Mindfulness

Aims of this session Introduction to mindfulness

How it helps depression and anxiety

Relaxation exercise

Research

Questions

Interactive

History of mindfulness

Practised in both Eastern and Western religions and philosophies.

Modern society also aware of it through Yoga, Tai Chi, Qi Gong, Meditation and Sport training.

What is mindfulness?

Full mind on what is happening now

Awareness

Noticing whats happening without commenting

Attentiveness to this moment

Simply being present

Qualities of Mindfulness Spaciousness

Feeling at ease

Benefits of mindfulness

Stepping back to allow a objective view of the internal or external experience.

Spontaneously produce insight into ones behaviour, allowing lasting change.

Depression and Anxiety

Internal and external stimuli trigger a response.

The physical, mental and emotional aspects feed off each other, eg thought of vulnerability – fear – hyperventilation

Hopelessness – sadness – tiredness

Habitual Patterns

Habitual patterns

Conditioning of present response by past events

A bad experience as a child produces a unconscious, and disproportionate fear response as an adult , eg fear of dogs

Depression follows an often well travelled, previously conditioned train of thought, spiralling down to despair. Disproportionate to the present stimulus.

Relaxation exercise

Stop thinking for a while Thinking is necessary for anxiety and

depression to persist.

Withdrawing thought starves the negative pattern of “fuel”, resulting in cessation.

Perseverance and practise are needed for success.

How to relax Put attention into the body and sustain attention there. E.g. the breath.

Double benefit of abdominal breath awareness for anxious people.

Frequent, short periods, at least to begin with.

To fit in with the persons lifestyle

Teaching awareness exercises Quick and easy, fits into a ten minute consultation.

Adjunct to other treatment.

Build a new resource for the future.

Try it now.

Information sheet.

Doing it

Sit comfortably. Hand over solar plexus. Close eyes. Notice the hand, notice the rising and falling. Follow the downward motion of the out breath

down towards the feet. Notice sounds, light, the body . If one starts thinking return attention to the hand. Open your eyes when ready.

Make it a new habit Lying in bed, sitting with a cup of tea etc.

Not when ones attention is needed elsewhere eg driving.

2-3 minutes, stop when one’s enjoying it.

Do it several times a day ideally.

Re-focusing ones mental energy, mindfulness will eventually enter activities without trying.

What is going on in the world of mindfulness? Jon Kabat-Zinn UMMS Full Catastrophe

Living (1990) http://www.umassmed.edu/cfm/

Bangor university. http://www.bangor.ac.uk/mindfulness/

Oxford university, Prof Mark Williams

http://cebmh.warne.ox.ac.uk/csr/mbct.html

What is going on in the world of mindfulness? Mindfulness based stress reduction

(MBSR)

mindfulness based cognitive therapy (MBCT) http://mbct.co.uk/

Endorsed by NICE.

Research (i)

Randomised clinical trial [Kabat-Zinn, Wheeler, et al 1998] Psychosomatic Medicine, 60, 625-32

Patients with moderate to severe psoriasis undergoing phototherapy(UVB) or photochemotherapy (PUVA)

Listened to guided meditation tapes while receiving the ultraviolet light treatments

Healed at approximately four times the rate of subjects receiving just the light treatments

Research (ii)

Kabat-Zinn, J., Massion, A.O., Kristeller, J., et al. (1992)

Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders

American Journal of Psychiatry, 149, 936-943

Research(iii)

Mindfulness-Based Cognitive Therapy (MBCT)

8-week MBSR course with added elements of Cognitive Behaviour Therapy

Professor Mark Williams, Dr John Teasdale, and Professor Zindel Segal

to address the problem of relapse and recurrence in clinical depression.

(iii-continued) randomisation to continue with treatment as usual

or, in addition, to receive MBCT (Teasdale et al., 2000).

RCT, 145 recovered (but recently and recurrently depressed) patients in the community

the following year, for those with 3 or more previous episodes of depression, MBCT treatment significantly reduced relapse from 66% (control group) to 37% (treatment group). These results have recently been replicated in another, as yet unpublished, RCT (Ma and Teasdale, 2002).

The Future locally.

? Set up a mindfulness training programme.

? Set up a mindfulness group for health professionals and/or patients.