Tag Archives: ADHD

Making Mindfulness Part of Your Life: Insights from an Adult with ADHD

By Lidia Zylowska MD

ZylowskaLidia Zylowska, MD is psychiatrist specializing in adult ADD/ADHD, mindfulness-based approaches and integrative psychiatry. Co-founding member of UCLA Mindful Awareness Research Center, Dr. Zylowska led the development of the MAPs for ADHD program and authored The Mindfulness Prescription for Adult ADHD book.

UCSD Mindfulness-Based Professional Training Institute is Book_zylowska_100pxnow offering Mindfulness for ADHD: Training for Adults, Parents and Professionals. The training will take place August 7-10, 2014 at Earthrise Retreat Center in Petaluma, CA. The training is a retreat-version of the 8-week MAPs for ADHD that my colleagues and I originally developed at UCLA. The training is open to all touched by ADHD: adults with ADHD and their spouses, parents of ADHD children, therapist or teachers that work with ADHD individuals. If that’s you, we hope you’ll join us for this gradual, ADD-friendly introduction to mindfulness. Please click here for more information or to register.

Preparing for the training, I recently posed several questions about mindfulness to Jon Krop, an adult living with ADHD. Jon has been practicing mindfulness for a long time and I wanted him to share his experience. Here are his answers which also highlight the fact that we each have to find ‘what works’ in keeping mindfulness in our lives.

Q: How do you think mindfulness (or meditation) helps with ADHD?

Distraction used to carry me off before I could even acknowledge what was happening. I’d be working on a project, and then before I knew it I’d be fifteen minutes deep in a Wikipedia black hole or surfing through random blogs. The process of distraction seemed to move too fast, with too much momentum, for me to intervene. Meditation has helped me with that. Not always, but decently often, I can spot the impulse to indulge in a distraction the moment it arises and before I reflexively act on it. It feels as if I have an extra second to decide what to do. Even when I don’t catch it that early, I catch myself earlier than I would have before I started my meditation practice.

Along those same lines of having an “extra second” to decide how to act, I feel that meditation has helped me think more before I speak. I used to say unintentionally hurtful things, only to regret it an instant after the words were out of my mouth. I didn’t have a filter — or I guess I had one, but it was too slow-acting to do its job. Now it feels like there’s a bit more space between the urge to speak arising and the words pouring out of my mouth, and I actually have a chance to reflect on whether or not I want to say what I’m about to say.

In general, there’s a feeling of increased clarity and control. I see the contents of my mind — impulses, emotions, thoughts, etc — much more distinctly, like they’re laid out neatly on a workspace in front of me instead of being a sort of murk clouding up my head. And where once my thoughts, impulses, etc would immediately grab me and sort of take possession of me, now I have that extra bit of space that lets me decide how I want to act and which emotions, impulses, etc I want to engage with.

Also, I generally just feel happier and more at ease. I didn’t realize how tense and jittery I felt all the time until I started meditating regularly and those feelings began to subside. My moment-to-moment experience is more peaceful and relaxed, with a sense that everything is basically fine.

Q: How do you think having ADHD has influenced your meditation practice?

I may have a harder-than-average time with the discipline of maintaining a daily practice. It took a lot of years to finally lock that down. Also, I’ve experienced doubts and fears about whether my ADHD will limit my ability to meditate, to progress along the path and experience the full benefits, etc. So far these doubts seem totally baseless, but I’ve had to face and overcome those beliefs so that they don’t become a self-fulfilling prophecy.

Q: Any advice for those for those with ADHD who are new to mindfulness/meditation?

1. Sticking to a daily practice is hard for everyone, and it’s probably even harder for us, but it’s really important. Here’s what’s worked for me:

-I wake up at a set time every morning and immediately meditate, before doing anything else. I have to be really strict about this. If I wake up late or do anything else first — breakfast, a workout, checking my phone — I have trouble getting myself to sit. But when I follow this rule, it’s almost effortless. Not sure why, but that’s how it is.

-If I absolutely can’t meditate first thing in the morning, and the resistance to sitting arises, I have a backup strategy: I shrink the length of the session in my head until I hit a level I don’t feel resistance to. Like, “Could I do 15 minutes? No, I feel resistance, I’m not gonna do it. Okay, what about 10? Still too long, the thought puts me off. Okay, 5? Huh, I don’t feel resistance to that. I feel like I can sit for 5.” I’d much rather sit for a short time, and keep the momentum of my meditation habit, than not sit at all.

2. Do a retreat as soon as you can, whether it’s ten days, or a week, or a weekend, or a day, or whatever you feel ready for. With daily practice alone, it might take a little time for the benefits of meditation to really show themselves (for me, it took a couple weeks). It can be a challenge to stay disciplined and put in daily work for a reward you haven’t experienced yet. You can skip that by doing a short period of intense practice and tasting the benefits right away. That should fire you up for the daily practice.

For More Information and to register for Mindfulness for ADHD: earthriseTraining for Adults, Parents and Professionals, August 7-10, 2014 at Earthrise Retreat Center in Petaluma, CA., please visit the UCSD Professional Training Institute website.

Attention is a Resource—Even With ADD/ADHD, and Mindfulness Training Has Been Shown to Help

By Lidia Zylowska M.D.

ZylowskaLidia Zylowska, MD is psychiatrist specializing in adult ADD/ADHD, mindfulness-based approaches and integrative psychiatry. Co-founding member of UCLA Mindful Awareness Research Center, Dr. Zylowska led the development of the MAPs for ADHD program and authored The Mindfulness Prescription for Adult ADHD book.

Recently the New York Times featured an article titled “Exercising the Mind to Treat Attention Deficits” by Daniel Goleman which highlighted the usefulness of mindfulness training for Attention Deficit Hyperactivity Disorder (ADD/ADHD). It is exciting to see a publication like NYT and the conventional ADHD researchers starting to see value of mindfulness for ADHD. I hope this will further our public and clinicians’ appreciation of mindfulness as a way to strengthen attention and emotion self-regulation skills in ADHD. My only wish is that the article did better job describing the resources that already exist for those interested in this approach, namely the Mindful Awareness Practices (MAPs) for ADHD program we developed at UCLA (1) and the Mindful Parenting/MYmind program developed by Dr Susan Bogel’s at U of Netherlands (5).   Such programs can help those struggling with ADHD (or clinicians that work with them) start incorporating mindfulness for ADHD management.

Book_zylowska_100pxAs an integrative psychiatrist specializing in ADHD, I have been working with ADHD since 2003. As a researcher at UCLA, I designed a feasibility study of mindfulness training in adults and teens with ADHD. The study was one of the first efforts to adapt mindfulness trainings to ADHD and my research collaborators and I set out to put together a program that was relevant to ADHD and overall taught in an ADHD-friendly way. Using MBSR and MBCT as models of mindfulness, we developed an 8-week training—Mindful Awareness Practices (MAPs) for ADHD–that was taught in gradual, ‘chunking way’ often helpful in ADHD. The program introduces new ‘objects of attention’ sequentially, starting with attention itself, then senses, breath, sounds, body, thoughts, feelings and interactions. We weaved ADHD education throughout the training. The formal practice was phased in gradually, starting with 5 min and up to 15-20 min, we emphasized informal practiced in daily life, and included self-compassion training. We anticipated that formal practice may be challenging for those with ADHD and wanted the training to be both flexible and encouraging. We also knew that self-doubt and negative feelings are common in ADHD and that self-compassion was much needed. The approach was well-accepted by teens and adults with ADHD in our study, who also showed reduction in ADHD symptoms, anxiety and depression and improvements on measures of attention and executive functions (1). Follow up studies further support the use of our program with ADHD adults (2) and children (3, 4) while Dr. Bogel’s group has shown that similar mindfulness-based approach can be helpful with families with ADHD children and teens (5-7).

The NYT article shows that combination of ADHD and mindfulness no longer raises eyebrows as it did back when I first started my research work. Then, I often had to respond to a question like this: ‘So you want to have people who have trouble sitting and paying attention sit quietly in meditation and pay attention?’ Now, there is a growing understanding that mindfulness is just the approach for ADHD, especially if taught in a gradual, ADHD-friendly way. So I am excited to say that UCSD Mindfulness-Based Professional Training Institute is now launching our course Mindfulness for ADHD: Training for Adults, Parents and Professionals, August 7-10, 2014 at Earthrise Retreat Center in Petaluma, CA. The training is a retreat-version of the 8-week MAPs for ADHD, a great introduction for those wanting to learn how to use mindfulness for ADHD. I am joined by Gloria Kamler, a long-time meditation teacher and faculty at UCLA Midful Awareness Center.   For this training, we decided to bring general public and clinicians together to create an accepting, non-judgmental learning environment in which both the unique struggles of ADHD and the struggles of ‘human condition’ can be seen on a spectrum. We hope to empower those with and without ADHD to incorporate a mindful and compassionate perspective into their lives.

I hope that if you or someone you know cares about ADHD, you will consider joining us for this training. The retreat setting will offer a respite and you get a concentrated dose of mindfulness. Why not hyperfocus on mindfulness for a weekend!

For More Information and to register for Mindfulness for ADHD: earthriseTraining for Adults, Parents and Professionals, August 7-10, 2014 at Earthrise Retreat Center in Petaluma, CA., please visit the UCSD Professional training Institute website.

Ref:

  1. Zylowska, L., Ackerman, D. L., Yang, M. H., Futrell, J. L., Horton, N. L., Hale, T. S., . . . Smalley, S. L. (2008). Mindfulness meditation training in adults and adolescents with ADHD: A feasibility study. J Atten Disord, 11(6), 737-746. doi: 10.1177/1087054707308502
  2. Mitchell, J. T., McIntyre, E. M., English, J. S., Dennis, M. F., Beckham, J. C., & Kollins, S. H. (in press). A pilot trial of mindfulness meditation training for ADHD in adulthood: Impact on core symptoms, executive functioning, and emotion dysregulation. J Atten Disord. doi: 10.1177/1087054713513328
  3. Uliando, A. (2010). Mindfulness training for the management of children with ADHD. Deakin University, http://dro.deakin.edu.au/view/DU:30033065.
  4. Worth, D (2013) Mindfulness Meditation and Attention-Deficit/Hyperactivity Disorder Symptom Reduction in Middle School Students. Walden University, http://gradworks.umi.com/35/99/3599854.html
  5. Bögels, S., & Restifo, K. (2014). Mindful parenting: A guide for mental health practitioners. New York: Springer.
  6. van de Weijer-Bergsma, E., Formsma, A. R., de Bruin, E. I., & Bogels, S. M. (2012). The effectiveness of mindfulness training on behavioral problems and attentional functioning in adolescents with ADHD. Journal of Child and Family Studies, 21(5), 775-787.
  7. van der Oord, S., Bogels, S. M., & Peijnenburg, D. (2012). The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. Journal of Child and Family Studies, 21(1), 139-147.

Seizing the Moment and Supporting the Work: Giving Mindfulness to the Next Generation

Ellyn Wolfe (2)By Ellyn Wolfe, MEd
Co-Director Workplace Initiatives & Giving
UCSD Center for Mindfulness

Within the virtually exploding field of mindfulness, perhaps no facet is growing faster and spreading wider than that of teaching mindfulness to the youth of our society. Imagine the vast potential of transforming this generation of children into a future generation grounded in a practice that promotes stability and composure, wellness and healthy relationships, and enhanced cognitive function.  This movement is on an unprecedented ascendant path within education, clinical practice and research.

bridging2013badgeThe UC San Diego Center for Mindfulness Bridging the Hearts & Minds of Youth Second Annual conference February 1-3, 2013 in San Diego is uniquely positioned to further contribute to the growth and vibrancy of the field by assembling the thought leaders, program developers, researchers and educators in an environment of collaboration, connection and dialogue. From presentations by leaders like Jon & Myla Kabat-Zinn, to the diversity found in innovative school-based programs such as Katherine Weare of the .b The Mindfulness in Schools Project  and the amazing work of bringing mindfulness and yoga to the inner city by Ali & Atman Smith’s Holistic Life Foundation,  it is all represented at the conference. This year the conference opens with first-ever research symposia covering a variety of topics, including interesting work by Lisa Flook of the Center for Investigating Healthy Minds  on “Mindfulness in Early Education to Promote Self-Regulation”and a full symposia session exploring research around clinical interventions using mindfulness to address issues of kids and teens with chronic pain, HIV, and ADHD. This movement is on an unprecedented ascendant path within education, clinical practice and research.

The conference presents an opportunity for those who actively participate and contribute, to make a real and lasting difference in the course of society, and in particular, to the field of bringing mindfulness to the next generation. The Center for Mindfulness is actively seeking the financial support of individuals and corporations who are interested in making an impact on the emergent field of mindfulness as an agent for change.  These contributions are essential to our success in connecting and supporting the hundreds of educators, researchers and experts who will attend the Bridging the Hearts & Minds of Youth conference and then carry the practice and research learned to every corner of the globe.  Every donation as a general conference supporter or as sponsor for the Friday night Dr. Jon Kabat-Zinn public lecture (which benefits the Youth and Family Programs at UCSD CFM) is important.  Every donation makes a difference.

We welcome the support of anyone in a position to give and make a significant difference in the lives of our children through supporting the important work of this conference and its attendees. If you or someone you know is interested in supporting this work, please feel free to contact us at mindfulness@ucsd.edu or by calling 858-334-4636.

One can also donate directly via the Center for Mindfulness Online Giving site.

Author’s Note: Education that motivates the individual to higher levels of being has always been a part of my life.  With a master’s degree from the Harvard Graduate School of Education, a master’s certificate from the Fielding Institute in Evidence Based Coaching, and Clinical Training in Mind/Body Medicine with Dr. Herbert Benson at the Mind/Body Medical Institute in Boston, I train corporate leaders in the art of coaching and coach clients to be the best they can be.  For the past twenty years I have worked in the corporate world teaching mindfulness-based programs for a variety of companies, including Dr. Herbert Benson’s Mind Body Medical Institute, FleetBoston Financial and the San Diego Convention Center.  What a different place the corporate world would be if employees and leaders had grown up understanding and practicing mindfulness.

To that end, I have recently been named as Co-Director of Workplace Initiatives and Giving, a newly launched arm of the UCSD Center for Mindfulness.  I will be working with my co-director, Christy Cassisa, to develop programs that address corporate need and also to elicit support for the UCSD CFM. I look forward to hearing from you through the Center for Mindfulness at mindfulness@ucsd.edu.

The Family ADHD Solution

The Family ADHD Solution, by Dr. Mark Bertin is the newest addition to our UCSD CFM Bookstore.

“Mark Bertin has written an insightful guide to help families approach the challenges of attentional difficulties with a mindful approach. Research has suggested that learning to be mindfully aware can help reduce stress, focus the mind, keep emotions balanced, and even improve your immune function. The bottom-line of these studies is that you can learn to approach challenging situations with resilience. So why not take the small amount of time to read this wonderful book and prepare yourself and your family well for the challenges ahead?”
–Daniel J. Siegel, M.D., author of Mindsight: The New Science of Personal Transformation and Parenting from the Inside Out

“The stress on parents raising a child with a developmental disorder such as attention deficit/hyperactivity disorder (ADHD) can be intense. It frequently is amplified by all the misinformation about ADHD available in our modern world, which may lead parents to believe they or their child are to blame in some way. This misinformation also can bias family and friends, leading them to be judgmental of parenting skills and to attribute behavioral issues to anything but the actual biological causes of ADHD. The chronic stress of parents has broad implications for all family members.

The Family ADHD Solution addresses parental stress and well-being as well, as that of their children. The foundation of comprehensive ADHD care is compassionate objectivity – in other words, mindfulness. Without any need for formal training, through reading this book parents begin to practice mindfulness as they start to grasp the intricacies of ADHD, better understanding their child and creating appropriate supports at home and school.

In his blog on Psychology Today, Dr. Bertin notes, “ADHD has distinct biological causes, and symptoms extend far beyond inattention and hyperactivity. It’s not a matter of effort for a child; it’s a matter of what skills they have, which ones they don’t yet have, and the care they need to develop them. Complicated decisions are simplified when parents acknowledge the reality of ADHD – including the fact that their kids generally are trying to do the best they can, and struggling because of their ADHD symptoms.”

Likewise, parents of kids with ADHD are trying to do the best they can and often struggling. The amount of effort and consistency required over the years may feel draining. When stress takes over for a parent, it affects their decision making and how they relate to their kids. It also affects how they address problems day-to-day, with old habits more likely to take over, and new possibilities less likely found. And a child’s behavior and well-being may be influenced by how their parents experience stress.

The Family ADHD Solution addresses these challenges through the practice of mindfulness. When parents practice mindfulness, they not only tend to feel calmer and more balanced day-to-day, their children benefit as well. The Family ADHD Solution integrates mindfulness into evidence-based, practical ADHD advice and helps both parents and their children find their way onto a simpler, more balanced path.

For more information, please visit Dr. Bertin’s website.

Cheers! Here’s to Wonderful Old Wine in Amazing New Mindfulness-Based Bottles

By Steven Hickman, Psy.D.
Director, UCSD Center for Mindfulness

A colleague of mine emailed me yesterday to ask my advice. She had submitted a paper for publication in a respected scientific journal that looked at one particular aspect of Mindfulness-Based Stress Reduction (MBSR). One of the reviewers, apparently intending it as a significant criticism, asked if MBSR wasn’t just “old wine in new bottles”, noting that Carl Rogers and Gestalt therapists had been bringing mindfulness into psychotherapy years before anyone had heard of MBSR. She wanted to know how to respond to this rather stern criticism of her very thoughtful and innovative work.

I told her that she should agree with the reviewer.

Mindfulness is indeed, VERY old wine. Relatively speaking, MBSR and all the rest of the mindfulness-based interventions being devised and deployed in clinical practice these days are indeed quite new “bottles.” But nobody has suggested otherwise! From the beginning, Jon Kabat-Zinn (MBSR) , Marsha Linehan (Dialectical Behavior Therapy – DBT), Zindel Segal, Mark Williams and John Teasdale (Mindfulness-Based Cognitive Therapy – MBCT) and other treatment developers have openly and reverently acknowledged the very deep and ancient roots of mindfulness, mindfulness practice and the wisdom of drawing on these roots for the relief of suffering.

In his book Full Catastrophe Living, Jon Kabat-Zinn writes:

Although at this time mindfulness meditation is most commonly taught and practiced within the context of Buddhism, its essence is universal. Mindfulness is basically just a particular way of paying attention. It is a way of looking deeply into oneself in the spirit of self-inquiry and self-understanding. For this reason it can be learned and practiced, as we do in the stress clinic, without appealing to Oriental culture or Buddhist authority to enrich it or authenticate it. Mindfulness stands on its own as a powerful vehicle for self-understanding and healing. In fact, one of its major strengths is that it is not dependent on any belief system or ideology, so that its benefits are therefore accessible for anyone to test for himself or herself. Yet it is no accident that mindfulness comes out of Buddhism, which has as its overriding concerns the relief of suffering and the dispelling of illusions. (p. 12-13)

But where the analogy of old wine in new bottles falls apart, is that the “bottles” or the interventions themselves are an integral part of what makes these new programs effective and powerful. These are not meditation classes or silent retreats at remote monasteries, but fully thought out, carefully devised and thoroughly researched psychological interventions that honor the roots of their “wine” and skillfully bring it to suffering individuals in very systematic, deliberate and empirically-supported ways.

A plethora of studies have established MBSR as an effective intervention for addressing the suffering associated with chronic pain, cancer, sleep disturbance, anxiety, and ADHD, just to name a few (Grossman, 2004)(Hofmann, 2010). The 8-week program has been shown to not only reduce a variety of physical and psychological symptoms, but more recently has been shown to bring about structural, measurable changes in the brain itself. Constructed thoughtfully, MBSR has a relatively standardized protocol and logical progression that has consistently (for over 30 years) guided skeptical novices (facing the full spectrum of illness and symptoms, both medical and psychological) through a series of specific exercises and homework practices to a place of ease and equanimity that motivates them to want to continue various forms of mindfulness and meditation practice for years to come.

Focused on helping people alter their relationship with the experiences of their lives (whether those experiences are physical symptoms like pain, or mental phenomena like critical thoughts), mindfulness practice exposes options and flexibility that many never realized they had. One patient of mine with chronic neck and back pain (and significant depression as well) said it best when he noted, “I’ve been a tough guy all my life. I learned to play hurt in sports, to claw my way to the top of my field, and even to fight every day with this horrendous pain. What mindfulness allowed me to do was to see that I could dance with my pain.”

A recent randomized clinical trial reported in the Archives of General Psychiatry by Zindel Segal and his colleagues has established MBCT as an equally effective treatment to antidepressant medication in preventing relapse in previously depressed patients (Segal et al. 2010). Based upon the twin foundations of cognitive behavioral therapy and mindfulness, MBCT is being implemented with a wider and wider variety of diagnostic populations with repeated (if still somewhat preliminary) success. The heart of MBCT is encouraging the patient to simply notice the activity and patterns of the mind, adopting a “decentered” stance toward thinking in which thoughts are experienced as arising phenomena in awareness and not fact or imperative. The patient begins to become aware of the constructions of the mind, the “stories” if you will, that the mind constructs around the actuality of experience. The unreturned wave of a friend soon balloons into yet another indication that one is not worthy of friendship. The flutter of a heartbeat in a stressful situation soon billows into the anxious mushroom cloud of the specter of a heart attack.  And the patient learns to adopt an abiding presence that notices these processes and recognizes the option to not become entangled in them in the way in which they have in the past.

In his 1923 encyclopedia article “Psycho-Analysis,” Freud noted that “the attitude which the analytic physician could most advantageously adopt was . . . a state of evenly suspended attention, to avoid so far as possible reflection and the construction of conscious expectations.”

“Construction of conscious expectations” indeed! And with some perspective and “evenly suspended attention” one can encounter the frightful booming Wizard of Oz and also notice the presence of the pathetic little man behind the curtain. Thoughts are not facts. “Don’t believe everything you think,” says the bumper sticker.

It is my observation that mindfulness, at its essence, is not a treatment in and of itself. It is a very important component of all good treatment, whether explicitly named or not. It is the attitude that we embody when we work with clients and patients, the space we create with them in the therapy room, and healing force that works in them when they encounter what they have often encountered and respond in a healthy way rather than react in a habitual way. And it can also be utilized in a very specific, explicit and replicable way to address a variety of psychological disorders.

I happily and gratefully acknowledge the roots of the old wine in its “new bottles.” And raise my glass to toast those who have applied their considerable wisdom, experience and intelligence to finding ways to relieve suffering in thousands, if not millions of our fellow human beings.

Cheers!

NOTE: This article will be appearing in the upcoming edition of the newsletter of the California Psychological Association.
REFERENCES:
Kabat-Zinn, J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Delta. 1990

Grossman, Niemann, Schmidt and Walach Mindfulness-based stress reduction and health benefits: A meta-analysis Journal of Psychosomatic Research/Vol 57 (No. 1), July 2004

Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol./Vol 78 (No. 2), Apr 2010

Segal, Bieling, Young, MacQueen, Cooke, Martin, Bloch and Levitan Antidepressant Monotherapy vs Sequential Pharmacotherapy and Mindfulness-Based Cognitive Therapy, or Placebo, for Relapse Prophylaxis in Recurrent Depression Arch Gen Psychiatry/Vol 67 (No. 12), Dec 2010

Mindfulness for ADHD

Frequently people ask about whether mindfulness “works” for people with ADD or ADHD. Dr. Zylowska has published extensively on this topic. Take a look: http://www.lidiazylowska.com/