using mindfullness as “theraputic soup” to create ...asapnj.camp9.org/resources/documents/a puig...

USING MINDFULLNESS AS “THERAPUTIC SOUP” TO CREATE & SUPPORT CHANGE

ANGE PUIG Ph.D www.angepuig.com

856 482 7744 Fall 2015

ASAP

1 mindfulness as Therapuetic Soup

http://www.angepuig.com/

Welcome

Who are you

Learning Objectives

Mindfulness

Ericksonian Tools


Learning Objectives

• Definitions of Mindfulness Mechanisms & Scope

• Mindfulness & Therapeutic Change

• Learn how Mindfulness can increase Clinician Counseling Skills & Client Coping Skills


Tara Brach

“Mindfulness is a way of paying attention moment-to-moment to what's happening within and around us without judgment. So, said differently, when we attend to the moment-to-moment flow of experience, and recognize what's happening…fully allowing it, not adding judgment or commentary, then we are cultivating a mindful awareness.”

Mindfulnet.org Jon Kabot Zinn

• The ABC of mindfulness A is for awareness - Becoming more aware of what you are thinking and doing - whats going on in your mind and body. B is for "just Being" with your experience. Avoiding the tendency to respond on auto-pilot and feed problems by creating your own story.

• C is for seeing things and responding more wisely. By creating a gap between the experience and our reaction to, we can make wiser choices.


Mindful Ways & Mindful Practice

Being Mindful is different from Meditation Mindful(Focused Pausing) Meditation (Systemic Engagement)

SOUP AS A METAPHOR

• The most celebrated cooks and epicures have long been advocates of the claims of soup to be recognized, as Careme says, as the provocative agent of the good dinner, while Grimod de la Reyniere goes still further. “Soup,” he says, “is what a portico is to an edifice.


Thoughts About Soup

Nourishment Filling Communal Recipe Sharing Creating


Mindfulness as the Soup for Effective Change

You can have the best ingredients but that alone does not equal good soup

Broth or Stock

We all make the same soup differently

Its best shared with others

Changes over Time

How mindful are we ?

1 2 3 4

Rarely/Not at all Sometimes Often Almost Always

CAMS-R People have a variety of ways of relating to their thoughts and feelings. For each of the

items below, rate how much each of these ways applies to you

1. It is easy for me to concentrate on what I am doing. 2. I am preoccupied by the future. 3. I can tolerate emotional pain. 4. I can accept things I cannot change. 5. I can usually describe how I feel at the moment in considerable

detail. 6. I am easily distracted. 7. I am preoccupied by the past. 8. It’s easy for me to keep track of my thoughts and feelings. 9. I try to notice my thoughts without judging them. 10. I am able to accept the thoughts and feelings I have. 11. I am able to focus on the present moment. 12. I am able to pay close attention to one thing for a long period

of time.

Reviewing the CAMS: A 3-leg stool to becoming a Mindful Therapist

• Personal Practice

• Mindfulness Informed Therapy

• Mindfulness based Psychotherapy

• Reflections –CAMS

• Facilitate vs. derail the Therapy Process

• Helps the client move towards Change

Mechanisms of Mindfulness

• Intention :setting the stage for the possible letting of the objective

• Attention : “ Here & Now” suspension of Interpretation non-judge-ment

• Attitude : Quality Open hearted-ness Kindness

• Reperceiving : stepping out side the immediate experience opening up the box to spacious awareness

• Introspection (Pat Ogden)

(Shapiro etal 2006)

Breath as Broth

Breathe

“Breathing in, I calm body and mind. Breathing out, I smile. Dwelling in the present moment I know this is the only moment.” ― Thích Nhất Hạnh, Being Peace

Focus

Anchor

Energy

Release


http://www.goodreads.com/author/show/9074.Th_ch_Nh_t_H_nh





http://www.goodreads.com/work/quotes/321908

Power & Gift of the Breath

Barometer of one ‘s internal state

Slow mindful breathe restores healthy healing patterns

Sustained breathing engages & calms the parasympathetic system

Talking to the breathe “thich that than “ I breathe in , I breathe out

mindfulness as Therapuetic Soup 16

Breathe

“ When the breath wanders the is unsteady, but when breath is still the mind is still “


MEDICINE HAS IMAGING TECHNIQUES

MH PRACTIONERS

Practice ( 5 minutes )

"paying attention on purpose, in the present moment, and nonjudgmentally, to the unfolding of experience moment to moment”

Jon Kabot Zinn

• Sit & Hands-Comfortable

• Down-toward Direct Eyes 30%

• Pay attention to our Breathe

• Notice without creating a Story

• Approach with loving kindness & Acceptance

Breathing

• Notice Holding

• Notice Constriction

• Notice Choppy


Thoughts

The Dynamics of Change

• What makes Changing so hard ?

• Requires letting Go

• What does real Change look like ?

• Does change ever continue “ live on”” its own ?

• Impermanence


Change & Psychotherapy

• Most people who come to treatment are Stuck

• Goal is to move from point A to point B

• Life is in process of letting go--- with out letting you cannot engage the next moments of journey of life

• Process change involves letting go to grab the next experience

• Letting go requires awareness & new learning

• Mindfulness cultivates awareness

Requires Letting Go


Therapeutic Change

• Effective clinical Intervention & Change is more techniques (10 %)

• Relationship accounts for 45 % & 25% chance

• Mindfulness can facilitate clinician attunement


Effects of Resistance to Change

Body Mind Emotions

Erickson & Change Assumptions about people: Walter &

Peller

People prefer to choose for themselves what they initiate and they want to

control as much as possible what they do Find change and cultivate when & where you can

Change occurs in the context of a safe relationship

Erickson : Never ask people to do things they don't want to do

What Change look Like ?

• Think about you change some behavior ?

• How you know ?

• What did you notice was Different ?

• Look like ?

• Sound like ?


What makes Changing so hard ?

• Human Nature

• Getting Go requires “Risk” & “Vulnerability”

• Accepting Uncertainty

There are no secrets to success. It is the result of preparation, hard work, and learning from failure. Colin Powell


http://www.brainyquote.com/quotes/authors/c/colin_powell.html

Breathe

“Breathing in, I calm body and mind. Breathing out, I smile. Dwelling in the present moment I know this is the only moment.” ― Thích Nhất Hạnh, Being Peace

Focus

Anchor

Energy

Release








Relationship Between Change & Slow

• Slowing Down makes it easier notice Changes

• Slow & Deliberate Breathes reduce Parasympathetic Reactivity

• Restfulness States positively influence Vagus Nerves Functions

“If you want to go fast slow down “ Ron Kurtz

Slow & Remembering

• Noticing Change in order to :

Incorporate

Enhance

Cement the wiring

Apply to crisis situations

• Stop

• Breathe

• Notice

• Accept & Allow

Practice Slowing Down

• Posture

• Eyes

• Focused attention breathe

• Keep steady

• Linger Notice Remember

Reactivity & Client Issues

• Clients are often in trouble because they act with out thinking

• Many act on “auto pilot”

• Poor Decisions are often with processing

• Avoid of emotional distress can lead rushing into situations

Reactivity

• The majority of neurons which fire are dedicated to action

• A sympathepatic which faulty braking is what brings most of our client into see us

• According to Babbitt Rothschild our first responsibility is to help our clients find the brakes

“Virtue simply involves regulating your actions, words, and thoughts to create benefits rather than harms for yourself and others.” ― Rick Hanson, Buddha's Brain: The Practical Neuroscience of Happiness, Love, and Wisdom

https://www.goodreads.com/author/show/417985.Rick_Hanson

https://www.goodreads.com/work/quotes/7001984

TRANSITION

CLINICIAN TRAPS & TOOLS

Mindfulness as a clinician’s Resource: Overlapping Applications

• Creating a Safe Environment

• Clinician as Calm & Aware

• Clear the treatment space of Judgement

• Tools to teach our Clients

• Reduction of “wear & Tear “ of our work

• Fostering of responsiveness vs. re-activeness

• Creativity vs. Narrowing of Thought


Change & Helping

• “Helpers want to help, to set things right, to get people on the road to health and wellness. Seeing people head down a wrong path stimulates a natural desire to get out in front of them and say, “Stop! Go back! Don’t you see? There is a better way over there!,” and it is done with the best of intentions, with one’s heart in the right place. We call this the “righting reflex”—the desire to fix what seems wrong with people and to set them promptly on a better course, relying in particular on directing. What could possibly be wrong with that?” ― William R. Miller, Motivational Interviewing: Helping People Change


http://www.goodreads.com/author/show/128663.William_R_Miller



What is the Clients Job ?

Shift the Foci to the Inside vs. Outside

Reduce Psycho-physiological Reactivity

Discover their Internal Resources

Practice Loving-Kindness

Seek a Mindful Life approach

Put aside the Quest for the “magic wand”

Therapists must remember the client did not read the Therapy Manual


A Model for Mindfulness intervention

Window Opportunity

Awareness

Acceptance Suppression

Loop Trap

Intention

Remembering

“ When the breath wanders the mind is unsteady, but when the breath is still so is the mind “ Saraswati 2000

Introduction of a client to “Mindfulness”

• Check Knowledge

• Check Experience

• Use Metaphors

• Use the Hourglass Technique

• Create

Safety

Comfort

Attentuate


WORKING WITH CLIENTS & SHARING RESOURCES

Hourglass technique

The Breath

Personal Story

My client (name)

Linkage to life skill (Golf)


Listening

“ I remind myself every morning: Nothing I say this day will teach me anything. So if I'm going to learn, I must do it by listening. “

Larry King www.brainyquote.com


http://www.brainyquote.com/quotes/authors/l/larry_king.html

Listening

• All Senses

• Managing Noise

• Staying Present

• Empathy

• Compassion


Listening Exercise

• Comfort

• Settle into Place

• Notice & Follow the Breath

• Notice Sounds

• Notice & allow to Fade

• Reflections


Power & Gift of the Breath

Barometer of one ‘s internal state

Slow mindful breathe restores healthy healing patterns

Sustained breathing engages & calms the parasympathetic system

Talking to the breathe “thich that than “ I breathe in , I breathe out


Breathe

“ When the breath wanders the is unsteady, but when breath is still the mind is still “


Body Scan

• Reconnection

• Focus

• Acceptance

• Release

• Calming

• Comfort

• Settle into Place

• Follow the Breath

• Notice Your xxxxxx

• Moment go any area requiring more notice

• Reflections


TRANSITION

More Tools

TARA BRACK R.A.I.N.

About twelve years ago, a number of Buddhist teachers began to share a new mindfulness tool that offers in-the-trenches support for working with intense and difficult emotions. Called RAIN (an acronym for the four steps of the process), it can be accessed in almost any place or situation. It directs our attention in a clear, systematic way that cuts through confusion and stress. The steps give us somewhere to turn in a painful moment, and as we call on them more regularly, they strengthen our capacity to come home to our deepest truth. Like the clear sky and clean air after a cooling rain, this mindfulness practice brings a new openness and calm to our daily lives.

Working With Difficulties: The Blessings of RAIN Adapted from Tara’s book: True Refuge: Finding Peace & Freedom in Your Own Awakened

Heart (Bantam, 2013)

• R-RECOGNIZE WHAT IS HAPPENING • A-ALLOW LIFE TO BE AS IT IS • I-INVESTIGATE INNER EXPERIENCE

WITH KINDNESS • N-NON-IDENTIFICATION ( Remove the personal story)

http://www.tarabrach.com/books-cds/

http://www.tarabrach.com/books-cds/

“Mindfulness is simply being aware of what is happening right now without wishing it were different; enjoying the pleasant without holding on when it changes (which it will); being with the unpleasant without fearing it will always be this way (which it won’t).” – James Baraz

MINDFULNESS


Acceptance

“Acceptance is, in many ways, a synonym for mindfulness. When we are mindful, when we give our full attention to whatever is happening now, and can do so without the usual storytelling, pushing, pulling, and judgment then we are here – in acceptance” Dr Arnie Kovak


Listening to Meditation Together

Suffering • People come to see us to

get rid of pain

• All pain is complex & multi-factored

• The Challenge is see the path to relief involves embracing their Pain

“ Pain X Resistance = Suffering”

Tara Brach


Gratitude & the Heart

We found that more gratitude in these patients was associated with better mood, better sleep, less fatigue and lower levels of inflammatory biomarkers related to cardiac health,” said lead author Paul J. Mills, PhD, professor of family medicine and public health at the University of California, San Diego. The study was published in the journal Spirituality in Clinical Practice®.

http://www.apa.org/pubs/journals/scp/index.aspx

http://www.apa.org/pubs/journals/scp/index.aspx

Practice of Acceptance & Impermanence

Sit

Sounds

Breathe

Room

Outside

Sounds

Come

Go

Clinic & Consultation

• Client

• Age

• Setting

• Dynamics

• Issues

• Challenges


Closing Reflections & Thoughts

What's

One

Things

Take

For

Your

Journey

Resources

Brach, Tara. Meditation and Psychotherapy: A Professional Training Course for Integrating Mindfulness into Clinical Practice.

Branch, Tara, PhD. Mindfulness Meditation: Nine Guided Practices to Awaken Presence and Open Your Heart.

Carlson, E. Linda, & Shapiro, L. Shauna. The Art and Science of MINDFULNESS: Integrating Mindfulness into Psychology and the Helping Professions. APA.

Epstein, M.D., Mark. Thoughts Without A Thinker: Psychotherapy From A Buddhist Perspective Hanson, Rick, Ph.D. & Mendius, Richard, MD. The Practical Neuroscience of Buddha’s Brain

Happiness, Love & Wisdom. Insight Timer- Meditation Timer by Spotlight Six Software, LLC- Phone Application Kornfield, Jack. The Wise Heart: A Guide to the Universal Teachings of Buddhist Psychology. Nhat, Hanh, Thich. The Miricle of Mindfulness: An Introduction to the Practice of Meditation. Smalley L. Susan, Ph.D. & Winston, Diana. Fully PRESENT: The Science, Art and Practice of

Mindfulness. UCLA Mindful Awareness Research Center: Free Guided Meditations http://marc.ucla.edu/

http://marc.ucla.edu/

using mindfullness as “theraputic soup” to create ...asapnj.camp9.org/resources/documents/a puig...

Documents