mantra without trying to eliminate thoughts. TM also taught me about preliminary practices such as exercise.
In the East, mindfulness is used to investigate the mind as well as everything else. A lot of the insights of Buddhist psychology are now being confirmed using Western methods, such as fMRI. I believe this aspect of the Eastern tradition doesn’t get enough attention. However, we need to separate the psychology, philosophy and the religion. Those who say that Buddhism isn’t a religion are lying: it is a religion, but as well as that there are psychological and a philosophical components. These can be separated out, just like has happened in the West.
The tradition in the East is 2,500 years old, so we run into a lot of interpretation and translation problems. The Eastern languages have changed in meaning and nuance in that time just as much as Western languages have. Jus think how much trouble we have interpreting Shakespeare and his writing was only 500 years ago. Furthermore, Buddhist psychology is based on human investigation that has evolved over time, so it’s not like the Bible that has been “handed down” and and passed on as some kind of unchanging truth. The Eastern mindfulness tradition, in fact, has a lot in common with the Western scientific tradition. This tradition has evolved from the Socratic tradition which is based on debate and questioning. rather than prescriptive rote learning. I believe that if we start paying more attention to what is already known in the East our progress in understanding the mind will be accelerated and our meditation practices will become even more effective.
Dr Walsh’s own website contains a lot of case studies and blog articles on mindfulness that I would highly recommend: mindfulness.org.au
A millennial's musings 
I think this post is really great really hit all the wickets. To me this is part of the journey discovering there really isn’t anything to get or to do, other than to just be and know it all just comes and goes. We learn the times to dive and when we are in we learn to still just see it all come and go. But its tricky, right? I mean it is the seeking that set us on the journey in the first place then we learn that there is nothing to really get. The journey then turn from a journey of seeking to enjoying the entire process, and you find out you can still make the journeys. Ugg this is the tricky part of trying to explain because it almost always sounds like circular babble. Sorry I just love this subject and could honestly almost talk endlessly on it. People ask what my hobby is and though my hobby is just living and seeing this is very weird and hard to explain. Sorry for blathering, great post!
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Thanks! I very much enjoy the subject matter of your blog. These matters are difficult to put in words! However, I think by articulating our thoughts, we learn!
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Interesting article. Zen buddhists are on a different journey that Americans who practice mindfulness. They work towards enlightenment which the common man has no clue what it is or how it feels. I was told at the Zen center that you were a novice until you have meditated vigorously for a decade.
Mindfulness is a much different animal. I have seen benefits within a couple of weeks. We need not be enlightened to heal from PTSD, Dpression or enhance our daily wellbeing.
We set no goals however we strive to reach an empty, no thought stage while we are focused on the breath. This is where healing and integration can take place.
As to mindfulness being used in therapy, mindfulness is not an intellectual property. Reading books or taking a class does not benefit you or help you understand the process. Not many therapists have sat in silent meditation for any extended period and thus are clueless how to use it correctly.
When I healed from PTSD, I started filling in the gaps for,others that I faced. Then I designed a model that would make it easier to focus and let thoughts go.
I also took out the abstract things about ,edit acting to simplify it.
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I completely agree, Marty! “Then I designed a model that would make it easier to focus and let thoughts go” – could you explain some key points form this?
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The breath is the focus object: Buddhists count their breathes. Math is the highest form of cognition, therefore it is difficult to not think.
We usually get lost in the pauses after the inhale and after the exhale.
I designed a simple model which is a continuum and flows concisely with each cycle of the breath.
A sample post
https://ptsdawayout.com/2015/07/05/breathing-track-basics/
We also slow the breath and listen quietly for the sound of our inhale and exhale.. we also try to feel our heartbeat and the pulsation below the heartbeat.
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Sounds like mindfulness at its purest!
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A shorter simpler version
https://ptsdawayout.com/2014/05/29/back-to-basics-new-stickers-of-the-breathing-track-model/
Practice on this model will be strong enough to withstand our fight or flight firing.
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I’m enjoying your posts immensely. Thank you.
I’m trying to read the old ones and the new ones to catch up, which is a bit time-consuming at times, but I like to be aware of all I can when I start something new.
I’m not a particularly excitable person and actually enjoy constant mind stimulation of some kind, so I’m finding the mindfulness technique being a bit difficult to accomplish; while listening to the lady from (Ireland?) I get a very strong urge to go read the news (an obsession of mine), or activate my thought processes about one thing or another, so this has been a bit of an interruption in the learning process, but I think, like all new things, it’ll just take some practice.
I recall decades ago taking some “bio-feedback” lessons, a process of meditation that, if I remember correctly, are very similar to this in the beginning (and I had the same problems then to – gotta get up and do/read something). What was really cool was being monitored with equipment that showed I could actually lower my blood pressure a bit and see that recorded after the sessions.
Looking forward to learning more. Thank you ever so kindly for sharing all this.
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I think that’s just par for the course, not really an interruption in the learning process- it is the learning process. Looks like it could be time for you to look for a teacher? Mindfulness can indeed lower BP! Good stuff.
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My first adult experience with it was at a makeshift shrine with a group of Cambodians in an all night laundromat in Arizona. She was an older lady that led the sitting. She invited me after I chased away some guys that were selling drugs at her laundromat. She said she could ease my anger. It felt like REM sleep. Like, if I concentrated harder on nothing I could wander. I didn’t feel the tingly spine thing you mentioned I felt like I was connected to my lower order processes you know, the lizard brain without fear just strangely connected to myself. I laugh when my California friend said she had to go to Costa Rica to meditate. I pointed to a piece of grass in front of a restaurant and said, that’s all I need.
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Very interesting! Could you explain what you mean by “It felt like REM sleep”? It was different to a day dream, I gather?
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REM sleep I’ve measured to a few hours. My therapist friend in Georgia said color dreams are rare. I have always dreamt in color so that’s separate. REM sleep is a body paralysis but a waking state. My mind is really open taking things apart putting them back together. I feel everything. I am unsure if that extends to others. I feel less angry and since I don’t have a thinking job I kind of play with it. Awareness is slighty overused, would it not be more like our Pooh Bear here in the states. Just content and focus, curious, and very true to himself.
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That’s a great image of Pooh Bear 🙂 It’s a great way to build an analogy – awareness is an abstract concept for sure!
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The creator of Zen Buddhism, Shunryu Suzuki said, if you want to have those out of body experiences while meditating do drugs. We as observers, have to be aware that any material collected on the process is slightly skewed because we have less devotion to that process. I will not attain what a monk achieved because I am not a monk. I respect them immensely. There was a guy writer, late 1800’s, talked about experiencing several presents, one past, and no future. The mindful part could be the several presents and awareness could be just connecting the dots.
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Dr. Martina, I’m still consciously giving myself permission to delve deeper into your writing. In fact I recently brought you up to my former landlord (retired medical teacher) who happens to share my sentiments towards the advantages of exercising mindfulness. Trying to pronounce your last name to him was a disaster, although ‘manova’ seems to roll off my tongue quite naturally. Would the first syllable of your name rhyme with ‘say’? And the second with ‘brake’? The name feels Russian. Attempted to leave this inquiry on your askwhale.com drmartinaf page but to no avail. Perhaps you could recommend another place to leave messages that are not relevant to your actual blog posting; which by the way was great. The darker side of mindfulness is definitely an attention grabber. I am bursting at the seams to comment on various sections but will defer my passion for another occasion. Seek First to Understand is a habit that requires much patience for me, as an ENTJ I love to keep the floor and with the J coming in at 55%, ENTP is where the ocean meets the sea.
Regards,
JY
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Oh sorry! Haven’t been on Whale for a little while. My last name is indeed Russian and I don’t expect people to be able to pronounce it! “Call me Martina”. The second syllable rhymes with brack (the bread). You are very welcome to comment here at any time and thanks for you kind words on the blog. There aren’t that many philosophically inclined blogs out there, so you and I will have to keep up the good work, Jason! Your recent video on Alan Watts is very cool.
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Really interesting read. As someone who meditates every day, I was fascinated. I don’t have a teacher; I’ve used books for the last 15 years. I have been to one or two retreats, though. I love meditating, though I hope I have no attachment to those blissful feelings. 🙂
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Thanks for comment. I think most people online don’t have a teacher, and it is evidently hard to find a good one! Retreats are great: how long did you go for?
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The first one was five days last summer, taught by a Buddhist nun. It was life-changing. The second one was 3 days and equally amazing. 🙂 They really are awesome.
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I disagree with the wording of “That mindfulness brings out negative emotions” It by itself does not do that, but it exposes.
As for mindfulness being stress relief. I agree with what He says That it is about awareness, that you train to direct and be without opinion and such and calm. “Truth shall set us free”. If you notice stress comes from an opinion then you can drop that opinion. Does training in Mindfulness Based Stress reduction therapy of Jon Kabatt Zinn give one the distinction between fact and opinion ?
Being able to stay calm and be present can or will calm the stress. I learned – from a painful foot cramp – that it helps to be direct the cramp to be open or is it to be open to the cramp ?
I learned that being present and letting pain rage, that it – after a relative short time – went away.
As i see it it sometimes helps the stressful spot by simply being present with a calm and open intention.
or by becoming aware what the cause is. That can have a immediate effect. Working vigorous setting up a festival i found myself with stress, discontent. It came from the vigor. Realizing that the srtess disappeared immediately.
Thinking a bit freely, I came upon the realization of noticing relativity while being mindful on something. Like something being half full or empty or noticing that I am calm but blocked out and rigid.
I learned that when I stray from mindfulness and I come back to it that it feels different. Like that before I strayed I seemed to be locked in a fixed sensation and could not feel progress
Side effects.
when I was very sensitive I had an instinctual feeling that someone was coming to the community center where I was. Someone did come. An other experience. When being mindful on my body, the thought came up that It was my head directing and focusing awareness at my body. I followed with adjusting. By letting my head take a step back. Through that I noticed that the rest of me also has awareness of its self. So I am not just a 1 I but also a 1 We. Where is the difference between imagining, dreaming, psychosis and having a vision ?
it is possible to notice things you would not otherwise because you’re to busy. You can even notice things you would belief you can. I noticed , saw – with my conscious-mind eye – that the left side of my body is connected to the right side of my brain. and Vice versa.
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A fantastic read! So much there to think about… Thank you.
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So much experience and an interesting perspective! Thanks
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Thank you for this detailed post. For me, mindfulness isn’t an activity as much as it is a lifestyle – one I did not adhere to before I started meditating. We cannot be mindful of everything all the time. We do not have the mental capacity. We have to choose what to be mindful of as well as when. For example, when I first tried incorporating mindfulness in my life, I started by noticing the energy change, if any, when I walked through a door. The door was my trigger to go, “Oh, I should pay attention for a second.” Over time when things would come up, such as a feeling of panic – even mild panic, say from a close call in traffic – then I was able to go “Oh, I should pay attention to how my body responded to that” so that when that feeling arose again I could just notice it, acknowledge it and go on.
Thank you for visiting my blog; I am so enjoying yours and look forward to your future posts. As you know, mindfulness is a major focus of my life.
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I find your writing incredibly helpful. A really balanced perspective on mindfulness, meditation and what the pitfalls can be. As you recognise in your piece, I am one of those people who finds sitting entirely still and meditation for any extended period of time can cause me to feel overwhelmed, even panicky. Practicing mindfulness and meditation are not easy, they do, indeed, require practice and what works for one person may well not work for another. I have found mindful yoga very good in the past, stretching and focusing on my body, rather than trying hard not to feel the pain in my back or the itch on my nose works far better for me. The mindfulness apps stress me out and ruin the point. But different things work for different people, it just takes a bit of persistence, experimentation and adaptability to find your right groove. Thank you for your excellent reflections on these matters, and your very beautifully and calmingly (is that even a word?!) designed blog 🙂
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Thanks very much for your kind words. It can be really tough to do it on your own, so I hope my reflections help you on your quest
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I’ve had some quite unpleasant experiences with mindfulness meditation classes, including an MBSR course, with fairly severe emotional distress. From what I’ve managed to find out subsequently by reading and talking to meditation teachers, if you have a history of traumatic experiences which you have primarily dealt with by avoidance (of the memories/ emotions/ body sensations), the process of becoming aware of your internal physical and mental states can allow a lot of incredibly painful and difficult-to-deal-with material to emerge, and unless you are working with a teacher who knows how to help you stay within a window of tolerance for managing this it can easily become overwhelming. This is not something that students seem to ever be warned about, and I see the trend towards drop-in meditation classes with no single regular teacher or mentor, and classes being taught by teachers with only a little experience themselves, as a risky practice.
I’ve written about my experience here in more detail: https://dangerousvoyage.wordpress.com/my-life/meditation-yoga-and-repressed-memories/
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