Introduction to Mindfulness

Alexandra Arbogast, LICSW, RYT, CMTProgram Coordinator & Therapist

Mind-Body Medicine ProgramInternal Medicine / Warrior Clinic / NICoE

WRNMMC301-319-4960 / Alexandra.S.Arbogast.ctr@mail.mil

Presenter

Based on the premise that the mind and body are intimately interconnected. Utilizes techniques to optimize this relationship for improved health and wellbeing.

Teach mindfulness-based skills that can be integrated into daily life to reduce stress, manage pain, enhance sleep, strengthen positive qualities, and improve overall quality of life.

Offers a low-cost, self-directed, complement to traditional medical care.

The Mind-Body Medicine Programat Walter Reed - Bethesda

Mindfulness Attention training to cultivate qualities of concentration, clarity,

and equanimity. The common thread connecting all other skills.

Relaxation Techniques to elicit the relaxation response in mind and body

Yoga Movement and breathing strategies to synchronize mind and body

and release tension.

Positive Psychology Practices to cultivate and strengthen positive mind/emotional

states.

Resiliency Training Techniques for balancing the nervous system, processing trauma,

and strengthening the ‘resilient zone’.

Mind-Body Skills

Mindfulness

It’s Hot!

“Mindfulness means paying attention in a particular way; On purpose, in the

present moment, and nonjudgmentally.”

-Jon Kabat-ZinnFounder of Mindfulness-Based Stress Reduction

(MBSR)

What is it?

Regular Practice Cultivates 3 Core Skills

Concentration: The ability to focus and stabilize one’s attention.

Sensory Clarity: The ability to keep track of the components of sensory experience as they arise in various combinations, moment-by-moment.

Equanimity: The ability to ‘be with’ experience with an attitude of gentle matter-of-factness.

Many techniques! Depends on teacher and traditionRestrictive or open attentionNoting option

Beginner practices: Restrictive focus, such as breath meditationDevelops/strengthens core skills of concentration,

clarity and equanimity

Intermediate / advanced practices:Open awareness to increasing amount of sensory

experience, such as “choiceless awareness”

Formal and informal practices

Mindfulness Training Techniques

Where Does It Come From?In the 19th century, mindfulness was used to

translate the Pali word Sati. Pali is the canonical language of Theravada, a form of Buddhism found in Southeast Asia.

“Establishing Mindfulness” (Satipatthana) is a primary practice of Theravada Buddhism.

It is said to lead to insight into the true nature of self and reality (impermanence, the suffering of conditioned existence, and non-self)

Mindfulness Arrives in the West

In the 60’s and 70’s, Westerners began going to Southeast Asia to learn mindfulness practices. They brought those practices back to the West and began to teach them within the framework of Buddhism.

In the 80’s and 90’s, it was discovered that those practices could be extracted from Buddhism and the cultural matrix of Asia and used within a secular context.

Secular MindfulnessMindfulness awareness practices started to

be used within a secular context to develop useful attentional skills.

These practices became ever more prevalent in clinical settings for pain management, addiction recovery, stress reduction, and as an adjunct to psychotherapy.

Mindfulness in Healthcare In 1979, Jon Kabat-Zinn created Mindfulness-Based Stress

Reduction (MBSR) at the University of Massachusetts Medical School to treat chronically ill patients.

Subsequently, a number of other psychotherapeutic modalities centering around mindfulness were developed: Acceptance and Commitment Therapy (ACT); Mindfulness-Based Cognitive Therapy (MBCT); Dialectical Behavioral Therapy (DBT).

Mindfulness in SocietyIncreasingly, it is being understood that mindful

awareness is a cultivatable skill with broad applications through all aspects of society,

including education, prison system, politics, business, and even the training of soldiers.

The Benefits of Mindfulness

Changes the Brain in Positive Ways

Mindfulness…

Shows how the brain changes in positive ways with meditation!

Overcoming Fear and Anger

Old BrainVs.

New Brain

Neuroplasticity• Recent research in neuroscience shows that we

have the power to influence our brains.

• When we think certain thoughts, it strengthens those neural circuits. Mental States Become Neural Traits!

• Self-Directed Neuroplasticity = Nurture positive states of mind to strengthen and build those neural networks. Make Happiness a Habit!

The brain is like a muscle that we can build through practicing skills.

Pro-Social Behavior

Impulse RegulationEmotional

AwarenessCompassion &

EmpathyForgiveness

Compassion Cultivation Training

Stanford University’s School of Medicine

The Center for Compassion and Altruism Research and Education (CCARE)

Helps Balance the Nervous System

Mindfulness…

Stress Response

Stress Response

Central Nervous SystemPerception - NarrowedMemory - Coarse, ImpreciseLearning - BlockedConditioning - DefenseTendency - Regress or

PerseverateTone – Fight or Flight

Muscular SystemTensionReady for ActionJaws ClenchBody Braces for Action

Autonomic Nervous SystemHeart rate increasesBlood pressure increasesOxygen need increasesBreathing rate increasesPalms, face sweatBlood sugar increasesAdrenalin flowsDigestive tract shuts down blood to musclesBlood vessels constrict in hands, face

Relaxation Response

Relaxation Response

Improves Self-Regulation

Mindfulness…

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The Resilient Zone

In our “Resilient Zone” we have the best capacity for flexibilty and adaptability in

mind, body and spirit.

chargeRelease

charge

resi

lien

t zo

ne

Mindfulness helps deepen the Resilient Zone

Stressful/Traumatic Event

orStressful/Traumatic

Triggers

Stuck on “Low”Hypo-arousal

HyperactivityHypervigilanc

eMania

Anxiety & PanicRagePain

DepressionDisconnection

Exhaustion/Fatigue

Numbness

resi

lien

t zo

ne

Stuck on “High”

Hyper-arousal

Graphic adapted from an original graphic of Peter Levine/Heller30

Let’s Practice!

Breath-Focus MeditationTrains the mind to settle, let go of mental clutter, and

focus in the present moment. Connects mind with body.

Find a comfortable position either lying down on your back, in a chair, or on a cushion on the floor. Spine should be erect but not rigid.

Scan through the body and release unnecessary tension.

Bring attention to the body with an attitude of friendly curiosity.

Tune into the sensations of your body breathing and focus your attention on the feel of the breath coming in and out.

When your mind wanders, notice, and gently guide attention back to the breath (over and over again).

Practice for 5-30 minutes daily for lasting positive results.

Body Scan MeditationConnects mind with body. Increases ability to track body sensations. Grounds

attention in the present moment. Increases insight into changing nature of sensation. Trains mind to tolerate sensation with greater equanimity.

Bring curious, friendly attention to the sensations in your feet. Feel vs think.

Gradually move your way up the body…feeling the ankles, lower legs, knees, upper legs.

Feel sensations in the buttocks, the lower back, middle back, and upper back.

Notice sensations in the pelvis, abdomen, and chest.

Sense the fingers, hands, wrists, forearms, elbows, and upper arms.

Feel sensations in the shoulders. Notice any tension without judging it or trying to change it.

Notice sensations in the neck, throat, jaw, and mouth.

Sense the nose, eyes, forehead, ears, and head.

Feel sensations in the whole body at once. The whole body as one universe of sensation.

Next Steps

Create ‘Mindful Pauses’ throughout your day.Take 1-5 minutes to practice slowing down, feeling the body,

breathing more fully, letting go of thoughts, and returning to the present moment with gratitude and acceptance.

Set aside 5-30 minutes a day for meditation, yoga, art, or another mindful activity you enjoy.

Surround yourself with support. Get books, audio, phone apps to learn more and keep you motivated in

the practice.

Take a mind-body class

Do a meditation retreat

Regular Practice

Questions or CommentsAlexandra Arbogast: 301-319-4960 / Alexandra.S.Arbogast.ctr@mail.mil