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    • The Way Our Minds Work

      An excerpt from When Antidepressants Aren’t Enough by Dr. Stuart Eisendrath

      Seventeen years ago, Dr. Stuart Eisendrath piloted research into the therapeutic effects of mindfulness-based cognitive therapy (MBCT) on people experiencing clinical depression. Ever since, he has been helping those who struggle with depression dramatically improve their symptoms and quality of life by changing how they relate to their thoughts and feelings.

      In When Antidepressants Aren’t Enough: Harnessing the Power of Mindfulness to Alleviate Depression (New World Library, October 1, 2019), Dr. Eisendrath outlines an easy-to-implement MBCT program that has been scientifically proven in a National Institute of Health study to bring relief to chronic sufferers of depression by helping them realize that their thoughts are not their reality. We hope you’ll enjoy this Q and A with him about the book.

      What is Mindfulness Based Cognitive Therapy (MBCT)?

      MBCT is a blend of some aspects of cognitive behavior therapy with mindfulness meditation. Mindfulness meditation is an ancient Buddhist technique that has been secularized so it can be used by all people regardless of their background. It teaches that in depression thoughts are often negative ones like “I’ll fail at whatever I try”. I’m not good enough” or “I’ll never get better”. In MBCT, you learn that such ideas are just thoughts, not facts.

      You say in the book’s introduction that you aim to help readers change their relationship to depression. How so?

      In traditional cognitive behavior therapy, you are taught to try and answer back to negative thoughts. This can be challenging because if you have been depressed for a long time you tend to believe the negative thoughts. In MBCT you learn a different approach. One by learning how to focus your attention you can let go of negative thought. For example if you can learn to focus on your breath, there is no bandwidth available to focus on negative thoughts. Secondly, MBCT is focused on the present moment. If you are focused on the present moment you let go of ruminations about the past or anticipation about the future. This is important because in depression you are often focused on past regrets and losses while with anxiety you are focused on upcoming catastrophes. Focusing on the present moment has a natural antidepressant and antianxiety effect.

      How has your own relationship with depression informed your work?

      With my first experience with depression I tended to believe the negative thoughts when they occurred. For example, when I felt guilty I tried to figure out why I was feeling that way. Had I down something in the past that warranted guilt? As I became more mindful, I realized such negative thoughts were symptoms of depression not facts that had to be investigated as actual realities. Moreover I began to see depressive moods as being similar to the weather. For example, if it is raining out today, it may mean I can’t go on a picnic but I realize it is a transient event and I can pursue alternatives for the day. So when I experience depression I can realize it is transient and not be completely flattened by it.

      You say in the book that when a depressive episode hits that it is important to see them for what they are: recurrences of an illness and not a personal weakness or moral failure. Tell us more about that please.

      When depression hits, as part of the syndrome, you are often filled with self-recriminations. There is a tendency to blame yourself and see yourself as having a personal weakness or failure. This is a rather specific aspect of reaction to an illness. You don’t see people with asthma or diabetes blaming themselves when they have an exacerbation. With a mindfulness approach you learn to accept things as they are. Winston Churchill embodied this approach when speaking of his depression; he said “the black dog is back today.”

      What advice do you have to offer someone who is interested in starting a mindfulness practice with the intention of healing from depression?

      If you want to learn mindfulness techniques to heal from depression, MBCT is a proven technique. I’d recommend taking an organized approach. This might be by taking a class or by following the program outlined in the book, When Antidepressants Aren’t Enough. Either way will serve as a guide that can offer a path to healing while helping avoid pitfalls.

      Tell us about the science behind Mindfuless-Based Cognitive Therapy (MBCT)?

      MBCT not only has powerful psychological effects, it also has effects on the brain itself.
      In the PATH-D study we investigate participants by looking at how their brains functioned before and after treatment. We did this by using functional magnetic resonance imaging of the brain. This technique shows second by second changes in the brain. In our studies, we found that areas of the brain associated with emotion regulation were enhanced while areas of the brain associated with emotion production—such as anxiety and depression—were reduced. Although research on the effects is still being investigated, it is clear that MBCT has definite brain effects. These effects appear to reverse the changes typically found in depression.

      What do you hope readers will take away from your book?

      I hope readers will gain a better understanding of depression including both its effects and ways of dealing with them. I hope that readers will learn to treat themselves with more self-compassion in realizing depression is a widespread illness. It is not a moral weakness or personal failure. There are new and powerful techniques like MBCT that offer hope in healing depression and empowering the individual with skills that they can utilize rapidly and effectively.

      Stuart Eisendrath, MD, is the author of When Antidepressants Aren’t Enough and the founding director of the University of California San Francisco Depression Center. Visit him online at www.stuarteisendrath.com.

      Excerpted from the book When Antidepressants Aren’t Enough. Copyright ©2019 by Stuart Eisendrath. Printed with permission from New World Library.

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    • Double Vision: Can Elderly Demented Visit Lucidly in Dreams?

      My name is Dee, and my birth date is Sept 12, 1965. My father-in-law is dying of dementia, and he has been visiting me in dreams for about six months. He is completely bedridden, can do nothing for himself physically or mentally, and is rarely lucid. The dreams are progressive. Dream #1: We are partying at his house with his departed wife, my husband and two youngest children. Dream #2: It was just him and me, and he was very happy, enthusiastic and loving. Dream #3: It was just him and me again, and he was trying to climb a ladder. Dream #4: It included him, me, my husband, and an old dark-haired lady. He was clearly telling us goodbye, and that he was happy to be going when he was going. When he stood up from his wheelchair to sit on the bed, he fell and the old woman caught him. He was very happy. Dream #5: He told me he wanted an entertainment center with a stereo in his room at the nursing home, because he was bored with the TV and he was going to be here for a while. He’s been fighting death for a long time now, for (his waking self) is afraid to die. Do you believe (as I do) that he is communicating with me in these dreams, and if so, how can I help him to peacefully transition to the other side?

      Dreamchaser:

      It is common knowledge in spiritual circles that people who have any type of illness that causes them to be unconscious or delirious frequently leave their bodies. Certainly, dementia and Alzheimer’s are diseases that make people leave their bodies. It’s the same with comas.

      It has been reported that people in comas can understand what is being said around them, which shows that even though the mind appears to be “shut down,” that person is cognizant on some level of what is happening. I think that people who are suffering like this often choose to leave the physical dimension and explore other realms of experience.

      I have no doubt that your father-in-law was visiting you in those dreams. To you they were just dreams, but to him, they were very real experiences. After he got sick, he began to interact with people and live his life on another plane.

      If you read this column frequently, you know by now that when we sleep, our souls leave our bodies and go where they most need to go. Your soul often hung out with him. You two got along well and so it seemed natural for you to “keep him company” while you were sleeping.

      You can’t, however, help him transition to the other side. He will do that himself when he’s ready to pass. He is already being made aware of his circumstances, and he knows full well the status of his health. When it’s time, he will just cross over to the other world. He is already quite familiar with that realm, so in many ways, dying will be easier for him than it is for most people.

      What you can do for him is just continue to allow yourself to go to him in your dreams and keep him company. When you visit him in person, you can also tell his body, as it lies in the bed, that you enjoy the dreams you two share. The part of him that is conscious and aware will then know that you know what is happening.

      Because of his adventures on the other side, he is becoming less and less afraid to die. I think his fear, by the way, was not so much about what would happen to him, but what would happen to all the loved ones he will leave behind, for his natural instinct is to take care of everyone around him. You can rest assured, however, that he is losing his fear about death.

      Have you bought him an entertainment center yet? You might take him his favorite music and play it, or read a book to him while he’s there. Do, however, turn off the television. When you hear a message like this in your dreams of him, please honor it, for he is trying to communicate with you.

      I wish you both peace.

      *****

      Astrea:

      The conventional explanation for what you’re experiencing with your father-in-law is that you are having “wish fulfillment” dreams. Because you would so like to be able to communicate with dad when you’re awake, your subconscious is creating those scenes in your dreams to ease your mind and prepare you for his passing. You wish he could talk to you in real time, so you dream that it happens, and that’s all this is.

      Do I believe that? Not for one second! I know from personal experience that people in the condition your dad’s in communicate with us just like he’s communicating with you.

      I also understand his fear of letting go. Though his body is worn out, he resists moving on. I feel that in part this is due to some guilt he feels about his family. Maybe he didn’t spend enough time with your husband and his other children. Maybe he was mean to them a time or two. Whatever it is, he is now afraid of facing the consequences for it in the afterlife.

      Many people experience this, and helping them cross over is very hard. Unfortunately, this is one of those things you can’t do for another person; he’ll have to find the strength to cross over on his own.

      What you can do is reassure him that he will go right to heaven. Every time you see him, tell him that, even if you don’t think he can hear or understand you. Even when someone is far gone, they have lucid moments.

      If he has done anything that you or your husband think he may feel bad about, let him know he is forgiven. Tell him this out loud when you visit him. Eventually, he’ll feel better about moving on.

      His will is very strong; that’s what’s keeping him stuck in this worn out shell. If he is a religious person, read to him about the kingdom of heaven. Make it sound attractive so he won’t be so afraid. Even though his mind may not be able to consciously grasp the words, his spirit will.

      This is a simple act of kindness that you can do for him. Also, remind him that even though he moves on, you’ll never forget him, and you’ll continue to think of him.

      As strange as these dreams may seem, he is indeed interacting with you in another realm. Your husband may be having dreams with him too, but he may not remember them because of his strong feelings, or he may not feel the need to share them.

      During the last year of her life, my grandmother communicated with me regularly through dreams. Ten years after her death, she still comes to me when something important is about to change in my life. I hope your dad is able to do the same for you; I have a feeling that he will.

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