MiT - Mindfulness Informed Therapy - Mindfulness and Self-Care

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Mindfulness and Self-Care workshop slides, delivered in Belfast on July 19th, 2013.

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  • Aware of their reactions to stuffIf they are not aware they will be acting throgh - neg impact on work productivity nadn relationships Self Awareness
  • Mindfulnes - worksheetDeliberatly self-care and its not a luxury
  • Turning Towards could be a worksheet ...... What areas of pain in your life do you find it easy to turn towards.... What areas do you find it difficult
  • MiT - Mindfulness Informed Therapy - Mindfulness and Self-Care

    1. 1. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au MINDFULNESS & SELF CARE Cameron Aggs Clinical Psychologist & Director Mindfulness Training Australia cam@bemindful.com.au Sponsored by The Belfast Trust
    2. 2. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au  Theory: To present an overview of mindfulness that allows you to develop your understanding of mindfulness and how it works  Experiential: To provide a space for you to experience a mindful state of mind, and to inspire the intention to return to this state of mind in the future  Tomorrow: To provide exercises to get you forming new habits.. Aims....
    3. 3. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au  How is your breathing?  Belly or Chest? Two Hands
    4. 4. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au 3 Qualities of Presence 1. Light as in buoyant in the Mind ◦ Unencumbered by past and future and fixation 2. Relaxed as in soft in the body ◦ The belly, chest, and shoulders 3. Grounded as in the bum in the chair and the feet on the floor Light. Relaxed. Grounded.
    5. 5. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Feet, Bum, Breath Technique  Feet on the floor  Bottom in the chair  And your breathing  4Breaths….  These four breaths are mine!
    6. 6. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Exercise  What brought you to this role?  What do you like / love about this role?  What helps you connect with this role?  What makes it more difficult to connect with this role
    7. 7. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au  Study (N = 23,521)  21% of GP‟s rated work-related stress as "excessive and unmanageable",  61% of GP‟s considered it "excessive but manageable".  55% of the sample group considered that work impinged on their quality of life to an "unacceptable" extent British Medical Association. National Survey of GP Opinion. BMA, London 2001. Stress Across the Atlantic...
    8. 8. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Study (N=123) with urban GP‟s (Lee, Stewart, & Brown, 2008)  69.2% reported high or moderate levels of stress  71.1% reported high or moderate levels of emotional exhaustion  69.4% reported high or moderate levels of depersonalisation (automatic pilot) Similar findings when stress and burnout is measured with rural samples (e.g. Thommasen et al., 2001) and British samples (e.g. Caplan, 1994) Stress and Burnout – Canadian Sample
    9. 9. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au  Long waits for accessing specialists, diagnostic tests, and community resources; feeling undervalued; difficult patients; and medicolegal issues (Lee, Stewart, & Brown, 2008).  Challenging patients, high workload, time limitations, competency issues, challenges of documentation and practice management (Lee, Stewart, & Brown, 2009). Causes of Stress
    10. 10. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Three Dimensions: 1. Emotional exhaustion (feelings of being emotionally overextended and exhausted with one's work), 2. Depersonalisation and automatic pilot (the development of negative, numb and/or uncaring attitudes towards others), and 3. Negative personal accomplishment (the loss of feelings of self-competence and dissatisfaction with one„s achievements). What is Burnout?
    11. 11. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Stress and burnout are associated with:  Increased fatigue,  Insomnia,  Heart disease,  Depression,  Obesity,  Hypertension,  Diabetes,  Premature aging (Spikard and colleagues, 2001). Why is Burnout A Problem?
    12. 12. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Stress and depressive symptoms significantly Reduce:  The clinicians‟ attention and concentration and decision making and communication effectiveness Burnout has been associated with  Patient satisfaction,  Suboptimal self-reported patient care,  Longer patient- reported recovery times see Irving , Dobson & Park (2009) for review Why is Burnout A Problem?
    13. 13. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Self Reflection: Responding to Stress  What are your sources of stress?  What do you notice when you are stressed?  How do you cope with this??
    14. 14. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Who among us can step outside their own ruminative thinking patterns?
    15. 15. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Ad hoc approaches:  Participating in continuing medical education, soliciting support from colleagues and staff, making use of teams, improving patient-physician relationships.  Reducing demands by flexible employment practices; increasing social support and staff development strategies (British Medical Association, 2000). Formal Interventions:  Few interventions exist to combat this problem (McCray et al., 2008). What can be done?
    16. 16. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Empirical research: 8-week MBSR courses with helping professionals doctors, nurses, psychologists, medical students associated with:  Reductions in depression and state and trait anxiety, increased overall empathy levels (Shapiro, Schwartz, Bonner, 1998).  Reductions in stress, anxiety, negative affect, and rumination (Shapiro, Astin, Bishop & Cordova, 2005).  Decreased stress and increased self-compassion (Shapiro, Astin, Bishop, and Cordova, 2008). Correlational research: Higher levels of mindfulness associated with increased work satisfaction and decreased burnout (May & O‟Donovan, 2007) Mindfulness-Based Solutions
    17. 17. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au “Bringing one‟s complete attention to the experiences occurring in the present moment, in a nonjudgmental or accepting way” (Brown & Ryan, 2003; Kabat-Zinn, 1990). Three aspects of this model of mindfulness:  Intention: Bringing (on purpose) …  Awareness: Ones complete attention to the present moment…  Attitude: In a non-judging or accepting way… For more detail see Shapiro, et al., (2006), Mechanisms of Mindfulness. Journal of Clinical Psychology, 62, 373– 386. What is Mindfulness?
    18. 18. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Carer responsiveness  Children learn to behave in ways to elicit a carer response  The level and quality of this response is a major factor in a child‟s attachment to a carer  Different levels of responsiveness result in different styles of attachment - categorised as secure, anxious resistant, avoidant or disorganised-disorientated
    19. 19. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Impact of Empathic Failure “Whatever she fails to recognise in him he is likely to fail to recognise in himself. In this way, it is postulated, major parts of a child‟s developing personality can become split off from, that is, out of communication with, those parts of his personality that his mother recognizes and responds to, which in some cases include features of personality that she is attributing to him wrongly.” - Bowlby (1988) p.132
    20. 20. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au 3 Minute Breathing Space = Making a Space for What is Happening now Step 1: Gathering the mind Step 2: Focusing and redirecting the attention Step 3: Expanding awareness and returning Hot tip: Bookmark: YouTube “3 minute breathing space” (it‟s the first one that comes up) Experiential Exercise: 3MBS:
    21. 21. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au I-SIFT The stance of the self towards experience determines the quality thereof, much more so than the bare facts themselves…. PAIN + NON-ACCEPTANCE = SUFFERING
    22. 22. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au “Mindfulness is the capacity to come into the present moment, to notice when it has got hooked and to free it when it has....” Awareness I: Mindfulness As an Exercise in Attention Regulation
    23. 23. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Component Skills:  Sustaining attention (staying in moments)  Noticing the mind (meta-cognitive awareness)  Attention switching/Inhibiting secondary appraisals How this helps:  Coming off automatic pilot (Siegel et al., 2002)  Dual Channel Theory: (Siegel et al., 2002)  Arriving in Natural Presence (Brach, 2007) Present Moment Awareness....
    24. 24. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au 1. Attending: centering one‟s attention in the „here and now‟ of immediate experiencing. 2. Knowing and noting: „Tuning in‟ “What is my experience now…..can I name it” (SIFT). 3. Releasing: Allowing experience to rise and pass freely. 4. Remembering and Returning: A willingness to return again and again to this process (of being here now). FOUR SKILLS OF MINDFULNESS
    25. 25. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Attending in the moment; correctly identifying one‟s experience (SIFT); Releasing what one cannot control; and returning back to the simplicity of the present moment. Interferes with:  Rumination (past) or anticipatory worry (future) or dissociation (fantasy).  Automatic pilot: Getting lost in “Doing-Mode”.  Stress and negative emotion build-up (through noticing as it is happening and letting it go). “Increased awareness may also enhance therapeutic presence and diagnostic accuracy” (Germer, 2005; Feldman, & Christensen, 2007). How this helps...
    26. 26. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au  Kindness: Positive regard, cultivating a friendly relationship towards „what is‟.  Openness: Also known as „Beginners Mind‟ or „Receptive Mind‟  Acceptance: allowing experience to be as it is......  Non-judgment: Cultivating an interest in the moment-to-moment processes of our day.  Relationship to therapists wellbeing and effectiveness:  Enhanced immune system functioning (Davidson, 2003).  Enhanced capacity to use relationships (Block-Learner et al., 2007).  Psychological adjustment and wellbeing (Shapiro et al., 2005).  Enhanced therapeutic relationship and empathy skills (Dekeyser et al., 2008). The Koan of Mindful Attitudes
    27. 27. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au Thank You! More information at www.bemindful.com.au Email me: cam@bemindful.com.au

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