Mindfulness for living well with a LTC

Transcription

1 Clinical Health Psychology Services Mindfulness for living well with a LTC A Patient Workbook Easy read version Developed by Clinical Health Psychology Services Aintree University Hospital NHS Foundation Trust Dr Mark Griffiths, November 2017

2 Clinical Health Psychology Services What is mindfulness? Our mind is full of thoughts; memories, plans for the future, hopes and dreams. Hopes Dreams Plans Memories Sometimes these thoughts are negative; critical, unhelpful, hurtful, mean, worrying, or scary. It is normal to have these thoughts. They grab our attention without us realising. We sometimes get stuck on these thoughts and they seem to take over our life. They make it hard for us to be happy and live well.

3 Clinical Health Psychology Services Critical Hurtful Scary Worrying Mindfulness tell us to pay attention to what is happening right now, in a calm and open-minded way. If we pay attention to the here-and-now, we pay less attention to those negative thoughts that come to mind. Mindfulness brings peace and calm. It helps us to cope with stress. Mindfulness needs to be practiced. Practice once or twice a day over the next few weeks.

4 How to start using mindfulness Clinical Health Psychology Services 1) Notice your thoughts We are always thinking. This is the normal job of our brain. Thoughts can be anything, like: What shall I have for tea? I can t cope anymore This isn t fair Why has this happened to me? I wonder what the doctor will tell me in my appointment tomorrow Noticing or spotting our thoughts is very useful. It stops us getting stuck on a thought, especially a hurtful or upsetting one. This stops our thoughts from taking over our lives.

5 Clinical Health Psychology Services 2) Coming out of automatic pilot Have you ever driven home on automatic pilot? Before you knew it you were home, without noticing how you got there. We might be missing out on life by living on autopilot. Instead of paying attention to where we are or what we are doing, we can seem miles away. On autopilot, it is easier for our negative thoughts to take over without us noticing. When negative thoughts take over, we feel down, depressed, worried, and angry. Coming out of autopilot means paying attention to things that are happening right now. o Notice your thoughts as they come to mind o Name how you are feeling right now o Spot any reactions in your body as they happen 3) Observing our thoughts Now you can spot your thoughts, you don t need to reply to them. Thoughts are a normal part of life. Thoughts are just ideas that your brain is having, all the time. This does not make them true. You do not need to respond to your thoughts; just let them pass through your mind. It s just a thought!

6 Clinical Health Psychology Services How to be mindful everyday Try to be mindful when you are doing an everyday job. Notice the difference between these two examples: Washing the dishes on autopilot 1. Rushing through the dishes as quickly as possible. 2. Thinking about tomorrow. 3. Worrying about a hospital appointment. What will the doctor say? 4. Before I know it, the dishes are done, but I feel stressed. Mindfully washing the dishes 1. Notice the temperature of the water. It is warm on my skin. 2. Feel the bubbles; slippery and soft. 3. I hear the water splash as the plates go in. 4. A thought pops into my head, what will the doctor say tomorrow? 5. Instead of trying to answer that impossible question (nobody can know what will happen in the future), I look back at the bubbles in the sink, the texture of the sponge, the sound of the water splashing 6. I feel calm. Other everyday activities you could do mindfully: Walking Walk slowly and comfortably. Take in what you can see, hear and smell? What do your feet feel like as they touch the ground? Eating Eat slowly. Imagine you are eating a very special meal. Notice the taste, texture, temperature, colour of your food. A bus journey Notice the sounds of the bus, the chatter of others, the smells, and sights, look out of the window, what do you see?

7 Clinical Health Psychology Services How to practice mindfulness Listen to your mindfulness CD or ask someone to read these exercises to you: Mindfulness exercise: Mindful breathing Sit comfortably, with your eyes closed. Bring your attention to your breathing. Imagine that you have a balloon in your tummy. Every time you breathe in, the balloon inflates. Each time you breathe out, the balloon deflates. Notice the sensations in your stomach as the balloon inflates and deflates. Your stomach rising with the in-breath, and falling with the out-breath. Thoughts will come into your mind, and that s okay, because that s just what thoughts do. Simply notice those thoughts, then bring your attention back to your breathing. Likewise, you can notice sounds, physical feelings, and emotions, and again, just bring your attention back to your breathing. You don t have to follow those thoughts or feelings, don t judge yourself for having them, or worry about them in any way. It s okay for the thoughts to be there. Just notice those thoughts, and let them drift on by, bringing your attention back to your breathing. Whenever you notice that your attention has drifted off and is becoming caught up in thoughts or feelings, simply note that the attention has drifted, and then gently bring the attention back to your breathing. It's okay and natural for thoughts to enter into your awareness, and for your attention to follow them. No matter how many times this happens, just keep bringing your attention back to your breathing.

8 Clinical Health Psychology Services Mindfulness exercise: Leaves on a stream Sit comfortably and close your eyes. Focus your attention on you breathing breathing in, and then breathing out. Be aware of your breathing and of the feeling of calmness and relaxation you can feel begin to wash over you, as you breathe in.and out, in..and out. Find a breathing rhythm that feels comfortable to you. Imagine there is a balloon in your stomach, with the balloon inflating as you breathe in..and deflating as you breathe out..the balloon getting larger as you breathe in.and smaller as you breathe out. You ll notice thoughts pop in your mind as you breathe just be aware of them, notice them but don t pay them too much attention. Be aware of them, and bring your mind back to your breathing, and the feeling calmness on each out breath. Notice sounds around you that you would not normally be aware of both inside and outside of the room. Just be aware of these don t pay any one thing too much thought. Notice.. and then continue to bring your attention back to your breathing. Notice different feelings in different areas of your body..some parts may feel warmer or colder than others; some muscles may feel tighter and some looser than others; some areas of your body may feel more comfortable than others. Just be aware of these differences that you can notice..and then bring your attention back to your breathing. Now imagine you are sat at the side of a stream, which is calmly flowing down a hill, on a warm sunny day. There is a tree next to the stream and its leaves are falling, one by one, into the stream, as the wind gently blows. Picture this in your mind. Take each thought that pops in your mind and place each one on one of the leaves, drifting down the stream. Watch each thought drift away, gently, as the stream runs gently down the hill. For every thought that pops in your mind, place it on a new leaf and watch it drift down the stream calmly and gently. Bring your attention back to your breath, feeling calmer with every out breath. When you are ready, bring your attention back to the room and open your eyes Mindfulness Script (M, Griffiths, 2014)

9 More ways to be mindful Clinical Health Psychology Services Other ways that we can be more mindful (so that our thoughts have less control over us) are: 1) Using the STOP mantra Stop ask yourself what is going on right now? Thoughts what kinds of thoughts are going through your mind? Feelings are you sad, angry, upset, worried? Sensations are you in pain, tired, hot, dizzy, short of breath? Take a breath pay attention to your breathing Pay attention to your breathing, to each in-breath and outbreath, one after another. Count to ten in your head whilst you are doing this. Observe - expand your awareness Start to think of your whole body, your posture, facial expression, and then further out to what is happening around you; sights, smells, sounds etc. Proceed differently continuing without expectation Don t act on autopilot. Do what is helpful to you and your life right now, not what your thoughts push you towards doing. 2) Label your thoughts. Am I predicting the future? Am I thinking of the past, or the future? Is it a worry? 3) Label your thoughts as thoughts. I am having the thought that These techniques can help remind you that thoughts are just thoughts.

10 How else can we take care of ourselves? By doing things that make us happy. By doing something that makes us feel proud. By doing calm, peaceful activities such as: o Bird watching o Pilates o Tai Chi o Painting o Jigsaws o Being with family

11 The impact of a long-term condition Having a physical health problem, illness or long-term condition can make life harder in many ways. You may: Only be able to eat certain foods Need to take medication Feel you miss out on things you want to do Struggle with jobs at work or at home Be in a lot of pain Feel tired all the time Feel, or look, different from how you used to Feel fed up, worried, angry. It is common to feel this way. But sometimes the stress of coping with your health problems causes more difficulties than the condition itself. This causes more and more stress and makes it even harder to manage your condition or live life well. The happier you feel, the better you will be able to manage your health problems and feel good in yourself. The aim of this booklet is to help you get on with life as best you can, even with your long-term condition.

12 Worry mode Do you find yourself worrying all the time? If you get stuck in worry-mode it can: Keep you awake at night Make it hard to concentrate Trigger the body s stress response, which might cause you: o Upset stomach o Breathlessness o Cramps o Heart racing o Dizzy spells Avoiding Do you try to stay away from the people, places or things that cause you stress? This may seem like a good idea at first and make you feel better for a shorttime. But in the long run it will: Make the problems worse Keep the problems going for longer Make it harder to face up to things in the future Stop you from living life to the full Bring more loneliness and boredom Avoiding your health problems Do you ever feel so worried about your health that you miss an appointment or ignore your health problems for a while? Again, avoiding reminders of your health problems might feel good for a short time, but in the long run it will: Risk worsening your health problems Worsen the fear next time

13 Getting caught up in your problems The things we may try to do to help us cope with a long-term condition end up causing us even more problems than the condition on its own. It can be difficult to change our behaviour. Do you feel stuck in a rut or a bad habit? Acceptance Instead of getting caught up in the difficulties of your health condition or illness, use your energy to work towards (as best you can) the things you are interested in, despite your physical health problems. Values Have your plans or hopes for life been blocked by your health problems? If your health problems cannot be cured, it is not possible to wait until you are better before you get back to getting on with life. Values Spend some time answering these questions: 1. Deep down, what is important to you? 2. What do you want your life to be about? 3. What sort of person do you want to be? Example values: Can you spot any values below that are important to you? (Please circle, or add your own) Confident Caring Brave Creative Fun Fair Fit Friendly Honest Busy Healthy Active

14 Living well Which areas of life are most important to you right now? In which areas are you not living well or out of step with your values? Barriers to living well Even when you have identified your values in life, things get in the way of living well. Common barriers include: Fear of failing Fear of getting upset Fear of pain or injury Fear of letting others down Fear of being a burden These are fears, not facts. If you notice your worries holding you back from what is really important to you, try doing something different:

15 How I will start to live well Make a note below of the steps you will take to start living life in line with your values: 1. When I am living well, I will do more of the following activities: 2. My life will get better when I do the following: Here are some goals I will work towards: Stop Take a breath Observe Proceed (differently)