Hello and welcome to the new psychology of Depression.
A series of programmes with me, Dr. Danny Penman and Professor Mark Williams of Oxford University.
In this programme, we'll be looking at mindfulness based cognitive therapy, a new approach to preventing depression.
That was code developed by Professor Mark Williams. Mark, how did you first become interested in mindfulness?
Well, it was almost by accident.
My colleagues Zindel Seagle and John Teesdale and I came together in order to try to find a way of dealing with recurrence in depression.
It was already known by then that if you gave certain forms of psychotherapy, not only in the acute phase, but as a maintenance treatment,
perhaps once a month for a year after that acute treatment, it could reduce the risk of relapse even further than the original treatment.
And the MacArthur Foundation in America had a psychobiology depression initiative,
and they wanted to come up with the similar sort of maintenance form of psychotherapy,
which came out of the cognitive therapy tradition and the accidental Seagle to get that together.
And he invited John TSL and myself to join him to come up with a new form of cognitive therapy, a maintenance form of cognitive therapy.
So we met and we reviewed the evidence and it actually seemed like if cognitive therapy worked for people,
their risk of relapse was already pretty low. There was very slim chance that we could do better than that.
I mean, you know, there's always a chance you might decrease it by a few more percentage points.
But if you want to evaluate a clinical trial, you need huge numbers to do that.
And so we asked permission of the MacArthur Foundation and Professor David Kupfer, who is leading this initiative,
if we could change the focus to try to prevent a new episode of depression in people who were well.
In other words, we knew depression was episodic. There are periods of wellness in between.
Could we find the critical vulnerability mechanisms and try to, as it were.
Stop the depressive slide before it actually started?
So were you in effect, trying to encapsulate the effective components of cognitive therapy and then then try and enhance them in some way?
Exactly. I mean, cognitive therapy was developed for people who are right now depressed.
You search for you look out for you, catch your negative thoughts and so on when you're not depressed anymore.
There are no negative thoughts. Not many around.
So it means that psychotherapy developed for the acute episode doesn't necessarily work for people when they're actually between episodes.
But it's exactly as you say.
Could we find out what it was that was making people vulnerable and change those risk conditions even when there wasn't an episode around?
So you had this idea. How did you run with it?
Well, originally, we didn't think that mindfulness was the issue.
But John Teesdale had some experience of certain forms of meditation.
He also had been speaking to a colleague of ours who had visited our unit in Cambridge where John and I worked.
Somebody called Marsha Linehan, who had used something called mindfulness as part of what she called dialectical behaviour
therapy in her treatment of people who had a diagnosis of borderline personality disorder,
people who were chronically suicidal. I knew her because of our mutual interest in trying to find ways of preventing suicide.
And she had talked about one component of her treatment was mindfulness.
Now, John had an interest in this, but he'd never sit with thought of a way of applying and applying mindfulness.
But what Marsha added was this a personal John Cupboard's in.
John's already heard of him, even seen him, I think, once in a workshop.
But what Marcia said was he's got an eight week programme which does virtually nothing but mindfulness, and he's developed a chronic pain.
Why did you go and consult him? Well, that's what John suggested to Zengel and I that we should do.
And I take it you weren't very enthusiastic about this? I was very sceptical, actually.
I mean, for a number of reasons. For a start, I thought that meditation was simply relaxation training.
After all, there'd been some evidence from the 60s that Transcendental Meditation,
or TMD, produced big effects on psychophysiology on the body and so on.
But deep relaxation had the same effects. So I thought meditation, relaxation, same thing.
And I knew that that was some evidence that relaxation alone for depression didn't actually work.
So that was the first thing. Secondly, it came out of a Buddhist tradition.
You know, I don't object to Buddhist religion or any religion, but my own particular growing up had been in the Christian tradition.
And although this wasn't a problem for me to, as it were, experiment with another tradition,
I had always kept religion in my private life and my professional life.
I was a psychologist and I thought the. These two things were getting too close together.
If you start meddling with meditation as part of a clinical treatment. So I was a bit reluctant to consider going down this road.
So why did you persevere then if you had no personal and professional reservations about this?
We, first of all, found out more about what John Covington was actually doing rather than just, you know, the label that he put.
We found that mindfulness meditation was different from transcendental meditation.
TMD teaches a focus as sort of a focus, concentrated awareness, and is very good for deep relaxation, as I said, and for other things as well.
Lots of evidence now, long term evidence that it has great health benefits.
Mindfulness meditation is in some ways much more similar to the cognitive therapy in that it teaches people not just to focus their attention,
but to broaden their attention and begin to see things happening in the internal external world with greater sense of perspective,
compassion, kindness and accuracy. Now, there's something about cognitive therapy, about being accurate that has a great deal of overlap.
For example, John Camenzind gives the example in his book Full Catastrophe Living,
which he wrote in 1990 of a person who came to his classes and he had a heart problem.
I he had a heart attack and he was coming for re as part of his rehab to learn how to deal stress.
He said that something had happened during the week that had been really transforming for him.
He'd had a list of things he had to do that day and he hadn't got round to everything on the college list.
For example, he hadn't got round to washing his car yet. Now it's 10 o'clock at night.
He found himself getting out the car, putting on the floodlights and preparing to wash his car.
And suddenly he thought, I must wash. My car is just a thought and I don't have to be a slave to my thoughts.
You know, I should be hit his head as a master of the thoughts rather than slave to them. I don't have to do this.
And that was a hugely liberating insight that many of his thoughts were just mental events.
He didn't have to act on them. And now when we read that, we thought that is rather similar to cognitive therapy.
It was enough to give us a theoretical basis for going ahead.
And also, Cabot's in had done some work on chronic pain, showing that in one of the most difficult conditions of chronic pain,
this had been this approach had been transformative for many people.
And actually, of course, chronic depression, chronic pain and very similar things in many ways.
And so we we thought, let's buy his books, let's see the videos, and let's eventually go and meet him and find out what he actually does.
So what exactly is mindfulness? Mindfulness itself is a translation of an ancient word that simply means awareness or non forgetfulness.
It's a bit like doing things just as you're doing them, but knowing that you're doing them.
So it's eating, knowing that you're eating, being aware of what you're eating.
It's walking. Knowing that you're walking.
Now, that sounds really trivial, but actually the awareness is so silent that we're hardly aware that we're aware,
as John Cabazon has said many times, and yet awareness can be cultivated.
If we're on automatic pilot all the time, that is, we just blindly sort of sleepwalking through life,
just rushing from one task to the next, yet hardly aware of what we're doing, what we're thinking.
We don't taste our food. We don't notice the sights and sounds and so on.
What tends to happen is we deplete ourselves rather than nourish ourselves.
We get into old mental and behavioural grooves where old habits just keep coming back.
You know, we might be driving the car down the highway for miles, miles and miles.
And we're hardly aware of even driving.
And when we're on autopilot about the patterns of our mind can begin to go down some very painful and depressing themes.
And when we wake up, we're already halfway to depression. We don't even notice that the mind has begun to do this.
And we've missed huge swathes of our life anyway,
which means that we don't have the nourishment that we could out of the taste of food and the sight of our children and the sight of flowers or trees.
We just take everything for granted. Mindfulness is about waking up to that and dealing with our own minds and with other
people with much greater kindness and compassion than we might have previously.
So is that mindfulness the cause of depression, or is it just that mindfulness is a very effective way of preventing depression
and mindfulness or lack of mindfulness is caused by a whole range of things? I mean, stress can do it.
Just general living in a frantic world. And what you find is that much of what you might call on mindfulness or automatic pilot is actually
due to the fact that our mind is continuing to problem solve even when we're not on the case.
So that when we're driving the car, it's solving some problems in the past or on.
Dissipated probably the future now that itself is not a problem.
But interestingly, we don't often choose the mind just automatically.
It's one of the wonders of the mind that when we're not doing anything else,
the mind goes off and tries to solve a problem from the past or a problem for the future.
And that even that maybe isn't a problem, except, of course, we don't taste our food, but maybe we don't need to taste our food.
But and this is where it relates to what we're saying in the last episode.
If that problem solving mode of mind turns up and starts to act on any slight deviation in our mood when we're feeling a bit sad,
then that's where the problem can arise.
Because before we know it, the problem solving mode of mind has tried to solve the problem of our mood, just like it solves the problem of,
you know, driving across town or the email we mean to send tomorrow or the last e-mail we got from that person.
It treats them all equally and where it might be very good at solving the problem of what to say in an email.
It can actually begin to drive our mood further and further down if we're not aware of it.
And that's what mindfulness can help with, to wake us up and then to give us the choice.
Do we want to carry on thinking of this or do we want to actually do something more skilful when it's actually relating to our mood?
So is it that the doing mode of mind, that the rational mind, as it were, when it tries to solve a problem,
solve our emotions, is that the cause of depression is the cause of the escalation of depression?
That is that sad moods are part and parcel of life. We can't ban depressed mood, sad mood, hopeless mood from time to time.
We all feel like that. What we can do something about is how we react,
how the mind reacts to their sad moods and what the discoveries that have been
made are telling us is that all of us may suffer sad moods from time to time.
But the difference is what happens next. And that's something we can treat.
So the cause of repeated depression is how people react in different ways to sad mood.
And if people react by this Problem-Solving mode,
then that depression will escalate and we will soon find ourselves completely preoccupied with the problem of ourselves and how to get out of this.
And the a toxic rumination will go round and round and round.
Mindfulness itself, how do you go about cultivating it?
Well, one of the things I could try a one minute meditation now, if you'd like,
and illustrate some of these things, because talking about meditation is a very curious thing to do.
It's just that idea in the mind. And so the trouble is, we're just talking about it is it becomes another problem solving mode.
It doesn't actually help because it just becomes. Oh, right. Okay. I will meditate.
So the idea is that we offer practises that people can do on a daily basis that range from a minute to half an hour to 45 minutes.
For many of our patients who come. But if you want to illustrate this, then why not sit now and do a one minute meditation?
And I'll perhaps illustrate this. What people actually do.
Yeah, that sounds perfect. People are in a position to do this now. I mean, if you're driving your car, obviously, what we have to close your eyes.
But if if you're sitting at home, you could just adjust your posture so that your spine is straight but not stiff.
And if you can, you can close your eyes if that feels comfortable to you or just lower your gaze, but not do this.
If you're doing anything that needs your eyes open. Just waiting to do this later.
If you if you want to.
And then when your posture is embodying a sense of waking up, a sense of being aware of being awake, then bringing your attention to your breathing.
So gathering the attention and placing it on one place where you feel the breath moving in and out of the body is maybe the tip of the nose.
Well, down in the chest. Well, down in the abdomen.
And we're not trying to control the breath in any way,
just tuning into the sensations that accompany the breath as we breathe in and as we breathe out.
And one of the things you may notice is that the mind begins to wander.
And if you notice that it's not a mistake. That's simply what minds do.
So when you notice your mind has wandered off the breath, simply acknowledge where it went.
And then very gently escort the attention back to the breath wherever you are following the breath.
And doing this over and over and over again, as many times as the mind wanders, simply acknowledge where it went and bring it back very gently.
And continue to do this as as long as you wish. Or at a certain point.
Beginning to move fingers and toes. And then when you're ready, opening your eyes, if they've been closed and taking in the room again.
I'm taking a few moments to acknowledge where you are.
So I'd be interested in any anything you noticed when you were doing that, Tony.
It's profoundly powerful. It doesn't matter how many times I do mindfulness meditations.
I'm always surprised at how focussed and relaxed I become, even after a minute.
Hmm. Is interesting, isn't it? Did you find your mind wandering at any point?
Yeah. I mean, that's that's as you said, that's what minds do. That's what minds do.
You know, my legs work. My mind wanders. That's a really good way.
And one of the interesting thing is, is to notice that meditation is not about clearing the mind.
Many people think, well, I can't I can't do this because my mind is all over the place.
And actually, the thing is. Absolutely. That's exactly what meditation is.
It's waking up to the fact that your mind has a mind of its own. And most people don't know that.
Most people don't know that. They're driven by thoughts that are, as John Cabot's insights, not subliminal.
They're just below the surface of awareness, but they end up driving a lot of what we do.
Much of the day without being aware of it. So if we want to wake up and make more choices, we have to wake up to what's going on inside our mind,
inside our thoughts, inside our our feelings without obsessing about them.
But just notice them. And that's an incredible. It gives us incredible advantage.
So is it just the act of observing your thoughts as they appear in your mind?
Is that where the therapeutic effects come from?
There's all sorts of things that go on when you do this. Notice what we were doing.
The first thing we were noticing, the patterns of the mind. So, yeah, noticing mind wandering is a very powerful thing.
I'm not dealing with them by criticising yourself.
It turns out a very powerful component of this is dealing with mind, wandering with kindness and compassion.
If you learn to be more kind to your own mind,
you end up being kinder to other people as well and having more compassion for other people with whom you share your life.
But it's not just the wandering mind that's important. It's not waking up to that.
Waking up and dealing with it with compassion. But one thing we did there, and of course, many of our meditations go on a little longer than that.
You're actually training as sort of a mind muscle if you want.
It's rather like a mental form of martial arts. You're training yourself to attend and to attend and keep your attention in one place.
And then when it wanders off to bring it back, wanders off. Bring it back once and bring it back.
You're actually training attention now. One of the things we know that goes in emotional problems is your attention is one of the first things to go.
You can't attend. Your attention gets hijacked by your concerns, whether it's obsession analogy, whether it's depression,
whether it's anxiety going off and worrying, you actually find it very difficult just to focus on one thing.
We know from the brain studies that actually the the mind is always the brain is always us.
We're looking to find an association and therefore taking you off track.
The one thing we do is to trade attention.
And many of the benefits that come from meditation come from the ability to keep your attention in one place.
The analogy that some people use, if you're looking at the stars through a telescope, you don't want to be on a rowing boat.
Yeah, because there's no stability there and you won't be able to focus. You want to make the thing you're basing yourself on, as it were, grounded.
You've got some stability. Then you look at the stars.
You can't gaze at something and really attend to it and really pick up everything that there is to be picked up while you're in a rocking boat.
So by training your attention, you're grounding things and then you're much more likely to notice when your attention wanders off to something else.
And that noticing that awareness gives you a choice.
You might want to go and pursue that daydream. You might want to go and solve the problem in the future or think of a problem in the past.
There's nothing wrong with a future in the past, but at least you can bring yourself back to the present moment and make choices.
And that coming back to the present moment gives you more choices. Let's go back a couple of steps.
What precisely is mindfulness based cognitive therapy? It's a combination of mindfulness, which is from an ancient meditation tradition,
secularised taken out of its religious context and made into a form of mental training.
So it's using ancient spiritual exercises in a secular form of mental training that allows you to train your
attention to be where you wanted to be intentionally and without harsh judgement coming up all the time.
So it's about wise and discerning judgement rather than harsh, self-critical judgement.
And it's about intention and training. Attention. Moment by moment.
So if you had to define mindfulness, how would you define it?
Mindfulness is a form of awareness. It comes from an ancient parly word.
Sarti, which originally meant memory or non forgetfulness, comes from a Sanskrit word Myrtie, which meant memory, but rapidly.
In the way that the historical Buddha used it, satti, it became broader than memory to this sort of awareness.
So, for example, if you had your children in a large church or cathedral, you're looking around.
They started Adua stamping their feet. You might say to them, remember where you are now.
You're not actually ask them to do a memory exercise.
You're asking them to do an awareness exercise or as you say, remember where you are is being aware of where you are.
That's what I mean by awareness.
Of course, usually that backfires with children because they then make more noise and you end up making more noise as a parent yourself.
But it illustrates the point that mindfulness is is awareness and therefore it's nothing esoteric, is nothing mysterious.
It's just that in our Western world, we don't cultivate it.
We're cultivate the rational thinking mind.
We don't cultivate the awareness that surrounds the rational thinking mind, but is much more than thinking.
So is it is MBC TV effectively 90 percent mindfulness and 10 percent CBT.
It's 90 percent mindfulness. And then it's adapting the John Cabot Zen MBA as our programme, which is mindless based stress reduction.
It's adapting that. So it's focussed on serious mental illness, of depression, of recurrent depression,
and therefore it takes the basic elements of of of mindfulness and drops into that vessel, into that pot, so to speak, into the mix.
Some elements we know are particularly useful for people who are recurrently depressed.
And there is an emphasis, for example, on thoughts and feelings and how connected they are.
In session two of the eight week session with MDD, eight week programme.
Basically, it's eight weeks, two hours a week, and people come to do a two group or two class.
And it's much more like a class than a therapy group. It's not a group that people have to speak or share their problems.
And so it's a skills training class, much more akin to a yoga class than a therapy group.
And so people come and learn the skills of meditation and then they take c.D home
with them to practise at home for up to an hour a day if they come to our clinic.
So it's 90 percent the mindfulness based work.
But there are these small but important differences, really significant differences from generic mindfulness training,
which have been designed for people who have a recurrent problem with depression,
especially illustrating the connexion between thoughts and feelings, the way in which when you're depressed, you often have no energy.
What you can do about that? The way in which you deplete yourself all the time when you're when you're in danger, getting depressed.
And the way you can build nourishment back into your life. Lots of elements.
Most class is out of the eight week class have some things which are common, mostly common to mindfulness based interventions all over the world,
but some critical things that are specifically designed for recurrent depression.
Okay, so mindfulness itself is I think you have a definition of it paying attention in
the moment to things as they actually are rather than as you wish them to be.
Is that correct? Yeah. And it's based on John Covington's definition of mindfulness being a way of paying attention in this special way.
Intentionally. Moment by moment. And without judgement.
And this has been modified in very slight ways over the years.
And we now say exactly the same mindfulness as a way of paying attention intentionally without judgement,
moment by moment to things as they actually are. And absolutely, as you say, rather than just all the time focussing on things as you wish them to be.
So you become aware of this gap focussed processing of discrepancy, focus processing,
and you take account of it in skilfully managing your your life on a day to day basis.
I mean, most people are going to quite rightly say, well, I do pay attention.
I'm acutely aware of everything that's going wrong in my life.
You know, how does that type of awareness differ from mindful awareness?
There are people who would say that, you know, unaware. I want to be less aware and fair enough.
If being less aware works. Fair enough. If distracting yourself works, if anything else works, do it.
We're not saying you've got to do this. However, many people find distraction only works for a short time and that it keeps coming back.
Now, the question is, why does that happen? And it usually happens because although people think that they're attending,
that they're aware of their problems, what is happening is that they attend to their problems.
But then very quickly, they're getting entangled in self blame about their problems.
So they're saying, you know, oh, okay. I'm acutely aware that that meeting didn't go well, for example.
And they might think I want to be less aware. So fair enough. They try to blanket hand, but they find it comes back.
Why did it come back? Because it wasn't just that the problem with the meeting didn't go well.
They now tell themselves and that just shows I'm not up to this. Lots of meetings go well, or it's that other person's fault.
They're always undermining me and I'll never do well while they're around, et cetera, et cetera.
And they soon lose touch, actually, with their original feeling of anxiety, depression, sadness or loneliness.
And it becomes entangled in this network of language based rumination about what they can do better next time or whatever.
And they're not then dealing with the original problem.
If it was possible for them to stay with the sadness of a meeting, didn't go well, simply notice the sadness.
Whereas in their body, I mean, we can do another meditation on that in a moment if you wish, but stay with where they are acknowledging it,
then that can change the whole thing because the very thing they think is acute awareness is not actually wise awareness.
It's just entanglement. That's the difference. So in a way, it's taking a step back and surveying the landscape.
It's surveying the landscape. In fact, I'll do a meditation which can illustrate this really well.
It's called a three minute breathing space or a three step breathing space.
And if people want to do it now, again, if they're in a position to do it now, that's fine.
If they're not in a position, do it now because they drive in their car, then they can try this later.
But let's just focus on the three minute breathing space and I can illustrate the point that you make.
So once again, if you if you're in a position to this now, then find a place where you can sit with the spine being straight but not stiff.
The head and neck balanced on the shoulders, shoulders themselves can be dropped and relaxed.
Feet flat on the floor. So if you could uncross the legs and put down your papers and just put the feet on the floor, flat on the floor.
And this posture then embodies the sense of being awake, being aware.
And then having prepared yourself, taking the first step of the breathing space and the first step is to acknowledge what's going on.
To notice what's going on in your mind and body right now. May become aware of thoughts.
Or feelings, emotions going on. They become aware of body sensation.
And see if it's possible to let go of the tendency that we all have to want things to be different.
And allow things in our mind and body to be just as we find them.
Just for this moment. Seeing clearly what's here.
Right now. Our thoughts, feelings, sensations.
Notice any reactions, we have, any sense that these are unpleasant or not wanted and just allowing that to be here as well?
Just acknowledging. Not wanting. And then letting these fade into the background as we take the second step of the breathing space,
gathering our attention and placing it on the breath. Perhaps focussing on the breath in the abdomen.
Noticing the rising on the in breath and the falling way on the outbreath.
And if the mind wanders away from the breath, just noticing where it went and gently escorting it back to the breath.
No matter how many times the mind wanders. Noticing it, bringing it back again and again.
And then the third step of the breathing space, expanding the attention to the body as a whole.
As if the whole body were breathing, now, noticing all the sensations in the body,
so noticing the contact with the floor, contact the body on the chair or whatever you you're sitting on.
Perhaps the hands on your lap, if that's where they are. Your whole posture.
Your facial expression. Aware of all the sensations in the body, the whole landscape of sensations.
And seeing if it's possible to allow the body to be just as you find it.
Opening to everything that's going on in the body as you sit here breathing.
Her sense of coming home to the body. Just as it has.
And then when you're ready. Beginning to move fingers and toes. And if your eyes have been closed, allowing us to open and taking in the room again.
And the experiences that you noticed that. The usual degree of relaxation and focus.
And this sense of beginning the breathing space, not by actually going to the breath.
That's the ironic thing. We call it the breathing. But the first step of the breathing space is acknowledging.
And this relates to what you said earlier about that the important thing about mindfulness and one of its essence is taking perspective,
sort of having a place to stand that you firm up your firm, up the foundations with his attentional training.
And then you look inwardly and outwardly with a firm place to stand.
So you can take a perspective on thoughts, feelings and body sensations on the whole package.
Now, we ask people to do this three times a day at set times for a whole week from week three of the AP programme.
And it's written up in the mindful way through depression in the book that myself, my colleagues wrote in 2007.
He's also written up in the Frantic World book that you and I wrote, as you know, in 2011, Mindfulness and Finding Peace in a Frantic World.
And in both books, we emphasise again and again that the first step is acknowledging what's going on,
what's coming up just now, maybe even labelling it, noting it are thinking, thinking, are worrying, worrying.
And then a feeling of sadness has arisen. What that does is allow people to stay with the sadness instead of do what the mind usually does.
Which is it? It actually starts to solve the problem of our sadness. And guess what?
It then gets entangled. And that's where just coming back to your original question, that's where people feel that they're too aware.
And actually, it's not too aware that too entangled. And it's a mistake to think that that entanglement is itself.
Awareness. It's a ruminative entanglement. Have ruminative awareness rather than pure.
A wise awareness, which is what we're talking about here. So it's like being trapped in quicksand.
It's there like trapped in quicksand.
And this analogy, which is, you know, we use in the mindful way and in the frantic world book like being in quicksand.
You're trying to struggle. Thinking, if I struggle, this will help me. But what happens?
The struggle only takes you further in.
And we need to teach people the skills of what to do when they noticed the quicksand, which is different from struggling echoes.
Struggling feels like the right thing to do. But it's an old habit and it's a habit that can, in fact, be broken.
And I think probably the mindfulness based cognitive therapy is a way of actually breaking the habit.
And in the next episode, we can begin to consider what actually happened when we invited people to do that, despite my scepticism.
What happened when we began to practise this in our own lives?
Get the theory together with the practise and invited people to come who are currently depressed.
What would be the effect? What would be the impact of teaching this over eight weeks to people who'd been recurrently depressed?
Where off they tried many, many different treatments and failed?
What would happen when they actually tried this? Maybe we could tackle that in the next episode.
Can you summarise in a few sentences what's the MBC TV programme entails?
It's an eight week programme,
skills training programme where people come to a class for two hours a week to learn the skills of mindfulness meditation,
starting by focussing on body sensations, on direct experience of tastes and sounds and sights,
but also on feelings from their own body, sensations from your own body.
And people learn to directly, as it were, come into contact with things that they normally would take for granted.
Learning this control of attention and then learning to take a broader perspective.
So those key skills allow people to catch negative thought patterns before a tip cements her downward spiral.
Precisely because we're not just focussing on the negative.
We're focus on anything where the mode of mind is the doing mode.
We call it the doing, though, because it's so helpful for doing this business about being on automatic pilot, on discrepancy based processing,
the gap focussed processing this way in which it gets into verbal problem solving, how it knows what it wants to avoid, how it depletes you.
All of that is very sensible problem solving.
And the point is that we recognise that in day to day life and therefore people can learn to recognise even we are not depressed.
So they begin to notice when sadness comes and that mode of mind is actually making things backfire.
And they can notice it much, much, much earlier than it would have done otherwise.
And that seems to be one of the key feature. And it stops people becoming trapped in the quicksand of depression abstracted down.
Absolutely. I mean, if you're working in an area where there's quicksand, right. And you're not even aware of it, you might know this in quicksand.
You want to know what the signs are and you won't have an expert to teach you what the signs are.
So, first of all, you won't get not so likely to get trapped in quicksand because you begin to recognise when things get a bit mushy under your feet.
But also, if you do start to sink, you're taught the skills are actually getting out without struggle.
And that's a critical thing. So the critical thing is, does this work in practise?
You can see the theory of it,
but would it actually work in practise to invite people along to a class in which they learn these techniques would actually prevent depression?
And that's the critical thing I think we need to consider in the next episode. And if people wish to know more.
In the meantime, they can read Mark and his colleagues book The Mind Four Way Through Depression or our book,
Mindfulness Finding Peace in a Frantic World. And if you're listening to this through I tunes you, you can click on the links on the series page.