Introduction to Mindfulness

1. Introduction to Mindfulness

2. Presenter Alexandra Arbogast, LICSW, RYT, CMT Program Coordinator & Therapist Mind-Body Medicine Program Internal Medicine / Warrior Clinic / NICoE WRNMMC 301-319-4960 / Alexandra.S.Arbogast.ctr@mail.mil

3. The Mind-Body Medicine Programat Walter Reed - Bethesda • Based on the premise that the mind and body are intimately interconnected. Utilizes techniques to optimize this relationship for improved health and wellbeing. • Teach mindfulness-based skills that can be integrated into daily life to reduce stress, manage pain, enhance sleep, strengthen positive qualities, and improve overall quality of life. • Offers a low-cost, self-directed, complement to traditional medical care.

4. Mind-Body Skills • Mindfulness • Attention training to cultivate qualities of concentration, clarity, and equanimity. The common thread connecting all other skills. • Relaxation • Techniques to elicit the relaxation response in mind and body • Yoga • Movement and breathing strategies to synchronize mind and body and release tension. • Positive Psychology • Practices to cultivate and strengthen positive mind/emotional states. • Resiliency Training • Techniques for balancing the nervous system, processing trauma, and strengthening the ‘resilient zone’.

5. Mindfulness

6. It’s Hot!

7. What is it? “Mindfulness means paying attention in a particular way; On purpose, in the present moment, and nonjudgmentally.” -Jon Kabat-Zinn Founder of Mindfulness-Based Stress Reduction (MBSR)

8. Regular Practice Cultivates 3 Core Skills • Concentration:The ability to focus and stabilize one’s attention. • Sensory Clarity:The ability to keep track of the components of sensory experience as they arise in various combinations, moment-by-moment. • Equanimity: The ability to ‘be with’ experience with an attitude of gentle matter-of-factness.

9. Mindfulness Training Techniques • Many techniques! Depends on teacher and tradition • Restrictive or open attention • Noting option • Beginner practices: • Restrictive focus, such as breath meditation • Develops/strengthens core skills of concentration, clarity and equanimity • Intermediate / advanced practices: • Open awareness to increasing amount of sensory experience, such as “choiceless awareness” • Formal and informal practices

11. Where Does It Come From? • In the 19th century, mindfulness was used to translate the Pali word Sati. Pali is the canonical language of Theravada, a form of Buddhism found in Southeast Asia. • “Establishing Mindfulness” (Satipatthana) is a primary practice of Theravada Buddhism. • It is said to lead to insight into the true nature of self and reality (impermanence, the suffering of conditioned existence, and non-self)

12. Mindfulness Arrives in the West • In the 60’s and 70’s, Westerners began going to Southeast Asia to learn mindfulness practices. They brought those practices back to the West and began to teach them within the framework of Buddhism. • In the 80’s and 90’s, it was discovered that those practices could be extracted from Buddhism and the cultural matrix of Asia and used within a secular context.

13. Secular Mindfulness • Mindfulness awareness practices started to be used within a secular context to develop useful attentional skills. • These practices became ever more prevalent in clinical settings for pain management, addiction recovery, stress reduction, and as an adjunct to psychotherapy.

14. Mindfulness in Healthcare • In 1979, Jon Kabat-Zinn created Mindfulness-Based Stress Reduction (MBSR) at the University of Massachusetts Medical School to treat chronically ill patients. • Subsequently, a number of other psychotherapeutic modalities centering around mindfulness were developed: Acceptance and Commitment Therapy (ACT); Mindfulness-Based Cognitive Therapy (MBCT); Dialectical Behavioral Therapy (DBT).

15. Mindfulness in Society Increasingly, it is being understood that mindful awareness is a cultivatable skill with broad applications through all aspects of society, including education, prison system, politics, business, and even the training of soldiers.

16. The Benefits of Mindfulness

17. Mindfulness… Changes the Brain in Positive Ways

18. Shows how the brain changes in positive ways with meditation!

19. Overcoming Fear and Anger Old Brain Vs. New Brain

20. Neuroplasticity • Recent research in neuroscience shows that we have the power to influence our brains. • When we think certain thoughts, it strengthens those neural circuits. Mental States Become Neural Traits! • Self-Directed Neuroplasticity = Nurture positive states of mind to strengthen and build those neural networks. Make Happiness a Habit! The brain is like a muscle that we can build through practicing skills.

21. Pro-Social Behavior • Impulse Regulation • Emotional Awareness • Compassion & Empathy • Forgiveness

22. Compassion Cultivation Training Stanford University’s School of Medicine The Center for Compassion and Altruism Research and Education (CCARE)

23. Mindfulness… Helps Balance the Nervous System

24. Stress Response

25. Stress Response Central Nervous System Perception - Narrowed Memory - Coarse, Imprecise Learning - Blocked Conditioning - Defense Tendency - Regress or Perseverate Tone – Fight or Flight Autonomic Nervous System Heart rate increases Blood pressure increases Oxygen need increases Breathing rate increases Palms, face sweat Blood sugar increases Adrenalin flows Digestive tract shuts down blood to muscles Blood vessels constrict in hands, face Muscular System Tension Ready for Action Jaws Clench Body Braces for Action

26. Relaxation Response

27. Relaxation Response

28. Mindfulness… Improves Self-Regulation

29. Release charge charge The Resilient Zone In our “Resilient Zone” we have the best capacity for flexibilty and adaptability in mind, body and spirit. resilient zone Mindfulness helps deepen the Resilient Zone 29 29

30. Stressful/Traumatic Event or Stressful/Traumatic Triggers Hyperactivity Hypervigilance Mania Anxiety & Panic Rage Pain Stuck on “High” Hyper-arousal resilient zone Depression Disconnection Exhaustion/Fatigue Numbness Stuck on “Low” Hypo-arousal Graphic adapted from an original graphic of Peter Levine/Heller

31. Let’s Practice!

32. Breath-Focus Meditation Trains the mind to settle, let go of mental clutter, and focus in the present moment. Connects mind with body. • Find a comfortable position either lying down on your back, in a chair, or on a cushion on the floor. Spine should be erect but not rigid. • Scan through the body and release unnecessary tension. • Bring attention to the body with an attitude of friendly curiosity. • Tune into the sensations of your body breathing and focus your attention on the feel of the breath coming in and out. • When your mind wanders, notice, and gently guide attention back to the breath (over and over again). • Practice for 5-30 minutes daily for lasting positive results.

33. Body Scan Meditation Connects mind with body. Increases ability to track body sensations. Grounds attention in the present moment. Increases insight into changing nature of sensation. Trains mind to tolerate sensation with greater equanimity. • Bring curious, friendly attention to the sensations in your feet. Feel vs think. • Gradually move your way up the body…feeling the ankles, lower legs, knees, upper legs. • Feel sensations in the buttocks, the lower back, middle back, and upper back. • Notice sensations in the pelvis, abdomen, and chest. • Sense the fingers, hands, wrists, forearms, elbows, and upper arms. • Feel sensations in the shoulders. Notice any tension without judging it or trying to change it. • Notice sensations in the neck, throat, jaw, and mouth. • Sense the nose, eyes, forehead, ears, and head. • Feel sensations in the whole body at once. The whole body as one universe of sensation.

34. Next Steps

35. Regular Practice • Create ‘Mindful Pauses’ throughout your day. • Take 1-5 minutes to practice slowing down, feeling the body, breathing more fully, letting go of thoughts, and returning to the present moment with gratitude and acceptance. • Set aside 5-30 minutes a day for meditation, yoga, art, or another mindful activity you enjoy. • Surround yourself with support. Get books, audio, phone apps to learn more and keep you motivated in the practice. • Take a mind-body class • Do a meditation retreat

36. Questions or CommentsAlexandra Arbogast: 301-319-4960 / Alexandra.S.Arbogast.ctr@mail.mil