Behavioral Health Minute

November 2011 - Present moments

The short summary

Emotional suffering typically happens as people live life either in the past or the future.  We can sometimes help to reduce suffering by helping people to focus their energy and hearts on present moments.

The modestly longer reflection

 Over the years, I’ve noticed a number of recurring patterns in emotional distress.  One of these patterns is that when people are suffering emotionally, particularly with what we would call “depression” or “anxiety,” they typically are focusing their thoughts, energy and hearts on either the past or the future.

They may feel sad or angry as they dwell on events that happened six days or six months or six years ago.  They may feel anxious or pessimistic or depressed as they dwell on what could happen six days or months or years from now.

In contrast, I often talk with patients about the idea of “now,” or “the present moment.”  I find that patients often resonate with the idea that the past and the future have some importance, but that life is lived in present moments. 

Clinicians can develop this idea in two ways.

First, we may consider with patients the spiritual and emotional costs of living in the past or in the future. 

• Living in the past… focusing on the past… how does that work for you?
• As we have said, realistic future planning is fine, but when you dwell on what could happen in the future, as you are describing… what effect does that have on you?
• When you spend the time and spiritual energy you’re describing to me on the past or the future, what does that keep you from doing?
• So… have there been times when you’ve missed out on something meaningful in life because you weren’t really able to be “there” emotionally?

The second way of developing the idea of the present moment is to consider with patients the benefits of being able to be present, here and now.  Exploring with people when they have really felt “alive” or really “in tune with life” usually points to times when they have really been present to what was happening, here and now.  Participating in the birth of a child.  Being part of a team that pulls well together.  Being caught up in the flow of discovering something new.  Taking a new and milestone step in physical rehabilitation.  Times like these of being really alive and engaged with life almost always relate to present moments.

A personal style of mine is that I also bring the idea of “present moment” into the conversations I have with patients.

With the two of us here, now, for instance, all we really have is the present moment.  I have a history, like you do… growing up, what I’ve done for work, the kinds of relationships I’ve had with people.  I have other things going on, other people I’m working with, other issues and decisions in the future for me… but any of those things that I focus on would take me away from really trying to understand you and listen to you and to be a part of your journey.  So what I have to do… what I have to remind myself of… is to let go of all of that in order to really be here, now.

Clinicians may also suggest to patients that we can all exercise more control over present moments than we can over the unchangeable past or the uncertain future.   I can’t control what I did last Tuesday and I may or may not be able to control what will happen next Tuesday, but I can control whether or not I will be respectful or compassionate with you, now.

Follow-up

Experiment, for yourself, with recognizing the importance of the past and the future, but trying to orient your energy and heart toward the kind of person you want to be in this present moment. 

Cross-reference

Healing connections [October 2010]
Serenity [March 2010]

Fred Craigie, PhD