The One You Feed - Dr. Stuart Eisendrath on Mindfulness for Depression

Episode Date: January 26, 2021

Dr. Stuart Eisendrath is the founding Director of the University of California San Francisco Depression Center where he served as the Professor of Psychiatry. His newest book is When Antidepressants Aren’t Enough: Harnessing the Power of Mindfulness to Alleviate Depression. This book aims to take the reader through steps they can utilize to gain relief from depression and anxiety.In this episode, Dr. Eisendrath and Eric discuss his new book about how mindfulness can help alleviate depression when anti-depressants aren’t enough.If you’d like to start out this new year restoring some balance and putting some healthy habits in place, or if you’re tired of waiting for the right circumstances to make progress towards your goals, Eric, as a behavior coach, can help you. To book a free, no-pressure 30-minute call with Eric to see if working with him in The One You Feed Personal Transformation Program is right for you, click here.But wait – there’s more! The episode is not quite over!! We continue the conversation and you can access this exclusive content right in your podcast player feed. Head over to our Patreon page and pledge to donate just $10 a month. It’s that simple and we’ll give you good stuff as a thank you!In This Interview, Dr. Stuart Eisendrath and I discuss Mindfulness for Depression and…His book, When Antidepressants Aren’t Enough: Harnessing the Power of Mindfulness to Alleviate DepressionChanging the relationship with depressive thoughts from dominating presence to peaceful coexistence Learning to interpret our thoughts in a different wayDealing with self-criticismRuminating and how being stuck in the downward spiral leads to more depressionThe simple meditation practice of counting each breath When the thoughts are creating an internal stormHow the most powerful thoughts are usually our own ideas that we’re applying in the presentDetermining the difference between facts and thoughtsFalse evidence and the importance of gathering more information to see if it’s trueAsking if there are other explanations to explain these feelingsThe trap of depression: thinking we’ll act when we feel better and how we actually feel better once we act.Taking action when we don’t feel like itThe importance of movement and being active when depressedHappiness equals achievements divided by expectationsHow depression can create distorted views Changing perspective by focusing on very small actionsReplacing the thought of “I should…” with “it would be nice if…”How mindfulness brings us into the present momentHow depressive thoughts are about the past and anxious thoughts are about the futureResistance amplifies emotional pain and increases sufferingThinking of feeling depressed as the weather Dr. Stuart Eisendrath Links:stuarteisendrath.comFacebookBest Fiends: Engage your brain and play a game of puzzles with Best Fiends. Download for free on the Apple App Store or Google Play.   Skillshare is an online learning community that helps you get better on your creative journey. They have thousands of inspiring classes for creative and curious people. Be one of the first thousand to sign up via www.skillshare.com/wolf and you’ll get a FREE trial of Skillshare premium membership.Peloton:  Wondering if a Peloton bike is right for you? You can get a free 30 day home trial and find out. If you’re looking for a new way to get your cardio in, the Peloton bike is a great solution. Eric decided to buy one after his 30-day free trial. Visit onepeloton.com If you enjoyed this conversation with Dr. Stuart Eisendrath on Mindfulness to Alleviate Depression, you might also enjoy these other episodes:Mindfulness and Depression with Elisha GoldsteinJonathan Rottenberg on DepressionSee omnystudio.com/listener for privacy information.

Before we get started, I want to give a big shout out to our newest Patreon members. Cynthia B, Cynthia G, Nicole G, Tara R, Dwayne P, and Stephanie B. Thanks so much to all of you and thanks so much to all of our Patreon members. If you'd like to experience being a Patreon member and all the benefits that come with it, go to oneufeed.net slash join. The trap of depression is the person often thinks they'll act once they feel better. It's actually the other way around. They'll feel better once they act. Welcome to The One You Feed.

Throughout time, great thinkers have recognized the importance of the thoughts we have. Quotes like, garbage in, garbage out, or you are what you think, ring true. And yet, for many of us, our thoughts don't strengthen or empower us. We tend toward negativity, self-pity, jealousy, or fear. We see what we don't have instead of what we do. We think things that hold us back and dampen our spirit. But it's not just about thinking. Our actions matter. It takes conscious, consistent, and creative effort to make a life worth living. This podcast is about how other people keep themselves moving in the right direction, how they feed their good wolf.

I'm Jason Alexander and I'm Peter Tilden and together our mission on the Really No Really podcast is to get the true answers to life's baffling questions like why the bathroom door doesn't go all the way to the floor what's in the museum of failure

and does your dog truly love you we have the answer go to reallynoreally.com and register to win $500 a guest spot on our podcast or a limited edition sign Jason bobblehead the Really No Really podcast

follow us on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. Thanks for joining us. Our guest on this episode is Dr. Stuart Eisendrath, the founding director of the University of California, San Francisco Depression Center, where he served as the professor of psychiatry. His newest book is When Antidepressants Aren't Enough, Harnessing the Power of Mindfulness to Alleviate Depression. The book aims to take the reader through steps they can utilize to gain relief from depression and anxiety. Hi, Stuart. Welcome to the show. Hi, thanks for having me.

It's a real pleasure to have you on. We're going to be discussing your book, When Antidepressants aren't enough, harnessing the power of mindfulness to alleviate depression. And depression is a common topic on this show. So I am really excited to talk with you about it. But let's start like we always do with the parable. There is a grandfather who's talking with his granddaughter and he says, in life, we have two wolves inside of us that are always at battle. One is a good wolf, which represents things like kindness and bravery and love, and the other is a bad wolf, which represents things like greed and hatred and fear. And the granddaughter stops and she thinks about it for a second. She looks up at her grandfather

and she says, well, grandfather, which one wins? And the grandfather says, the one you feed. So I'd like to start off by asking you what that parable means to you in your life and in the work that you do. In my life, I would say that that parable gives a good perspective on the topic of my book, and that is your emotions, and whether you're going to be ruled by your emotions, or whether you're going to be ruled by your emotions or whether you're going to be able to look at your emotions with some perspective. If you're ruled by your emotions, you're kind of battered around by the changing winds, wherever they are. If you're able to look at your emotions, you can have much more equanimity in your life and be able to have a different stance towards them.

Yep, absolutely. I agree 100%. So much of this is about how do we deal with our emotions skillfully enough that they can be there, but then we can live according to our values. Exactly. I love the title of your book, When Antidepressants Aren't Enough, because it doesn't imply that there's a problem with antidepressants or you shouldn't take antidepressants. It just says that oftentimes, and I would argue in a lot of cases, we need more than just a pill, right? A pill can be a lifeline to a lot of people. It has been for me, for sure. And I've needed all sorts of other techniques and tools and perspectives and resources to deal with it. And so I really love the title because I think it sets us off on the

right foot that like, okay, if you need antidepressants, great. And there's probably more you can and should be doing. That's completely correct. I'm not anti-antidepressants. As you say, they can be invaluable. But what we find with antidepressants are that they usually, at least in half the cases, don't get the person back to full recovery from a depressive episode. So we really developed this approach as a way to help people improve upon any recovery that they have made with antidepressants and go to be a more complete recovery. You say very early on in the book that many treatments for depression try to suppress symptoms, which is often difficult to achieve.

This book's approach is different. It aims at changing your relationship to depression without focusing on a decrease of its symptoms. Say a little bit more about that. It's hard for people who've been depressed for a long time to stop having depressive thoughts. For example, in our research, when we studied people who had taken two or more antidepressants, their average time in a depressive episode was seven years. So those people have been having depressive thoughts for a long time. And it's very challenging to have them stop having depressive thoughts. Instead, we want them to change their relationship to those thoughts so they're no longer

ruled by them. So they may still have them, but instead of being, in a sense, dominated by those thoughts, they can start to have a different relationship. And the relationship we're describing here is one of almost peaceful coexistence, right? It's, okay, these thoughts are here in my brain, and I'm going to go, okay, they keep coming up because thoughts just tend to do that. They just arrive. Without any help from us, here they are. But my relationship to them is going to be one of like, all right, I can let you be there, but I don't have to believe you and I don't have to act on

what you tell me to do. Is that the essence of it? That's the essence of it right there. You nailed it. I'll give you an example from my own experience. As you mentioned, we all have our own experiences with these things, but I have migraine headaches and I was having a very severe headache and I felt like somebody was putting this vice on my head and tightening it up and I felt completely miserable. Then I started to say, well, wait a minute, what's going on here? Actually, I'm having the thought somebody is putting a vice on my head. And it was getting away from the sensation I was having and putting that interpretation on it. And if I was operating from those thoughts, it's no wonder I was feeling

miserable. But as I said, well, wait a minute, that is an interpretation. Those thoughts that I'm having a vice on my head by somebody's putting it there is just a thought. I may still have the painful sensations, but my interpretation of them varies tremendously if I'm able to step outside of myself and just what we call de-center from those thoughts and have another viewpoint. So when I have the thought that somebody's putting advice on my head, instead of being condemned to believe that, I can say, oh, that's a thought. I can let it go. Right. I do this often. My back will start hurting and I'll find my brain saying, my back is killing me. It'll just do that. And I'll sort of go along

like my back's killing me. But if I get enough awareness that I stop and I go, hang on a second, let's really check in with the back here. And I go, no, it's not killing me. Yeah, there's some sensations of pain back there. But I have definitely overblown the situation. My brain has taken sort of some cognitive shortcut where it has suddenly given this extreme language to it. And I think physical pain is a great way to look at because when we look at physical pain, there's the sensation component of it. But then there's also our interpretation of it, and the stories we tell ourselves about it and our resistance to it. All of those things sort of come together to create

the experience we call pain. Exactly. They actually create the experience we call suffering. Yes, yes. That we go through. And the same applies for mental problems as much as for physical pain, because what we found with people who are experiencing depression, they have depression, they have painful emotional states, but they often add to it and amplify those states by saying, well, I'm a rotten person for feeling this way, or I'll never get over this, or I'm condemned to this for the rest of my life or what's the use in going on because I'm just going to have more of the same. And all that does is move the person away from what is the painful experience actually like and can they shift in their attitude about it

and let those thoughts such as I'm a bad person or I'm a rotten person drop away and just be there with the painful sensation. It's not to say it's not painful, but once you let those things drop away, your suffering may diminish quite a bit. That's one of those things that is relatively easy for us to say and pretty hard to do, which is to just let those thoughts go because they tend to be somewhat, as you said, somebody's had these depressive thoughts for a long time. What would you say to somebody to do if they, okay, we're in this moment, I realize that I'm having these thoughts and I'm having the painful emotions. I'm having that thought that I'm a terrible person. I'm having the thought this is never going to go away.

How do I start to reorient? Well, there's several possibilities for that situation. One is if you take the person in depression, it's common for a person to be very self-critical, like I'm a bad person, or I'm a rotten person, or I'm guilty of various crimes that I can accuse myself of. And one way is to help the person de-center from those thoughts. Realize those thoughts are actually not a realistic assessment. They're part of depression. So a person who has a depressive state and says, I'm a bad person, if you can help them say, well, actually, the thought I'm a bad person is part of your depression. Just like if you had pneumonia, your fever would be part of the pneumonia. It doesn't mean your metabolic state has actually changed. It means you're having a syndrome, which includes a fever

or in depression includes having negative thoughts. In depression, we notice people tend to ruminate quite a bit, or they keep going over things. And what we try to do is help the person realize they're ruminating, because when they're in the middle of it, they're just stuck in this downward spiral that leads to more depression. And if they can catch themselves and say, they're ruminating because when they're in the middle of it, they're just stuck in this downward spiral that leads to more depression. And if they can catch themselves and say, wait a minute, I'm ruminating. I mean, it sounds simple. And to some extent it is because it's shifting out of what we normally do. One way I have tried to help people realize this is some simple meditation techniques. For example, if you count your breath, if you sit still and just try counting each breath, starting from zero

and going up to 10, one breath, two breath, three breaths. And every time your mind wanders, you go back down to zero and start again. And what we find is that many people, when they get started doing this, they can get up to about two or three. That's as far as they go before their mind wanders. And what you start to notice, what is my mind wandering? Wow, I'm having a lot of thoughts that I wasn't even aware of myself having. And those thoughts are often the drivers of depression. So it's very important to start to notice, ah, there it is. I mean, one woman,

for example, in doing this exercise says, you know, I'm having all these thoughts that I'm a bad person, that I'm a fat person, that my thighs are too fat. And then after doing the exercise, she says, wow, I realize I'm having a public relations campaign against myself. It's exactly it. I was interviewing somebody else recently. We were talking about this and we're talking about that inner critic. And, you know, he was like, we have a tendency to do one of two things with it.

Either we argue with it or we just accept it. It's like you're an awful person. You're, you know, like you said, you're fat, you're ugly, you're terrible. And we just go, or we just accept it. It's like, you're an awful person. You're, you know, like you said, you're fat, you're ugly, you're terrible. And we just go, yeah, you're right. When you look at it in that light, you're like, well, that's kind of insane. Like if somebody else came up to me and said that, I'd be like, well, hold on a second, fella. You know, I'm not going to take that. But from ourselves, we just go, oh, it must be true. And you and I had this conversation before, and we had some sound issues. So we're doing it again. And one of the things that you said to me that has stuck with me ever since was I was saying to you, what do we do when we're in one of these sort of emotional

storms, right? Sometimes it's easy to dissenter from our thoughts. It's not too stormy, but sometimes it's really stormy. And you said something along the lines of the very fact that the thoughts are causing that much of a storm is a clue to not believe them. And I thought that was really wise because I think we tend to do the opposite. We tend to think the harder I'm thinking it, the more true it must be. But actually, that's not the case. That's right. Those kinds of thoughts that have a great deal of passion are often incorrect. And the trouble is we tend to operate from those thoughts. And what we're trying to learn in this approach is instead of operating from those thoughts, we're actually trying to look at those thoughts and see them quite

differently. And so the thoughts that are most powerful often are really ideas that we are laying onto the situation. And they're often based on experiences we've had in the past or issues that have come up for us, but we're applying them in the present. And so we're trying to help people shift in their attitude about those thoughts. You say that one step in coping with these thoughts is trying to decide if they are facts or just thoughts. Say a little bit more about how we would tell the difference between a fact and

a thought. Well, there's a saying that often in depression, there's false evidence that appears real. And the person tends to say, for example, a young woman said, I was out for dinner with the new fellow, and he was looking down at his phone that was on the table. And I thought, he must be bored with me. And as we explored it, there were plenty of other alternatives about that situation than he's bored with me. If you operate from that idea, he's bored with me, it generates all kinds of feelings. I'm depressed.

I've been rejected. Or I'm angry with him for being bored with me. All kinds of things which really are what we would call false evidence. Various things can be done in a situation like that. One is try to gather more information. Well, does he sit there focused on his phone all night and completely ignoring you. That's different than if he glances down at his phone or if the phone dinged and he got a message or if he was waiting for a certain callback or something like that. It's getting more evidence and seeing whether the evidence that you were operating from is actually valid or not. And also, this is why

mindfulness-based cognitive therapy, which is the technique that we've used, borrows from some cognitive therapy elements of saying, are there other explanations? Are there other potential explanations that might explain what I'm seeing and what I'm observing in this particular situation, and hence the feelings that I'm having. Yeah, I love both those. One of the best descriptions I ever heard of this, it was in a book about communication, so it was something slightly different, but it was basically like the fact is what could be observed with a camera. So using your scenario, if there was a camera watching the couple at dinner, the camera would record that the man glanced at his phone a few

times. That would be the fact. Everything else is interpretation. Everything else about why he did that and what he meant by that and how he feels about her, that's all the interpretation. That's all the meaning making, which is what we as humans are always doing. We're always taking a fact and trying to go, well, what does it mean? Right? But we lose the delineating line. We lose the line between fact and interpretation and they merge and it all feels like the same. But I just thought that example of what would a camera see as a really helpful way of honing in on what's a fact and what's an interpretation or a thought.

Very good point. I mean, the old show Dragnet, which I don't know how many of your listeners still remember, but it was really a detective series. And the detective always asked his witnesses, just the facts, ma'am, just the facts, without the interpretation, as you say, being put on it. The same thing really applied to me with that headache example that I mentioned, because when I let go of the idea that somebody was putting a vice on my head, I still had unusual sensations, but actually, they stopped being so painful. They were more like a buzzing sensation that I had been putting on to them. This is a vice being put on my head versus, well, tingling, numbness, buzzing, is another way of assessing a thought is to ask yourself how you feel in thinking it. If you feel more depressed, there's a very good chance that the thought is being driven by depression. quite a bit. We say to them, first of all, notice you're ruminating. Now, when people start to ruminate, they say, oh, if you ask them, what are you doing when you're ruminating? Well, I'm trying to solve a problem. Well, is it leading to a solution? If so, then you're problem solving.

The trouble is with most ruminative thoughts, you're not solving a problem. And in fact, try ruminating for 10 minutes and see how you feel. Usually, you'll feel much more depressed. And rumination is a driver of depression. So you can do these experiments like, how do you feel in doing this? How do you feel in having a certain thought? And if having the thought that you have fat thighs makes you feel worse, chances are the idea you have fat thighs is part of your depressive state. I'm Jason Alexander. And I'm Peter Tilden. And together on the Really No Really podcast, our mission is to get the true answers to life's baffling questions like

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bobblehead. It's called Really, No Really, and you can find it on the iHeartRadio app, on Apple Podcasts, or wherever you get your podcasts. One of the things that happens when somebody has depression is often they start not taking actions that they need to take in their life. And as that happens, it basically provides evidence. You talked a minute ago about false evidence appearing real. So false evidence, I'm going to be a failure, right? But then all of a sudden I get depressed and I start being less able to do the things that I know are important for me to say, do well at work. So all of a sudden now, I'm doing less well at work because of my depression. And my brain is going, see, you're doing less well at work at depression. It's just going to keep happening. So some of the evidence is not

necessarily false in that case. It's actually starting to become a self-fulfilling prophecy to a certain extent. How to break out of that cycle. Because I think a lot of times the thoughts, albeit distorted, might contain a truth in them about how we're living. What you're getting at is the trap of depression, where the person feels like, you know, I can't do anything. And they adapt a rather passive stance. I can't do anything. What's the point of going to the dance tonight because I'll just be rejected? And you could apply that same approach that you just mentioned. Well, does that make you feel better or worse? How does that affect your mood? Well,

it makes me feel worse because I'm just stuck at home, never having any social life. Well, the trap of depression is the person often thinks they'll act once they feel better. It's actually the other way around. They'll feel better once they act. And you don't have to feel like you want to do it in order to do it. Like, should I go to the dance tonight or am I going to get rejected? Well, I don't have to feel like I want to go. I just go. And that's where depression has a tendency to paralyze you. And the way out of it is to start to act and take some steps towards doing something and not just giving in. Same thing happens with depression and sleep or

rest. I mean, if you're depressed, you have a tendency to want to stay in bed, for example, all the time, pull the covers over your head. But actually, that doesn't lead to a feeling of being refreshed in any way. It leads to more feelings of lethargy. The way out of it is to say, even though I don't feel like exercising, I'm going to do it. You don't have to feel like exercising to actually do it. And what we find is once the person does it, they generally feel quite a bit better. Yep. You brought up two of my favorite phrases that we've used on this show countless times. The first is sometimes you can't think your way into right action. You have to act your way into right thinking, you know, which is just this exact point you're making. There's just

times that the brain isn't going to make the right decision, but you, you, you can do the action. And oftentimes the feelings will follow. And then the other one for me with depression is depression hates a moving target. You know, when I get depressed, my goal is just to be in motion to some degree, some sort of positive movement. I don't just mean exercise, although that's a key part of it, but get outside, take a walk, read a book.

I mean, just move, go from the bedroom to the couch, go from the couch to the shower, move. I agree with that completely. And you can apply modest expectations to it. You don't have to go run a marathon. Just going for a walk may be sufficient to get you moving and get you out of a depressive state. Some of the studies, there's a large study that looked at people, it's called the Heart and Soul Study and found that probably the most important thing was a person being active and exercising whenever possible, more so than almost any other factor that they could put their finger on. So for people who have, especially who

had medical problems, this was a very useful finding. Yeah. It's so boring to recommend exercise. I always wish I had something better, something more exciting, something, but it's just crazy. The number of conditions that go, if you just exercise, it'll get better. I'm like, well, it pretty much name your condition and exercise helps with it. It really is a wonder drug. Exactly. And I often tell people that it's a drug. I mean, I tell them this is like medicine. You need to do what you need to build it into your life so that it's something you can do

every day or six days of the week at least. Yeah. If I could only have one intervention for depression, that's the one I think I would pick. If I was forced to just say, you only get one, I like having 20 of them, right? I like to throw, as I say, sometimes I throw the kitchen sink at it, you know, just everything I've got, and not so much the type of OCD that we see where it's like outward behavior, but the obsessiveness of thoughts. That's kind of like a rumination. Is the approach still the same? Yes. In essence, you're trying to help people start to notice their thoughts and change the relationship. So if I'm having obsessive thoughts about a certain situation or about certain ideas that I have, start to notice, oh, there it is

again. There I'm having the thought. I'm having the thought, as one fellow said, I'm having the thought I probably have cancer and I need to check myself all the time because I think I'm having the thought I probably have cancer and I need to check myself all the time because I think I'm having another cancer develop. Changing the relationship to that means instead of acting on that thought, like having to check myself literally saying, ah, there's the cancer thought again. There it is. And instead of having to be terrified, I can notice there it is. I've had it 10 times today. And that's what I do. I have cancer thoughts, or maybe I have cancer thoughts in relationship to stressors in my life. But that doesn't mean I have cancer. It means I'm having an obsessive thought. Yeah. And this stuff is, again, kind of easy to say. And when you're really deep in it, it's hard. It's really hard to find a way through don't want to have expectations that are too high.

One of the problems with depression is individuals often have very high expectations of themselves. And in a sense, what that means is they're very critical of themselves. And to help people get an idea of this is the equation where happiness is equal to achievement divided by expectation. And in depression, what happens is that expectation is very high in the denominator, and the achievement is diminished. So the person doesn't think they've done much in their life, and they have very high expectations. And so no matter what they actually achieve, they end up feeling pretty miserable. And what we have to help them do is realize what they've achieved is reasonable. And let's get those expectations

into alignment. I agree. I love that concept that happiness is equal to achievements divided by expectations. And when I do coaching work with people, we're working on both of those. Let's bring the expectations down. And then let's bring the achievements up, even if it's just a little bit, right. And then let's really work to feel good about those small victories. Because feeling good about the small victory leads you to the next one to the next one to the next one. And before long, your ability to function is going up and up and up. But if we can't feel good about the small wins, it's hard for them to gain a lot of momentum. Yes, that's exactly right.

Depression tends to make it very challenging to work with those things because there's a distortion that takes place. When you talk to people who've depressed, they're invariably very harsh and self-critical. And part of what we've learned with mindfulness is that the person learns to become more self-compassionate, start to change their relationship to themselves. So instead of being critical, say, oh, okay, you know, I didn't run the marathon today, but I did walk around the block. So doing things in small bites is an important way of doing it. Right, because it can be really helpful to say, I'm going to walk around the block today. And then if we do it, I often refer to it as an

inner coherence between what we said we were going to do and what we did. And that feels good. It's back to that idea of let's get our expectations kind of in line here. Here's where I'm at. Let me set a goal that's one step ahead of me. And then when I hit that one step goal, I go, okay, good. I did what I said I was going to do. Wonderful. That feels good. It's an upward spiral. You mentioned the trap of depression. The trap of depression is that downward spiral, right? I feel bad about myself, so I don't do much. And since I didn't do much, I now feel worse about myself. And since I feel worse about myself, I don't do much. And down it goes. And the upward spiral is just the opposite direction. Pick something small, do it, feel good about it. Oh, I feel good about it. So that gives me a little bit more energy to do the next thing. Exactly. One way we try to help people understand the concept of making small

victories is to, if you think about all the food you have to eat in the rest of your life, and you were to put it in a room, it would be overwhelming. But if you say, well, actually, I need to eat it one meal at a time, it changes your perspective. And you can feel good about, okay, I ate one healthy meal, and I don't have to eat the whole pile. And it's the same way in depressive states to say, okay, what is one thing? What is one kind of exercise you can do? What is one accomplishment? one thing? What is one kind of exercise you can do? What is one accomplishment? What is one confronting your passivity? It may be going to one dance, doing one thing along the path of accomplishment. Thank you. I am. Let's talk about another thing, though, which is that one very common feature of depression is should in ourselves, right? I should,

I should, I should, I should. And so how do we find that ability to take sort of a next step forward without then layering too many shoulds on ourselves? Well, I always try to urge people to replace should with the phrase, it would be nice if. And it helps the individual to gain a little bit less absolute view of themselves. Instead of I should be more accomplished, it would be nice if I was more accomplished. And my son has picked up this concept quite well because when I say to him something like, you should be doing this or that, he says, you mean, dad, it would be nice if I was doing this or that. Good for him. Good for him. Albert Ellis coined the term masturbation, which is a variation on

this, right? It was the, I must, I should, you know, and it was really that idea of change your requirement. It must be this way to a preference. I really like that. As we start to think about Albert Ellis and some of those people, there's cognitive behavioral therapy, and then there's more mindfulness-based therapies. And you're describing something called mindfulness-based cognitive therapy, which brings elements of both. And one of the questions that I often find interesting to try and sort out, and as I look at all this, I sometimes get muddled on and I try them in my own life, is on one hand, cognitive behavioral therapy says, hey, the reason you feel bad is because you're believing thoughts that are negative or aren't true. So if you just change those, if you see through those, if you see the truth, that'll go away. Acceptance-based therapies

or mindfulness-based therapies tend to be a little bit more on, hey, let's not wade into the muck with the thoughts and wrestle with them. Let's just see them as thoughts and give ourselves a little bit of distance from them. How do you know which of those styles is going to be more effective? Or is it really both? Or how do you work through that? And am I making a distinction that's not even real there? Well, I think you're right on the money that cognitive behavior therapy tries to help a person identify distortions that they're having and come up with alternatives. The difficulty with that is, in my experience, and I actually...

I'm Jason Alexander. And I'm Peter Tilden. And together on the Really No Really podcast, our mission is to get the true answers to life's baffling questions like... Why they refuse to make the bathroom door go all the way to the floor. We got the answer. Will space junk block your cell signal? The astronaut who almost drowned during a spacewalk gives us the answer.

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Wayne Knight about Jurassic Park. Wayne Knight, welcome to Really, No Really, sir. Bless you all. Hello, Newman. And you never know when Howie Mandel might just stop by to talk about judging. Really? That's the opening? Really, No Really.

Yeah, Really. No Really. Go to reallynoreally.com. And register to win $500, a guest spot on our podcast or a limited edition signed Jason Bobblehead. It's called Really No Really, and you can find it on the iHeartRadio app on Apple Podcasts or wherever you get your podcasts. I ran cognitive therapy groups for a long time. Is that people who have been depressed for quite some time are really stuck. And I felt like I was a lawyer trying to prove a case with them. You know, if they said, well, I'll be rejected at this party. I'll never be able to have a social life or whatever. And then you try to say, well, that's a distortion. Maybe,

you know, you could have an alternative thought. Well, they'll argue against it. Maybe, you know, you could have an alternative thought. Well, they'll argue against it. And that's one of the challenges. If pointing out the distortion works, that can be very helpful. But again, if it doesn't work, an acceptance or mindful approach is a very good alternative because they don't have to argue against it. They can say, okay, there's the thought. And instead of trying to come up

with an alternative thought, they could say, that's just a thought. I'm having the thought, somebody's putting advice on my head. That's just a thought. It's a passing mental event, and I don't have to change it. I just notice it. And once you start to notice it, it has much less power in your life. I love that idea of you end up becoming like a trial lawyer. I have an example of this in my own life. It's slightly different, but my partner's mom has Alzheimer's and she'll occasionally get really afraid of something. I don't do this anymore.

I've learned my lesson, but I would try and wade in with logic. I'd be like, well, hey, you know, she'd be like, I'm going to starve to death and die alone this winter. And I'm like, well, no, hold on. Like, that's not going to happen. Here's why. And I start to list the reasons. And she just keeps coming up with increasingly bizarre scenarios to counter every possible reason I have. You know, before long, we are in the zombie apocalypse, you know, like that's where we, because I'm giving her a fact and she's going, No, here's why you're not right. And I finally just realized, like, that approach is not working. It's a little bit different. But then with her, it's just sort of like, that sounds

really scary. And boom, we've just diffused the whole thing to some extent. But I think we can all look in our own lives at the way we argue with ourselves back and forth. You know, the mindfulness approach seems to be the middle ground between arguing with my thought or completely believing it. Like you said, it's just a thought. It's not necessarily real. And the other thing I think is so fascinating about meditation is it's such a learning experience if we take it that way, which is just these thoughts just pop up. I'm not doing it. Our minds are like popcorn poppers. They generate thoughts. And it's just like sensations in the body that we feel all the time, that our minds generate thoughts. And unfortunately, if you

are prone towards depression, those thoughts are going to be negative ones. Or if you're prone towards anxiety, they're going to be negative ones about the future. So that's why in mindfulness, we're focused on the present moment because in depressive states, the person feels as if they've undergone a significant loss. Whereas in anxiety states, they feel as if they're going to experience a loss. So they're either in the past or in the future. By having a mindfulness approach, you're helping them focus on the present moment. And in that present moment, there's no loss in the past or the future. They're just focusing on their breath, for example, or on their body sensations right now in this moment.

So it has a natural antidepressant and anti-anxiety effect when you bring your attention to the present moment. Which, when you have ruminating thoughts, is kind of hard to do because you come and it just keeps dragging you away. But it's the exercise of doing it. You have an exercise in the book I really liked, which is basically you close your eyes and you put your finger up in front of you. Well, why don't you describe it? You use your finger as the indicator. Close your eyes and focus on moving your finger to the left with each thought about the past that comes into your consciousness or to the right with each thought about the future that comes into your consciousness and leaving it centered when you're just focused on the present moment. And you can begin to notice

how much your finger moves towards the past or towards the future and stays out of that present focus. Just becoming aware of, wow, I spend a lot of time focused on the past, or I spend a lot of time worrying about what's going to happen in the future. And the idea is not to stop that, but just to bring your attention to noticing that. Like one woman who came into one of our mindfulness groups, by the end of it, she says, you know, when I came into the group, I was expecting I would get rid of all my anxious thoughts. She had a lot of anxiety coming in. She had three children. She worried about, you know, was some disaster going to happen to them? Were they going to be abducted? Were they going to go out driving and be in an accident or,

you know, some other kind of disaster? At the end of the eight weeks of the mindfulness training, she realized she was going to have just as many thoughts like that, but she didn't have to react to them so powerfully. She could really respond to them more skillfully. So, yes, it's not you're going to stamp out those thoughts. The thoughts emerge. But if you're able to say, ah, okay, there's the disaster thought again, you start to change your relationship to it. Instead of believing it to be true and feeling quite miserable, you can say, oh, there it is again. You start to change your relationship to it. Instead of believing it to be true and feeling quite miserable, you can say, oh, there it is again. It's like the radio playing in the

background. I have a radio that's tuned to one station. It's a disaster station, but I don't have to let it rule my life. Yeah, it is helpful sometimes to think of it as a radio and put that voice in a funny announcer voice. Let's talk briefly about the role of resisting in our depression. To what extent is resistance a problem and how do we work with that? Resistance can amplify the emotional pain that a person is having. In that sense, it increases the suffering because here's another equation that we have, and this is not a unique one that has been followed in Buddhist philosophy for many years, but pain times resistance equals suffering. So you may have a painful stimuli, but the amount of resistance you have can amplify or diminish the amount of suffering that takes place. So, for example, if you have a bear that walks in the woods and steps on a thorn and has

painful stimuli in its paw, how does the bear respond to it? Well, it maybe responds quite differently than somebody who's in the middle of depression. The bear doesn't think, oh, how did this manifest itself in relationship to my mother? Why did I have this happen to me? I must be a bad bear to have this happen. You know, there's all kinds of things that a bear, as far as we know, wouldn't get into. Whereas with humans, we tend to add a lot of overlay to the situation. And with depression, it's like, if I was a better person, I wouldn't have this, or this means I'm a bad person, or some other kind of resistance to the idea, well, I have some painful emotions today, but I don't have to resist them. I can just experience in them. That sounds a little odd because who wants to experience painful emotions? But oddly enough,

if you stop resisting it, you may suffer quite a bit less. I like to think of depression as being like the weather. I think we maybe talked about this before and use the word instead of depression, like I'm experiencing depression. I like to think of it as it's depressing out today. So like if you wake up and it's depressing out, it may not be that pleasant a situation, but just like it's raining out. unpleasant situation, but just like it's raining out. Well, if I wanted to go on a picnic today and it's raining out, I can't do it. But if I respond skillfully, I can do other things. I can go to a museum. I can go bowling. I could do a lot of other things that don't involve being out in

the rain. So it's responding to that situation. And the same thing, if you have a depressive state, you wake up and you're feeling depressed. If you start going into it like, I'm a terrible person because I'm feeling depressed today, that's different than say, noticing, ah, I'm depressed today. And it's like it's depressing out. And instead of berating myself, I could say, okay, I have to take care of myself because I'm having depression today. But it doesn't mean I'm going to be depressed tomorrow., this is not necessarily always going to be this way, you know? And I think that skillful response is so important. I often say to people, I just think one of the things that's happened to me over the years is I've gotten better at being depressed,

which doesn't sound extremely hopeful, but it really is because my response to it is so much more skillful that it really does minimize it almost to the point of like what a rainy day is like, oh, it's a rainy day. Okay, not the end of the world. Like, okay, here's what I'm going to do. Here's how I'm going to adapt. It's such a different response versus, oh my God, I'm depressed. What's the matter? Everything's bad. You know, it's just a lot more like, okay, here we are again. And I do what I know helps. And I take the preventative measures and the helpful measures, and then I relax. That's right. Instead of having it be a catastrophe, you can say, okay, there it is again. You know, I'm going to just ride with it.

I'm going to ride on the surface of it, surf the emotions, as they say, and not expect that it's going to be a forever thing all of a sudden. Yep. Yep. Well, thank you so much, Stuart, for taking the time to come back on the show. I found this to be a really helpful discussion, and I think our listeners will too. So thank you so much for your time. Okay.

Thanks for having me. I appreciate it. Yeah, it's been a real pleasure. If what you just heard was helpful to you, please consider making a monthly donation to support the One You Feed podcast. When you join our membership community with this monthly pledge, you get lots of exclusive members-only benefits. It's our way of saying thank you for your support. Now, we are so grateful for the members of our community. We wouldn't be able to do what we do without their support, and we don't take a single dollar for granted. To learn more, make a donation at any level, and become a member of the One You Feed community,

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