Working for Carers
Session 1: Introducing Mindfulness
The bad news: life can be difficult
Life contains some problems that we simply can’t avoid. And being a carer brings a whole extra layer of challenges and complications, especially during our current Covid and lockdown reality. You may be facing all sorts of tough issues - anxiety, overwork, social isolation, strained relationships, money worries, and so on.
On top of that, it's easy to make things worse for ourselves by how we react to the original problem. This can be explained by how our minds have evolved to have an ‘autopilot’ mode, which immediately tries to solve problems. ‘Autopilot’ is very useful for us in carrying out routine tasks – we don’t have to work out how to do them every time. But it’s not so helpful when we experience a difficult emotion like sadness or anxiety, or irritability. It tries to ‘fix’ it for us, but it just can’t – because emotions don’t need to be ‘fixed’, they are a normal feature of human existence.
The very failure of autopilot to fix things can then make us feel worse, because it leads to negative and self-attacking thoughts about why we shouldn’t feel as we do. And then, because thoughts and moods are so closely linked, our mood gets worse, giving rise to more negative thoughts, then our mood gets even worse…and so we find ourselves in a downward spiral. This whole process happens at an unconscious level – we don’t mean to do this to ourselves. We have simply created a ‘mental habit’ for thinking and feeling in this way. And it’s all because we have allowed autopilot mode to have way too much power.
The good news: there is another way…mindfulness
There is another way to relate to problems and difficult emotions, including those created by your caring responsibilities. By practising mindfulness, you learn to simply notice things, without judging them as good or bad; or trying to instantly change them – even if you don’t like them. The training involves very simple ‘awareness’ techniques: including formal meditations, and other informal activities throughout your day.
The ABC of mindfulness
Awareness – of what is happening in our experience
Being with our experience – accepting what is already there and cannot be fixed immediately
Choosing wise responses – instead of reacting automatically, allowing the most helpful actions and choices to emerge
The benefits of mindfulness
Recent clinical research shows that mindfulness training can completely alter the structure of the brain, making it more robust and flexible. Specific benefits include:
Less stress – and more resilience as you learn better responses to difficult situations, and to turn off the damaging ‘fight/flight/freeze response’ in your body more of the time.
Clearer mind – increased attention, concentration, and memory enables you to do things better and faster.
Emotional intelligence – as you become aware of what’s going on for you and others, you’re better able to communicate assertively while kindly, and so build healthier relationships. This is particularly helpful for carers having to negotiate with multiple organisations and agents.
Creativity – and innovative thinking, due to an ability to hold a wider perspective and think ‘outside the box’.
Decision making – and problem-solving skills, particularly at times of high pressure, as your mind sifts through lots of data more intuitively and efficiently.
Healthy body – an enhanced ability to relax in your mind and body leads to a stronger immune system and alleviates problems like hypertension, heart disease and chronic pain.
More enjoyment – mindfulness isn’t only about alleviating problems, it’s also about finding out what really makes you tick, so that you can do more of what gives you a sense of pleasure and fulfilment.
Home practice before next session
1. ‘Waking up to yourself’ meditation: Follow the instructions on the audio meditation. (Every day, or as close to this as you can manage)
2. Mindful minute: several times a day, stop what you’re doing for 30 seconds or so. With your eyes open or closed; notice your body, and notice what you can see, hear, smell, taste or touch. Allow all of these things to merge into a general awareness of what’s going on right now in and around you. You can do this on your own, or listening to the ‘mindful minute’ on the CD (when appropriate).
3. Do a routine activity ‘mindfully’: Pick a routine activity that you do every day – for example, brushing your teeth, or making a cup of tea. Instead of doing it on ‘autopilot’ as we normally do, try and get into more of a ‘being’ mode by bringing awareness to the physical sensations of the movements your body makes. Notice anything else coming into you through your senses: sounds, textures, light and colour, smells and so on. Bring curiosity and interest to how this routine activity feels different each time you do it, when you pay this special kind of attention.
4. Do something different: sit in a different chair from the one you usually do. What does it feel like? What do you notice when you change something around like this?
Feel free to jot down what you discover by doing the practices – whatever feels relevant to you, but here are a few possible pointers:
How much time do you normally spend in ‘doing’ mode?
What happens when you focus your attention on one part of your body, or your breath? How easy is it?
What’s different about doing a routine activity when you notice what it feels like in your body?
Session 2: The A of the ABC - Awareness
Mindfulness is about:
1. Training the mind to pay attention…and to pay attention to your attention
2. A different way of being: seeing things as they really are, and opening up the broadest perspectives.
The primary mindfulness tool: meditation
Meditation develops your ability to concentrate and focus on one thing at a time. Its ultimate aim is to develop your overall awareness – and it uses concentration as the main tool.
The ‘waking up to yourself’ meditation
In this meditation, you are training two skills:
1) Concentration or ‘absorption’. This is your ability to pay attention to your experience. You just notice what you notice. Don’t force your concentration, rather allow your mind to become naturally absorbed in the sensations.
2) Mindfulness. This is the ability to notice what is happening to your attention. Your mind will wander, that’s natural. Each time it happens, you just bring your attention back to your body/breath with kindness and patience.
The main aim of this practice is to become aware, and not to make relaxation happen. But if you are very agitated, stressed or restless, you can do some conscious deeper belly breathing to help you establish some calm. Some people also find that counting their breath helps them stay focused. So, you breathe in, and breathe out, and say silently to yourself ‘One’, and so on up to 10, and then go back to 1.
The ‘movement meditation’
You don’t have to be completely still to practise mindfulness. This movement meditation does two main things:
Strengthens your ability to pay attention (concentration) and to bring back your attention (mindfulness)
Realigns many of the body’s muscles and joints, which helps to release stress in the body
Some helpful pointers about how to approach this meditation:
Focus on the physical sensations.
Notice how your mind relates to the sensations.
See if you can find an ‘edge’ for each movement.
Starting to get to know yourself
Mindfulness is about seeing things more clearly…including yourself. As you start to practise more, you will see how your mind jumps about a lot from one thing to another, especially when it is either pushing something unpleasant away, or holding onto something pleasant. Start to notice this tendency. You can also start to notice the kinds of places your mind habitually tends to wander off to – and the kinds of thoughts, emotions and body sensations that accompany this. When you do this, you are really getting to know yourself – and that’s the foundation for making changes in your life.
Home practice before next session
1. Alternate each day between these two practices:
‘Waking up to yourself’ meditation – follow the instructions on the audio meditation above
‘Movement meditation’ – follow the audio or video guides above
2. Keep doing a routine activity mindfully – like brushing your teeth or making a cup of tea
3. Mindfulness in nature: choose a regular walk in your local area and bring mindful awareness to the experience. Notice things around you. Perhaps choose a few particular objects of interest and spend a few moments really noticing everything about them - using all your senses.
4. Jot down some notes about how certain events are connected with habitual thoughts, emotions and body sensations. You can use the format of the table below to capture what you discover:
Session 3: The B of the ABC - Being with your experience: Part 1 - Working with thoughts
Thoughts can become the master of you
The ‘autopilot’ mode that evolved in our prehistoric past to help us avert danger has left a legacy in the human mind: a strong tendency to make sense of things and to build up an accurate picture of what’s going on. How your mind interprets a situation then has an effect on how you feel:
Situation + Interpretation → Emotion
The same situation can give rise to a whole range of different emotions depending on what your mind makes of it. For many people the interpretation that the mind automatically selects most frequently lead to unpleasant emotions. If this happens repeatedly those emotions themselves become habitual, just like the thoughts that lead there in the first place. A habitual emotion then itself reinforces the original mental pattern, leading to more difficult emotions. And so the vicious cycle goes on. Memory plays a vital role in this whole process. It’s as if the past gets frozen and stuck in the mind.
As human beings with a common heritage we tend to have similar kinds of patterns and rules in our mind. But as we are also unique individuals, each of us will have our particular ‘brand’ of habitual patterns and thoughts.
Loosening the grip of thoughts
We have become so accustomed to our thoughts and interpretations over many years of them being there that they can often feel like the absolute truth. But the actual truth is that thoughts are not facts. They are merely events happening in our minds: they come and go. This doesn’t mean that everything you think is wrong, or has no truth in it all. Rather, it’s a cue to help you start to relate to your thoughts in different ways.
Confronting unhelpful thoughts with cool logic often doesn’t work – it doesn’t get rid of them, but just puts them off for a while. The mindful way to loosen the grip of thoughts is to step outside of them, and simply watch them come and go in their own natural way. This is far more effective.
The ‘working with your thoughts’ meditation
In this meditation, you start with grounding and settling down through awareness of your body and breath. Then you notice sounds, which like thoughts are simply passing events. This helps prepare you for the final stage of noticing thoughts coming and going, like clouds passing across the sky. You notice the most frequent kind of thoughts you tend to have, and how one thought tends to lead to another. You also notice how different thoughts lead to different emotions and sensations in the body.
Working with your thoughts outside meditation
Ask yourself where this thought takes you.
Remind yourself that your mind is like a good story teller
Imagine your thoughts as leaves floating down a stream.
Repeat the thought using a silly voice
Sense the thought’s form, location, sound and speed.
Simply notice that you are having the thought.
The ‘mini meditation’ – three step breathing space
You can use this meditation at any time to help you come back into the present moment.
1. Awareness: Overall sense of your experience right now. What am I thinking? What mood am I in? What can I feel in my body?
2. Gathering: Bring the focus of your awareness onto your breathing
3. Expanding: Broadening out your awareness to include your whole body and facial expression, especially to any sense of discomfort, tension or resistance. Breathe into these, and let them soften and open on the outbreath.
Three step breathing space in action: mindful planning
When you train in mindfulness, you are training your mind to pay attention to your experience in the here and now. But this doesn’t mean that mindfulness is only about being aware of the present, in some kind of vacuum. You can turn the same skills of paying attention – in a clear, calm and focused way – towards the future, whether that’s today, this week, this month, or this year.
At the beginning of each day you can spend a few quiet moments consciously planning the day ahead. You can also set aside brief moments for relaxed reflection throughout your day – giving your mind a chance to process what’s already happened, and checking in with yourself how you feel. Based on that, you can amend your day’s plan (where possible) - responding flexibly to your experience and energy levels. This is an absolutely invaluable tool for carers who often have to balance so many different responsibilities in any given day.
Home practice before next session
1. Alternate each day between these two practices:
‘Working with your thoughts’ meditation – follow the instructions on the audio meditation.
‘Movement meditation’ – follow the audio instructions and/or the video above. Notice particularly the thoughts that come up when you do the movements.
2. Working with your thoughts away from meditation – try using some of the techniques detailed above to help you work with unhelpful thoughts that you notice.
3. Mini meditations: three step breathing space and/or the mindful minute – practice this whenever you have a spare few moments: either on your own, or listening to the audio.
4. Mindfully planning your day: see above.
5. Do something different: instead of watching your favourite TV show, choose something different to do instead (don’t worry, you can record it and watch it another time!)
Jot down some notes about how you are relating to your thoughts. If you feel stuck, these pointers might help:
Am I taking my thoughts to be facts?
How do my thoughts affect my behaviour?
Are there common threads through many of my thoughts?
Session 4: The B of the ABC - Being with your experience: Part 2 - Working with emotions
Trying to ‘fix’ difficult experiences eventually stops working
Your autopilot tries to fix, ignore or get rid of unpleasant experiences. It’s why people might turn to things like alcohol, food, or over-work to push away difficult feelings. These can kind of work for a while. But trying to fix things eventually stops working, and can leave you feeling exhausted or inadequate.
It’s better to turn towards unpleasant experience
We can choose to relate differently to difficult sensations/emotions/thoughts - including those triggered that may get by your caring responsibilities. This is about acceptance. It doesn’t mean resignation, giving up or suppressing your feelings. Rather it’s about noticing how things actually are, then choosing to turn towards them and feel them deeply in your body. This strengthens your ability to withstand difficulties and to recover from setbacks (resilience). This process of fully turning towards your feelings requires both courage and kindness towards yourself.
Nipping things in the bud, in your body
With mindfulness, you will increasingly notice how there is often first an original experience of difficulty, and then the mind’s automatic reaction is to try and push it away. But if you are able to simply stay with the original difficulty, then that automatic desire to push it away can diminish. The best way to practise this is by noticing how your body responds to difficulties, rather than trying to figure it out in your thinking mind, which can’t always solve things. Working with body responses allows space between ‘you’ and the ‘problem’ – so that you can process the same raw material, but with ‘being’ rather than ‘doing’ mode. It also means you get more familiar with signs in your body that you’ve been ‘triggered’.
Acceptance applies to pleasant experiences as well
The same acceptance approach is useful with pleasant experiences. If you allow yourself to feel a pleasant sensation fully, two things can happen. First, you learn about appreciating simple pleasures that are available to you without the need for too much external stimuli. Second, you might notice how the mind wants to ‘hold on’ to pleasant experiences for as long as possible – and how this is part of the same phenomenon of wanting things to be other than they are.
Using the three step breathing space to practise acceptance
The three step breathing space (already introduced) is particularly useful when you find yourself ‘triggered’ or facing some strong difficult feelings. You follow the same steps as before, but with an emphasis on turning towards those strong feelings in the last stage, and breathing into them – allowing them to soften and open on the outbreath.
How to practise acceptance out of meditation
Use imagery: picture yourself trying to get out of quicksand – what effect does the struggling have?
Curious scientist: explore the feeling like an object – its size, weight, shape, colour, texture, etc.
Choice to feel: would you choose to stop feeling this if it meant you could no longer care about anything?
Normalising: all feelings are natural and human
The mountain beyond the swamp: if you can get through these difficult feelings (swamp) you get to the thing you really want (mountain)
Home practice before next session
1. Alternate each day between these two practices:
‘Acceptance’ meditation – follow the instructions on the audio meditation.
‘Movement meditation’ – follow the audio instructions and/or the video above. Notice particularly if you get any strong difficult feelings or sensations, and notice how you relate to them. Can you allow them to be there without trying to fix them?
2. Practising acceptance away from meditation – try using some of the techniques outlined above to practise acceptance.
3. Three step breathing space – use this whenever you get triggered or are experiencing some difficulty: either on your own, or using the audio.
4. Do something different – the next time you watch the news or read a newspaper, notice when you have a strong opinion about something. Then try constructing an argument that’s totally the opposite.
Jot down some notes about what you notice when you allow yourself to turn towards all your experiences more. If you get stuck, here are some pointers:
How do I tend to try and fix or block out difficult experiences?
What happens when I allow myself to feel them more – even if only for a moment longer?
What else might I be blocking out of my life by doing this?
Session 5: The C of the ABC - Choosing wise responses to your experience
Part 1 - Living with wisdom and kindness
By learning the two first core skills of Awareness and Being with experience, you already have all you need to make naturally wise choices in your life. That’s because you can create a gap between an initial event and your next move, and choose a wise response. This goes for both the everyday events, and the big decisions in your life. And as a carer, you may be having to make lots and lots of choices and decisions, both in relation to the person you care for, and to your own life and wellbeing. There are various ways where you can enhance your ability to make wise choices:
Connecting with your values and purpose
Self-awareness includes identifying your core values - the guiding principles about what you want to stand for. Our choices in life are more likely to be wise if they are in accordance with these values. It’s worth spending some time reflecting on your core values – and finding your top 10. You can download a 'Values Worksheet' here to help you reflect on this.
Clearer thinking and better planning
Mindfulness promotes a better quality of thinking processes than run-of-the-mill automatic thinking. This leads to better planning, organisational and decision-making skills. It’s due to your ability to pay attention to the detail while also seeing the big picture. You train this skill in meditation by being able to switch between a narrow focus (e.g. just your left big toe) and a broader awareness (your whole body).
Emotional intelligence is about being able to recognise emotions in yourself and other people, and working more effectively with this information to increase your wellbeing, to be more effective, and to build better relationships with others. Mindfulness is the best training for it because it teaches you how to be aware of and ‘hold’ all your experience, including your emotions.
1) Self-awareness, self-esteem and confidence
As you get to know yourself better, you can be more honest and balanced about your strengths and weaknesses. This can lead to feeling clearer about your priorities and goals in life, which is the basis for a realistic self-confidence.
2) Empathy, communication and kindness
‘Empathy’ is the ability to imagine the world from another person’s perspective – a vital skill in forming good relationships. It’s possible to consciously enhance empathy by using the same ABC of mindfulness applied to communication and relationships with other people:
A. Awareness: of your thoughts, emotions and body sensations, when you are communicating with someone
B. Being with: noticing any automatic reactions and choosing to stay with them for a moment before acting…
C. Choosing a wise response: tuning into what’s really going on in the situation by considering what both you and the other person are feeling, and what your needs are. This can help you choose a wise response – which is usually when you can be assertive about your own feelings and needs, while also being understanding and kind about the other person’s feelings and needs.
Developing empathy means you also develop your natural human capacity for kindness and compassion. This isn’t about being ‘nice’. It’s about recognising that your wellbeing depends on good relationships with others. You can take this kindness practice out into your everyday life: each time you meet someone, simply wish them well. This doesn’t mean you have to like or approve of everyone – but you can wish them well.
Self-care: developing your own ‘manual’ for your life
Self-awareness also includes understanding what activities and pursuits promote your general wellbeing and sense of fulfilment. For carers experiencing high levels of demand and stress, this point is absolutely essential. Some activities nourish us and make us feel alive (‘up’ activities); while others tire us out and make us feel low (‘down’). Most ‘up’ activities are of two main types:
Mastery: skills that we learn; and basic things we need to do make life organised and run smoothly.
Pleasure: things that we really enjoy doing, e.g. taking a long bath, eating our favourite food, going for a walk, seeing a friend, watching a good film, listening to music etc. When people are very busy they tend to give up nourishing activities that seem less ‘urgent’. This tends to deplete energy rather than boost it. With less energy they then cut off even more nourishing activities – setting up a vicious cycle leading to exhaustion. To counteract this, it’s good to choose to spend more time on ‘up’ activities and less time on ‘down’ ones.
If you have a setback in life, mindfulness can help you recover. The key is to check if your thoughts and feelings are in line with reality – and to find a different way of describing things that’s true without being harsh. Then you can start afresh, and make a new commitment that’s positive while realistic.
You can consciously enhance ‘optimism’ in three steps.
1. Be realistic and objective in every situation: just notice and describe what’s actually happened.
2. Give yourself permission to feel whatever emotion arises in any given situation.
3. Change your automatic approach to success and failure. Take conscious note of successes and accept the credit for them. With failures, focus on realistic evidence that they are only temporary, and are in the context of lots of other successes in your life.
Gratitude and happiness
Research shows that one of the biggest factors for happiness is our day-to-day behaviour and thinking. Mindfulness has a role here – so that we can actually train in happiness. A good way to do this is to develop our ‘appreciative’ awareness by noting down frequently things we’re grateful for. Sharing this with others helps embed this skill further.
Home practice before next session
1. Alternate each day between these two practices:
‘Wise choices’ meditation – follow the instructions on the audio meditation above
‘Kindness meditation’ – follow the instructions on the audio meditation above
2. Three step breathing space: practise this as a way to find a wise choice quickly in a situation: either on your own, or listening to the audio.
3. Mindful communication: when you’re in communication with someone else, see if you can be more aware of your own feelings and needs, and sense what theirs’ are too.
4. Getting to know yourself better: Jot down some notes about which ‘up’ activities you could do more of, and which ‘down’ activities you could do less of.
5. Do something different – Strike up a conversation with someone you don’t know.
Session 6: The C of the ABC - Choosing wise responses to your experience
Part 2 - Taking mindfulness into your future
Keeping mindfulness alive
Mindfulness is a skill, and like any skill, regular practice helps keep it fresh and potent. To keep your mindfulness practice alive, you can make a few simple mindful activities a regular part of your daily routine. These don’t need to take any extra time, but they can really help you stay more present and to make wise choices, from moment to moment. For example:
On waking and before going to sleep, observe five mindful breaths.
Taking a few mindful breaths when you need to
Mindful eating - feel the food’s nourishment, taste and smell it
Bringing simple mindful awareness to routine physical activities
Using the three step breathing space – in as little as one minute
Practising mindfulness in ‘dead’ time – e.g. when queuing, or waiting for a train or bus, etc.
Making it your own
The ultimate aim of mindfulness is for you to lead your life in a way that feels right and meaningful to you – rather than according to some preconceived idea about how you should live. So as you carry on practising, remain open to which particular techniques work for you, and feel free to adapt them. It needs to feel alive and creative. So enjoy making it your own.
Practising with other people
Practising mindfulness alongside other people can help you keep up motivation – and you can learn from each other. You could do that with a group of people you already know, or join a meditation group in your area. Or you could do more formal training at a public centre. Some internet research should throw up some options in your local area.
It could be really helpful to keep reflecting and writing about what are ‘up’ and ‘down’ activities for you. Jot down thoughts in a notebook. This is like your ‘life manual’ – your guide for yourself on how best to live your life. Eventually you could write it all down in some kind of logical order if that’s helpful.
Selecting a meditation for each occasion
You may find that you want to keep listening to the guided audio meditations, and to choose which one to listen to at different times:
‘Waking up to yourself’ meditation: if you get a sense that you need just to re-establish some basic awareness
‘Working with thoughts’ meditation: if you notice that you’re caught up in a lot of negative thoughts
‘Acceptance’ meditation: if you’re aware that you’re finding it difficult to stay with something difficult
‘Wise choices’ meditation: if there’s a particular issue that’s troubling you that you need to get some fresh perspectives on
After a while you may not want to listen to the audio versions. Instead you could just set a timer for however long you want to meditate and follow the steps in your own mind in silence.
Advanced meditation – ‘open awareness’
As you mature with mindfulness, a more advanced approach you might try is called ‘open awareness’. This starts with the A of the ABC – grounding yourself in awareness of your breath and body (A). Then for the rest of the meditation, you stand back from your experience and simply observe what particularly calls for your attention – thoughts, memories, images, body sensations or emotions. Whatever comes up, make this the focus of the meditation. Turn towards it and give it more space. See what it might be trying to communicate to you. Then, when it’s no longer calling for your attention, return to awareness of the body/breath – until the next significant thing comes into your awareness.
In taking this approach, you are flexing two vital complementary aspects of mindfulness: focused awareness (depth) and broad awareness (breadth). You are reinforcing the essential mindfulness point that everything that comes up is worthy of attention. This also applies to many common difficulties that people experience in meditation including: drowsiness, low concentration, boredom, anxiety, fear, restlessness etc. They are not ‘problems’ to be avoided or fought off. So you can just allow yourself to notice what they feel like in your body. By doing this, you can find out something interesting about your usual patterns of thoughts and feelings.
It’s best to do this meditation without any audio guidance, so there’s no guided meditation for this. So you can just sit in silence with a timer. If you find this approach to meditation hard at first, you can always return to a more focused awareness of your body and breath.
Home practice from now on and indefinitely!
1. Meditation – work with a combination of any of the main meditations – either with or without the audio guided versions.
2. Daily mindfulness – refer to the suggestions above
3. Getting to know yourself better – keep writing your ‘life manual’, as described previously.
4. Keep doing something different – use your imagination!