MINDFULNESS IN SCHOOLS

Transcription

1 MINDFULNESS IN SCHOOLS APRIL 2ND, 2016 PROMOTING RESILIENCE IN EDUCATION Rahul Gupta MD, MBSR Facilitator

2 LEARNING OBJECTIVES Explore the history of mindfulness-based interventions Develop a greater understanding of the physiology of stress and resilience Examine the value of mindfulness for supporting social emotional learning in schools Experience several mindfulness practices ( Gupta

3 MINDFULNESS IN THE NEWS Gupta

4 (c) Gupta

5 MINDFULNESS IN PUBLIC INSTITUTIONS - A THREE PART MOVEMENT The 1st Frontier: Health Care MBSR began as a stress reduction program in a single hospital in Massachusetts in Thirty-five years later, it is offered at over 200 hospitals, clinics and universities worldwide.

6 MINDFULNESS-BASED INTERVENTIONS IN MEDICAL CARE Asthma Cancer Transplants Chronic pain Heart disease Hypertension HIV Diabetes Obesity Irritable Bowel Syndrome Lupus Hot flashes Seizure disorders Shapiro SL & Carlson LE. The Art & Science of Mindfulness-integrating mindfulness into psychology and the healing professions American Psychological Association

7 MINDFULNESS INTERVENTIONS IN PSYCHOLOGICAL CARE Anxiety disorders Depression Suicidality Personality disorders Eating disorders PTSD Schizophrenia Delusional disorder Drug abuse and dependence Shapiro SL & Carlson LE. The Art & Science of Mindfulness-integrating mindfulness into psychology and the healing professions American Psychological Association

8 MINDFULNESS IN PUBLIC INSTITUTIONS - A THREE PART MOVEMENT The 2 nd Frontier: Mental Health The development of Mindfulness-Based Cognitive Therapy (MBCT) in the early 1990s set the stage for the widespread integration of mindfulness into the mental health field. The widespread adoption of MBCT and other MBIs in mental health set the stage for using mindfulness with child and adolescent populations.

9 MINDFULNESS IN PUBLIC INSTITUTIONS - A THREE PART MOVEMENT The 3 rd Frontier: Education New but growing. Currently, in the process of validating the results of MBIs with child & adolescent populations by developing more sophisticated research designs with larger samples

10 TRAINING PROGRAMS FOR MINDFULNESS IN SCHOOLS Mindful Schools MindUp Still Quiet Place.b (dot be ) Inner Explore InnerKids Relax Kids YogaKids WakeUp Schools

11 MINDFULNESS IN EDUCATION Gupta

12 WHY IN SCHOOLS? High levels of stress Anxiety and depression Bullying Inability to focus Impulsiveness, leading to difficult classroom management Loss of support and role models

13 ALL STARTS WITH SCHOOL TEACHER/COUNSELOR/LEADER Teacher/counselor may themselves be under high stress Teaching mindfulness without modeling it won t be mindfulness Mindfulness is easy to misunderstand Children regulate their nervous systems by attuning to adults ***EMPHASIZE TEACHER SELF-CARE & EMBODIMENT 13

14 BRIEF GUIDED PRACTICE 14

15 UNDERSTANDING STRESS THE PHYSIOLOGY OF STRESS & BURNOUT 15

16 THE PHYSIOLOGY OF ACUTE STRESS Human mind & body constantly subjected to changing world inside and outside of body When alterations perturb the homeostatic baseline, stress occurs Stress can be physical, metabolic, psychological or emotional in origin Acute stress causes coordinated series of nervous, endocrine and immune system responses Jones, D. Textbook of Functional Medicine, p 610 Gupta

17 THE PHYSIOLOGY OF ACUTE STRESS Essential purpose is immediate survival Stress ignites the HPA axis, with subsequent rise in cortisol level & catecholamines Results in surge of readiness to deal with threat Stress HPA axis Cortisol & Catecholamines Gupta

18 SYMPATHETIC ACTIVATION: Gupta

19 SYMPATHETIC ACTIVATION Accelerate cardiopulmonary activity (HR, BP, contractility, arterial vasoconstriction, RR) Shunting of blood to heart, organs of perception, and muscles Inhibits gastric contractility and emptying Lower natural killer cell activity Reduce blood flow to prefrontal cortical regions Freeman ME, Houpt TA. The hypothalamus. In Conn PM ed. Neuroscience in Medicine. 2 nd edition Totowa, NJ: Humana Press, 2002: Gupta 2014

20 CORTISOL EFFECTS Raises blood sugar level to sustain fight/ flight challenge Inhibits growth/regeneration Lowers local immune response Arborelius L., Owens MJ., Plotsky PM., et al. The role of CRF in depression and anxiety disorders. J Endocrinol. 1999;160:1 12 Gupta

21 THE PHYSIOLOGY OF ACUTE STRESS Net effect is physiological and psychological hyper-arousal Remarkably powerful & coordinated system Ultimately followed by rest and recovery once stress dealt with Kabat-Zinn J. Full Catastrophe Living, Delta Gupta

22 PARASYMPATHETIC ACTIVATION (c) Gupta

23 ASSAULTS TO THE STRESS SYSTEM Early, prolonged or severe stress Lack of self-awareness (to stress reactions) Stimulation overload The negativity bias Social isolation Gupta

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25 CHRONIC STRESS Gupta

26 The burnout syndrome is characterized by losing enthusiasm for work (emotional exhaustion), treating people as if they were objects (depersonalization), and having a sense that work is no longer meaningful (low personal accomplishment). (c) Gupta

27 CHRONIC STRESS: MEDICAL OUTCOMES Chronic Pain & Inflammation Diabetes Cardiovascular Disease (HTN, IHD, arrhythmias) Neurologic Disease (migraine, Alzheimer s) Hampered Immunity (infections, tumours) Depression, Anxiety, Insomnia, PTSD Substance Abuse Chronic Fatigue Syndrome Chrousos GP and Gold PW. The concepts of stress and stress system disorders. Overview of physical and behavioral homeostasis. JAMA 1992;267(9) Gupta

28 TEACHER BURNOUT: COSTS TO SYSTEM Increased absenteeism, early retirement Reduced effectiveness in the classroom Higher confrontations (reduced connectivity) Increased job turnover Elevated costs associated with recruitment Flook et al. Mindfulness for Teachers: A Pilot Study to Assess Effects on Stress, Burnout, and Teaching Efficacy. Mind, Brain and Education, Volume 7-Number 3 ( ) (c) Gupta

29 GROUP EXERCISE (c) Gupta

30 THE SCIENCE OF MINDFULNESS CULTIVATING RESILIENCE 30

31 RESILIENCE the human capacity to deal with, overcome, learn from, or even be transformed by the inevitable adversities of life. -Edith Grotberg Resilience for Today Gupta

32 Results included: Reduced burnout Improved classroom organization Better able to attend to classroom climate Increase in self-compassion Stable AM cortisol during school year (c) Gupta

33 BRAIN FUNCTION: Greater left-sided activation EEG (associated with positive affect, resilience to stress and regulation of limbic areas) IMMUNE FUNCTION Influenza titer response to vaccine- first study that demonstrated physiologic effects, after just 8 weeks Gupta

34 2015 REVIEW: THE NEUROSCIENCE OF MINDFULNESS 21 studies in last decade investigated changes in brain structure through mindfulness Also studies demonstrating changes in functional properties of brain, post meditation 8 regions consistently found to be altered Tang Y, Holzel B, Posner M. The Neuroscience of Mindfulness Meditation. Nature Review Neuroscience 16, (2015). (c) Gupta

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37 WHAT IS MINDFULNESS? 37

38 WHAT IS MINDFULNESS? Japanese character Top character for presence, bottom is for heart Calligraphy by Kazuaki Tanahashi Gupta

39 MINDFULNESS MYTHS WHAT IT S NOT: (c) Gupta

40 MINDFULNESS! paying attention in a particular way on purpose, in the present moment, and nonjudgmentally. -Jon Kabat-Zinn 3 Components: ON PURPOSE IN THE PRESENT MOMENT NON-JUDGMENTALLY Gupta

41 ATTITUDINAL FOUNDATIONS OF MINDFULNESS Beginner s Mind Kind, Compassionate Non-Judging Letting be Non-striving Stahl B. & Goldstein E. A Mindfulness-Based Stress Reduction Workbook (New Harbinger 2010) Gupta

42 MINDFULNESS-BASED STRESS REDUCTION Based on centuries of eastern meditation traditions JKZ: 1979 started Stress Reduction Clinic Gupta

43 8 WEEK MBSR PROGRAM Intensive training (not therapy) 8 weekly (2.5 hours) classes & all-day class Highly participatory Includes: Guided instruction in practices Gentle stretching and mindful yoga Group dialogue aimed at enhancing awareness Assignments for home practice Discussions on stress physiology & communication Audio materials and workbook Gupta

44 Meditation is the only intentional, systematic human activity which at bottom is not about trying to improve yourself or get anywhere else, but simply to realize where you already are. Jon Kabat-Zinn From Wherever You Go, There You Are Gupta

45 MINDFULNESS MYTHS Myth #1: I have to quiet my mind in order to have a successful practice Myth #2: It takes years to receive any benefit Myth #3: I don t have enough time to be mindful Myth #4: It requires religious or spiritual beliefs Gupta

46 MINDFULNESS PRACTICE Gupta

47 HOW CAN MINDFULNESS BE HELPFUL? Increased self-awareness & self-regulation Decrease arousal or hasten recovery Respond vs React to range of stressors Re-perceive situations Expand capacity to experience empathy Better able to create safe learning environments Build resilience through neuroplasticity Siegel, D. Mindsight: The New Science of Personal Transformation, 2011: Bantam Jacobs TL, Epel E. et al. Psychoneuroendocrinology. 2011, 36: 664 Gupta

48 DE-BRIEF EXERCISE S Stop T Take 3 breaths O Observe (body, feelings, thoughts) P Proceed into the next moment Can be used at the beginning of the day, between patients if feeling distracted or when upset (c) Gupta

49 MOVING FORWARD RESOURCES 49

50 SCHOOL DISTRICTS IN BC School District 46 (Sunshine Coast) School District 73 (Kamloops) School District 62 (Victoria)

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53 TAKE HOME PRACTICES S.T.O.P. technique. Mindfulness of breath/body: Come to your senses Mindful Communication Gupta

54 MINDFULNESS RESOURCES Contact Rahul: Research: 8 Week Courses in BC: Mindful Schools: resources/healthy-habits-of-mind/ Center for Mindfulness: (c) Gupta

55 MINDFULNESS RESOURCES

56 We can not always build the future for our youth, but we can build the youth for our future. -Franklin Roosevelt Gupta

57 THANK YOU! -Thich Nhat Hanh

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