WHOLE HEALTH: Change the Conversation. Mindful Awareness & The Power of the Mind

Transcription

1 WHOLE HEALTH: Change the Conversation Mindful Awareness & The Power of the Mind OCTOBER 2013

2 One by One I never look at the masses as my responsibility. I look at the individual. I can only love one person at a time. I can only feed one person at a time. Just one, just one So you begin - I begin. I picked up one person - maybe if I didn t pick up that one person, I wouldn t have picked up 42,000. The whole work is only a drop in the ocean. But if I didn t put that drop in, the ocean would be one drop less. Same thing for you, same thing in your family, same thing in the community where you live. Just begin one, one, one. -Mother Teresa

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4 Objectives Define mindful awareness Explore why and how it matters Review some of the research Practical applications Resources for further learning VETERANS HEALTH ADMINISTRATION

5 Pause and Presence Pause Be Present Proceed Towards Whole Health Pause, Presence, Proceed VETERANS HEALTH ADMINISTRATION

6 When are you most Aware Present Centered Focused Calm VETERANS HEALTH ADMINISTRATION

7 Definitions of Mindful Awareness Way of being In the present moment On purpose Nonjudgmentally VETERANS HEALTH ADMINISTRATION

8 Mindful awareness is an opportunity to be in the wholeness of life including suffering, joy, peace, unrest, creativity, fullness, emptiness everything Not merely a technique for coping with a specific problem.

9 Encompassed by many practices Yoga as preparation Meditation Seated Movement Eating Compassion Breathing Washing dishes, doing laundry Techniques found in most spiritual traditions Goal is to bring it to moment-by moment awareness VETERANS HEALTH ADMINISTRATION Dailyheal.com

10 The Challengers TIES Thoughts Images Emotions Sensations Modernworld4.blogspot.com VETERANS HEALTH ADMINISTRATION

11 The nature of mindful awareness Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom. -Victor Frankl, MD,PhD VETERANS HEALTH ADMINISTRATION 10

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13 The Info-Medical Cycle Belief Memory Information Perception Behavior Emotion Somatic Change Perception VETERANS HEALTH ADMINISTRATION Rakel D, Shapiro D. Textbook of Family Medicine, 6th Ed.

14 How Many Fs? FINISHED FILES ARE THE RESULT OF YEARS OF SCIENTIFIC STUDY COMBINED WITH THE EXPERIENCE OF YEARS. VETERANS HEALTH ADMINISTRATION

15 Word Association with United States= #1 Answer = Guilt France= #1 Answer = Celebration! Rozin, et al. Health Psychology. 1996;15(6): VETERANS HEALTH ADMINISTRATION

16 I am an old man and have known a great many troubles, but most of them never happened. -Mark Twain-

17 Judgment Hostility Anger Beauty Self-Doubt

18 Awe Authenticity Awakening Awareness

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24 Drop Beneath your mind s thoughts and..observe. Thoughts Judgment Emotions Awareness VETERANS HEALTH ADMINISTRATION

25 Guess what? When it comes right down to it, wherever you go, there you are Like it or not, this moment is all we really have to work with. Yet we all too easily conduct our lives as if forgetting momentarily that we are here, where we already are, and that we are in what we are already in. In every moment, we find ourselves at the crossroad of here and now. But when the cloud of forgetfulness over where we are now sets in, in that very moment we get lost. Jon Kabat-Zinn, Wherever You Go, There You Are

26 Mindful awareness is gently bringing our attention back to the present moment, with acceptance (and curiosity) of what is

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28 Reversible cardiomyopathy with severe emotional stress 19 people with heart wall motion dysfunction after emotional stress Ejection Fraction = 20% Monocyte infiltration Moderate Troponin I catecholamines 95% had normal arteries VETERANS HEALTH ADMINISTRATION Wittstein, et al. NEJM 2005;352:

29 A Wandering Mind Is an Unhappy Mind Matthew A. Killingsworth*, Daniel T. Gilbert Science 12 November 2010: Vol. 330 no p Adults in US. Mean age = 34 How are you feeling right now? What are you doing right now? Are you thinking about something other than what you re currently doing?

30 VETERANS HEALTH ADMINISTRATION J Am Coll Card: Vol 45(5);2005

31 Nationalgeographic.com

32 Gamma wave synchronization Longtime practitioners show organized brain activation on scale never seen before High-frequency gamma wave synchronization especially intense in the left prefrontal cortex Gamma waves associated with attention and mood Lutz et al. PNAS 2004;101(46): VETERANS HEALTH ADMINISTRATION

33 Promega Study Methods: 48 right handed subjects employees of Promega in Fitchburg, WI Subjects randomized into Meditation group (N=25, 19 females) and a wait-list control group (N=16, 10 females) Mean age 36 years Wait-list controls were provided 8-wk MBSR training program after completion of study Richard J. Davidson, Ph.D., Jon Kabat-Zinn, Ph.D., et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine. Aug/Sept VETERANS HEALTH ADMINISTRATION

34 Right vs Left Prefrontal Cortex VETERANS HEALTH ADMINISTRATION Negative ---- Positive Balance predicts typical range of moods.

35 Negative emotions: right prefrontal cortex Anger Fear Anxiety Depression VETERANS HEALTH ADMINISTRATION

36 Positive emotions: Left prefrontal cortex Enthusiasm Vigor Optimism Buoyancy VETERANS HEALTH ADMINISTRATION

37 Promega study A short course of meditation practice increases left prefrontal cortex activity anxiety & negative affect positive affect immunity (antibody titer to flu vaccine) Davidson et al. Psychosom Med 2003; 65(4): VETERANS HEALTH ADMINISTRATION

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39 fmri Brefczynski-Lewis, et al (27):

40 Genius means little more than the faculty of perceiving in an un-habitual way. -William James VETERANS HEALTH ADMINISTRATION

41 Mindfulness for Clinicians and Staff Fortney L, Luchterhand C, Zakletskaia L, Zgierska A, Rakel D. Abbreviated Mindfulness Intervention for Job Satisfaction, Quality of Life, and Compassion in Primary Care Clinicians: A Pilot Study. Ann Fam Med. 11(5); VETERANS HEALTH ADMINISTRATION

42 Burnout by Specialty (n = 7288) Arch Intern Med. Published online 08/20/12. doi: /archinternmed Percent Reporting Burnout

43 Significant improvements with Maslach Burnout Inventory

44 Significant improvements with depression, anxiety and stress

45 Mindful awareness in a nutshell Pause o Stop what you are doing; drop in o Challenge is to make this a habit Presence o Observe it, acknowledge it o Nonjudgmental. No striving let it be Proceed o Return to your activity, anchored in present moment awareness (breath, physical sensation, groundedness) o Compassion, appreciation, positive intention VETERANS HEALTH ADMINISTRATION Adapted from:

46 How can your meditation cushion become your clinical chair? VETERANS HEALTH ADMINISTRATION

47 Mindful Awareness and Medicine VETERANS HEALTH ADMINISTRATION

48 Healing Thresholds VETERANS HEALTH ADMINISTRATION 47

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51 What does this look like? What does this look like?

52 Suggestions for practice Listen with your whole body Deep breath before each patient Threshold exercise Stethoscope use as a reminder to be mindful Call room/office centering The moment you sit in your chair Supportive group Daily practice Others? VETERANS HEALTH ADMINISTRATION

53 Tell me what you pay attention to, and I will tell you who you are. Jose Ortega y Gasset

54 Five Facet Mindfulness Questionnaire Feeling yourself walking Responding to emotions, not getting caught up in them Distractibility Noticing background sounds Feeling the water from the shower Noticing smells Putting experiences into words Self-judgment VETERANS HEALTH ADMINISTRATION 53

55 Appreciative Inquiry Appreciative Inquiry is about the co-evolutionary search for the best in people, their organizations, and the relevant world around them. In its broadest focus, it involves systematic discovery of what gives life to a living system when it is most alive, most effective, and most constructively capable in economic, ecological, and human terms. VETERANS HEALTH ADMINISTRATION

56 It is true that we are called to create a better world. But we are first of all called to a more immediate and exalted task: that of creating our own lives. -Thomas Merton