Combining the power of the latest brain science with the wisdom of contemplative practice, these are practical methods for centering your brain in its natural state of gladness, love, and peace.
Mindfulness at Work: Navigating Multitasking With Focus & EaseShalini Bahl
This is a webinar I did for AllOne Health’s clients on mindfulness at work and how it enhances the ability to focus and well being. If you would like to see the full webinar please visit the website:
http://mindfuluniverse.com/video/mindfulness-at-work-new-approaches-to-maximize-focus If you would like the slides please let me know and I will be happy to email you a copy
Here are top 6 positive thinking tips that can help you change the way you think about other people and things around. To learn more tips of this type, click the link: http://vkool.com/discover-16-positive-thinking-tips/.
1. Treat Others As You Want To Be Treated
All people wish to be treated with respect. The way that you behave others shows your personality. Therefore, if you want to have good personality, including positive thoughts, you should treat other people the way you want to be treated. If you want to be trusted by friends, learn to trust them first. If you want to be loved by your relatives, learn to love them first. If you want to be welcomed by neighbors, learn to welcome them first.
2. Be Tolerant
In order to build positive thoughts, you should learn to forgive people who make you sad or angry. You even need to learn to forgive the ones who offend you. No matter what they do to you, they are teaching you some good lessons in life.
Moreover, you should be honestly happy when people around you succeed in life or at work. Do not be jealous with them as jealousy is one of the typical causes of negative thinking.
3. Avoid Negative Self-Talk
Among positive thinking tips, avoiding negative self-talk is the most important. What you talk to yourself also will result in the way you behave people around. If your mind is full of negative self-talk, you will not be able to treat others with respect as you may believe that they do not deserve your good behavior. When you are in that situation, try to eliminate your negative talk, and tell yourself that everyone may make mistakes, but everyone has something for you to learn from.
4. Do Meditation Or Yoga
Bath helps clean your body and meditation helps clean and refresh your mind. People who meditate on a regular basis have more positive thoughts than the ones who do not meditate. Meditation will certainly become the future of mankind. If you are a wise person, you should start doing meditation today to enjoy its benefits, to think more positively, and to have a better life.
Yoga helps you stop thinking negatively about others as it is really relaxing when you do it. Doing yoga also helps ease and refresh your mind, building positive thoughts.
5. Help People Around
If you can live for others, your mind will always be clean and relaxed. Helping people around is one of the top positive thinking tips. When you try your best to give others a helping hand, you are building your dignity. What you give others will certainly return to you some ways. If you help others, your mind will be built up with love, respect, and gratitude. As a result, you will be thinking positively.
6. Make Friends With Positive People
When you are with positive people, you can learn from them the way they treat others, and the way they think about life. You will gradually change the way you think as positive as they do.
According to The Energy Project, 74% of employees are experiencing an energy crisis. As this number continues to rise in the workplace, leaders and companies are now open to creating mindfulness programs in the workplace. In this session, Lorie shared the research behind the power of mindfulness, the benefits, mindful companies, and how to integrate mindfulness programs into organizations today.
Utilizing recent neuroscience research, this presentation builds awareness of 5 key factors which enable leaders to more effectively communicate in ways that build connection through the establishment of safety and respect.
Mindfulness at Work: Navigating Multitasking With Focus & EaseShalini Bahl
This is a webinar I did for AllOne Health’s clients on mindfulness at work and how it enhances the ability to focus and well being. If you would like to see the full webinar please visit the website:
http://mindfuluniverse.com/video/mindfulness-at-work-new-approaches-to-maximize-focus If you would like the slides please let me know and I will be happy to email you a copy
Here are top 6 positive thinking tips that can help you change the way you think about other people and things around. To learn more tips of this type, click the link: http://vkool.com/discover-16-positive-thinking-tips/.
1. Treat Others As You Want To Be Treated
All people wish to be treated with respect. The way that you behave others shows your personality. Therefore, if you want to have good personality, including positive thoughts, you should treat other people the way you want to be treated. If you want to be trusted by friends, learn to trust them first. If you want to be loved by your relatives, learn to love them first. If you want to be welcomed by neighbors, learn to welcome them first.
2. Be Tolerant
In order to build positive thoughts, you should learn to forgive people who make you sad or angry. You even need to learn to forgive the ones who offend you. No matter what they do to you, they are teaching you some good lessons in life.
Moreover, you should be honestly happy when people around you succeed in life or at work. Do not be jealous with them as jealousy is one of the typical causes of negative thinking.
3. Avoid Negative Self-Talk
Among positive thinking tips, avoiding negative self-talk is the most important. What you talk to yourself also will result in the way you behave people around. If your mind is full of negative self-talk, you will not be able to treat others with respect as you may believe that they do not deserve your good behavior. When you are in that situation, try to eliminate your negative talk, and tell yourself that everyone may make mistakes, but everyone has something for you to learn from.
4. Do Meditation Or Yoga
Bath helps clean your body and meditation helps clean and refresh your mind. People who meditate on a regular basis have more positive thoughts than the ones who do not meditate. Meditation will certainly become the future of mankind. If you are a wise person, you should start doing meditation today to enjoy its benefits, to think more positively, and to have a better life.
Yoga helps you stop thinking negatively about others as it is really relaxing when you do it. Doing yoga also helps ease and refresh your mind, building positive thoughts.
5. Help People Around
If you can live for others, your mind will always be clean and relaxed. Helping people around is one of the top positive thinking tips. When you try your best to give others a helping hand, you are building your dignity. What you give others will certainly return to you some ways. If you help others, your mind will be built up with love, respect, and gratitude. As a result, you will be thinking positively.
6. Make Friends With Positive People
When you are with positive people, you can learn from them the way they treat others, and the way they think about life. You will gradually change the way you think as positive as they do.
According to The Energy Project, 74% of employees are experiencing an energy crisis. As this number continues to rise in the workplace, leaders and companies are now open to creating mindfulness programs in the workplace. In this session, Lorie shared the research behind the power of mindfulness, the benefits, mindful companies, and how to integrate mindfulness programs into organizations today.
Utilizing recent neuroscience research, this presentation builds awareness of 5 key factors which enable leaders to more effectively communicate in ways that build connection through the establishment of safety and respect.
Search Inside Yourself is the mindfulness-based emotional intelligence program that started at Google and is now taught world wide to develop clarity, resilience, and compassionate leadership in organizations.
If you are curious to learn more, please email shalini@MFactor.org
motional intelligence (EI) is the capability of individuals to recognize their own emotions and those of others, discern between different feelings and label them appropriately, use emotional information to guide thinking and behavior, and manage and/or adjust emotions to adapt to environments or achieve one's goal
Self motivation and its importance in lifekomalnan123
This PDF dictates importance of self motivation and some useful tips through which any person can acquire this skills easily. Dr Arvinder Singh, the popular motivational counselor also helps the person in achieving this skill.
The power of believing that you can improve by Carol Dweck a visual summarySameer Mathur
Backed up by proven Scientific studies, Carol Dweck explains that Intelligence is Malleable.
Years of research provide concrete data that when we struggle with problems, we actually grow. When you grapple with problems, you make new neural connections which makes you smarter.
Most people believe personality traits are fixed characteristics that are present at birth and persist throughout an individual’s lifetime. Recent research, however, indicates these “fixed” traits are simply the symptoms of a person’s belief system. These beliefs can be so strong, in fact, that they positively or negatively influence every aspect of an individual’s life: sports, business, relationships, parenting, teaching, and coaching.
According to Carol S. Dweck, one of the world’s leading researchers in the field of motivation, there are two main belief systems, or mindsets, that people can possess. These mindsets strongly influence the way individuals respond to success and failure, and in Mindset, Dweck uses research, examples of well-known business and sports leaders, and specific scenarios to demonstrate how changing one’s mindset can profoundly affect the outcome of almost every situation. Dweck also explains how understanding the basics of mindsets can help in accepting and understanding relationships and the people who comprise them
This three-hour presentation introduces the practice of mindfulness and explores practical applications in the workplace. Mindfulness is the non-judgmental, moment to moment, awareness of the present moment. Mindfulness encompasses your ability to deepen self-awareness and be fully present to others. It enables you to initiate change or creatively meet the need for change with mindful planning and decision making. Studies show that stress is the number one issue in the workplace. Mindfulness addresses our responses to stress and fosters focus, clarity, creativity, and compassion in the workplace.
The Negativity Bias and Taking in the GoodRick Hanson
The brain's evolved bias is like Velcro for negative experiences, but Teflon for positive ones. The unfortunate results include stress and threat reactivity, anxiety, depression, and limited gains in psychotherapy. Happily, through tree steps of mindful attention, we can internalize positive experiences in implicit memory systems, weaving resources for well-being, coping, and kindness into the fabric of the barin and the self.
Pairing Positive and Negative to Fill the Hole in the HeartRick Hanson
Implicit memory systems – including expectations, emotional residues and reactive patterns – are a primary target of therapy. Since they are vulnerable to change during consolidation, the skillful pairing of positive and negative material in awareness can gradually soothe and ultimately replace negative implicit memories. This workshop will explore neuro-savvy methods for doing this, including how to identify the positive material that will best "antidote" old pain or deficits in internalized resources.
Search Inside Yourself is the mindfulness-based emotional intelligence program that started at Google and is now taught world wide to develop clarity, resilience, and compassionate leadership in organizations.
If you are curious to learn more, please email shalini@MFactor.org
motional intelligence (EI) is the capability of individuals to recognize their own emotions and those of others, discern between different feelings and label them appropriately, use emotional information to guide thinking and behavior, and manage and/or adjust emotions to adapt to environments or achieve one's goal
Self motivation and its importance in lifekomalnan123
This PDF dictates importance of self motivation and some useful tips through which any person can acquire this skills easily. Dr Arvinder Singh, the popular motivational counselor also helps the person in achieving this skill.
The power of believing that you can improve by Carol Dweck a visual summarySameer Mathur
Backed up by proven Scientific studies, Carol Dweck explains that Intelligence is Malleable.
Years of research provide concrete data that when we struggle with problems, we actually grow. When you grapple with problems, you make new neural connections which makes you smarter.
Most people believe personality traits are fixed characteristics that are present at birth and persist throughout an individual’s lifetime. Recent research, however, indicates these “fixed” traits are simply the symptoms of a person’s belief system. These beliefs can be so strong, in fact, that they positively or negatively influence every aspect of an individual’s life: sports, business, relationships, parenting, teaching, and coaching.
According to Carol S. Dweck, one of the world’s leading researchers in the field of motivation, there are two main belief systems, or mindsets, that people can possess. These mindsets strongly influence the way individuals respond to success and failure, and in Mindset, Dweck uses research, examples of well-known business and sports leaders, and specific scenarios to demonstrate how changing one’s mindset can profoundly affect the outcome of almost every situation. Dweck also explains how understanding the basics of mindsets can help in accepting and understanding relationships and the people who comprise them
This three-hour presentation introduces the practice of mindfulness and explores practical applications in the workplace. Mindfulness is the non-judgmental, moment to moment, awareness of the present moment. Mindfulness encompasses your ability to deepen self-awareness and be fully present to others. It enables you to initiate change or creatively meet the need for change with mindful planning and decision making. Studies show that stress is the number one issue in the workplace. Mindfulness addresses our responses to stress and fosters focus, clarity, creativity, and compassion in the workplace.
The Negativity Bias and Taking in the GoodRick Hanson
The brain's evolved bias is like Velcro for negative experiences, but Teflon for positive ones. The unfortunate results include stress and threat reactivity, anxiety, depression, and limited gains in psychotherapy. Happily, through tree steps of mindful attention, we can internalize positive experiences in implicit memory systems, weaving resources for well-being, coping, and kindness into the fabric of the barin and the self.
Pairing Positive and Negative to Fill the Hole in the HeartRick Hanson
Implicit memory systems – including expectations, emotional residues and reactive patterns – are a primary target of therapy. Since they are vulnerable to change during consolidation, the skillful pairing of positive and negative material in awareness can gradually soothe and ultimately replace negative implicit memories. This workshop will explore neuro-savvy methods for doing this, including how to identify the positive material that will best "antidote" old pain or deficits in internalized resources.
Taking in the Good: Building Resilience into the Brain through Positive Exper...Rick Hanson
How the brain evolved a “negativity bias” that continually looks for, reacts to, and stores negative experiences; how this shapes the interior landscape of the mind, leading to pessimism, depressed and anxious mood, and over-reactions; the neural machinery of memory; how to “trick” that machinery into weaving positive experiences into the brain and the self, leading to greater resilience, happiness, and interpersonal effectiveness; applications to particular situations, including healing trauma, cooperation with medical or psychological treatment, and raising or teaching children.
Managing the Caveman Brain in the 21st CenturyRick Hanson
The human brain evolved in three stages: reptile, mammal, and primate. Each stage has a core motivation: avoid harm, approach reward, and attach to "us." Modern life challenges these ancient neural systems with bombardments of threat messages, the endless stimulation of desire, and social disconnections and tensions of industrial, multicultural societies. This talk will explore brain-savvy ways to cultivate mindfulness in young people, and then use that mindfulness to internalize a greater sense of strength and safety, contentment, and being loved.
Rick Hanson gave this keynote address for the Bridging the Hearts and Minds of Youth: Mindfulness in Clinical Practice, Education and Research Conference at the UCSD Center for Mindfulness in February, 2012.
Presented at Spirit Rock Meditation Center - December, 2011.
The biological evolution of awareness and the apparent self; what neuroscience tells us about the distributed and endlessly variable neural nature of the apparent self; the stress, suffering, and interpersonal difficulties that come from “excesses of self”; the importance of healthy self-compassion and self-advocacy; how to heal injuries to self-worth; methods for taking things less personally, relaxing possessiveness, and feeling more at one with all things.
Paper Tiger Paranoia - Rick Hanson, PhDRick Hanson
How the brain’s “negativity bias” makes clients overestimate threats, underestimate opportunities, and underestimate inner and outer resources, leading to anxiety, anger, depression, and conflicts with others – and how to help clients overcome that bias, see the good facts about the others, the world, and themselves, and build resilience for happiness, healthy relationships, and occupational success.
More resources are freely offered at http://www.rickhanson.net.
Introduction to the neuroscience of mindfulness and meditation; brain-wise methods for steadying the mind, quieting it, bringing it to singleness, and concentrating it; an exploration of what could be happening in the brain during the non-ordinary states of consciousness
Mindfulness and Taking in the Good: Using Neuroplasticity to Weave Resources ...Rick Hanson
How the brain evolved a “negativity bias” that continually looks for, reacts to, and stores negative experiences; how this shapes the interior landscape of the mind, leading to pessimism, depressed and anxious mood, and over-reactions; the neural machinery of memory; how to “trick” that machinery into weaving positive experiences into the brain and the self, leading to greater resilience, happiness, and interpersonal effectiveness; applications to particular situations, including healing trauma, cooperation with medical or psychological treatment, and raising or teaching children.
New science is showing how mental activity sculpts neural structure. Using the power of self-directed neuroplasticity, you can target, stimulate, and thus gradually strengthen the neural substrates of well-being.
More resources are freely offered at http://www.rickhanson.net.
Buddha's Brain: The Practical Neuroscience of Inner Peace - Rick Hanson, PhDRick Hanson
Integrate the latest brain science research with the ancient wisdom of contemplative practice. Discover practical methods for improving mindfulness and concentration, calming the heart, weaving positive experiences into your brain and your self, and then bringing these new strengths into your relationships with both kindness and assertiveness.
More resources are freely offered at http://www.rickhanson.net.
Taking in the Good: Helping Children Build Inner Strength and HappinessRick Hanson
Scientists believe the brain evolved a "negativity bias" that makes it like Velcro for negative experiences but Teflon for positive ones. This helped our ancestors survive, but it's bad for children (and parents) today - leading them to overreact, hold onto hurts and resentments, and have a harder time developing inner resources. To address this challenge, this presentation will use practical neuroscience to show how to weave positive experiences into the fabric of the brain and the self - including how to pair a positive experience with a negative one to heal old pain.
Rick Hanson gave this public lecture for the Bridging the Hearts and Minds of Youth: Mindfulness in Clinical Practice, Education and Research Conference at the UCSD Center for Mindfulness in February, 2012.
Steadying the Mind - Healing and Treating Trauma, Addictions and Related Diso...Rick Hanson
To stay alive in the wild, our ancestors evolved highly distractible attentional systems – which pose real challenges to developing greater mindfulness today. This presentation covers how attention works in your brain, and the implications of normal neurological diversity for the “turtles” and “jackrabbits” at either end of the spectrum.
The Loving Brain - Healing and Treating Trauma, Addictions and Related Disord...Rick Hanson
Over millions of years, social abilities – such as bonding, empathy, compassion, language, and cooperative planning – really aided survival. Love, broadly defined, has profoundly shaped the evolution of the human brain.
The Neurology of Awakening - Rick Hanson, PhDRick Hanson
Using the New Brain Research to Steady Your Mind.
Introduction to the neuroscience of mindfulness and meditation; brain-wise methods for steadying the mind, quieting it, bringing it to singleness, and concentrating it; an exploration of what could be happening in the brain during the non-ordinary states of consciousness known as samadhis or jhanas.
More resources are freely offered at http://www.rickhanson.net.
Buddha's Brain: Natural Enlightenment and Unshakable Peace - Rick Hanson, PhDRick Hanson
Combining the power of the latest brain science with the wisdom of contemplative practice, this workshop will present practical methods for centering your brain in its natural state of gladness, love, and peace. In particular, you'll learn brain-savvy ways to reduce anxiety and irritability, feel stronger and safer, and clear old pain.
More resources are freely offered at http://www.rickhanson.net.
Natural Contentment And Brain Evolution - Rick Hanson, PhDRick Hanson
With the power of modern neuroscience, informed by ancient contemplative wisdom, you can use your mind alone to change your brain for the better. Self-directed neuroplasticity involves steadying the mind (key to both worldly success and spiritual practice), cooling the fires of stress reactivity, weaving positive experiences into the fabric of your brain and self, and taking life less personally.
More resources are freely offered at http://www.rickhanson.net.
Buddha's Brain: The Practical Neuroscience of Happiness, Love and Wisdom - Ri...Rick Hanson
How mental activity sculpts neural structure; the benefits and pitfalls of integrating neuroscience and psychotherapy; the neural substrates of self-compassion; and how to activate the lateral networks of mindful awareness.
More resources are freely offered at http://www.rickhanson.net.
Use Your Mind to Change Your Brain: Tools for Cultivating Happiness, Love and...Rick Hanson
Tools for well-being, grounded in cutting-edge science and the wisdom of the world’s contemplative traditions.
More resources are freely offered at http://www.rickhanson.net.
Self -Directed Neuroplasticity: Using the New Brain Research to Deepen Clinic...Rick Hanson
How mental activity sculpts neural structure; the benefits and pitfalls of integrating neuroscience and psychotherapy; the neural substrates of self-compassion; and how to activate the lateral networks of mindful awareness.
Mindfulness in Clinical Practice - Rick Hanson, PhDRick Hanson
On mindfulness as a concept, experience, and clinical tool for clinical and personal practice.
More resources are freely offered at http://www.rickhanson.net.
Buddha's Brain: Lighting up Your Own Circuits of Happiness, Love, and Wisdom ...Rick Hanson
How mental activity sculpts neural structure; the benefits and pitfalls of integrating neuroscience and psychotherapy; the neural substrates of self-compassion; and how to activate the lateral networks of mindful awareness.
More resources, freely offered at http://www.rickhanson.net
Using the Mind To Change the Brain: Talks @Google - Rick Hanson, PhDRick Hanson
Jesus, Moses, the Buddha, and other great teachers were all born with a brain built essentially like anyone else's. Then they used their minds to change their brains in ways that changed history. With the new breakthroughs in neuroscience, combined with insights from thousands of years of contemplative practice, you, too, can shape your own brain for greater happiness, love, and wisdom.
Written with neurologist Richard Mendius, M.D., and with a Foreword by Daniel Siegel, M.D. and a Preface by Jack Kornfield, Ph.D., Buddha's Brain: The Practical Neuroscience of Happiness, Love, and Wisdom joins modern science with ancient teachings to show you how to have greater emotional balance in turbulent times, as well as healthier relationships, more effective actions, and greater peace of mind.
http://amzn.to/oLTD3B
Use Your Mind to Change Your Brain: Tools for Cultivating Happiness, Love an...Rick Hanson
Tools for well-being, grounded in cutting-edge science and the wisdom of the world’s contemplative traditions.
More resources, freely offered at http://www.rickhanson.net
Whose Brain Is It, Anyway? Part I - Rick Hanson, PhDRick Hanson
Talk given at Hampton Boys School, London, England.
* How your brain works
* Why that matters
* What you can do about it
More resources, freely offered at http://www.rickhanson.net
Buddha's Brain: The Practical Neuroscience of Happiness, Love and WisdomRick Hanson
How mental activity sculpts neural structure; the benefits and pitfalls of integrating neuroscience and psychotherapy; the neural substrates of self-compassion; and how to activate the lateral networks of mindful awareness.
More resources, freely offered at http://www.rickhanson.net
Whose Brain Is It, Anyway? Part II - Rick Hanson, PhDRick Hanson
Talk given at Hampton Boys School, London, England.
* How your brain works
* Why that matters
* What you can do about it
More resources, freely offered at http://www.rickhanson.net
The Whole Holy Brain: Activating Integrative Processes in Your Nervous System...Rick Hanson
How you can use your mind to reshape your brain for the better, plus three specific ways to promote integrative processes in your brain.
More resources, freely offered at http://www.rickhanson.net
How the brain’s “negativity bias” makes clients overestimate threats, underestimate opportunities, and underestimate inner and outer resources, leading to anxiety, anger, depression, and conflicts with others – and how to help clients overcome that bias, see the good facts about the others, the world, and themselves, and build resilience for happiness, healthy relationships, and occupational success.
More resources, freely offered at http://www.rickhanson.net
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. Topics
Self-directed neuroplasticity
The power of mindfulness
Being on your own side
The evolving brain
Coming home to happiness
The negativity bias
Threat reactivity
Taking in the good
Clearing old pain
Your loving nature
Two wolves in the heart
Empathy
Compassion and lovingkindness
Relationship virtues
Assertiveness
4. Domains of Intervention
We can intervene in three domains:
World (including relationships)
Body
Mind
All three are important. And they work together.
We have limited influence over world and body.
In the mind:
Much more influence
Changes are with us wherever we go
5. The history of science is rich in the example
of the fruitfulness of bringing
two sets of techniques, two sets of ideas,
developed in separate contexts
for the pursuit of new truth,
into touch with one another.
J. Robert Oppenheimer
6. Common - and Fertile - Ground
Psychology Neurology
Contemplative Practice
7. When the facts change,
I change my mind, sir.
What do you do?
John Maynard Keynes
8. Being with, Releasing, Replacing
There are three phases of psychological healing and
personal growth (and spiritual practice):
Be mindful of, release, replace.
Let be, let go, let in.
Mindfulness is key to the second and third phase,
sometimes curative on its own, and always beneficial
in strengthening its neural substrates. But often it is
not enough by itself.
And sometimes you need to skip to the third phase to
build resources for mindfulness.
12. One Simple Neuron . . .
One neuron: on or off. A simple switch, yes?
13. The Connectome - 2
Hagmann, et al., 2008, PLoS Biology, 6:1479-1493.
14.
15.
16. All cells have specialized functions. Brain cells have
particular ways of processing information and
communicating with each other. Nerve cells form complete
circuits that carry and transform information.
Electrical signaling represents the language of mind, the
means whereby nerve cells, the building blocks of the brain,
communicate with one another over great distances. Nerve
cells generate electricity as a means of producing messages.
All animals have some form of mental life that reflects the
architecture of their nervous system.
16
Eric R. Kandel, 2006
17. The Mind/Brain System
“Mind” = flow of information within the nervous system:
Information is represented by the nervous system.
Most mind is unconscious; awareness is an aspect of mind.
The headquarters of the nervous system is the brain.
In essence then, apart from hypothetical transcendental
factors, the mind is what the brain does.
Brain = necessary, proximally sufficient condition for mind:
The brain depends on the nervous system, which intertwines
with and depends on other bodily systems.
These systems in turn intertwine with and depend upon nature
and culture, both presently and over time.
And as we’ll see, the brain also depends on the mind.
18. Evolution is a tinkerer. In living organisms, new capabilities
are achieved by modifying existing molecules slightly and
adjusting their interaction with other existing molecules.
Science has found surprisingly few proteins that are truly
unique to the human brain and no signaling systems that
are unique to it.
All life, including the substrate of our thoughts and
memories, is composed of the same building blocks.
18
Eric R. Kandel, 2006
19. We ask, “What is a thought?”
We don't know,
yet we are thinking continually.
Venerable Tenzin Palmo
20. Fact #1
As your brain changes, your mind changes.
21. Ways That Brain Can Change Mind
For better:
A little caffeine: more alertness
Thicker insula: more self-awareness, empathy
More left prefrontal activation: more happiness
For worse:
Intoxication; imbalances in neurotransmitters
Concussion, stroke, tumor, Alzheimer’s
Cortisol-based shrinkage of hippocampus: less
capacity for contextual memory
22. Fact #2
As your mind changes, your brain changes.
Immaterial mental activity co-occurs with, correlates
with material neural activity.
This produces temporary changes in your brain and
lasting ones. Temporary changes include:
Alterations in brainwaves (= changes in the firing
patterns of synchronized neurons)
Changing consumption of oxygen and glucose
Ebbs and flows of neurochemicals
25. Christian Nuns, Recalling a
Profound Spiritual Experience
Beauregard, et al., Neuroscience Letters, 9/25/06
26. Pain network: Dorsal anterior cingulate cortex (dACC), insula (Ins), somatosensory cortex (SSC),
thalamus (Thal), and periaqueductal gray (PAG). Reward network: Ventral tegmental area (VTA),
ventral striatum (VS), ventromedial prefrontal cortex (VMPFC), and amygdala (Amyg). K. Sutliff, in
Lieberman & Eisenberger, 2009, Science, 323:890-891
27. Mind Changes Brain in Lasting Ways
What flows through the mind sculpts your brain.
Immaterial experience leaves material traces behind.
Increased blood/nutrient flow to active regions
Altered epigenetics (gene expression)
“Neurons that fire together wire together.”
Increasing excitability of active neurons
Strengthening existing synapses
Building new synapses; thickening cortex
Neuronal “pruning” - “use it or lose it”
28. Lazar, et al. 2005.
Meditation
experience is
associated
with increased
cortical thickness.
Neuroreport, 16,
1893-1897.
29. Some Physical Effects of Meditation
Thickens and strengthens the anterior (frontal) cingulate cortex
and the insula. Those regions are involved with controlled
attention, empathy, and compassion – and meditation improves
those functions.
Less cortical thinning with aging
Increases activation of the left frontal regions, which lifts mood
Increases the power and reach of fast, gamma brainwaves
Decreases stress-related cortisol
Stronger immune system
30. Honoring Experience
One’s experience matters.
Both for how it feels in the moment and for the
lasting residues it leaves behind, woven into
the fabric of a person’s brain and being.
31. Fact #3
You can use your mind
to change your brain
to change your mind for the better.
This is self-directed neuroplasticity.
How to do this, in skillful ways?
33. Self-Goodwill
All the great teachers have told us to be compassionate and
kind toward all beings. And that whatever we do to the world
affects us, and whatever we do to ourselves affects the world.
You are one of the “all beings!” And kindness to yourself
benefits the world, while hurting yourself harms the world.
It’s a general moral principle that the more power you have over
someone, the greater your duty is to use that power wisely.
Well, who is the one person in the world you have the greatest
power over? It’s your future self. You hold that life in your hands,
and what it will be depends on how you care for it.
Consider yourself as an innocent child, as deserving of care and
happiness as any other.
34. If one going down into a river,
swollen and swiftly flowing,
is carried away by the current --
how can one help others across?
The Buddha
35. The good life, as I conceive it, is a happy life.
I do not mean that if you are good you will be happy;
I mean that if you are happy you will be good.
Bertrand Russell
36. Self-Compassion
Compassion is the wish that a being not suffer, combined with
sympathetic concern. Self-compassion simply applies that to
oneself. It is not self-pity, complaining, or wallowing in pain.
Studies show that self-compassion buffers stress and increases
resilience and self-worth.
But self-compassion is hard for many people, due to feelings of
unworthiness, self-criticism, or “internalized oppression.” To
encourage the neural substrates of self-compassion:
Get the sense of being cared about by someone else.
Bring to mind someone you naturally feel compassion for
Sink into the experience of compassion in your body
Then shift the compassion to yourself, perhaps with phrases like:
“May I not suffer. May the pain of this moment pass.”
37. “Anthem”
Ring the bells that still can ring
Forget your perfect offering
There is a crack in everything
That’s how the light gets in
That’s how the light gets in
Leonard Cohen
39. The Power of Mindfulness
Attention is like a spotlight, illuminating what it rests upon.
Because neuroplasticity is heightened for what’s in the
field of focused awareness, attention is also like a vacuum
cleaner, sucking its contents into the brain.
Directing attention skillfully is therefore a fundamental way
to shape the brain - and one’s life over time.
The education of attention
would be the education par excellence.
William James
40. How the Brain Pays Attention
Key functions:
Holding onto information
Updating awareness
Seeking stimulation
Key mechanisms:
Dopamine and the gate to awareness
The basal ganglia stimostat
41. Challenges to Mindfulness and Concentration
We evolved continually scanning, shifting, wide focus
attention in order to survive: “monkey mind.”
This generic, hard-wired tendency varies in the
normal range of temperament, extending from
“turtles” to “jackrabbits.”
Life experiences - in particular, painful or traumatic
ones - can heighten scanning and distractibility.
Modern culture - with its fire hose of information and
routine multi-tasking - leads to stimulation-hunger
and divided attention.
42. Individual Differences in Attention
Holding Updating Seeking
Information Awareness Stimulation
High Obsession Porous filters Hyperactive
Over-focusing Distractible Thrill-seeking
Overload
Mod Concentrates Flexible Enthusiastic
Divides attention Assimilation Adaptive
Accommodation
Low Fatigues w/Conc. Fixed views Stuck in a rut
Small WM Oblivious Apathetic
Low learning Lethargic
43. Basics of Meditation
Relax
Posture that is comfortable and alert
Simple good will toward yourself
Awareness of your body
Focus on something to steady your attention
Accepting whatever passes through
awareness, not resisting it or chasing it
Gently settling into peaceful well-being
44. 7 Neural Factors of Mindfulness
Setting an intention - “top-down” frontal, “bottom-up” limbic
Relaxing the body - parasympathetic nervous system
Feeling cared about - social engagement system
Feeling safer - inhibits amygdala/ hippocampus alarms
Encouraging positive emotion - dopamine, norepinephrine
Panoramic view - lateral networks
Absorbing the benefits - positive implicit memories
45. Increased Medial PFC Activation
Related to Self-Referencing Thought
Gusnard D. A., et.al. 2001. PNAS, 98:4259-4264
46. Self-Focused (blue) and Open Awareness (red) Conditions
(in the novice, pre MT group)
Farb, et al. 2007. Social Cognitive Affective Neuroscience, 2:313-322
47. Self-Focused (blue) vs Open Awareness (red) Conditions
(following 8 weeks of MT)
Farb, et al. 2007. Social Cognitive Affective Neuroscience, 2:313-322
48. Ways to Activate Lateral Networks
Relax.
Focus on bare sensations and perceptions.
Sense the body as a whole.
Take a panoramic, “bird’s-eye” view.
Engage “don’t-know mind”; release judgments.
Don’t try to connect mental contents together.
Let experience flow, staying here now.
Relax the sense of “I, me, and mine.”
49. Whole Body Awareness
Sense the breath in one area (e.g., chest, upper lip)
Sense the breath as a whole: one gestalt, percept
Sense the body as a whole, a whole body breathing
Sense experience as a whole: sensations, sounds,
thoughts . . . all arising together as one unified thing
It’s natural for this sense of the whole to be present
for a second or two, then crumble; just open up to it
again and again.
50. Panoramic Awareness
Recall a bird’s-eye view (e.g., mountain, airplane)
Be aware of sounds coming and going in an open
space of awareness, without any edges: boundless
Open to other contents of mind, coming and going
like clouds moving across the sky.
Pleasant or unpleasant, no matter: just more clouds
No cloud ever harms or taints the sky.
51. Dual Modes
“Doing” “Being”
Mainly representational Mainly sensory
Much verbal activity Little verbal activity
Abstract Concrete
Future- or past-focused Now-focused
Goal-directed Nothing to do, nowhere to go
Sense of craving Sense of peace
Personal, self-oriented perspective Impersonal, 3rd person perspective
Focal view Panoramic view
Firm beliefs Uncertainty, not-knowing
Evaluative Nonjudgmental
Lost in thought, mind wandering Mindful presence
Reverberation and recursion Immediate and transient
Tightly connected experiences Loosely connected experiences
Prominent self-as-object Minimal or no self-as-object
Prominent self-as-subject Minimal or no self-as-subject
52. “Bahiya, you should train yourself thus.”
In reference to the seen, there will be only the seen. To the heard,
only the heard. To the sensed, only the sensed. To the cognized,
only the cognized.
When for you there will be only the seen in reference to the seen,
only the heard in the heard, only the sensed in the sensed, only
the cognized in the cognized, then, Bahiya, there’s no you in
that.
When there’s no you in that, there’s no you there. When there’s no
you there, you are neither here nor yonder nor between the two.
This, just this, is the end of all suffering.
The Buddha
54. Evolution
~ 4+ billion years of earth
3.5 billion years of life
650 million years of multi-celled organisms
600 million years of nervous system
~ 200 million years of mammals
~ 60 million years of primates
~ 6 million years ago: last common ancestor with chimpanzees,
our closest relative among the “great apes” (gorillas,
orangutans, chimpanzees, bonobos, humans)
2.5 million years of tool-making (starting with brains 1/3 our size)
~ 150,000 years of homo sapiens
~ 50,000 years of modern humans
~ 5000 years of blue, green, hazel eyes
60. Reverse Engineering the Brain
What’s the nature of the brain when a person is:
In peak states of productivity or “flow?”
Experiencing inner peace?
Self-actualizing?
Enlightened (or close to it)?
61. Home Base of the Human Brain
When not threatened, ill, in pain, hungry, upset, or
chemically disturbed, most people settle into being:
Calm (the Avoid system)
Contented (the Approach system)
Caring (the Attach system)
Creative - synergy of all three systems
This is the brain in its natural, responsive mode.
63. Behind the Obscurations
Sam sees “peeping among the cloud-wrack . . . a white star
twinkle for a while.
The beauty of it smote his heart, as he looked up out of the
forsaken land, and hope returned to him.
For like a shaft, clear and cold, the thought pierced him that
in the end the Shadow was only a small and passing thing:
there was light and high beauty forever beyond its reach.”
Tolkein, The Lord of the Rings
64. Some Benefits of Responsive Mode
Recovery from “mobilizations” for survival:
Refueling after depleting outpourings
Restoring equilibrium to perturbed systems
Reinterpreting negative events in a positive frame
Reconciling after separations and conflicts
Promotes prosocial behaviors:
Experiencing safety decreases aggression.
Experiencing sufficiency decreases envy.
Experiencing connection decreases jealousy.
We’re more generous when our own cup runneth over.
65. But to Cope with Urgent Needs,
We Leave Home . . .
Avoid: When we feel threatened or harmed
Approach: When we can’t attain important goals
Attach: When we feel isolated, disconnected,
unseen, unappreciated, unloved
This is the brain in its reactive mode of functioning
- a kind of inner homelessness.
67. Reactive Dysfunctions in Each System
Avoid - Anxiety disorders; PTSD; panic, terror;
rage; violence
Approach - Addiction; over-drinking, -eating, -
gambling; compulsion; hoarding; driving for goals at
great cost; spiritual materialism
Attach - Borderline, narcissistic, antisocial PD;
symbiosis; folie a deux; “looking for love in all the
wrong places”
69. Negativity Bias: Causes in Evolution
“Sticks” - Predators, natural hazards, social
aggression, pain (physical and psychological)
“Carrots” - Food, sex, shelter, social support,
pleasure (physical and psychological)
During evolution, avoiding “sticks” usually had more
effects on survival than approaching “carrots.”
Urgency - Usually, sticks must be dealt with immediately,
while carrots allow a longer approach.
Impact - Sticks usually determine mortality, carrots not; if
you fail to get a carrot today, you’ll likely have a chance at a
carrot tomorrow; but if you fail to avoid a stick today - whap!
- no more carrots forever.
70. Negativity Bias: Some Consequences
Negative stimuli get more attention and processing.
We generally learn faster from pain than pleasure.
People work harder to avoid a loss than attain an
equal gain (“endowment effect”)
Easy to create learned helplessness, hard to undo
Negative interactions: more powerful than positive
Negative experiences sift into implicit memory.
71. Negative Experiences Can Have Benefits
A place for negative emotions:
Anxiety alerts us to inner and outer threats
Sorrow opens the heart
Remorse helps us steer a virtuous course
Anger highlights mistreatment; energizes to handle it
Negative experiences can:
Increase tolerance for stress, emotional pain
Build grit, resilience, confidence
Increase compassion and tolerance for others
72. Health Consequences of Chronic Stress
Physical:
Weakened immune system
Inhibits GI system; reduced nutrient absorption
Reduced, dysregulated reproductive hormones
Increased vulnerabilities in cardiovascular system
Disturbed nervous system
Mental:
Lowers mood; increases pessimism
Increases anxiety and irritability
Increases learned helplessness (especially if no escape)
Often reduces approach behaviors (less so for women)
Primes aversion (due to SNS-HPAA negativity bias)
73. Neural Consequences of Negative Experiences
Amygdala initiates stress response (“alarm bell”)
Hippocampus:
Forms and retrieves contextual memories
Inhibits the amygdala
Inhibits cortisol production
Cortisol:
Stimulates and sensitizes the amygdala
Inhibits and can shrink the hippocampus
Consequently, chronic negative experiences:
Sensitize the amygdala alarm bell
Weaken the hippocampus: this reduces memory capacities and the
inhibition of amygdala and cortisol production
Thus creating vicious cycles in the NS, behavior, and mind
74.
75. Neural Consequences of Negative Experiences
Amygdala initiates stress response (“alarm bell”)
Hippocampus:
Forms and retrieves contextual memories
Inhibits the amygdala
Inhibits cortisol production
Cortisol:
Stimulates and sensitizes the amygdala
Inhibits and can shrink the hippocampus
Consequently, chronic negative experiences:
Sensitize the amygdala alarm bell
Weaken the hippocampus: this reduces memory capacities and the
inhibition of amygdala and cortisol production
Thus creating vicious cycles in the NS, behavior, and mind
77. A Major Result of the Negativity Bias:
Threat Reactivity
Two mistakes:
Thinking there is a tiger in the bushes when there isn’t one.
Thinking there is no tiger in the bushes when there is one.
We evolved to make the first mistake a hundred
times to avoid making the second mistake even once.
This evolutionary tendency is intensified by
temperament, personal history, culture, and politics.
Threat reactivity affects individuals, couples, families,
organizations, nations, and the world as a whole.
78. Results of Threat Reactivity
(Personal, Organizational, National)
Our initial appraisals are mistaken:
Overestimating threats
Underestimating opportunities
Underestimating inner and outer resources
We update these appraisals with information that
confirms them; we ignore, devalue, or alter
information that doesn’t.
Thus we end up with views of ourselves, others, and
the world that are ignorant, selective, and distorted.
79. Costs of Threat Reactivity
(Personal, Organizational, National)
Feeling threatened feels bad, and triggers stress consequences.
We over-invest in threat protection.
The boy who cried tiger: flooding with paper tigers makes it
harder to see the real ones.
Acting while feeling threatened leads to over-reactions, makes
others feel threatened, and creates vicious cycles.
The Approach system is inhibited, so we don’t pursue
opportunities, play small, or give up too soon.
In the Attach system, we bond tighter to “us,” with more fear and
anger toward “them.”
80. A Poignant Truth
Mother Nature is tilted toward producing gene copies.
But tilted against personal quality of life.
And at the societal level, we have caveman/cavewoman
brains armed with nuclear weapons.
What shall we do?
86. Just having positive experiences is not enough.
They pass through the brain like water through a
sieve, while negative experiences are caught.
We need to engage positive experiences actively to
weave them into the brain.
87. How to Take in the Good
1. Look for positive facts and let them become positive
experiences.
2. Savor the experience:
Sustain it.
Have it be emotional and sensate.
Intensify it.
3. Sense that the positive experience is soaking into
your brain and body - registering deeply in emotional
memory.
88. Targets of TIG
Bodily states - healthy arousal; PNS; vitality
Emotions
Views - expectations; object relations; perspectives
on self, world, past and future
Behaviors - reportoire; inclinations
89. Kinds of “Good” to Take in
Things are alright; nothing is wrong; there is no threat
Feeling safe and strong
The peace and relief of forgiveness
The small pleasures of ordinary life
The satisfaction of attaining goals or recognizing accomplishments -
especially small, everyday ones
Feeling grateful, contented, and fulfilled
Being included, valued, liked, respected, loved by others
The good feelings that come from being kind, fair, generous
Feeling loving
Recognizing your positive character traits
Spiritual or existential realizations
90. Psychological Antidotes
Avoiding Harms
Strength, efficacy --> Weakness, helplessness, pessimism
Safety, security --> Alarm, anxiety
Compassion for oneself and others --> Resentment, anger
Approaching Rewards
Satisfaction, fulfillment --> Frustration, disappointment
Gladness, gratitude --> Sadness, discontentment, “blues”
Attaching to “Us”
Attunement, inclusion --> Not seen, rejected, left out
Recognition, acknowledgement --> Inadequacy, shame
Friendship, love --> Abandonment, feeling unloved or unlovable
91. Why It’s Good to Take in the Good
Rights an unfair imbalance, given the negativity bias
Gives oneself today the caring and support one should have
received as a child, but perhaps didn’t get in full measure; an
inherent, implicit benefit
Increases positive resources, such as:
Postive emotions
Capacity to manage stress and negative experiences
Can help bring in missing “supplies” (e.g., love, strength, worth)
Can help painful, even traumatic experiences
92. Benefits of Positive Emotions
The benefits of positive emotions are a proxy for
many of the benefits of TIG.
Emotions organize the brain as a whole, so positive
ones have far-reaching benefits
These include:
Stronger immune system; less stress-reactive cardiovascular
Lift mood; increase optimism, resilience
Counteract trauma
Promote exploratory, “approach” behaviors
Create positive cycles
93. How to use taking in the good
for healing painful, even traumatic experiences?
95. Equanimity is a perfect, unshakeable balance of mind.
Nyanaponika Thera
With equanimity, you can deal with situations with calm and
reason while keeping your inner happiness.
The Dalai Lama
96. Balanced, Steady, Present
Balance - not reacting to fleeting experiences
Steadiness - sustained through all circumstances
Presence - engaged with the world but not troubled
by it; guided by values and virtues, not reactions
The ancient circuitry of the brain continually triggers
reactions. Equanimity is the circuit breaker that
prevents the craving that leads to suffering.
97. Whose mind is like rock, steady, unmoved,
dispassionate for things that spark passion,
unangered by things that spark anger:
When one's mind is developed like this,
from where can there come suffering & stress?
The Buddha, Udāna 4.34
98. Indeed, the sage who's fully quenched
Rests at ease in every way;
No sense desire adheres to him or her
Whose fires have cooled, deprived of fuel.
All attachments have been severed,
The heart's been led away from pain;
Tranquil, he or she rests with utmost ease.
The mind has found its way to peace.
The Buddha
102. Equanimity in the Brain
Steadiness of mind - Sustained by oversight from the anterior
cingulate cortex (ACC); over time, probably becomes a whole-
brain stability of attention
Understanding and intention - Conceptual in prefrontal cortex;
embodied in prefrontal cortex (action tendencies), parietal cortex
(perspective), limbic system (emotion), and brainstem (arousal)
Global coherence - So as not to be caught by anything,
experience presents itself as a coherent whole, probably
enabled by large-scale gamma wave synchronization.
Calm and contentment - Much parasympathetic activation,
inhibiting fight-flight stress reactions; underlying well-being in the
core motivational systems (Avoid, Approach, Attach)
104. Ceaseless Change
Everything changes:
Big Bang, galaxies, sun, earth, mountains, rivers, wind
Molecules, atoms, photons, quantum particles
Life: microbes, sponges, mammals, primates, humans
Societies, traffic, politics
The body: breath, digestion, hormones, cells, synapses
The mind: thought, feeling, hopes, fears, consciousness
Relationships: closeness and distance, friends and rivals
We live at the edge of a waterfall, everything
changing as it rushes past in this razor-thin instant of
Now - already gone as soon as we recognize it.
106. Interdependence
Everything arises and passes away dependent on
conditions. As the Buddha put it: “When this is, that
is; when this is not, that is not.”
This means that:
Things happen in a vast network of causes.
Everything is related to everything else.
Nothing has absolute self-existence, including “I.”
Boundaries are relative, not absolute. The body continually
exchanges molecules with the world, people influence each
other, thoughts blur into each other inside the mind.
107. Eight Worldly Winds
Pleasure and pain
Praise and blame
Gain and loss
Fame and ill repute
108. The Chain of Suffering
Contact: An external or internal stimulus
Feeling: The “hedonic tone” of pleasant, unpleasant, or neutral;
likes and dislikes
Craving: Wanting what you like to continue and what you dislike
to end; tanha - thirst - in Pali
Clinging: The elaboration of craving
Suffering: Discomfort related to wanting (e.g., tension, anxiety,
pressure, frustration, disappointment, longing, sadness,
remorse, anger)
109. The First and Second Dart
The Buddha referred to unavoidable discomfort - including disease, old
age, death, and sorrow at harms befalling others - as the “first dart.”
Then we add our reactions to that first dart. For example, one could
react to a physical pain with anxiety, then anger at oneself for feeling
anxious, then sadness linked to not being comforted as a child.
Sometimes we react with suffering when there is no first dart at all,
simply a condition that there is no need to get upset about.
And sometimes we react with suffering to positive events, such as a
compliment or an opportunity.
The Buddha called these reactions “second darts” - the ones we throw
ourselves.
110. When the uninstructed worldling experiences a painful
feeling, he or she sorrows, grieves, and laments; he or she
weeps beating the breast and becomes distraught. He or
she feels two feelings - a bodily one and a mental one.
Suppose they were to strike a person with a dart, and then
strike him immediately afterward with a second dart, so
that the person would feel a feeling caused by two darts.
So too, when the uninstructed worldling experiences a
painful feeling, the person feels two feelings - a bodily one
and a mental one.!
The Buddha, SN 36:6
111. Disenchantment
The brain routinely simulates possible events and the
experiences you could have if they occur. This was a
major evolutionary accomplishment that promoted
planning and learning.
But this also makes you suffer: it “enchants” you with
exaggerated anticipated pleasures and pains, and
makes you invest in strategies to deal with these.
Instead, recognize the truth of your experience:
pleasures are usually not that great and pains are
usually not that bad. Intend to wake up from the spell.
113. First Aid for Upsets
Pause
Self-compassion
Get on your own side
Make a plan
Take action - thought, word, and deed
114. Parasympathetic Nervous System
The “rest-and-digest” parasympathetic nervous
system (PNS) balances and dials down the “fight-or-
flight” sympathetic nervous system.
It soothes, resets, renews the body-mind. Though the
SNS gets more press, the PNS is more primary.
115. Cooling the Fires
Recognize that stress is not good for you. Get on
your own side to prevent and minimize it.
Cultivate relaxation and calm in your resting state.
When you get stressed, activating a PNS, “cooling”
cascade:
Inhale super-fully; hold it; l-o-n-g exhalation; repeat
Relax the tongue
Touch the lips
Relax the body
116. Feeling Stronger and Safer
Be mindful of an experience of strength (e.g., physical
challenge, standing up for someone).
Staying grounded in strength, let things come to you without
shaking your roots, like a mighty tree in a storm.
Be mindful of:
Protections (e.g., being in a safe place, imagining a shield)
People who care about you
Resources inside and outside you
Let yourself feel as safe as you reasonably can:
Noticing any anxiety about feeling safer
Feeling more relaxed, tranquil, peaceful
Releasing bracing, guardedness, vigilance
117. Elemental Safety
Fear learning associates an inherently unpleasant stimulus - the
“unconditioned stimulus” (US) - with a “conditioned stimulus”
(CS) that is not inherently aversive - e.g., rats trained to expect
an awful noise (US) following a puff of air (CS).
Living itself can become the conditioned stimulus for anxious
people.
What’s needed are many small moments of associating basic
parasympathetic alrightness to life: this breath is alright; this
interaction is alright; I’m actually alright even if there is anxiety.
Repeatedly practice feeling safe while engaged in basic, simple,
brief bodily activities, such as touching, breathing, chewing,
walking, hearing, seeing, etc.
118. A Serenity Prayer
May I find the serenity to accept the things that cannot be changed,
the courage to change the things which should be changed,
and the Wisdom to distinguish the one from the other.
Living one day at a time,
Enjoying one moment at a time,
Accepting hardship as a pathway to peace,
Taking this imperfect world as it is,
Not as I would have it,
Trusting in my refuges,
May I be reasonably happy in this life,
And supremely happy forever some day.
Adapted from the Serenity Prayer, by Reinhold Niebuhr (1892-1971)
120. Liking and Wanting
Distinct neural systems for liking and wanting
In the brain: feeling/hedonic tone --> enjoying (liking)
--> wanting --> pursuing
Wanting without liking is hell.
Liking without wanting is heaven.
The distinction between chandha (wholesome wishes
and aspirations) and tanha (craving)
But beware: the brain usually wants (craves) and
pursues (clings to) what it likes.
121. The Great Way is easy.
For one with no preferences.
Third Zen Patriarch
122. I make myself rich by making my wants few.
Henry David Thoreau
123. Practicing with Wanting
Positive wants (e.g., practice, sobriety, love, aspirations) crowd
out negative ones.
Surround pleasant or unpleasant hedonic tones with spacious
awareness - the “shock absorber” - without tipping into craving.
Regard wants as just more mental content. Investigate them.
Watch them come and go. No compulsion, no “must.”
Be skeptical of predicted rewards - simplistic and inflated, from
primitive subcortical regions. Explore healthy disenchantment.
Pick a key want and just don’t do it.
124. Feeling Rewarded
What is already going alright in your life?
What goals have you recently attained? What things
have you recently accomplished?
What are you glad about?
What are you grateful for?
126. Using Memory Mechanisms to Help Heal Painful Experiences
The machinery of memory:
When explicit or implicit memory is re-activated, it is re-built from schematic
elements, not retrieved in toto.
When attention moves on, elements of the memory get re-consolidated.
The open processes of memory activation and consolidation create a
window of opportunity for shaping your internal world.
Activated memory tends to associate with other things in awareness
(e.g., thoughts, sensations), esp. if they are prominent and lasting.
When memory goes back into storage, it takes associations with it.
You can imbue implict and explicit memory with positive associations.
127. The Fourth Step of TIG
When you are having a positive experience:
Sense the current positive experience sinking down into old pain,
and soothing and replacing it.
When you are having a negative experience:
Bring to mind a positive experience that is its antidote.
In both cases, have the positive experience be big and strong, in
the forefront of awareness, while the negative experience is
small and in the background.
You are not resisting negative experiences or getting attached
to positive ones. You are being kind to yourself and cultivating
wholesomeness of mind.
129. Practicing with Rejection and Hurt
RAINBOW:
Recognize the experience
Accept that it is what it is
Investigate it: textures and layers
Not-self it: observe it without identifying with it; see its
compounded nature; see the vast stream of causes of it
Breathe and let go; activate PNS; release “wrong views”
Open to new perspectives, feelings, and plans; find refuge
Welcome that new wisdom into your being: take in the good so it
becomes part of you
131. The Social Brain
Social capabilities have been a primary driver of brain evolution.
Reptiles and fish avoid and approach. Mammals and birds
attach as well - especially primates and humans.
Mammals and birds have bigger brains than reptiles and fish.
The more social the primate species, the bigger the cortex.
Since the first hominids began making tools ~ 2.5 million years
ago, the brain has roughly tripled in size, much of its build-out
devoted to social functions (e.g., cooperative planning, empathy,
language). The growing brain needed a longer childhood, which
required greater pair bonding and band cohesion.
132. All sentient beings developed through natural
selection in such a way that pleasant
sensations serve as their guide, and
especially the pleasure derived from
sociability and from loving our families.
Charles Darwin
133.
134.
135.
136.
137.
138.
139.
140.
141.
142.
143.
144.
145.
146.
147.
148.
149.
150.
151.
152. Ananda approached the Buddha and said,
“Venerable sir, this is half of the spiritual life:
good friendship, good companionship, good
comradeship.”
“Not so, Ananda! Not so Ananda!” the Buddha
replied. “This is the entire spiritual life. When you
have a good friend, a good companion, a good
comrade, it is to be expected that you will develop
and cultivate the Noble Eightfold Path.”
[adapted from In the Buddha’s Words, Bhikkhu Bodhi]
153. In the cherry blossom’s shade
there is no thing
as a stranger
Issa
154.
155. If there is anything I have learned about [people], it is that
there is a deeper spirit of altruism than is ever evident.
Just as the rivers we see are minor compared to the
underground streams, so, too, the idealism that is visible is
minor compared to what people carry in their hearts
unreleased or scarcely released.
(Hu)mankind is waiting and longing for those who can
accomplish the task of untying what is knotted, and
bringing these underground waters to the surface.
Albert Schweitzer
161. Us and Them
Core evolutionary strategy: within-group cooperation, and
between-group aggression.
Both capacities and tendencies are hard-wired into our brains,
ready for activation. And there is individual variation.
Our biological nature is much more inclined toward cooperative
sociability than toward aggression and indifference or cruelty.
We are just very reactive to social distinctions and threats.
That reactivity is intensified and often exploited by economic,
cultural, and religious factors.
Two wolves in your heart:
Love sees a vast circle in which all beings are “us.”
Hate sees a small circle of “us,” even only the self.
Which one will you feed?
162. In between-family fights, the baboon’s ‘I’
expands to include all of her close kin;
in within-family fights,
it contracts to include only herself.
This explanation serves for baboons
as much as for the Montagues and Capulets.
Dorothy Cheney and Robert Seyfarth
163. Feeding the Wolf of Love
Focus on similarities between “us” and “them.”
Consider others as young children.
Notice good things about neutral or unpleasant people.
Bring to mind the sense of someone who cares about you.
Keep extending out the sense of “us” to include everyone.
Consider others as your mother or dear friend in a past life.
Restraint about over-identifying with “us”
Reflect on the suffering of so many people in the world.
Self-generate feelings of kindness and love.
165. What Is Empathy?
It is sensing, feeling, and understanding how it is for
the other person. In effect, you simulate his or her
inner world.
It involves (sometimes subtly) all of these elements:
Bodily resonance
Emotional attunement
Conceptual understanding
Empathy is usually communicated, often tacitly.
We can give empathy, we can receive it, and we can
ask for it.
166. Neural Substrates of Empathy
Three simulating systems:
Actions: “mirror” systems; temporal-parietal
Feelings: resonating emotionally; insula
Thoughts: “theory of mind”; prefrontal cortex
These systems interact with each other through
association and active inquiry.
They produce an automatic, continual re-creation of
aspects of others’ experience.
167. Empathy Skills
Pay attention.
Be open.
Read emotion in face and eyes.
Sense beneath the surface.
Drop aversion (judgments, distaste, fear, anger, withdrawal).
Investigate actively.
Express empathic understanding:
Reflect the content
Resonate with the tone and implicit material
Questions are fine
Offer respect and wise speech throughout
168. Can you attend to the postures, facial expressions,
and movements of another person?
Can you attune to and feel something of the
emotions of another person?
Can you have some sense of the thoughts, hopes,
and concerns of another person?
169. Reflections about Empathy
You’re more likely to get empathy if you’re:
Open, present
Honest, real, authentic
Reasonably clear
Responsible for your own experience
Taking it in when you feel felt
Empathy can be negotiated:
Name it as a topic in the relationship
Follow NVC format: “When X happens, I feel Y,
because I need Z. So I request ______ .”
Stay with it.
170. If we could read the secret history
of our enemies,
we should find in each [person's] life
sorrow and suffering enough
to disarm any hostility.
Henry Wadsworth Longfellow
173. The Wisdom of Connection
A human being is a part of a whole, called by us“universe,” a
part limited in time and space. He experiences himself, his
thoughts and feelings as something separated from the
rest... a kind of optical delusion of his consciousness.
This delusion is a kind of prison for us, restricting us to our
personal desires and to affection for a few persons nearest
to us.
Our task must be to free ourselves from this prison by
widening our circle of compassion to embrace all living
creatures and the whole of nature in its beauty.
Albert Einstein
174. The Buddha’s Words on Lovingkindness
Wishing: In gladness and in safety, may all beings be at ease.
Omitting none, whether they are weak or strong, the great or the
mighty, medium, short, or small, the seen and the unseen, those
living near and far away, those born and to-be-born: May all beings
be at ease.
Let none through anger or ill-will wish harm upon another. Even as a
mother protects with her life her child, her only child, so with a
boundless heart should one cherish all living beings; radiating
kindness over the entire world: spreading upwards to the skies, and
downwards to the depths, outwards and unbounded, freed from
hatred and ill-will.
One should sustain this recollection.
This is said to be the sublime abiding.
175. When others address you, their speech may be timely or untimely, true or
untrue, gentle or harsh, connected with good or harm, and connected
with a mind of loving-kindness or inner hate.
You should train thus: My mind will remain unaffected, and I shall utter
no evil words; I shall abide compassionate for their welfare, pervading
them with a mind of loving-kindness, and pervading the all-
encompassing world with a mind that is abundant, exalted,
immeasurable, without hostility and without ill will.
Even if bandits were to sever you savagely limb by limb with a two-
handled saw, anyone giving rise to a mind of hate would not be
carrying out my teaching.
You should train thus: My mind will remain unaffected, and I shall utter
no evil words; I shall abide compassionate for their welfare, pervading
them with a mind of loving-kindness, and pervading the all-
encompassing world with a mind that is abundant, exalted,
immeasurable, without hostility and without ill will.
The Buddha [adapted from The Simile of the Saw, trans. Bhikkhu Bodhi
176. Lovingkindness Practice
Types of wishes
Safety
Health
Happiness
Ease
Types of beings
Self
Benefactor
Friend
Neutral
Difficult
Continually “omitting none” in all directions
177. Feeding the Wolf of Love
Focus on similarities between “us” and “them.”
Consider others as young children.
Notice good things about neutral or unpleasant people.
Bring to mind the sense of someone who cares about you.
Keep extending out the sense of “us” to include everyone.
Consider others as your mother or dear friend in a past life.
Restraint about over-identifying with “us”
Reflect on the suffering of so many people in the world.
Self-generate feelings of kindness and love.
180. There are those who do not realize that
one day we all must die.
But those who do realize this
settle their quarrels.
The Buddha
181. If you let go a little,
you will have a little happiness.
If you let go a lot,
you will have a lot of happiness.
If you let go completely,
you will be completely happy.
Ajahn Chah
182. Benefits of Unilateral Virtue
It simplifies things: all you have to do is live by your
own code, and others will do whatever they do.
It feels good in its own right; it brings peace of mind,
“the bliss of blamelessness.”
It minimizes inflammatory triggers, and encourages
good behavior in others.
It stands you on the moral high ground.
It teaches you what you can ask for from others
184. Healthy Assertiveness
What it is: Speaking your truth and pursuing your aims
in the context of relationships
What supports it:
Being on your own side
Self-compassion
Naming the truth to yourself
Refuges: Three Jewels, reason, love, nature, God
Taking care of the big things so you don’t grumble
about the little ones
Health and vitality
185. Healthy Assertiveness:
How to Do It - 1
Know your aims; stay focused on the prize; lose
battles to win wars
Ground in empathy, compassion, and love
Practice unilateral virtue
186. Healthy Assertiveness:
How to Do It - 2
Communicate for yourself, not to change others
Wise Speech; be especially mindful of tone
NVC: “When X happens, I feel Y because I need Z.”
Dignity and gravity
Distinguish empathy building (“Y”) from policy-making
If appropriate, negotiate solutions
Establish facts as best you can (“X”)
Find the deepest wants (“Z”)
Focus mainly on “from now on”
Make clear plans, agreements
Scale relationships to their actual foundations
187. So that all cubs are our own . . .
So that all beings are our clan . . .
All life, our relatives . . .
The whole earth, our home . . .
May you know love, joy, wonder, and wisdom,
in this life, just as it is.
Thank you!
189. Great Books
See www.RickHanson.net for other great books.
Austin, J. 2009. Selfless Insight. MIT Press.
Begley. S. 2007. Train Your Mind, Change Your Brain. Ballantine.
Carter, C. 2010. Raising Happiness. Ballantine.
Hanson, R. (with R. Mendius). 2009. Buddha’s Brain: The Practical
Neuroscience of Happiness, Love, and Wisdom. New Harbinger.
Johnson, S. 2005. Mind Wide Open. Scribner.
Keltner, D. 2009. Born to Be Good. Norton.
Kornfield, J. 2009. The Wise Heart. Bantam.
LeDoux, J. 2003. Synaptic Self. Penguin.
Linden, D. 2008. The Accidental Mind. Belknap.
Sapolsky, R. 2004. Why Zebras Don’t Get Ulcers. Holt.
Siegel, D. 2007. The Mindful Brain. Norton.
Thompson, E. 2007. Mind in Life. Belknap.
190. Key Papers - 1
See www.RickHanson.net for other scientific papers.
Atmanspacher, H. & Graben, P. 2007. Contextual emergence of mental
states from neurodynamics. Chaos & Complexity Letters, 2:151-168.
Baumeister, R., Bratlavsky, E., Finkenauer, C. & Vohs, K. 2001. Bad is
stronger than good. Review of General Psychology, 5:323-370.
Braver, T. & Cohen, J. 2000. On the control of control: The role of
dopamine in regulating prefrontal function and working memory; in
Control of Cognitive Processes: Attention and Performance XVIII.
Monsel, S. & Driver, J. (eds.). MIT Press.
Carter, O.L., Callistemon, C., Ungerer, Y., Liu, G.B., & Pettigrew, J.D.
2005. Meditation skills of Buddhist monks yield clues to brain's
regulation of attention. Current Biology. 15:412-413.
191. Key Papers - 2
Davidson, R.J. 2004. Well-being and affective style: neural substrates and
biobehavioural correlates. Philosophical Transactions of the Royal Society.
359:1395-1411.
Farb, N.A.S., Segal, Z.V., Mayberg, H., Bean, J., McKeon, D., Fatima, Z., and
Anderson, A.K. 2007. Attending to the present: Mindfulness meditation reveals
distinct neural modes of self-reflection. SCAN, 2, 313-322.
Gillihan, S.J. & Farah, M.J. 2005. Is self special? A critical review of evidence
from experimental psychology and cognitive neuroscience. Psychological
Bulletin, 131:76-97.
Hagmann, P., Cammoun, L., Gigandet, X., Meuli, R., Honey, C.J., Wedeen, V.J.,
& Sporns, O. 2008. Mapping the structural core of human cerebral cortex. PLoS
Biology. 6:1479-1493.
Hanson, R. 2008. Seven facts about the brain that incline the mind to joy. In
Measuring the immeasurable: The scientific case for spirituality. Sounds True.
192. Key Papers - 3
Lazar, S., Kerr, C., Wasserman, R., Gray, J., Greve, D., Treadway, M.,
McGarvey, M., Quinn, B., Dusek, J., Benson, H., Rauch, S., Moore, C., & Fischl,
B. 2005. Meditation experience is associated with increased cortical thickness.
Neuroreport. 16:1893-1897.
Lewis, M.D. & Todd, R.M. 2007. The self-regulating brain: Cortical-subcortical
feedback and the development of intelligent action. Cognitive Development,
22:406-430.
Lieberman, M.D. & Eisenberger, N.I. 2009. Pains and pleasures of social life.
Science. 323:890-891.
Lutz, A., Greischar, L., Rawlings, N., Ricard, M. and Davidson, R. 2004. Long-
term meditators self-induce high-amplitude gamma synchrony during mental
practice. PNAS. 101:16369-16373.
Lutz, A., Slager, H.A., Dunne, J.D., & Davidson, R. J. 2008. Attention regulation
and monitoring in meditation. Trends in Cognitive Sciences. 12:163-169.
193. Key Papers - 4
Rozin, P. & Royzman, E.B. 2001. Negativity bias, negativity dominance, and
contagion. Personality and Social Psychology Review, 5:296-320.
Takahashi, H., Kato, M., Matsuura, M., Mobbs, D., Suhara, T., & Okubo, Y.
2009. When your gain is my pain and your pain is my gain: Neural correlates of
envy and schadenfreude. Science, 323:937-939.
Tang, Y.-Y., Ma, Y., Wang, J., Fan, Y., Feng, S., Lu, Q., Yu, Q., Sui, D.,
Rothbart, M.K., Fan, M., & Posner, M. 2007. Short-term meditation training
improves attention and self-regulation. PNAS, 104:17152-17156.
Thompson, E. & Varela F.J. 2001. Radical embodiment: Neural dynamics and
consciousness. Trends in Cognitive Sciences, 5:418-425.
Walsh, R. & Shapiro, S. L. 2006. The meeting of meditative disciplines and
Western psychology: A mutually enriching dialogue. American Psychologist,
61:227-239.
194. Where to Find Rick Hanson Online
http://www.youtube.com/BuddhasBrain
http://www.facebook.com/BuddhasBrain
w
www.RickHanson.net
www.WiseBrain.org 194