Existential Perspectives in Mind Stimulation Therapy

Mind stimulation Therapy encourages collaborative discussion between the therapist/counselors and clients around existential perspectives of our conscious living existence. This may include highlighting the universally shared experience that we all of us have, as living creatures, facing the Unknown in terms where we came from and where we are going to, existing from a moment to a moment, having thoughts about past, present, and the future, and having to deal with inevitable changes in life and dealing with the reality of the “entropy process” of our body and mind. All of us learn to cope with these thoughts, which may appear in our private moments of our life at some conscious or unconscious level, independent of our different ” psychological conditions or states of our mind” in our daily existence.

As part of our daily existence, we all use some form of active re-direction to various activities of our day routine, work, family, sports, hobbies, social contacts, etc, to divert our mind from pre-occupation with such existential thoughts, that may be discomforting to us. Many of us may have difficulties in accepting the reality of Unknown and Unknowable of our living human experience. And many may use religious and spiritual faiths to cope with these existential thoughts.

Any discussion of existential thoughts must respect different religious faiths, and strives to promote a sense of Unity to human beings around us, as well as to all living creatures, and the non-living matters in the Universe. This kind of discussion should not be on comparative evaluation of different religious practices, pointing out differences, or superiority, rather how one can symbolically identify common themes in all religious practices to avoid conflicting discussion of faith based concepts.

Besides religious perspectives identifying some universal themes that all religious beliefs hold, therapist may also entertain discussion of science based knowledge of astronomy. The Big Bang Theory, the origin of the present known Universe from a Point of Singularity, and formation of galaxies, stars, planets, and how every living and non-living things, can be presented as the manifold expression of the One Creative Force, which Astronomers call the Point of Singularity. This view may be not be that different from the religious held view of One God that created everything, thus highlighting a point of convergence of Scientific Facts with Religious based Faiths , when faiths are interpreted in a symbolic manner to represent that everything was created or came from One Reality, a la God or from the astronomy perspective of Big Bang Theory, everything is a manifestation of One.
When entertaining any discussion of these existential issues, one needs to be very brief, as well as supportive of one’s existing religious or non-religious faiths, drawing some sense of universal underlying unity to all faiths, pointing out the similarity in some ways to known scientific facts.

As one discusses these thoughts, one can all leave behind our pre-occupations with our own individual psychological problems, and experience in the process a collective sense of connection to all human beings, and the Nature around us, and to a larger Universal Force underlying all that we see or experience. In this way, all of us, specifically our clients, have a feeling of empowerment in the sense of being in the same boat with everybody else in the World, and having a sense of Equality with all, without necessarily associating this kind of feeling only with “death.” One may also emphasize the importance of the value of positive redirection to everyday routine activities of daily life as important in coping with the existential thoughts that may often reflect the Unknown and Unknowable to human mind.

Therapists should therefore respect different ways clients and people get some sense of security of comfort from their own individual beliefs and faiths that they have grown up with or have come to accept or believe in, which cannot be subjected to rational discourse, because of the underlying faith based nature of the beliefs, as well as various activities in their daily life that people choose to engage in Through the discussion existential topics, therapist may focus on the issue of choosing activities that promote greater satisfaction to the person, while reducing personal and social distress,

Therapists, thus, should not bypass these existential issues when they are brought up spontaneously in therapeutic encounters between client/s and the therapist, as it could very be the underlying theme in the mind of many psychologically compromised clients, including persons with schizophrenia. It is up to the individual therapists to make oneself comfortable in discussing these existential themes, but they should not consciously or unconsciously neglect these issues in their therapy encounters. The value of active redirection to everyday adaptive behavior routine can be promoted and highlighted through this discussion. stimulating clients mind the value of “practical intelligence” and involvement in the present activity routines of one’s life circumstances, thus making a strong case for need to be involved in the present and to make the best of one’s present life circumstances, not only to reduce personal and social distress, but also to contribute to more adaptive coping with “existential thoughts” that we all experience.

One in this process of discussion can highlight the difference in human search for knowledge, in terms of what is presently unknown but knowable in the future, and what is Unknown and possibly Unknowable due to limitation of the human mind. Many people having persistent psychological problems may have difficulties in differentiating these two domains of investigation of knowledge. Roots of persistent psychological problems may relate to confusion that one may have in relation to
what is Unknown and what may be Unknowable, as they relate to one’s past and future.

Mind Stimulation Therapy, therefore, actively integrates and promotes elements of existential perspective in its model and practice to promote adaptive thinking, feeling, and behavior.

Please note, this is a blog posting by Mohiuddin Ahmed, Mind Stimulation Therapy, 2014. Any unauthorized use and/or duplication of this material without express and written permission from this blog’s author is strictly prohibited. Excerpts and links can be used provided full and clear credit is given to Mohiuddin Ahmed and Mind Stimulation Therapy with appropriate and specific direction in the original context.

We don’t live alone and our behavior is guided by internal thoughts and social envioronment

Traditional psychotherapy entails the notion that therapeutic dialogue between the client and the therapist/counselor in some ways get internalized in client’s mind in ways that allows  the client to change one’s thinking and behavior outside the therapy situations. While this may be true for many who have the capacity to internalize such experiential encounters, by demonstrating their capacity for  “adaptive behaviors” in their daily lives, and by engaging in activities  such as work, family, recreation, hobbies, and other mind stimulating activities, but for many having persistent and long-term psychological problems, who are continually “pre-occupied with their “problems,” and show varying degree of difficulties in “adaptive functioning,” (including in areas of working and long-term memory, problem solving skills, sustaining attention to tasks or problem solving, effective social communication, etc.), this capacity for internalization and in the ability to translate such encounters into thinking and behavior change from therapeutic encounters to outside the sessions  may be compromised, and there is a need to ensure provision of therapeutic prompts in their milieu environment to ensure benefits from such therapeutic encounters. Awareness of our social environment, practice of mind stimulation activities in our daily life,(through work of any kind,paid or volunteer,  recreation, hobbies,  family and social interactions, practice of spiritual faith, etc.) and ability to do reflective thinking and being open to incorporating feedback from others, etc., are some of the  elements of our “adaptive behavior strategies” that we all employ in our daily lives. When this capacity is compromised,  the ability to internalize from therapeutic encounters  to effect changes in one’s behavior and thinking outside the the therapy session may also be impaired, limiting the positive generalization effect from therapy sessions to the outside world. Success of any psychotherapy endeavors, including mind stimulation therapy, must in some ways, ensure that therapeutic prompts are built into one’s social and therapeutic milieu, requiring active collaboration with “significant other people,” and the milieu environment of the client, to effect enduring positive changes and to maximize effect of any therapeutic encounters for people with long-term and persistent psychological problems.     

Body Movement Relaxation (BMR) in conjunction with Mindfulness and Existential Thought

One of the key elements of Mind Stimulation Therapy that we describe in our book: Mind Stimulation Therapy: Cognitive Intervention for Persons with Schizophrenia (Mohiuddin Ahmed and Charles Boivert, Routledge, 2013) involves Body Movement Relaxation ( BMR ) exercises. Mind Stimulation Therapy has application to a variety of clinical populations as we describe in the book such as  persons with severe and persistent mental illness such as schizophrenia, persons with persistent substance abuse history,  and physically and or psychiatric compromised adults in nursing home settings.  The BMR exercise we describe can by used  not only by special clinical  clients but also by the general population at large,

The BMR exercise we present is of a shorter duration than most relaxation-mindfulness exercises proposed,  and it can be practiced at different times of the day, including while one is  lying on bed. In my four years of work with varied disabled nursing home clients, many of them were wheelchair bound, I was impressed how readily these clients learned to practice the short BMR exercises and to use the exercise to redirect themselves away from “negative thoughts and moods,” which is often a common occurrence in many of these people, with or without any clinical diagnosis of depression. Some of the typical such exercises may involve moving two hands slowly in a clapping manner without touching the two hands or moving one hand up and down without stopping at any time , while looking at the hand/s,  or squeezing with one or both hands the handle of the wheelchair or bed support in a slow rhythmic continuous  movement, and learning to  admire the feeling of being alive by acknowledging sensing one’s movement of one’s body.  The central theme of all these movement-awareness exercises is the continuous movement of a specific part of one’s body, anticipating the next moment of movement of the body, and keeping the specific body movement flow continuous, (not stopping even for a second at the end of a range of motion, similar to Tai Chi type of exercise) ,while the rest of body is still. This has to be done without inducing any discomfort or pain.  as such the range of movement may vary from person to person depending upon his or her movement restrictions due to physical health. This kind of exercise promotes a total concentration to one’s body movement, across clinical and  normal populations, displacing any negative thoughts and feelings that one may have at the time,  and giving  a sense of feeling “high” or “elated” by noticing one’s body movement and being  aware that one is alive in this moment of one’s existence. After all,  the criteria of being alive is being able to notice one’s movement of the body as well as  movement in others or sensing changes (movement) in the physical world. We may take these experiences for granted in our daily life.  But by focusing on this type of exercise intimately,  may promote relaxation, mindfulness, and displacement of our “negative thoughts and feeling” , and help us to  practice affirming and reaffirming the value  of our existence that “I am still alive in this World….How beautiful my body is moving…This experience is real…The Unknown World that I  may face just like all the living beings on earth is not there yet,… None of us will know when and how it will happen …”  

Everyday productive life for most people contain many discrete events of goal setting and goal attainment experIences. This may be lacking in many people with “severe and persistent mental illness” or in people who  have long-standing psychological problems or have physical disabilities associated with physical illness or with aging process, and they  may have lost the habit of daily goal setting and goal attainment experiences on their own volition, It is important, therefore, to practice BMR exercises with specific count number, such as 10 or 15, with the idea of having goal setting and goal attainment experience, and to promote experience of being in the present (analogous to practicing  mindfulness). This aspect can be integrated in counseling with clients.

 One may use one’s own religious faith or science based knowledge to complement this feeling of “happy affirmation of being alive,”  “being in the present,” and displace “any negative thoughts and feelings” one may be experiencing for the moment, and thus may be positively energized.  The  effect of which may last for sometime, or for a longer periods of time depending on our mood, activities, and social support we have. For some it may have a booster spiral positive effect on our daily life that may last for a long period of time. For some we may have to repeat this process more frequently on a daily basis.

 

Please  note, this is a blog posting by Mohiuddin Ahmed, Mind Stimulation Therapy, 2014.  Any unauthorized use and/or duplication of this material without express and written permission from this blog’s author is strictly prohibited.  Excerpts and links can be used provided full and clear credit is given to Mohiuddin Ahmed and Mind Stimulation Therapy with appropriate and specific direction in the original context.

Major Tenets Underlying the Mind Stimulation Therapy- A Sample of Highlights

Some of the elements of Mind Stimulation Therapy are as follows:

Awareness of the present moment of existence to maximize attention to the immediate present reality of living experiences, physical and social surroundings, and inner body cues through a practice of Body Movement Relaxation (BMR) exercise as outlined in our recently published book : Mind Stimulation Therapy: Cognitive Intervention for Persons with Schizophrenia (Mohiuddin Ahmed and Charles Boisvert, Routledge, 2013).  Seeing and experiencing one’s movement of body, one becomes acutely aware of one’s own living existence and one then can try to reflect on one’s personal connection to “others” and to the World.

Reflection on existential perspectives (existential uncertainty, existential anxiety, and existential mystery) that helps us see the time flow of our life as series of momentary living experiences, and gives us a sense of connection to living and non-living beings around us, and help us see the World around us as expression of an underlying universal “spiritual’ force , without necessarily contradicting one’s religious faith or science based knowledge.

Acknowledgement of “negative” and “positive” thoughts and feelings as a part of human living existence.  It is the practice of “redirection” that allows us to ‘reduce personal distress experience,” and gives us a senses of control of life that we value.

Awareness of the importance of processing “information’ in ways that are “adaptive” to us – minimizing social and personal distress and providing us with a positive meaning in our personal lives. Psychological problems often are a function of how one processes information (e.g., dynamics of anger experience may be related to one’s expectation of change that may not be “realistic”).

Recognition of the benefit of focusing on the “intact positive traits” that one may have, and not focusing on what one has lost or the negative traits that one may currently demonstrate. This kind of “negative attention focusing to oneself, may generate a negative relationship framework for a therapeutic encounter, as well as reinforce unwittingly the “negative behavior traits and feelings,” by a process of Law of Exercise, specifically for people who have been struggling with their long-term psychological problems and issues. As one tries to understand the “long standing” negative thoughts and behaviors, by visiting these thoughts by repeated discussions, one may in fact reinforce these thoughts and feelings through a simple repetitive process, and  thereby strengthening the “habit of negative thinking” and possibly the underlying neural networks that support them. Often diverting one’s mind to “other thoughts,” displaces these negative thoughts by itself, without necessarily understanding its dynamic origin, as they can be manifold, and may not be fully known or understood, and more importantly they are in the past, and not necessarily relevant to the present, unless one chooses to make it. We all, in our daily life, use active day routines, which serves the purpose of positive redirection in our lives (e.g., work, sports, religious practice, family involvement, recreational activities, daily routine of housework, etc.)

Mind Stimulation Therapy believes that independent of any level of “disability” or psychological problems that one may present, everyone has functions and capacities that not only contribute to one’s sense of well being, but by making them prominent in one’s behavior and thinking, one can help displace or “limit” the effects of “negative traits” on their present behaviors. Feeling of empowerment that may arise from this process can spiral itself into promoting “recovery” or “enhancing functioning” in one’s own life.

Mind Stimulation Therapy – Mohiuddin Ahmed, Ph.D.

I will be posting here from time to time my thoughts and commentaries on Mind Stimulation Therapy (MST), which I pioneered in the course of my clinical practice over a 40-year period working with varied client populations across ages in varied settings. The MST model was further refined and developed through my years of collaboration with a former student of mine, Dr. Charles Boisvert, Professor of Counseling, and Education Leadership at Rhode Island College, and through our many collaborative publications, and more recently by our collaborative work in writing a book:

Although this book is written by us, two clinical psychologists, the foreword and the published commentaries are by three eminent psychiatrists, signifying a strong cross discipline support and advocacy for the Mind Stimulation Therapy model and its application to clinical practice with “challenging mental health populations.”

The model will appeal to a large number of mental health clinicians of diverse clinical training backgrounds such as psychologists, psychiatrist, mental health clinicians, social workers, psychiatric nurses, occupational therapists who may be working in diverse clinical settings. Clinicians of all experience levels will find the model easy to adapt and implement in their ongoing clinical work with persons with schizophrenia. The model can also be easily adapted in working with clients in individual therapy sessions.

The appeal of the model is in its theoretical framework that provides practical approaches to work with difficult and varied clinical populations. The model can be adapted for use with substance abuse clients and psychiatrically and physically-compromised adults in nursing homes. Two chapters are devoted to the use of the MICST model with these client populations. (The use of Mind Stimulation Therapy model with substance abuse populations was presented at the 23rd and 26th Cape Cod Symposium on Addictive Disorders, and was well received.)

MICST emphasizes mind stimulation techniques characterized by stimulating and enhancing clients’ “intact” areas of memory and cognitive functioning so as to enhance clients’ information processing and ability to engage in reality-based discussions, and to promote recovery. MICST is grounded in information processing and cognitive stimulation techniques and operates out of a “positive psychology” framework