Lisa  Wolk RDN,  LDThe  Center  for  Mind  Body  

Nutrition

Coping  well  with  disruptionsBouncing  back  easily  from  setbacksOvercoming  adversityAbility  to  change  direction  when  the  old  way  is  no  longer  working

with  a  fresh,  green  living  core.    When  twisted  out  of  shape,  such  as  a  twig  bends,  but  it  does  not  break;  instead,  it  

George  Vaillant in  Aging  Well

developing  brain  is  the  most  malleable  and  most  sensitive  to  experience,  (This  is  why  we  so  easily  and  rapidly  learn  language,  social  nuance,  motor  skills,  and  dozens  of  other  things  in  childhood,  and  why  we  

A.  Masten (1994)

Most  of  us,  at  some  point,  will  be  struck  by  one  or  more  major  traumasFor  some,  these  events  will  cause  chronic  stress,  possibly  lasting  for  yearsSome,  may  become  depressed,  withdrawn,  cynical  or  angrySome,  will  take  up  drinking  or  drugs  to  numb  the  painIn  contrast,  some  will  meet  the  challenge  and  after  a  period  of  time,  bounce  back  and  carry  onSome  will  evolve  better  than  before  the  tragedy  and  find  it  as  an  opportunity  for  growth

Realistic  OptimismConfronting  FearSocial  SupportHealthy  Moral  CompassReligion  or  SpiritualityHealthy  Role  ModelsPhysical  FitnessBrain  FitnessCognitive  and  Emotional  FlexibilityMeaning  and  Purpose  in  Life

The  opposite  of  learned  optimism  is  learned  helplessnessPositive  emotion  helps  us  increase  our  creativity,  physical  health,  and  relationshipsThere  is  a  hereditary  component  to  an  optimisticpersonality,  but  this  can  be  improved,  even  in  the  pessimistOptimism  provides  energy  to  power  the  rest  of  the  resilience  factorsOptimists  are  more  likely  to  report  that  their  lives  have  meaning

The  greater  the  optimism  in  the  caregiver,  the  more  likely  he  or  she  is  to  be  engaged  with  the  patientA  patient  who  expects  an  optimistic  outcome  will  be  more  likely  adhere  to  treatment  goals  and  actively  pursue  them

Make  a  true  statement  of  your  abilities  and  increase  it  by  10%Stamp  a  clear  picture  in  your  mind  of  your  success  no  matter  how  badly  things  seem  in  the  momentJournal  a  list  of  positive  and  peaceful  thoughts  dailyDo  not  build  up  obstacles  in  your  imagination

Start  each  day  by  affirming  positive,  successful,  peaceful,  and  happy  attitudesCultivate  friendships  with  those  who  share  this  hopeful  attitudeAvoid  conversations  that  involve  heavy  amounts  of  worry

When  something  bad  happens:

Where  there  is  currently  pain,  over  time,  good  things  will  returnOne  day  at  a  time

Bring  in  resources  and  support  where  you  canFind  the  good  in  the  situation

When  something  good  happens:Give  yourself  credit  for  your  role

eventThink  of  ways  to  extend  the  good  happening  into  other  areas  of  your  life

Ask  yourself  the  following  questions:What  is  the  evidence  for  this  negative  belief?Is  there  a  less  destructive  way  of  looking  at  this  belief?Am  I  catastrophizing  or  exaggerating  the  potential  negative  impact  of  the  situation?How  useful  is  my  pessimistic  approach  at  hand?

What  you  think,  you  become;

What  you  feel,  you  attract;

What  you  imagine,  you  create.Buddha,  The  Dhammapada

The  eye  is  the  lamp  of  the  body.So,  if  your  eye  is  good,  your  whole  body  will  be  full  of  light;  But  if  your  eye  is  bad,  your  whole  body  will  be  full  of  darkness.

Bible,  Matthew  6:22

All  or  nothingMind  readingFortune  tellingMagnification/MinimizationShould  statementsLabelingEmotional  reasoningPerfectionismComparisonSelf-­‐righteousnessApproval-­‐seeking

The  Science  of              Resiliency

Fight  or  Flight  ReactionRelease  of  catecholaminesHPA  Axis  (Hypothalamic  Pituitary  Adrenal  Axis)  is  the  

flight  systemThese  responses  are  perfect  in  a  dangerous  situation  but  not  on  a  chronic  basis

Stress  (Allostatic  Loading) Selective_________________                    =        Vulnerability

Resiliency  Factors                                    Propensityto

IllnessAdapted  from  Dr.  Greg  Fricchione,  Benson  Henry  Institute  for  Mind  Body  Medicine  

Associated  with  elevated  allostatic      loading

Higher  levels  of  HTN,  Coronary  Disease,  Diabetes,  Depression  and  

Anxiety

We  live  in  different  subjective  worlds  even  though  the  world  we  live  in  is  the  same

Happy:    Motivated  by  reward  (top-­‐down  response)Unhappy:    Motivated  by  fear  (bottom-­‐up  response)

Same  situation  can  have  2  different    responses  depending  on  where  your  brain  is  living

Techniques  to  protect  the  brain  and  body  from  the  toxic  effects  of  stress  can  be  learnedYou  can  develop  a  stress-­‐resilient  mindsetYou  can  learn  stress  resilient  skills  to:

Reduce  anxietyElevate  moodExperience  a  more  positive  moodEnhance    calm,  mindful  behavior

MINDFULNESS

The  awareness  that  arises  by  paying  attention,  on  purpose,  in  the  present  moment,  and  non-­‐judgementally.

Jon  Kabat-­‐Zinn

Understanding  mindfulness  as  a  practice  rather  than  an  idea

Any  transformational  changes  must  be  experienced

Most  of  our  day  is  governed  by  habit  and  inattentionOur  thoughts  tend  to  travel  from  past  events  to  future  anticipations  spending  very  little  time  in  the  presentWe  have  little  understanding  as  to  why  we  have  particular  thoughts  or  repetitive  thoughtsWhen  we  do  stay  in  the  present,  we  tend  to  churn  out  relatively  useless  information.  

IntoxicationFoodEntertainmentOver-­‐devotionIncessantly  busy  livesHours  on  the  internet

Make  snap  judgements  about  ourselves  and  others  based  on  little  evidenceSpin  out  false  storiesCompare  ourselves  to  others.Put  ourselves  down

Cultivation  of  Attention      

Sustained  Awareness

Beginning  Check  In

This  is  a  brief  3  minute  practice  that  you  can  use  to  be  mindful  of  the  present  moment  and  center  yourself  for  whatever  is  coming  next  in  your  day.    Although  short,  it  can  help  you  recognize  how  you  are  feeling  mentally,  physically,  and  emotionally.    This practice  can  be  incorporated  into  your  daily  life,  using  it  as  often  as  you  like  throughout  the  day.    I  suggest  practicing  with  your  eyes closed  and  in  a  quiet  environment  where  you  will  not  be  disturbed.    It  can  be  done  sitting  or  lying  down,  but  in  a  way  that  will  not promote  sleep.

Take  a  few  moments  to  be  still.

Take  a  few  deep  breaths.    Feel  the  belly  rise  and  the  air  coming  in  through  your  nose  on  the  in  breath  and  feel  your  belly  contracting  as  you  breath  out.    Once  more,  breathing  in  through  your  nose  and  releasing  through  your  mouth.  

Begin  the  mindful  check-­‐in  by  feeling  into  your  body  and  mind  and  simply  allowing  for  any  waves  of  thought,  emotion,  or  physical  sensation.    Perhaps  this  is  the  first  break  you  have  taken  during  a  busy  day.    As  you  begin  to  enter  the  world  of  being,  rather  than  doing,  you  may  notice  several  feelings  that  you  have  been  carrying  around  throughout  your  morning/day.    You  may  notice  sensations  in  your  head  or  neck  or  shoulders  that  you  had  not  previously  noticed.    

There  is  no  need  to  judge,  analyze,  or  figure  anything  out.    Just  allow  yourself  to  be  here  and  now,  amidst  everything  that  is  this  present  moment.    

Allow  any  thoughts  to  be  acknowledged  and  watch  them  dissipate.    

As  you  come  to  the  end  of  the  mindful  check-­‐in,  congratulate  yourself  for  taking  the  time  to  take  care  of  your  health  and  well-­‐being.

Begin  to  come  back  to  the  room  and  when  you  are  ready  ,  you  can  open  your  eyes.

Practice  1:    The  Three  Minute  Breathing  SpaceMinute  1   AwarenessTake  a  pause.    If  you  care  to,  closing  your  eyes.    Bringing  your  attention  to  your  body:    noticing  bodily  sensations  (heaviness,lightness,  temperature,  breath  rate,  heart  rate,  ect.);  then  attending  to  your  thoughts:    Is  your  mind  calm?    Are  your  thoughts  racing?  What  is  the  quality  of  thought?    (dense,  light,  fleeting,  ect.)    Then  attending  to  mood  states:    How  do  you  feel  in  the  moment?    (peaceful,  anxious,  joyful,  sad,  ect.).    Acknowledge  and  register  your  experience,  even  if  it  is  unwanted.Minute  2   GatheringThen,  gently  bring  your  attention  to  your  breathing,  to  each  in-­‐breath  and  to  each  out-­‐breath,  as  they  follow,  one  after  the  other.    When  your  attention  is  drawn  away,  noticing  that,  and  gently  bringing  it  back  to  the  breath.Minute  3   ExpandingExpand  the  field  of  your  awareness  beyond  the  breath,  back  to  the  sensations  in  the  body,  thoughts  and  mood  state.    Checking  in  to  how  it  is  with  you  now.    This  breathing  space  provides  a  way  to  step  out  of  automatic  pilot  mode  and  reconnect  with  the  present  moment.Freely  adapted  from  Segal,  Z.V.  Williams,  J.M.G.,  and  Teasdale,  J.D.  (2002)    Mindfulness-­‐based  cognitive  therapy  for  depression. A  new  approach  for  preventing  relapse,  new  york:  Guilford  Press

Practice  2:    Relaxing  SighsInhaling  through  your  nose  and  exhaling  through  your  mouth,  making  a  quiet,  relaxing  sigh  as  you  exhale.    Taking  long,  slow,  gentle  breaths  that  rise  and  lower  your  abdomen  as  you  inhale  and  exhale.    Focusing  on  the  sound  and  feeling  of  your  breath.You  can  use  cues  throughout  your  daily  routine  to  remind  yourself  to  take  three  to  six  relaxing  sighs  (red  lights  while  driving,telephone  sounds,  waiting  for  elevators,  waiting  in  line,  ect.)    You  may  want  to  place  stickers  in  areas  where  you  look  frequently,  or  

MBSR  for  Professionals:  presented  by  Jefferson-­‐Myrna  Brind Center  for  Integrative  Medicine

ALLOWBy  Danna  Faulds

There  is  no  controlling  life.Try  corralling  a  lightning  bolt,containing  a  tornado.    Dam  astream  and  it  will  create  a  newchannel.    Resist,  and  the  tide  will  sweep  you  off  your  feet.Allow,  and  grace  will  carry

you  to  higher  ground.    The  onlysafety  lies  in  letting  it  all  in  the  wild  and  the  weak;  fear,

fantasies,  failures  and  success.When  loss  rips  off  the  doors  of  the  heart,  or  sadness  veils  yourvision  with  despair,  practice

becomes  simply  bearing  the  truth.In  the  choice  to  let  go  of  yourknown  way  of  being,  the  whole

world  is  revealed  to  your  new  eyes.

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Contu,  D.  (2002).  How  Resilience  Works.    Harvard  Business  Review.  May,  46-­‐55

Folkman,  S.  (1997)  Positive  psychological  states  and  coping  with  severe  stress.    Social  Science  and  Medicine (1982),  45  (8),  1207-­‐1221

Kabat-­‐Zinn,    J.  (2013).    Full  catastrophe  living.  New  York,  NY:  Bantam  Books

Peale,  N.V.  (1952).  The  Power  of  Positive  Thinking.  Englewood  Cliffs,  NJ:  Prentice-­‐Hall.

Seligman,  M.E.P.  (1998)  Learned  optimism:  How  to  change  your  mind  and  your  life.    New  York,  NY:  Free  Press

Seligman,  M.E.P.  (2002).    Authentic  Happiness:  Using  the  new  positive  psychology  to  realize  your  potential  for  lasting  fulfillment.    New  York,  NY:  Free  Press

Southwick,  S.,  Charney,  D.  (2012).    Cambridge  University  Press

Stahl,  B.,    Goldstein,  E.    (2010)  .    A  mindfulness-­‐based  stress  reduction  workbook.    Oakland,  CA:  New  Harbinger  Publications,  Inc.

The  role  of  mindfulness  in  Positive  Reappraisal.    Author  manuscript;  available  in  PCM  2009  Jul  31.    Published  in  final  edited  form  as:  Explore  (NY).  2009;5  (1):  37-­‐44.  doi:  10.1016/j.explore.2008.10.001