Encountering Negative Emotions in Mindfulness Practice

I enjoyed reading Alexandra Morris’s thoughtful article “When Shrinks Put Mindfulness on the Couch” on WBUR Boston’s NPR health blog. Morris asks important questions:

Can medications and meditation co-exist? Or, put another way, does mindfulness — the deliberate act of paying attention to the present moment and observing your thoughts drift by — have a place in psychiatric care. The answer, according to some doctors: yes, maybe, at least for some patients.¹

The author shares that because the number of patients taking antidepressants and antipsychotic drugs has increased significantly over the last 20 years, with some patients taking 3 or more medications, researchers are examining the role that mindfulness can play in reducing some of the anxiety and distress associated with mental illnesses. Could mindfulness reduce the need for medication?In my experience, mindfulness practice has many benefits, including a greater sense of wellbeing overall. For some people, this may also mean an enhanced ability to handle pain, anxiety, or depression – whether a reduction or replacement of medications is indicated is best left to the individual’s doctor, because there are many variables to consider in each person’s physiology, history, and environment. As Morris also states,

It’s a careful balancing act, they say: for some, mindfulness-based therapy may be more effective at relieving stress and addressing mental health symptoms, while others may benefit more from medications or a combination of medication and meditation.²

Where I think Morris needed to go further with her analysis regards her observation that “in some cases, mindfulness can produce negative side effects – it has been shown to draw out negative memories of past events.”³ Yes, mindfulness can make us aware of negative emotions, but that doesn’t necessarily equate to negative side effects. Sometimes we spend so much time avoiding negative emotions that when we finally sit still for even five minutes the negative emotions bubble to the surface rather quickly.My first instructional CD is called "Being With Yourself" for that very reason. In it I teach how to learn to sit and be still with your self. Contrary to popular belief that mindfulness practice comes from Eastern religions, this concept of being still and focused is something that all religions teach. For example, Jesus Christ needed private time with God and Moses went into the desert.⁴If negative emotions come up during mindfulness practice, they may be shining a light on past experiences that need to be examined, so that we can recognize them for what they were and accept the feelings that go along with them in a non-judging way.It’s a fact of life that negative emotions are there for most people, just as pain is present for people who have chronic pain. In mindfulness practice we learn to allow our emotions and we attempt to hold off judgment in the moment. This is a practice that, over time, cultivates kindness toward ourselves, rather than self-pity.I’ve found that most people feel guilty about their negative thoughts.  They feel they should be happy, not negative. But in my understanding of mindfulness, acceptance and non-judgment is key. Negative emotions come and go.In mindfulness practice, we can label the emotions for what they are, then breathe and refocus. We can shift our attention and attempt kindness toward ourselves. Now, this is a practice many of us can benefit from developing!I remind my students that mindfulness is something active, rather than passive. Medication is something taken to alleviate symptoms, while mindfulness is a practice you can do to develop awareness of yourself, how you interface with yourself and the world around you, and your patterns of reacting versus responding.In other words, medication can help with symptoms.  Mindfulness practice is a way to increase an awareness of the negative patterns of thought and emotion. It’s a way to commit to curiosity about self and emotions. Many of my patients with moderate to severe symptomatology utilize both medication and mindfulness.No matter where we are on our life journeys, mindfulness practice can bring us many benefits.Peace,Dr. Pamm ¹Morris, Alexandra, When Shrinks Put Mindfulness on the Couch, “wbur’s CommonHealth Reform and Reality,” WBUR Boston 90.9, April 25, 2014.²Ibid.³Ibid.⁴Luke 4:1-14; Matthew 26:26-42; Exodus 3