Category Archives: Meditation

The Mindfulness Solution to Pain: Read The Story of Adam & MBCPM

 

Mindfulness-BJG_1-full-resolution-copy-150x150ased Chronic Pain Management (MBCPMTM) founder Jackie Gardner-Nix is a Physician and Chronic Pain Consultant, St Michael’s Hospital, Toronto and Associate Professor, University of Toronto. Join Jackie May 10-15, 2016 at EarthRise Retreat Center, Petaluma, CA, for a 5-Day Professional Training.

The Mindfulness-Based Chronic Pain Management (MBCPMTM) course is a modification of the Mindfulness-based Stress Reduction courses established by Jon Kabat-Zinn which are now world-wide. There are cognitive aspects to the MBCPMTM course, as well as carefully crafted meditations to speak more to the chronic pain sufferer than the general participant who signs up for mindfulness training.

In most Mindfulness program there MBCPM-Bookis a curious ratio of 70 to 80% women to 20 to 30% men, yet men benefit very much from this work, and many of the leading teachers in Mindfulness are men. The following is a moving story emailed to me one year after taking our course by a young man, his site connecting with mine where I was co-facilitating the course via telemedicine in Ontario, Canada. At his site sat a young, softly spoken neurologist, doing her first co-facilitation via telemedicine with me after training in our curriculum, before launching her own courses. He repeated the course to gain more training in mindfulness, joining her for her first solo course.

Adam’s Story

by Adam Michael Segal

Pain overview:

My chronic pain odyssey began in early 2012. It was based in my bladder and was from an inflammatory condition called Interstitial Cystitis (IC). I also later developed chronic neuropathic pain. The pain was debilitating, relentless and as it persisted and intensified, it completely broke me down. It ruled my life. As a result, my marriage ended. I was unable to work. I fell into a major depression. I was 37 and doubted I would make it to 40.

MBCPMTM: After seeing nearly 20 specialists, I was referred to Dr. Jackie Gardner-Nix’s Mindfulness Based Chronic Pain Management (MBCPMTM) class in the summer of 2014. While initially shy and quiet, as I started to speak with classmates, I felt understood for the first time in years, even validated. Finally, there were people who could relate to me and my suffering. And a doctor who actually ‘got it!’ As I read sections of Dr. Jackie’s book, The Mindfulness Solution to Pain, it was like reading my biography. Some case studies in the book were people just like me – similar personality traits, pain triggers and emotional responses to pain.

Over time, the book, classes, activities, guided imagery and meditation collectively led to something transformative happening; my attitudes and views started to change. I began to realize that my emotions, especially bitterness and hopelessness, impacted my pain in a negative way. I began to gradually accept the pain and let it be. I started to focus my thoughts on the positive things in my life. For example, I had written a manuscript for a children’s book and I started to explore publishing it. And I went to my GP to get referred to a urologist in Kingston, Ont., who was Canada’s leading authority on IC.

Fall of 2014: I met with the urologist. I went into that consult with a positive, hopeful attitude. I can say emphatically that MBCPMTM contributed significantly to me being positive during the doctor visit. Everything I learned from MBCPMTM helped arm me with the courage to follow the urologist’s treatment regimen, which included invasive and painful bladder instillations – a treatment I had feared tremendously. Within a few months, my symptoms started to improve considerably.

Winter 2014/2015: I participated in a second round of MBCPMTM led by another doctor who was trained by Dr. Jackie. By March, I returned part-time to my job and dedicated the rest of my time and strength to the arduous process of self-publishing a book. In September, the book was printed and I started to do readings and author visits at schools. Children literally mob me like a rock star when I read. They laugh and learn and I glow in knowing my creation brings them such joy. In October, I hosted a book launch party with over 100 people. An article about the book and the pain I managed well enough to produce it, was published in a local paper.

Fall 2015: I continue to take most of the medications prescribed by the urologist, but I no longer require the invasive treatment. I still experience neuropathy, but it has no impact on my mood. My thoughts, views and attitudes are bursting with hope and optimism. MBCPMTM enabled me to really understand the mind-body connection. It helped me cultivate a frame of mind in which I control my life, not pain. I am mindful every day of how far along I have come and how happy I am to live in the here and now. And that gives me strength to live a fulfilling life.

About the Author

Adam Michael Segal is an expert in healthcare communications and author of the recently published children’s book, Fartzee Shmartzee’s Fabulous Food Fest, available on Amazon. Mr. Segal intends to develop the main character into a health & wellness super hero for children. Earlier in his career, Mr. Segal was a journalist and wrote articles for such media as The Toronto Star, National Post and CBC. Mr. Segal hopes his story inspires others with chronic pain to make mindfulness a central part of their healing solution. He holds degrees in Arts, Education and Journalism.

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Mindfulness Training Leads to Important Changes in the Brains of World-Class BMX Cyclists

By Lori Haase, Ph.D.

mpeak-medals copyResearchers at UC San Diego School of Medicine who have been working with Olympic BMX cyclists to improve their athletic prowess have documented areas of the brain that appear to respond to mindfulness training. Specifically, recent results suggest that these peak performers were better able to appropriately anticipate challenges and found that they could remain focused and aware of their performance in the midst of the split-second stressors that arise in a BMX race that can be intense and often lasts for fewer than two minutes with multiple competitors vying for a place at the finish line. These results suggest that BMX performance may be enhanced through the regular practice of mindfulness meditation.

Reporting in a recent issue of Frontiers in Behavioral Neuroscience (abstact, full article) researchers show that a 8-week intensive mindfulness training course, known as mPEAK, altered the cyclists’ brain activity patterns in two performance-relevant ways:

As measured by fMRI activity in the anterior cingulate cortex (ACC) and insula were enhanced during the anticipatory and recovery phases of a stress-provoking exercise. The ACC and insula are believed to play a strong role in interoception, the ability to sense bodily sensations such a heart rate and integrate them with external stimulation and emotional overlay.

“Prior to the test, their brains were ramping up for activity,” said first author Lori Haase, Assistant Clinical Professor of Psychiatry, UC San Diego School of Medicine. “We interpret this as meaning the athletes are anticipating the stress and getting ready for it.”

The second measurable change was an apparent reduction in the level of connectivity between posterior cingulate cortex (PCC) and both the right medial frontal cortex and ACC, during the stress-evoking test, in which athletes were asked to breathe through a narrow straw that restricted air flow. The PCC is implicated in self-awareness and self-referential thoughts. A reduction in connectivity to this brain area is consistent with the idea that mindfulness training heightens a person’s awareness of bodily sensations, with less self-referential processing added to what is being experienced physically. “This can potentially help athlete stay present to their performance ,” Haase said.

Taken together, these results suggest that significant changes in the brain, directly related to performance in intense and physically demanding activities like BMX cycling or other athletic endeavors, can result from a relatively brief and focused program like the UC San Diego Center for Mindfulness’ mPEAK course.

About The Author: Lori Haase is a Licensed Clinical Psychologist and in addition to her clinical training, she is also a neuroscientist investigating the neural substrates of resilience and optimal performance and their modification through mindfulness training. Dr. Haase is Director, co-developer, and teacher of the Mindful Performance Enhancement, Awareness and Knowledge (mPEAK) program.​

Learn about the mPEAK 3-Day Intensive mPEAK program February 13-15, 2016  at the Catamaran Hotel in San Diego, CA. Activities include: meditation; talks on the relationship between neuroscientific findings, peak performance and mindfulness; experiential exercises; group discussion; and home practices. CE credits are available. Register here.

For our local San Diego residence you are also invited to register for the full 8-Week mPEAK program held at the UC San Diego Center for Mindfulness. The next course starts in January 2016.

 

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.

 

Why go on retreat?

by Beth Mulligan

Beth Mulligan is a co-founder of Mindful-Way Stress beth mulligan headshopReduction Programs, which offers MBSR and other mindfulness based interventions and retreats through out Southern California, nationally and internationally. Beth has a background in primary care medicine as a Board Certified Physician Assistant and has practiced medicine for over 25 years. She is a long time student of Roshi Charles Tenshin Fletcher at Yokoji Zen Center where she has lived in residence, is a Vipassana Dharma teacher at Insight Community of the Desert, and a certified yoga instructor.

Why go on Retreat?
Great question! As a certified MBSR teacher and teacher trainer – for the UMass Center for Mindfulness and a mentor for the UCSD Mindfulness-Based Professional Training Institute (MBTI), I get asked this question more and more. If you look at the prerequisites for teaching MBSR or other MBI’s all over the world, the recommendation for personal retreat practice is consistent. To answer the question, I may start by quoting the originator of MBSR; Dr. Jon Kabat-Zinn (from his article “Some Reflections on the Origins of MBSR, Skillful Means, and the Trouble with Maps.”
“ I personally consider the sitting of relatively long…teacher led, silent retreats to be an absolute necessity in the developing of one’s own meditation practice, understanding and effectiveness as a teacher… it is a laboratory requirement.” Jon Kabat-Zinn

Regarding information on Mindfulness Meditation retreats, I might also refer them to the UMass CFM website and Spirit Rock Meditation Center.

But really I have to answer this question for myself, just as the heart of Mindfulness Based Interventions are an invitation to access one’s own wisdom, I need to turn within to answer it. In order to ask people to face the difficulties of their lives, chronic pain, sick family members, financial stressors, “The Full Catastrophe”, I need to know and have the confidence that I can do this myself. With the help of a good teachers in a supportive environment. I have found this capacity on the many retreats that I have attended. Mindfulness and the teaching of mindfulness are “inside out” learning and teaching. So while we hold the written curriculum with great integrity, and educate ourselves about the research, and understand the foundations of experiential learning, ultimately we have to know the interior landscape of our own hearts, minds and bodies. This is where the real curriculum lies. If we are asking people to go inside to find their own wisdom, to face pain and loss with openness, curiosity and kindness (a very tall order) then it is important that we do this ourselves. Not just to be good teachers- of what has been described as “Intensive training in meditative practices”, but to really know and live our lives fully. For thousands of years people have found the silent container of retreat, held by strong teachers – who have sat on their own cushions for many hours, to be an effective way to see into the changing nature of things and to build resilience to face whatever comes in our lives with some degree of equanimity. In the age of technology and heightened busyness and distraction, it feels more important than ever, to find this silence and stillness where we can study the real curriculum that lies within.

If this has inspired you, I hope you’ll join us in January 2015 at a 5 night silent retreat designed with you in mind. We’ll meet at the beautiful historic Joshua Tree Retreat Center January 13-18th. Please go to www.mindful-way.com/retreats for more information.

Beth Mulligan, PA-C is a certified MBSR teacher and teacher trainer through UMass Center for Mindfulness. She has been teaching MBSR for over a decade to diverse populations; from the critically ill, to non-profit organizations, the underserved, educators, and corporate leaders. She currently teaches at the Susan Samueli Center for Integrative Medicine at UCI and Insight LA. Beth teaches the 10 week and 9 day practicum for teachers in training nationally and internationally through the UMass CFM. She is also trained in and teaches Mindful Eating and Mindful Self Compassion

Learning to Teach MBCT Practices Via the Web: Technology Supporting Teacher Development

By Zindel Segal, PhD and Sona Dimidjian, PhD

Online Training for Teaching Mindfulness In Your Clinical Practice

Z MindfulNoggin_email_adIt was February in 2010, Sona and I were at the end of the fourth day of teaching together a five-day intensive training in MBCT. We were sitting in the lodge of the meditation retreat center in Joshua Tree, California enjoying the beauty, silence, and spaciousness of our surroundings and beginning to engage a question raised by participants in that workshop, like many before them and many to come: how do I carry all that I have learned back into my daily life and work setting? It is a common reaction among participants who have taken MBCT clinical workshops. It usually surfaces towards the end of the training and is expressed in questions such as ‘what comes next?’ or ‘how can I support my learning?’. As we reflected on these questions, we realized that some of the searching arose from the very natural apprehension about returning to solo practice after days of instructed group learning and returning to the hustle and bustle of daily life after engaging deeply the practices of MBCT in a retreat setting. At the same time, however, we also heard in these questions a desire for more support, guidance and community in their intention to integrate the skills and practices they had learned over the week. We began to wonder about ways in which we could support such intentions, building on what we could provide during in person workshops. How could we best support practitioners as they worked to strengthen the experiential and content learning that comes with personal practice and clinical implementation?

mmb-enroll-imgThe issue resurfaced in an interesting way, during our collaboration to develop an online version of Mindfulness Based Cognitive Therapy. We evaluated this digital version of MBCT – called Mindful Mood Balance – in a quasi-experimental open trial with 100 recovered depressed patients at Kaiser-Permanente Colorado and got promising results, Sona Dimidjian, S. Beck, A. Felder, J. Boggs, J. Gallop, R. & Segal. Z. (in press). Web-based Mindfulness-Based Cognitive Therapy for reducing residual depressive symptoms: An open trial and quasi-experimental comparison to propensity score matched controls. Behaviour Research and Therapy. We are continuing this work on extending MBCT for patients with a recently funded, larger definitive, randomized trial that we will conduct with recovered depressed patients reporting residual depressive symptoms (R01 – MH102229). As we developed Mindful Mood Balance, we began to realize that it was one way we might respond to the questions that were raised at the Joshua Tree retreat center in 2010. Mindful Mood Balance was built to teach patients explicitly some of the core skills of MBCT, but it also might be a valuable resource for clinicians who want to get the “feel” of the MBCT curriculum as it unfolds over time and who might benefit from the structure of an 8-week program in supporting their own practice of the core elements of MBCT. With this knowledge in mind, we also began to imagine other ways in which we could offer training to clinicians on some of the more subtle and challenging aspects of delivering MBCT. We built a program that taught therapists the detailed use of one of the core MBCT skills, the three minute breathing space, which they could use with their clients. We didn’t see either of these offerings as a replacement for in person training, but as another option in the array of treatment/ training resources, with distinct advantages of being able to learn from one’s home on one’s own schedule. .

The Three Minute Breathing Space Course, for example, teaches therapists how to deliver this practice, how to perform inquiry, how to make one’s own recordings and how to integrate the practice into daily life.

Therapists can also participate in a community of learners who are taking the course at the same time. Provided there is interest and benefit, our vision would be to build more contexts for learning responsive to what clinicians find challenging in delivering MBCT.

We have partnered with eLearning experts Brian and Traci Knudson in order to integrate clinical science and leading e-Learning technology, in courseware for health care professionals who want to enhance and enrich their clinical practice through delivering compassionate and effective mindfulness-based interventions. While it is still early days, we are curious to find out whether such modern / technological means can help support others in their use of these ancient / simple practices.

zindel_segal_120x1561Zindel Segal is one of the co-founders and developers (along with John Teasdale and Mark William) of Mindfulness-Based Cognitive Therapy (MBCT). Dr. Segal, along with Sarah Bowen and Steven Hickman, will be leading a 5-Day Professional Training Retreat in MBCT on February 15-20, 2015 at the EarthRise Retreat Center in Petaluma, California. Registration is now open for this experiential training event.

 

 

Mindful Presence: Embodying sensitivity with a heartfelt presence

Professional Training Institute BannerThe UC San Diego Center for Mindfulness has partnered with Susan Woods and Char Wilkins to offer a 5-day program entitled: MBSR:Mindfulness-Based Stress Reduction 5-day Teacher Training, November 11-16, 2013, at the Chapin Mill Retreat Center, Batavia, NY. The following is the second in a series of periodic posts by Susan and Char, sharing their vision and wisdom in formulating and offering this training, and exploring the territory of teaching mindfulness in general. We invite you to get to know them through this series and perhaps to reflect on your own relationship to mindfulness teaching.

By Susan Woods

WoodsSusanIn the second of these of these reflections on the nature of teaching mindfulness I thought it would be interesting to continue with the theme of mindful presence.  As teachers of mindfulness in secular settings, we bring an emotional and cognitive sensibility to our teaching that is based on our personal experience and understanding of mindfulness.  When we respond to questions from our participants via the process of mindful reflective inquiry, we are embodying an awareness that embraces and acknowledges a way of being that is able to stay quietly present even in the midst of ambiguity.  Being able to allow for those places of uncertainty, anxiety, and doubt and then know when and how to respond are important components for our teaching.  It is likely there will be times when one of our participants will ask a question or make a comment that elicits a moment(s) when we have no idea of what’s next or how to respond.  In addition these moments may touch a strong emotional reaction inside of us of doubt, worry, distress, anxiety, irritation, despondence, even anger.  I suspect we have all had some or perhaps all of these instances.

No experience is wasted; even those that have challenged me in sometimes very uncomfortable ways.  When I have found myself in those places, part of my own journey of mindfulness, has been in allowing an emotional and cognitive unfolding that can be relaxed. Remembering to take a breath can help to soften into these moments; relaxing into the body another.  This becomes a way of sensing into the current experience where understanding grows from letting all of the uncomfortableness be present, cognitive, emotional and somatic.

reflectionsBeing emotionally sensitive to these moments requires an active intention and receptivity. Being a mindfulness teacher asks that we are willing to take our seats in the uncertainty and teach to and through that experience.  This means that we include an experiential sense of our own complexity in those moments and in that awareness do our best to step out of our own way.  As we meet these moments we also notice that being gentle and patient rather than a problem solver, allows us to start from where we truly are rather than from where we think we should be.

It is this emotional awareness and sensitivity that we bring to our teaching of mindfulness.  It allows for the landscape of the moment to reveal itself, an inner and outer attunement and brings us into the present, one where we are receptive to our own experience and at the same time responsive to that of the other.  It is a moment of being attuned to an inner and outer noticing, where compassion is embodied through mindful presence, heartfelt sensitivity and through mindful reflective speech.   In this way the teacher and participant(s) are involved in co-creating a journey of relationship which entails a kindhearted understanding of self, of other and the unfolding nature of the present. These moments of connection are sacred moments of wisdom and humility.

Putting good out, Getting good in?

By Blair Buckman

michelleBecker

Michelle Becker, MA, LMFT, Director of Compassion Programs, Senior Teacher

Join Michelle Becker, licensed Marriage and Family Therapist for one of our Mindful Self-Compassion (MSC) programs this fall. Michelle believes, “when we meet suffering with awareness and kindness it is often life-changing.”

We’ve all heard the expression that if “you put good in, you get good out,” but what about the opposite? What about putting “good” out by spreading kindness to oneself and others and seeing the benefits on your health and well-being? More and more research is pointing to the health benefits of exhibitingself-compassion-sm compassion towards oneself and others. Compassion, as defined as an affective state and subjective feeling, distinct from empathy or sympathy, it can be said to encompass three main components, which are self-kindness, common humanity, and mindfulness (Neff, 2003; Schzntz, 2007; Goetz, Keltner, & Simon-Thomas, 2010). Moreover pioneering compassion researcher, Kristin Neff (2003) supplements that compassion involves being understanding of oneself and one’s struggles, viewing one’s suffering in the context of the shared human condition, and being aware and nonjudgmental without over-identification, with a desire to alleviate suffering. Recent compassion research is demonstrating the positive benefits of compassion on one’s health and well-being, including less self-judgment, less isolation, lower levels of pain, anger and psychological distress (Pinto-Gouveia & Costa, 2011; Carson et al., 2005). Other studies refer to the implications of compassion on the neuroendocrine, innate immune, and behavioral responses to psychosocial stress (Pace et al, 2009).

With more research continually demonstrating compassion’s potential, perhaps it is time for you to consider taking one of our upcoming Self-Compassion Programs.

At the UCSD Center for Mindfulness we offer
two great ways to explore Mindful-Self Compassion

The first is by participating in our 8-Week Mindful Self-Compassion Program. The next 8-week MSC program begins in September 11, 2013. The second is by participating in our Two Weekend Intensive November 1-3, 2013 & November 9-10,2013.

We are proud to be the  first center teaching the 8-Week Mindful Self-Compassion program as originated by Drs. Neff and Germer.

 

Finding the Toolkit Within: An MBSR Teacher Training Experience

by Chandra Beal

CB_np_headshot-2Chandra Beal is a Massage Therapist and Yoga Teacher in San Diego. She is currently expanding her understanding of mindfulness with a plan to teach it in the community.

In June I packed a suitcase to spend a week in the desert, my meditation cushion and yoga mat taking up most of the space. I journeyed to Joshua Tree, California with about 50 other people for the inaugural Mindfulness-Based Stress Reduction Teacher Training through the University of California at San Diego’s Center for Mindfulness.

I looked forward to the training for months, counting down the date in my journal. As a long time meditator and yoga teacher, I was excited to expand my experience of mindfulness and pick up the tools to begin teaching MBSR. In preparation, I intensified my mindfulness practice, almost as if I was cramming for an exam. With a curious awareness I observed myself practically swallowing the required reading. I was certainly in a hurry to learn this mindfulness stuff!

As I set off I said a little prayer to myself, that I remain open to whatever the training would bring and meet it with simple awareness. Retreats and group trainings can be intense and life-changing, and I felt some fear of the unknown as I drove off into the desert.

The first hour into the trip I had an ache in my chest. I was already missing my loved ones and feeling homesick. I couldn’t wait to go to the training and now I felt reluctant. Being in between, in the present, was difficult.

The first night we gathered for a lavish dinner, prepared by our own chef who would nourish us all week. We chatted at group tables like the first day of school, with all the excitement and trepidation of what was to come. People had traveled from all over the world and came from different backgrounds, but all had a desire to share mindfulness. Every conversation was inspiring.

The first night we simply sat. There were no student introductions. The teachers, Susan Woods and Char Wilkins, never wrote on the white board. No syllabus was handed out. We simply practiced sitting. That night I felt resistant. I can meditate at home, I thought. I didn’t like the desert. I didn’t like the bed. I didn’t like not having agenda. I couldn’t sleep. I wanted to go home.

The second day we also sat. A lot. I tried to remember my intention to be open to the experience. I also wondered when I was going to get my toolkit. My mind was hungry for the didactic side of learning, the ‘meat’ as I called it. Little did I realize I was already chewing on it. My back hurt from sitting longer than I was used to. But still we sat, extending our practice to remaining silent during our breaks.

By the third day the group was growing restless, everyone wondering how much longer we had to sit, and when we were going to actually talk about teaching this stuff. I felt like I was at meditation boot camp, sleep deprived and frustrated by my own inner blocks, but soldiering on, sitting on my cushion. Meeting my own resistance with my breath.

Then we began to explore the eight-week curriculum in detail, interspersed with practice. We practiced sitting and walking meditation. We worked in pairs with the body scan, and experienced facilitating the group in mindful inquiry. We dipped in and out of experiencing and teaching, which helped to ground us in mindfulness itself.

I began to realize that maybe my toolkit was within. My own practice was going to be the foundation of this work. I wasn’t going to pick up a kit and run; I was going to have to embody the teaching myself. But if I got stuck, all I had to do was take a breath. The practice and the teaching were interwoven like a net, one I could safely relax into.

On the final morning we gathered for a beautiful ritual led by Susan and Char. Sitting in a circle we passed a ball of yarn, each person taking saying a word about what was happening in the present moment. Taking hold of a length of string, they passed the ball on to the next person. Observing the growing web of connection between us all, I chose the word “unity”. Some people cried. We hugged and held hands. We had climbed a little bit of the mountain together.

Then we passed the scissors, a symbol of impermanence, and cut apart our united web, each person taking a section of yarn as a reminder of their experience as we dispersed around the globe to continue our inner and outer practice of this work. I went home, put my notes in a drawer, and sat on my cushion, ready to begin using my toolkit within.

The UC San Diego Center for Mindfulness Professional Training Institute has partnered with experienced clinicians and mindfulness teachers Susan Woods, MSW, LICSW and Char Wilkins, LCSW, to offer two 5-day MBSR teacher training retreat programs.

MBSR: Mindfulness-Based Stress Reduction 5-day Teacher Training,                                                                                                             November 11-16, 2013 at Chapin Mill Retreat Center, Batavia, NY 
March 23-28, 2014 at Sevenoaks Retreat Center, Madison, VA

Advanced Training for MBCT and MBSR Teachers: Embodying Mindful Presence and Investigating Mindful Inquiry,                                July 20-25, 2014 at Chapin Mill Retreat Center, Batavia, NY

Mindful Presence: Embodying kindness and the listening heart

The UC San Diego Center for Mindfulness has partnered with Susan Woods and Char Wilkins to offer a 5-day program entitled: Advanced Training for MBCT and MBSR Teachers: Embodying Mindful Presence and Investigating Mindful InquiryJune 9-14, 2013 at the EarthRise Retreat Center in Petaluma, CA. The following is the second in a series of periodic posts by Susan and Char, sharing their vision and wisdom in formulating and offering this training, and exploring the territory of teaching mindfulness in general. We invite you to get to know them through this series and perhaps to reflect on your own relationship to mindfulness teaching.

WoodsSusanBy Susan Woods, MSW, LICSW

Suffering is not personal, but in so many ways we are inclined to feel it in that way.  Of course the feeling of pain and heartache is universal; it’s what connects us and also what can separate us.  Mindfulness meditation practice encourages and supports us in developing a profound understanding about how we relate to pain and gives us choices on how we can respond.  It took me some time and lots of practice to relax into appreciating this.  What I became aware of was the more I could allow myself to show up and pay a kind and steady attention, without denying or pushing anything away or alternatively chasing after something, the steady momentum of mindfully noticing became compelling as an act of generosity.

reflectionsWe don’t often talk too much about acts of generosity when facing suffering; a sense that it is permissible and might even be imperative to be kind when facing the overwhelming; that by cultivating a tender abiding, embodying an intentional and attentive mindful consciousness which supports a friendly and intimate awareness we come to experience our pain, our difficulties in a different way.  We also come to notice that being mindful is dynamic and creates just enough intuitive and emotional space to acknowledge pain and the story around it without needing to react to it so much.  Learning by this measure we come to see directly the simple and powerful presence of kindness and patience, acknowledging that nothing needs fixing, residing in the meaning of being present and in the power of deep noticing and listening.  And so paradoxically we are able to let go more and more sensing what lies behind the narratives of our ego driven world.

It is this awareness, this presence, that nurtures caring which is deeply compassionate; an attentive listening heart which is quiet, calm, loving and knows from experience the storms of suffering, the rages, the hatreds, criticisms, judgments, frustrations, sadness’s and anxieties.  And when these arise, the listening heart opens, quivers, creates space, embraces, bearing witness to all while residing with the movement of breathing.  Breathing in, inhabiting this moment, breathing out, softening and letting go.  This heart has learned the worth of gentleness, has learned the value of an attending presence – a presence that asks for nothing in return, only this moment now.

In our lives and in our teaching of mindfulness, embodying a mindful presence conveys the hope that we may all slowly walk this journey of kindness with a listening heart.

Mindful Matters: Nourishing Our Wellbeing in Clinical Practice

by Chris Gauthier

There are lots of people, many of them healthcare professionals, who are serving this world by caring for others. Something within some of them is so completely synchronous with the desire to heal others that there is nothing in this life they would rather do. The fact that there are people so committed to helping others become whole is awe-inspiring. However, too many times the basic premise of healing is forgotten: we must heal ourselves if we have intentions of healing others, so we can better serve all.

stethoscopeWith the world of medicine constantly changing, areas of improvement in patient care are abound while its practitioners continue to meekly manage mindful self-care rather haphazardly. In America, this recent structural revolution in the medical industry, regardless of personal opinions and politics on the subject, is significant. The demand for physicians, psychologists, and other medical practitioners is exponentially growing. Medical professionals that do well in their care – because let’s face it, we have or know someone who has had a needlessly negative experience seeking quality care, can be likened to an oasis in this increasingly desert-esque landscape. How do we as practitioners, continue to offer the top care that we do, while combating increasing instances of burn-out, fatigue, and a general lack luster experience where on occasion we may dip our toes into the depths of existential darkness? With greater work loads and less time that we do not have, it is imperative for us to find ways to care for ourselves. These sharp changes in the field require equally acute transformations of focus.

There is another movement germinating in this field z krasner9258-1within the western context that proffers a way for us to take care of ourselves so that we can do what we love: take care of others. This movement is towards mindfulness. Mindfulness in clinical practice is essential to thriving long-term in the duty of serving our patients to the best of our abilities. Mick Krasner, MD FACP practices primary care internal medicine in Rochester NY and teaches that the University of Rochester School of Medicine and Dentistry. Going strong after 12 years of integrating Mindfulness-Based Stress Reduction into the lives of his patients, medical students and various health professionals, Mick might be on to something. A plethora of research on this topic shows an improvement in quality of care of patients, and an increase in well being for the health professionals who practice it. An example of one of the aspects whereby we can incorporate mindfulness is within the context of communication education with our colleagues.

Howard B. Beckman et. al. published a fascinating study exploring mindfulness-based interventions with practitioners, finding that these kinds of mindful communications skills when learned and practiced, promote a sense of community and an increase in time devoted to personal growth. In the paper, “The Impact of a Program in Mindful Communication on Primary Care Physicians,” they conduct in-depth interviews with physicians who had completed a specific 52-hour mindful communication course, which had known effects of reducing distress and burnout as well as increasing empathetic capacities. Generally there were three main themes that surfaced through the randomized qualitative data: 1) sharing personally the experiences from medical practice with other colleagues in the class setting reduced professional isolation, 2) increased skill sets to listen attentively to patients, 3) developing a greater sense of self-awareness is a positive experience. It is clear here as is true in other studies, that learning how to engage in mindfulness practice (and practicing!) does tremendous good for the individual and by proxy, for the community as a whole.

This education in mindfulness has ineffable multi-facetted value, but we already don’t have enough time as it is! So what do we do? Well, one way is by looking for those CE’s that will offer us this kind of education that will teach us to nourish ourselves so we can continue to do the important work that we do. Being aware of the consequences, good and bad, of our decisions we make for ourselves and about ourselves is one of the pillars of this mindfulness journey to creating the life we want to live. We can seek out continuing education courses that we have to do anyway, that will also aid us in this journey towards taking care of ourselves therefore enabling us to sustainably care for others.

We are delighted Dr. Krasner is coming to San Diego on May 11, 2013 to present a daylong workshop on mindful practice entitled “Mindfulness in Clinical Practice: Our Patients, Ourselves.” This event will include an hour-long presentation on the Neuroscience of Mindfulness by Tom Chippendale, MD, Director of Neuroscience at Scripps Health and longtime MBSR teacher. The day-long training has been approved by the AMA PRA for Category 1 Credit.

Work Cited:

Beckman, Howard B., MD, Melissa Wendland, Christopher Mooney, MA, Michael S. Krasner, MD, Timothy E. Quill, MD, Anthony L. Suchman, and Ronald M. Epstein, MD. “The Impact of a Program in Mindful Communication on Primary Care Physicians.” Academic Medicine 87.6 (2012): 1-5. Print.

Krasner, M. S., R. M. Epstein, H. Beckman, A. L. Suchman, B. Chapman, C. J. Mooney, and T. E. Quill. “Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians.” JAMA: The Journal of the American Medical Association 302.12 (2009): 1284-293. Print.

About the Author:

Chris Gauthier is an alumnus of the University of California, San Diego with a degree in Cognitive Science and a focus in Neuroscience. He has many passions, most revolving around skills of wholeness, health, and self-discovery. Chris is affiliated with the UCSD Center for Mindfulness. He also travels and presents a variety of topics in a workshop style, mostly to college-level minds. Mr. Chris Gauthier can be reached at: chris.a.gauthier@gmail.com.