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8/3/2019 Mindfulness & Stress Reduction
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Rezvan Ameli, Ph.D.Chief Psychologist and Director of Clinical
Training, MAP-NIMH
May 2009
www.rezvanameli.com
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Some Facts About Mindfulness Mindfulness does not require any particular religious
or cultural belief system.
It is not something we acquire.
It is simple but not easy!
There has been and explosion of interest inmindfulness.
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Definition # 1"Mindfulness is to be aware . To be aware when you are breathing in and to be aware when you are
breathing out…it is the capacity to be aware of what is here. Anything can be the object of mindfulness. Your breath. The sky. It is to be intouch with our felt experience in each moment“
Thich Nhat Hanh
Book recommendation: Peace is Every Step
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Definition # 2"Mindfulness is paying attention,
on purpose,
in the present, and
non-judgmentally ,
to the unfolding of experience moment by
moment” Jon Kabat-Zinn
Book Recommendation: Full Catastrophe Living
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Definition #3“ Mindfulness is to distinguish
awareness from mental activity
it is to learn to be aware of our own mental states without being caught in them “
Jack Kornfield
Book Recommendation: Wise Heart
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Influential scientist of mindfulness:
the Buddha
Subject: Human Condition
Finding: Suffering is universal. We suffer because of the way in which we relate to
our human condition (not the human conditionitself).
There is hope of liberation from suffering
Suggestion: Replace the word “suffering” with
“stress”
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Pain vs. SufferingPain
First Arrow
Inevitable Sensation
Impermanence(Sickness, old age,
death) is inherent inhuman condition
Suffering
Second Arrow
Optional Pain + resistance
Attachment to theoutcome
(Avoidance/Clinging)
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What is the Solution?
Accept what is, including impermanence
Let go of attachments Stay “present” (live in our bodies not in our
heads)
Maintain a kind & friendly attitude towardsourselves and others
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Attitudinal Foundations of Mindfulness Non-Judging
Patience
Trust Non-striving
Acceptance
Letting go
Beginner’s Mind
Adapted from Full Catastrophe Living by Kabat-Zinn
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Be empty of worryingThink of who created thought
Why do you stay in prison
When the door is so wide open Move outside the tangle of fear thinking
Live in silence
Flow down and down Into always widening
Rings of being -Rumi
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Stress Reaction Vs. Response
Stress reaction: External event internal event
alarm reactivity
stress reaction
acute hyperarousal increases chance of survival in a dangerousand hostile situations
Stress Response: introducing conscious process that
influences the flow of events that are likely to bringabout automatic reactivity.
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We can make a choice:
React or Pause and Respond
“Between the stimulus and response, there is a space
and in that space lies our freedom and power tochoose our response."
Victor Frankl
We can choose not to throw the second arrow atourselves
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The President pauses . . .
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Adverse impact of stress Immune system
Cardiovascular system
Nervous system Increases inflammation
Increases negative mood states
Increases adrenaline and cortisol levels
Sky is the limit
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Stress
Changeable aspects
Problem focusedstrategies
Teaching skills/providing information
Unchangeable aspects
Acceptance Compassion
Humor
Keeping count of
positives in life
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Familiar?God grant me the serenity
to accept the things I cannot change;courage to change the things I can;
and wisdom to know the difference.
Reinhold Niebuhr (1892-1971)
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Positive & Negative Affect
Are not on the same continuum.
Impact physiological , behavioral and social domains
They impact disease outcome (Grant, et al 2009) andlongevity (Nyklicek & Kuijpers 2008)
Mindfulness decreases negative affect and increases
positive affect (Ludwig & Kabat-Zinn 2009, Greeson2008, Baer 2003)
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Mindfulness Research Pain management/pain reduction (Kabat-Zinn)
Immune functions (Kabat-Zinn, Creswell)
Brain function changes with mindfulness(Davidson)
Depression (Segal, Williams, Teasdale)
Eating disorders (Wansink) Empathy/reduction in physician error (Epstein,
Santorelli)
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Mindfulness: Major Impact
Third Wave of Psychotherapies
Mindfulness Based Stress Reduction (MBSR) (Jon
Kabat-Zinn) Mindfulness Based Cognitive Therapy (MBCT) (Zindel
Segal, John Teasdale, Mark Williams)
Dialectical Behavior Therapy (DBT) (Marsha Linehan)
Acceptance Commitment Therapy (ACT) (Steve Hays)
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What do people report after a
course in mindfulness training? Lasting decrease in physical and psychological
symptoms
An increase in ability to relax Reduction in pain/or enhanced coping with pain
Greater energy and enthusiasm for life
Improved self-esteemCenter for Mindfulness in Medicine, Health Care, and Society, UMASS
School of Medicine
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How do we do it? simplified
RAIN of Compassion
R ecognition- NOTICE what is happening
A cceptance – say “yes”, allow, make room for the experience.
Investigate –be curious, even familiar experiences do not repeat.
Non-identification –become a witness to the experience. Do notget caught in it.
+ Compassion: maintaining at attitude of kindness,friendliness, and gentleness towards self and others.
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To what do we apply Mindfulness?Start with a pause and a heartfelt smile of course:
Eating Walking Standing
Breathing Listening Seeing
Pain Anger Fear
Cravings … …
Sky is the limit!
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Practice, practice, practice Developing and cultivating a mindfulness practice is
simple but not easy. Most likely you will need teachers
and fellow travelers along the way. Formal practice
Informal practice
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Practice & Research resources NIH- R&W –Next course beginning May 15th.
NIH Mind Body Week Sept 8-11, 2009
Insight Meditation Community of Washington DC
University of Maryland
NCCAM
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Other practice & research resources
University of Massachusetts Center for Mindfulness in
Medicine, Health Care, and Society UCLA Semel Institute, Mindful Awareness Research
Center
Insight Meditation Society -Massachusetts
Spirit Rock - California Omega Institute – New York