John M. Talmadge, M.D.

A Blog Covering Many Topics

Spiritual Reflection, Contemplation

A contemplation experiment: research says that if we practice a new habit for 21 days our brains adapt and, after a fashion, rewire around the new habit. With a friend I have agreed to read a morning meditation from "the little black book," 24 Hours a Day. Each day we agree to share our reflections with each other. Here is Day One.

9/22 Woke up feeling pretty good for an old man. 24 Hour book was on coffee table when I sat down with my cup of java. What I got from the reading was that "each day is an opportunity to serve God." This is curiously one of those insights that often makes me smile. I call these my "baloney sandwich" moments. In 1986 I was alone in my kitchen, having just turned 40, and I was spreading mayonnaise on a slice of bread, grabbing a quick bite before charging off to whatever I had to face that day.
For reasons I have never understood, the thought occurred to me that all God asks is that we love God and serve God by doing what He would have us do. Within two seconds the experience had passed, and I was standing there with bread and baloney. How strange to think now, thirty years later, that I have never forgotten a baloney sandwich. Perhaps God was telling me that on the one hand I have "bread for the journey," and on the other hand there is "the baloney of my life." This never fails to bring a smile, because I usually expect that God should bring me a burning bush, a blinding flash of light, or at the very least the power to part the Red Sea or raise Lazarus from the dead. "No, John," God seems to say, "you're confusing the bread with the baloney. Just eat your sandwich, and I will tend the universe around you."
When Brother Lawrence wrote his letters about the Practice of the Presence of God, he said that he realized that he could feel close to God in the privacy and relative darkness of his monastic cell, but that he experienced God most clearly when he was amidst the noise, heat, and commotion in the monastery kitchen, where he had once despised his job as a distraction and a burden. Today I will think on these things as I toil and sweat, perhaps enjoying the discernment that helps me distinguish the bread from the baloney. I am smiling as I write this.

Addendum: Brother Lawrence was a man of humble beginnings who discovered a secret about living spiritual life here on earth. That "secret" is the art of "practicing the presence of God in one single act that does not end." He often stated that it is God who paints Himself in the depths of our soul. We must merely open our hearts to receive Him and His loving presence. For nearly 300 years this unparalleled classic has given both blessing and instruction to those who can be content with nothing less than knowing God in all His majesty and feeling His loving presence throughout each simple day. You can browse a copy of the book on Amazon here.

Twenty-Four Hours A Day is available through major booksellers, and also from Hazelden. Written by Richmond Walker, it's a book that offers daily thoughts, meditations and prayers to help recovering alcoholics live a clean and sober life. It is often referred to as "the little black book." The three most published A.A. authors are Bill W., Richmond Walker, and Ralph Pfau, in that order. Ralph, who lived in Indianapolis, became in 1943 the first Roman Catholic priest to get sober in A.A., and under the pen name "Father John Doe," wrote the fourteen Golden Books© along with three other books, all of them still in print and read by A.A. people today. Richmond Walker got sober in Boston in May 1942, and later moved down to Daytona Beach in Florida, where in 1948 he published Twenty-Four Hours a Day©, which became the great meditational book of early A.A. from that point on.

Mindfulness Therapy: Alternative to Antidepressants

Many psychiatrists like me recommend mindfulness and cognitive therapy to our patients. These two approaches work well together because psychotherapy ("talk therapy" is best when individualized rather than using a "cookbook" approach. One size does not fit all. The legendary British medical journal The Lancet (April 2015 includes a recent scientific paper showing that mindfulness-based cognitive therapy (MBCT) could provide an alternative non-drug treatment for people who do not wish to continue long-term antidepressant treatment. This is one example of brain science at its best.


Mindfulness-based cognitive therapy aims to change the way people think and feel about their experiences. How we think affects how we feel. And the use of mindfulness practice is relatively easy for most people. Just 10-15 minutes two or three times daily makes a difference. The current study compares MBCT with maintenance antidepressant medication for reducing the risk of relapse in depression. The results are encouraging.

The study aimed to establish whether MBCT is superior to maintenance antidepressant treatment in terms of preventing relapse of depression. Although the findings show that MBCT isn't always more effective than maintenance antidepressant treatment in preventing relapse of depression, the results, combined with those of previous trials, suggest that MCBT may offer similar protection against relapse or recurrence for people who have experienced multiple episodes of depression, with no significant difference in cost.

"Mindfulness gives me a set of skills which I use to keep well in the long term. Rather than relying on the continuing use of antidepressants mindfulness puts me in charge, allowing me to take control of my own future, to spot when I am at risk and to make the changes I need to stay well." — Study Participant

MBCT builds on the insight that when people with a history of depression experience even a brief period of feeling low they tend to be especially vulnerable to negative thinking. That negative thinking is often accompanied by what’s known as “processing biases”: worrying about past problems, for example, or returning to unpleasant memories. Thinking like this raises the risk of a full-blown depressive episode.

MBCT focuses on helping people to become more aware of these thoughts and feelings, and thus better able to gain distance from them. As its founders put it: “We discover that difficult and unwanted thoughts and feelings can be held in awareness, and seen from an altogether different perspective – a perspective that brings with it a sense of warmth and compassion to the suffering we are experiencing.”