Adapted for the UAE MINDFULNESS- BASED STRESS REDUCTION COURSE WORKBOOK

Transcription

1 Adapted for the UAE MINDFULNESS- BASED STRESS REDUCTION COURSE WORKBOOK MBSR Course Workbook Vol. 1

2 This workbook has been created using content from the references listed below. It should be used as a supplement to the group MBSR workshops. Chaskalson, M. (n.d.). Mindfulness works. Eight week MBSR course workbook (4 th ed.). Cambridge: Mindfulness Works. Stahl, B., & Goldstein, E. (2010). A mindfulness- based stress reduction workbook. Oakland, CA: New Harbinger Publications, Inc. MBSR COURSE WORKBOOK VOL. 1 2

3 TABLE OF CONTENTS PAGE SESSION 1: AUTOMATIC PILOT 4 SESSION 2: DEALING WITH BARRIERS 12 SESSION 3: MINDFULNESS OF THE BREATH AND OF THE BODY IN MOVEMENT 20 SESSION 4: RESPONDING INSTEAD OF REACTING 28 SESSION 5: ACCEPTANCE ALLOWING / LETTING BE 38 SESSION 6: THOUGHTS ARE NOT FACTS 43 SESSION 7: HOW CAN I BEST TAKE CARE OF MYSELF 53 SESSION 8: ACCEPTANCE AND CHANGE 60 MBSR COURSE WORKBOOK VOL. 1 3

4 SESSION 1: AUTOMATIC PILOT 1. The aim of the programme is to learn new and more effective ways of handling our moods and emotions. 2. We do this by focusing on the small changes in thoughts, feelings and bodily sensations that are linked to mood fluctuations. 3. To focus on these changes we have to become more aware of them. 4. The raisin exercise shows how our attention is not always placed fully in the moment we are often not at home. 5. It also shows us how, by being more aware of each moment, we can actually alter our experience and the effects it has on us. 6. The body scan helps us gain control over our attention, enabling us to enter more deeply into our present experience. SESSION OUTLINE o An introduction to Mindful Meditation: Mindful Eating The Raisin Exercise o Automatic Pilot Explained o The Body Scan AN INTRODUCTION TO MINDFUL MEDITATION: MINDFUL EATING At the beginning of most mindfulness- based stress reduction classes, mindful eating is introduced to demystify the concept of meditation. (If you do not have a raisin any food will do). As you complete this exercise put aside all distractions, turn off your phone and focus direct, clear awareness on each aspect and each moment of the experience. You can practice by reading the following text, taking some time with each instruction. If you are reading this meditation, take five minutes or so to do this practice. Place a few raisins in your hand. If you don t have raisins, any food will do. Imagine that you have just come to Earth from a distant planet without such food. Now with this food in your hand, you can begin to explore it with all of your senses. Focus on one of the objects as if you have never seen anything like it before. Focus on seeing this object. Scan it, exploring every part of it, as if you have never seen such a thing before. Turn it around with your finger and notice what colour it is. Notice the folds and where the surface reflects light or become darker. Next explore the texture, feeling any softness, hardness, coarseness, or smoothness. While you are doing this, if thoughts arise such as Why am I doing this weird exercise? How will this ever help me? or I hate these objects, then just see if you can just acknowledge these thought, let them be, and then bring your awareness back to the object. Take the object beneath your nose and carefully notice the smell of it. Bring the object to one ear, squeeze it, roll it around and hear if there is any sound coming from it. MBSR COURSE WORKBOOK VOL. 1 4

5 Begin to slowly take the object to your mouth, noticing how the arm knows exactly where to go and perhaps becoming aware of your mouth watering. Gently place the object in your mouth, on your tongue, without biting it. Simply explore the sensations of this object in your mouth. When you are ready, intentionally bite down on the object, maybe noticing how it automatically goes to one side of the mouth versus the other. Also notice the tastes it releases. Slowly chew this object. Be aware of the saliva in your mouth and how the object changes in consistency as you chew. When you feel ready to swallow, consciously notice the intention to swallow, then see if you can notice the sensations of swallowing the raisin, sensing it moving down to your throat and into your oesophagus on its way to your stomach. Take a moment to congratulate yourself for taking this time to experience mindful eating. Process Questions:! What did you notice with the raisin in terms of sight, touch, sound, smell and taste?! Was anything surprising?! Did any thoughts or memories pop up while doing this practice? AUTOMATIC PILOT EXPLAINED In a car we can sometimes drive for miles on automatic pilot, without really being aware of what we are doing. In the same way, we may not be really present, moment- by- moment, for much of our lives. We can often be miles away without knowing it. On automatic pilot, we are more likely to have our buttons pressed (i.e. easily annoyed). Our thoughts, feelings and sensations, as well as events in the world around us many of which we may be only dimly aware of can trigger habits of thinking that are unhelpful and lead to stress. By becoming more aware, from moment to moment, of our thoughts, feelings and bodily sensations, as well as the world around us, we give ourselves the possibility of greater freedom and choice. We do not have to go down the same old mental ruts that have caused us problems in the past. The aim of this course is to increase awareness so that we can respond to situations with choice, rather than react automatically. We do that by practising becoming more aware of where our attention is, and deliberately changing the way we pay attention, over and over again. Mindfulness is not about trying to get anywhere; rather, it is simply a matter of being aware of where and how we are and allowing ourselves to be that. THE BODY SCAN To begin with, we consciously place our attention in different parts of the body, using each part of the body as a focus to anchor our awareness in the moment. We train ourselves to place our attention and awareness in different places at will, thus enabling us to enter more deeply into our present experience. The process of entering more deeply into our current experience is the aim of the Body Scan exercise, which forms the main home practice exercise for next week. The body scan is a wonderful way to get in touch with your body and mind. Do this practice in a relaxing environment without distractions. It is suggested that you lay down while doing the body scan, but if you MBSR COURSE WORKBOOK VOL. 1 5

6 find yourself becoming sleepy or you would rather sit or stand, you are welcome to do so. Bring your full, undivided attention to this practice as you listen to the instructions. Try to do the full practice.! Lie down, making yourself comfortable, on a mat or a rug on the floor or on your bed and allow your eyes gently to close.! Take a few moments to get in touch with the movement of your breath and the sensations in your body. When you are ready, bring your awareness to the physical sensations in your body, especially to the sensations of touch or pressure where your body makes contact with the floor or bed. On each out- breath, allow yourself to sink a little deeper into the mat or bed.! Remind yourself of the intention of this practice, to fall awake rather than to fall asleep. Its aim is not to feel any different, relaxed, or calm; this may happen or it may not. Instead, the intention of the practice is, as best as you can, to bring awareness to any sensations you detect, as you focus your attention on each part of the body in turn.! Now bring your awareness to the physical sensations in the belly, becoming aware of the changing patterns of sensations in the abdominal wall as you breathe in, and as you breath out. Take a few minutes to feel the sensations as you breathe in and as you breathe out.! Having connected with the sensations in the belly, bring the focus or spotlight of your awareness down the left leg, into the left foot, and all the way to the toes. Focus on each of the toes in turn, bringing a gentle interested, affectionate attention to be with and investigate (in a non- conceptual way) the quality of the sensations you find, perhaps noticing the sense of contact between the toes, a sense of tingling, warmth, perhaps numbness, whatever is here, perhaps even no sensations at all if that is the case; it is all okay. In fact, whatever you are experiencing is okay; it is what is here right now.! When you are ready, on an in- breath, feel or imagine the breath entering the lungs, and then passing all the way down the body, through the left leg, to the toes of the left foot. On the out- breath, feel or imagine the breath coming all the way back up from the toes and the foot, right up through the leg and torso and out through the nose. As best you can, continue breathing in this way for a few breaths, breathing down into the toes on each in- breath, and back out from the toes on each out- breath. It may be difficult to get the hang of this just practice this breathing into as best you can, approaching it playfully.! Now, when you are ready, on an out- breath, let go of awareness of the toes, and bring your awareness to the sensations on the bottom of your left foot bringing a gentle, investigative awareness to the sole of the foot, the instep, the heel (noticing, for example, the sensations where the heel makes contact with the mat or bed). Experiment with breathing with any and all sensations being aware of the breath in the background, as, in the foreground, you explore the sensations in the bottom of the foot.! Now allow the awareness to expand into the rest of the foot to the ankle, the top of the foot, right into the bones and joints. Then, taking a deeper and more intentional breath in, directing it down into the whole of the left foot, and, as the breath lets go on the out- breath, let go of the left foot completely, allowing the focus of awareness to move into the lower left leg the calf, skin, knee, etc., in turn.! Continue to scan the body, lingering for a time with each part of the body in turn: the left shin, the left knee, the left thigh; the right toes and then foot and ankle, the right lower leg, the right knee, the right thigh; the pelvic area groin genitals, buttocks and hips; the lower back and the abdomen, the upper back and the chest and shoulders. Then we move to the hands, usually doing both at the same time. MBSR COURSE WORKBOOK VOL. 1 6

7 We rest first with the sensations in the fingers and thumbs, the palms and the backs of both hands, the wrists, the lower arms and elbows, the upper arms; the shoulders again and the arm- pits; the neck; the face (jaw, mouth, lips, nose, cheeks, ears, eyes, forehead); and then the entirety of the head.! When you become aware of tension, or other intense sensations in a particular part of the body, you can breathe in to those sensations as well as you can to any others using the in- breath to gently bring awareness right into the sensations, and, as best you can, have a sense of what happens in the region, if anything, as each breath lets go and releases on the out- breath.! The mind will inevitably wander away from the breath and the body from time to time. That is entirely normal. It is what minds do. When you notice it, gently acknowledge it, noticing where the mind has gone off to, and then gently return your attention to the part of the body you intended to focus on.! After you have scanned the whole body in this way, spend a few minutes being aware of a sense of the body as a whole, and of the breath flowing freely in and out of the body.! It is also very important to remind yourself that if you, like most modern people, suffer from low- grade chronic sleep deprivation, since the body scan is done lying down, it is very easy to fall asleep. If you find yourself falling asleep, you might find it helpful to prop your head up with a pillow, open your eyes, or do the practice sitting up rather than lying down. If I Had My Life To Live Over I d like to make more mistakes next time. I d relax; I would limber up. I would be sillier than I had been on this trip. I would take fewer things seriously. I would take more chances. I would climb more mountains and swim more rivers. I would eat more ice cream and less beans. I would perhaps have more actual troubles, but I d have fewer imaginary ones. You see, I m one of those people who live sensibly and sanely hour after hour, day after day. Oh, I ve had my moments, and if I had to do it over again, I d have more of them. In fact, I d try to have nothing else. Just moments, one after another, instead of living so many years ahead of each day. I ve been one of those persons who never goes anywhere without a thermometer, a hot water bottle, a raincoat, and a parachute. If I had to do it again, I would travel lighter than I have. If I had my life to live over, I would start barefoot earlier in the spring and stay that way later in the fall. I would go to more dances. I would ride more merry- go- rounds. I would pick more daisies. By Nadine Stair 85 years old MBSR COURSE WORKBOOK VOL. 1 7

8 The Journey One day you finally knew what you had to do, and began, though the voices around you kept shouting their bad advice the whole house began to tremble and you felt the old tug at your ankles. Mend my life! each voice cried. But you didn t stop. You knew what you had to do, though the wind pried its stiff fingers at the very foundations, though their melancholy was terrible. It was already late enough, and a wild night, and the road full of fallen branches and stones. But little by little, as you left their voices behind, the stars began to burn through the sheets of clouds, and there was a new voice which you slowly recognized as your own, that kept you company as you strode deeper and deeper into the world, determined to do the only thing you could do determined to save the only life you could save. Mary Oliver, from Dreamwork in New and Selected Poems, Beacon Press, Boston, MBSR COURSE WORKBOOK VOL. 1 8

9 One Person s Report This man had been in hospital for depression four years before, following with his wife and three children left him and there had been no further contact except through lawyers. He had become very depressed and lonely, although had not been in hospital again. He was no over the worst of his depression, and started to use the body scan to help prevent his mood from deterioration. These were his comments after eight weeks: For the first ten days it was like a burden. I kept wandering off and then I would worry about whether I was doing it right. I kept having flights of fantasy. After ten days I relaxed more, I stopped worrying if I was thinking about anything else. When I stopped worrying about it then I actually stopped the flights of fancy. If I did think of something else I picked him up again when I stopped thinking. Gradually the flights of fantasy reduced. I was happy to listen to him and then I started to get some value from it. I began to feel very relaxed, when he got to the bit about the neck it felt like someone was massaging my shoulders. I was able to breather into my toes. It becomes more real the more that you try it. I began to look forward to it. Soon I had developed it so that I could actually feel the breath going down to the base of my foot. Sometimes I did not feel anything, but then I thought, if there is no feeling then I can be satisfied with the fact there is no feeling. I tried too hard to start with. Eventually I just put it on and expected to go off into a realm of thoughts. I did not worry if concerns came in. Gradually the forty minutes passed without me losing him and from then on, the next time was more effective. It s not something you can do half a dozen times. It has got be a daily practice. It sounds silly, but I found it helpful in a snooker match I was playing. There were five of us in the team and we were two- all with me as the last on to play so everything depended on me. There was a blue and pink and black to pot so it could go wither way. I felt very highly stressed, felt my heart beating and other team members urging me on. And then I felt the breath going into my fingers and I relaxed and I won. Those little thoughts themselves relaxed my arms. Psychological stress is a particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well being. Richard Lazarus, Stress Appraisal and Coping p.19, Springer Publishing Co., NY, MBSR COURSE WORKBOOK VOL. 1 9

10 FAQ: Am I doing the body scan right if I don t feel anything? It is important to know that neutral sensations can be part of the body scan. Human beings generally feel three types of sensations: pleasant, unpleasant and neutral. If you are experiencing a neutral sensation, simply be mindful that it is neutral. As you deepen your practice of the body scan, you may begin to be aware of more and more subtle feelings. It is like when you go to the ocean and initially only hear the loud crashing of the waves; after some time you may distinguish smaller and more subtle sounds that make up the overall crashing. So it is with the body scan. As you deepen your practice, you will begin to feel more and more sensations. HOME PRACTICE FOR WEEK FOLLOWING SESSION 1! Do the Body Scan section of the Meditation and Body Scan CD (Track 6) for at least 6 days of the coming week. Do not expect to feel anything in particular from listening to the CD. Rather, as best as you can, give up all expectations about it. Just let your experience be your experience. As best as you can, do not judge it, just keep doing it, and we will talk about it next week.! If you would like to, record your experience on the Home Practice Record Form each time you listen to the CD. Make a note of anything that comes up in the home practice so that we can talk about it at the next group session. The Home Practice Form is for your own record only.! Choose a routine activity in your daily life and make a deliberate effort to bring moment- to- moment awareness to that activity each time you do it, just as we did in the raisin exercise. Possibilities include: your first cup of tea or coffee, brushing your teeth, showering, drying your hair, getting dressed, your walk to the bus or car, eating anything that you do every day just make a point of knowing what you are doing as you are actually doing it.! Note any times when you find yourself able to become more deeply aware of what you eat in the same way you noticed the raisin. Eat at least one meal mindfully in the way that you ate the raising. MBSR COURSE WORKBOOK VOL. 1 10

11 HOME PRACTICE RECORD If you want to, record on the Home Practice Record Form anything that comes up in your home practice so that we can talk about it at the next meeting. DAY/DATE PRACTICE COMMENTS MBSR COURSE WORKBOOK VOL. 1 11