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I recently had someone who was considering my Mindful Hike service ask me why a hike was worth the price if no therapy was involved. The important contextual piece here was that the individual was already in therapy with another therapist, and in such cases I am careful to point out that we are not doing individual therapy because to do so would be professionally inappropriate. So the intent and value of Mindful Hike needed clarification. This blog entry is the e-mail I sent in response to a really important question.
Glad to clarify. Great question and prepare yourself because it is a rather involved answer.
Mindful Hike, in short, is hiking with incorporated mindfulness exercises. Mindfulness defined is: "the awareness that arises from paying attention on purpose, in the present moment, non-judgmentally, to things as they are." (Kabot-Zinn) How this applies to mental health in general and depression in particular has to do with the ways in which we are psychologically inflexible. Put another way, we get into ruts of thinking and behavior. In depression we ruminate, which is a repetitive thought process of trying to figure things out, brooding about the past, worrying about the future, considering over and over the possible causes, meanings and consequences of our situation and ways to avoid the suffering. We are on autopilot and doing things with little awareness as to why and if they are effective or not. Mindfulness has been proven to undercut this process and to foster what we call psychological flexibility, which allows us to see perspectives we never knew existed and wisdom we never new we had.
When people are suffering depression they turn inward, both psychologically and behaviorally. They are coping in the only way they know how, but unfortunately these strategies are actually contributive to their condition: sleeping a lot, never leaving the house, pulling away from social relationships, distracting themselves from the pain with media distractions (TV, video games etc...), and all the while their thought processes are becoming increasingly self-referential and self defeating. And, their self-esteem and sense of self-efficacy is disappearing.
There are a handful of newer therapies that incorporate mindfulness exercises, which all have sound research supporting their efficacy. They are: Mindfulness-based Cognitive Therapy for Depression, Acceptance and Commitment Therapy, or ACT, & Dialectical-Behavior Therapy. One of the key elements in mindfulness, which is thought to be a pivotal change agent, is the acceptance of things as they are. Now on the surface this appears to be a conceding to one's pain and suffering, which it is to some degree. But what we have found is that a lot of our suffering is actually in the fear-based reaction to aversive events in our lives, be they physical, psychological or both. We like to make the distinction here between reacting and responding. Through mindfulness we access a greater capacity to respond to our situation aware & accepting of our fear and emotional reactions and open to other ways of knowing beyond analytic mind, which is actually quite limited when it comes to figuring out questions of Being, in the existential sense of that word. A larger self is taking over from the afore mentioned "autopilot." Some refer to it as a development of the heart with the mind. In our culture we have an over-emphasis on mental/verbal processes. These new therapies take this into account.
And then I need to clarify the piece about us not doing therapy on Mindful Hikes. The hikes are definitely therapeutic, profoundly so. But they do not interfere with other forms of therapy. If anything, they are quite complimentary in that they create the psychological flexibility that will enhance the individual work that is being done. This distinction is important because it would be professionally inappropriate to undertake a distinct therapeutic intervention (i.e. personalized treatment plan) with some one who was already in the care of another therapist, as this could undermine that process. So obviously I believe quite strongly that Mindful Hikes, while therapeutic, are not of a nature as to be conflictual with existing therapy. Further, I encourage clients to make their therapist fully aware of the work they do with me and am always open to discussing the client with the other therapist provided that the client gives formal written consent.
Finally, as to the hikes themselves, what they actually look like: mindfulness practices are various meditation practices basically. Different meditation practices have different foci of awareness, the breath being the most common. I use a variety of meditations on the hikes, which are intended to get people out of their heads and into their bodies in the most general sense. And then there are more specific goals which are a bit beyond the time and space of this already lengthy reply. So as we are walking along I am giving instruction. One of my favorite exercises is called "wide-angle vision," or "panoramic awareness." This is particularly good for depression because it breaks the intense inward focus that occurs with rumination. If you observe someone who is depressed you will often find their eyes cast down and this is an embodiment of what is happening in their internal experience.
Now another hallmark of the new behavioral therapies I mentioned is that we, as a profession, have come around to the fact that we can effect change internally by external means, as opposed to the more traditional route which was a one-way street in the other direction- one had to shift something internally for anything to change outwardly. So in this exercise the participant is instructed to take in their peripheral vision in addition to straight ahead and to keep their line of site above their chest. The result is a 180 degree vision that causes a palpable shift in perspective. One is also instructed on how to deal with thoughts as they arise and how to keep returning to the present moment. So there is the more immediate shift in perspective and feeling in one's own body, but there is also a longer term cultivation of present moments awareness and the ability to pull out a bit from one's ruminative thinking. This is just one example to give you an idea of how Mindful Hikes are different from just going on a hike, which I highly recommend as well.
I hope this was helpful and not too much. It is important to establish the value of my rather unique service. I also encourage you to do some research on your own of mindfulness and the therapies I mentioned. Please let me know if I can be of any further assistance.
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