A Mindfulness-Based Stress Reduction Workbook

I am happy to introduce you to Cassandra Vieten, Ph.D. to help us out with the integration of mindfulness into pregnancy, birth, and early parenting. Cassandra is a licensed clinical psychologist, director of research at the Institute of Noetic Sciences, co-director of the Mind Body Medicine Research Group at California Pacific Medical Center Research Institute in San Francisco, CA, and co-president of the Institute for Spirituality and Psychology. Her research has focused on mindfulness-based approaches to cultivating emotional balance, the involvement of emotion regulation in addiction and recovery, and the factors, experiences, and practices involved in psychospiritual transformation. She has published several academic articles and spoken at academic conferences worldwide.

She is also author of the wonderful book Mindful Motherhood: Practical Tools for Staying Sane During Pregnancy and Your Child’s First Year (New Harbinger/Noetic Books, 2009) and co-author of Living Deeply: The Art and Science of Transformation in Everyday Life (New Harbinger/Noetic Books, 2008).

Elisha: There is a whole field of psychology called “attachment theory” that is dedicated to understanding the effects of the child parent bond on the rest of our lives. What role do you see mindful parenting or mindful motherhood playing in this field?

Cassandra: This is a great question because Mindful Motherhood, or mindful parenting, does not happen in you as a parent. It happens in relationship with your baby, and it is increasingly being recognized how much of your child’s development is shaped by their early experiences with primary caregivers. My premise, and that of other scholars and clinicians such as Daniel Siegel, is that mindful awareness forms the ideal platform for healthy parent-infant attachment to take place.

From the Mindful Motherhood book:

For example, as a mom, having your attention in the present moment lays the groundwork for what developmental psychologist Daniel Stern called being attuned to your baby, or being aware of and perceiving accurately your baby’s communication of her emotions and needs. Attunement with your baby is sort of like a tuning fork–the baby hits a particular tone, and you resonate with that tone, reflecting it back to her with your facial expressions, tone of voice, touch, and way of being. These subtle actions communicate “Yes, I see and hear you, and I get what you’re feeling.” Through thousands of these little micro-interactions with your baby, her sense of self develops, as well as her own capacity to begin to learn how to deal with her emotions.

Attunement is not just matching your baby’s state. It’s making a complementary response, one that both conveys your empathy (“I can feel what you are feeling”) and responds appropriately to what the baby is communicating. For example, if the baby gets really upset, it’s not ideal attunement to get equally upset. Ideal attune­ment might be making sure the baby knows that you see that he’s upset and reflect­ing a sense of being able to tolerate or contain that upset. This reaction could be holding him with firmness and making low and deep sounds. Luckily, with present-moment mindful awareness that meets experiences as they are, this comes pretty naturally-you don’t have to figure it out with your thinking mind.

Transmitting a secure sense of self through attunement happens in thousands of micro-interactions, not just one, or two, or even fifty. This is not about being per­fectly attuned all the time-that’s impossible. It’s about deciding that you want to actively engage, more and more often, in present-moment awareness with your baby and cultivating the capacity to do so. Your baby is always in the present moment. Mindful awareness allows you to join her there more often.

D. W. Winnicott was a pediatrician and psychoanalyst who is probably most famous for his work on “transitional objects.” These are the treasured objects, like a favorite teddy bear or blankie, that help toddlers transition from relying on mom for soothing and a sense of security, to being able to regulate themselves to a certain extent. Winnicott also talked about the holding environment, or the whole space around and between you and your baby, physically and psychologically, as you move through your days together. At first, you are pretty much solely responsible for creating and maintaining this holding environment. You maintain and regulate the connection between you and baby by staying present, aware, and in connection. By about three or four months old, your baby takes his turn being the leader in the dance. By this time he’s contributing quite a bit to the ongoing creation and maintenance of this environ­ment. He’s eliciting facial expressions, emotions, and even thinking patterns in you. And if you’ve ever had your milk let down in response to your baby’s cry, you know he’s even driving some of your physiology.

But your job in this holding environment is to, well, hold what is happening. To tolerate his distressing moments, to recognize and reflect his feelings and their expressions in his body and on his face, even to be the target of and survive his anger, frustration, and aggression. You can do a kind of aikido with your baby. This is a martial art that emphasizes a reflective and complementary sparring, where you receive and reflect and give back some of what your partner throws at you, and some of it you just let pass right on through, protecting yourself by letting the force of your partner’s energy fly by. Mindful awareness can help you in this dance of attunement, synchrony, and consciously participating in co-creating the space through which both of you move through your days.

Elisha: Share with us a bit of the research you did that led to the book Mindful Motherhood.

Cassandra: A very robust scientific literature links postpartum depression to impairments in mother-infant bonding. In addition, a large body of empirical evidence in both animal and humans studies indicates that stress and mood disturbance experienced during pregnancy increases the risk for preterm birth (which is considered one of the most pressing problem in maternal-child health in the U.S.) and other pregnancy-related complications, and may adversely affect the developing fetus. Prenatal maternal stress may also be an important mediator of the observed relationship between race/ethnicity and rates of preterm birth.

In comparison to the potential far reaching benefits, relatively little research has focused on developing interventions to reduce stress and improve mood during the perinatal period.

In response to the need for a brief, low-cost, non-pharmaceutical intervention to reduce stress, improve mood, and decrease the effects of stress and distressed mood on mother-infant bonding, and based on our own experiences as parents, my colleague John Astin and I developed the Mindful Motherhood program. Bringing together elements from several different mindfulness-training pro­grams, as well as our own newly developed material, we piloted the program first in a group of ten women.

After this group ended, we made some changes to the program based on participants’ feedback and our experience as facilitators and researchers and tried it out on another group of women. Finally, we compared two groups of women–one that received the training in pregnancy and one that did not. The women who did not receive the training during pregnancy participated in it when their babies were between three and six months old.

Though small, this pilot study showed that it was possible to learn mindful awareness during pregnancy and early motherhood (even with baby in tow!), and women who engaged in mindfulness training during pregnancy had reduced negative emotions and anxiety during pregnancy compared with women who did not participate in the training (Vieten and Astin 2008). There were also trends toward reduced symptoms of depression and increased positive emotion.

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Thank you so much, Cassandra, for your wisdom.

To my readers: Please share your thougths, stories, and questions below. Your interaction provides a living wisdom for us all to benefit from.

Reposted from Elisha Goldstein’s Mindfulness Blog on Psychcentral.com

In his recent book , Buddha’s Brain: The Practical Neuroscience of Happiness, Love, and Wisdom neuropsychologist Rick Hanson, PhD and neurologist Richard Mendius, MD, talk about the growing discoveries being made at the intersection of Psychology, Neurology and Contemplative practice and how we can influence our own minds. We’ll get more into this in an upcoming interview with Rick.

Prior to that interview, I wanted to share with you some interesting facts about our brains that he shares in the book that blew my mind and I thought you’d find interesting.

•  Your brain is 3 pounds of tofu-like tissue with 1.1 trillion cells and 100 billion neurons.
• A typical neuron fires 5-50 times a second. As you’re reading this, literally quadrillions of signals are travelling around in your brain.
• Although the brain is about 2% of your body weight, it uses 20-25% of the oxygen and glucose we consume. It never stops, always moving while we’re awake and asleep.
• The combination of connections that occur with the 100 billion neurons in our heads is 1 to the millionth power or 1 followed by a million zeros (I’d write that out, but you may not make it back to the important things to do today).

Hanson mentions Psychologist Donald Hebbs research findings that “neurons that fire together, wire together.” In other words, as we create certain mental states with our attention, we are influencing the growth of our brains. This is what is known as neuroplasticity. We have this capability all our lives.

There is a growing amount of studies pointing to the positive effects of mindfulness on various regions of the brain that lead us to less stress, greater resiliency and well-being. We also mention many of these studies in A Mindfulness-Based Stress Reduction Workbook.

The intersection between Psychology, Neurology and Contemplative practice is getting a lot of attention right now truly because people are experiencing real change in their lives and finding that they actually have more choice to become more present to life and become less reactive to the tides.

It helps that neuroscience is now involved because often times to get the motivation to practice, most of us need to see something to believe it. Science helps us do that and then we can truly realize it through our own experience.

As always, please share your thoughts, stories and questions below. Your interaction provides an opportunity for others to interact and this creates a living wisdom for us all to benefit from.

Reposted from Elisha Goldstein’s Mindfulness Blog on Psychcentral.com

There is a tradition on the Mindfulness and Psychotherapy blog. Every Monday, I cite a quote or a poem that is related to mindfulness and psychotherapy in some way and then explore it a bit and how it is relevant to our lives. For me, quotes and poetry can often sink me into a state of greater understanding. So for today, here is a quote by Tara Brach:

“When we put down ideas of what life should be like, we are free to wholeheartedly say yes to our life as it is.”

Well, here we are again, the “shoulds.” Or the classic saying, “I need to stop shoulding on myself.”

What should life be like anyway? Should it be like the stories and images we see in a romantic comedy? Should it be like the destruction and chaos we see in suspense or horror flick? Or maybe we should all be travelling a stream of light blissfully riding the love train.

Well, here are 3 realities of life to chew on:

1. Life is like this – What’s this? It is exactly whatever you are experiencing right now.
2. Here’s another reality, life is always changing. That means that whatever “this” is right now, will become something else.
3. One last truth, we are active participants in our health and well-being.

However, it takes saying “yes to our life as it is” in order to have a choice in how we want to make a change. In other words, if we are feeling sad, it’s important acknowledge this so we know the reality of the moment and what are capabilities are. We can choose to feel the sadness or if we are really depressed and we feel the sadness will take us down a deep dark rabbit hole, maybe we can just acknowledge it, let it be, and choose to do something different in the moment.  

So, I guess there’s a fourth truth: Being present to life as it is, is a prerequisite for having more choice in life.

The beauty of this is that we can actually cultivate the ability to become more present to our lives by practicing mindfulness. (Here is a short video to practice right now – you may have already viewed this, but even so, one practice in mindfulness is to bring a beginner’s mind to any practice, as if it was for the first time).

So at the end of the day, there are some things we can’t choose (i.e., our genetics, our biological or inherited families, some life events), but in being present we can choose how we want to relate to them and that can make all the difference.

To hear more about Tara Brach, you may want to check out interviews with her on 5 Keys to Emotional Freedom and Radical Acceptance.  

As always, please share your thoughts, stories and questions below. Your interaction provides a living wisdom for us all to benefit from.

Reposted from Elisha Goldstein’s Mindfulness Blog on Psychcentral.com

Today I have the honor of interviewing Susan Kaiser Greenland who had the courage to leave a well-paying law career to embrace a calling to teach mindfulness meditation to children as young as four years old. She is author of the upcoming book The Mindful Child (Free Press, May 2010) and developed the website Mindfulnesstogether.com and the Inner Kids program, to teach young kids vital skills toward a more peaceful and compassionate world.  

Elisha: Susan, what an amazing path you’ve chosen. When I teach mindfulness to adults, I often hear, how come we didn’t get this education when we were little, the world would be a much better place. What inspired you to leave the golden handcuffs and venture into this sorely needed area?  

Susan:  Thanks Elisha, I’m not so sure I choose the path often it feels more as if it chose me.  I practiced meditation myself and saw how it helped me, so it was only natural to wonder if it could help my children too.  But the inspiration to begin looking in earnest for ways to practice with my children (who were quite young at the time) came when I was on a week-long meditation retreat with Ken Mcleod.   I had studied with Ken for a few years before this retreat and was friends with many of his students. 

Looking around the meditation hall one evening I noticed that many of us were parents and was struck by the fact that none of us were talking about brining mindfulness to our kids.  Something happened during that retreat and I felt a shift – a desire to integrate mindfulness into my family life in a more direct way.   It’s not uncommon for me to leave a retreat thinking that I’ve had some major insight – so after having one of these a-ha moments after meditation I wait a week or so before acting on it.   If after a week I still feel that way I try to do something about it.  A week after I got home from Ken’s retreat that year – now over a decade ago – I knew this practicing mindfulness with kids was something I wanted to do (maybe needed to do)  although I had no idea that it would eventually lead me away from my law practice – which I also enjoyed.

Elisha: Can you give us a brief synopsis of some of the vital skills you teach these children?

Susan:  The Inner Kids program has evolved over the years and now my primary objective is to teach kids a more mindful worldview.  In classical training that worldview comes through the development of three qualities simultaneously:  awareness, wisdom, and values.  My work is secular, yet informed by classical models, and those three qualities (awareness, wisdom and values) can be translated beautifully as attention, balance and compassion, what I like to think of as the New ABCs of learning.   By learning these new ABCs, kids, teens and their families can develop a more mindful worldview by: 

• Approaching new experiences with curiosity and an open mind;
• Developing strong and stable attention;
• Seeing life experience clearly without an emotional charge;
• Developing compassionate action and relationships;
• Building communities with kindness and compassion;
• Working together to make a difference in the world;
• Expression gratitude; and
• Planting seeds of peace by nurturing common ground. 

Elisha: While the instructions in mindfulness practice can be simple, the practice itself can be anything but easy at times. What happens when children throw tantrums or when they are bullied? How do you approach this practice during the difficult moments?

Susan:  It’s crucial that adults working with kids understand that this is a process-oriented practice (as opposed to a goal oriented practice) and the aim of the process is transformation.  It is not at all uncommon for kids to have a hard time when they begin to look at their inner and outer experiences clearly without an emotional charge (or with less of one).  Sometimes it’s tough for kids, teens, and even adults to process what they see through introspection and it may be impossible for them to contextualize or understand their insights on their own.   It’s important to have patience with kids and simply see them clearly, and love them, for who they are – even when they are not on their best behavior – and trust that navigating this less than perfect behavior is a necessary part of the transformation that mindfulness and meditation can bring about.

Elisha: Can you share a practice that parents, caregivers, or teachers may be able to take into their lives with their kids?

Susan:  I think helping kids find a physically comfortable posture from which to practice meditation is very important.  Encouraging kids to lie down while practicing breath awareness is quite useful but also is an activity that I use called the Pendulum Swing (or tic-toc with younger children.)  The aim of this activity is to help those who find it hard to be still (either sitting or lying down) to meditate in a group.  Here’s how it goes:

Objectives

• To build body awareness.
• To make it easier and more pleasant for those who find it difficult to be still to meditate with a group of people.

• To help settle body and mind before meditating.
  
• To develop concentration skills by attending to the sensation of movement.

Leading the Activity

Preparation

Make sure students have enough space to sway from side-to-side without touching each other.

Introduction

• Starting from either a seated or standing position encourage children to take one or more breaths and notice the sensations associated with breathing.
• Explain that we will swing our bodies from side to side slowly, starting to the right (keeping our sit-bones firmly on the cushion) and then slowly swinging back to the left. 
• Remind students that the object of attention (or focus) is the visceral sensation of swinging from side-to-side and when they notice that their minds have wandered, just bring it back to the sensation of movement. 
• The goal is to help children find and establish a repetitive, rhythmic swing that works for them.  Irregular movements with respect to pacing or pattern are not as likely to promote a felt-sense of calm, center and concentration. Because the swing must viscerally resonate with the person swinging to be effective, the pace and duration may vary from child to child. What is calming for one child may or may not be calming for another, in fact what is calming for one child may agitate or frustrate another. Just as there is no right or wrong way to practice mindfulness in general, so long as children respect each other (and don’t intentionally knock into other people or things) there is no right or wrong way to practice the pendulum.

Instruction 

• If you are familiar with the classical instructions for walking meditation it is helpful to use them as a reference point for the this activity.  In the classical instruction there are three parts to walking:  lifting the foot, moving it and placing it down (or stepping).
• There are three similar occurrences in the pendulum – moving, shifting, and center. 
  • Starting in a centered position first sway (or move) to one side keeping your sit bones on the cushion. 
  • When you reach the point where you cannot sway any further without lifting your sit bone, shift weight and sway back again toward the center.  Shifting is similar to lifting in slow and silent walking.  You’re moving again as you sway back toward center. 
  • When you reach the center of the cushion pause for a moment – that moment is similar to placing (or stepping) in slow and silent walking.  
  • The sway begins again to the opposite side (moving);
  • the moment that you reach the end of the sway to one side and shift weight before beginning to sway back toward center is similar to lifting; and
  • the moment you notice the feeling of being centered again on the cushion is similar to placing. 
• The instruction goes like this – move to one side; shift weight; move back toward center;  pause for a moment to feel centered sitting on the cushion.  Then, move to the opposite side; shift weight; move back again toward center; pause for a moment to feel centered sitting on the cushion.  Repeat.  At first there is a slight pause at each change, but gradually the practice becomes more fluid.
   
• Once students are familiar with the eight pieces of the exercise (moving/ shifting/moving/center — then in the other direction –moving/shifting/moving/center), and the movement becomes more fluid, encourage students to sway from side to side without pausing in the middle of the movement to notice the feeling of being centered on the cushion.  
• With young children it is helpful to use a stringed instrument to accentuate each change, strumming as a prompt signal it’s time to shift weight and move in the opposite direction.

Elisha: What can parents do to support their children in being more mindful? 

Susan:  Hands down the most powerful thing a parent can do to support his or her children in their practice is to develop their own mindfulness and practice themselves.  Kids learn by example and what we do often has a greater impact on our children what we say.  

Thank you so much Susan. As always, please share your thoughts, stories, and questions below, your interaction provides a living wisdom for us all to benefit from.

Reposted from Elisha Goldstein’s Mindfulness Blog on Psychcentral.com