APNA Conference 2014 Maryanne Jones Godbout, DNP, PMHCNS-BC Disclosure This speaker has no conflicts of interest. Objectives Describe the concepts of spaciousness and the pause as fundamental concepts which lie at the core of the mindfulness experience. Identify how integration within the nurse is supported by mindfulness practices. List three methods to incorporate mindfulness in both personal and professional life. Godbout 1
Temporary state of non-judgmental, non-reactive, presentcentered attention and awareness that is cultivated during awareness and attention practice Enduring traits that can be described as a dispositional pattern of cognition, emotion, or behavioral tendency Meditation practice Intervention in therapy Mindfulness Antidote to mind wandering and time travel Act with awareness Be less reactive Be nonjudgmental Development of the ability to label and describe with words the internal world Self observation Mindfulness Traits Non conceptual Nonverbal Present centered Nonjudgmental Participatory Liberating Mindful Moments Godbout 2
The Core of Mindfulness Awareness of awareness Paying attention to intention Awakened presence Equanimity The Pause Temporal pause from habitual automatic thoughts and responses Redirects attitude of awareness of the present experience with acceptance and compassion Allows for awareness of the changing vibrations of self and other Enhances the depth of attention, concentration and spaciousness in the relationship Ways to Be Present Physical being there acts of care, tasks, technical interventions Psychological being with communication. Authentic listening, empathy, non- judgmental Therapeutic- mindful attentiveness, attunement, resonance Awakened presence - an embodied understanding of and interaction with the things that are in the world Godbout 3
Breath Object of awareness for most mindfulness practices Boundary between the involuntary and the voluntary, the automatic and the effortful Interface between the internal and the external. Rhythm is a repeated pattern where the in-breath is always is followed by the out-breath Rhythm is related to in nervous system functions and integration. Forms of the Mind Spacious awareness - Diffuse rather than narrow attention in the present moment; expansive with infinite space Concentrated Awareness a focus of attention on an object without distraction of other stimuli Both forms are characteristics of the conditioned phenomenon of consciousness Pure Awareness is an experience Godbout 4
Mindfulness Meditation Three practices types: Focused attention (FA), a type of concentrative practice Insight or open monitoring (OM), a type of receptive practice Loving- Kindness and Compassion, quality of the attitude or emotion of tenderness, soothing, comfort, ease, care and connection Objects of Awareness Sensations, thoughts, feelings in me Words, body language, mood of the other other Flow of relationship felt sense of connection or distance Godbout 5
Components of Compassion Distress-sensitive Sympathy Care for well-being Of others Compassion Distress-tolerance Non-judgment Empathy Create opportunities for growth and change with warmth (Gilbert, 2005) Mindfulness in Practice Presence with awareness is critical in listening empathically and responding appropriately to others. Establishes rapport wordless experience of mindful attentiveness As long as one person in the dyad is mindful, the regulatory capacity of the state is present for the interpersonal system. (Surrey & Kramer 2013) Promotes well-being in body, mind, and relationships. Therapeutic experiences that move an individual toward well-being promote integration. Mindfulness Experience Reduces biases through specific forms of mental training that develop meta-awareness of self (self-awareness) Increases the ability to effectively manage or alter one's responses and impulses (self-regulation) Enhances the development of a positive relationship between self and other that transcends self-focused needs Increases prosocial characteristics (self-transcendence) Godbout 6
How Mindfulness Works Attention regulation Body awareness Emotional regulation Reappraisal Exposure Flexible sense of self (Germer, 2013) Neurocognitive Mechanisms Intention and motivation Attention and emotion regulation Extinction and reconsolidation Prosociality Non-attachment De-centering (Siegel, D., 2010) Mindful Practice Fully present Open to whatever emotional content arises Defused from our own judgments In touch with our core values (connection, compassion and contribution) Facilitates relationship qualities of warmth, resonance, openness and authenticity Allows the focus of mind and attention on the internal world of another sparking the sense of truly being felt Godbout 7
Mindless Practice Experiential avoidance Cognitive fusion and its projection into the conceptualization of self Repertoire narrowing form personal narratives, old scripts and roles Too much talk, not enough of action Reinforcing avoidance Insensitivity Failure to link acceptance with values Mindful Awareness Practice (MAP) Breath Meditation Mediation (Sitting, Standing, Walking) Body -Mind work- Yoga Tai Chi. Qi Chong, Centering Prayer Intention with attention of everyday activities Loving Kindness Meditation Insight Dialogue (retreats) Clinical Training Paying attention Affect tolerances, emotional regulation and fearlessness Practicing acceptance Empathy and compassion Equanimity and humility Learning to see Letting go and starting again Exposing narcissistic needs Overcoming infatuation with theory/techniques (Fulton, 2013) Godbout 8
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 Frankel References Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27 45. Bazarko, D. (2014). Mindfulness and You Being Present in Nursing Practice. Silver Spring, MD: American Nurses Association Nursesbooks.org. Germer, C,. K., Siegel, R. D., & Fulton, P. R. (2013). Mindfulness and Psychotherapy (Second Edition ed.). New York, NY: The Guilford Press. Gilbert, P. (Ed.). (2005). Compassion and Cruelty A biopsychosocial approach. Compassion Conceptualisations, Research and Use in Psychotherapy (p. 52). New York, NY: Routledge Taylor & Frances Group References - continued Gottlieb, L. N., (2013).Strengths-Based Nursing Care. New York, NY: Springer Publishing Company Harris, R. (2009). ACT Made Simple ( ed.). Oakland, CA: New Harbinger Publications, Inc. Kabat Zinn, J., Mindfulness based intervention in context: Past, present, and future. Clinical Psychology: Science and Practice. 2003; 10; 144 156 Lutz, Antoine., Slatger, Helen A., Dunne, John D., & Davidson, Richard J. (2008). Attention Regulation and Monitoring in Meditation. Trends in Cognitive Sciences, 12(4), 163 169. Marci, C.D., Ham, J., Moran, E.K., & Orr, S.P. (2007) Physiologic concordance, empathy, and social-emotional processing during psychotherapy. Journal of Nervous and Mental Disease, 195, 103-111 Godbout 9
References- continued Miller, L. D. (2014). Effortless Mindfulness Genuine Mental Health Through Awakened Presence. New York and London: Routledge Taylor & Frances Group Pollak, S. M., Pedulla, T., & Siegel, R. D. (2014). Sitting Together Essential Skills for Mindfulness-Based Psychotherapy. New York, NY: The Guilford Press. Neff, K. D. (2012). The science of self-compassion. In C. Germer & R. Siegel (Eds.), Compassion and wisdom in psychotherapy. New York: Guilford Press. Siegel, D. J. (2010). The Mindful Therapist. New York, NY: W,W. Norton & Company. References - continued Siegel, Daniel J.(2009) 'Mindful Awareness, Mindsight, and Neural Integration', The Humanistic Psychologist, 37: 2, 137 158 Vago, D. R., & Silbersweig, D. (2012). Self-awareness, self-regulation, and self-transcendence(s-art):a framework for understanding the neurobiological mechanisms of mindfulness. Frontiers in Human Neuroscience, 6, 296. doi:10.3389/fnhum.2010.00296 Wilson, K., & DuFrene, T. (2008). Mindfulness for Two: an acceptance and commitment therapy approach to mindfulness in psychotherapy. Oakland, CA: New Harbinger Publications. Godbout 10