Awareness, Acceptance & the Broader Aspects of "Emotional Availability"

     "Based on attachment theory, developed by John Bowlby beginning in the 1950s, as well as emotional perspectives of Emde and Mahler, Pine & Bergman, Emotional Availability (EA) is a research-based, scientifically driven way of understanding the quality of communication & connection between a parent (or caregiver) and child." http://www.emotionalavailability.com/

     To effectively engage with anyone or anything - person, animal, object, or process - we must be emotionally available - we must be there fully, our whole package: mind-heart-body. Such complete engagement is not just the most effective, it also ensures the best quality of life for the one so engaged.
     What blocks this quality of engagement with life? Fear & it's associates: anxiety - catastrophization, depression - rumination, anger, greed, etc. 
     What can we do about these hindrances? Recognize their characteristic accompanying physical feel; accept them fully at the physical level; let go of words, stories, intellectual analysis; bring attention back to whatever you are working on with mindful presence - an open-hearted attitude - full mental-emotional-physical availability. If attention drifts off 1,000 times, bring it back 1,001 times - perseverance will always triumph.

The Waiting Room

Competence, Sense of Agency and Periods of Ambiguity & Liminality

     We work so hard to feel and be seen as competent. This quest to be good enough consumes much of our life. Yet, no matter how hard we try, there are regular, unavoidable times of transition in life - several during training, starting work, marriage, break-up, moving, serious illness - our own or loved ones', retirement, death - of loved ones' and inevitably, our own.
     Even during a single day, we have moments where we feel "the illusion of control," then fairly quickly we wake up to reality. The problem is not so much that life is incomprehensibly complex, it's that we keep worrying that we should be able to understand and control it - or at least the healing & mortality aspects. A major underlying problem is that our current Western society has lost the meaningful rituals that help smooth out and help integrate important transitions in our lives. We're becoming great at counting stuff ... and forgetting the things that really count.

     See: http://www.johnlovas.com/2013/06/liminality-insight-into-emptiness.html
     and: http://mindfulnessforeveryone.blogspot.ca/2013/10/425-arising-urges-to-be-squirrel.html
     and: http://healthyhealers.blogspot.ca/2013/08/developing-strong-sense-of-efficacy.html 

Brazo   www.dpreview.com

Integrating Mindfulness into the Education Programs of All Health Care Professionals?

     "Students and clinicians in the allied health profession possess a demanding workload and are susceptible to burnout, which may reduce the ability to attend, concentrate, and make good decisions. Consequently, it is important to investigate how a student manages his own stress. Secondly, offering an opportunity for students to learn and practice mindfulness techniques would facilitate the enhancement of one’s full professional capacity by learning to be less reactive to stress-related activities and to increase self-awareness that enables him/her to be more connected with himself or herself and with one’s clients in preparation for intervention sessions.
     Currently, mindfulness is incorporated in graduate curricula in a variety of formats, including as being the topic of an elective course. The 'Mind/Body Medicine and the Art of Self-Care' is a 15-week, three-credit elective in the graduate school curriculum of counseling at Montana State University. The course, open to graduate students in the counseling field as well as all allied-health disciplines, was designed (a) to familiarize students with mindfulness and its relevance for the health and wellness fields and (b) to offer future healthcare providers practical methods for self-care and prevention of burnout. A qualitative study that explored the effects of this course on graduate student’s lives corroborated the results of previous mindfulness-based programs relating to enhanced self-awareness. Professor John Christopher, who primarily designed this course to improve the student’s inner resources for growth, learning, and healing through mindfulness-based stress reduction techniques, found that it also had significant impact on the students’ counseling practices. One student stated that this course was the most transformative experience in her graduate education and had the maximum influence on her clinical work. Overall, the impact of this experience has been so great that there have even been discussions about making this course a requirement for counseling students. Positive outcomes from this course include increased comfort with silence during interventions, heightened clarity of thought and capacity for reflection, enhanced ability for empathy and listening skills, and improved ability to focus on one’s clients and the therapeutic process. Additionally, students reported an intention to continue practicing mindfulness on their own given the demonstrated value to them as students and clinicians. This type of class may act as a paradigm for the future integration of mindfulness for all allied-health professional educational programs.

        Gura ST. Mindfulness in occupational therapy education. Occup Ther Health Care 2010; 24(3): 266-73. 

Individual Efforts Invariably Change Systems

       The origins of many health-care professionals' problems "are rooted in the environment & care delivery system rather than in the personal characteristics of a few susceptible individuals." 
       Shanafelt TD et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med 2012; 172(18): 1377-85.
 
     The system is ultimately composed of a lot of individuals. How can each one of us best, most profoundly influence this group of individuals? While "changing the system" may be the grand political ambition, individuals influencing individuals - one-to-one, one-person-at-a-time - is the most common, realistic, effective method (even in the political arena - eg door-to-door campaining). And, the first person we need to change is our self. To paraphrase Gandhi, we bring about desired changes best by embodying these changes. By letting go of cynicism about "the system", we instantly have energy to invest in making relentless incremental changes towards our ideals.

      “We can do no great things, only small things with great love.”             Mother Teresa

     With time and persistence, water wears away stone.

     See: http://healthyhealers.blogspot.ca/2012/12/health-harmony-meaning-navajo-wisdom.html

Ordinary magic, on our street, October 13, 2013

Mindfulness for Health Care Providers

     "While the use of mindfulness is steadily growing as a component of intervention by healthcare professionals, there is also a growing interest in the use of mindfulness for the healthcare provider. Recent studies delineate how the use of mindfulness improves practitioners’ work lives by increasing self-awareness and openness to new ideas, focus, and patience that contribute to enhanced client intervention as well as fostering a more healthy approach to living. Additionally, studies specifically exploring the effects of teaching mindfulness to undergraduate, medical, counseling, and nursing students demonstrated positive effects on their roles as students and future clinicians. Specific results included significant decrease in levels of depression, mood disturbance, and anxiety, as well as increased mental clarity, self-awareness, and concentration. Schure et al. (2008) showed how students personally benefited from learning mindfulness, including an increased comfort level with silence during sessions and a greater attentiveness with clients. Students in this study report an intention to continue to practice mindfulness given its demonstrated value to them as students and future clinicians." 

        Gura ST. Mindfulness in occupational therapy education. Occup Ther Health Care 2010; 24(3): 266-73. 

Corimenga   www.dpreview.com

Well-being - Wholehearted Embrace of One's Reality

     "Being at peace with self and others;

     Having opportunities for continual 'becoming' beyond mere lack of illness; 

     'Wholehearted and successful carrying out of valuable activities' relative to a person’s situation;

     Contentment with one’s health, self-esteem, sense of belonging, security, and opportunities for self-determination, meaning, roles, and helping others;

     Being able to 'carry out the activities of everyday living with satisfaction and comfort in ways that reflect sociocultural norms and idiosyncratic variation';

     Subjective state of contentment and life satisfaction;

     Meaning, contentment, and/or flow;

     The good life, positive human health, active living, sense of coherence."
 

       Aldrich RM. A review and critique of well-being in occupational therapy and occupational science. Scand J Occup Ther 2011; 18(2): 93-100. 

 

krsna   www.dpreview.com

 

Uncomfortable Being Still?

     We need to feel that we're getting somewhere, onto bigger & better things, greener pastures, onward & upward, ... Conversely, we fear going nowhere, getting nowhere fast, being stuck, ... Many of us, when we find that we have nothing to do, nothing planned - free unstructured time, instead of savoring this rare luxury, feel anxious, lost!
     So there's a common compulsion to keep busy, be productive, remain active, ... There's great emphasis on movement itself, not direction, nor how or even if movement relates to any particular plan.

     “Do not confuse motion and progress.
      A rocking horse keeps moving but does not make any progress."          Alfred A. Montapert

     We've come to associate a type of person who's restless, irritable, cynical, sarcastic, "doesn't suffer fools well", as a "man of action", a doer, capable, competent, someone who can get things done. On the other hand, someone who is quiet, reflective, still, peaceful, a deep thinker, tends to be seen these days as quite the opposite. And yet, the restless fellow is more suited to a widget assembly line, whereas the reflective person is better suited for leadership positions, or at the very least advising leaders.
     To accurately assess what's going on right now, one must first be able to accept what's going on ie be comfortable enough in the present moment, in one's own skin, in stillness, in quietness - to gather sufficient, accurate data. Only then can one reasonably decide what to do, in which direction to proceed regarding long-term goals. Having "ants in your pants" and a cynical attitude is a distinct handicap. Reasonable long-range planning and restlessness are mutually exclusive.
     "Doing" needs to be balanced with "being" - very different modes. The former is adequate for carrying out relatively simple physically tasks. The latter is essential where executive function is required: mature ethical judgment, long-term planning, etc (prefrontal cortex) - AND is the portal to real quality of life.
     See: http://mindfulnessforeveryone.blogspot.ca/2013/10/417-appreciating-even-prioritizing.html
     and: http://www.johnlovas.com/2013/10/self-concepts-sense-of-momentum-or.html

alex326   www.dpreview.com

Creating the Choice to Experience the Present Moment

     Recent research suggests "a close association between higher levels of mindfulness, either as a trait or as cultivated during treatment, and lower levels of rumination, avoidance, perfectionism & maladaptive self-guides. These four characteristics can be seen as different aspects of the same ‘mode of mind’, which prioritizes the resolution of discrepancies between ideas of current and desired states using a test-operate-test-exit sequence. Mindfulness training allows people to recognize when this mode of mind is operating, to disengage from it if they choose, and to enter an alternative mode of mind characterized by prioritizing intentional and direct perception of moment-by-moment experience, in which thoughts are seen as mental events, and judgemental striving for goals is seen, accepted and ‘let go’." 

       Williams JMG. Mindfulness, depression and modes of mind. Cognitive Therapy and Research 2008; 32: 721–33.

Halifax, October 19, 2013

Mindfulness Training - Skillfully Healing Emotions

     "In his book The Expression of the Emotions in Man and Animals, Darwin reports the following experiment on himself at the London Zoo reptile house. 

        'I put my face to the thick glass-plate in front of a puff adder in the Zoological Gardens, with the firm determination of not starting back if the snake struck at me; but as soon as the blow was struck, my resolution went for nothing, and I jumped a yard or two backward with astonishing rapidity. My will and reason were powerless against the imagination of a danger which had never been experienced.' 
     ... emotions evolved long before hominids roamed the planet. We can easily see that bottom-up reactivity to threats and losses provides a good explanation of why emotions in animals and humans switch on. It does not do such a good job of explaining why emotions in humans are maintained. For this, we need to look at how humans evolved the capacity to build mental models and symbolic processing that released them from sensitivity to current contingencies. Although such symbolic representations of past and future give humans great advantages in problem-solving capabilities, it is this same capacity to work 'off-line' that means emotions do not switch off. For current low mood can reactivate recollections of past loss and humiliation, and anxiety can simulate future terrors. Problems arise when our 'simulations' are treated by the evolutionary primitive neural pathways as real threats & real losses to be dealt with now and with a high degree of priority. 

      Failure to switch off emotion is due to the activation of mental representations of present, past, and future that are created independently of external contingencies.

     Mindfulness training can be seen as one way to teach people to discriminate such 'simulations' from objects & contingencies as they actually are. (Research) shows how even brief laboratory training can have effects on processing affective stimuli; that long-term meditation practitioners show distinct reactions to pain; that longer meditation training is associated with differences in brain structure; that 8 weeks’ mindfulness practice brings about changes in the way emotion is processed showing that participants can learn to uncouple the sensory, directly experienced self from the 'narrative' self; that mindfulness training can affect working memory capacity, and enhance the ability of participants to talk about past crises in a way that enables them to remain specific and yet not be overwhelmed."

       Williams JM. Mindfulness and psychological process. Emotion 2010; 10(1): 1-7.

 

Force of Habit vs Reason

     "By leveraging preventive medicine, we can reduce the incidence of catastrophic illness and serious disease, thereby diminishing the need for expensive interventions. As the old adage has it, 'an ounce of prevention is worth a pound of cure,' yet our current system focuses mostly on cure and largely overlooks the advantages of investing in prevention. Paying more attention to disease prevention and health promotion will result in a healthier population with less call for expensive medical interventions. Low-tech, cost-effective approaches to disease prevention and health promotion already exist; it is merely a matter of exploring how best to employ them for greatest impact. Strategies for health promotion and disease prevention — those that focus on self-responsibility and that support positive behavioral change — will yield the greatest long-term cost savings and are the foundation for a sustainable health-care system for the 21st century."
        McCabe Ruf, K, Mackenzie ER. The role of mindfulness in healthcare reform: a policy paper. Explore (NY) 2009; 5(6): 313-23. 

 

     The above paper logically and convincingly argues for greater implementation of mindfulness technologies within our healthcare system. But this is an uphill battle, since both the healthcare system, as well as each of us individually, are far less rational and far more 'creatures of habit' than we think. Even people who've trained in, and have had very favorable experiences with, mindfulness practices tend to neglect these in favor of their previous (less mindful) behavior patterns. No, it doesn't make sense, but old habits - no matter how dysfunctional - die hard. 

     For too many of us, the motto is: "Even if it's broke, don't fix it!" Too many of us have to crash before we make significant lifestyle changes.

 

 

Mindfully Improving Our Health & Creating a Culture of Wellness

     “Mindfulness practices can be an important tool in addressing our public health problems. Mindfulness training can enhance other nationwide health promotion efforts by helping people become more self-aware, more resilient to stress, and more responsible about their lifestyle choices. One of the great advantages of mindfulness training is that it assists people in making those lifestyle changes we all know we should make. It is one thing to know that smoking or obesity very often lead to disease, but another thing to have the capacity for behavioral change. Mindfulness-based practices can help us to cope with psychological stress and support us while we make the lifestyle changes we know will help us to become healthier. Creating a ‘culture of wellness’ entails promoting a culture of self-responsibility, which requires a society composed of individuals cultivating self-awareness. 

     As researchers have repeatedly noted, by increasing awareness in the present moment, we can interrupt existing patterns of behavior and make wiser choices. In essence, practicing mindfulness skills throughout the day leads to the possibility of a different relationship to any situation. With mindfulness, one moves from being distracted and inattentive, or stuck on ‘autopilot,’ to being present and aware in every moment. In this way, mindfulness training can help individuals make and sustain the lifestyle changes that lead to improved health. The regular practice of mindfulness meditation can also help our bodies to become more ‘stress hardy,’ less likely to succumb to the wear and tear of chronic psychological stress. As the evidence mounts that the mind exerts a real and demonstrable influence on the central nervous system, the endocrine system, and the immune system, policy makers are called upon to explore the ways in which training the mind can prevent disease and promote health of populations. What the scientific studies suggest is that we have, within us, the key to better health. Mindfulness practices unlock this potential and greatly increase the odds of avoiding debilitating and costly disease, while simultaneously improving quality of life, enhancing mood, and promoting general well-being. 

     Applying what we know about the potential for mindfulness-based interventions to prevent disease, promote health, treat chronic conditions, and improve the quality of care, may well turn out to be a cornerstone of a more humane, equitable, and effective approach to health and healthcare that can actually reduce costs in a meaningful way. Leveraging the body’s innate capacity to heal itself may be the key to creating a sustainable healthcare system for the 21st century.”

       McCabe Ruf, K, Mackenzie ER. The role of mindfulness in healthcare reform: a policy paper. Explore (NY) 2009; 5(6): 313-23.

Life-giving water

Awareness, Meditation and the Deep Changes Necessary for Healing

     “Awareness and meditation are, for me, fundamental to the deep change that is necessary for healing. Chronic illness is a way of life as well as, perhaps even more than, a disease entity. Before we can be free of the symptoms of illness and the role of the sick person, we need to know what has precipitated those symptoms, and how we are responding to our sickness. We need to recognize in our own lives the psychological, biological, and sociological factors that may affect our health.
     Awareness allows us to see where we are; to stand for a moment outside ourselves; to appreciate in a powerful, personal way, how the world around us affects us; to observe the thoughts, feelings, and sensations that arise in us. Meditation is a state of moment-to-moment awareness that over time may help to dissolve physical symptoms and habitual ways of thinking and acting. Both awareness and meditation enable us to experience the way our mind may limit or free us. Together they prepare us to use our mind to make the deep changes in thought, feeling, and action that are necessary for our healing.”                 James S. Gordon, MD

       McCabe Ruf, K, Mackenzie ER. The role of mindfulness in healthcare reform: a policy paper. Explore (NY) 2009; 5(6): 313-23.

Boundaries, Therapeutic Relationships & Effectiveness

     "The idea of firm, intractable boundaries as a way to guarantee ethical action in professional helping relationships may be a comforting one. It is, however, a false comfort. Fixed general rules cannot capture the complex reality of therapeutic relationships. Normative principles can be invaluable as guides to ethical practice. They are, nevertheless, insufficient. Practitioners need to follow the ethical codes and standards of their discipline, but they must do more than this. They need to be unceasingly attentive to the way in which they act within the moral context of practice.
     rules etched in stone ... cannot replace careful examination of motives, behaviors, and the ethical possibilities of the particular situation
     'we have historically been unwilling to explore the complexities of ethical dilemmas and content to be reactive rather than proactive in the development of ethical norms.'
     concrete boundaries in therapeutic relationships can diminish both the humanness of encounter between client and practitioner and therapeutic effectiveness."
         Austin W, Bergum V, Nuttgens S, Peternelj-Taylor C. A Re-Visioning of Boundaries in Professional Helping Relationships: Exploring Other Metaphors. Ethics & Behavior 2006; 16(2): 77-94.

Dale Chihuly   http://www.chihulygardenandglass.com/

Gratitude during Canadian Thanksgiving Day

     "Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend."                     Melody Beattie

Dale Chihuly   http://www.chihulygardenandglass.com/

Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend.
Read more at http://www.brainyquote.com/quotes/quotes/m/melodybeat177949.html#rBmEJwXhzYRja6gX.99

Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend.
Read more at http://www.brainyquote.com/quotes/quotes/m/melodybeat177949.html#rBmEJwXhzYRja6gX.99

Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend.
Read more at http://www.brainyquote.com/quotes/quotes/m/melodybeat177949.html#rBmEJwXhzYRja6gX.99

Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend.
Read more at http://www.brainyquote.com/quotes/quotes/m/melodybeat177949.html#rBmEJwXhzYRja6gX.99

Keeping This Moment Clean - Training to be Present

     For many of us, past events - like a mud slide - spill on top of, and often nearly obliterate our present life. Anxiety about, or obsessively planning for the future, can also invade - like a forest fire - our present. These are serious attentional boundary violations.
     As soon as any event ends, it's gone forever. No amount of thinking will prevent it from having happened, eradicate it, or change it in any way - yet we waste a lot of time & energy trying to accomplish these impossible tasks.
     No amount of planning guarantees perfection. Most of our time obsessing about the future is not productive planning - instead we catastrophize - anxiously hypnotizing ourselves to have a negative outcome.
     The best, healthy, productive use of our time and effort is being fully present, fully engaged in our present activity. The only way to do this is to let go of the past, let go of the future, and embrace the now. Though such "presence" is clearly the very basis of mental health, it's a rare phenomenon. But presence is a trainable mental habit - an important part of mindfulness training.
     See: http://mindfulnessforeveryone.blogspot.ca/search?q=presence
     and: http://www.johnlovas.com/2013/10/choose-now-fresh-or-stale.html