Category Archives: Anxiety/Panic

Learn From the Founder of Mindful Awareness in Body-oriented Therapy (MABT)

By Cynthia Price

Cynthia Price, PhD MA LMT is a Research Associate Professor at the University of Washington in Seattle.  Shestudies Mindful Awareness in Body-oriented Therapy (MABT), an approach she developed to facilitate body/interoceptive awareness and related skills for self-care and emotion regulation.  She has clinical and research expertise working with people who are disconnected from their bodies due to trauma, chemical dependency, chronic pain or other life stressors.  Director of the non-profit Center for Mindful Body Awareness http://www.cmbaware.org/ she is involved in training clinicians in the MABT approach and implementing programs, particularly for underserved populations, to help make somatic awareness more available to more people.

Interoceptive awareness – the awareness of inner body sensations – is integral to mindfulness practice.  Most often, in mindfulness classes and practice, people engage in interoceptive awareness by attending to the sensation of their breathing or by engaging in a body scan.  Learning to become aware of how one feels inside is critical for gaining access to emotions, the link between emotions and physical sensations, and having an overall embodied sense-of-self.  Likewise, learning to integrate mindful attention to bodily experience in daily life can enhance regulation and self-care.

However, mindful attention to the body is not easy for everyone.  This tends to be particularly true for people who are unfamiliar with the practice, those who have high levels of stress, and those who may avoid awareness of their inner body sensations due to physical or emotional pain, for example those with a history of physical and/or sexual trauma. For some, individualized assistance in a safe therapeutic relationship is needed to develop interoceptive awareness as well as the capacity for sustained attention to internal experience. Mindful Awareness in Body-oriented Therapy (MABT) was developed to explicitly teach fundamental interoceptive awareness skills and to develop the capacity for sustained attention to interoceptive experience. The MABT approach grew out of Cynthia Price’s clinical work with people who were seeking emotional awareness and healing but were disconnected from their bodies. In more recent years, research findings highlight how helpful the MABT approach can be for reducing mental and physical health distress and for increasing emotion regulation.  As one research participant wrote about learning this approach:  “I tried meditating over the years and I was never able to concentrate. With MABT, I was able to slow my mind down and then follow what she (the therapist) was saying, concentrating on a body part, and what I was feeling and afterwards talking about that. Eventually, I learned to do that by myself. This is why I thought this approach was amazing because it taught me to meditate. Now I meditate every night. The difference is having someone lead me into learning how to do it first.’’ 

Join Cynthia Price and her colleagues for the Mindful Awareness in Body-oriented Therapy (MABT) professional training, April 28 – May 7, 2018 at Joshua Tree Retreat Center, Joshua Tree, CA. Mindful Awareness in Body-oriented Therapy (MABT) is an empirically validated 8-week intervention that combines manual, psychoeducation, and mindfulness approaches to teach interoceptive awareness and related practices for self-care and regulation.  To learn more, listen to the Liberated Body podcast in which Cynthia describes the MABT approach:  https://www.liberatedbody.com/podcast/cynthia-price-lbp-060

References:

  • Price, C. & Smith-DiJulio, K. (2016). Interoceptive Awareness is Important for Relapse Prevention: Perceptions of Women who Received Mindful Body Awareness in Substance Use Disorder Treatment. Journal of Addictions Nursing, 27 (1): 32-8. PMC4784109.
  • Price, C., Wells, E., Donovan, D., Rue, T.  (2012). Mindful Awareness in Body-oriented Therapy as an Adjunct to Women’s Substance Use Disorder Treatment:  A Pilot Feasibility Study.  Journal of Substance Abuse Treatment, 43: 94-107.
  • Price, C., Taibi, D., Smith Di-Julio, K., Voss, J. (2013). Developing Compassionate Self-Care Skills in Persons Living with HIV: a Pilot Study to Examine Mindful Awareness in Body-oriented Therapy Feasibility and Acceptability. International Journal of Therapeutic Massage and Bodywork, 6(2): 1-11.
  • Price, C., McBride, B., Hyerle, L., Kivlahan, D. (2007).  Body-oriented Psychotherapy for Female Veterans with PTSD Taking Prescription Analgesics for Chronic Pain: A Feasibility Study.  Alternative Therapies in Health and Medicine, 13(6):32-43.
  • Price C. (2005).  Body-Oriented Therapy in Recovery from Childhood Sexual Abuse:  An Efficacy Study.  Alternative Therapies in Health and Medicine, 11, (5): 46-57.

 

 

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Navigating Aortic Valve Replacement (AVR) Surgery with mPEAK and Mindfulness

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Read this very personal story from a recent mPEAK participant and Join Pete Kirchmer for the next mPEAK 3-Day Intensive March 11-13, 2017, UC San Diego Center for Mindfulness, San Diego, CA.

By William R. Matthews, MA, LPC

Medical literature contains numerous references proclaiming the benefits of meditation and mindfulness on cardiovascular health and pain management. But to me, these were merely academic case studies, as I had not personally known anyone who had successfully used mindfulness to manage through a major medical procedure. That is, until August 17, 2016, when I had aortic valve replacement surgery.

I need to back up a moment. In March of 2016 I participated in the three-day mPEAK intensive that included six weekly one-hour conference call follow-ups. For me the follow-up sessions were critical for integrating the didactic and practice sessions taught in the three-day into a consistent meditative practice. mPEAK was my first hands-on experience with mindfulness. At that point in time, I had been aware for several years that I had a bicuspid aortic valve that would “eventually” need replacement (in fact it kept me from fully participating in the five-mile mindful walk that is part of the program), but there had been no discussion of surgery with my primary physician or cardiologist. Two months after returning from mPEAK, my new primary care physician sent me for an ultrasound of my heart. The results indicated significant blockage of the aortic valve, and that started the ball rolling for surgery “as soon as possible.”

When a date for surgery was set, I emailed mPEAK ccf9e-headshot2program director, Peter Kirchmer, asking if he could provide me with additional mindfulness resources on pain management, since that seemed to be a big concern connected to surgeries. In response, Pete wrote “Forget about additional resources. You have everything you need already. Just continue developing the skills you already have.” Wise counsel indeed. So I loaded up my iPod with all the meditation files mPEAK had made available to us on its website, added John Kabat-Zinn’s Mindfulness Meditation for Pain Relief, and a few other meditations. I played these every evening before bed, in the waiting lounges of airports, and in my office sharing them with my clients. Ultimately, my iPod was headed with me to the hospital.

The night before surgery I slept soundly without the benefit of any sleep aid other than my meditation-filled iPod. I arrived at the hospital at 5:40 AM surgery day and was taken back to pre-op shortly thereafter. The nurse remarked that my blood pressure showed no signs of anticipatory anxiety.  I too was surprised at how calm I was considering someone was about to cut my chest open and mess with my heart. I told the nurse about my mindful preparation and she asked a lot of questions of interest to learn more. A brief chat with a family member, a friend and a short prayer from the rector of my church was all I remember before waking up almost six hours later.

I awoke in recovery to see the same three faces that I had left there that morning. After a few minutes I was taken to cardiac ICU. A nurse and a member of the physical therapy team armed with a pillow were waiting for me. The PT announced that she was there to help me get into bed by “leaning into my pain and clutching the pillow” as my incisions were on the right side along with two chest tubes. Even in my post-anesthesia fog, my mind went immediately to a body scan, noting that my left side was incision- and tube-free. I also made a mental note that at home my bedroom is set up so that I can only get into bed from my left side. I got up off the gurney without assistance walked around the end of the hospital bed, sat down and got into bed on the left side of the bed without assistance (with minimal pain) and said, “I think I’ll do it this way instead.” The PT could only respond, “I guess that way’s OK too.”

The nurse waiting her turn with me announced that she was there to help me with pain management. She advised, “The key to pain management is staying ahead of the pain.” I interpreted that to mean don’t wait until the pain gets bad, keep taking your medication. At that point my mind recalled an activity from mPEAK where we were asked to insert a hand up to mid-forearm into a bucket of ice water and keep it there until the pain started to hurt. Most people removed their hands from the buckets in under a minute. The teachers explained that a large part of managing pain is changing our relationship to the pain. After sharing techniques and mindsets for doing so, we were given the opportunity to try immersing our hands into the ice water again. Most everyone were able to keep their hands in the ice water for considerably longer the second time around. With this recollection I informed the nurse of my plan – to measure my pain on a scale from 0-5 every hour or so, and if the pain number was not any higher than the last “reading” I wouldn’t be asking for pain medication. I received medication for pain only twice: 1) shortly after arriving in the ICU and 2) later that day when they removed the chest tubes. By the next morning, the day after surgery, I had discontinued all pain medication for the remainder of my hospital stay.

Prior to my surgery, my cardiologist and cardiac surgeon both agreed that I would need to go to a rehab facility “for at least a week” after being discharged from the hospital because I live alone. However, I created a dilemma for them because my recovery was so quick and complete. The discharge social worker advised me that I didn’t meet any medical criteria for rehab placement. She even had PT and OT evaluate me one more time in hopes of coming up with some reason to get me admitted, but neither could come up with a medical need. So I was discharged after 4-1/2 days, with my doctors agreeing that I could stay with a friend who lived within a mile of the hospital. I had a return visit to the cardiac surgeon four days afterward. At that appointment my cardiac surgeon said I was free to go back home and decide for myself when I would go back to work. I was back to work half-time three weeks after surgery and returned to full-time work the following week.

While I wouldn’t necessarily put AVR surgery in the category of a high performance activity, I am convinced that the skills and tools I learned from mPEAK, played a central role in my recovery.

William R. Matthews, MA, LPC is in private practice with the Great Lakes Psychology Group. Bill works out of GLPG’s office in Clinton Township, Michigan, where he counsels with children, adolescents and adults using family systems, EMDR, Mindfulness and sports psychology approaches. Bill is also a volunteer trainer and curriculum consultant for the University of Notre Dame’s Play Like a Champion Today educational program. Bill can be reached at bill.matt.GLPG@gmail.com.

Join Pete Kirchmer for the next mPEAK 3-Day Intensive March 11-13, 2017, UC San Diego Center for Mindfulness, San Diego, CA.

ccf9e-headshot2Pete Kirchmer is  the Program Director for the UCSD Center For Mindfulness mPEAK (Mindful, Performance Enhancement, Awareness & Knowledge) Program. Pete specializes in coaching his clients in applying the practice of mindfulness to making healthy lifestyle changes as well as improving performance in life, work and sport. For more information about Pete Kirchmer please visit his Mindfulness Based Health Coaching website.

Mindfulness Shines A Light on Anger

by Margaret Cullen and Gonzalo Brito Pons

margaretMargaret Cullen and Gonzalo Brito retrato-gonzalo-argentinaPons, co-authored “The Mindfulness-Based Emotional Balance Workbook. Join them for the Mindfulness-Based Emotional Balance (MBEB) Teacher Training Intensive, April 9-15, 2017 at EarthRise Retreat Center, Petaluma, CA. Mindfulness-Based Emotional Balance is an empirically-supported 9-week psycho-educational group intervention that teaches mindfulness meditation and emotion training.

It’s such a shame to think of how often we deride ourselves, and each other, for being “emotional.” It’s like jumping on someone for breathing. Emotion is a process that is a vital part of being alive. As the pioneering psychologist of emotions Paul Ekman has said, emotion is a kind of rapid, automatic appraisal of what’s going on. It’s influenced by our evolutionary past as well as our personal past, such that when “we sense that something important to our welfare is occurring…a set of physiological changes and emotional behaviors begins to deal with the situation.”

You’ve been endowed with a nervous system that has evolved over thousands of generations in a way that you didn’t choose. By the time you actually realize that you have a mind and a brain, the basic rules of how they work are already in place. The events that trigger our emotional responses are sometimes universal and sometimes personal. Almost anyone would feel fear at the sight of an oncoming car, but only some of us are afraid of hiking down steep trails while others happily scramble down them like a mountain goat. The triggers that each of us carries with us often come from early childhood and can continue quite unconsciously into adulthood.

And opportunities for emotion abound. Remembering, talking about, or imagining a past emotional scene or thinking of future scenarios can trigger emotions. Observing another person’s emotions (even on a TV screen) can elicit an emotional response. Role playing or theater can elicit emotion; and so can seeing an event that offends our sensibilities, like someone talking on a cell phone at the symphony or throwing trash into the street.

One of our most potent emotions—whose inward and outward effects can have disastrous consequences—is anger. In evolutionary terms, its main adaptive function is to remove obstacles that thwart us. When we feel anger, it’s because the primitive brain is trying to tell us something needs to change. We share this emotion with other mammals and even with reptiles. Baby humans come already well equipped with the capacity to get angry. If you hold a baby by her arms from behind, preventing her from grabbing a toy, she will get pretty angry, furrowing her brow, tightening her muscles, trying to move forcefully to get the toy, and perhaps shouting with a squeaky voice. When the baby grows up, she can have an analogous reaction when someone cuts her off on the road, especially if she’s already late for an important meeting! Anger also shows up when you—or others you feel connected to—are treated unjustly, or when someone or something prevents you from meeting your goals and needs.

Regardless of what triggers them, emotional responses can be either functional or dysfunctional. If we automatically swerve from an oncoming car, the fear response is extremely functional. If we’re afraid to leave the house for fear something terrible will happen, we are now in a disorder that is on the very dysfunctional side of fear, a disorder that no doubt is being triggered by an imported script from past trauma.

Until around the 1970s, it was commonly believed that the nervous system was essentially fixed throughout adulthood; that brain functions remained constant and that it was impossible for new neurons to develop after birth. If you were born with a “glass half-empty” attitude, it would be a life-sentence of unhappiness. Neuroscience has changed all that with the concept of neuroplasticity, which suggests that, in reality, human brains are flexible and change through experience. Although there are some fixed rules about what minds and brains can do, it’s also true that there is a space of freedom to respond rather than react that can be cultivated through mindful observation and practice. And in that space, we have an opportunity to work creatively with the dysfunctional aspects and enhance the more functional aspects of our emotional life.

Consciously or not, we’re constantly training our minds and brains to respond to circumstances. By virtue of repetition, our reactions crystallize into emotional patterns and neural pathways, which, in turn, influence the way we perceive reality. This is particularly true when we’re in the grips of a strong emotion, which is sometimes called the refractory period, a period of time when we’re only able to take in information and evoke memories that confirm, maintain, or justify the emotion we are feeling. This same mechanism that guides and focuses our attention can also distort our ability to deal with both new information and knowledge already stored that does not match the current emotion. We can all think of countless examples when we have missed obvious cues or forgotten historical data when we were “blinded” by a strong emotion. It’s not called “blind rage” for nothing.

Blind and Blaming

MindfulnessBasedEmoBalanceWB-CF.inddAlthough it’s quite possible to get mad at ourselves, the energy of anger is generally directed outward and it’s often linked with blame. This tendency to blame, strike out, punish, and retaliate makes anger especially challenging to sit with, and a big source of interpersonal suffering. When we feel anger toward someone, our sense of “self” and “other” gets very solid. In this state, we exaggerate all the negative qualities of the other person and become blind to positive attributes, which in turn feeds the aversion. The complexity and nuance of the other is reduced to a monolithic negative cartoon called “the enemy.”

We often wonder why we’re angriest at those we’re closest to. For one thing, people who know us intimately also know what can hurt us the most. Someone said, “Your family knows how to push your buttons because they actually installed them.” But a less glib reason is that it tends to be safer to show anger to an intimate than to a stranger. You can express aggression to your partner when you’re actually mad at your boss, probably because it’s less likely your partner will fire you. We can be frustrated about ourselves but direct our anger outside. It’s uncanny that we can even get quite angry at inanimate objects—a door, a table, a wall, or a shoe.

And that very fact reveals something that illuminates what’s really happening: although it feels as if the source of anger is out there, the anger comes from within. Other people are just pretending to be the real enemies. In fact, it’s possible to see them as our “patience coaches,” offering us opportunities to explore and tame the anger habit. If everyone was nice and considerate, how could we train in patience, how could we learn to tame our anger?

There’s an old story about a man who was sailing his boat on clear and sunny day, when a dense fog rolled in. Just as he had decided to return to shore, he noticed the profile of another boat coming in his direction. “Keep your distance!” the boatman shouted, concerned about a possible collision. But the other boat just kept approaching. The boatman used all his skills to swiftly shift direction, so there was more room for the other boat. He got really upset when he saw that the other boat changed its own course, now coming directly to him. “Stay out of my way!” he shouted again, but the other boat just kept coming closer, until it finally crashed into his boat.

The man was enraged: “You idiot! What the hell are you doing?!” He got totally worked up and continued his rampage until the fog lifted enough so that he was able to see that the other boat was empty—it was just an old abandoned boat floating downstream. Now he was perplexed and frustrated: To whom could he express his anger? Could he project his anger onto an empty boat? Without a person to blame, it was impossible to keep the story of anger going.

Ask yourself: Do I ever get mad at “empty boats”? If so, where does this anger come from? Where does it go?

Becoming aware of the inner terrain of anger can be helpful in catching it sooner and sparing ourselves and others the hurt and regret that often ensue from acting out anger. To work with anger, we need to see the space between trigger and reaction in order to mindfully look within.

Door Number Four

Anger is tricky because there’s a cost both to showing anger and to suppressing it. Suppressing doesn’t actually solve anything. It only postpones having to deal with anger while it keeps quietly simmering under the surface, wreaking havoc with our bodies. But if we show it, almost invariably we either hurt others or provoke retaliation. Another common habit is unconsciously “feeding” the mind states of anger with our stories of blame and victimization, thereby reinforcing the anger habit.

It’s rare that therapists nowadays advise their clients to act out their anger with real or symbolic others (punching pillows, shouting loudly in an empty room, and so on), partially because brain science has demonstrated that each time anger is expressed it gets rehearsed and strengthened. The idea that if you let your anger out you will reach peace and calm is simply not true—the satisfaction of the discharge will invariably be transient relief. And the anger will be saying, “I’ll be back.”

Most of us know we can get a certain satisfaction or relief when we express aggression. There can be a seductive quality to the anger, and an adrenaline rush, and that’s why it can become a habit, even an addiction. Anger is like a fuel. When we get angry we can feel energized, stronger, bigger—picture an angry cat with a curved spine and raised hair, pretending to be bigger than it is to scare away what it’s actually scared of. However, anger isn’t a very efficient fuel, because it burns hot and costly. It can be quite polluting on the inside and outside, and it’s heavy and corrosive in the system.

Fortunately, there are other options besides the “three doors” of suppression, expression, and unconscious fueling. When insults or obstacles are perceived, it’s normal for an anger response to arise. It’s just our nature and evolutionary history at work. Though we may succeed in becoming angry less often, it will always be a part of our emotional lives and it is therefore critical to learn how to relate skillfully with this challenging energy. As soon as you remember that you’re not just a victim of your anger, that you can actually use it as a path of self-discovery, you can practice being present with the feeling of anger, connecting with it, and allowing its energy to arise and pass away without acting on it or suppressing it.

This is “door number four.”

Don’t underestimate the power of this simple method. As with mindfulness generally, it’s simple, but it’s not easy.

The capacity to work with anger mindfully is not a binary, either-you-have-it-or-you-don’t proposition. It’s a practice that builds gradually, strengthening the muscle of mindfulness in the face of pleasant and unpleasant experiences. Instead of identifying with, rejecting, or being unaware of anger, we can learn to approach it with openness and curiosity, trusting that anger has something to teach us, and that this can be a very productive part of practice.

Anger is not a special problem getting in the way of mindfulness practice. It actually provides you with an exceptional opportunity to practice mindfulness, to open up when habit tells you to shut down, to connect with experience when habit makes you disconnect, and to question if the image you’ve constructed of yourself and others is as solid as it appears.

There’s a Cherokee story that captures the nature of anger beautifully. A boy tells his grandfather about his anger at a friend who had done him an injustice. His grandfather replies: “Let me tell you a story. I too, at times, have felt great hate for those who have taken so much, with no sorrow for what they do. But hate wears you down, and does not hurt your enemy. It’s like taking poison and wishing your enemy would die. I have struggled with these feelings many times. My son, the battle is between two wolves inside us all. One wolf brings happiness. It is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith. But the other wolf…ah! The littlest thing will send him into a fit of temper. He fights everyone, all of the time, for no reason. He cannot think because his anger and hate are so great. Sometimes it is hard to live with these two wolves inside me, for both of them try to dominate my spirit.”

The boy looked intently into his grandfather’s eyes and asked, “Which one wins, Grandfather?”

The grandfather smiled and quietly said, “The one I feed.”

Training in mindfulness is remembering that every moment is an opportunity to practice peace, no matter the circumstances. Our thoughts, words, and actions are food for the wolves we all have inside. There’s no need for guilt when you notice you’re feeding the angry wolf (we all do this, and guilt won’t help). Instead, know that you have the freedom to learn from your experience and keep practicing with patience. Trust that it’s the small—often invisible—steps that take you forward.

MindfulnessBasedEmoBalanceWB-CF.inddMargaret Cullen and Gonzalo Brito Pons, co-authored “The Mindfulness-Based Emotional Balance Workbook. Join them for the Mindfulness-Based Emotional Balance (MBEB) Teacher Training Intensive, April 9-15, 2017 at EarthRise Retreat Center, Petaluma, CA. Mindfulness-Based Emotional Balance is an empirically-supported 9-week psycho-educational group intervention that teaches mindfulness meditation and emotion training.

 

 

What Time is It? Inspiring a shift from tic-toc to lub-dub.

by Royan Kamyar

royanRoyan Kamyar, M.D., MBA is Founder and CEO of Owaves, a lifestyle medicine technology company based in Encinitas, CA producing software tools for wearable devices that inspire and motivate the next generation to engage in healthy lifestyle activities.  Royan has presented at TEDxUCSD and been quoted by Forbes, Reuters, FOX News, Xconomy, U-T San Diego and the San Diego Business Journal.  Royan earned his M.D. at Baylor College of Medicine, MBA at the Rady School of Management, UC San Diego, and BA and BS in Biochemistry and Business Administration at UC Berkeley and the Haas School of Business.  He serves on the Formative Board of Directors for UC San Diego Center for MindfulnessMindfulness-Based Professional Training Institute and is an active member of the American College of Lifestyle Medicine.

Image Credit: Dadara

[Image Credit: Dadara]

Imagine a flowering plant. A baking cake. A rising stock price. A healing wound. Time passing can be a beautiful thing.

Why then does the cartoon above resonate so deeply with us? Is it our fear of mortality? Our never-ending list of to-do’s and things left undone that haunt us moment-to-moment? Are we as a culture, as a species, doomed to brood on the past, fear the future, and run away from the present?

The Centers for Disease Control and Prevention (CDC) identifies our sense of “time scarcity” as a leading source of stress in the United States — a primary cause of heart disease, our number one killer. Meanwhile, growing positive psychology research demonstrates the healing power of “being in the present.”

What if our relationship with time shifted? What if we began to view time as a source of inspiration instead of dread? What if each glance at the watch put us more “in the moment,” made us feel more focused, centered and alive? Few realize that our modern timekeeping system is fundamentally arbitrary. Hours, minutes and seconds have no home in cosmology, but rather the digits of our hands…

Technology is evolving as we speak to put smartphones on our wrists. The era of smartwatches with heart rate sensors and real-time monitoring systems is dawning upon us. With processing powers greater than the earliest mainframes and NASA spaceships embedded into our timepieces, we are no longer compelled to settle for a construct of time rooted in hand gestures, ropes and rocks. What if we, as a community of innovators and healers, took the first step in evolving our modern-day answer to the age-old question, “What time is it?”

Mindfulness & Innovations in Timekeeping

The mindfulness community actually has a long and storied track record of innovation in timekeeping, centered around spiritual observations, holidays, rites, rituals, meditation and prayer:

32,000 BCE – Cave art found in France and Germany depicts lunar and seasonal cycles of the “heavens”, representing the first known calendaring system. Its creators are believed to be astronomer-priests of the late Upper Paleolithic Cultures.

4,200 BCE — Ancient Egyptians calculate 365 days between alignments of the sun and Sopdet, goddess of Sirius the Dog Star, marking the Nile’s concurrent flooding and enrichment of the soil.

3,000 BCE — Stonehenge in modern-day England demarcates the annual winter and summer solstices, serving as burial grounds and a venue of ancestor worship and rituals.

2,400 BCE – The first known clocks are the shadow clocks or “obelisks” of ancient Egypt, erected by clerics in pairs at temple entrances for ritual observances.

2,100 BCE — Assyrians, Sumerians and Babylonians of the Middle East establish twelve phases of the moon, or “moonths”, per lunar calendar year. Holy days are declared on the first, seventh and fifteenth of each month.

1,000 BCE – Egyptian clerics develop water clocks or “clepsydras” to continue tracking proper timing of rituals throughout the night, i.e. in the absence of sun and shadows.

100 BCE – Chinese, Korean and Japanese Buddhist monks advance incense timers to replace the more flammable and inaccurate candle clocks of the day. Utilizing various scents, one smells the time change.

1200-1300 AD — Benedictine Monks of Western Europe become the first clockmakers of the region and create the mechanical clock. Adding weights and escapements to water clocks automates ringing of the communal prayer bell.

1582 AD — To more accurately celebrate Easter in its relation to the March equinox, Pope Gregory XIII spearheads the Gregorian Calendar widely used today. The Gregorian Calendar arrives closer to the tropical or “solar” year than the preceding Julian Calendar.

The Origins of Tic-Toc

The divisions of years, months and days are rooted in cosmological events and account for consistent measurements across disconnected cultures. Subdivisions of weeks, hours, minutes and seconds, however, are largely arbitrary and varied more greatly throughout history.

Weeks, for example have seen lengths of 3 to 13 days depending on prevailing leadership. Decisions usually hinged on what was deemed a reasonable workweek as per autocrat or religious text, i.e. “… on the seventh day he rested.” Papal States used six hour days as recently as the 1800’s with 6 o’clock pointing fixedly to sunset, and the Japanese had a twelve hour system with intervals that varied in length according to the season. Decimal time was used by China throughout most of its history dating back to 1000 BCE, was espoused by the French Revolutionary thinkers of the late 1700’s and resurfaced in 1998 when the Switzerland-based Swatch company proposed “Internet Time” of 1000 beats per day.

The sexagesimal system which lies at the heart of our modern-day “tic-toc” was similarly devised for convenience, not derived from scientific fact or basic principles. The ancient Sumerians and Babylonians used sixty as a mathematical base due to its ease of counting with two hands. Each finger segment on one hand represented a number one through twelve demarcated by the thumb, and each digit of the other hand represented a multiplier. Multiplying twelve finger segments by five digits provided a max count of sixty. The number sixty is also considered a “superior highly composite number” in mathematics, meaning it is easily divisible and lends itself well to fractions.

hands

[Image Credit: Ministry of Education, Brazil]

The Problems with Tic-Toc

Dr. Jon Kabat-Zinn presents a valuable anecdote from the Mindfulness-Based Stress Reduction (MBSR) program he developed at the University of Massachusetts Medical Center, in his manuscript Full Catastrophe Living:

Linda described feeling as if a large truck were always right on her heels, driving just faster than she can walk. It was an image people could relate to; the vividness of it sent a wave of acknowledging nods and smiles through the room…

Her mind was the truck. It was always right behind her, pushing her, driving her, allowing her no rest, no peace.

In the modern age, feeling overwhelmed and out-of-sync is an increasingly common experience. Heart disease is real, heart attacks are real, and the CDC sobers us with the knowledge that this “time scarcity” mentality is a chronic stressor.

Perhaps it is not surprising then that one of the central tenets of mindfulness-based stress reduction is to encourage patients to adopt the present moment. As Dr. Kabat-Zinn explains:

Mindfulness is paying attention on purpose, in the present moment, and nonjudgmentally, to the unfolding of experience moment to moment.

The ancient Greeks embraced two definitions of time to help carry this distinction. “Chronos” was used to discuss chronological or sequential concepts of time, with which we are most familiar and tic-toc describes quite well. “Kairos”, on the other hand, translates to the “eternal moment” in which everything actually happens. This latter concept is missing from our current communication of time and resonates with Dr. Kabat-Zinn’s teaching.

Among pools of evidence collecting around the importance of present moment awareness, Science published a Harvard study in 2010 demonstrating a link between “mind-wandering” and mental health. Over 250,000 data points from 2,250 subjects between the ages of 18 and 88 shows our minds are focused on the past or future 46.9% of the day, leading directly to poor mood. As summarized by study co-author psychologist Matthew A. Killingsworth:

Mind-wandering is an excellent predictor of people’s happiness. In fact, how often our minds leave the present and where they tend to go is a better predictor of our happiness than the activities in which we are engaged.

The tic-toc almost by definition puts us in a sequential frame of mind rather than in the moment. This shift first took hold in the Western world during the Middle Ages with the spread of the mechanical clock. Benedictine Monks lived ascetic lives centered on punctual communal prayer six to seven times per day. Bells (Celtic = clocca or “clock”) were rung manually to inform the community of established timetables. By adding weights and escapements to water clocks, a bell could be rung automatically without requiring a brother present, and more dependably as well.

As the National Watch and Clock Collectors Association notes:

Time no longer flowed like water through a clepsydra — it ticked. It was no longer a seamless continuum, but a succession of short periods.

The streaming of water, passing of a shadow or burning of a flame became replaced by the now familiar “tic-toc”. With the dawning of the Industrial Revolution and mass scaling of clock and watch production, “dollar watches” put everyone in a mechanical state-of-mind and helped synchronize the workforce. Time became money as factories calculated hours worked as key labor costs and employees as wages. As per American historian Lewis Mumford, “… the archetypal model for the industrial era was the clock.”

The tic-toc represented a major departure from cosmological cues for the average person organizing her or his day, as the sundial became officially obsolete in the 1800’s. Perhaps the greatest divorce came more recently with the International Committee for Weights and Measures decision to re-define the second in 1967. A “second” no longer represents an arbitrary fraction of Earth’s rotation around the Sun, but rather:

9,192,631,770 periods of the radiation corresponding to the transition between the two hyperfine levels of the ground state of the caesium 133-atom.

While this advances our computer networking capabilities and satellite communications, the tightening of our “tic-toc” does not necessarily serve to heal our emotional relationship with time. In fact, the focus by such governing bodies on the physics and engineering components of time misses the human implications that actually define it.

Within some of our lifetimes, Albert Einstein brought forward the general theory of relativity, which proved without a doubt that a second for you is not the same as a second for me:

Put your hand on a hot stove for a minute, and it seems like an hour. Sit with a pretty girl for an hour, and it seems like a minute. That’s relativity.

Our speed, our culture, our circumstances, our environment, our climate, our neighbor, our mindspace all dramatically impact our individual perceptions of time. Further, Einstein’s contributions to quantum mechanics helped show the existence of time actually depends on our perceptions of it. No consciousness, no time. So these changes in perception that we feel and experience on a regular basis are not simply novelties or asides in the calculations of time, but real occurrences that get neglected in our current approach.

In the 1950’s, University of Minnesota biologist Franz Halberg coined the term “circadian” (Latin = around a day). Known as the “godfather of chronobiology,” he helped establish a fundamental, evolutionary relationship between our biology and time. We now know that every cell in our body, down to the DNA level, has some “awareness” of (or dependency on) the time of day. This is true for virtually every known organism, even those that are single-celled.

The implications of these “circadian rhythms”, or physiological patterns dictated by the rise and fall of the sun, are both broad and deep. Recent research encouraged the World Health Organization to label night-shift work as a “probable carcinogen”, in the same class as UV radiation, due to its devastating impact on circadian rhythms. Poor circadian rhythms are also linked to heart disease, obesity, diabetes, metabolic syndrome and mental health disorders. Our 24/7, hyper-connected, always-on smartphone culture makes the bulk of us “social-shift workers,” exposed to blue light late into the night… and shifting our hormones into dangerous patterns.

circadian

Why then has nothing changed? Does our new subjective, dynamic definition of time, no longer static and mechanical, not change the underlying formula? Does the realization that our biology has a fundamental, natural and overarching relationship with time not beg us to re-evaluate why this is not factored into the perennial question, “What time is it?”

Introducing Lub-Dub

The arbitrariness of our current timekeeping method, combined with the facts that it is out-of-date and fosters a stressful mindset, presents us with a wide-open opportunity to improve. Coupling our evolved understanding of time with modern needs and the latest technologies, perhaps we can imagine a way to re-define the concept so that it better serves our bodies, hearts and minds.

Consider your daily routine. It might look a lot like this: wake up, meditate, eat breakfast, drive to work, work, eat lunch, go for a walk, work some more, drive home, cook dinner, spend time with family, relax and read a book, go to sleep. What is the optimal way to get you from one “daily milestone” to the next? When you realize the bulk of these milestones don’t generally change from one 24-hour block to the next, you begin to sense there might be a better way to organize and track your day.

Peter Galison, physics professor, historian and philosopher at Harvard University defines clocks accordingly:

We’re always looking for things that repeat, over and over again… and that repetition, that cycle of things, forms a clock. That’s all time becomes, is some repetitive process.

So since my daily activity patterns generally repeat from one day to the next, what if they became my “tic” and my “toc”? So my cadence became linked to “breakfast time” and “exercise time” rather than some mechanical, arbitrary construct that lies beneath it? In essence, I become my clock. Lub-dub.

What we can imagine is a shift from a quantitative, mathematical and mechanical view of time towards a more heartful, experiential and soulful view of time — one that makes sense on an emotional and psychological level.

Amazingly, this approach has a biological basis as well. In his study of circadian rhythms, Dr. Aschoff also coined the term “zeitgeber”, German for “time giver” or “synchronizer. ” The zeitgeber is any external or environmental cue that “entrains” or synchronizes an organism’s biological rhythms to Earth’s 24 hour light/dark cycle and twelve month orbit.

Decades of chronobiology research tells us that these same types of intuitive markers for progression of the day, or daily milestones outlined above, are in fact biological zeitgebers. Meals, exercise, and socializing each play a role in establishing our cyclical physiological relationship with the solar environment. This has implications for: our sleep/wake cycle, body temperature, patterns of hormone secretion, blood pressure, digestive secretions, levels of alertness, mood and reaction times just to name a few.

brain

[Image Credit: Nature Reviews Neurology]

Timothy Monk, Professor of Psychiatry at the University of Pittsburgh Sleep Medicine Institute summarizes the value of this framework well:

Circadian rhythms are driven by endogenous processes, are self-sustaining, and rely upon circadian time cues (zeitgebers) to remain appropriately oriented to the individual’s environment and desired routine. The gold-standard measures of human circadian rhythms have been core body temperature and salivary or plasma melatonin levels. However, one can also make the case that the behavioral circadian rhythms related to the timing of sleep, meals, work and social interactions are just as valid circadian rhythms as the physiological ones. Moreover, these are the rhythms most salient to the individual himself or herself.

An additional “bonus” of shifting to this type of intuitive, biologically-based system is that these same behaviors — nutrition, sleep, exercise and socializing — are deemed by the American College of Lifestyle Medicine to be the fundamental building blocks of a long, healthy life. Also called “lifestyle vital signs,” measuring and monitoring these parameters might be more meaningful in predicting long-term morbidity and mortality than the traditional set of vital signs for current and future generations (due to an overall shift from acute to chronic and preventable disease). Following the age-old adage that you cannot manage what you do not measure, taking these health fundamentals into account would help prevent and treat diabetes, obesity, heart disease, high blood pressure, depression, anxiety and more.

For example, we know that heart attacks are most likely to occur shortly after dawn due to concurrent rises in blood pressure and cortisol levels. We also know they are more likely to occur at the beginning of the workweek, when stress from anticipating future events reaches its peak. What if your timekeeping tools took this knowledge into account, and helped you time activities accordingly? Perhaps optimizing algorithms to discourage Monday AM work meetings when possible? Or suggesting stress-reducing sounds or images during these times? Something as simple as a picture of a loved one, left in ambient view on your wristwatch at the right time, might go a long way in dipping your odds for a cardiac event.

CFM OWAVES

[Image Credit: Owaves]

Now time becomes something we can control, name, juggle, design, manipulate and relate to according to our personal biology, desires and needs. Granted, a universal timekeeping system would always need to lie at its base. Meeting times must be coordinated and train crashes prevented. And yet, analogous to “personalized medicine”, we can evolve or grow from this generalized base to create a truly individualized and relevant concept of time that inspires and heals rather than stresses and reduces.

Commonly in mindfulness courses today, we are taught that certain external stressors cannot be changed, and are best addressed by mobilizing our internal resources to better respond and adapt to our environment. Yet our maligned relationship with time seems to be universal and we know now, increasingly, that our historical perspective of time is incomplete, arbitrary and malleable. Perhaps we should learn from the mindfulness leaders of millennia ago, and play an active, creative role with regard to understanding, communicating and measuring time.

As we speak, physicists and engineers continue to develop incredible methods for fine-tuning existing calculations of timekeeping tools to better run the machines of the world. I propose it is our duty, as a community of healers and innovators, to ensure that human health and well-being is plugged more squarely into the equation.

Continue to explore the Mindfulness courses presented at the UC San Diego Center for Mindfulness. Registration is open for our local 8-Week Mindfulness programs along with our Mindfulness-Based Professional Training Programs that are held in various locations in North America.

 

Staying : turning towards what is difficult [ Part I]

By Char Wilkins,

charwilkinsChar Wilkins, MSW, LCSW is a mindfulness-based psychotherapist who works with individuals, couples and groups incorporating the intention and skills of mindfulness as a foundation from which to explore one’s life. She leads  MBSR, and Mindful Eating/Conscious Living (MECL) retreats for our Professional Training Institute and programs in her own practice for the general public.

When challenging or unwanted thoughts, emotions or behaviors arise most of us want to avoid or distract ourselves. We may use food, drugs, work or exercise to temporarily sooth, comfort or numb the difficult internal experience. Unfortunately, repeatedly coping in this way creates a habituated pattern that carries with it more shame and fear, and the hope of change slips further away into a seemingly endless out-of-control cycle.

There is of course, a reason why in mindfulness-based work we turn towards what we believe to be so difficult that if we don’t run, we won’t survive. And that is because when we come to know the taste, texture, temperature, shape, sound and movement of the unwanted thought, emotion or sensation, it is no longer a lurking shadow threatening to overwhelm us. It is felt and known for what it is: just a thought. Observed and held in awareness without judgment, it takes its right-sized place in the scope of who we are. Turning toward the difficult offers the possibility of freeing ourselves from the very patterns we fear the most.

Perhaps you’re thinking that this “staying with thing” is not the way you want to spend your day off. It’s not a comfortable thing to do. It just doesn’t have the same feeling that you get when you’re angry, depressed or anxious and think: ” A day at the beach is what I need.” or “A hot fudge sundae would do the trick right about now.”   But one getaway is never enough, is it?  And then, of course, returning is too much. This jumping back and forth we do is wearisome. That’s why the practice of mindfully staying with what is here right now, is so important. Ultimately it conserves energy, time, wear and tear on body and soul, and so much drama is avoided.

I’m aware that I ask participants in MBSR, MBCT and MECL programs to do a very challenging thing: be present to what is arising in the moment and to allow it to be known. It isn’t easy to not turn away from, to not disassociate, to not to run.  Bolting is the norm. If it doesn’t feel good, leave. Leave the person, place or thing. I’m not suggesting that you stay if you’re being abused. I’m talking about the everyday moments when we think, “I wouldn’t have to get so angry if only he wouldn’t ____________.  If she’d just ______________, I’d be happy.” As I’ve sat with clients and participants over the years, I’ve watched so much “bolting,” that recently I thought a new reality TV show entitled “Extreme Bolting might get higher ratings than the X Games since more people bolt than Cave Dive, go Wingsuit Flying or attempt Extreme Ironing. Look it up, it’s worth it.

In Part 2, I’ll share how in working with women who have experienced abuse or trauma mindfulness of the body can help them learn how to stay with what is difficult.

Listen on Monday September 9, 2013 from 12:00pm-1:00pm to Char Wilkins, MSW, LCSW, in a special teleconference  exploring how we sometimes use food which temporarily soothes, comforts or submerges the difficult internal experiences.

 

Calming the Rush of Panic: A Mindfulness-Based Stress Reduction Guide to Freeing Yourself from Panic Attacks and Living a Vital Life

An exclusive excerpt from “calming the rush of panicby Bob Stahl, PhD and Wendy Millstine, NC

Frank’s Story

calming the rush of panic cover photoFrank, an inventor, had come up with some new medical devices for use in lifesaving heart surgery. When he started a business to get these inventions in the hands of doctors, he had to deal with experiencing panic at times. When he was at the office—on his own turf and in control of his environment—he was fine and things went fairly well, but when he had to travel to sell and support the use of his devices it was another story.
Frank would have liked to have someone else in charge of sales for his business since he had so much panic, but he couldn’t afford to hire the right professional just yet, and those who might be interested in helping him didn’t have enough of a technological background. As a result, Frank needed to make sales presentations himself as well as thoroughly explain to the surgeons how to use his devices, which often meant accompanying them into surgery to consult with them on how best to implant and use them.
Just the thought of walking into the surgery was enough to make Frank’s hands sweaty and his breathing rapid and irregular. He knew that he desperately needed to learn to calm down his panic so that he could successfully market his devices and see them put to good use. The last thing he wanted was to have a full-blown panic attack in the operating room.
Frank became proactive and took a mindfulness class, where he learned various formal meditations and informal practices that helped him a lot. Mindful belly breathing was one of his favorites since it helped him regulate his breath and come back into balance. Frank also related with the notion from sitting meditation that you are not your thoughts, but most of all he connected with “Pause, Observe/Experience, and Allow.” This was incredibly helpful for him, in conjunction with mindful breathing that he could bring into everyday situations.
Whenever he thought about going out to see the surgeon or when he was about to go into the operating room, Frank would pause and take some mindful breaths in and out. This opened up a space for him to observe in a matter-of-fact way just what he was experiencing physically, mentally, and emotionally. Frank then began to allow and acknowledge what he was feeling and began to let things be. In time, those panicky feelings subsided and dissipated and Frank felt great relief, release, and happiness by learning how to face and transform his panic.

A helpful way to work mindfully with panic is called “Pause, Observe/Experience, and Allow.” This informal daily practice can help you work through panicky thoughts and events so that you don’t get so caught up in them.

So wherever you are—at the post office, at the bank, at the office, or at home, if you feel an activation of panic rushing within you — you can practice:

“Pause, Observe/Experience, and Allow.”

Here’s how it works:

1) When you notice the rush of panic emerging within, take a moment to breathe from your belly and pause to become present.
2) Observe and experience your body sensations, thoughts, and emotions.
3) Then allow them to be, giving space for them to go wherever they need to go.

See what happens when you bring the practice of “Pause, Observe/Experience, and Allow” into a panicky moment. Reflect upon the fact that life is indeed made of moments and although a moment of panic may seem like a thousand years, in actuality it’s not very long. Like all events in the body and mind, whatever arises, passes—for all things are certain to change.

By practicing “Pause, Observe/Experience, and Allow” you can begin to be with the storms of panic as they come and go and gradually feel less affected by them. You are learning to give space to the storm of panic by not reacting to it. You are learning to pause, observe/experience, and allow the panicky feelings to go wherever they need to go. When you give space to the storm of panic, eventually the storm dissipates. You will come to see these mind and body states of panic as impersonal formations that are always changing. When you become less reactive and regard these panicky events as transient, you will become not so enslaved by them. In time, you’ll experience deeper levels of freedom and peace.

Just as a mountain is steady and grounded in the midst of changing weather day in and day out, you can learn to sit in more balance with the weather systems of your own body and mind.

Bob StahlBob Stahl, PhD., is the co-author of A Mindfulness-Based Stress Reduction Workbook, Living With Your Heart Wide Open, and Calming The Rush Of Panic.

Bob founded Awareness and Relaxation Training in 1991 as an educational organization based in Santa Cruz, CA. and has founded seven mindfulness-based stress reduction programs in the San Francisco Bay Area and currently directs MBSR programs at Dominican Hospital, El Camino Hospital, and O’Connor Hospital.

Dr. Stahl is a certified MBSR teacher who also serves as an Adjunct Senior Teacher for Oasis – the institute for mindfulness-based professional education and innovation of the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. Bob conducts numerous mindfulness meditation retreats and workshops for health care professionals, corporations, and educational institutions and has extensive experience working with individuals facing physical disabilities, chronic pain, life-threatening illnesses, and stress-related conditions.

Wendy Millstine Photo

Wendy Millstine, NC, is a freelance writer and certified holistic nutrition consultant who specializes in diet and stress reduction. With Jeffrey Brantley, she is coauthor of the “Five Good Minutes®” series and “Daily Meditations for Calming Your Anxious Mind.” She lives in Sonoma County.

Petaluma: Training in Mindfulness-Based Cognitive Therapy

text & photos by Dzung Vo
Windswept Trees. MBCT Training, Earthrise Retreat Center, Petaluma, California (2/18/13)
Gratitude
Hope
Connectedness

these three words
express my experience with
the Mindfulness-Based Cognitive Therapy (MBCT) Teacher Training
which is a very skillful application
of mindfulness for preventing relapse of chronic depression in adults

Sitting View. MBCT Training, Earthrise Retreat Center, Petaluma, California (2/17/13)

the five-day training was an interesting hybrid
of a meditation retreat
and professional training workshop
i was fascinated to watch my mind going back and forth
between “just being”
enjoying the breathtaking natural environment
walking, eating, and sitting mindfully
being fully in each breath
and “doing”
watching my analyzing, planning, comparing and judging mind at work

breathing in, i am aware of my thinking
breathing out, i smile …

View from Hill. MBCT Training, Earthrise Retreat Center, Petaluma, California (2/18/13)

how lucky i am
to be able to consider this experience
part of my “work”
more and more, as my work comes from the heart
the line between my profession and my bodhisattva path
begins to dissolve…

Deer Having Dinner. MBCT Training, Earthrise Retreat Center, Petaluma, California (2/18/13)
"May Peace Prevail on Earth." MBCT Training, Earthrise Retreat Center, Petaluma, California (2/21/13)

the faculty
(zindel segal, sarah bowen, and steve hickman)
brought tremendous warmth, gentleness
and clarity of vision
in teaching and embodying the training
the students brought a depth and diversity
of practice and experience
and a bright curiosity

it gives me great hope
to see these practices
skillfully adapted and offered to the world

it gives me great humility
to be a part of this growing “professional sangha”

MBCT Petaluma Class of 2013. Earthrise Retreat Center, Petaluma, California (2/22/13)
MBCT Teacher Training, Petaluma, Class of 2013

i bow deeply to all of you

Dzung Vo and Ken Ginsburg, Philadelphia, 11-21-11I have long had a dream to teach mindfulness practice to adolescents suffering from chronic illness and chronic stress. With my position at the British Columbia Children’s Hospital–and the luxury of having a more functional health care system with sufficient time to spend with my patients and explore issues deeply–I have finally had a chance to start making this a reality.

(see more photos on my flickr set)

Is it possible to panic mindfully?

For James Henry, a psychiatry resident at UC San Francisco, the question is not just theoretical. While a medical student at UC San Diego, Dr. Henry noticed a shortcoming in the treatment of anxiety— during moments of extreme stress, people are most apt to forget mindfulness strategies.  This observation led to the development of an iPhone app, Let Panic Go, that helps to guide the user through a panic attack.

The program uses a synthesis of mindfulness, cognitive-behavioral therapy (CBT), and breathing biofeedback.  Initial users have indicated that the program, by redirecting awareness to the very thoughts and sensations they were trying to avoid, paradoxically diffuses the experience of anxiety. One reviewer notes “by the end of it I felt like I had a much clearer perspective about what was going on…it will be a relief knowing that I have this with me in my pocket.”  For more information on this app, visit www.letpanicgo.com or click here for a link to Let Panic Go at the iTunes store, where you can read further user reviews or purchase the program.

(Note: While the UCSD Center for Mindfulness consulted with Dr. Henry on the development of Let Panic Go, we do not have a financial interest in the product.)