Decenter to Be Centered

What is decentering? Why is it central to mental health?

Posted Oct 29, 2008

Decentering in order to be centered? Most of us know what it means to be centered. When someone is centered he enjoys the present moment and is comfortable in his own skin. What is decentering?

One of the first prerequisites common to both cognitive therapy and mindfulness practice is learning that we do not have to believe all of our thoughts. This has been described as decentering. In essence, to decenter is to take a figurative step back from our beliefs and thoughts. Instead of a reality of "I can't do anything right," one learns that they had a thought "I can't do anything right."

In cognitive therapy one then disputes irrational thoughts (sometimes called "cognitive distortions"). In mindfulness practice thoughts are non-judgmentally noticed and let go. So in both mindfulness practice and cognitive therapy it is key to learn that we do not need to believe all our thoughts. An important component of mindfulness practice is also to not resist our thoughts. Otherwise marked frustration may ensue. If we resist our thoughts, the object of frustration may change from "not being able to do anything right" to having too many thoughts that one can't do anything right. "If only my situation were different, I would be happy" becomes "If only I did not have so many distracting thoughts, I would be happy."

How can one be taught the skill of mindfully noticing thoughts and decentering? Traditional exercises for cultivating mindfulness include the "concentration meditations" in which one focuses on the breath, body sensations, or sound. When the attention drifts from the object of concentration is patiently and repeatedly returned. Then one learns "mindfulness meditation" in which one non-judgmentally focuses on whatever arises - be it breath, sensation, emotion, thought or sound. Other traditional mindfulness exercises include walking meditation and mindful eating.

For the past 16 years, I have also had success teaching what I call a "letting go meditation." In that meditation, students/clients can practice letting go of thoughts that were previously contributing to distress. The exercise serves several functions:

1. It demonstrates that thoughts in themselves do not cause distress or depression. It is the way in which the thoughts are dealt with that causes the distress. This technique allows people to gain this insight through their own experience.
2. One gains experience and practice in non-judgmentally noticing thoughts. One can include thoughts that have been bothersome. If someone has been getting panic attacks, typical thoughts might be "I might die," or "This is horrible," "I wish my heart would slow down." In that way he gets practice in mindfully noticing the thoughts that are a component of his problem.
3. Not only does one get practice in mindfully dealing with thoughts, as he practices the letting go exercise, the physical reaction to the thoughts can continue to decrease. In a sense, the exercise can act as desensitization to the thoughts. The thoughts that were formally very "charged," become no big deal.

People benefit from using traditional mindfulness exercises for daily practice. The letting go meditation can be used when the situation warrants.

1. Before doing the exercise, it is ideal if one has some background information and, if possible, experience with mindfulness.
2. Then start a relaxation exercise in which you focus on the breath, repeatedly letting go thoughts and returning to the breath. Then you can relax one body part at time.
3. Once someone is relaxed, the next instruction is to repeat certain phrases/thoughts. This technique can be used to teach people without any psychological illness to mindfully deal with thoughts. For patients with certain psychopathology, someone may eventually choose phrases that have been associated with that pathology. For instance, with agoraphobia the thoughts may be something like "I hope I don't have another panic attack. That would be horrible." For panic disorder it might be "Oh no; I hope my heart would slow down." For OCD, the thought might be "I need to count."
4. Before introducing the statements, the participant is specifically instructed not to believe the thoughts or resist the thoughts. It is essential to do this several times during the exercise. We do not want the repetition of the thought to actually strengthen the belief. Instead we want to strengthen the ability to decenter, mindfully notice thoughts, and let them go.
5. The student silently repeats the thought and then lets it go. I usually vary the thoughts throughout the exercise. However, I also have the student repeat certain thoughts more than once. In that way, they learn that a certain thought can be mindfully attended to and let go again and again.
6. After he repeats a thought once and lets it go, he is instructed to pay full and complete attention to a diaphragmatic breath. Suggest he enjoy or even luxuriate in the breath. He can relax a muscle group. With subsequent thoughts the procedure is repeated and a different muscle group can be selected.

Almost universally, people are more relaxed at the end of the letting go exercise. Therefore, they realize that it is not the thoughts themselves that cause the problem, but rather the most important issue is how they deal with thoughts. In a relaxed atmosphere, they have practiced letting go of previously bothersome thoughts and bringing their attention to a present moment sensation (like a diaphragmatic breath and relaxing a muscle group). When the thoughts occur during their day-to-day life, they have already practiced how to effectively deal with them.

(Further discussion of this topic is in Take the Stress Out of Your Life and the letting go excercise is one of the ten exercises on the accompanying CD set.)

About the Author

Jay Winner, M.D., is family physician the founder of the Stress Reduction Program at Sansum Clinic and the author of Relaxation on the Run.

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