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Mindfulness - Il contributo della mindfulness nella pratica clinica

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Secondo Kabat-Zinn (1999), la Mindfulness non può avere altro significato se non quello di porre attenzione al momento presente in modo consapevole e non giudicante. La consapevolezza emerge dall’essere desti e vigili, nella comprensione del proprio comportamento qui ed ora. La tendenza dell’essere umano è quella di creare delle profezie o fantasie su un momento futuro ed eventuale, tuttavia non rientra nelle capacità umane il poter predire l’andamento reale delle cose. In questa azione di previsione del futuro, ciò che è presente diventa passato e di conseguenza non viene vissuto. Le persone possono arrivare a farsi scorrere la vita davanti, cullandosi e costringendosi nel passato o sperando che giungano determinate variabili a cambiargli il destino fantasticato. Il momento è difficile da cogliere, ma è indispensabile all’individuo affinché comprenda di essere immerso in un continuo cambiamento, in balia di cause e condizioni, e che il vivere è legato all’attimo (Kabat-Zinn, 2005).
Secondo Kabat-Zinn (2005) questa consapevolezza, non è altro che attenzione intenzionale, rivolta ad oggetti che diversamente nemmeno noteremmo.
La mindfulness, sostanzialmente, è l’insegnamento all’essere vigili, che si può acquisire grazie alla pratica della stessa. Tale tecnica attraverso un meccanismo sistematico, ha la capacità di poter far affiorare nel praticante, uno stato di chiara consapevolezza. Ciò può avvenire sia grazie a pratiche formali di mindfulness come: il body scan, la meditazione seduta, la meditazione mindful; che informali, nell’attenzione quotidiana al presente (Crane, 2012). La consapevolezza è il prodotto di quello che è concentrazione ed attitudine; ovvero l’esercizio alla presenza.
La pratica meditativa mindful concerne quella dinamicità grazie alla quale il risultato nell’operante sia una quieta attenzione discernente e non reattiva, centrata sull’assenza di giudizio e nell’osservazione di ciò che si presenta momento per momento.
La profondità dell’attenzione è nella sua durevolezza, differentemente dall’attenzione abituale che viene continuamente spostata da stimolo a stimolo (Shapiro, Carlson, 2013).
Tuttavia nella pratica della mindfulness non basta essere capaci di porre attenzione, ma è essenziale la qualità della concentrazione che viene prestata. Di fronte ad un evento, anche portatore di dolore, il soggetto deve essere chiamato a viverlo con curiosità, nell’ascolto di ciò che in lui provoca; sia da un punto di vista psichico che fisico. L’apertura è determinata come quella capacità di comprendere i propri movimenti interni e per questo accettarli. Infine, l’ultima capacità richiesta è quella dell’amore nei propri riguardi. La gentilezza nei propri confronti è il passo che dà l’energia necessaria a superare quei pattern lesivi che si innescano nelle condizioni di difficoltà, (Siegel, 2009).

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Mindfulness - Il contributo della mindfulness nella pratica clinica

  1. 1. Eleonora Lombardi PsyD
  2. 2. Questo tipo di meditazione è stata derivata unendo alcune parti della Vipassana, alle tecniche di terapia cognitivo- comportamentale.
  3. 3.  L’attenzione intenzionale rivolta al momento presente coltivando un atteggiamento aperto, curioso, amorevole e non giudicante.
  4. 4.  Idee e pensieri deformati a causa del bagno emotivo in cui sono immersi.  Porre attenzione alla propria corporeità e all’entità del proprio pensiero.
  5. 5. “Il cervello è un sistema che apprende. Dal momento che i neuroni sono interconnessi tra di loro, il cervello cambia: si formano nuovi neuroni e nuove connessioni tra di loro. Gradualmente la soglia perché questi si attivino si abbassa. Abbiamo imparato un compito” .  MODALITA’ FAREMODALITA’ FARE -- MODALITA’MODALITA’
  6. 6.  Esistono meccanismi neurodinamici, in grado di rendere il soggetto capace di viversi un rispecchiamento all’interno di sè.  Tra empatia, personificazione, previsione delle intenzioni altrui.
  7. 7.  Le intenzioni all’interno di un cervello quando finalizzate ad un obbiettivo, vengono decodificate ed apprese …  … grazie al lavoro svolto dai neuroni specchio e dalle regioni temporali superiori.
  8. 8.  Nel momento in cui un cervello apprende, uno stimolo può essere organizzato in pattern di significato che rendono la persona capace di avere intuizioni.  La Mindfulness aumenta la coerenza tra l’anticipazione stessa e la mappa cognitiva che va formandosi ogni volta che il soggetto esperisce realmente l’azione intuita.
  9. 9.  Jon Kabat-Zinn  Stress Reduction Clinic.  Center of Mindfulness in Medicine, Health Care and Society.  Modello di Percezione basato sull’attenzione intenzionale.
  10. 10.  Tale tipo di intervento, venne sviluppatoTale tipo di intervento, venne sviluppato per colmare il vuoto burocratico in cuiper colmare il vuoto burocratico in cui cadevano tutti quei pazienti checadevano tutti quei pazienti che soffrivano disoffrivano di dolore cronicodolore cronico e che none che non rispondendo ai trattamenti clinici,rispondendo ai trattamenti clinici, finivano col non essere più accolti nellefinivano col non essere più accolti nelle strutture.strutture. MINDFULNESS-BASED STRESSMINDFULNESS-BASED STRESS REDUCTION (1982)REDUCTION (1982)
  11. 11. DOLORE: solo un evento mentale e fisico. POSITIVITA’ disciplina alla consapevolezza, per l’interiorizzazione di un modello cognitivo virtuoso.
  12. 12.  MBSR e DOLORE CRONICO  MBSR ed ANSIA  MBSR e PSORIASI  MBSR e CANCRO
  13. 13. PRATICA FORMALE  Body scan  Sitting meditation  Yoga hatha  Walking meditation INFORMALE Meditazione non strutturata … Nell’adempimento di tutte le attività routinarie
  14. 14. Altri usi in Ambito Clinico  Disturbo Borderline  Disturbo DOC  Disturbo Depressivo
  15. 15. “La base di ogni volere è bisogno, mancanza, ossia dolore, a cui l'uomo è vincolato dall'origine, per natura. Venendogli invece a mancare oggetti del desiderio, quando questo è tolto via da un troppo facile appagamento, tremendo vuoto e noia l'opprimono: cioè la sua natura e il suo essere medesimo gli diventano intollerabile peso. La sua vita oscilla quindi come un pendolo, di qua e di là, tra il dolore e la noia, che sono in realtà i suoi veri elementi costitutivi”. (A. Schopenhauer)
  16. 16.  Marsha Linehan  Procedure cognitive e comportamentali 1. Abilità della mente saggia. 2. Abilità di contenuto. 3. Abilità formali.
  17. 17. ““COGITO ERGO SUM”COGITO ERGO SUM” ““PENSO DUNQUE SONO”PENSO DUNQUE SONO” (R. Cartesio,(R. Cartesio, Discorso sul metodoDiscorso sul metodo, 1637)., 1637).
  18. 18.  Fabrizio Didonna  Unità dei Disturbi d’Ansia e dell’Umore 1. Livello espressione del problema. 2. Livello addestramento nelle abilità mindful. 3. Livello di integrazione della procedura ERP con la Mindfulness.
  19. 19.  Rituali a scopo di verifica  Rituali di pulizia/igiene  Ossessività nel pensiero, senza compulsioni.  Lentezza Ossessiva  Ritualistica mistica ??!
  20. 20. “La via di mezzo è quella delle api” (Bacone).  PROGRAMMA STRUTTURATO  Informazioni sulla patologia  Modifica degli atteggiamenti disfunzionali
  21. 21.  Stimolo ansiogeno  Soppressione della risposta compulsiva suscitata.  Spinta al contatto con l’interiorità a fronte di emozioni spiacevoli Non rinunciare a vivere il dolore per esporsi consapevolmente.
  22. 22.  “I dolori degli uomini sarebbero minori se essi […] non si affaticassero con tanta forza di immaginazione a risuscitare i ricordi del male passato, piuttosto che sopportare un presente privo di cure”. (J. W. Goethe, I dolori del giovane Werther, 1774)
  23. 23. MBCT in 8 settimane 1. Metacognizione. 2. Ruminazione. 3. Evitamento. 4. Pilota automatico. 5. Ricordi che si attivano in base all’umore.  Segal  Teasdale  William
  24. 24.  Esiste un’interconnessione tra la sfera sensoriale e quella dell’attività mentale.  Questa è la chiave nascosta dello scatenarsi di un’emozione. Ruminazio- ne Rimuginio Sensazione Memoria Ricordo
  25. 25.  Il giudizio suscitato viene fatto scorrere senza apprensione  Indagare con gentilezza tutte le sensazioni corporee per come si presentano.
  26. 26.  Consapevolezz a sul respiro e sul corpo.  Ogni pensiero sfugge alla stessa velocità in cui si introduce in noi, l’importante è non trattenerlo …
  27. 27.  Una mini- meditazione di soli 3 minuti, per ritrovare la FORZA.
  28. 28.  Un modo per comprendere come il proprio corpo sia divenuto esperto nel compiere azioni che un tempo ha dovuto apprendere.
  29. 29. Eleonora Lombardi PsyD Gli Dei non sanno pronunciare falsità, perché devono essere ogni parola. Eschilo

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