Five philosophical myths about mindfulness that are sabotaging your practice

From a useful superstition with medical benefits to a deeply spiritual practice, mindfulness has seen a variety of labels. Together with Nguyên Giác, we put together a list of common misplaced attitudes towards mindfulness, so that you don’t sabotage your practice. [Watch video instead]

Mindfulness has become quite popular and seems to be gaining further momentum. It is set to soon be mainstream.

As is often the case with explosive popularity, there are some misconception and misinterpretations about mindfulness making the rounds among bloggers and on social media. 

1. Mindfulness is a Buddhist concept

It’s not uniquely Buddhist. Mindfulness has roots going back to Christianity. More that that: wherever humans have existed, they have discovered mindfulness. Many traditions poke around the mindfulness bush, some more directly than others. Why? Because mindfulness is healthy. It makes sense, evolutionarily. A mindful population will thrive. A population lacking mindfulness will have a hard time propagating the memes (Richard Dawkin’s meme, not the funny picture, meme.. although they are related) and genes that define its character.

Christianity has elements of mindfulness practice present in ritual and scriptural form (both within and outside of the canon).

There are a number of passages that obviously point to the practice of mindfulness, and there are many others that, when understood in context, point to mindfulness practice.

Whenever you have people that are practicing awareness of what they are doing in that moment, you have mindful people. When people know they are washing dishes, they are mindful dishwashers. Christians who are mindfully carrying candles, passing out bread and wine, and consciously delighting in each other’s company are Buddhist Christians – they are increasing awakeness in the world.

As Thich Nhat Hanh says,

“‘Buddhism is a practice. Like Yoga’. It is not a ‘religion’ in the way that Christianity is a religion. There are no gods. No required beliefs.. Nothing to take ‘on faith’.”

It is an open-handed teaching, hiding nothing, encouraging actual practice, letting you realise things without forcing it. The labels of “Buddhist” and “Christian” can be hindrances. It is nice to respect our spiritual ancestors, but it is foolish to isolate ourselves within the confines of some set of teachings. Old “maps” may not accurately represent the present territory.

Some people make the claim that there is an actual historical link between Jesus and Buddha. Indeed, there were Mahayana Monks in Egypt during Jesus’ lifetime. But, with or without the causal connection, Buddha/Gnosis is one – the message is the same. People can happen across the same spiritual truths in totally separate cultural contexts. The historical connection would be interesting and exciting, but it is not necessary.

So, in conclusion, there are some big chasms to cross as one journeys between world views, but if we look within we will find one human experience– we are unique, but we share common ground. It is beautiful. If we can learn to gently share our ideas with respect and give credit where credit is due, this era of history can be an amazing one.

Naturally, mindfulness occurs in religions other than Christianity and Buddhism, we shall try to address that another time.

myths and misconceptions about mindfulness
Sure, who wants an article on mindfulness without a picture of a woman meditating?

2. Mindfulness is about detachment and emptiness

Buddhist terminology also presents some problems for the Western Mind.

The translators of yore did not have the proper conceptual tools to work with the subtle ideas generated by Buddhist genius. And, still, people are hung up on ideas of “nonself”, “emptiness”, “detachment”, etc.

The Christian West has to do some serious psychic judo to make sense of these things without experiencing intense fear and trembling.

There are many potential points of conflict, but, let’s focus on non-self. Anatman. Anatta. No atman. This seems to have been one of the Buddha’s big ideas. There is no independently existing ego, or self-sustaining identity, anywhere in existence. All is dependent on all. Every square inch, square centimetre, every atom is as significant as the largest star. Look at “Indra’s Net”. It’s a nice way to visualise emptiness, or non-self: emptiness and non-self are the same idea. Interdependence is a better word. So when you read, “non-self”, “emptiness”, “voidness”, etc… just remember interdependence.

In the West, largely populated with traditional Christians, many have trouble with all this. There is this idea of “something out of nothing” that the Christian must accept in order to fall in line with dogma. It is totally illogical. Therefore, the Christian declares that faith is necessary. The question, “what was before the beginning?” will never be answered. Those who try to convince you that they have answered that question are liars or fools. Asserting that “God did it” is dangerous, the priests who make such assertions are “like dogs in the cattle manger, they can’t eat and they won’t let the cattle eat”. And, this is what Jesus is implying in the Gospel of Thomas when he encourages us to ignore those who claim to know “the way to heaven”.

On a more comforting note, the Jesus of the Gospel of Thomas also recognises this truth of non-self, which is very closely related to the truth of impermanence, another central Buddhist idea.

He also declares that all things that come together will fall apart. Everything will change.

Gospel of Thomas, 11:

Yeshua said / This heaven will pass away / and the one above it will pass away. / The dead are not alive / and the living will not die. / During the days when you ate what is dead / you made it alive. / When you are in the light, what will you do? / On the day when you were one / you became two. / But when you become two, what will you do?

Some people want to hide in their meditation halls, with their tibetan loving-kindness mantras – that’s fine… However, the Bodhisattva (the being tending toward awakening) engages the world and meets people where they are at. By helping others in real life, the Bodhisattva also develops her own Buddha Nature.

what we get wrong about mindfulness meditation

3. Mindfulness is part of the positive thinking / law of attraction world view

Many have come to view mindfulness as a close cousin of positive thinking. This is a misconception.

Mindfulness cultivates non-judgement – which the exact polar opposite of insisting on only ever dignifying positive thoughts with our attention.

A concept seemingly resonant with positive thinking/ law of attraction appears in the Dhammapada, one of the primary collections of teachings attributed to Siddhartha Gautama:

Mind precedes all mental states. Mind is their chief; they are all mind-wrought. If with an impure mind a person speaks or acts suffering follows him like the wheel that follows the foot of the ox.”

However, mindfulness emphasises the value of accepting things as they come.

Yes, we “create our own reality”, but we certainly don’t do it alone.

Reality is seen from a fundamentally different viewpoint in the philosophy underpinning mindfulness. The Bodhisattva does not proclaim that things are either positive, negative or neutral– Buddha abides “beyond good an evil” – beyond positive and negative and neutral.

In many Buddhist schools, there is this idea of the Five Skandhas. The Five Heaps. The Five Collections or Aggregates. Instead of a self-sustaining ego, Buddha spoke of these components – the Five Skandhas – that make up a personality.

The sensory experience, contact with sense objects through one of the sense doors (light / eye, sound / ear, chemical / taste and smell, pressure and heat / touch, thought / mind), is either positive, negative or neutral.

There is an event, and there is a knee-jerk reaction to it that is either good, bad, or not good or bad.

The Five Skandhas are empty”. They are interdependent. Sensation is just one of these heaps. Sensation depends on form, perception, mental formations, and consciousness. And – positive, negative and neutral are also empty!

There is no positive without negative or neutral, and the same is true for negative and neutral.

Our strength is not found in forcing reality to remain “positive”. We are considered accomplished because of the strength we have to endure the snaky shifting of Samsara. We endure the ups and downs, we remain in this mind system with these sentient beings, unperturbed by the positives and negatives and neutrals. We are beacons of peace and stability in this chaotic ocean.

4. Mindfulness is a natural remedy for anxiety

People want to talk about mindfulness like it’s some miracle pill. Despite what we so often hear, this practice of mindfulness is not always roses and cotton-candy. The practice of mindfulness may reveal things one has been been avoiding. This can be painful. This is the real work though! Learning to see clearly requires deep compassion for oneself and for all sentient beings. Gentleness can smooth over those scratchy rough spots.

Mindfulness meditation is work, but it is healthy, soothing work.

New things will be noticed. New things can cause fear. If new things aren’t being noticed, if fear isn’t arising, it is probably a good idea to refocus the practice. But how?

The goal is not to be rid of negative emotions.

Mindfulness meditation teaches us to put harsh feelings into context and not become totally overwhelmed by their presence. The goal is not to become a tranquil yuppy – it is to become present, aware and in touch with actual bold faced reality.

Yes, there are benefits. Mental and physical health benefits.

Breathing meditation can bring calm. “Negative” feelings can also arise – they are as real as “positive” feelings.

During practice, all of these arising positive and negative thoughts are gently touched – and like the fragile bubbles they are, they pop. It is not difficult. There is no strain. However, it is work. Perfectly paradoxical.

You may also like: Mindfulness is pointless – and that’s the point

what we misunderstand about mindfulness

5. Mindfulness is a medical treatment

Here in the West, the main drive for the explosion of mindfulness practice seems to be coming from the medical community. This is awesome. As always, medicalising normal processes is dangerous. It is especially common these days when people look to science for answers – rather than to religion. However, difficulty arises when science, which is much more about questions than it is about answers, becomes scientism, or high priests with Ph.D.’s handing out evidence-based dogma.

There is a lot of cultural appropriation going on around here. Doctors are not far off taking credit for practices that have already been employed for thousands of years. On the surface, this is all fine and dandy, but looking deeper we can see that it’s part of a larger pattern. We Westerners have not been so kind to our friends around the world. We take and take and take. The practice of mindfulness cannot be “owned”, but it seems to me that we should be giving more credit to it’s Eastern roots. Indeed, those roots extend beyond the Buddhist tradition. There are things to be learned from the cultures that have grown up with these practices.

Instead, it looks to me like as Westerners, we are trying to distill the “useful” practices from what we consider to be “superstition”.

Our sciences are constantly revealing a stranger and stranger reality. We would do well to hold our verdicts on what is and is not superstition.

philosophical misconceptions about meditation mindfulness

Four reasons why daydreams scare off mindfulness

Complex problems have simple easy to understand wrong answers.

Henry Louis Mencken

I have recently been very interested in what it is that makes mindfulness feel quite difficult at times.

Up to 96% of adults daydream every day.

I am using the term daydreaming in the broadest possible way. There are ways in which it is positive (visualisation, rehearsal, creativity), but we all know that it can get out of hand very easily.  These so called self-generated thoughts (SGTs) interfere with external task performance and can signal unhappiness and even mental health issues. They also occupy our thoughts for upwards of half of the time. In appropriate contexts, SGTs

  • allow us to connect our past and future selves together,
  • help us make successful long-term plans and
  • can provide a source of creative inspiration.

Given the time dedicated to the task, it seems natural to suggest that there must be an evolutionary advantage to being preoccupied with a daydream.

Contrary to the mindfulness rhetoric, daydreams can be seen as a mechanism for the consciousness gain freedom from the here and now – reflecting a key evolutionary adaptation for the mind.

There is evidence that  SGTs are normal and may even be beneficial, so our natural inclination  to dismiss mind-wandering – and recent odes to the benefits mindfulness – are perhaps oversimplifying the problem.

mindfulness slipping into daydream

For the moment, however, I will focus on the negative aspects of daydreaming.  In 2016, the Journal of Conscious Cognition did a study on self-identified “maladaptive daydreamers”. These guys had more daydreams that involved fictional characters and elaborate plots and spent 56% of their waking hours fantasising.

Maladaptive daydreaming caused significant distress to the affected and was associated with higher rates of ADHD and OCD.

Another study echoed the findings and showed that the daydreams were typified by complex fantasised mental scenarios that were often laced with emotionally compensatory themes involving competency, social recognition, and support.

Of note, solitude is required for elaborate daydreams – worsening any existing social dysfunction.

Mind-wandering is situations when attention is required is obviously negative: it can signify performance disruptions, cognitive problems, risk taking or low motivation to perform a task. At the same time, the question arises: how do we define a situation that requires attention?  The resolution here is obvious. The capacity to regulate the occurrence of SGTs so as to reduce the risk of derailing on-going task performance is a marker of properly functioning, well-adjusted cognition. It is context-dependent – and requires self-awareness. Indeed, a brain trained with the practice of mindfulness would seem better equipped to recognise appropriate situations and adapt more quickly.

On a more philosophical note, however, what’s to say one isn’t missing out on some important unknown unknown in an apparent “safe-to-daydream zone”?

Based on some research and a preliminary Twitter poll, I have come up with 4 main feelings that trigger daydreams.  If none of the four describe what it is like for you, please do comment, I am very keen to find out!

maladaptiveday dreaming mindfulness

Friday’s 5 cognitive curiosities journal club

Here are my top picks from the neuroscience-mindfulness spectrum for this week.

1. We judge our previous decisions based on new information

From The Journal of Neuroscience

Thinking about thinking (known as metacognition) is hugely important for adaptation, however, little is known about it. The results of this study demonstrate that the information used to make the initial decision differs from the information that is used in metacognitive judgments.

2. Obesity is linked to memory problems

From The Quarterly Journal of Experimental Psychology

Obesity could play a part in the development of neurodegenerative diseases such as Alzheimer’s Disease. It appears that the relationship is a two-way street: being overweight or obese impacts memory function, then the memories of eating experiences change and thus affect future eating behavioural patterns.

3. There is little or no diagnostic specificity in the fMRI results for mental illness

From Human Brain Mapping

It appears that individuals with mental illness – regardless of the diagnosis – have abnormalities in their limbic system responses to various tasks. The limbic system is associated with emotion.

Put simply, the fMRI of a depressed person isn’t different to the fMRI of a person with a (seemingly) completely different disorder schizophrenia.

This could be a reflection on insufficient sample sizes. It could also be a reflection on the worry of going into an MRI scanner. A number of studies emerged recently showing that we’re possibly misinterpreting the findings of fMRI.

neuroscience mindfulness latest news
From Addressing Reverse Inference in Psychiatric Neuroimaging: Meta-Analyses of Task Related Brain Activation in Common Mental Disorders

4. Fat shaming is associated with poor health outcomes

From Obesity

Individuals suffering from obesity who self-stigmatise may be at an increased cardiometabolic risk. Physiological and psychological mechanisms linking weight bias internalisation and metabolic syndrome warrant further research.

One of the researchers commented:

“There is a common misconception that stigma might help motivate individuals with obesity to lose weight and improve their health,” Pearl said. “We are finding it has quite the opposite effect.

When people feel shamed because of their weight, they are more likely to avoid exercise and consume more calories to cope with this stress.”

5. Thinking loops lead to emotional loops

From Tara Brach

Tara Brach humorously talks about the relationship between biases, emotion, beliefs and thinking. Emotions can subside in 90 seconds unless we generate cycles of thinking that re-trigger and reinforce them.

Have a great weekend everyone.

neuroscience mindfulness news

Mindfulness is pointless – and that’s the point

It seems that the focus of many bloggers and mindfulness advocates is to promote mindfulness as yet another miracle fix on the way to flat abs and a yacht. Mindfulness isn’t a shortcut to effortless positive thinking.

The fact that the 440×220 pixel Twitter platitudes with a stock sunset background and a quote from a Buddhist have become so popular reflects the growing misunderstanding surrounding mindfulness.

psychology of mindfulness

While mindfulness does help with depression, anxiety and other difficult mental states, achieving a certain mental state – or indeed happiness – isn’t the purpose of mindfulness. While it isn’t necessary to buy into the philosophy behind mindfulness to practice it, it’s important to understand what it is one’s getting themselves into.There’s nothing at all wrong with “secular” mindfulness, the kind pedalled by corporations, promoted to children, etc. Indeed, I am in no way a Buddhist. However, I believe that hiding from this philosophy and still expecting to get experience mindfulness to the full is futile. The philosophy states that…

At the root of all suffering is attachment.

Non-attachment is a key tenet of the Buddhism. Attachment is our attempt to deny the fact that everything is impermanent, hence is causes a dissonance between reality and perception ultimately resulting in suffering. The concept seems at odds with out common view of happiness that involves the strife to get through a checklist of experiences and things – and walk of into the sunset in permanent bliss. However, the concept of non-attachment is echoed in the philosophy of Stoicism, the thoughts of Friedrich Nietzsche and modern talking therapies such as CBT and REBT. Indeed, I struggle with the concept again and again. It seem that Buddhism advocates that we live our lives a bit like plants: accept everything that comes our way and adapt.

mindfulness philosophy psychology

Using mindfulness as some kind of trick to accomplish certain goals just doesn’t make sense.

Google, having a finger in virtually every pie, have a Search Inside Yourself Leadership Institute. It’s mission is stated as:

Born at Google and based on brain science, SIY uses the practices of mindfulness to train Emotional Intelligence skills, leading to resilience, positive mindset, and centred leadership. In the midst of complexity, it’s about finding the inner capacity to create, to thrive, to lead. And it’s surprisingly fun. Backed by some of the world’s leading experts in neuroscience and mindfulness, SIY is changing thousands of lives in over a dozen countries.

Here’s a book they propose. I haven’t seen the inside, but if I may judge by its cover, I find it wanting.

mindfulness isn't a positive psychology hack

Indirectly, insights into how to achieve goals may be precisely the result of the practice. However, a realisation of the irrelevance of those goals may also be the outcome. Being in the moment involves not knowing how it will all turn out. Barry Magid is an American psychiatrist who went against the current. He argued against using meditation as yet another vehicle en route to the conventional happiness prescription, i.e. maximum pleasant feelings and thoughts, minimum unpleasant feelings and thoughts.

Magid’s understanding of mindfulness is that it is a way to stop trying to “fix” ones’ experience of things.

His argument is somewhat routed in mythology: struggling to escape one’s demons is what gives them their power.

The fight for a vision of happiness is the cause of the problem, not the solution to it.

Freud’s seemingly basic idea of our psychology was that we seek pleasure and avoid pain (and we avoid pain much more than we seek pleasure). He argued that our subconscious was a big long list of everything we avoid. The Buddha confronted suffering, he didn’t move away – he moved into the pain – and that is how he became free.

As a doctor, I know that it’s very worrying when a patient doesn’t flinch away from a painful stimulus. I am starting to come around to the idea that for our higher cognition, the non-reflex, non-fight-or-flight, it is better to not flinch away from mental pain.

That’s how I understand mindfulness. It’s not sitting there thoughtless. In fact, trying hard to fix the busy mind is yet another trap. The way I understand it is that it is necessary to observe it without clinging or fleeing. Like I discussed with Bela,

For me the experience of mindfulness is a bit like being on a tight rope: the abyss of clinging to the left and of fleeing to the right. Sometimes of the past to the left and of the future to the right. Just like it takes a lot of awareness to remain on the tight rope, flexing the right muscles, adjusting to the wind, it takes the same kind of awareness to stay in the moment.

Seneca, Freud, the Buddha – and our new friend the living psychiatrist Magid all seem to think that flinching away from suffering is what makes it worse.

The Abhidhamma, a central text for Buddhism, teaches that the mind is a bit like a sense organ. Thoughts and feelings come in just like smells, sounds and tastes. Recently, I observed a thought that seemed completely extraneous to me: having relaxed after non-stop worrying about a sick animals, I found it strange how someone else would get so upset about a pet in hospital. Not every thought and emotion belongs to us. Why do certain songs cling to our minds? In what way are they ours?

We could consider the inescapable nature of the smell of cigarettes – or the taste of toothpaste every morning as a way to understand the presence of certain thoughts and feelings.

It gets a little bit “meta” – as we are more abstractly thinking (one may say observing non-judgementally) of regular thinking (to do list, he said, she said, itchy, hungry, Never mind I’ll find someone like you, and other assorted circular randomness) – and saying that regular thinking is just like an organ of perception. What does that say about abstract thinking? Is that the “real” thinking? Somewhat over-simplistically, I suspect that this abstract thinking is a process of the prefrontal cortex, while the regular thinking is carried out by more basic circuitry we share with many animals.

philosophy behind mindfulness
Observing the clouds pass by without chasing them

In this vein, not being able to get the motivation to do something because one’s sad doesn’t make sense. One needn’t feel pumped to do work. If thoughts and feelings are like smells and sounds, one can still muster the agency to do what needs to be done. The Stoics would argue like this also.

In a sense, this still means that mindfulness is a route to happiness, only I changed the goal posts of what happiness is. In a sense, mindfulness is a fight to stay on the tightrope of the present moment – and thus a fight for happiness. This is all difficult to state in words, but I think you all know what I mean.

Mindfulness doesn’t have a purpose, except perhaps to reconcile perception and reality – which is so obvious, it is a bit embarrassing to state as a purpose.

mindfulness non attachment

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Don’t change the channel

When mindfulness seems impossible

Don’t change the channel

Mindfulness is effective in treating many mental health problems and psychiatric conditions. For those who don’t suffer from the above, it seems to still be beneficial in terms of focus, mood, relationships and results – based on many people’s personal experiences. Why then, is it so difficult at times? It is difficult for the same reason than escapism is easy. I am not Bill Murray’s biggest follower, but in one interview he said:

I would like to be more consistently here… I would like to see what I could get done if I didn’t cloud myself with automatic [thoughts]… If I were able to not change channels in my mind and body.

everyday mindfulness not day dreaming

He didn’t say anything ground-breaking, but his channels analogy really struck home with me. Having listened to this interview in the morning, I was on an uncomfortable journey between two cities today. To the right of me was a morbidly obese gentleman who sprawled himself across about three seats in an unorthodox position rarely seen in public. To the left – a lady who evidently led a lifestyle that didn’t involve too much personal hygiene. Having sneakily moved to another seat, I was putting my headphones in, prepared to sail away into a safe and pleasant day-dream. However, in my mind, I could hear the echo of the interview: don’t change the channel. Some voice of cognition questioned what I could possibly gain by being present when the present is like this? I wasn’t sure. What did I have to gain by being in a day-dream? A mindfulness devotee would surely say: nothing. Well, if people never day-dreamed, we would still live in caves. If we didn’t rehearse situations, ruminate, “mind-read” and obsess, the world would be different. I guess some may even argue it would be better. I am not sure.

I wish it was clear cut. I wish this story had an elegant twist where being present resulted in some kind of miraculous revelation. Instead it made me more aware that it is as easy to slip into the mindfulness cult as it is into a day-dream.

Ironically, Spotify shuffled to a nice house remix of R. Kelly’s Bump and Grind. As my mind was indeed very distinctly telling me “No“,  I took my headphones out. I could feel so much resistance. It angered me and made me sad that instead of floating off into a day-dream, I righteously deemed it necessary to stay in the present moment. I felt a bit like a Brave New World character without her soma. It felt necessary to stay present though. I ended up just being aware – of a storm inside.

Now, at the end of this mindful day, I can’t proudly declare that I feel at peace. There was no external conflict whatsoever, but I feel like I’d been in a blazing row for hours. With it though, there’s a certain exhausted clarity, like everything has been unreservedly said and it is all out in the open.

Faced with a choice like this again, I will probably choose mindfulness over the day-dream – again. I will stick with this channel called Reality, as we know it, rather than If I were with my friends or some other blissful escape route to rainbows and unicorns. Being honest, in part it is because I “read it in a book” and the high priests say it’s good for me. However, in part it is because I appreciate just how rarely I am even present enough to make this choice.

The day-dreams will happen regardless, the awareness won’t.

how to stop daydreaming

Validation and self-esteem

I’ll drop my glove, to prove his love; great glory will be mine.

Leigh Hunt

Vanity and fair are simple words. However, it was only recently that I understood what these words mean together. In more contemporary English, it means an exchange of validation between two people. What got me thinking about it is the book I recently read by Robert Cialdini called Influence. It describes the mechanics of how easily people’s need for validation  can be used to play them in a Machiavellian way.

Validation is always a treat. We must be wired for it. Given that humans are social animals, it makes sense to yearn for validation as it increases one’s chances of survival. If one is part of a tribe (i.e. accepted/validated by the tribe), he/she is less likely to get eaten by a sabre-toothed tiger. However, it seems that this pathway gets hijacked an awful lot.

addicted to validation

I think the best way to explain this is by looking at an extreme example: narcissism, because the logic is the same no matter where someone is on the spectrum. I grew up with and subsequently encountered some florid narcissists – though I didn’t always know it at the time. While the full blown narcissistic personality disorder is relatively uncommon, traits thereof appear quite ubiquitous. I will loosely use the word narcissistic here to signify anyone with traits of the disorder. During my late teens I loved high-achieving people and hated arrogance. It made no sense to me why somebody would act so unpleasantly. I thought that arrogant people believe they are better and that I am not worth their time. It turns out that’s only half-true.*

I subsequently figured out – through a mix of psychiatry training and reading (Daniel Goleman’s Emotional Intelligence is brilliant for this) – that arrogance is a form of insecurity. However, the exact same insecurity can be revealed through being super friendly (hence, not all narcissistic people are arrogant**).

Much of it boils down to the source of one’s self-esteem. I hypothesise that a self-esteem based on external circumstances is one of the factors that contributes to much unhappiness and perhaps even the poorly understood personality disorders – such as narcissistic, histrionic and emotionally unstable.

What does that actually mean? What is it like to be narcissistic (or a person with some narcissistic traits)? Most people think they are deluded with their own glory. This can be true – if the narcissistic person doesn’t have insight into just how hooked they are on validation. Sadly, having insight doesn’t instantly cure it. If the person with narcissistic traits does have insight, it’s a never ending cycle of feeling high from validation, feeling pathetic for being like that and seeking more validation to take the edge of. New Insights Into Narcissistic Personality Disorder highlights their fragility, internal vulnerability and external self-enhancement, their attempts to regulate insecurity by numbing emotion, especially in interpersonal contexts and their preoccupation with blame, and criticism.

For some, it is “I think therefore, I am”. For people with narcissistic tendencies, it is “I produce a good reflection, therefore I am worth existing.”

Interestingly, patients with narcissistic personality disorder have intact cognitive empathic ability and can identify with thoughts, feelings, and intentions of others. However, their capacity for emotional empathy is compromised, especially their ability to care about and share feelings of others.

Having one’s self esteem decided by external factors is hugely painful. It’s like waking up every morning and feeling awful about oneself – and yearning to encounter something or someone in the world that will prove that one’s actually worth something. No amount of proof will ever stop this feeling of emptiness for very long.

This proof could be likes on a social media post, getting any sort of good news, a reassuring friend, attention from a member of their desired sex – anything that reminds them that they aren’t near worthless (which is the default setting). This is also why so many narcissistic people are high achievers. Actually “being the best” is sometimes the only way to get rid of the pain.

If one’s self-esteem is only lifted from the depth of despair by accomplishments (validation), then he/she will do anything to accomplish – and ease the pain.

If one’s self-esteem is set externally, validation is like an addictive drug. If it’s  set internally, validation is like an occasional glass of wine. These two types of self-esteem are also knows as contingent and non-contingent.

However, what does that even mean, “set internally”? Having an interest in mindfulness, I often come across things like loving-acceptance, unconditional positive regard, etc. Maybe the reader understands them better, but more often than not, they make me feel like there’s something fake there. To me, an internally-controlled self-esteem means answering the question: is a person proud of his/her actions.

It’s impossible to hold oneself fully responsible for one’s circumstances. Yes, over time, patterns emerge that reflect the small decisions made everyday. However, there is so much beyond our control that one needs to be cautious making conclusions about themselves based on results. As all of these kind of musings, this is specific to the person in question. Some people are perhaps too laid back about how much they control and others – too intensely determined to control everything. (See this post on how to find good tailored advice.)

I think that one has to always learn from their results, but it isn’t always true that their results are a reflection of their actions. Even learning from results is tough because it is so hard to attribute results to causes.

So to bring one’s self-esteem back to being internal, one can only judge whether he/she is happy with their actions and decisions given the information they had at the time.

This post is to some extent inspired by N.N. Taleb’s commencement speech transcript. It’s not like any commencement speech I’d heard before. He says:

…I have a single definition of success: you look in the mirror every evening, and wonder if you disappoint the person you were at 18, right before the age when people start getting corrupted by life. Let him or her be the only judge; not your reputation, not your wealth, not your standing in the community, not the decorations on your lapel.

Taleb says that by his definition, he’s not successful. Fair enough. However, he doesn’t strike me as the kind of person who lacks in self-esteem. This goes back to how different people use the same words to mean different things. Obviously, to Taleb being successful is a kind of a luxury, not a must-have. Otherwise, if one looked in the mirror and resented themselves everyday, that’s a shortcut to despair.

need for validation ruins self-esteem

I wonder what it’s like for other people. For me, my 18 year old self had no clue about how the world works, so I can’t adopt this definition of success – it’s pretty useless to me. Maybe though, that’s Taleb’s point – that one should think back to their idealistic self and see what they would think. I probably shouldn’t say what my 18 year old self would think of me now, but I do wonder what Taleb got up to so that he doesn’t approve of.

I think that’s it though – reconnecting with one’s internal self-esteem is an uncanny exercise of separating oneself into two people and getting one to judge the other’s decision and actions – not their results.

Perhaps, at this point the concept of acceptance become relevant. Otherwise, it is the same old addiction to validation sugar coated with forced positive thinking.

* Whether a narcissistic person believes they are better depends on their insight into the need for validation and their actual achievements. However, narcissists do prefer to associate with people they see as being worthy of surrounding them.

** Some narcissistic people are sweet and charming. Different people use different strategies to feel special and seem worthwhile to others.

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how to regain self-esteem narcissism

Words or empathy?

Words. Words can change how we feel in an instant, they can prime us to act in a certain way without us knowing – but they also can completely misfire.

It seems very obvious now, but it took me ages to figure this out: people don’t always mean what they say.It’s not necessarily because they are lying, but a lot of the time it is because they lack insight and communication skills.

What really hammered it home to me was when a consultant psychiatrist was explaining to me how to handle the “admit-me-or-I-will-kill-myself” kind of presentation. He asked me a very simple question: “If you wanted to kill yourself, would you go to a hospital to inform the doctor?” I’ve no intention of trying to simplify the complex issue of suicide, but there is certainly a type of patient who honestly believes they want to kill themselves and come to hospital, still. Why??? Because the words are misfiring. The words they are saying are: “I want to kill myself”. What (some of them) mean is that they are in so much emotional pain that they have no idea how to get out of it, but they would really like help. It can be, strangely, easier to identify the desire for suicide as the problem because it is a bit more external – at least compared to one’s coping skills.

The moral of the story was: people don’t always mean what they say – and they may not even know it.

This disconnect between words and insight is well known among international relations officials. Here what is said is just as important as what it is left unsaid. The people who answer questions at conferences (e.g. press conferences at the White House) aren’t the officials and military generals actually who know the most. The spokespeople are briefed in a very specific way and believe the things they say. It is too difficult to have insight into how you will be understood, so they get people who specifically understand the exact right stuff.

The significance of precise language is well known in Hollywood.

The production team of Gone with the Wind fought long and hard just to be allowed to have Rhett say “Frankly, my dear, I don’t give a damn.”

Damn was a vulgar word and the censors weren’t happy. However, “I don’t care” just doesn’t provoke the same emotions. Also, it is often said that the word frankly was an unscripted improvisation by Clark Gable – it wasn’t. It’s just different from the book, but that’s how it was in the script.

Nassim Nicholas Taleb said it well here:

when one of these [Salafi] fundamentalists talks to a Christian, he is convinced that the Christian is literal, while the Christian is convinced that the Salafi has the same oft-metaphorical concepts to be taken seriously but not literally –and, often, not very seriously.

empathy and suicide

What got me reminiscing about this was a post by FJ of The Pensives about critical thinking as an antidote to manipulation. FJ identifies reading people (and empathy) as a key part of examining one’s true intentions. FJ’s insight certainly resonates with my own – that there is meaning way beyond words. I think context needs to be examined. Incentives need to be looked at. FJ’s argument is that putting oneself in someone else’s shoes is important. Maybe he is saying the same thing in different words – no pun intended, but there’s also a potential caveat here. It’s best expressed by Nicholas Epley wrote in his fabulous book Mindwise:

Reading body language and trying to take on the other’s perspective doesn’t seem to help to understand the person better. What does help is creating situations where people can openly tell you what they think – and listen carefully.

Obviously, that’s not always possible. However, the point I am trying to make is that while empathy has become an increasingly popular concept, we shouldn’t envisage it as an antidote.

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Knots

I was reminded of R.D. Laing’s book Knots, which is a gleefully brusque collection of various traps of thinking.

Here are some of my own examples. This one is from my time on the medical wards:

Patient’s family: “We don’t agree with your diagnosis. Do some more tests”Me: “Did you have any specific alternative diagnoses or additional tests in mind?”Patient’s family: “Don’t ask us. You’re the doctor!”

Source: Knots – an absolute gem of a blog on psychiatry

Exercise and thinking

I recently chanced upon a study showing that aerobic exercise can be beneficial in mild cognitive impairment. It literally increases the size of the brain. The fact that we can now image brains in a way that detects this is exciting. Nobody is really quite sure what it means, but the fact that it is so tangible and obvious is really gratifying – and hard to argue with. Interestingly, mindfulness also changes brain structure on imaging.

There have been plenty of studies of this sort – including on healthy people. They show that exercise benefits one’s mood and working memory, enhanced cognitive strategies, hippocampal neuroplasticity – in short, exercise helps your brain do its thing. I wish this message was easier to spread. Exercise for a functional brain.

In my own subjective n=1 experience, exercise makes a huge difference to how I feel emotionally. It’s like a shield that keeps irrelevant noise out – and it was quite hard to believe how well it works until I tried it. At this point, I’ve been non-stop at it for over 3 years. My main motivator to stay going with exercise is how it makes me feel. Not immediately, not right after a gym session, but on average. Having said that, isn’t our motivation nearly always how it makes us feel? How I got into it was the classic monkey-see-monkey-do dynamic. Some like to call it having a role model. During my masters, I was surrounded by a bunch of health-freaks: they were all from continental Europe, wore fancy running shoes, drank a lot of coffee and read the Economist. The enthusiasm with which they discussed running routes for their new city, whether or not a Fitbit is worth the investment – and so on, rubbed off on me. I had to try this, ze fitness. I never stopped.

exercise benefits depression

I’ve experimented with running, spinning, HIIT, swimming, weights – pretty much anything that is solitary and non-competitive is good. During a particularly busy stint at the hospital, I injured a joint – meaning I couldn’t properly weight bear. I could barely get around the seemingly endless corridors of a large Dublin hospital with nobody to cover for me on call. Exercise was not on the menu. About a week into this state of affairs, I noticed that I was starting to get sad for no reason at all. It took some introspection to figure out that it was likely down to the fact that I wasn’t exercising. The biochemistry shifted, the chemicals released during exercise wore off – and now I was feeling down. I took corrective action: so I cannot weight bear. Time for abs of steel! As if. In any case, the change in my mood from a week of significantly diminished physical activity was stark.

This experience is echoed in the story of a patient I once saw in a psychiatric hospital. He was a young guy who exercised a lot: 20 miles on a bike every day, marathons, the works. For about a year and a half he attended a cardiologist about a chest pain. He had virtually every conceivable test done – none of these tests detected any abnormalities. By the time he saw me, he had had a few attacks of this chest pain in the space of a few days – and a very low mood. The week before two things happened: he twisted his ankle and his girlfriend had just broken up with him. Long story short, the man’s chest pain was psychosomatic. He had a perfectly healthy heart. The stress of his girlfriend breaking up with him, superimposed on not being able to exercise due to a twisted ankle, led to the mood collapse as well as the chest pains.

Clearly, exercise is addictive. This is part of the reason why people keep exercising despite pain. Before I discovered the absolute must that is a foam-roller, I caused a repetitive strain injury in my calf from running too much. I couldn’t really stop: I was so into it, I just gobbled down two Nurofen and off I went. If, six months previously, someone told me that I would be like this, I would never have believed them. My buzz was all about cuddling up with a book and drinking hot chocolate – not hopping around with a painful calf in the permeating Dublin rain.

Once a psychiatry professor came to talk to us during lunch. His opening question was: “What is the single most effective intervention for both physical and mental health?” Some annoying know-it-all raised their hand and said: “Exercise.” (Okay, okay, it was me). I would still say it though.

I think it is the perfect example of the 80/20 rule, or even a 99/1 version of it. Exercise takes up very little time – if you’re clever about it – and delivers unbelievable results. In short, exercise is definitely on the to-do list of anyone who is interested in having a clear head. It’s surprisingly easy to get carried away into fitness-junkie territory, however, it is definitely worth the risk. In any confusing situation, it’s mindfulness and exercise.

exercise for healthy brain and good mood

To help, or not to help

Milton Erickson was an American psychiatrist who is highly regarded in certain circles. I didn’t know what to make of him – he is best known for his work in hypnosis – and so I wanted to have a look at his work for myself. Luckily, there are a few videos of him. While I don’t necessarily subscribe to his theories and explanations, he does seem to have a lot of insight into human behaviour. He recounts a story of a colleague, a psychiatrist who demonstrated avoidant behaviour in his personal and professional life. Erickson had numerous opportunities to intervene, but in the video he declares that he didn’t have the right.  Among doctors, there is a doctrine that unless you are asked, you generally don’t intervene. Obviously, we don’t wait for a patient to point out gaping wounds and pools of blood – we intervene. As a spotty teenager coming in for bronchitis, I’ve left the GPs office many times with advice to drink plenty of fluids and sleep – but no word about the spots, though she hardly missed them. You get the gist.

should I help my friend

I always wondered about the concept of having a right to help someone. Not just in a medical context. If you are in the supermarket and you see a woman who’s skirt is tucked into her tights, do you tell her? Or is it not your place? If your friend is stuck in a toxic relationship or getting too accustomed to alcohol – do you interfere or is in the their family’s job?

Inevitably, it is difficult to be the one to call the bad news out. The person whom you are trying to help will resent having their issues pointed out – even if you are as supportive as can be. Some people may even see this as a form of confrontation. I think culture play a role. The level of insecurity of the person in question is also important. However, it seems to me that if you want to be helpful, certainly if you call someone your friend, it is an ethical obligation to help.

can i help my friend with depression

This doesn’t mean they have to change, or even accept your point of view. Maybe, Erickson’s friend wouldn’t have wanted to hear about it and, filled with resentment, would never have spoken to Erickson again. Maybe, teenage me would have felt that the GP was being horrible criticising how I look. However, I feel there’s something genuine about being more open. I think in truth the main motivation to not volunteer to help is fear of resentment – not respect for autonomy. People opt for superficial relationships rather than a gamble between a deeper relationship or drifting apart.

I feel that it takes tremendous courage for someone to ask for help. This is another reason why I err on the side of reaching out first. I am sure many teenagers wish that somebody would just tell them that their acne needs to be treated. I am sure many people who are abusing alcohol, self-harming or losing too much weight will never ask for help – but are silently screaming for it. I am still in touch with a beloved former teacher of mine. She will never go to the doctor – she subtly explained that her blood pressure is all over the place. Is that enough to have the right to help? I jumped at it.

It’s a risky strategy, and you will surely lose some friends over it. At least, you will always know that you were a friend.