THE HEART OF MINDFUL LIVING: AN APPROACH TO

THE HEART OF MINDFUL LIVING: AN APPROACH TO

THE HEART OF MINDFUL LIVING: AN APPROACH TO RESILIENCE Karen Goble, MA, Assistant Director Continuing Medical, Dental, Pharmacy Education, Integrative Health Coach, Chaplain, CBCT Instructor December 10, 2018 https://elishagoldstein.com/3-key-practices-for-calm-self-compassion-and- OBJECTIVES Describ e Describe the foundations of mindfulness and how they contribute to resilience.

Identify Identify core mindfulness practices and their application in everyday life Discuss Discuss practices that support well-being and resilience WHAT IS MINDFUL NESS? ATTENTIONAL STABILITY The stability of the body supports the stability of the mind.

Attention And, like this morning, here the sun is shining, the air smells good, theres just a gentle breeze, and the fall colors are brilliant, and the dogs happy and hes prancing along, and as I am walking I am aware of every, I am aware of all of my five senses (Goble et al, 2016).

Mindfulness Based Stress Reduction (MBSR) (1979) MINDFUL NESS IN MEDICIN E Jon Kabat-Zinn, PhD, University of Mass Medical

Center 8 weekly sessions; 2.5 hr plus day long retreat Widely studied in medicine and behavioral health FOUNDAT ION PRACTIC

ES Awareness of breathing Awareness of the body Open field of awareness Mindful eating

Yoga Mindful movement Walking meditation Loving kindness Attitudes of mindfulnes s Compassio

n Insight Dialogue FOCUSED ATTENTION PRACTICES (CONCENTRATIVE) CREATE STABILITY OF ATTENTION, BODY, ANS, DECREASE MENTAL PROLIFERATION (MINDWANDERING, RUMINATION), CONCENTRATION ON OBJECT (BREATH) OPEN MONITORING PRACTICES (INSIGHT MEDITATION) THAT HAVE NO OBJECT OF ATTENTIONAL

FOCUS BUT RATHER ARE RECEPTIVE TO WHATEVER PHENOMENA (PHYSICAL, MENTAL OR EMOTIONAL) ARISE TO CULTIVATE MINDFULNESS: REFLECTIVE MEDITATION PRACTICES; CULTIVATION OF QUALITIES LIKE LOVINGKINDNESS, COMPASSION AND FORGIVENESS; GRATITUDE, PATIENCE, ATTITUDES OF MINDFULNESS Way of navigating the 10,000 joys

and 10,000 sorrows of human life. Resilience is bolstered by cognitive flexibility. http://www.curiositiesbydickens.com/perspective-is-everything-boat-land/ Mindfulness: Noticing our habits and reactions De-coupling the cue and response, event and reaction Choosing the next step DEFAULT NETWORK Mental Models Moral Distress Education

Project http:// moraldistressproject.med.uky. edu/ Reaction The number of people who admit they feel uncontrollable anger toward another driver has doubled since 2005 (Washington Post, 9/1/13). HANNAH ELIZABETH GILMER

With permission: Officer L.B. Mixon GA Governors Safety Pause Attentional stability Perspective-taking Care and Connection Compassion (self) WHATS IT GOT TO DO WITH WELLBEING AND

RESILIEN CE? MINDFULNESS PRACTICE AND WELL-BEING Awaken from constraints of limiting views, default network, mental map, edge states Respond rather than react to stressors Present for your life and with others Align your outer life to your inner life and live a life that is grounded in a deep sense of meaning and purpose Happiness (10%)

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. Viktor E. Frankl WHAT IS COMPASSION

? Compassion involves both the heartfelt wish that others be free from suffering and the readiness to act on their behalf. It arises from a deep sense of affection for others. --Brooke Dodson-Lavelle, Emory CBCT Instructor Compassion meditation may shift habits of becoming overly distressed when we encounter anothers pain, Helen Weng, assistant professor of psychiatry, Osher Center for Integrative Medicine. https://news.wisc.edu/training-compassion-muscle-may-boostbrains-resilience-to-others-suffering/

Survival of the social Ancient response to those with whom we identify, kinship circle --Frans de Wall, Age of Empathy SELFCOMPASSION Kristin Neff, Self-Compassion: A Healthier Way of Relating to Yourself (2011). See ourselves clearly And make changes

Because we care about ourselves And want to reach our full potential B.J. Miller, MD SELFCOMPASSION & RESILIENCE This is why people are relating to my story -- all of us suffer heartache. All of us suffer difficulties in our lives. And if you say to yourself 'find a way,' you'll make it through."

Perspective-taking Self-Awareness & problem- solving (respond vs react) E.I.: Manage difficult emotions and difficulties Resource and stay optimism & grit Social connection; team Diana Nyad THE G.R.A.C.E. MODEL

Gathering attention: focus, grounding, breathing, presence Recalling intention: connection to vision and values; the resource of motivation Attuning to self /other: affective resonance [check-in], self-compassion, awareness of our edges Considering: what is helpful for the person, both expertise and perspective taking Engaging, then Ending, closure for yourself and patient JOURNAL OF PALLIATIVE MEDICINE, Volume 16, Number 9, 2013, DOI: 10.1089/jpm.2013.0105 Rushton,C.H., Kaszniak, A. W., Halifax, J.S. GATHER ATTENTION Create the space between stimulus and response

Shift from autopilot or distraction to presence Breath Grounding Use senses How do you come back to presence? RECALL INTENTION: KINDNESS & COMPASSION The heartfelt wish that others be free of suffering Practice the intentional generation of well-wishes

Wishing a mentor, those dear to us, ourselves, those with whom we have difficulty, all persons safety, health, happiness, ease, freedom from suffering. ATTUNE TO SELF/OTHERS: MINDFUL CHECK-IN: BODY SCAN Sense into the body and notice whats present:

Breath is it slow, fast, deep, shallow? Warm or cold? Alert or sleepy? Hungry or thirsty or satisfied? Hands clenched or open?

Shoulders, neck tight or relaxed? Chest open or contracted? Facial muscles tight or soft? Notice other sensations in the body restlessness, heaviness, relaxation, numbness

Allow the attention to sweep the body, gathering a sense of the body as a whole The body breathing Ground by shifting awareness to contact of feet with floor, body with seat, wall CE: CONSIDER, ENGAGE, END

WHAT IS WELLBEING? WELLBEING IS A SKILL! Wear Red Day 2/1/2019 MINDFULNESS RESOURCES Brantley, J. (2007). Calming your anxious mind. 2nd ed. Oakland: New Harbinger Publications. Brantley, J. & Millstine, W. (2007). Five good minutes at work. Oakland: New Harbinger Publications. Davidson, R.J. & Goleman, D. (2017). Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body. Epstein, R. (2017). Attending: Medicine, Mindfulness, and Humanity. New York: Scribner. Farb, N.A., Segal, Z.V., Mayberg, H., Bean, J., McKeon, D., Fatima, Z, & Anderson, A.K. (2007). Attending to the present: mindfulness meditation reveals distinct neural modes of self-reference. Soc Cogn Affect Neurosci (2007) 2 (4): 313-322 first published online August 13, 2007 doi:10.1093/scan/nsm030

Halifax, J. (2018). Standing at the Edge: Finding Freedom Where Fear and Courage Meet. New York: Flatiron Books. Hayes, S. C. (2004). Acceptance and commitment therapy and the new behavior therapies: mindfulness, acceptance, and relationship. New York: Guilford Press. Kabat-Zinn, J. (2013). Full catastrophe living. Rev. and updated. New York: Bantam Books. KabatZinn, J. (2003). Mindfulnessbased interventions in context: past, present, and future. Clinical psychology: science and practice, 10(2), 144-156. Ludwig, D. S. and J. Kabat-Zinn (2008). Mindfulness in medicine. JAMA 300(11): 1350-1352. Neff, K. (2011). Self-Compassion: The proven power of being kind to yourself. Salzberg, S. (1995). Loving-kindness: the revolutionary art of happiness. Boston: Shambhala. Sheridan, C. (2016). The Mindful Nurse: Using the Power of Mindfulness and Compassion to Help you Thrive in Your Work. Rivertime Press. Siegel, D. J. (2007). Mindfulness training and neural integration: differentiation of distinct streams of awareness and the cultivation of well-being. Social Cognitive and Affective Neuroscience, 2(4), 259-263. Siegel, D. J. (2010). Mindsight: The new science of personal transformation. NY: Bantam Books. MINDFULNESS RESOURCES

Center for Mindfulness in Medicine, Health Care, and Society. Department of Medicine, UMASS Medical School. https://www.umassmed.edu/cfm/ Center for Mindfulness. UC San Diego School of Medicine. Department of Family Medicine and Public Health. https://health.ucsd.edu/specialties/mindfulness/Pages/defau lt.aspx Cognitively Based Compassion Training. Emory-Tibet Partnership and Science Initiative. https://tibet.emory.edu/cognitively-based-compassion-traini ng/

Center for Compassion and Altruism Research and Education. Stanford Medicine. http://ccare.stanford.edu/ http://elishagoldstein.com/videos/the-stop-practice/ https://www.tarabrach.com/meditation-the-rain-of-self-comp assion/

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