Introduction to Mindfulness           Based Therapies                                  By Chris Walsh"Only what you have e...
Definition of MindfulnessConsciously cultivating   an openhearted,        moment to moment,                nonjudgemental ...
Mindfulness not new!!!
Purpose of Workshop• What Mindfulness Is And How It Works• Clarify Common Misunderstandings• Suitable Application of Mindf...
The New Wave  of Mindfulness Based Treatments• Jon Kabat-Zinn: MBSR• Marsha Linehan: DBT• Zindel Segal, Mark Williams & Jo...
"Meeting of Minds".His Holiness the 14th Dalai Lamawill meet withProfessor Aaron Tim Beck
Wild geese
What is Mindfulness?  Definition (Kabat- Zinn)  Paying attention in a particular way                     on purpose,      ...
Mindfulness not a new therapy!• Eastern & Western Spiritual Contemplative Traditions• Phenomenology• Psychoanalysis   – Fr...
Five Minute Breathing     Mindfulness
Mindfulness Instructions• Relaxed But Alert Posture• Focus Attention on The Breath• Let Breath Breathe Itself• All Thought...
Pleasant Events CalendarWhat was         Were you       How did          What               Whatthe              aware of ...
Five Minute Breathing     Mindfulness
Waving to a Friend
Mood Based Inferences
NAT’s             CBT        Anxiety                  Safety Behaviours                     (Avoidance)
Mindfulness Not Just RelaxationSuppression of Thoughts, Sensation or EmotionsCauses Rebound.(Wenslaff et al. 1991)  So Dea...
“The practice of mindfulness defuses our  negativity, aggression, and turbulent  emotions…..Rather than suppressing emotio...
ComfortChallengeOverwhelm
Carmen• Worry, Over-concern for Others & Over-Activity• Labelling “Just Worrying” for Continued Over-  Responsibility• Une...
Unpleasant Events CalendarWhat was       Were you       How did          What              Whatthe            aware of the...
Five Minute Breathing     Mindfulness
Doing Mode                       Being Mode• Problem Solving               • Accepting & Allowing• Activated by           ...
Mindfulness & CognitiveTherapies• MBSR & MBCT  –   Being mode versus Doing Mode  –   Automatic pilot & discrepancy driven ...
SESSION 1 MBCT/MBSR      Stepping out of Automatic Pilot• Rationale  – Mindfulness starts when we recognise the tendency  ...
MBCT/MBSR DeliveryMBCT Practitioners adopt a Person-Centered, Rogerian approachMBCT Practitioners use a motivational inter...
Five Minute Breathing     Mindfulness
Advantages of Mindfulness•   Develops “Observing Self” (Segal, Williams & Teasdale 2002)•    Avoids Feeding or Fighting Th...
Initial Problems Practising Mindfulness• Teacher Needs to be an Experienced Mindfulness  Practitioner• May Initially Lead ...
Solutions To Initial Problems• Practice With Therapist in Therapy Sessions   – Containment   – Grounding   – Get Experienc...
Manageable Mindfulness            Homework• Daily 5 Minute Breath Meditation• Awareness of An Aspect of A Physical Habit e...
Breathing SpaceObserve                      1. Body                      2. Thoughts andBreathe                         In...
The Workbench of Your Mind              ThoughtsBodily                            EmotionsSensations              Behaviour
StopTake a breathObserveProceed
Mindful Movement e.g. Yoga
Mindfulness Part• Meditation practices• Automatic pilot → Present awareness• Doing mode → Being mode• Intellectual constru...
CBT Part• Psychoeducation (mood & thinking)• Options for skilful action   – Nourishing activities   – Options for working ...
Yin                        Receptive                        Phenomenology                        Openness                 ...
Urge Surfing – Alan Marlatt
Coral• 26 y.o.  – Single, living with friends  – Public Servant, Intelligent, University Educated• Chronic Dysthymia / Dep...
Coral‟s Psychotherapy Issues• Establish connection between drug use and mood• Differentiate between temporary downs and de...
Systemic Constellations                  www.constellationflow.com• Mindfulness Based• Explores Interconnectedness• Cultiv...
Five Minute Breathing     Mindfulness
www.mindfulness.org.au
About Dr Chris WalshDr Chris Walsh MBBS, DPM, FAChAM is a psychiatrist working in privatepractice in North Carlton (Melbou...
Chris is a member of The Family Alcohol and Drug Network (Fadnet) which is agathering of professionals from the drug and a...
Mindfulness singapore 2010
Mindfulness singapore 2010
Mindfulness singapore 2010
Mindfulness singapore 2010
Mindfulness singapore 2010
Mindfulness singapore 2010
Mindfulness singapore 2010
Mindfulness singapore 2010
Mindfulness singapore 2010
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Mindfulness Singapore 2010 by Dr Chris Walsh

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Mindfulness singapore 2010

  1. 1. Introduction to Mindfulness Based Therapies By Chris Walsh"Only what you have experienced yourself can be calledknowledge. Everything else is just information"Albert Einstein
  2. 2. Definition of MindfulnessConsciously cultivating an openhearted, moment to moment, nonjudgemental awarenessAdapted from J Kabat-Zinn 2005,Coming to Our Senses, p24
  3. 3. Mindfulness not new!!!
  4. 4. Purpose of Workshop• What Mindfulness Is And How It Works• Clarify Common Misunderstandings• Suitable Application of Mindfulness to Your Work• Practical Applications in Daily Experience• Brief Mindfulness Interventions• Strategies to Address Difficulties• Where to Access ResourcesUsing• Theoretical Framework & Direct Experience
  5. 5. The New Wave of Mindfulness Based Treatments• Jon Kabat-Zinn: MBSR• Marsha Linehan: DBT• Zindel Segal, Mark Williams & John Teasdale: MBCT• Steven Hayes: ACT• Alan Marlatt: Urge Surfing, Vipassana, MBRP
  6. 6. "Meeting of Minds".His Holiness the 14th Dalai Lamawill meet withProfessor Aaron Tim Beck
  7. 7. Wild geese
  8. 8. What is Mindfulness? Definition (Kabat- Zinn) Paying attention in a particular way on purpose, in the present moment, and nonjudgmentally. • Sensory impressions • Thoughts including Imagery • Emotions • Urges & Impulses Technique: Focus on breath, repetitive phrase Mindfulness is oriented to the processes of consciousness rather than content
  9. 9. Mindfulness not a new therapy!• Eastern & Western Spiritual Contemplative Traditions• Phenomenology• Psychoanalysis – Free Association & Free Floating Attention• Experiential Therapies – Gestalt – Existential Psychotherapy
  10. 10. Five Minute Breathing Mindfulness
  11. 11. Mindfulness Instructions• Relaxed But Alert Posture• Focus Attention on The Breath• Let Breath Breathe Itself• All Thoughts Including Images Are Equal While Meditating• Sounds & Sensations Are Okay• When Realise Distracted Gently Bring Attention Back To Breath• Whatever Happens is Okay
  12. 12. Pleasant Events CalendarWhat was Were you How did What Whatthe aware of the your body moods, thoughtsexperience? pleasant feel, feelings, are in feelings in detail, and your mind while during this thoughts now as you the event experience? accompanie write about was d this this event? happening? event?Heading Yes. Lightness in Relief, It was such ahome at the the face. pleasure. small thingend of work Aware of “That‟s good.” but I‟m– stopping, shoulders “How lovely!” glad I noticedhearing a bird dropping, (the bird) “It‟s it.sing. Uplift of so corners of the nice to be mouth. outside”
  13. 13. Five Minute Breathing Mindfulness
  14. 14. Waving to a Friend
  15. 15. Mood Based Inferences
  16. 16. NAT’s CBT Anxiety Safety Behaviours (Avoidance)
  17. 17. Mindfulness Not Just RelaxationSuppression of Thoughts, Sensation or EmotionsCauses Rebound.(Wenslaff et al. 1991) So Dealing With Anxiety by Distraction (Including Relaxation Techniques) Is Considered Another Form of Avoidance Mindfulness Deals With This Problem By Accepting Whatever Arises.
  18. 18. “The practice of mindfulness defuses our negativity, aggression, and turbulent emotions…..Rather than suppressing emotions or indulging in them, here it is important to view them, and your thoughts, and whatever arises with an acceptance and generosity that are as open and spacious as possible.”(Sogyal, 1992 p123 the Tibetan Book of Living and Dying.)
  19. 19. ComfortChallengeOverwhelm
  20. 20. Carmen• Worry, Over-concern for Others & Over-Activity• Labelling “Just Worrying” for Continued Over- Responsibility• Unexpected of Powerful childhood Classical Conditioning• Sitting Mindfully with Somatic Sensations of Anxiety Guest House
  21. 21. Unpleasant Events CalendarWhat was Were you How did What Whatthe aware of the your body moods, thoughtsexperience? pleasant feel, feelings, are in feelings in detail, and your mind while during this thoughts now as you the event experience? accompanie write about was d this this event? happening? event?Driving in a Yes Tightness in Anxiety at It doesn‟ttraffic jam, the arms. running late. really seem torunning Holding Frustration matterlate for an steering with traffic. now. Gettingappointment. wheel tightly. “People upset Jaws should certainly clenching. respond more didn‟t help me Breathing quickly to the get there any tight and traffic lights. faster. restricted. Bloody idiots”
  22. 22. Five Minute Breathing Mindfulness
  23. 23. Doing Mode Being Mode• Problem Solving • Accepting & Allowing• Activated by • Activated by: – Tasks requiring planning – Being relaxed, meditation – Threat or stress – Creative Activity “in the zone”• Evaluates as Good or Bad • Greater Ability to tolerate the Unpleasant• Registers Discrepancy • Allows in New Information• Recurring Sense of Unsatisfactoriness • Approach (Open)• Automatic Pilot – Activated L Frontal Lobe• Avoidant • Allows Embodied Cognition – Activated R Frontal Lobe• Thoughts & Feelings Develop Independent “Reality”
  24. 24. Mindfulness & CognitiveTherapies• MBSR & MBCT – Being mode versus Doing Mode – Automatic pilot & discrepancy driven behaviour – Interoceptive exposure – Attention Control• DBT – Distress Tolerance – Social Skills (Skilful Means)• ACT – Defusion – Values
  25. 25. SESSION 1 MBCT/MBSR Stepping out of Automatic Pilot• Rationale – Mindfulness starts when we recognise the tendency to be on automatic pilot – Commitment to learning how to step out of it and become aware of each moment – Practice purposefully moving attention round the body• Practice – Eating meditation – Body scan – Routine activity (homework) – „Noticing‟ (homework – continues throughout)
  26. 26. MBCT/MBSR DeliveryMBCT Practitioners adopt a Person-Centered, Rogerian approachMBCT Practitioners use a motivational interviewing styleMBSR (MBCT) Program is characterized by the qualities of authenticity, unconditional acceptance, empathy, humor, present moment experience through which both teacher and student experience the group process; with each being changed as a result (Santorelli)MBCT Practitioners have their own ongoing mindfulness meditation practice similar to what they teach to the groupMBCT Practitioners use a manual with spontaneity and creativity
  27. 27. Five Minute Breathing Mindfulness
  28. 28. Advantages of Mindfulness• Develops “Observing Self” (Segal, Williams & Teasdale 2002)• Avoids Feeding or Fighting Thoughts & Feelings (Sogyal Rinpoche, 1992)• Repetitive Spontaneous Exposure & Desensitisation to Previously Avoided Thoughts & Feelings (Breslin et al 2002)• Increases Cerebral Left Prefrontal Activity (Davidson 2003)• Increases Empathic Capacity & Emotional Intelligence (Goleman)• Increases Compassion for Self & Others (Neff K.)• Alternative to Mindless Compulsive Behaviour (Linehan 1993 p69)• Observing Impermanence thus Allowing Urge Surfing (Marlatt & Gordon 1985)• Frees Mind from Paradigm Traps Inherent in Language (Hayes, S. C. 2002)• Creates a Space for Spontaneous Creative Thoughts
  29. 29. Initial Problems Practising Mindfulness• Teacher Needs to be an Experienced Mindfulness Practitioner• May Initially Lead to Increased Awareness of Repressed Unpleasant Feelings• Need some Pre-existing Ego Strength to Do It• Difficulty Establishing a Regular Practice• Striving and Judgementalism
  30. 30. Solutions To Initial Problems• Practice With Therapist in Therapy Sessions – Containment – Grounding – Get Experience of: • “Observing Self” • Automatic Flow of The Mind • Continuingly Changing Nature of Mental Phenomena• Begin With Simple Awareness of Body Sensations• Set Brief Easily Manageable Homework Exercises• Reading, Education, Helpful Feedback
  31. 31. Manageable Mindfulness Homework• Daily 5 Minute Breath Meditation• Awareness of An Aspect of A Physical Habit e.g. – How tight you hold the steering wheel. – What happens to your breathing in an argument? – Breath Awareness on Cue • Waiting for Phone to Be Answered, At a Red Traffic Light • Walking, Listening to Music, Getting Dressed• Behavioural experiments – Shifting awareness in specific situations E.g. Detailed Awareness of The Phenomena Associated With Cravings
  32. 32. Breathing SpaceObserve 1. Body 2. Thoughts andBreathe Inferences 3. Skilful ActionObserve Body
  33. 33. The Workbench of Your Mind ThoughtsBodily EmotionsSensations Behaviour
  34. 34. StopTake a breathObserveProceed
  35. 35. Mindful Movement e.g. Yoga
  36. 36. Mindfulness Part• Meditation practices• Automatic pilot → Present awareness• Doing mode → Being mode• Intellectual construct → direct experience• Past/Future → Present• Criticism/judgement → compassion• Avoidance → approach
  37. 37. CBT Part• Psychoeducation (mood & thinking)• Options for skilful action – Nourishing activities – Options for working with negative thoughts• Relapse Prevention – Relapse signatures – Action planning• Homework
  38. 38. Yin Receptive Phenomenology Openness Being Mode Exquisite AwarenessYangCreativeScientific EnquiryFocused ConcentrationDoing ModeAutomatic Pilot
  39. 39. Urge Surfing – Alan Marlatt
  40. 40. Coral• 26 y.o. – Single, living with friends – Public Servant, Intelligent, University Educated• Chronic Dysthymia / Depression – Cipramil 20- 40 mg, ECT• Recreational Party Drugs, Very Occasional THC
  41. 41. Coral‟s Psychotherapy Issues• Establish connection between drug use and mood• Differentiate between temporary downs and depressive relapse – Harm reduction• Address broad range of nat‟s that reinforced her sense of incompetence and inadequacy• Self doubt, worry, anxiety• Traditional CBT perceived as invalidating
  42. 42. Systemic Constellations www.constellationflow.com• Mindfulness Based• Explores Interconnectedness• Cultivates harmony within community• Cultivates compassion – through intergenerational perspective• Cultivates wisdom – by courageously acknowledging what is
  43. 43. Five Minute Breathing Mindfulness
  44. 44. www.mindfulness.org.au
  45. 45. About Dr Chris WalshDr Chris Walsh MBBS, DPM, FAChAM is a psychiatrist working in privatepractice in North Carlton (Melbourne, Australia). He has been working inpsychiatry since 1985. In that time, he has worked in hospitals, jails, communitysettings, and drug and alcohol institutions.In 1983, as a young doctor Chris did a short stint helping out at the Tibetanrefugee hospital in Dharamsala. The Tibetan peoples common sense, goodhumour and happy nature left a lasting impression on him.Chriss daily mindfulness practice began eighteen months later, at the same timeas he began working in psychiatry. As a result mindfulness has been organicallyintegrated into his psychiatric practice from the very start. Chris has a specialinterest in applying mindfulness meditation practices to psychotherapy. He isformally trained in Self Psychology, but his psychotherapy integrates diversetheoretical frameworks, including cognitive Behavioural Therapy (CBT) andGestalt.Chris also works in the Drug and Alcohol treatment setting and has a strongcommitment to promoting use of mindfulness and awareness of family issues inthat area.
  46. 46. Chris is a member of The Family Alcohol and Drug Network (Fadnet) which is agathering of professionals from the drug and alcohol field with a particular interest infamily work. These professionals share a deep respect for families and a commonbelief in caring for family members affected by problematic substance use. Theyrecognise and value the healing power within families, and also recognise the valueof family-aware and family-inclusive practice in the treatment of alcohol and otherdrug difficulties.Chris has taken a leading role in family constellation work in Australia. He runsregular workshops, sponsors senior European teachers, and is a foundationmember of the Melbourne peer supervisions group. He has given presentations atAustralian national professional conferences on both mindfulness and familyconstellations. Chris is also the founder and moderator of Constellation Talk a veryactive email chat group with almost 600 subscribers worldwide. He has presentedthis work around Australia and overseas in the USA, New Zealand and Singapore.He also coordinated the development of the website for the International sytemicConstellations Association (ISCA) www.isca-network.orgChris has a breadth of experience both in his life as well as his work. When he wasa medical student he took a year off from his studies. He spent this year travellingaround Australia working as a labourer in factory and farm jobs. He has diverseinterests including music, poetry and football and is fluent in Spanish.

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