MINDFULNESS TOO! BRINGING THE PRACTICE HOME

1. MINDFULNESS TOO! BRINGING THE PRACTICE HOME Presented by Dianne Lemieux, Ph.D. & Elaine Rodgers, R.N.

2. Mindfulness Oriented PsychotherapyPractice Options 1) A therapist may develop a personal formal or informal practice of mindfulness meditation in order to develop a more mindful presence in psychotherapy. 2) A therapist may utilize a therapeutic frame which is informed by their own practice of mindfulness, research or literature regarding mindfulness or Buddhist psychology. 3) A therapist may teach patients how to practice mindfulness. Germer, C. (2005)

3. Personal Inquiry 1) Am I interested in pursuing mindfulness practice for my own personal and or professional growth? 2) Am I willing to commit to a daily practice of mindfulness? 3) How would I like to incorporate mindfulness in my clinical, teaching or consulting practice? 4) What further training do I need?

4. Forms of Meditation Practice • Concentration Practices use one-pointed focus on a single object (breath, sound, mantra, word, image) to calm and stabilize the mind. “Aim and sustain.” • Mindfulness or awareness practices cultivate an open awareness on what is happening as it is happening without judgment. Also sometimes referred to as insight meditation or Vipassana in the Theravada Buddhist tradition.

5. Concentration MeditationSamatha (laser light beam) • Samatha (Pali) : tranquility and concentration • Any object of awareness may be used as an object of concentration • Internal objects: words, images, a spot on the body, the breath • External objects: candle flame, mandala, image, a dot on the wall. • Benefit: calm, stable mind detached from emotional and interpersonal involvement • In concentration practice, the mind is gently returned to the object of meditation when we notice it has wandered. • The “Relaxation Response” (Benson, 1975) Germer, C. (2005)

6. Mindfulness MeditationVipassana, Insight (searchlight) • Sati (Pali): awareness, attention, remembering • Expanded focus on a wider range of objects as they arise in awareness one at a time. • Benefits: Greater awareness of the personal conditioning of our minds and an understanding of the mind itself • May include any sense (sight, sound, touch, smell, taste, hearing) as well as thoughts and emotions Germer, C. (2005)

7. Mindfulness/ConcentrationMeditations • Concentration and mindfulness practices actually complement each other • Mindfulness begins with concentration meditation. Once a certain stability of the mind is reached, the practioner shifts to a mindfulness focus. • Research suggests that the two forms of meditation are in fact neurologically different Lazar, S. (2005)

8. Definitions of Mindfulness “Mindfulness is paying attention on purpose non-judgmentally in the present moment.” Kabat-Zinn, J. (1994) “Mindfulness meditation is a consciousness discipline revolving around a particular way of paying attention in one’s life. It can be most simply described as the intentional cultivation of nonjudgmental moment-to-moment awareness.” Kabat-Zinn, J. (1996)

9. Definitions of Mindfulness • Mindfulness is “self-regulation of attention so that it is maintained on immediate experience thereby allowing for increased recognition of mental events in the present moment” and “adopting particular orientation toward one’s experience that is characterized by curiosity, openness, and acceptance” Bishop et al. (2004)

10. Components of Mindfulness • Intentionality • Present Centered Awareness • Acceptance/Non-Judgment

11. Mindfulness Practice is Not • Trying to have a blank mind • Trying to achieve a special state of mind or trance state • Avoiding difficulties • Escaping physical pain • Pushing away thoughts or emotions • Bypassing our personality problems • Withdrawing from other people • A relaxation technique • A religion

12. Attitudinal Foundations of Mindfulness Practice 1. Non-Judging 2. Patience 3. Beginner’s Mind 4. Trust 5. Non-Striving 6. Acceptance 7. Letting Go - Kabat-Zinn, J. (2005)

13. Modes of Practice • Informal • Formal • Intensive Retreat

14. Guided Informal Practice/Discussion

15. Informal Practice ExamplesFor Daily Life • Washing your hair • Brushing your teeth • Shaving • Taking a shower • Eating • Walking from your house to the car • Driving • Petting the dog • Washing the dishes (any chore)

16. Practice Opportunities For Mindfulness During The Day • Waiting for 3 rings of the phone before answering • Pausing before speaking • Notice getting up from your desk at work • Turning the computer on or off or switching applications take a mindful pause • Notice the action of walking through doorways • Notice the action of picking something up • Pause after looking at the clock or your watch

17. Quick and Instant Practice(Helpful for Anxiety) • Choose a reference point as a meditation bell • Stop and take three slow deep breaths • Bring the mind to the present moment on the in breath • Scan the body and relax as much as you can any tension held in the body on the out breath • Notice any thoughts/emotions • Proceed with what you had been doing

18. Quick and Instant Practice(with visualization) • Choose a reference point as a meditation bell • Stop and take three slow deep breaths • With each exhalation repeat the phrase “I feel calm, relaxed and at peace” or choose another phase that you resonate with. (Your visualization is a function of your intention for yourself.) • Proceed with what you had been doing

19. MBCTThe 3-Minute Breathing Space Basic Instructions 1. Awareness Bring yourself into the present moment by deliberately adopting an erect and dignified posture. If possible, close your eyes. Then ask: “What is my experience right now…in thoughts…,in feelings…and in bodily sensations?” 2. Gathering Then, gently redirect full attention to breathing, to each in-breath and to each out-breath as they follow, one after the other. Your breath can function as an anchor to bring you into the present and help you tune into a state of awareness and stillness.

20. MBCTThe 3-Minute Breathing Space Basic Instructions Continued 3. Expanding Expand the field of your awareness around your breathing, so that it includes a sense of the body as a whole, your posture, and facial expression. The breathing space provides a way to step out of automatic pilot mode and reconnect with the present moment. The key skill in using Mindfulness-based Cognitive Therapy (MBCT) is to maintain awareness in the moment. Nothing else. Segal, Z., Williams, J., Teasdale, J (2002)

21. On The Spot Informal Practices 1)Whenever you encounter distress this week, turn your attention toward it. 2) If your reaction is overwhelming to a particular part of the practice, take a break and switch to lovingkindness or mindfulness practice 3) Choose one day this week to do a kindness for someone and pay attention to all of the kindnesses that come your way on that day. 4) Practice inner smile on a daily basis. 5) Choose one day to do walking Metta meditation.

22. Guided Formal Practice/Discussion

23. Examples of Formal Practice • Sitting meditation • Standing meditation • Body Scan • Walking Meditation • Loving-Kindness/Compassion Practices • Contemplative Prayer • Yoga • Taiji • Qigong

24. Mindfulness Myths 1) I don’t have the time! 2) I’m too restless! 3) I am afraid of my mind! 4) I won’t get anything done! 5) It will take time away from my kids! 6) I can’t meditate! 7) I’m too tired!

25. The Five Hindrances to Meditation (From the Pali Cannon) • Attachment • Aversion • Sloth/Torpor • Restlessness/Worry • Doubt

26. Working with Attachment“Wanting Mind” Desire, lust, obsession with sensory objects or spiritual desires • Shift the attention of the mind from the object itself to the experience of the wanting mind. Equanimity practice is useful to bring in.

27. Working with Aversion Hatred, frustration, impatience, guilt, depression, pain, resistance • Avoid going into the practice with the attitude “If I’m mindful, it will go away” • Don’t bore into the aversion or it will feel like a pressure cooker. Open attention wide and alternate between the aversive experience and sound and back (Titrating the experience with the spaciousness of sound.) • Notice the quality of mind whatever it is

28. Working With Sloth/Torpor Sleepiness, boredom • Recognize what is happening • Refrain from acting it out • Realize it is impermanent • Get interested in the changing nature of it • You may need more sleep! • Keep your eyes open • Switch to standing or moving meditation

29. Working with Restlessness“Wandering Mind” Restlessness, agitation, often suppression of another affect that wants to be known • “Putting the bull in a big pasture” • Opening the field of awareness to seeing (with a soft gaze) or hearing without noting • Attempt to stay as still as possible “vow sitting”

30. Working with Doubt Delusion, indecision, confusion, over intellectualizing • Don’t go into the storyline and stay out of the content of the doubt • See what else is there

31. Intensive Retreat Practice

32. Breath Awareness

33. Set Up Instructions for Breathing Meditation 1) Settle into a comfortable posture in which you are relaxed but alert. 2)Take a few long slow breaths connecting with the body and releasing any obvious tension. 3) Allow the breath to return to normal. 5) Feel your body as a whole with wide attention. 4) Continue to scan through the body releasing any obvious tension as best you can.

34. Breath Practice Instructions 1) Become aware that you are breathing. 2) What are the sensations? 3) Let your attention center on the part of the body where you experience the breath most vividly. 4) Let your attention focus on those sensations as you experience breathing in and breathing out. 5) Note where your mind goes when it wanders. 6) How has thinking impacted your experience? Has any tension returned? 7) Let the mind open again to the breath.

35. Breath Practice Advantages • Breathing is a neutral object of attention for most people so less likely to trigger reactivity • The experience of breathing is present moment (as are all body centered foci) • Breathing changes which allows for easier tracking • Breathing is rhythmic and cyclic appearing and disappearing

36. Working With The Body

37. Working With Pain Or Discomfort 1) Bring your attention to the sensations themselves. If the body is in an awkward position that is doing harm, move to a more comfortable position, mindfully noting your intention to move and paying attention to the movement itself. 2) If the pain is tolerable bring your attention to the sensations themselves and note the sensations. Be aware of any feeling tone as you note. These tones may underlie emotions your are also experiencing Note any emotions i.e.. “anxiety, anxiety” or “anger, anger” and return to noting the body sensations. As much as possible try to stay out of the story about the pain. Focus on the present moment instead of projecting into the future or slipping back to the past.

38. Working With Pain Continued 3) If the pain sensations are overwhelming, you can shift focus to your breath, sound or focus on a different part of the body such as your hands or the bottoms of your feet.

39. Working With Difficult Emotions

40. Body Awareness 1) Take three deep breaths and focus your attention on your body and a sense of presence releasing any obvious tension as best you can. 2) Allow your posture to move into sitting or standing “with dignity” relaxed, comfortable and alert. 3) Allow a slight inner smile to come to your lips. 4) Allow the chest to open by rolling the shoulders back and letting them fall away from the ears. 5) Relax the jaw, the knees and the hands.

41. R.A.I.N. Practice Recognize: Notice what you are experiencing. Stay with the experience rather than thoughts about the experience (the story line), simply note what you are experiencing. Accept/Allow: Allow the experience (emotion, thought, body sensation) to be as it is in the moment without trying to change it. Look for the impulse to avoid or cling to the experience. Investigate: Explore the experience with an attitude of openness, curiosity and self-compassion. Watch for the impulse to judge. Non-identification: Continue to investigate and note the stream of sights, sounds, body sensations, thoughts, emotions and other contents of the mind that come and go. Notice the difference within between claiming the experience as I, me, of mine and just noting the stream or flow of experience. Michelle McDonald

42. Using The Breathing Space- Extended Instructions When you are troubled in thoughts or feelings: 1. Awareness Observe- bring the focus of awareness to you inner experience and notice what is happening in your thoughts, feelings, and bodily sensations. Describe, Acknowledge, Identify- put experiences into words, for example, say in your mind, “A feeling of anger is arising” or “Self-critical thoughts are here.” 2. Redirecting Attention Gently Redirect your full attention to the breath. Follow the breath all the way in and all the way out. Try noting “at the back of your mind,” “Breathing in…breathing out” or counting, "inhaling , one…exhaling, two…etc..”

43. Using The Breathing Space- Extended Instructions Continued 3.Expanding Attention • Allow your attention to expand to the whole body-especially to any sense of discomfort, tension, or resistance. If these sensations are there, then take your awareness there by “breathing into them” on the in breath, then breathe out from those sensations, softening and opening with the out- breath. Say to yourself on the out-breath, “It’s OK. Whatever it is , it’s OK. Let me feel it.” Become aware of and adjust your posture and facial expression. As best you can, bring this expanded awareness to the next moments of your day. Segal, Z., Williams, J. , Teasdale, J. (2002)

44. Working With Difficult Thoughts

45. Working with Thoughts • The brain is an organ that naturally produces thoughts. • In meditation, there isn’t a need to look for thoughts. • Some thoughts are merely a drifting away from our focus. With these, we can note them and return to our intentional focus of awareness

46. Working with Thoughts Continued • Some thoughts are compelling. • With these we can note them and see if there is an emotional tone to the noting. • If so we can utilize the instructions for working with difficult emotions or with the body. • It is not necessary to investigate the contents of the thoughts. • Notice how thoughts appear, persist, change and disappear. • How does observing thoughts change them?

47. Mindful Movement

48. Walking Meditation

49. Qi Gong and Taiji

50. Yoga