mindfulness & stress reduction

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

[email protected]

www.rezvanameli.com

mailto:[email protected]

http://www.rezvanameli.com/

http://www.rezvanameli.com/




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.



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



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



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



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”



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)



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



Attitudinal Foundations of Mindfulness Non-Judging

Patience

Trust Non-striving

Acceptance

Letting go

Beginner’s Mind

Adapted from Full Catastrophe Living by Kabat-Zinn



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



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.



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



The President pauses . . .



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



Stress

Changeable aspects

Problem focusedstrategies

Teaching skills/providing information

Unchangeable aspects

Acceptance Compassion

Humor

Keeping count of

positives in life



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)



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)



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)



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)



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



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.



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!



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



Practice & Research resources NIH- R&W –Next course beginning May 15th.

([email protected] )

NIH Mind Body Week Sept 8-11, 2009

Insight Meditation Community of Washington DC

University of Maryland

NCCAM





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

mindfulness & stress reduction

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