Mindfulness and Meditation

Let’s start out by getting some important information out of the way. The stigma surrounding mental health is still generally negative. People who deal with mental health issues or those who go to therapy are often seen as “weak” – a belief held more by older than younger generations. This macho stance is often a result of ignorance; many of us just don’t understand mental health or feel comfortable talking about it. Thankfully, mental health literacy in America is expanding, media depictions of mental health have become more realistic, and our comfort levels have subsequently improved.

So, I throw myself into the fire here to help tear down some walls. I go to therapy. I see a mindfulness-based cognitive therapist – a psychologist who focuses on meditation and mindfulness as a mechanism to help manage anxiety, depression, and all things our minds like to do to us. I’ve been going for three years. I’ve always had anxiety – so bad that it manifested as chest pain, radiating pain down my left arm, and jaw numbness. It’s pretty scary as a young dude with a young family member who died due to cardiovascular issues. That added fear just made it worse. On top of this, I’ve got a temper because I’m generally impatient. I used Lexapro (escitalopram) for a decade, but despite the medicine, it kept getting worse. I was reluctant, as many people are, to seek professional help. For me, I really clicked with my therapist and his methods were, in my opinion, THE answer. About 3 months after starting therapy, I was able to stop my Lexapro and haven’t needed it since, despite objectively higher stress levels than before.

We’re all pretty screwed up. Most of us have difficulty dealing with our “darkness.” I find that it’s worse for us in the quiet, when all we have is our mind telling stories, getting us all riled up. I wrestle with this constantly… as we all do.

I make the joke that mindfulness and meditation is needed for the upcoming holidays, as we dance around the political and social tensions that are piling sky high. Nyuk Nyuk, ya know? It’s too cliche a joke to make, even for me. I’ll do better.

What I hope to accomplish with this article is to introduce concepts that I consider “life saving.” If we are climbing the Wellness Pyramid in the journey to be well and optimize our health, we must properly address stress management. More importantly, let’s bring this mental health discussion into the light. Let’s not be afraid to say “I have lots of anxiety” or “I have dark, negative thoughts sometimes.” This life really is quite beautiful, especially for us in America. Let’s really see it and experience it more fully. Let’s get mindful!

Pain and Suffering

“You got all serious, then positive, now you’re going to talk about pain and suffering? This is the darkest blog yet!” There is a method to my madness. All of these concepts I introduce are building to the grand finale. Buckle up buckaroos!

Let’s define two key words using an analogy, ok? Pain: A guy cuts you off in traffic. Suffering: You get angry, slam on the horn, get road rage-y, and think (and talk) about that one event all day long.

This is an important distinction. The guy cut you off in traffic. In that moment, it was painful. It was unsafe, unwelcome, and unkind. But that moment passed. You reacted quickly. You were safe, your passengers were safe, and the people in traffic around you were safe.

What happens? Well, we assign value to the painful event. We build it up to be something it wasn’t. We think about the disrespect. We make it bigger than what was real: for some reason, someone cut in front of you and you had to apply your brakes and take action. We then respond and react to how we feel about the event, not the event for what it was. This is our suffering.

Another analogy? Your girlfriend dumps you. That’s painful. You grieve. It’s sad, no doubt. But then, we make it bigger. “I”ll never find someone else.” “She meant everything to me.” “I can’t believe this would happen to me.” Days, weeks, even months. The event was a single moment. The pain was a few moments. The suffering, however, lasted a while.

Personally, I’m juggling three or four sufferings. Three or four moments that have been painful that I’m dragging on the suffering. What pain have you been suffering over? How many sufferings are you volleying around? Are you going for seconds on the plate of suffering?

If you take away any lesson, let it be this: pain is not always our fault, but our suffering is 100% on us.

Something that should be made very clear is that it is ok to have feelings. I’m not suggesting that you become a robot that says “Input X. Painful Event. Delete emotion. /End”

If you are sad, be sad. If you are scared, be scared. Acknowledge your feelings. Be kind to yourself. Say “this thing that I’m dealing with is hard.” Just don’t amplify it and drag yourself down into a spiral of negative thoughts and feelings. It’s ok!

In our house, we tell our kids “It’s ok to feel upset. It’s not ok to whine about it and stomp around, or to give your sister The People’s Elbow because you’re upset.” Pain and suffering.

The practice of looking at life for what it truly is is called mindfulness. It’s the experience of life at the level of the exact input you are getting, not the story we make up about the events, nor the typically dramatic reaction we have to that story.

Mindfulness sees the pain for what it is. It watches and observes external AND internal chains of events. The mindful person sees the patterns that begin to unfold after a painful (or happy) event.

You see an old colleague that screwed you over, then you have a visceral gut reaction – a queasiness of sorts – then a little tightness in your chest, then you start to get angry, and you start thinking horrible thoughts. If you aren’t mindful, you wake up in a bus stop in Indiana wearing someone else’s clothes. If you are mindful, you’ll watch it happen, but you won’t attach to it. You don’t let it whip you around and take you halfway across the country. Instead, you watch, curiously, at where it goes and watch it wash over you.

Practicing mindfulness is simple. Simple, but not easy. Wherever you are right now, set a timer on your phone for 5 minutes. Close your eyes, sit up straight, hands on your lap. What does the seat feel like on your butt, legs, and back? What does the air feel like on your skin? What sounds do you hear? Really take the time to feel it. What about your feet? How do they feel in your socks, in your shoes?

Practicing mindfulness keeps you grounded in what is real. Are you currently experiencing pain? Is someone delivering horrible news? Is someone, right now, cutting you off? Are you, in this moment, being broken up with? If not, this moment is probably fine. There’s a good chance if thoughts are invading that it isn’t pain, but suffering.

All we want to do is identify, not judge. If you’re in pain, acknowledge that. If there isn’t a painful event happening in this moment, realize there’s a good chance you are inducing suffering. But don’t judge yourself. All we want to do is be able to be mindful. Is it pain I am feeling, or is this suffering? If this is suffering, you could take a deep breathe and be mindful of what’s real, right now. That feeling will pass as you ground yourself into the moment. Don’t beat yourself up, just figure out which side of the coin you’re on. If you wake up to this – what’s real – you can breathe and begin again.

The Gap

Let’s talk about stories. Our brain makes up stories to make sense of the world around us. One of the stories we tell ourselves is the story of how it “should be.” If we aren’t being mindful, there’s a really good chance that story is different than what is real.

  • “I should be more successful at this point in my life.”
  • “I weigh more than I think I should.”
  • “I’m a top tier chef/nurse/pharmacist/businessperson/janitor.”

These projections are a result of all the stories we tell ourselves, our upbringing, our environment, our conditioning (the thoughts we “practice” or repeat most frequently). Here’s one American’s are using a lot:

“America is the greatest country in the world.”

When we are in the stories, life is fine. It’s when the light of reality is shined on us that we realize that there may be a bit of a gap between the story and what’s real. Keep in mind, many of us may never have that light shined on us. Many of us live in story-world 24/7. Some people don’t practice introspection. Usually, something – some relationship drama – bubbles up to a problem level and we’re left facing harsher truths than we’re used to..

Here’s my untrained opinion: Anxiety and depression result from the gap between the stories we tell/the projections we place on the world and what is real. The larger the gap between the projections of what reality should be and what is real, the more serious or severe the anxiety or depression.

Is America the greatest country in the world? Probably not. It’s awesome here for many of us, for sure. There are lots of different ways this claim of our greatness (projection) can be objectively measured (reality). When you do so, we don’t do so hot. In truth, we’re maybe top 10 and trending towards an oligarchy. That statement on its own could cause many people to get the twinge of tension in their chest or straight up cause their heads to explode. They get defensive because they’re offended, then Thanksgiving turns into a wrestling match where a father accidentally shoots his son. That literally happened. ‘Muricuh. Pain: Someone said something. Suffering: I don’t agree with it, I’m offended anyone would say anything like that, How dare they attack me?, etc etc etc…

You can tell yourself all day long that you’re a good person. But if your actions in many of your moments are inflicting pain on others, there’s a chance that you’re a jerk. Despite your intentions or the stories you tell yourselves.

This gap stresses us out. When we awake to the reality, it hurts. Instead of looking at what is real, we react to our feelings about what’s real. Albert Ellis called this the ABC model.

Being more mindful will allow you to see what is real. What is really going on? Am I being accurate in my assessment of my self/work/life/reality? Am I making up stories?

It’s fine to set goals. It’s fine to want something to happen, to have a vision for your future. Please – plan away! Just don’t attach to the results or outcomes. “I want to have 15% company growth for 2019.” Take the actions to make this a reality. Execute on it for each moment. But don’t think for a moment (tee hee) that you can will something into reality. You have to do the work for a future you want. And sometimes, despite doing everything right, it still could not work out. That’s life.

Time Is An Illusion

If we’re talking about what is real vs the stories we tell ourselves about what is real, we should talk about time. This one is a bit of a trip…

The only time that exists is right now. This moment. We’re REASONABLY confident that another moment may be coming shortly, and we know a moment has just passed.

Tony Soprano’s experiencing moment in the diner/restaurant. Then, black and a bunch of confused and angry fans. His next moment didn’t come.

The past and future are stories we tell ourselves. They are projections that aren’t an accurate reflection of what’s real. What’s real is right now. If we try to reflect on what was real in the last moment, 2 weeks ago, or 10 years ago, it probably won’t be accurate. The future is just made up nonsense. How do we know what is going to happen? We can make reasonable conclusions, but there’s a good chance we’re wrong.

What we humans end up doing, usually because our brains suck, frankly, is assign greater value to the events of the past. We hold tightly to our expectations of what the future will bring. Both are projections – a big gap between what we think and what is real. My teacher/shrink taught me what his teacher taught him: The past is tears; the future is fears.

We relive the past over and over – thinking about things we didn’t do, things that used to be, things that didn’t work out. MAYBE if you’re better adjusted than me (which most people are), you’ll think of only the positive events of the past. Or better yet, think of all the events of the past – the good and bad – with a contentedness or sense of gratitude for experiencing all of it.

The future, for many of us, ends up being apprehension filled. What’s coming? Will I lose my house? Will I have enough money? Will someone die? Will my spouse leave me? Ignore the future. It’s not here yet. Instead, ask, what’s real? Am I currently in pain? Is my spouse leaving me? Is someone dying right now?

We spend many moments of our lives stuck in a past that we can’t change or worrying about a future that may not come. It would be best if we could leave those tears and fears where they are, and instead focus on experiencing this moment fully.

Again, your feelings are real. If someone you love has passed away, please, by all means, mourn. Life can be difficult. But holding on to the ideas like “it’s not fair,” “I wish she were here,” or “I hope I don’t have to live without her” creates an emotional roller coaster of suffering that you don’t need to put yourself through.

The Mood Chart

How was your day yesterday? Was it good? Was it bad? It’s pretty crazy that we assign such values to such a large amount of data points… Let me explain:

Think about how many moments there are in a day. Let’s pretend a moment is a breath, which is about 3 seconds for most of us. Assuming 8 hours of beautiful sleep, we’re awake for 16 hours or 57600 seconds. This is 19,200 “moments”.

Were literally all of those 19,200 moments bad? Or were there a few moments that were actually bad, but many moments we spent inducing suffering?Suffering is like an infection, spreading and contaminating your day like E. coli to romaine lettuce.

If we were to be honest about what is real, we’d realize quickly the truth about life: most of our moments are just “meh.” Average. Nothing really going on. Not too good, not too bad. Just uneventful.

When we say our days are anything but what they are – a collection of mostly meh moments sprinkled in with some pain and great moments – we’re creating a label. Winning, losing, success, failure, good, bad. All labels create that gap between what is real and a projection. If my day wasn’t “good,” that’s an outcome that I’m attaching to as an expectation, and that causes me suffering.

We could track our mood over time using a good/meh/bad methodology. If you were honest, it would be mostly meh. Even if you did assign good or bad on a day that you had a handful more than normal good or bad moments, you’d find that as a whole, most of your days are either meh or good, with very few truly bad days thrown in there. A young lady on reddit did this:

While I don’t agree with her color coding choices, you can see most of her days were green or blue – good or average.  I would assume most of our lives would look like this, if we were being honest.

Most of our moments aren’t overly positive or overly negative, but instead average or uneventful. In most moments, we’re just here and we’re fine, even those of us experiencing bad circumstances. By suffering, we amplify these moments and drag them over and onto other moments that otherwise would be meh at best.

Our goal here is to close these gaps. The gaps between our projections and what is real. In the moment. In the story of time – the future and the past. The closer the gap, the less anxiety, depression, and overall suffering we’ll experience.

The point of this is to highlight all the points in our lives where we can be more mindful. Mindfulness is simply looking at what is real, right now, in this moment. It’s experiencing this moment fully. The past is gone. The future isn’t here. This moment could be painful, and that’s ok. But if this moment isn’t painful yet you feel “bad”, there’s a good chance you’re causing some suffering. When you see it, wake up, breathe, and begin again.

We Live With A Crazy Person

Where does this tendency for negativity some of us have come from? Where do the stories that don’t match reality originate? Why do our sad thoughts seem to get caught in a death spiral, getting progressively worse as the day goes on? It comes from a crazy person that lives with you. Not your spouse, cat, or roommate, but from your brain. Though cats, scientifically speaking, are jerks.

When trying to convince someone mental health therapy is ok, my argument normally goes something like this: “When your heart isn’t working like we want, we see a cardiologist. When your liver is broken, we see expert help. Why is it any different for the brain – the big organ in your skull?”

Your brain, like the rest of the organs in your body, exists almost entirely outside of our attention or focus. I mean, have you really been paying attention to what your liver’s been up to today? What about the part of your brain that makes you breathe – have you been mindful of what it’s doing? What about the part of the brain sending signals to your eyes to make them blink, or to your gut to help you digest? Nothing, right?

Just like the moments in the day, there are an incredibly large amount of things our brain does that are just “meh” or irrelevant to the “meaning” of our lives. Breathing is important, but we don’t focus on it – it just happens.

There are a few brain activities that we certainly pay close attention to, and paying too much attention to them is the problem. One of these clumps of cells in our brain is actually a guy (since men are the cause of all problems). A crazy guy. Our roommate that we’re stuck with from here on out. A real troublemaker.

You’re not crazy, but there’s a crazy person living with you at all times!

Here’s what I mean. Let’s pretend we’re sitting in a room together. I say “hello!” You hear me. I spoke. You heard.

Now, say “hello” in your own mind. If you think about it, there’s someone in that brain of yours who is saying hello, and another person who hears the hello. Do it a couple times. You didn’t know this was an interactive article, did you?

The guy who is saying “hello” is an a-hole. Sorry, but he is. He’ll say anything. His whole purpose is to create words. These words turn into thoughts, feelings, and emotions. Sometimes it’s an accurate reflection. Sometimes he’s just talking smack.

The guy or gal in your brain who is listening to our crazy roommate… now that person is WAY more important! That’s who you REALLY are. You’re the person who is hearing the words and observing the patterns of word-thought-emotion. You are the person who assigns value to those words and determines if you are going to pay attention to the crazy roommate.

The problem is we think those 2 people are the same. The gap between saying and hearing is too small. We feel like the person who is listening is saying the stuff, too, so it must be important.  

Just because this guy says something crazy like “You’re not as successful as you thought” or “You’re fat” or “You’ll be alone forever” doesn’t mean that those things are true.

Though we just talked about how gaps are bad, our goal is to create a gap this time, instead of closing one. We want to create a gap between the talker and the listener. The crazy roommate and us. We need to separate what this one part of our brain does or says and what we value and pay attention to. We do this via meditation.

Meditation is simple, but not easy. It takes practice. It takes a non-judgemental approach. “I suck at this!” Everyone sucks at it. You’re literally reprogramming your brain – it will take work. I’ve come to the conclusion that I’ll never be “good” at it, which helps me as I practice more and more.

Meditation starts with sitting quietly in a room with little distractions. Feet flat, arms at your side or on your lap. Sit up straight with eyes closed. You don’t need to be on a mountaintop sitting criss-cross looking like Dr. Strange. You can do this anywhere.

Here are the steps:

  • Focus on your breath. How it feels as the air moves in and out of your nose or mouth. (I normally focus on the sensation at end of my nose as my schnoz is super large, but some people may focus on any one part of the process – the chest, stomach, etc)
  • Your attention will probably get pulled away towards a thought. That’s the roommate at work. You may not even realize it. Eventually, you realize that your attention isn’t focused on your breath any longer. No judgement. Simply begin again.
  • Refocus on your breath and start the 3 steps over.

In even simpler terms:

  • Breathe
  • Lose track
  • Awaken
  • Begin again

Five minutes a couple times a day is all you need to help start building in the gap between the crazy roommate and our more sane selves. In just 20 minutes a day for 8 weeks, our brain literally rewires itself in positive ways.

When we practice meditation, we’re training our mind to realize the talker and the listener aren’t one, but two, very distinct parts of our brain. We become mindful of what’s real: the talker is just a part of our brain that just spouts off words

We Are What We Practice

If you get up every day and do 10 push-ups, you’ll certainly be ready for a family push-up contest that may arise this summer.

If every time you have a negative thought, you sit in it and suffer with it, you’ll be good at thinking negatively, and probably will do it more often.

If every time you get angry, you lose control and lash out physically, you’ll get really good at reacting physically (and mindlessly).

We are what we practice.

If we instead practice acknowledging negative thoughts as they arise, but not paying any attention to them and return to breathing or focusing on our breath, we’ll get good at not getting thrown into a negative thought vortex.

If we realize we’re not responding to our anger appropriately, we may be able to at least apologize after an explosion. Ideally, though, we’d recognize and observe the feelings coming over us, knowing they often result in physical violence, and watch them pass over. If we did this, we’d start getting really good at responding appropriately.

Meditation is the practice of waking up when our focus is lost during breathing and beginning again. This applies at this internal level but all the way up to our behavior patterns and the external level – our actions.

Neal’s Rewind

Let’s go over some important concepts:

  • We humans must endure painful experiences. Because we are human and our brains are jerks, we end up intensifying and reliving painful moments. This is called suffering.
  • Being aware of what is real in this moment is called being mindful.
  • The gap between our projections of reality and what is real in this moment causes us suffering, usually in the form of anxiety and depression.
  • Being mindful helps us stay grounded. All we have is this moment – the future is our “fears” and the past are our “tears.”
  • Meditation is a practice where you focus your attention on a single point, instead of all the distracting things of life – including our own minds. By doing this daily, we get better and better at separating the words said by the “Crazy Person” in our head from our real selves, the listener.
  • All of the above are quite simple, but not easy. It’s like wrestling a bear.
  • We become what we practice. You’ll suck at it at the beginning, but don’t judge yourself. We all are “bad” at it.

Simple, But Not Easy

As I’ve said it a half dozen times, all of this practice is simple but not easy. It’s my favorite saying, and it’s quite an apt metaphor for most of our lives.

Understanding these concepts will put you on a path of mental wellness that most of us have never been on before. It’s the most “natural” recommendation I can make and can positively impact every aspect of your day and life.

I hoped to just introduce these concepts, though, not dive into it too deeply.  If you’d like to discuss this more, don’t forget to reach out for a wellness consult with me at any time!

A meditation and mindfulness practice daily is a powerful step at managing stress.  It is the true “adaptogen”, amplifying and improving our stress response.  Just like eating healthy, exercising, and using essential supplements, it’s a pillar of optimizing wellness.

Most importantly, know that anxiety, depression, and other mental health issues are a part of the human condition. Use these tips as a starting place, but don’t hesitate for a moment to seek professional help. It’s saved my life!

Just trying to keep it real…

Neal Smoller, PharmD
Owner, Pharmacist, Big Mouth

Dr. Neal Smoller, Holistic Pharmacist

About Neal Smoller

Dr. Neal Smoller, PharmD, is a licensed pharmacist: and owner of Village Apothecary, an independent pharmacy in the most famous small town in America—Woodstock, NY. He’s also the host of the popular wellness podcast, The Big Mouth Pharmacist.”


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