Treasure The Pleasure

Treasure The Pleasure

One of the themes of MindSurgery London’s May Mindfulness course has been Treasure the Pleasure. So often we rush from one end of our day to the other without feeling like we’ve had many moments of pleasure at all. The world we live in now is always selling us the next best thing – bigger, better, brighter, the idea that the real treasure is somewhere around the corner.  Now more than ever, we need to skill of paying attention, and that includes paying attention to and appreciating the small pleasures of our day.

It is easy to dismiss this as happy-clappy nonsense, but the brain has an in-built negativity bias; it’s like Velcro for the bad things that happen to us, and like Teflon for the good.  The makes perfect evolutionary sense. Our brains evolved to keep us alive; the brain’s number one priority is our survival.  For early humans roaming the Savannah, trying to look for food while avoiding predators, the brain evolved to pick out the negative information and give it greater weight.  After all, we would live to see another day without nice juicy berries (good information) but we definitely wouldn’t if we were eaten by a tiger (negative information)! In other words, the negativity bias, the tendency that things of a negative nature have a greater impact on our psychological state than positive ones, helped to keep us alive.

We are now living in a modern world, where most of us don’t have to worry about our immediate survival, but we still have the same old hardware of the brain, making us more responsive to negative information.  But there are things we can do to combat this. The daily practise of ‘treasuring the pleasure’, or engaging our full attention and focus, being present in that moment, on the small pleasures of our day can help to balance out this bias. We don’t need to wait for the big pleasures in life – the next holiday, the next job promotion, a fancy meal out – but instead we can learn to get maximum positive effect out of the everyday pleasures; the sound of birdsong, the smell of freshly brewed coffee, a moment of connection with a loved one.

And this brings us to the question of method – how? Mindfulness is the perfect skill to bring to this challenge as it helps us to pay attention in a particular way, on purpose, and without judgement. We can use the mindfulness practice of the senses to really drop down into being mode, and disengage from thinking mode. By focusing on our senses – the feel of the warmth of the coffee mug, the smell of the coffee, the taste of the first sip. By bringing our attention and focus to these elements of our present experience, we are directly experiencing the small pleasure, instead of gulping back our coffee while rushing around the kitchen, hunting for the house keys. By making this a habit throughout our day, we can go some way in redressing the balance of the negativity bias. We can nourish ourselves with these small acts, adding to our bank of positive experiences, ensuring that there is capital to be drawn on in times of stress or challenge. And like stringing pearls together on a necklace, they add up to more than the sum of their parts.

Renowned Irish poet, Patrick Kavanagh, in his poem Canal Bank Walk, captures this with beautiful brevity and invites us to  ‘wallow in the habitual, the banal.’ 


(c) MindSurgery London 2017




No Crayons Required – Busting the Myths about Mindfulness

No Crayons Required – Busting the Myths about Mindfulness

(This is an open letter to the journalist Eva Wiseman following the publication of her article on Mindfulness in the Observer newspaper in the UK. Read the original article at

Dear Eva,

I was struck, when writing this response, how difficult it was to clearly articulate how alarmed I was at the suggestions made in your article “The Mind-blowing Expense of Mindfulness” (Observer 13 Sept 2015). I found it difficult because – as you will know – writing is a skill. It is to be learned, honed, practised and perfected. The same, you might be surprised to discover, is true of mindfulness.

As a Clinical Psychologist, Mindfulness is a part of some of the psychological therapies I use in my clinical work (with not a colouring book in sight!). Mindfulness is a component of a number of types of evidence-based psychological therapies.  It is recommended by the National Institute of Clinical Excellence (NICE) as treatment for recurrent depression as it cuts relapse rates in half; it is regularly used in the NHS for a range of difficulties as diverse as chronic pain, dealing with difficult emotions, recurrent depression and coping with physical health conditions. As evidence supporting Mindfulness based therapies has grown, the benefits of mindfulness for general well-being have also been established (unsurprisingly, as mental health problems are on a continuum with well-being).

I mention this evidence and application to well-being as I was concerned and non-plussed to see the practice of mindfulness put into the same bracket as hipsters munching Coco Pops. As with any trend, there is a danger that mindfulness, as it gains in popularity, becomes co-opted, a watered down ‘buzz word’ used to sell products which are not rooted in science. In such a situation, it is yet more important for people to be informed about what mindfulness really is. This is one of the reasons that I am so concerned about the misconceptions in this article, as, at the same time as decrying the popularisation of mindfulness,  it feeds in to the myths about mindfulness that render it a meaningless buzz word, and the reduction of its concepts and adherents into jaded stereotypes.

The article is full of misconceptions about mindfulness.

Practising mindfulness is not to ‘stop thinking’. At its heart, mindfulness is about paying attention in the present moment, on purpose, in a non-judgemental way.  it is about developing a different relationship with our thoughts, stepping back from our thoughts and realising that we are not our thoughts. Mindfulness is about observing our patterns of thought-response, and recognising our thoughts for what they are – mental events.

Mindfulness is not a means for us to  ‘buy inner peace’, just as a gym membership doesn’t buy you a six pack. Mindfulness is a skill and a practice that can be learned and practised and has a wide range of benefits. Like exercise.

Mindfulness is not  ‘paid-for passivity’, neither is it a retreat to an infantile world. Mindfulness is the opposite of this, it is about engaging with the world, right now, in the present moment, which is the only moment we’ve got. It is about engaging with the world and our experience directly, instead of getting caught up, as we do so easily, in the flotsam and jetsam of thoughts and feelings.  The nature of the mind is such that our thoughts tend to take centre stage; the mind jumps, like a monkey, from one thought to another, a ceaseless merry go round which distracts us from the present moment. Mindfulness helps us to be in the present moment, to ‘switch on’ rather than ‘switch off’.

The idea that mindfulness is something one can just pick up ‘working out the method from the word’ is misguided.  Can we write well because we understand the concept of writing? We cannot. Many people are fooled into the idea that Mindfulness is easy – it is not. It is, at heart, a simple idea, but it is not easy.  Thousands of years of religious traditions, in addition to scientific study and research,  recognises that Mindfulness practice is something that needs to be learned, practised, and maintained.

Finally, to the title of the article – you refer to the ‘mind-blowing expense’ of mindfulness. At £7.95 a month, I think the Headspace app is excellent value, and significantly less outlay than a month’s worth of The Observer. Mindfulness based therapies as part of NHS treatment are, like all talking therapies, delivered free at the point of access.

But Mindfulness is something that really has to be experienced to be understood.  I would like to invite you to our next taster session of Mindfulness for well-being. No crayons necessary. Just an open mind, or one willing to be opened.

For further details see

Dr S Yap

Chartered Clinical Psychologist

Mindsurgery London

When sex hurts….

When sex hurts….

There are various medical terms to describe different types of female genital pain – dyspareunia, vaginismus, vulvodynia, vestibulitis, pelvic pain… As a specialist Clinical Psychologist and qualified psycho-sexologist, sometimes the women I work with have one of these diagnoses, and sometimes no diagnosis at all. Often women have had multiple diagnostic labels, which can be even more confusing.

If you are experiencing pain during sex, it is important to first investigate any medical factors that might be causing or contributing to your sexual pain problem.

‘This is not all in my head!’

Some women are disappointed that medical examinations and tests do not show up any physical explanation for their problem. Other times, the biological factors (such as a skin problem, for example) contributing to the pain has been treated but still the problem persists.

One of the questions people often ask me is “Do you think it is all in my mind?”, as if somehow they are imagining their problem or causing it themselves, or that their problem is not ‘real’.  It is important to remember that the body and mind are connected in complex ways, so dividing problems into body versus mind is not a helpful or representative way of looking at problems.  When we look at women’s sexual response cycle as well as the psychology of the pain system, it is clear that sexual pain problems are complex, involving physiological and psychological systems which are inter-related, and feed information back to each other. A specialist psycho-sexology approach, in addition to recommended medical treatment where advised, has been shown to be effective for female sexual pain problems.

Just as specialist Clinical Psychologists play a key role in treating chronic pain problems, clinical psychologists also play a key role in treating sexual pain problems. Everyone’s problem is different and therefore treatment and therapy is tailored to the individual.

I have worked with many clients who thought that they would never have pain-free or even enjoyable sex again, and came along to psychology reluctantly, as a ‘last ditch effort’, only to surprise themselves by how much progress they made in a relatively short space of time, and have been able to reclaim their bodies and resume a pleasurable sex life.


Mindsurgery London provides individual sessions, face-to-face and over Skype, for a range of psychosexual issues. See for more details.



Mindfulness and Anxiety: Observing the Storm

Mindfulness and Anxiety: Observing the Storm

The human mind is designed to detect threat. It is primed to be alert to danger so that it can keep us safe and ensure our survival. Our brain developed in a different environment to the one in which we now live. When our ancestors heard a storm coming in on the savanna, worrying about finding shelter quickly and feeling anxiety in the body – racing heart, breathing faster – helped to prioritise survival.  The problem now is that modern threats are very different in nature. In the Western world, most of us are lucky enough not to have to worry about our basic survival needs: food, shelter, water, predators.  But we still have the same brains, the same hardware with which we experience our world.  So instead, we worry about events in the future, what may happen, or things that have no immediate answer, setting ourselves up for chronic worry.

We can get stuck in our heads, worrying about a situation, convincing ourselves that X or Y will happen.  We can feel trapped with the worry, with no escape.  Our attention is completely focused on the worry thoughts, and sometimes it can be immobilising. We can get trapped in our heads trying to fight against worry, or push it away.

We can’t get rid of our capacity for worry, and neither should we want to. We need to understand our brain and its tendency to worry and how we can work with that rather than against it.

Mindfulness techniques can be useful in managing worry as they can teach us to become skilled in focusing our attention. When we worry, our attention is directed internally, we can find it difficult to focus on anything other than the worry. Mindfulness techniques train us to cultivate our attention; if we think of attention like a spotlight, worry hogs the spotlight at the expense of everything else. Mindfulness can teach us to direct that spotlight at other things, thereby using a different part of our brain, switching from thinking mode to perceiving mode. When we worry, we can get caught up in our thinking mode, and get locked into a battle… if this happens, what will I do, how will others react, what will happen then… At times like this, it can be beneficial to switch into perceiving mode and change gear as our thinking mode is not helping us.  Perceiving mode is about turning our attention to moment-by-moment experience.  What is there when we direct our attention away from the worry? There is you – a body, much more than the sum of your thoughts, breathing, existing in this moment, being.

With regular practice, mindfulness techniques can teach us how to relate to our worry differently. We can learn to observe our thoughts by taking a step back and recognising thoughts as just that, thoughts.  Thoughts do not necessarily reflect reality however much our anxious minds try to convince us of it. Our thoughts are not always the storms we think they are; with mindfulness we learn to observe the storm instead of getting swept away by it.

Both anxiety and mindfulness are huge topics, and this blog is merely the briefest of introductions. To find out more, see our other blogs on mindfulness and try our free guided mindfulness exercise to learn more about the topic.  Mindsurgery London runs mindfulness courses in the workplace and for the public. Contact us for more details.

© Copyright MindSurgeryLondon Ltd. 2016

5 Things Mindfulness Is Not




1. It’s Not Easy

Mindfulness seems to be everywhere these days and yet what it is exactly can seem unclear. Let’s start with what it’s not…

At the heart of mindfulness is a very simple idea; it is about paying attention in the present moment, in a particular way.  It may be a simple idea, but it’s not easy. You might have already noticed this if you have tried even a short Mindfulness exercise and seen how your own mind has a very strong tendency to wander off in all directions and jump from thought to thought.

2. It’s Not About Clearing Your Mind!

This one might surprise you. Mindfulness is not about clearing the mind, or having a blank mind, because that would involve pushing thoughts away, which would get you into a situation where you are wrestling with your mind. Mindfulness is not about striving or struggling at all. It is about observing the full range of present moment experience, including thoughts, bodily sensations, and feelings, holding them all in spacious awareness.

3. It’s Not About Relaxation!

Again, this might surprise you. The goal of mindfulness is not relaxation or helping you get to sleep. Some people find that it does both, but again, these are happy by-products of practising mindfulness rather than the aim itself. Mindfulness is about falling awake, about showing up, with full attention, for the present moment.  This is why it is best to practice Mindfulness at times of the day when you can practice for the amount of time that you want, and not fall asleep after the first 2 minutes of practice.

4. It’s Not Just For When You’re Feeling Stressed!

It’s not just for when you are feeling stressed.  Sometimes people think that they only need to practice Mindfulness when they feel stressed or worried.  This is not the case.  Mindfulness is an on-going practice that has benefits for your entire quality of life.  You wouldn’t only go the the gym the day that you are doing a marathon, you would have put in hours of training before the big day. It’s the same with mindfulness, it is about training your attention, and, in some ways, a bit like taking your mind to the gym, you need to practice regularly to see benefits and also to be able to draw on the skills at difficult time.

5. It’s Not Just For A Particular Type Of Person!

Anyone can practice Mindfulness and see benefits.  You don’t have to have a particular personality type, you don’t have to have an interest in complimentary health, you don’t need to have a particular faith or an interest in the spiritual, you don’t have to be a yogi or a Buddhist,  (and of course if that’s you, that’s great) but the point is, the benefits of Mindfulness can be accessed by anyone who is willing to learn about it and to practice.

If you are interested in trying out a mindfulness practice, listen to the 5 minute breathing space exercise at or contact us for details on our mindfulness workshops and courses.

Copyright 2015 © MindSurgery London

Rumination:’Chewing the Mental Cud’

Cow 2

Have you ever watched a cow chew the cud? The mechanic, circular movement of the jaw; the dead-eyed stare; the seemingly never-ending sameness of the action. The word “ruminate” derives from the Latin word for chewing cud, a process in which some animals grind up, swallow, then regurgitate and rechew their food. Similarly,  as humans, we can all have a tendency to  ruminate or mull over a situation, turning it over and over in our heads.    It becomes rumination and not problem solving when we no longer have any new ideas about solving the problem, but replay the situation in our minds regardless.  When ruminating we tend to focus on causes and consequences rather than solutions; why has this happened to me or what will happen in the future rather than how can I solve this. We all ruminate to a greater or lesser degree; think about a conversation you’ve had with, say, your boss at work, a conversation that didn’t go the way you’d hoped. You turn it over and over in your mind, worrying at it, second-guessing and teasing out meanings that may or may not be real. The gift keeps on giving – we have all had the experience of thinking back on something that irritated or annoyed us, and feeling irritated and annoyed all over again even if the event happened quite a while back.

We ruminate because we are trying to come up with a solution, or trying to make sense of something.  Sometimes it can feel as if we are stuck in a rut of rumination that we cannot get out of.  In my experience as a Clinical Psychologist, I regularly see how rumination is linked to anxiety and depression.  This is supported by large scale research which shows that excessive rumination on negative events acts as a mediating factor between a negative life event and stress and is the biggest predictor of depression and anxiety.  In other words, a bad thing can happen in your life, but if you have a tendency to ruminate on this, you are much more likely to experience higher stress and increased risk of developing anxiety and depression. It is not only what happens, but how you process what happened that is important.

It is not just our mental well-being that suffers if we ruminate excessively, it also has a negative impact on the rest of our bodies.  Ruminating on  a stressful event can extend cortisol stress responses and keep the physical stress responses including pounding heart, breathlessness, sweatiness, feeling flushed or light headed going for longer too.   In this way, repeated rumination can have a negative impact on our physical health.

Breaking the habit of rumination

What can we do to break the habit of rumination? Seeing a Clinical Psychologist for a limited number of sessions can help change thinking habits.  Cognitive Behavioural Therapy or CBT is one of the approaches that you are likely to learn in sessions to give you practical strategies for managing your thoughts in a more helpful way.  Mindfulness based therapies can also be a very helpful approach to manage rumination as it teaches us not to attach to thoughts, and helps us to take a step back from the cycle of rumination.

Aside from individual sessions with a Clinical Psychologist, there are also practical first steps that you can take now to reduce rumination:

  1. Become aware of when you are ruminating.  ‘Thought catching’ or identifying that you are ruminating is the first step towards change. Take time to check in with your mind throughout the day and see what it is doing.
  2. Once you catch yourself ruminating, label it as such by saying to yourself ‘I’m engaging in rumination now’ thus creating a distance between you and your thoughts.
  3. Distraction and switching activities can also be a good way to start to break the cycle of rumination.  Beware of passive activities like watching TV or surfing the Internet as these are prime times when our minds can slip into ruminating without us being aware.   If you sit on the couch with the TV on, but really you are ruminating on an argument with a loved one, then you need to do something to focus your attention elsewhere. Get up and engage your attention with another task – plan your day, make a call, do a crossword, decide what to cook for dinner…it can be as mundane or marvellous an activity as you like as long as it involves focusing your attention somewhere else.
  4. Go for a walk – it may be what your granny told you but there is research to show that going for a walk in a nature filled area is correlated with lower levels of rumination. The nature bit is important, just going for a walk around the block won’t do it – research has shown that urban walks did not have the same effect on rumination as a walk in a natural environment. Go walk in your local park, a forest, or a farm – you might even meet those cows, ruminating, while you free yourself from it!

© Copyright MindSurgeryLondon Ltd. 2016

MindSurgery London provides individual therapy sessions and also runs events for well-being and mental health. For further information please contact us at


Kinderman P, Schwannauer M, Pontin E, Tai S (2013) Psychological Processes Mediate the Impact of Familial Risk, Social Circumstances and Life Events on Mental Health. PLoS ONE 8(10): e76564. doi:10.1371/journal.pone.0076564

Zoccola, P. M., Figueroa, W. S., Rabideau, E. M., Woody, A. & Benencia, F. (2014). Differential effects of poststressor rumination and distraction on cortisol and C-reactive protein. Health Psychology, 33, 1606-1609. doi:10.1037/hea0000019

Gianferante, D., Thoma, M. V., Hanlin, L., Chen, X, Breines, J,. Zoccola, P. M., & Rohleder, N. (2014). Post-stress rumination predicts HPA axis responses to repeated stress. Psychoneuroendocrinology, 49, 244-252. doi:10.1016/j.psyneuen.2014.07.021

Zoccola, P. M., Rabideau, E. M., Figueroa, W. S., & Woody, A. (2014). Cardiovascular and affective consequences of ruminating on a performance stressor depend on mode of thought. Stress and Health, 30, 188-197. doi:10.1002/smi.2588

Bratman, G.N. , Hamilton , J.P., Hahn , K.S, Daily, G.C & Gross, J. (2015).  Nature experience reduces rumination and subgenual prefrontal cortex activation. PNAS.


The Desire Myth: The things you never knew about sexual desire

The Desire Myth: The things you never knew about sexual desire

What if we were missing some vital information on desire and how it works in our bodies? What if this information could help us view our bodies and our sex lives differently?

In my clinical practice as a Psycho-Sexologist and Clinical Psychologist, I see many women who feel that something is very wrong with them if they don’t experience sexual desire in the way that they expect.  They complain of low libido, low sex drive, no interest in sex….

Behind these complaints is often the idea is that desire is something innate, something that we feel or that we don’t, something that is spontaneous and cannot be forced.  But where do these ideas come from? Popular culture, magazines, films, all portray desire as something we can think of as spontaneous desire.  Spontaneous desire is high adrenaline, it’s exciting, it’s ripping each others clothes off.. it’s Hollywood, it’s porn, it’s advertising, it’s pop songs.

But, is there more to desire than this? Our understandings of sex and desire have been changing slowly over the past 50 years, since Master’s and Johnson’s pioneering sex research.  More recent theory and research led by Rosemary Basson, Clinical Professor at University of British Columbia, and her colleagues, introduced the concept of responsive sexual desire.

Responsive desire is when the motivation to have sex begins AFTER something sexy has started happening. For example, you are sitting on the couch watching TV, not thinking about sex at all, not feeling remotely horny, and your partner leans over and starts kissing your shoulder, your neck, and you think, ‘Mm thats nice’, and things continue and after a while you feel desire, ‘in the mood’. That’s responsive desire. You are responding to the context and situation. Desire has come out of an openness to go with what feels good.

Desire can be spontaneous or responsive. Desire is not a pre-requisite for sex, it can follow with an openness to see what feels good. Of course there are reasons that some men and women don’t experience either spontaneous or responsive desire, and that can be very difficult, but more about that in another post..

Spontaneous desire is more common a style in men, and responsive desire more common in women, but both men and women can experience both at different times.  Women’s desire tends to be more varied and more sensitive to context. Relationship dynamics, mood, intimacy, and how we feel about our bodies, all play an important role in women’s sexual response.

Research on style of responsive versus spontaneous desire in men and women and found that about 30% of women and 5% of men experience their sexual desire as more or less exclusively responsive, while about 15% of women and 75% of men experience their desire as more or less exclusively spontaneous. About half of women experience some combination of both spontaneous and responsive desire, depending on the context.

Why do we need to know this?

Media and popular culture and even out-dated academic research may have us believe that if, as women, we don’t feel desire in the way that it is most commonly culturally portrayed then SOMETHING IS WRONG WITH US… Responsive desire doesn’t translate so well onto the screen or into cultural media. It’s a slower burn. But it is absolutely just as normal as spontaneous desire.

Understanding responsive and spontaneous sexual desire can change how, as women, we view ourselves and our sex lives. It saddens me when I see women who are so quick to label themselves and their bodies as faulty in some way, when it is perfectly normal to not feel spontaneous desire much or any of the time. And of course, this can lead to a vicious circle where some women feel that they are not meeting some imagined sexual standard in terms of desire and sex drive, so then feel less sexy, and are less likely to experience desire.  If they believe that spontaneous desire is the one true desire, then they can often abort any sexual activity without going with the flow to see if desire follows….

Men, what does this mean for you?

Often the male partners I see feel that their partner’s lack of spontaneous desire means that she has gone off them, or are no longer attracted to them.  At the beginning of a relationship, sex is commonly more frequent, and spontaneous desire is more common in both men and women. With time, as the relationship progresses, frequency of sexual activity reduces, and also the responsive style of desire can become more dominant for some women. Men, be reassured that simply because she does not experience desire in the same pattern as you, this does not (necessarily!) mean she is not attracted to you or that she has low libido.

Take charge of your sex life!

There is nothing more guaranteed to kill any kind of desire than the belief that you are somehow broken or faulty.  Language matters. The more you and your partner label you as being somehow ‘deficient’ in desire, the less opportunities you have to escape this label. So, embrace your desire style, whatever it is. If responsive desire is more common for you, think with your partner about how you can create situations so that you are open to responsive desire.

Let’s start breaking down the dominance of spontaneous desire. Let’s stop buying into the idea that desire is one dimensional.

So perhaps the question to ask your partner is not ‘are you in the mood tonight darling?’ But rather, are you up for seeing if you get into the mood…

Mindsurgery London provides individual sessions, face-to-face and over Skype, for a range of psychosexual issues. See for more details.