Saturday, April 19, 2008

Renewal

I am building a place for mindful practice in the backyard beside the pond. There are repairs to be done and the work feels hard. Last night I removed the old bridge and today so far I have tried to locate the leak in the stream. I think I may have found it. It's a spot where roots have worked there way between the seams of the last fix. I can't be sure that this is the place, but it looks promising.

And part way through the work I think, I don't like this, it's tedious. I'd rather be doing something else. It dawns on me as I continue to breath, stretch and exert myself into deeper acceptance of this moment with its accumulation of sediment, mud, rocks and toil. That the place to practice has already been laid carefully before me.

Tuesday, April 15, 2008

Ecotones

In his book Return to Warden's Grove: Science, Desire, and Lives of Sparrows, Christopher Norment talks about ecotones. In biology these are known as the transition zones between two communities where the species from each community co-exist. In effect they are verge areas, like transition between between states of awareness; becoming aware after a night's sleep.

Spring is akin to an ecotone; a transition between states that sees the remnants of winter leaving and the emergence of new life taking its place within our inner and outer landscapes. There is an anticipation, an excitement and even anxiety in the what the changes will mean. We are jolted into a transition that is ripe with possibilities of anything. Norment quotes part of a poem that captures this feeling nicely and I have reproduced it here in its entirety.

I go among trees and sit still.

All my stirring becomes quiet

around me like circles on water.

My tasks lie in their places

where I left them, asleep like cattle.

Then what is afraid of me comes

and lives a while in my sight.

What it fears in me leaves me,

and the fear of me leaves it.

It sings, and I hear its song.

Then what I am afraid of comes.

I live for a while in its sight.

What I fear in it leaves it,

and the fear of it leaves me.

It sings, and I hear its song.

After days of labor,

mute in my consternations,

I hear my song at last,

and I sing it. As we sing,

the day turns, the trees move.

-Wendell Berry

Saturday, April 12, 2008

MBSR Conference -Day Two


6 pm

Drop into the moment that is now. No need to judge, no need to have an agenda as to what will be, no need to say, "I am meditating". Just be here, drink in all that this moment has to offer as if it is the only one that you have - because it truly is. Living fully demands that we pay attention, to this moment, with intention, acceptance and without judgement.

This the message of Jon Kabat-Zinn who led through an hour of practice of attending to this moment. He repeats this message in his important books that serve as introductions to this way of being and the titles are evocative of the importance of the experience of now:

Full Catastrophe Living (1990); Wherever You Go , There You Are (2005); Coming to Our Senses (2006)

Keynote Address: Mark Williams

Saki Santorelli introduced Mark Williams, Oxford Professor of Clinical Psychology, by reading the Rumi poem "Cry Out in Your Weakness". Mark Williams, like Marsha Linehan has spent his career finding ways to alleviate much suffering in the world - finding ways to prevent relapse in depression, that can and often does, lead to increased levels of depression and suicide.

Dr. Williams and is colleagues John Teasdale and Zindel Seigel have been important contributors to the treatment of depression, specifically the prevention of relapse. By combining many of the principles behind cognitive therapy with those of mindfulness practice, a powerful synergy has emerged that offers new hope for those suffering with chronic depression.

Dr. Williams spoke today about the role of the experience of psychological pain in preventing access to the specific episodic memories that are essential to problem solving. In effect the experience of a negative emotional state leads to a rapid flood of painful thoughts that cut off access to specific memories about how to solve the problem facing the individual. What remains are general memories that offer few, if any real solutions. Mark pointed out that mindfulness offers a way to reconnect with, and allow time for, specific memories to re-emerge promoting effective problem resolution and improved mood states.

Miriam "Miv" London, University of Vermont - Mindfulness programs for anxiety and depression for college students:

The effectiveness of a of 7-week mindfulness-based intervention for college students was discussed in this workshop. The net results were that the students benefited from the program through a reduction in their anxiety and depressed symptoms. The challenges with this group of clients was that they often were quite distracted by other priorities in their lives that the commitment to formal practice had often to compete with school work, social opportunities and space and time constraints. Despite this, many of the students were able to deal effectively with their anxiety and depression through incorporating many of the practices into daily life.

Arnold Kozak, University of Vermont - Curriculum course in the Psychology of Mindfulness:

Arnold spoke about a course he has developed and taught now for two years at the University of Vermont. The course includes the 8-week MBSR component, academic work in cognitive therapy, Buddhist psychology and clinical applications of mindfulness in psychology and health. The course includes both experiential and didactic components. The evaluation of the course has been positive, both in terms of student appraisals and in outcome measures that looked at whether students were incorporating the practices into their own lives. I would like to know to what an extent such a course might lower levels of stress for the students at Conestoga College. Anyone interested in working up a proposal with me?


Summary - conference themes in some of the informal discussions:

  • Has there been too much emphasis on mindfulness as technique in psychotherapy, when in the end it will be shown to be no more effective than other psychotherapeutic techniques accounting for only 15% of the variance in symptom reduction?
  • Is the benefit of mindfulness in its effect on the therapist, making them more empathetic, more non-judgemental, able to build better therapeutic alliances and less reactive? On this point, one meta-analysis shows that non-treatment aspects of the therapy (i.e. therapist listening skills) account for 30% of the symptom reduction.
  • What will it take to resolve the fundamental biases that exist within the two different ways of knowing between psychology and mindfulness? There was tension here at times between the agenda of the researchers who wanted to know about the randomized clinical trials and the therapists who were more concerned with the effect on the lives of their clients.
  • Finally, I sat in on a number of interesting sessions where the focus was on marketing mindfulness as a product. The cost of an eight week MBSR course has currently reached about the $2000 mark. Training of professionals can be substantial as anyone interested to investigate on the internet will find. This means that by the time the program hits the street, it will likely only be available to those who can afford a health club membership. It runs the risk of becoming "spa" treatment for the wealthy. And Buddha winces. So my question, how do we get mindfulness in the hands of those working with some of the most disaffected people in our communities?
  • Personal note: I have spent nearly 3 months now, offering my 30 years clinical experience for free, for a year. My sabbatical next year allows me to do this. My price: let me come and learn to hone my mindfulness clinical as part of the team. That means a net saving to your organization one senior clinician's salary and perhaps 20 - 30 clients off the waiting list. Total organizations that have jumped at the offer so far= 0. We need to look seriously, I think, at how we can massage the system to, as George Miller might say, "give mindfulness away". Anyone interested in setting up a volunteer list to assist with referrals for the treatment of depression, anxiety or trauma?






Friday, April 11, 2008

Mindfulness Conference - Worcester MA

6 am

The day begins with sitting, walking and stretching in present awareness led by Saki Santorelli. I am slowly letting the flight, the other things to do, the distractions leave the now - but they are persistent in creating "noise". I decide to practice accepting noise - I am more or less successful.

7 am

I am successful in finding friends and colleagues from Waterloo. I am delighted and we have breakfast together. This is a conference on the science of mindfulness and its relationship to healing arts. There is excitement here, a quiet anticipation we all feel about the power of this approach to relieve much suffering. Breakfast conversation is about how the community that this embraces is something like the ripples in a pond that spread ever further out from the centre. And today I am at one of the centres of the movement, the birthplace of MBSR; mindfulness-based stress reduction.

Keynote Address: Marsha Linehan

Dr. Linehan spoke eloquently about her career as a behavioural therapist, scientist and student of Zen and how this led her to the developmental of dialectical behaviour therapy
Her work has been with some of the most troubled individuals, those who have received as diagnosis of borderline personality disorder, people who she points out are the most likely of all psychological disorders to succeed at suicide. One in every ten people with BPD will take their own life.
Using a mindfulness-based approach Linehan invites her clients to practice the art of acceptance in their lives. Clinically sound and scientifically validated over 30 years, her approach offers the most hopeful of all treatment modalities for this complex human response to betrayal trauma, abuse and neglect in childhood.

I found Dr. Linehan to be full of energy, realistic and the embodiment of compassion. As Saki Santorelli described her, "She is a force of nature".


Research Sessions:

Ruth Baer

Ruth Baer has been interested in cognitive therapy and has written an important work that reviews the effectiveness of mindfulness based interventions. Her discussion today was on the relationship between formal mindfulness practice, informal mindfulness activities and psychological wellbeing.




Donald McCown and Diane Reibel

Donald and Diane presented a compelling story about their attempt to market an MBSR program to train people in various workplaces how to reduce stress and to respond as people and as corporations in a more "contemplative" manner. While their program didn't get the funding needed from the university, their were able to run a scaled-down version of the offerings to some pretty impressive organizations. They reported that they are happy doing work they love in the not-for-profit sector.

One of their training programs has been offered to anaesthesia nurses, perhaps the most stressful of all nursing jobs. Students in the course learned methods of being more aware, less stressed and more at ease with themselves with the workplace. I found this talk quite relevant to my work teaching psychology to nursing students

Donald Marks, Alix Sarubbi and Rosanna Sposato

What role does compassion play in healing? There is little doubt that it is significant. Marks et al. presented their research on the relationship between the relief of suffering and active compassion. The results of their work can be summed up by the story Donald told of a woman, so debilitated by pain that she was unable to get out of one particular chair in her house. To add to the suffering, she had been diagnosed with terminal cancer of the spine. This woman, with the help of Marks and his team, was able to do something she'd wanted to do for a long time - volunteer at the school attended by her disabled daughter. The times when she was volunteering, the pain she suffered was less meaningful to her than what she had to offer the children. During these times the pain, became a background in her life, rather than the entire focus of her existence.

As a closing, Mark took us through a mindfulness session where we were encouraged to embody in ourselves "the perfect nurturer". It is from this base of compassion, we are told, that we are able to extend healing into the world.

Day's end:

Today has been busy and exceptional. At the end of the day we had a banquet and danced to the type of music that Geoff Johnstone loves. (Hope you had an ale or two for me on Thursday, brother). Wish all of you could have been here, there is much that is of interest to Liberal Studies folks; culture, philosophy, communications, sociology, economics, psychology, wellness and history to name a few. Even some comparative religion, like how the message of the Buddha and Christ and all religions has been the same since the earliest times - a compassionate heart is the key to peace that begins with ourselves.

As they say here:

metta (lovingkindness):
Barry