Mindfulness,Mindfulness,Mental Health, Mental Health, and the Brainand the Brain

Richard W. Sears, Richard W. Sears, PsyD, PhD, MBA, ABPPPsyD, PhD, MBA, ABPP

Clinical Psychologist, Private PracticeClinical Psychologist, Private PracticeAlliance Institute for Integrative MedicineAlliance Institute for Integrative Medicine

UC Center for Integrative MedicineUC Center for Integrative Medicine

Stress ResponseStress Response

Adrenalin & cortisolHeart rate & blood pressureDigestion stopsMuscles tighten

Stress ResponseStress Responseshort-term – helpful – then relax

long-term – many problems

90% of doctor’s visits have a stress component

What is Mindfulness?What is Mindfulness?““the awareness that emergesthe awareness that emerges

through paying attention through paying attention

on purpose, on purpose,

in the present moment, in the present moment,

and nonjudgmentally and nonjudgmentally

to the unfolding of experience to the unfolding of experience moment to moment” moment to moment”

(Kabat-Zinn, 2003, p. 145)(Kabat-Zinn, 2003, p. 145)

Being vs. DoingBeing vs. DoingBeing: Present focusedBeing: Present focused

Doing: Future focusedDoing: Future focused

What is Mindfulness?What is Mindfulness?

Relating differently to stressRelating differently to stressWorryWorryGetting stuck in vicious circlesGetting stuck in vicious circlesDiving into the swimming pool Diving into the swimming pool Stepping back from thoughtsStepping back from thoughts

Exercising the brainExercising the brain

Brain Changes After 8 Weeks(Sara Lazar, PhD)

“Participating in an 8-week mindfulness meditation

program appears to make measurable changes in brain

regions associated with memory, sense of self, empathy and stress”

www.sciencedaily.com

Neurological FindingsNeurological Findings

Neurological FindingsNeurological Findings

The Nine Middle Prefrontal Functions(The Mindful Brain, Dan Siegel MD)

• Body Regulation• Attuned Communication• Emotional Balance• Response Flexibility• Empathy• Insight, or self-knowing awareness• Fear modulation• Intuition • Morality

Neurological FindingsNeurological Findings

Children - MBCT-C (12 wks)

Increased activation of structures that subserve interoception and processing of internal stimuli

Increased mindfulness predicts decreased amygdala activity during fear processing

•Increases in bilateral insula, lentiform nucleus, thalamus, & left anterior cingulate while viewing emotional stimuli.•Increased mindfulness associated with increased activation in bilateral anterior cingulate & insula during emotional stimuli.•Post-tx decreases in right amygdala activation

(Strawn, Cotton, Luberto, Patino, Stahl, Weber, Eliassen, Sears, & DelBello, 2014)

Children - MBCT-C (Strawn et al, 2014)

Research-Supported Treatments

http://www.psychologicaltreatments.org/ (APA Div 12)

Behavior Therapy and CBT• “modest to strong research support”

Mindfulness-Based Cognitive Therapy• “strong research support” (with CT-Depression)

Acceptance and Commitment Therapy• “modest to strong research support”

Dialectical Behavior Therapy• “strong research support”

Mindfulness-Based Stress Mindfulness-Based Stress Reduction (MBSR)Reduction (MBSR)

•Pioneered by Jon Kabat-Zinn (Full Catastrophe Living)• 8-week program• Large groups• Daily homework• Incorporates yoga• Initially used for stress & chronic pain

Mindfulness-Based Cognitive Mindfulness-Based Cognitive Therapy (MBCT)Therapy (MBCT)

•Pioneered by Segal, Teasdale, & Williams • 8-week program, based on MBSR• Smaller groups• Daily homework, CBT assignments• Incorporates CBT elements (recognizing cognitive

distortions, relapse prevention plan, etc)• Initially used for prevention of depressive relapse

Mindfulness-Based Relapse Mindfulness-Based Relapse Prevention (MBRP)Prevention (MBRP)

Pioneered by Alan Marlatt & Sarah Bowen

8-week program, based on MBSR/MBCT

Person-Centered / Rogerian Approach

Motivational Interviewing style

“Urge surfing”

Dialectical Behavior Therapy Dialectical Behavior Therapy (DBT)(DBT)

Pioneered by Marsha Linehan

> 6 months

Team Approach Indiv Th, Skills Group, Support Group, Crisis Line

Four major modules:Mindfulness (Wise Mind)Interpersonal EffectivenessEmotion RegulationDistress Tolerance

Mindfulness exercises are very brief

Radical Acceptance

Acceptance and Commitment Acceptance and Commitment Therapy (ACT)Therapy (ACT)

Pioneered by Steven C. Hayes

Relational Frame Theory / Cognitive Fusion / Psychological Flexibility

Acceptance/MindfulnessFormal exercises are less emphasized

CommitmentMove toward valuesBehavioral activation

Other Interventions Under Other Interventions Under DevelopmentDevelopment

•Mindfulness-Based Eating Awareness Training (MB-EAT)

•Mindfulness-Based Elder Care (MBEC)•Mindfulness-Based Childbirth & Parenting (MBCP)•Mindfulness-Based Relationship Enhancement

(MBRE)•MBCT-C (children)•MBCT for Cancer•MBCT for PTSD

3-Minute Breathing Space3-Minute Breathing Space

Minute 1 – Noticing this momentMinute 1 – Noticing this moment Body, feelings, thoughtsBody, feelings, thoughts

Minute 2 – BreatheMinute 2 – Breathe Mind wanders, just bring it backMind wanders, just bring it back

Minute 3 – Be in your bodyMinute 3 – Be in your body If it’s already here, just feel itIf it’s already here, just feel it

Mindful LivingMindful Living

Notice what you’re doingNotice what you’re doingRemember to breatheRemember to breathe

Let go of struggleLet go of struggleBe kind to yourselfBe kind to yourself

Suggested ReadingsSuggested Readings

Full Catastrophe LivingFull Catastrophe Living-Jon Kabat-Zinn-Jon Kabat-Zinn

Mindfulness:Mindfulness:Living through Challenges and Living through Challenges and

Enriching Your Life in this MomentEnriching Your Life in this Moment--Richard W. SearsRichard W. Sears

ContactContact

Richard W. SearsRichard W. Sears

www.psych-insights.com

513-899-MIND (6463)513-899-MIND (6463)

Alliance Integrative MedicineAlliance Integrative Medicine

www.myhealingpartner.com

513-791-5521513-791-5521