Becoming more mindful: Can you benefit?

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Becoming more mindful Can you benefit?

• Richard E. Berger, MD
• University of Washington

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receiving a cancer diagnosis is like a soldier
being dropped into a jungle war zone without a
map, compass or training.

• Michael Lerner-Commonweal Cancer Self Help
  Program

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How do you make sound decisions and live fully,
when you are up to your ass in alligators?
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Mindfulness is a mental state, characterized by
concentrated awareness of one's thoughts,
feelings and actions.
Paying attention, on purpose, in the present
moment, non-judgmentally

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Mindfulness promotes the replacement of
reactivity withconsidered conscious
decisions.Development generally
requirespractice.
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Benefits mindfulness

• Live life more fully in present moment
• Practice kindness toward yourself
• Less suffering from pain
• Appreciate what is right with you
• Mobilize inner and outer resources
• Take control of life and attention

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Mindfulness Effects on Cancer Patients

• Improved mood
• Decreased stress
• Decreased anxiety
• Improved adjustment to diagnosis

Metanalysis of 6 studies by Mitchim et al,
ONCOLOGY NURSING FORUM - VOL 34, NO 5, 2007
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Mindfulness Effects on Cancer Patients
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• Improved quality of life
• Improved feeling of control
• Improved sleep
• Less suffering from pain

Metanalysis of 6 studies by Mitchim et al,
ONCOLOGY NURSING FORUM - VOL 34, NO 5, 2007
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Effects Mindful Practices

• ?weight
• ?blood sugar
• ?bp
• Improved lipid profile
• ?cortisone
• ?inflammation
• Improved well-being, alertness
• ?pain with stress

• ? brain size, grey matter
• ? quality of life
• ? concentration
• ? learning
• ? sleep quality
• ? body awareness
• ?depression
• Changes DNA activation

NIH conference 2009 Mind/Body Med.
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Mindfulness Increases Survival

• Hypertension
• Cardiac Disease
• Cancer??
• Decrease PSA rise. J Urol. 2001 Dec166(6)2202-7

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"Moral excellence comes about as a result of
habit. We become just by doing just acts,
temperate by doing temperate acts, brave by doing
brave acts." -Aristotle
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What is cost of becoming more mindful?

• A. Nausea?
• B. Your hair falls out?
• C. 6 weeks painful recovery?
• D. 30-60 minutes/day of sitting quietly, alertly
  and non-doing?

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PRACTICEPRACTICEPRACTICEBut the practice
isthe goal!
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Things for Pretty Sure

• If you dont practice something, you wont get
  much better at it.
• You are always practicing something. (Habits)
• You can choose what you practice.

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A Native American elder once described his own
inner struggles in this manner Inside of me
there are two dogs. One of the dogs is mean and
evil. The other dog is good. The mean dog fights
the good dog all the time. When asked which dog
wins, he reflected
The one I feed the most.
George Bernard Shaw
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Start Easy
Real life problems
Mindfulness Practice
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MEDITATION IS

• THE PUPOSEFUL PRACTICE OF MINDFULNESS
• AWARENESSING
• PRACTICING CALM ALERTNESS
• PRACTICING EXPERIENCING WHAT IS
• GETTING FAMILIAR WITH YOURSELF

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What do you practice in mindfulness?

• Quieting your mind
• Recognizing discursive thoughts
• Letting go of discursive thoughts
• Recognizing urges

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What do you practice in mindfulness?
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• Letting go of urges
• Recognizing emotions
• Letting go of emotions
• Creating space around mental events

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RAIN

• R-Recognize
• A-Allow
• I-Investigate
• N-Not me or Let go or Let be

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Mindfulness and View
Sensory Perceptions
, concepts
Thoughts
Thoughts, concepts
Confusion Thoughts With Reality
Mindful view of Thoughts, Emotions, Sensations
Experience of World
Experience of World
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PINBALL WIZARD THINKING
That deaf, dumb, and blind boy, sure plays a
mean pinball. The Who
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You Are Not Your Thoughts
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Mindfulness Based Stress Reduction MBSR

• MEDITATION
• BODY AWARENESS PRACTICE
• YOGA
• 8 weeks, 2-3 hours/week
• Daily practice-45 min.

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MEDITATION IS NOT

• SPACING OUT
• ANALYZING
• TRYING NOT TO THINK
• THINKING HAPPY THOUGHTS
• VISUALIZATION
• DISTRACTION
• AVOIDANCE
• POSITIVE THINKING
• PRAYER?

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Mindfulness v Phys. Exercise

• Need faith to start
• Need 6-8 weeks to see results
• Hardest in the beginning

• Gets more enjoyable with time
• Takes 2 weeks to establish habit
• Lifelong benefits

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Application Mindfulness
RAIN
RAIN
RAIN
RAIN
Event
Emotion
Pre-response
Response
Thoughts Past associations
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Neuron
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Neuroplasticity
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Meditation Brain Studies
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Mindful Meditation
Orientation/Association Area of Parietal Lobe
Attention/Association Area of Frontal Lobe
Th
amygdala/hyppocampus- emotional significance and
LT memory
A
mb
H
Increased activity
H
H
Decreased activity
Activation sympathetic/ Parasympathetic n.s.
CVS, Immune effects
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Right v Left Brain
Labeling Analytic thought Logic Language Conceptua
l thought Discursive thought
Experiencing Holistic thought Creativity Art/Music
Intuition
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Increasing Awareness
Gradual acceptance of holistic, non-reductionist e
xperience
Holistic experience of analysis, conceptual
thought and discursive thought
awareness
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We are Human Beings
Analyzing Ruminating About Past
Fantasizing, Ruminating, Planning About Future
The Present
What lies behind us and what lies before us are
tiny matters compared to what lies within
us. Oliver Wendell Holmes
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GOALS

• Better decision making
• Increased quality of life
• Increased enjoyment of life as it is
• Being present

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How do you know that you are doing it right?

• If you try, you are doing it right!
• Do only as much as maintains your enthusiasm!
• .

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What is Measures of Success?

• KINDNESS to yourself others
• Less reactive decisions

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Cancer and Mindfulness

• As long as you are breathing, there is a lot more
  right with you than is wrong with you.

Practice Being Aware of What is Right With you!
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Laboratory

• Your Mind and Life
• Practice Living Every Moment

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We All Have an Illness Story

• Be mindful of your story

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Views of Illness

• Restorative
• Chaos
• Quest

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Restorative Narrative

• Ill be healthy again
• Our institutionalized narrative
• For every suffering there is an outside remedy
  given by some authority
• Isolating, authority gives patients story
• Evades question of mortality and medical failure
• No personal story to fall back on

Arthur Frank
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Chaos Narrative

• Life never gets better, no sequence of causality
• Vulnerability, futility and impotence.
• There is no plot to story, no voice, no one is in
  control
• Isolating and no motivation
• Too easy to dx depression

Arthur Frank
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Quest (Mindful) Narrative

• Accept illness and attempt to use it
• Awareness of illness and life in the present
• Illness as personal but shared journey
• Teller tells own story
• Personal perseverance and purpose.
• Relationship to others- Empathetic

Arthur Frank
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Resources

• Selected Readings on Mindfulness
• 8 Minute Meditation Quiet Your Mind. Change Your
  Life. by Victor N. Davich
• Turning the Mind Into an Ally by Sakyong Mipham
  and Pema Chodron
• Silence How to Find Inner Peace in a Busy World
  by Christina Feldman
• Full Catastrophe Living Using the Wisdom of Your
  Body and Mind to Face Stress, Pain, and Illness
  by Jon Kabat-Zinn
• Wherever You Go, There You Are by Jon Kabat-Zinn
• Coming to Our Senses Healing Ourselves and the
  World Through Mindfulness by Jon Kabat-Zinn
• The Miracle of Mindfulness by Thich Nhat Hahn

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Web Resources

• www.mindandlife.org
• http//www.dharma.org/ims/ss_meditation_resources.
  html
• http//www.umassmed.edu/cfm/home/index.aspx
• http//amberstar.libsyn.com/index.php?post_categor
  yIntroduction20to20Meditation

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Resources

• Mindfulness Based Stress Reduction courses.
• John Wendt MD and Sherry Williams
  http//paccentermind.org
• Carol Jakus, MA, MSW, LICSW-Seattle Washington,
  cjakus_at_mindfullivingnw.com
• Carol McManus, PT, MS, MA, http//www.carolynmcman
  us.com/pages/workshops.html