2. Lifting spirits. Holding hope.
Part I:
Meditation and Mindfulness
• Learning objectives
1. The Science of Meditation.
2. Why is it important?
3. How to Meditate. (Crash Course)
http://www.yalescientific.org/2012/05/the-healing-art-of-meditation/
3. Lifting spirits. Holding hope.
The Science of Meditation
Greater ACC (anterior cingulate cortex)
activation
Greater gray matter concentration in the
right anterior insula and temporo-parietal
junction
http://usatoday3
0.usatoday.com
/news/health/20
08-09-09-brain-
scan-
emotions_N.ht
m
7. Lifting spirits. Holding hope.
How does it work?
• Practice
“…when you are weight training, every time you flex your biceps in
resistance to the weight of the dumbbells, your bicep muscles grow a
little bit stronger. The same process happens during meditation. Every
time your attention wanders away from your breath and you bring it
back…your “muscle” of attention grows a bit stronger.”
8. Lifting spirits. Holding hope.
Meditation vs Day Dreaming
• “…paying attention in a particular way: on
purpose, in the present moment, non-
judgmentally” – Jon Kabat-Zinn
• “…keeping one’s consciousness alive to
the present reality…” – Thich Nhat
9. Lifting spirits. Holding hope.
The Philosophy
“When it is realized that no self is to be found in the
elements of our experience, it begins the process of
liberation. Understanding that our sense of “I” is not as
solid, permanent, or substantial as we habitually hold it to
be ultimately uproots clinging, attachment, and hostility.
Understanding this burns up the fuel that runs our repetitive
habits.” –Jack Engler
10. Lifting spirits. Holding hope.
How to start?
• Focus on breathing (meta-attention)
• Focus to promote a state of acceptance
and compassion for self and others- metta
meditation or Loving Kindness Meditation
11. Lifting spirits. Holding hope.
Metta-Meditation
• Why?
Forgiveness- “Forgiveness is a way of loosening the
grip of fixation, but I’ve seen over and over again that it is a
process. It is not decision, and it does not come about by
force of will…If we can find a way to forgive and free our
hearts, we are saying life is bigger, we are bigger, we are
stronger than the hurt and the feelings around it.”
–Sharon Salzburg
13. Lifting spirits. Holding hope.
Do you have 10 minutes a
day?!
This is not another infomercial to a
better you…well maybe it is.
14. Lifting spirits. Holding hope.
Reactions
• General – I did not know. I did know. I
have to add.
• Concerns – How am I going to add this
in to my time? Can I do this on my own?
• Enthusiasms
16. Lifting spirits. Holding hope.
Local To Winston? You’re in
Luck!
Meditation every Wednesday morning at 7:30AM for an
embodied, heart-centered practice. Cultivating authentic
self-love, loving-kindness and quiet mind.
18 Springs Center for Healing Body and Earth
2424 Reynolda Rd.
Winston-Salem, NC 27106
http://www.amandazabel.com/meditation.html
17. Lifting spirits. Holding hope.
Part II
Art and Self-Care
• Learning objectives
1. Art Therapy and Self Care
2. Music
3. Writing
4. Visual Arts
http://reginaholliday.blogspot.com/2012/05/pecking-
order.html
http://musicmakessense.blogspot.com
/2011/08/top-5-music-therapy-
activities-for-in.html
18. Lifting spirits. Holding hope.
Neuroscience of Art
• “Artistic contemplation and creation may be tentatively viewed as a
discrete and singular conscious synthesis taking place within the
personal global neuronal workspace of external perceptions, internal
memories and stored emotions” - Jean Pierre Changeux
http://www.rachelgoede.com/blog/2011/08/art-makes-people-
happy/
19. Lifting spirits. Holding hope.
Art and Self Care
Importance of Art Therapy and Self Care
• connect with their wholeness
• make peace with, discover, and respect the coherence of their life’s story
• seek reconciliation with alienated family, friends [coworkers, patients]
• give and receive love, forgiveness, appreciation, and expression of affection
• say good-byes (or, if you prefer, au revoir)
• complete relationships with others
• assure continuity, relationship, and meaning beyond death.
-Sandra Bertman
http://www.soulschoolonline.com/2013/05/empathy-
banishes-shame/
20. Lifting spirits. Holding hope.
“Since grief is not a cerebral problem but a subjective
experience, we understand grief only and entirely as we
filter and interpret it through our own experience. Initially it
captures us, but we can capture it back and reshape it;
and the expressive arts and therapies function beautifully
as vehicles to help us reshape grief. Ultimately, the
potential for healing in the midst of suffering exist because
grief is about creating and transforming bonds of
attachment, not severing them irrevocably.”
– Sandra Bertman
21. Lifting spirits. Holding hope.
Music
“A reader may say ‘I will not be able to tend my grief in the
ways you describe because I neither sing nor play an
instrument.’ However, the reality is that everyone can be a
listener. Only a minority compose or actively make music.
The rest of us listen to music-- and we join with the
composers and musicians in responding to sounds. There
is only silence until music is given sound." – Sallie Bailey
22. Lifting spirits. Holding hope.
Clive Wearing
• Suffered an infection that caused him to lose his ability to
retain memory and create new ones.
• Remembers his wife, remembers how to play the piano
and conduct.
23. Lifting spirits. Holding hope.
Great music plays the entire pianoforte of human
feelings
which are the memory carriers of the soul
as it sings and
suffers and
shapes its destiny.
-Willis Elliot
24. Lifting spirits. Holding hope.
Fix You by Coldplay
When you try your best, but you don't succeed
When you get what you want, but not what you need
When you feel so tired, but you can't sleep
Stuck in reverse
And the tears come streaming down your face
When you lose something you can't replace
When you love someone, but it goes to waste
Could it be worse?
Lights will guide you home
And ignite your bones
And I will try to fix you
And high up above or down below
When you're too in love to let it go
But if you never try you'll never know
Just what you're worth
Lights will guide you home
And ignite your bones
And I will try to fix you
Tears stream down your face
When you lose something you cannot replace
Tears stream down your face and I
Tears stream down your face
I promise you I will learn from my mistakes
Tears stream down your face and I
Lights will guide you home
And ignite your bones
And I will try to fix you
26. Lifting spirits. Holding hope.
For Katrina’s sun dial
By Henry Van Dyke
Time is too slow for those who wait,
Too swift for those who fear,
Too long for those who grieve,
Too short for those who rejoice,
But for those who love, time is
Eternity.
27. Lifting spirits. Holding hope.
• Silent Burial
By Janet Greene, RN
Loving in secret takes its toll.
Afraid to discover my twisted soul
which loves things without beauty,
I close the door hoping to find shelter.
Feeling the chill from the wind of people’s
voices,
I wrap my sweater to me,
And tuck my hands carefully in the cuffs.
Quietly I cherish someone others loathed to
touch.
Her mind grew like a crooked branch,
And her laugh had a silly shrill.
Restless eyes betrayed her childish spirit
That earned no wisdom over time.
Distance keeps my secret even in death.
May the earth
Gently bury my untidy companion,
And let me mourn in peace.
In Memory of Bertha Ann, 1984
Nursing is an art: and if it is to be made an art,
It requires an exclusive devotion as hard a
preparation, as any painter´s or sculptor´s work;
for what is the having to do with dead canvas or
dead marble, compared with having to do with the
living body, the temple of God´s spirit? It is one of
the Fine Arts: I had almost said, the finest of Fine
Arts.
by Florence Nightingale
32. Lifting spirits. Holding hope.
Discussion
Share-
• What does death sound like to you?
• What music helps with your own therapy?
• Dear Diary….
• Share any books or poems you have loved as an escape or way of processing.
• What artistic fancies do you have?
33. Lifting spirits. Holding hope.
Conclusion
Happiness is “a deep sense of
flourishing that arises from an
exceptionally healthy mind…not a mere
pleasurable feeling, a fleeting emotion,
or mood, but an optimal state of
being…a profound emotional balance
struck by a subtle understanding of how
the mind functions.”
-Ricard Matthieu PhD
Molecular Genetics, Tibetan
Buddhist Monk
34. Lifting spirits. Holding hope.
Works Cited:
Medina, J. (2008) Brain Rules. Pear Press. Seattle, WA.
Tan, Chade-Meng. (2012) Search Inside Yourself; the unexpected path to achieving success, happiness (and world
peace). Harper One. New York, NY.
Bertman, S. (1999) Grief and the Healing Arts; Creativity as therapy. Baywood Publishing, Amityville, NY.
Garrison, K., Zeffiro, T., Scheinost, D., Constable, T. and Brewer, J. (2015) Meditation leads to reduction default mode
network activity beyond an active task. Cognitive Affect Behavior Neuroscience. DOI; 10.3758/s13415-
015- 0358-3
Garrison, K., Scheinost, D., Constable, T. and Brewer, J. (2014) BOLD signal an functional connectivity associated with
loving kindness meditation. Brain and behavior. DOI: 10.1002/brb3.219
Hozel, B., Lazar, S., Gard, T., Schuman-Olivier, Z., Vago, D. and Ott, U. (2011) How does mindfulness meditation
work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on
Psychological Science. 6(6). p. 537-559.
Garrison, K., Dustin, S., Worhunsky, P., Elwafi, H., Thornhill IV, T., Thompson, E., Saron, C., Desbordes, G., Kober, H.,
Hampson, M., Gray, J., Constable, T., Papademetris, X., Brewer, J. (2013) Real-time fMRI links
Subjective experience with brain activity during focused attention. NeuroImage. 81. p. 110-118
Changeux, J. (2010) The Neuroscience of Art: A research program for the next decade? Medical Hypotheses 75(1)
In 7-8 week studies on meditation, novice meditators were shown to have greater activation and connectivity in areas of the brain that control body awareness, emotional regulation, fear response, empathy and focus. Increase activities in the right ventrolateral prefrontal cortex and medial prefrontal cortex specifically help with emotional regulation, while other studies show increased activation in the ventromedial prefrontal cortex that helps the brain use more of its circuitry, again for managing emotions. Greater ACC activation helps with focus, while gray matter concentration helps with first-person perspective (mitigating issues with body dysmorphia and pain regulation) and the insula and temporo-parietal junctions specifically with empathy. Meditators in 7-8 week studies had reductions in emotional interference and physiological reactivity during tasks, or impulse control and “flight or fight” responses. Meditation and the practice of meditation has been neurologically shown to improve your mental processing.
Sitting still and focusing on your attention is actually not a bunch of hippy, feel good nonsense.
Successful medical and technological industries are incorporating “mindfulness” and this training into their programs and curriculum. It is shaping emerging science on learning, pedagogy, communication and business. I have copied just a few of the sites here, from Virginia Tech to Umass Center for Mindfulness and one of the most successful, Google. I will be referencing a lot of the creator of the “Search Inside Yourself” institute founded by one of the original engineers of Google, Chade-Meng Tan and his book by the same name.
If any of you are like me, you do not just wear one hat, you’re at work, you have a family, a home, maybe even some community involvement. If you are a mom like me, inevitably when you finally sit down to do something quiet is when everyone needs you, and emergently and sitting “still” and quiet also involves running over your grocery list. Meditation is a nice idea, but how does one have it work if they do not feel like it is in their “personality?”
I think it is powerful for someone like me who feels pulled in a million directions to know it is not your ability to concentrate in meditation, but the development of that process that creates this mental strength. [Read quote] During meditation, meditators are told initially to focus on their breath and breathing, when you find yourself drifting, you are to gently nudge your thoughts back to breathing. It is this nudging, the practice of getting back to your focus that builds your “mental muscles.”
To be sure, meditating is not building a story in your mind. [Read slide] It is paying attention to paying attention.
The goal of mindfulness, as the psychologist Jack Engler (2004) puts it: When it is realized that no self is to be found in the elements of our experience, it begins the process of liberation. Understanding that our sense of “I” is not as solid, permanent, or substantial as we habitually hold it to be ultimately uproots clinging, attachment, and hostility. Understanding this burns up the fuel that runs our repetitive habits.” According to Buddhist philosophy, a change in perspective on the self is thus the key in the process to enduring forms of happiness. Mindfulness, as developed from meditation, “facilitates a detachment from identification with the static sense of self. Rather than as a static entity or structure, the sense of self can be experiences as an event.“ –Hozel et al
There are actually a number of different approaches to meditation, all of which center on focused attention. The one in particular I wanted to share for the purposes of our work here was Metta Meditation or Loving Kindness Meditation.
Scientific data specifically on Metta Meditation, or Loving Kindness meditation reports results that areparticularly powerful. In Loving Kindness meditation you focus on the emotional response have when you see a familiar face that make you instantly wish the person you well, for their health, for their happiness. For some it may be your matriarch, or a close friend. In my research to find a video on guided Loving Kindness meditation I found one that corresponded to an article on forgiveness. I was struck not only by this quote, but how much it related to the work that we hope to accomplish here and the power of meditation. Viktor Frankl said “Between stimulus and response, there is a space. In that space lies our freedom and power to choose our response. In our response lies our growth and our happiness.” Meditation helps to grow that space to process. When we are held back in some experience, by regret, by anger, by hurt, we are fixated on something, and we need to experience forgiveness. Forgiveness is not just about a human to human relationship, it is about breaking a particularly negative fixation. In that sense, meditation, particularly Loving Kindness meditation stands to help us expand our emotional- fear, anger and stress responses to ourselves, an event, maybe even our profession.
This meditation is lead by Sylvia Boorstein, and I specifically picked her because she is a Jewish Buddhist. Why is this particularly important for this presentation? Because the art of focusing one’s attention, training one’s mind is not particularly denominational. Buddhists have a clear understanding on meditation because it has been such an integral part of their practice for thousands of years. I have been living in the Bible Belt all of my life, so I wanted to challenge any notions out there that the practice of meditation is somehow in conflict with your own personal religion, spirituality or personally held beliefs or non beliefs. Before we do this, and I know I am with health care practitioners, but there is neurological science behind this as well, I am going to ask everyone to turn OFF their cell phones and communication devices. It is just a little over 7 minutes. Hopefully nothing drastic happens in that 7 minutes, but there is bodies of information out there about your consciousness and cell phones and something of particular mention is that if your cell phone is on, your brain is aware of that and aware of that even when you do not think it is, sleeping, engaging in other tasks, etc. So for a scouts try please power off, not silence, power off your cell phones. I will give you a minute to do this and then we’ll get started.
The research I have sited prior in the 7-8 week studies done with novice meditators, had these individuals starting with 7 minutes of meditation. I could not help but think of an infomercial when I started compiling these slides, but lucky for you, you do not have to buy anything in any sort of monthly plan to meditate.
So we are going to break out into small groups to discuss this. I have listed some general suggestions if you all are unsure of what to address but I know this has always been where I have learned the most- discussion amongst peers and colleagues.
I wanted to share that over the past 2 years I have started carrying prayer beads on me to help with some of my anxiety and anxious habits (the one my husband hates the most is fidgeting with my hair). Now, just the feel of them in my palm helps me to center. It’s very simple, I run them through my fingers and say in my mind “I wish my enemies peace. I wish my enemies health. I wish my enemies love.” I always start with enemies and then I work to friends and family and lastly myself. I do it in the car, or when I am waiting, or sometimes even during class or before presentations.
Any one recognize the gentle man in the hat? That is Walt Whitman was a Civil War nurse. Read slide
As many of you are aware, art uses different functions, sides and area of the brain than scientific inquiry or mathematics. [Read slide] In other words, an artist engages various pathways in the brain that are not otherwise manipulated, and this interconnectivity is a unique process. When one is dancing, painting, or playing in music, they are making their brain to work in a unique capacity which is hugely impactful and psychologically healthy for an individual.
[Read slide] the psychological impact of art and self care psychologically has been proven to provide these important functions. Notice, some of what we have been discussing in mindfulness plays into these same themes. Being able to process, identify and control one’s attention and emotional response, engage more empathetically with others in mindfulness and finding a deeper way of identifying, exploring, understanding expressing one’s emotions, experiences and self-awareness are intricately related. Now, one can seemingly mindlessly crochet or knit for hours, but I doubt anyone has ever made a scarf for someone they love without also somehow weaving in their own warm thoughts for the individual.
In her essay on Music and Therapy, Sallie Bailey noted laments in song extend far back into human history, documenting loss of loved ones and community, one of the more powerful are the Psalms of the Hebrew Bible. Songs have across history documented struggle, But, music is not just for the skilled musician or composer. [Read]
Maybe some of you are familiar with the Clive Wearing story. Clive Wearing was born in the 1930’s, was an accomplished composer and musician who suffered an infection in his brain that affected his ability to retain any memory- both sort and long term. He, however, remembered his wife, and music. This is a picture from his journal he keeps every 7 minutes. There’s a great 47 minute video you can google on youtube about this man. I will play only 3 minutes here but the mystery of Clive’s story and his brain is how he has not forgotten his wife nor music. If you do not believe in the power of love, or the power of music, I think this should solidify both. If not give you something to google tonight.
Now, little secret, I am a musician. I went to high school right down the street at the University of North Carolina School of the Arts where I played Violin and have since I was 3. Music has been the easiest way for me to talk….Read slide
This song has a special place in my heart, and I will explain more later, but as we did before I am going to take pause here, I have the lyrics up, for us to listen, maybe respond to the sounds. While we’re listening (and this style may not be for everyone) I want folks to think of a song, lyric or music that has particular power in your life to share with your group a bit later. Make note of it now. Also, let’s begin thinking about the question, What does death sound like to you? What does fear, illness, suffering look or sound like? A bit later we’ll revisit this question. I would like people to start thinking over this “odd” question while we explore other artistic forms.
As with music, not just about the personal act of writing, but also reading, responding, connecting that engages the mind in the unique way we require for healthy emotional processing.
Short stories, poems and novels serve as another way to engage the experience of suffering, death and life through recall, metaphor or simile. There’s a never ending source of poems, stories and writing on the subject of death and loss. Emily Dickenson immediately comes to mind, Poe, along with many other authors, Isabel Allende has an amazing story on the death of her daughter called Paula. I have a few poems here that I will allow you all a few moments to read over and digest.
I selected two poems here written by nurses, maybe you recognize one. It is important to remember, the writing process, be it a poem, short story or journal entry all employs the same creative process one hopes to engage in order to process an experience in a different way. Poems are quick to share in this setting, but we must remember that creative writing encompasses more than poems.
Do your thoughts and the thoughts, musings and reactions to care have a real place in health care? The answer is yes. Not only is the creative writing process, both the engaging in and participation in important for self care, it is serving to inform the healthcare setting as well. Narrative Inquiry in Bioethics which has an editor down the street at the Reynolda Campus, Dr. Ana Iltis, is a product of the John Hopkins University Press. From the their own website Narrative Inquiry in Bioethics (NIB) provides a forum for exploring current issues in bioethics through the publication and analysis of personal stories, qualitative and mixed-methods research articles, and case studies. Articles may address the experiences of patients and research participants as well as health care workers and researchers. NIB is dedicated to fostering a deeper understanding of bioethical issues by engaging rich descriptions of complex human experiences. While NIB upholds appropriate standards for narrative inquiry and qualitative research, it seeks to publish articles that will appeal to a broad readership of health care providers and researchers, bioethicists, sociologists, policy makers, and others. The writing process stands to not only benefit your own deeper understanding of your own experiences, but it could potentially inform and better the healthcare system. These stories and reactions to illness and suffering are having a huge impact in the bioethical world in particular. Who knows? Your own musings may be published!
Recent studies on 3D images and fMRI show a powerful correlation between shapes and images and the human mind. For example, a Smithsonian article details how just the image of a flexed wrist triggers neurological responses in the viewer’s brain that activate the muscles in the viewers wrist. A visit to the art gallery or museum will trigger neurological responses you are not even aware of. Again, art is not just about it’s production, but also the involvement of the audience.
I do not have any drawing talents or visual art talents in particular myself. Hair on a stick figure is about all I can do for an artistic rendition. I do not know if any of you have the same problem I do, a trip to AC Moore or Michael’s has you spending more money on craft supplies than a frame or just the glue sticks you originally had intended on purchasing. You walk through and come up with all these little crafts you could do instead of Christmas presents or Mother’s Day because of course that’s more meaningful and come out with buckets of stuff, you have to stash away from your husband. Good news is now you do not have to hide it from your partner, there’s a truly justifiable reason you need to craft, you need art. As we have seen already, it engages interconnectedness in your neurological functions in a completely unique way that helps you better process your day and your emotional life.
This is one of my personal favorite “me time” activities, and I can do it with my kids which matters to me a lot as a mom, as you can see here. This is me, and my 4 year old daughter a couple weekends ago, in the floor of our playroom coloring. The boys had gone for a boys day to watch football and she did not have school the next morning. The both of us broke out our coloring books and colored until about 11:30PM. Daddy crept home tucked the sleeping boy in bed and caught us coloring. It works great for me because both my kids enjoy coloring so I do not have to worry too much about entertaining them while we’re doing it together. My personal favorite is Mandala coloring books. They’re about $6-7 online, I know Michael’s has a bunch up front because I purchased 2 or 3 more recently for myself and a friend last week. For this project I googled “Adult Coloring books” under images and there are plenty of free images that popped up, you can print them out, gives you a great excuse to go buy the big pack of sharpies all of us eyeball, you know we all do. Who doesn’t like a good sharpie pen? Nothing beats it. The concentration I have to put into completing a Mandala, paying attention to what color patterns I have started, what will make the images I want to come out better against the other patterns, requires all my attention and focus. The level of detail involved might be too much, in which case there are other types of coloring books to chose from, other crafting activities to chose from, other art forms to engage in. The point is that you try, or you allow yourself the time to indulge this knowing it is a critical part of your self care. Bryan will be going more into the “me time” importance of self care in his presentation as well.
Remember in the music section I had raised the question “What do you imagine death sounding like if it were music? Is it dissonant? Painful to hear? Or do stringed instruments play tender melodies?... Does it depend on the situation?” The question can be extended to other experiences as well- suffering, forgiveness, redemption, healing. What does healing sound like to you? Or what does it look like to you? You do not have to answer this particular question but I wanted to offer a few different ways to discuss this in the next few minutes.
My hope from the presentation is that you have gleaned something important, both personally and scientifically about mindfulness, meditation, and art and it’s role in self care. I wanted to end with these two quotes, one from Ricard Matthieu who has a PhD in Molecular Genetics, from the Institut Pasteur, who decided to become a Tibetan Buddhist monk and was whom the Dalai Lama called upon to research the science of meditation. [Read] The other quote is in my hero’s book, you probably have heard of her, Elizabeth Kubler-Ross “On Death an Dying.” This quote brings us back again to forgiveness, and the release of that which fixates us as static beings [Read]
This is Avery. My son who was born in 2009 with the birth defect Gastroschisis. Avery was born at a healthy 37 weeks of gestation with a small loop of bowel exposed and expected to make a full recovery however he passed unexpectedly after 107 days of life. My son sent me on a whole new path. I started the NPO Avery’s Angels to service the research, patient and practitioner world of gastroschisis. Not anything of my own doing, only because there was so much of a need for this sort of avenue, it now services over 10,000 world wide families across 5 countries. I also believe my life belongs in Palliative Care Perinatology and Neonatology. I love sitting with folks in the dark, as strange a that may sound. I believe that medicine is not a verb, but a noun. Healing is the verb. It takes a unique blend of patient, practitioner and family to determine what is necessary and what must be done for healing to occur. I know a lot of emphasis is placed on the patient and family, but in our case the family extended to those who were more apt for providing for my son than his father or I could at the time. The mindful and engaged, intimate relationships we made at that hospital made me who I am now. The song “Fix you” is one of my personal songs for my son. The song I played during discussion was what my brother, a professional acclaimed violinist played at Avery’s funeral during the video portion of the service. In other words, some of these methods have been effectively tested.
