Mindfulness

co-regulation

1. Help patients co-regulate to better cope 2. If you can bring your attention to what youre doing, and your body, you bring yourself to a regulated state

Introducing concept of mindfulness to conversation

"I wonder how it feels in your body when you do that", you don't have to introduce the concept of mindfulness. -Its just a capacity of our attention, don't need to bring in the definition/stigma

chronic pain and mindfulness

- Chronic pain: "neurons firing, nociceptors are affected" - What does that feel like? And how do you percieve that? - Our normal response is I don't want this, the mindfulness response is "its already here", can I be friendly toward it? - How far does that get to me? "let me welcome this sensation"

Group effects in mindfulness-based stress reduction

- Group effect accounted for 7% of the variability in psychological symptom outcomes (in a client-therapist relationship, 5% of variability is accounted from therapist), so 7% is significant -In individual psychotherapy, the therapeutic alliance accounts for about 5% of variability in outcomes — about 30% of the total "curative factors" If figured as above, the 7% variability accounted for by the MBSR group would be about 40% of curative factors Authors suggest that: (a) something about the group impacts the ability of an individual to learn and practice specific mindfulness techniques (b) something about [the] group influences outcome through 'non-mindfulness' pathways (e.g., expectation of change, provision of support, group cohesion [let's add co-regulation!]), or (c) a combination of these, with the last the most probable - We need co-regulation. Co-regulation is not about doing something, as an expert, it's about being with someone, as a person

clinicians mindfulness, affect on patient care

- Promoting mindfulness in clinicians influences the treatment results of their patients: 1. Clients showed significant difference in symptom reduction measured by SCL-90: GSI, and 7 of 9 2. Better understood their own psychodynamics 3. Better assessed their clients subjective progress -We regulate ourselves and thereby co-regulate others

polyvagal theory

- two functionally distinct branches of the vagus, or tenth cranial nerve r/t evolutionary stress response: the more primitive branch elicits immobilization behaviors (e.g., feigning death), whereas the more evolved branch is linked to social communication and self-soothing behaviors. - The most primitive systems are activated only when the more evolved structures fail. These neural pathways regulate autonomic state and the expression of emotional and social behavior. Thus, according to this theory, physiological state dictates the range of behavior and psychological experience. For example, healthy human fetuses have a high variability in heart rate, which is mediated by the vagus. On the other hand, heart rate decelerations, which are also mediated by the vagus, are a sign of fetal distress. More specifically, prolonged withdrawal of vagal influence on the heart creates a physiological vulnerability to the influence of the Dorsal Vagal Control, which in turn produces bradycardia (very low heart rate).

Mirror neurons

- we have in our motor cortex, neurons that specifically help us to feel what others feel, move the way others move, so they don't actually move us but they give us the feeling. - The mirror neurons are trying on others perspectives (when in a fight, trying to prevent the other person from reading your mirror neurons, when youre dancing, youre trying to let other people read your mirror neurons) - Allows you to open yourself to listening better, and understand yourself better

long term mental effects of stress

-Mental ruts -Negative mood -Negative bias in attention and memory (can be a helfpul component, brings back negative memories, which may bring back previous responses to negative stressors) -Trouble remembering -Difficulty focusing attention -Difficulty making decisions -Inability to learn new ways of coping -Inability to see things in a new way

The relaxation response effect on body

-Reverses Fight or Flight -Creating new memories and associations -"Positive" emotions (approach) -Focused attention; decisiveness -Improved immunity -Increased serotonin, dopamine, etc. -Better, more refreshing sleep

meta-analysis of MSBR studies

-This review included MBSR which included mindfullness, yoga, thai chi- so might not be exactly pertinent to mindfulness - Mindfulness meditation programs had moderate evidence of improved anxiety, depression, and pain, and low evidence of improved stress/distress and mental health-related quality of life -Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. - no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies)- BUT not worse...just the same, so why not implement?

How does the group affect work? What should we consider?

1. Consider systems theory 2. Then consider mirror neurons - We open our eyes, and see others' faces and attitudes - and mirror neurons pick up how they are - As we "try on" their expressions and attitudes, we are regulated -The place then becomes a space in which we can approach our own (aversive) experiences, and those of others 3. Add what we learn from the handy model of the brain 4. Then add Stephen Porges's polyvagal theory

How do we turn cortex on when people are upset?

1. Cortex is in charge of logic, language, empathy. If you bring your attention to how your feeling, you bring the cortex into play - Get someone curious, turn on their logic to get them to regulate their emotion (like, how many red things are in the room?) -Focus on your body (breathing, feel your feet)

looping effects

-we diagnose someone, now they know whats expected/how to act (socially decide how to construct their categories), and then we talk you out of your diagnosis - Mindfullness based stress reduction: everybody is an individual case, even if they present with similar symptoms, there is something different -looping effect causes an anxiety, when a safe space is created with less anxiety regarding diagnosis, then will see less symptomology

Long term negative effects of stress on the body

1. Cardiovascular disease: High blood pressure, heart disease, stroke 2. Musculoskeletal disorders: Back and upper extremity disorders 3. Psychological disorders: Insomnia, anxiety, depression, burnout 4. Sexual dysfunction: Impotence, reduced drive and desire 5. Impaired immune function: Increased incidence of colds and flu

Good vs bad stress

1. Desire eustress--> results in high performance 2. Stress management and reduction is to prevent distress

Fight or flight vs tend and befriend

1. Men — "Fight or Flight" -In primate culture, when a group was under attack: they found that men had high levels of fight or flight hormones, testosterone (turns on SNS, slows PNS) 2. Women — also, "Tend and Befriend" - And women, would reach out to make a social connection (with eachother, or with the enemy)which would release ooxytocin reducing the cascade of stress hormones

biologic steps of stress

1. Perception of threat/challenge 2. Assessment of resources 3. Resources (utilizes resources for coping, or if no resources then get stress response- if healthy/acute response, then its motivational)

Mindfulness (Physiological impact, Psychological impact, Relational impact)

1. Reduced sympathetic activation: self-regulation 2. Emotional self-regulation 3. Increased potential for empathic responding

shapiro, kabat zinn, and siegel definitions

1. Shapiro: "reperceiving" 2. Kabat-Zinn calls it "an orthogonal rotation in consciousness" (seeing something differently, a different perspective of reality) 3. Daniel Siegel sees it as interpersonal and calls it "Mindsight"we see into our minds the same way we see into others minds

Effects of MSBR

Associates changes in brain activity (left side, anterior regions-prefrontal) with: 1. Decrease in trait anxiety 2. Increase in positive affect (by EEG seeing left prefrontal pre and post mindfulness course) 3. Enhancement of immune function (via flu shot)

Mindfulness definition

Attention that is: Intentional, Non-judgmental, Moment-to-moment (emotion is moment to moment, not fixed..."I feel sad" instead of "I am sad" - Does not create distance and disconnection from one's experience, but rather enables one to look, feel, and know more deeply (participatory AND being able to see as a distance) A three-word definition 1. Renew, 2. Remind (your mind of the moment) 3. Remember (coming into our body, becoming a member of the group we are with)

Simple definition of stress

Comparison (judgments, compare how we wish it were to how it is), can I be ok with how it is? 2 words: Holding on. (holding onto past, holding onto perceptions of future...ect)

Brain as a hand model

Wrist: Spinal cord 1. Brainstem (lower palm): scanning for threat in inner/outer environment, and controlling ANS 2. Limbic system (thumb): amygdala, hippocampus (control emotion, memory) 3. Outside surface of hand: neocortex (controlling brainstem and limbic system)- people with good stress response are those who can fold fingers over thumb and cortex is controlling emotional response