Mindfulness, Wisdom, Sati in Pali & Compassion in Connotes - PDF document

What is Mindfulness? Mindfulness, Wisdom, • Sati in Pali & Compassion in � Connotes awareness , attention , & remembering Psychotherapy • In therapeutic arena, also includes � Non-judgment � Acceptance Ronald Siegel, Psy.D. • Adds kindness & friendliness Therapeutic Mindfulness Mind less ness 1. Awareness • Operating on “autopilot” • Being lost in fantasies of the past and future 2. Of present experience • Breaking or spilling things because we’re not paying attention 3. With acceptance • Rushing through activities without attending to them Life Is Difficult, for Everybody Mindfulness Can Help Us • Everything changes • To see and accept things as they are � Loss is inevitable • To loosen our preoccupation with “self” • We’re hard wired to try to enhance our • To experience the richness of the self esteem moment � But we win some and lose some • To become free to act skillfully � And we get sick and die 1

Breath Awareness Mindfulness Practice is Not: • Having a “blank” mind • Becoming emotionless • Withdrawing from life • Seeking bliss • Escaping pain The Roles of Mindfulness • Practicing Therapist Implicit � Relates mindfully to patients regardless of therapeutic How it Works intervention • Mindfulness Informed Psychotherapy � Insights from mindfulness practice inform treatment • Mindfulness Based Psychotherapy � Teaches mindfulness practice to Explicit patients Overwhelmed? Capacity to Intensity of Fly bear experience experience 2

The Thinking Disease • Analyze past pleasure and pain • Maximize future pleasure and avoid future pain Decisions, Decisions 1. Which skills to emphasize? Fitting the Practice to the 2. Formal or informal practice? Person 3. Which objects of attention? 4. Religious or secular practices? 5. Narrative or experiencing mode? 6. Relative or absolute truth? 7. Turning toward safety or sharp points? Core Practice Skills Concentration vs. Mindfulness • Concentration 1. Concentration (focused attention) � Choose an object and follow it closely 2. Mindfulness per se (open monitoring) • Mindfulness � Attend to whatever 3. Acceptance and Compassion object rises to forefront of consciousness 3

Acceptance Loving-kindness Practice • “Metta” practices � May I be happy, peaceful, free from suffering � May my loved ones be happy. . . � May all beings be happy. . . Continuum of Practice Telephone Meditation Informal Mindfulness Practice Formal Meditation Practice Intensive Retreat Practice Shower Meditation Taillight Meditation 4

Formal Practice Intensive Retreat Practice (Results May Vary) • Data supports effects of formal meditation • Structural and functional brain changes. Resources at: meditationandpsychotherapy.org Objects of Attention Religious or Secular? Coarse • “Spiritual” practices • Feet touching ground � Devotional and theistic • Sights and sounds of nature • Taste of food • Secular practices • Sound of bell � Science grounded • Breath in belly • Mantra • Seek cultural consonance • Air at tip of nose Subtle Narrative Mode Experiencing Mode • Psychodynamic • How is it felt in the body? � Earlier, transference, other relationships • How does the mind respond? • Behavioral � Grasping � How learned, how reinforced � Pushing away � Ignoring • Systemic � Maintained by family, community, culture 5

Relative Truth Absolute Truth • Human story � Success & Failure • Anicca � Pleasure & Pain (impermanence) � Longing • Dukkha � Hurt (unsatisfactoriness) � Anger • Anatta (no enduring, � Envy separate self) � Joy � Pride Processing Trauma 1. Open to painful emotions Timing is Everything 2. Explore the facts of trauma 3. See it through lens of dependent origination 4. Develop compassion Turning toward Safety I Turning toward Safety II • Inner focus • Outer or distal focus � Mountain Meditation � Walking Meditation � Guided Imagery � Listening Meditation � Metta Practice � Nature Meditation � DBT techniques � Eating Meditation � Open eye practices 6

Turning Toward the Sharp Different Strokes Points • Need for frequent adjustment of • Moving toward anything exercises unwanted or avoided • How is it experienced in • Elicit feedback about the experience the body? � Both during and after practice � Pain, fear, sadness, anger � Unwanted images or memories • Titrate between Safety and Sharp � Urges toward Points compulsive behaviors When Mindfulness of Inner Alternate Techniques when Experience Can Be Harmful Overwhelmed • When overwhelmed • Eyes open, external by traumatic sensory focus memories � Ground, trees, sky, • When terrified of wind, sounds disintegration, loss • Yoga practices to of sense of self stretch and relax • When suffering from muscles psychosis Decisions, Decisions 1. Which skills to emphasize? Wisdom in Psychotherapy 2. Formal or informal practice? 3. Which objects of attention? 4. Religious or secular practices? 5. Narrative or experiencing mode? 6. Relative or absolute truth? 7. Turning toward safety or sharp points? 7

“Hard core pornography is hard to define” “If we are doomed to die [but] —let us spend.” “I know it when I see it.” -- Mesopotamia (3000 BCE) -- Justice Potter Stewart (1964) “Be not puffed up with thy “The narrow intelligence flashing knowledge, and be not proud from the keen eye of a clever because thou are wise.” rogue” is not wisdom. -- Socrates (400 BCE) -- Egypt (2000 BCE) Paul Baltes – Berlin Group 1. Factual knowledge 2. Procedural knowledge 3. Life-span contextualism 4. Value relativism 5. Awareness and management of uncertainty A 15 year old girl wants to get married right away. What should she do? 8

Meeks & Jeste Monika Ardelt 1. Prosocial behavior/attitudes “A fool can learn to say all the things 2. Social decision-making/pragmatic life a wise man says, and to say them knowledge on the same occasions, but this 3. Emotional homeostasis isn’t real wisdom.” 4. Reflection/Self-understanding --John Kekes 5. Value relativism/tolerance 6. Acknowledgement of/dealing effectively with uncertainty/ambiguity. Not Knowing Beginner’s Mind Wisdom In Psychotherapy Buddhist Psychology Susan Bluck and Judith Gluck 1. Intelligence 2. Insight 3. Reflective attitude • Compilation of insights derived largely from mindfulness practice 4. Concern for others • Not a religion in Western sense, but the 5. Problem-solving abilities results of a 2500 year old tradition of introspection 9

Three Marks of Existence Mindfulness • Anicca (impermanence) • Dukkha (unsatisfactoriness) • Anatta (no enduring, separate self) How Mindfulness Fosters How Mindfulness Fosters Wisdom I Wisdom II • Stepping Out Of the Thought Stream • Transpersonal Insight • Being With Discomfort • Seeing How the Mind Creates Suffering • Disengaging From Automatic • Embracing Opposites Responses • Developing Compassion Factor Analysis Of R-A-I-N Mindfulness Scales 1. Nonreactivity to inner experience • Recognize what is happening. 2. Observing/noticing/attending to • Allow life to be just as it is. sensation/perceptions/feeling • Investigate inner experience with 3. Acting with awareness/automatic kindness. pilot/concentration/non-distraction • Nonidentification; rest in Natural 4. Describing/labeling with words awareness. 5. Nonjudging of experience --Tara Brach Baer, R., Smith, G., Hopkins, J., Krietemeyer, J., & Toney, L. (2007). Using self-report assessment Methods to explore facets of mindfulness. Assessment, 13 (1), 27-45. 10

Stages of Acceptance • Aversion : resistance, avoidance, rumination Anatta • Curiosity : turning toward discomfort with interest • Tolerance : safely enduring • Allowing : non-resisting • Friendship : embracing, finding hidden value --Chris Germer Narcissism in Western The Western View of the Self Psychology • Emphasis on separateness vs. • DSM connection to family, tribe, nature, etc. � Character disorder • Healthy (Western) development: • Behavior therapy � Individuated � Self efficacy � Aware of Boundaries • Psychodynamic psychotherapy � Knowing one’s needs � Healthy narcissism or self esteem � Clear identity and sense of self Narcissism in Buddhist Buddhist Therapeutic Psychology Progress Not about me Not about me • We suffer when we don’t know who we really are ”mine” about me • Attempt to buttress self is central cause of suffering ”mine” about me about • Our concept of “self” is based on a me fundamental misunderstanding -- Adapted from Engler & Fulton 11

Where do I Begin and End? What about Boundaries? Boundaries Where is the Organism? Us and Them Constructing Experience • Identity is a Servant Meat construction project Servant • Mind is a world- Enemy building organ Enemy � Makes order out of Servant chaos Servant � Constructs reality Meat from data streaming Meat in at break-neck Enemy speed Servant Meat Enemy Servant 12