Source: Created by Chat GPT/DALL-e
Part 4 of the series.
As a quick recap, the core four are:
Mindful breathing: This technique, which focuses on the sensation of breathing while suppressing judgment and unnecessary thoughts, is the most basic and effective of the four mindfulness care tactics. It can serve as an introductory mindfulness practice, a valuable tool for managing acute stress, and a foundation for other moment-to-moment mindfulness practices.
scanning: In its various forms, this technique involves shifting awareness sequentially from one phenomenon of personal experience to another, allowing one to focus on a particular sensation or aspect of the present moment, such as one’s breath, body, emotions, thoughts, etc. In the medical field, this technique is particularly useful for identifying and managing discomfort, and for increasing self-awareness and a sense of control in a variety of challenging situations.
Visualization: An imagination tactic often used in conjunction with mindful breathing techniques to help people mentally rehearse and desensitize to feared situations such as phobias, nightmares, and traumatic experiences. It involves creating detailed mental images of the event, including sights, sounds, and sensations. The goal is to create positive, or at least adaptive, outcomes, reduce anticipatory stress, and increase self-confidence in various scenarios.
As with other mini-exercises, these aren’t necessarily meant to replace more formal meditation or other mindfulness practices as a long-term approach to increasing your capacity for mindfulness, but I think of them as MacGyver-esque — that is, they’re a quick, effective tool for anyone, especially those facing medical challenges, that doesn’t require duct tape, pipe cleaners, or bobby pins.
Simplifying them to make them more accessible was an aspect of a new academic book I co-authored. Mindfulness in Medicine (Springer Nature, due for publication mid-2024) aims to infuse the concepts and tactics of mindfulness throughout today’s enormous and insensitive healthcare system. Enough marketing. Let’s dig into gratitude.
Positive or volitional practices are gaining increasing attention in the mindfulness community and mainstream allopathic medicine as an aspect of managing medical and emotional distress. Rather than focusing on moment-to-moment awareness of one’s condition, these practices focus on generating or accessing positive, volitional feelings before or during discomfort.
Gratitude meditation involves focusing on feelings of gratitude and acknowledging the positive aspects of one’s experience, such as the access to care, the knowledge and expertise of health care professionals, and support from loved ones.
A favored orientation is to “open” to images and feelings of gratitude and observe the effect it has on the heart and mind. The pop culture metaphor I use when teaching and writing about this tactic is the old Iron Chef metaphor of “theme ingredients”: instead of quail eggs or raw abalone, you introduce a planned phenomenon into the realm of mind. (Yes, this metaphor is getting old, just like me. And hungry. More on this exploratory use of meditation practice.)
As always, we settle into a comfortable but mindful posture, set an expectation of time, perhaps a timer for a few minutes, and then we begin. Yes, chef, here we can tap into the “mother sauce” of basic meditation: observe, stop observing, and observe again without too much effort. First, take a few warm-up breaths, clearing your mind of any distracting thoughts that may have accumulated before sitting down. Then we consciously redirect to the “theme” of bringing gratitude into our mindscape.
Specific options and tactics for expressing gratitude include:
- This can be posed as a question: “What am I grateful for?” “Who am I grateful for?” Allow your mind to naturally respond in the moment. It’s a short question, so focus on one thing, breathe and think about it.
- For others, a more free-associative moment will suffice: think of the idea of ”gratitude,” or even just the word “gratitude,” and pay attention to it for a moment, using the gentle effort you usually do.
- Some people find it helpful to do a few short breaths, inhale and exhale, “inhale with awareness and exhale with gratitude.”
- Either way, when a “theme” opens, we pause to witness how the moment is operating within us. What else comes to mind along with gratitude? Where and how do we feel it? We may bask in that desire for a moment, and, of course, we may not.
A must-read book for those with gratitude
This last part is important: the power of this practice, even this brief one, is in witnessing what happens when you sit with the state—the effect it has on your body, your mind, your head, and your meta.
“Sitting in gratitude” is about accessing possibility, not faking your worst moments. The wrong way to practice gratitude is to use (or encourage) it as a contrived, false distraction. It can also be a form of self-gaslighting. “I just got robbed, and I’m grateful for what I learned from the experience” might resonate a little, but don’t. (“It’s bad to put ketchup on an overcooked steak” might be another cooking metaphor, but I’ll try to hold off on that one during this political season.)
Although it comes with a warning label, there are favorable considerations for “gratitude work in the midst of stress,” especially for those in the midst of obvious and profound suffering. Breathing “on the other hand, there are some things I can be grateful for” before and after a period of sitting with direct attention to physical or psychological pain can help balance the tension and open us to both the pain and the positive as coexisting aspects of our present-moment life. This is a more authentic and sincere observation than “completely covering up that smoking meatball.”
Warning label: the generation of gratitude as “yes, but” may continue to be a way of insulating ourselves from fully experiencing and adapting to stressful or painful experiences, as a kind of false equivalence, albeit in a more insidious and insidious way. I think it’s better to approach gratitude as a question, as an opening for curiosity without a forced expectation of an outcome.
Finally, don’t overthink it. The idea of gratitude is just another phenomenon in our experience, a secondary response to what we observe, pay attention to, pay close attention to, and witness. Our breath, the cramps in our legs, the bird singing outside the room, these are all “things” in the mind. Our thoughts, emotions, and the sequence of events are things too. We witness, and in this process, we develop a sense of our capacity to witness.
Finding yourself in a state of desire is the same approach, but of course the content is very different. Finding yourself in sadness, anger, or grief is inherently difficult to recognize and adapt to, whereas a positive state like gratitude may be less difficult.
And remember, while sitting for long periods with gratitude or other desires is a beneficial and rewarding meditation in itself, this is a little exercise in “here’s what I can be grateful for.” Rather than feeling like you’re being forced to “perform” with your state of mind, this “powerful mini” meditation can foster a sense of resilience and optimism. Enjoy!
For more information on this series, check out the core four “Powerful Minis.”
