Mindfulness in Clinical Practice
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Transcript Mindfulness in Clinical Practice
Mindfulness &
Self-Care
Refresh and Renew
April 30, 2011
Richard Sears, PsyD, MBA, ABPP
Director, Center for Clinical Mindfulness & Meditation
Core Faculty, PsyD Program, Union Institute & University
The Nature of Stress
Goal is not zero stress,
but to find balance
Stress Response
Release
of adrenalin & cortisol
Increased
Reduced
heart rate & blood pressure
blood flow for digestion
Increased
blood flow to major muscles
Stress Response
Stress
response for short-term
emergencies is good – countered
by relaxation response
Chronic
stress causes many
problems – overwhelms natural
balance systems
Up
to 90% of doctor’s visits are for
conditions in which stress at least
plays a role
Nature of Stress
Stress alone does not cause disease
Makes you more vulnerable to disease
Makes current conditions worse
5 Ways to Well-Being
Connect…
Be active…
Take notice…
Keep Learning…
Give…
centre for well-being, nef (the new economics
foundation)
5 Ways to Well-Being
Connect…
With the people around you. With
family, friends, colleagues and
neighbours. At home, work, school or
in your local community. Think of these
as the cornerstones of your life and
invest time in developing them.
Building these connections will
support and enrich you every day.
5 Ways to Well-Being
Be active…
Go for a walk or run. Step outside.
Cycle. Play a game. Garden. Dance.
Exercising makes you feel good. Most
importantly, discover a physical activity
you enjoy; one that suits your level of
mobility and fitness.
5 Ways to Well-Being
Take notice…
Be curious. Catch sight of the beautiful.
Remark on the unusual. Notice the
changing seasons. Savour the
moment, whether you are on a train,
eating lunch or talking to friends. Be
aware of the world around you and
what you are feeling. Reflecting on
your experiences will help you
appreciate what matters to you.
5 Ways to Well-Being
Keep Learning…
Try something new. Rediscover an old
interest. Sign up for that course. Take
on a different responsibility at work. Fix
a bike. Learn to play an instrument or
how to cook your favourite food. Set a
challenge you will enjoy achieving.
Learning new things will make you
more confident, as well as being
fun to do.
5 Ways to Well-Being
Give…
Do something nice for a friend, or a
stranger. Thank someone. Smile.
Volunteer your time. Join a community
group. Look out, as well as in. Seeing
yourself, and your happiness, linked to
the wider community can be incredibly
rewarding and will create connections
with the people around you.
What is Mindfulness?
Historical
Perspectives
Present in many cultures
Eastern
Wisdom Traditions
Siddharta Gautama
- 8 levels of samadhi (absorption)
- Added insight meditations
What is Mindfulness?
“the awareness that emerges
through paying attention
on purpose,
in the present moment,
and nonjudgmentally
to the unfolding of experience
moment to moment”
(Kabat-Zinn, 2003, p. 145)
What is Mindfulness?
Mechanisms
Worry/rumination
Negative Reinforcement
Exposure Therapy
Decentering/Defusion
Need
for Systematic Training
Homework practice
Journal
What is Mindfulness?
Being vs. Doing
Being: Present focused
Doing: Future focused
What is Mindfulness?
Differences
Transcendental/Absorption
Hypnosis
Relaxation
Methods
Meditation
What is Mindfulness?
Mindfulness-Based Stress Reduction (MBSR)
Mindfulness-Based Cognitive Therapy (MBCT)
Dialectical Behavioral Therapy (DBT)
Acceptance and Commitment Therapy (ACT)
Mindfulness-Based Relapse Prevention (MBRP)
Mindfulness-Based Eating Awareness Training
Mindfulness-Based Elder Care (MBEC)
Mindfulness-Based Childbirth & Parenting (MBCP)
3-Minute Breathing Space
Essence
of MBSR/MBCT program:
Body Scan
Mindfulness of Breath
Mindfulness of Body as a Whole
Mindfulness of Thoughts
3-Minute Breathing Space
1 – “Tuning In”
Notice what is here
Minute
Body sensations
Feelings
Thoughts
Let go of judgments, as best you can
“it’s already here, just let me feel it”
3-Minute Breathing Space
2 – “Gathering”
Focus on the breath
Minute
Pay attention to one spot – rising
and falling of abdomen, nostrils, etc
Mind wanders, just gently bring it
back, again and again
3-Minute Breathing Space
Minute
3 – Expand awareness
Expand from breath to
body-as-a-whole
Obstacles to Self Care
Time
Priorities
Focus
on others
Not feeling that we are worth it
Bringing mindfulness into daily life
Self-monitoring
Take
a breath, take a break
Become aware of
thoughts/feelings/sensations
throughout the day
Leaving issues at work
Noticing tension in your body
Noticing feelings and thoughts
“how interesting,
there you are again”
Investigating vs. Letting Go
Insomnia
by Billy Collins
Even though the house is deeply silent
and the room, with no moon,
is perfectly dark,
even though the body is a sack of exhaustion
inert on the bed,
someone inside me will not
get off his tricycle,
will not stop tracing the same tight circle
on the same green threadbare carpet.
It makes no difference whether I lie
staring at the ceiling
or pace the living room floor,
he keeps on making his furious rounds,
little pedaler in his frenzy,
my own worst enemy, my oldest friend.
Insomnia
by Billy Collins
What is there to do but close my eyes
and watch him circling the night,
schoolboy in an ill-fitting jacket,
leaning forward, his cap on backwards,
wringing the handlebars,
maintaining a certain speed?
Does anything exist at this hour
in this nest of dark rooms
but the spectacle of him
and the hope that before dawn
I can lift out some curious detail
that will carry me off to sleepthe watch that encircles his pale wrist,
the expandable band,
the tiny hands that keep pointing this way and that.
Mindful Stress Reduction
Groups
Based on MBSR & MBCT
8 sessions, 90 minutes each
Mindful Stress Reduction
Class consists of discussions of
stress, anxiety, & depression
Practice of mindfulness
exercises
Discussions of how to apply this
to daily life
Not required to disclose
personal info
Mindful Stress Reduction
30 minutes of homework
required each day between
classes
Practice exercises on CD
Practice daily activities mindfully
Mindfulness for providers
significant
declines in stress,
negative affect, rumination,
state and trait anxiety
significant
increases in positive
affect and self-compassion.
(Shapiro, Brown, & Biegel, 2007)
Mindfulness for providers
Training
in mindfulness increases
provider effectiveness and
patient mental health, even if
providers do not explicitly use it
with patients (Grepmair et al. 2007).
Loving-kindness
meditation
Suggested Readings
Full Catastrophe Living (MBSR)
Jon Kabat-Zinn
The Mindful Way through Depression
Williams, Teasdale, Segal, & Kabat-Zinn
Mindfulness in Clinical Practice
Sears, Tirch, & Denton – forthcoming from
Professional Resource Press
Contact
Richard Sears
www.psych-insights.com
513-487-1196
Alliance Institute for Integrative Medicine
www.myhealingpartner.com
513-791-5521