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We all get cognitively, emotionally, or behaviorally inflexible and stuck. We fixate on the same thoughts over and over again, feel trapped and overwhelmed by certain emotions, or constantly repeat the same behaviors. Change takes energy and effort and there is a strong sense of familiarity, and therefore comfort, that can come from repeated patterns, of doing things the same way, even if it’s unhelpful.

Yet stuckness is demoralizing. It sucks the sense of capability, confidence, and hope out of us. It makes us want to stay in bed with a blanket over our heads, literally or figuratively. Practicing mindfulness is one way to get unstuck, to create options and a greater sense of psychological flexibility.

When you are caught in your thoughts and feeling stuck, you are missing out on opportunities in the present moment to do things you find meaningful and important. Mindfulness skills help you connect with the present moment and notice and observe your thoughts and feelings without getting overly focused or fixated on them.

What Is Mindfulness?

Mindfulness is the practice of bringing direct, intentional, and nonjudgmental awareness to the present moment and what you are doing while you are doing it. Mindfulness allows us to see more objectively what is happening in the moment vs. what our automatic thoughts or emotions may be telling us is happening.

The aim of practicing mindfulness exercises is not to change how we feel, nor to lessen stress, anxiety, depression, etc. The aim is to practice tuning into the present moment and our direct experience rather than solely thinking about our experience.

At the same time, it can be the case that we can change our experience by changing how we pay attention to it. Practicing mindfulness creates options for how we relate to our experiences, particularly unpleasant emotions and experiences. For example, if I am feeling physical pain or feeling anxious, I can practice noticing and observing this experience rather than automatically trying to avoid or decrease it.

Brief Mindfulness Exercises

1. Notice and Name

A few times per day, perhaps around meal times, pause and notice your thoughts, feelings, and physical sensations no matter what they are, pleasant, unpleasant, or neutral. Then, practice naming your experience. You can do this by completing the following sentences:

• I am having the thought(s) that… [insert thoughts here]
• I am feeling… [insert feelings here]
• My body/specific body part, shoulders, stomach, back, etc., is feeling [insert physical sensation words here]

By pausing and tuning into what we are thinking and feeling, you create the option of using other useful coping skills and engaging in purposeful and helpful behaviors.

2. STOP Skill

• Stop and slow your breathing: Whatever you are doing, simply stop. Take a few slow breaths, and mindfully observe the breath flowing in and flowing out. Notice the physical sensations of your breath as it moves in and out of your body, your chest and/or belly rising and falling. This will help you to shift out of autopilot mode and connect with the present moment, here and now.

• Take note: While staying connected to your breathing, take note of your experience at this moment. Notice what you are thinking (perhaps saying “thinking” to yourself). Notice what you are feeling. (Take a moment to name the feelings that are here.) Notice any physical sensations in your body. See if you can practice acknowledging and noticing your experience, even if it is unwanted or unpleasant. Practice being curious about your experience rather than judgmental.

Mindfulness Essential Reads

• Open up: Practice opening to your experience, allowing it to be whatever it is in this moment. See your thoughts and feelings for what they are (things that come and go) and give them space. Breathe into any sensations of discomfort, tension, or resistance. Not to get rid of the sensations, but to practice relaxing into your experience, holding it in friendly awareness. Try saying to yourself, “It’s okay. Whatever it is, it’s okay. Let me feel it.”

• Proceed mindfully and pursue your values: Mindfully consider how you would like to move forward in this moment. If it feels helpful, ask yourself, “What is best for me, for others, and for the situation I’m in? How would I like to act, so that I can look back and think my response was helpful?” Going forward, see if you can allow what is most meaningful and important to guide you.

It is helpful to practice the STOP exercise when emotional intensity is increasing, when feeling overwhelmed, or when you recognize that it would be helpful to take a moment to ground yourself and be more fully present (vs. caught in your head).

3. Mindful Breathing

Mindful breathing is the practice of fully tuning into the sensation of your breath as you breathe, of noticing the air moving in and out of your body.

To practice, pause and focus your awareness on wherever you notice your breath. It may be in your nose, your chest, your belly, etc. You may notice the sensations of slight stretching in your chest and/or belly as it rises with each inhale and gently collapses with each exhale.

Notice the sensations of your breath as the breath first enters your body on the inhale and follow the sensations all the way through as the breath leaves your body on the exhale. There is no need to try to control or change your breathing in any way—simply let the breath breathe itself and focus on the physical sensations of the breath moving in and out of the body.

By practicing mindfulness skills, you are helping yourself connect with the present moment over and over again. The more you are connected with the present moment, the more flexible you are in how you respond to your thoughts and emotions, and the helpful behaviors you practice vs. being stuck in unhelpful patterns.

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When pain is accepted for what it is, a lesson and a warning, and deeply looked into and heeded, the separation between pain and pleasure breaks down, both become just experience—painful when resisted, joyful when accepted. –Sri Nisargadatta Maharaj

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Early in my career as a psychotherapist, when someone would enter counseling with the goal of wanting personal growth, I would jump right in with the latest technique in my professional toolbelt. Aided by a plethora of self-help books, clients would embark on deep explorations of their histories, of dreams left unfulfilled, aspirations extinguished, and hopes still flickering in the distance. Invariability, the catalyst for this quest was some form of pain—often presented as a psychological symptom of depression, anxiety, or a combination of both.

For most who began this trek, it was clear that the goal was not the transformation of the self, but the ending of the pain—a decrease in suffering so that life would, once again, be enjoyable. If along the way they gained some insights into their true nature, that was the icing on the cake. However, gaining these insights, minus the alleviation of pain, or, worse, the increase in psychological discomfort, was a quick ticket to a new therapist and a rush back to the bookstore to find whatever new best seller was promising a life free of discomfort.

After years of unsuccessfully trying to remove the pain from my clients’ growth process and scaring them away with the mantra, “Pain is inevitable; suffering is optional,” I chose a more mindful approach that both honors their pain and seeks its transformation.

Growth and pain weave their way throughout our lifespans. From the lesson of caution taught by the hot stove to the broken heart that teaches the rollercoaster of romantic love, our daily experiences consistently remind us that pain serves a purpose. We are both blessed and cursed to measure our development through the slings and arrows of random misfortunes and self-inflicted wounds.

As the growing pains of childhood give way to the bumps and bruises of adulthood, we often leave behind the most important lesson learned in those earlier years—pain, is itself, a movement and, therefore, is transient and informative. It is the primary lesson in the school of hard knocks that life hurts, and what doesn’t kill us makes us stronger. Yet, as we grow older, we lose sight of this fact. Weary from experience, we miss the warning signs that arise when the love of oneself—expressed in our attempts to be free of suffering—runs into an obstacle.

The teacher Nisargadatta Maharaj pointed out that pain is a call for attention and “the penalty for carelessness.” Its remedy, he said, is “intelligent and compassionate action.” While this might sound like more doing—a class in Suffering 101, a “feel-the-burn” yoga, or some other form of self-punishment cloaked as self-enrichment—the truth is that action is already happening. What we miss when we strain to see a future, minus pain, is that the movement of love has run into a roadblock and a life lesson is at hand. Rather than frantically searching for immediate relief, sitting in mindful awareness of the pain is often the best course. Likewise, a compassionate act of not doing anything foolish to ease the discomfort may be the right prescription.

The poet Kahlil Gibran wrote that pain, “is the bitter potion by which the physician within you heals your sick self.” Mindfulness teaches us that resisting this potion or attempting to replace it with something more palatable often impedes the recovery process and risks turning the potion into a poison.

Through compassionate wisdom, we learn that beneath the hardened shell of the ego, there is a true self that seeks growth through the deepening of conscious awareness. Growing pains are, as Gibran writes, “the breaking of the shell that encloses your understanding.” Once both the mechanism and purpose of pain are exposed to the light of loving awareness, through Gibran’s antidote of “silence and tranquility,” we discover that the self we had been trying to poke and prod to grow was the false self and that our true nature is revealed when we remove the obstacles to the natural movement of love.

Paradoxically, guiding someone through this “silence” can be a very noisy endeavor. Resistance to emotional pain rivals any of the mind tricks used to block out physical pain, and psychotherapy clients often go kicking and screaming into the unexplored lands of their psyches. While Carl Jung advised that “there is no birth of consciousness without pain,” it remains a hard sell to many worn-out souls who seek psychotherapy as bathing in calming waters only to find a raging river. Convincing clients to head straight into these waters—albeit with the floatation device that is the supportive counseling relationship—requires the Zen assurance that “the obstacle is the path.”

In my current work with clients, I advise them that acceptance of the present moment, to include moments of psychological pain, does not mean becoming life’s punching bag, passively taking whatever life dishes out. Instead, it encourages what the Buddha referred to as “right action”—acting in accordance with wisdom and compassion. I assure them that the energy freed up when they let go of resistance and face pain with courage and endurance allows them to flow with the movement of life and, when appropriate to the situation, act. Borrowing from the world of chronic pain management, my new mantra for clients facing psychological suffering, “Know pain, know gain,” does not scare clients away and opens more doors to healing.

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Self-efficacy refers to an individual’s belief in their ability to accomplish a specific task or goal. It is the confidence that one has in their abilities to perform a task successfully. Self-efficacy is a significant determinant of human behavior, motivation, and achievement. It affects how individuals perceive and approach challenging situations, and it influences their response to failure and setbacks.

In self-help, self-efficacy plays a critical role in determining the success of the individual’s efforts. The higher the self-efficacy, the more likely an individual is to engage in self-help activities and to persist in their efforts. Individuals with high self-efficacy are more likely to set challenging goals, take risks, and persist in the face of adversity.

Research has shown that self-efficacy can be enhanced through various techniques, including cognitive-behavioral therapy, positive self-talk, and visualization. These techniques help individuals develop a more positive self-image and foster a sense of mastery over their behavior and emotions. They also help individuals develop a more realistic view of their abilities and limitations, which helps them set more achievable goals.

Self-help programs often use self-efficacy as a central component of their approach. For example, programs that focus on weight loss or smoking cessation emphasize self-efficacy by helping individuals develop a belief in their ability to change their behavior. These programs provide individuals with the tools and skills necessary to achieve their goals and help them build self-efficacy through positive reinforcement and support.

In conclusion, self-efficacy plays a crucial role in self-help. It is the belief in one’s ability to accomplish a task or goal, and it influences how individuals perceive and approach challenging situations. Self-help programs that focus on enhancing self-efficacy can be effective in promoting positive change and achieving long-term success. By developing a sense of mastery over their behavior and emotions, individuals can take control of their lives and achieve their goals.

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Lifestyle modifications and coping strategies along with the prescribed treatment can help in improving people with SCD to have better physical and mental health.

Sickle cell disease assumes the shape of a sickle. Typically red blood cells contain an iron-rich protein, haemoglobin, that carries oxygen. People with Sickle Cell Disease inherit genes with instructions, or codes, for abnormal haemoglobin. This abnormal haemoglobin makes these red blood cells – sickle or crescent-like making them rigid and sticky, causing obstruction in normal blood flow and, at times, occluding complete blood supply to organs leading to sickle cell crisis, which commonly presents with acute pain frequently managed with the help of opioids. Dr Saswinder Kaur, Senior Resident, Department of Psychiatry, Amrita Hospital, Faridabad, explains the situation may begin within the first year of life and continue throughout life.

People With SCD

People with SCD must remain vigilant throughout their life, which can be emotionally & physically draining. They may also have trouble coping with pain, fatigue, frequent medical visits and hospitalizations. The limitations imposed on children because of susceptibility to infection can lead to social isolation in early childhood, causing low self-esteem and making it difficult for them to learn adequate social skills predisposing these children to develop mood and anxiety disorders in adulthood. They may become dependent on opioids, predisposing them to develop opioid-induced mood disorders. It is difficult for people living with SCD to have an everyday life. Depression is common in people with SCD. Rates of depression are similar to those found in other serious chronic illnesses, ranging from 18% to 44%.

Causes Of SCD

Potential causes are chronicity of the disease, the unpredictability of crises, chronic pain, and the overwhelming nature of medical complications, including anaemia, fatigue, growth retardation, leg ulcers, renal failure, strokes, and substantially reduced life expectancy. As with depression, anxiety has also been shown to predict more pain. In various studies, depression and anxiety have been linked to more daily pain and poorer physical and mental quality of life. It is recommended that along with pain management, people with SCD should undergo screening for depressive and anxiety disorders during their regular health check-ups.

Lifestyle modifications and coping strategies along with the prescribed treatment can help in improving people with SCD to have better physical & mental health:

1. Recognize and avoid triggers predisposing to the crisis, like dehydration, over-exertion, cold exposure, alcohol & smoking.
2. Regular moderate-intensity exercise can provide adequate blood flow & release endorphins, improving mood & anxiety symptoms.
3. Talking to friends, family & treating medical team: Talking about their feelings and concerns may help them prepare a personalised treatment plan for the individual and provide moral support to improve their quality of life.
4. Seek help from mental health professionals like Psychiatrists, Psychologists and Psychiatric social workers (PSW) if needed. Psychiatrists & psychologists can recognise early warning signs of anxiety & depression and guide accordingly. PSW can help with the financial burden and arrange social support groups. They help families by creating awareness about national policies which can help such families in terms of need.

Other coping strategies which can be utilized for people living with SCD :

1. Regular yoga and meditation
2. Socialisation
3. Healthy eating habits

In The End

Make people living with SCD aware that one should take life one day at a time, although it’s difficult because no one knows or can predict the future. We only know the present moment in which we are living, so take advantage of this moment & live the life you desire without fears, guilt & regrets. It is easier said than done, but at least we can always try, no matter how often we fail. And help is always there when one decides to take help.

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Personal growth is an essential aspect of self-help, and it can help individuals improve their mental health in numerous ways. Here are some of the psychological benefits of personal growth:

1. Increased self-awareness: Personal growth requires individuals to become more self-aware. This means that they become more attuned to their emotions, thoughts, and behaviors. When individuals are more self-aware, they can better understand their mental health struggles and develop strategies to manage them.

2. Improved self-esteem: Personal growth can also improve self-esteem. When individuals engage in self-help and personal growth activities, they often set goals for themselves and work towards achieving them. This can result in a sense of accomplishment and increased self-confidence.

3. Decreased stress and anxiety: Engaging in self-help and personal growth activities can also decrease stress and anxiety. These activities can include mindfulness, meditation, or yoga, which can help individuals manage their emotional responses to stressors.

4. Increased resilience: Personal growth can also increase resilience. When individuals engage in self-help activities, they develop coping strategies that can help them bounce back from setbacks and challenges.

5. Improved relationships: Personal growth can also improve relationships. When individuals are more self-aware and have improved self-esteem, they are better able to communicate their needs and boundaries in relationships. This can result in stronger and more fulfilling connections with others.

In conclusion, self-help and personal growth can have significant psychological benefits for individuals seeking to improve their mental health. Increased self-awareness, improved self-esteem, decreased stress and anxiety, increased resilience, and improved relationships are just some of the benefits that individuals can experience through engaging in self-help activities. By making a commitment to personal growth, individuals can take control of their mental health and improve their overall well-being.

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But what are the inner workings of self-help? How does it work, and why do so many people turn to it for guidance and support? From a psychological perspective, there are several key factors that contribute to the effectiveness of self-help.

First and foremost, self-help is based on the principle of self-efficacy. Self-efficacy is the belief in one’s ability to accomplish a specific task or goal. When an individual has high self-efficacy, they are more likely to take action and persist in the face of obstacles. Self-help programs often focus on building self-efficacy by providing individuals with practical strategies and tools to achieve their goals.

Another key component of self-help is the use of positive psychology. Positive psychology is a branch of psychology that focuses on the study of human strengths and virtues, rather than just treating mental illness. Self-help programs often incorporate positive psychology principles, such as mindfulness, gratitude, and positive thinking, to help individuals develop a more positive outlook on life.

Self-help programs also often include goal-setting and monitoring. Setting clear, achievable goals is an important step in achieving personal growth and success. Self-help programs provide individuals with the tools and support necessary to set and achieve their goals, as well as monitor their progress along the way.

Finally, self-help programs often incorporate social support and community. Humans are social creatures, and we often thrive when we have a sense of belonging and connection with others. Self-help programs create a sense of community by connecting individuals with like-minded people who are also working towards similar goals. This social support can provide individuals with the motivation and encouragement they need to stay on track and achieve their goals.

In conclusion, the inner workings of self-help are rooted in psychological principles such as self-efficacy, positive psychology, goal-setting and monitoring, and social support. By providing individuals with the tools and support necessary to achieve their goals, self-help programs can be effective in helping individuals improve their lives and reach their full potential.

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One of the primary psychological mechanisms behind self-help is the power of positive thinking. This is the belief that if you think positively and focus on your goals, you will be more likely to achieve them. This is because positive thinking can help to reduce stress and anxiety, which can often hold us back from achieving our goals. Additionally, positive thinking can help to increase motivation and confidence, which can be essential for achieving success in any area of life.

Another key psychological mechanism behind self-help is the power of visualization. This involves imagining yourself achieving your goals and visualizing the steps that you need to take to get there. Visualization can be a powerful tool for self-improvement because it helps to create a mental image of what you want to achieve, which can help to keep you motivated and focused on your goals.

Self-help can also be effective because it often involves setting clear and specific goals. Having a clear goal in mind can help to provide direction and motivation, and can help to break down larger goals into smaller, more manageable steps. Additionally, setting goals can help to create a sense of accountability, as you are more likely to stick to your goals when you have a clear plan in place.

Another important psychological factor that contributes to the effectiveness of self-help is self-awareness. This involves being aware of your thoughts, emotions, and behaviors, and being able to identify areas where you may need to make changes. Self-awareness can be essential for self-improvement, as it can help you to identify areas where you may be holding yourself back or where you need to make changes in order to achieve your goals.

Finally, self-help can be effective because it often involves taking action. This can involve anything from setting goals and developing a plan, to taking small steps towards your goals every day. Taking action is important because it can help to build momentum and create a sense of progress, which can be essential for staying motivated and achieving long-term success.

In conclusion, self-help can be a powerful tool for self-improvement, and there are several psychological mechanisms behind its effectiveness. These include the power of positive thinking, visualization, setting clear goals, self-awareness, and taking action. By understanding these mechanisms, you can begin to develop a more effective self-help plan and start making positive changes in your life today.

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