MindfulnessTherapy

Boo Yan Jiong+60126309759

byanjiong@yahoo.comHealth Psychology Student

Agenda• Introduction• Path of Mindfulness

– Healthy lifestyle– Mindfulness– Self-actualization/Wisdom cultivation/etc.

• Benefit of mindfulness• Current Research• Therapeutic Interventions

– MBSR, MBCT• Add-on info• Summary• Q&A

From ancient to recent

Introduction• Meditation is a worldwide practice, although it may different in the techniques

– Concentration meditation, chanting, contemplation, repetition of sounds/words, prayer, etc

5000 4000 3000 2000 1000 0 1000 2000BC AD

Old Testament: hāgâ (to meditate)

Buddhism (~500BC)

Hinduism: Historical Verdic Religion (1500~500BC)

Islam: Sufism, Dhikr (~600AD)

Jainism: Acaranga Sutra (~500BC)

Tao: LaoTzu (~500BC)

Christianity (~0AD)

Etc…

Every human being has the potential to performmeditation share the similar genetic structure

Introduction

• Example of meditation practices in different culturesA strong believer in Christian meditation, Saint Padre

Pio stated: "Through the study of books one seeks God; by meditation one finds him"

Dhikr singing, sufism, prayer

Jainism: Lord Mahaveer in meditative posture

Hinduism: A large statue in Bangalore depicting Lord

Shiva meditating

Judaism: Old Testament, there are two Hebrew words for meditation: hāgâ (Hebrew means to sigh or murmur, but also to meditate, and sîḥâ (Hebrew: which means to muse, or rehearse in one's ,(שיחה

mind.

Buddhism: Buddha in meditation pose

Path of Mindfulness

• Typical path of mindfulness– Shared by Hinduism, Buddhism, Jainism, Bahai, etc

Healthy Lifestyle MindfulnessSelf-actualization /

Wisdom Cultivation/Etc.

Healthy Lifestyle• Healthy lifestyle can enhance the quality of mindfulness training

– Unhealthy lifestyle (e.g. addiction, anger, neuroticm, etc.) almost make mindfulness impossible• Changes of lifestyle is needed!

• Criteria of healthy lifestyle:– Healthy diet– Physically healthy– Mentally healthy– Socially healthy– Spiritually healthy– etc

“Healthy” defined by the “norms” is just not enough, advance cultivation

of ‘more’ healthy lifestyle is essential…

Mindfulness

• Types of mindfulness• Types of suitable references• Stage of mindfulness• Example of mindfulness techniques

Types of meditation

• TypesTypes

Right mindfulness Inappropriate mindfulness

Related to healthy lifestyle Related to unhealthy lifestyle

Yield positive results Yield unhealthy results

E.g. [to be introduce in following slides] E.g. concentrating on PC games for long period, stay awake to watch TV drama for many hours, keep on focusing on breathing meditation even though feel tired, etc

Types of meditation• Result of right and inappropriate mindfulness• Practitioner should aware of the differences

– Stay on right track in order to progress well

Comparison Right Mindfulness Inappropriate Mindfulness

Result Serene, peaceful mind ‘Blockage’, ‘static’ mind

Physical revitalization, recovery Stiff neck, rigid shoulder, headache, exhausted

Sharp awareness, cognitive function improved

Awareness, understanding, and reasoning skill impaired

Mind aware of here and now, able to work efficiently

Distance feeling of the mind, yet feel sort of ‘mindfulness’

Patience, content, happy, Irritable, prone to anger, even though look ‘serene’ on the surface

Types of suitable references• To establish right mindfulness, we need to use appropriate

references– Can we establish right mindfulness by observing the monkeys in jungle?

Maybe yes, but it will be very very hard• Suitable subject as references

– Object• E.g. Breath, postures (sitting/walking/lying), material elements, sounds, light,

water, etc.

– Sensation/Feeling• E.g. pleasant or unpleasant (neutral) feeling, etc.

– Mind/Consciousness• E.g. stat of emotion, state of mind

– Idea/Mental contents• E.g. concepts, idea, etc.

Stages of mindfulness

• Progressive subtle changes of mind in mindfulness practice– Number of stages may different across culture, yet the trend is shared

by most culture 1. Stage of the joy and pleasure of abandoning coarse desires2. Stage of solely in the joy and pleasure produced by mindfulness3. Stage of sublime pleasure that transcends ordinary joy4. Stage of mental stability free from various sensations of pain and

pleasure5. Stage of boundless space and abides therein6. Stage of boundless consciousness and abides therein7. Stage of nothingness and abides therein8. Stage of neither-perception- nor- non- perception and

abides therein

Example of mindfulness techniques

• Different techniques may serve different purposes– E.g.

• Cultivate concentration: breathing meditation, mantra, etc• Cultivate virtues: loving kindness meditation, etc• Cultivate wisdom: analytic meditation, contemplation

• Different techniques may reach different state of mindfulness

• There is no any ‘best’ technique, every technique is good

Techniques of meditation are limited only by human imagination…

Breathing Meditation (Anapanasati)

• Brief descriptions:– To bring the attention to the breath, but not to control it– Give full attention to the inhale and exhale, non-judgmentally– Dwell in the present, moment by moment, breath by breath– When attention wanders, note it and then gently bring awareness back to the breath

• Why breathing ?– Truth, vital, always with you, present tense, carrier of mind

• Emotions, thoughts, and perversions

– Breathing can be either voluntary or involuntary• Even though you are panic, you can involuntary control your breath to become slow and

steady, which enable breathing meditation to be applied

– “Tune” the body breathing mind• Tune from the “Coarse” to the “fine”

Visualization & Chanting Meditation

• Brief description:– May use certain images, sounds to achieve

mindfulness state• Images: The Holy-One, The Noble-One, natural objects

(e.g. flow of water, plants, flower), etc• Sounds: natural sounds, mantra, poem, etc

– There are variety of the techniques, and each traditions have different viewpoints

Observing Bodily Sensation Meditation

• Brief description:– Observe the bodily sensation with:

• Calm and quiet mind• Awake and attentive mind

– Cultivate the equanimity, happiness in within oneself– To perceive the world with the ‘beginner’s mind’, non-striving, and

acceptance mind– E.g.

• if there is pleasurable sensation, then it is it• If there is pain sensation, then it is it

Yoga Meditation• Brief descriptions:

– A traditional physical and mental disciplines that originated in India• Reach the unity between the physical and mental

– Major branches of Yoga in Hindu philosophy:• Raja Yoga, Karma Yoga, Jnana Yoga, Bhakti Yoga, and Hatha Yoga

– Basically, yoga:• Stretching for flexibility• Improved Strength• Improved Balance• Improve breathing technique• Unite physical and the mental

Samadhi

Dhyana

Dharana

Pratyahara

Pranayama

Asana

Niyama

YamaRaja Yoga

Example:

Chakra Meditation• Brief description:

– A physical, mental and spiritual discipline for developing and tapping into inner energy and awareness

– An active approach to awaken the kundalini energy– Change the quality of awareness, experience, intellect and of the mind

• Note:– Different traditions have slightly different interpretations of the chakra

meditation• Further reading is needed• This slide is unable to provide any further information, except the name itself

Tummo Meditation• Brief descriptions:

– Origin from Tibet– A quite advance type of meditation (inner-fire meditation)– A practice associated with the subtle body of energy-channels, of energy-winds and

energy-drops– Primary purpose is to gain control over subtle body processes as a foundation for more

advanced practice• Scientific investigation

– subjects exhibited the capacity to increase the temperature of their fingers and toes by as much as 8.3°C

A Buddhist monk has his vital signs measured as he prepares to enter an advanced state of meditation in Normandy, France.

During meditation, the monk's body is said to produce enough heat to dry cold, wet sheets put over his shoulders in a frigid

room (Photo courtesy of Herbert Benson).

Daily Living Meditation• Brief descriptions:

– Daily activities as meditation– Observed the nature with equanimity, non-judgement, ‘beginner’ mind– Awareness from moment to moment, loving kindness, forgive, trust,

etc.

Living mindfully, you detach yourself from the past and future…Dwelling in the Now, you found the true happiness…

Living in the moment, you observe there is space between the past and the future, where freedom lay in between it…

Loving Kindness Meditation (Metta)

Send the love gradually to your family members, friends, ‘neutral’ person, ‘difficult’ person, other beings, and gradually to the entire universe…

• Brief description:– A technique to cultivate the loving kindness by wish happiness

to one-self, parents, friends, teachers, … gradually to the universe

– In daily life, keep on practicing:• Wish others to be happy• Contemplate on the course of happiness• Fulfil the act of compassion

– “What can I do to help them?”

If you have the love in within you, then there will be thousand of hands reaching you whenever your are in difficulty;If you have the love in within you, then you will have the ability to stretch out thousands of hand to help those who are in difficulties.

Analytic Meditation (Contemplation)

• Brief descriptions:– A practice of self-transformation through self-observation and

introspection– An intellectual practice that look deep into every single

phenomenon in life• Asking the ‘why’, ‘what’, ‘how’, etc.

– Very essential in cultivating wisdom• Only practice concentration meditation is not good enough (without

wisdom, one may attach to the bliss sensation of mindfulness)– Similar to CBT in psychology, except analytic meditation required

sharp awareness cultivated from concentration mindfulness• i.e. ‘Switch’ from concentration meditation to analytic meditation in

order to contemplate

Other mindfulness techniques

• There are plenty of techniques, such as:– prayers, dream yoga, Zen yoga, Taoism meditation,

mindfulness-based programs, secular meditation, music meditation, etc.

– Last but not least:• ‘your technique’ (your creation of mindfulness

technique)

Self-actualization/Wisdom Cultivation/Etc.

• Different traditions have different interpretations of the destinations of mindfulness practices– To be a better human being– To unite with The-One– To get closer to The-One– To purify and achieve equanimity between sensibility

and rationality– To inter-be with the universe/self/etc.– Grand virtue cultivation, e.g. universal compassion

E.g. Grand virtue Cultivation• If you sincerely help every people you met in your life…• You contributed your time and life to the society…• Ranging from the poor to the rich, you had helped everyone…• What if… some of them did not acknowledge it, and punished you badly…• And it may cost your life… • What is your feeling, perception, sensation?

– Anger? Distress? Hatred?Someone in the history showed different responses…

"Father, forgive them, for they know not what they do."[Lk. 23:34] “Truly, I say to you, today you will be with me in Paradise."[Lk. 23:43]

Implication:Universal loving kindness, forgiveness is not impossible!You can cultivate it too!

Benefit of Meditation• Physiological– Decreased heart-rate during meditation– Lower blood-pressure– Quicker recovery from stress, and as a prevention of

depression relapse technique– Increase in alpha rhythms (relaxation)– Increase in synchronization (hemispheres)– Reduced cholesterol levels– Reduction in the intensity of pain– Profound relaxation – Healing– Etc.

Benefit of Meditation

• Psychological– Greater happiness and peace of mind– Less emotional reactivity– Increased empathy, loving kindness– Enhanced creativity– Enhanced reasoning skills– Heightened perceptual clarity– Reduction in acute and chronic anxiety– Enhanced self-actualization– Etc.

Current Research

Current Research• Research findings:

– With 7 weeks of meditation, cancer patients decreased their degree of depression, anxiety, anger, confusion, and chest and stomach symptoms by 50% - and felt more vigor

– With 10 weeks of meditation, 2/3’s of chronic pain patients had a 30% reduction in pain, and half had more than a 50% reduction

– With 10 weeks of meditation, chronic pain patients had less pain, less mood disturbances, used less pain medication, and could be more active. The benefits were still present one year later

– Three years after an 8-week meditation instruction, patients with anxiety and panic disorders still showed a benefit

– All patients with fibromyalgia who meditated for 10 weeks improved, and over half showed moderate to marked improvement in pain, fatigue and quality of sleep

– Meditation has been found to be quite useful in most of the psychosomatic disorders including asthma, rheumatism, gut problems, blood pressure, diabetes etc.

– With 6 weeks of meditation irritable bowel syndrome patients had less flatulance, belching, bloating and diarrhea

Current Research• Research findings: (cont.)

– Even though daily fluctuations in cortisol are unchanged, people who meditate don’t have the daily fluctuations in the cortisol-stimulating hormone (ACTH), or beta-endorphins, suggesting a change in feedback sensitivity

– People trained in and performing an imagery-based relaxation prior to injection, had less inflammatory reaction to chili pepper “extract” (capsaicin) injected under the skin

– With 6 months of meditation, athletes had less increase in the CD8+ suppressor T cell response to strenuous physical stress, improving the immune system’s helper to suppressor cell ratio. It also reduces post-traumatic stress

– Patients who meditated during ultraviolet light treatment for psoriasis had quicker clearing of their skin disease

– With 6 months of meditating for 20 minutes twice a day, hypertensive African Americans had a decrease in the carotid artery wall thickness

– With 4 years of daily meditation, coronary artery narrowing showed regression rather than progression

– Etc.

Current Research

• An example…– SPECT Images during baseline and meditation

Baseline Meditation

Prefrontal Cortex

Superior Parietal Lobe

Therapeutic Interventions• Mindfulness-Based Stress Reduction (MBSR)• Mindfulness-Based Cognitive Therapy (MBCT)• Areas cover in MBSR & MBCT

– Mindfulness of the body (body scan, stretching, walking)– Mindfulness of sensory experience (sound, vision)– Mindfulness of routine activities– Mindfulness of breathing– Mindfulness of thoughts and feelings– Mindfulness of difficulties (emotional, physical)– Etc.

• Participants often report:– Lasting decreases in physical and psychological symptoms (depression, anxiety, eating disorder,

chronic pain, etc)– An increased ability to relax – Reductions in pain levels and an enhanced ability to cope with pain that may not go away – Greater energy and enthusiasm for life – Improved self-esteem – An ability to cope more effectively with both short and long-term stressful situations– Etc.

Since MBSR and MBCT is quite similar, this presentation will focus on MBCT as example

MBCT

• Mindfulness-Based Cognitive Therapy for Depression: a New Approach for Preventing Relapse. Segal, Williams & Teasdale (2002), Gilford Press, New York. (MBCT)– Adaptation of Kabat-Zinn’s Mindfulness-Based

Stress Reduction Program– 8-Week, structured program with CDs, homework

and handouts specific to depression, group interaction/support

– Book is a Comprehensive Therapist’s Manual for providing this form of treatment

MBCT Weekly Themes

• Week #1: “Automatic Pilot”– Mindfulness starts when we recognize the tendency to

be on automatic pilot and make a commitment to learning how best to step out of it to become aware of each moment. Practice in purposely moving attention around the body shows both how simple and difficult this can be

• Week #2:“Dealing with Barriers”– Further focus on the body begins to show more clearly

the chatter of the mind, and how it tends to control our reactions to everyday events

MBCT Weekly Themes

• Week #3:“Mindfulness of the Breath”– With a greater awareness of how the mind can often be

busy and scattered, learning to take awareness intentionally to the breath offers the possibility of being more focused and gathered

• Week #4:“Staying Present”– The mind is most scattered when it tries to cling to some

things and avoid/escape other things. Mindfulness offers a way of staying present by giving another place from which to view things: to help take a wider perspective and related differently to experience

MBCT Weekly Themes

• Week #5:“Allowing/Letting Be”– Relating differently involves bringing to experience a

sense of “allowing” it to be, just as it is, without judging it or trying to make it different. Such an attitude of acceptance is a major part of taking care of one-self and seeing more clearly what, if anything, needs to change

• Week #6:“Thoughts Are Not Facts”– Negative moods, and the thoughts that accompany

them, restrict our ability to relate differently to experience. It is liberating to realize that our thoughts are merely thoughts, even the ones that say there are not

MBCT Weekly Themes

• Week #7:“How Can I Best Take Care of Myself?”– There are some specific things that can be done when

depression threatens. Taking a breathing space will come first, and then deciding what action, if any, to take. Each person has his or her own unique warning signs of relapse, but participants can help each other in making plans for how best to respond to the signs

• Week #8:“Using What Has Been Learned to Deal with Future Moods”– Maintaining a balance in life is helped by regular mindfulness

practice. Good intentions can be strengthened by linking such intentions to a positive reason for taking care of oneself

Add-on info

• Decomposition after Clinically Death– Some advance practitioner’s bodies may stay fresh

for days, even weeks after declared clinically death– Some advance practitioner’s heart may stay warm

to the touch even though after 24 hours declared clinically death

Hard to imagine?

Add-on info

• Beyond 5 senses?– Some ancient literatures talk about some beyond

5 senses abilities which can able to be cultivated from meditation, myth or real?

• Physical healing from mindfulness practice– Some research is on-going…– To what extend?– Physical and mental inter-related?

Add-on info• Reduction in the intensity of pain, how?• Background:

– [1963] Thích Quản Đức was a Tibetan Buddhist monk who burned himself to death in the streets of Saigon as a protest against the persecution of Buddhists by South Vietnam’s Ngô Đình Diệm administration. It later proved to be the turning point of the collapse of the Diệm regime. • We are not going to discuss history matter, but focus on the reduction in the intensity of pain

• How is it that a man can immolate himself and yet keep such composure, “static”?– American Journalist David Halberstam recalls

• “As he burned he never moved a muscle, never uttered a sound, his outward composure in sharp contrast to the wailing people around him.”

Summary

• Mindfulness need to be started from a healthy lifestyle, and it is a life long process

• Practicing different types of meditation to cultivate different fields of strength– Compassion, concentration, reasoning, forgiving, trust,

confidence, etc.• Practice single type of mindfulness is not sufficient in this fast

pacing world

• Scientific research in mindfulness is still at the beginning state– More researches are needed“If you want to use mindfulness training with your patients, first, do it yourself.”

-Jon Kabat Zinn

Lastly…

1. Meditation is something beyond words…– Understand meditation through practices, not words

2. Seek help from meditation instructor will always help [ideally]3. Apologize for being unable to deliver the meditation topic completely

– The knowledge of meditation is just like the ocean, while my knowledge about it is too little

Relax Mind

Non-judging Mind

Patience Mind

“Beginner” Mind

Attentive Mind

Equanimous Mind

Non-striving MindAcceptance Mind

“Letting Go” Mind

“Being mode” Mind

Compassion MindPresent Mind

Q&A