MINDFULNESS and DISTRESS TOLERANCE SKILLS September 28, 2007 Patricia M. McGuire, M.D.

Goals and Objectives  Identify the basic tenets of Mindfulness  Identify the triad of Distress Tolerance Skills  Practice skills during the seminar and set future practice goals

MINDFULNESS

MINDFULNESS  Being in the PRESENT MIND  Being be in control of your own mind  Not letting your mind be in control of you

MINDFULNESS is NOT…  Meditation  Relaxation  Spiritual or religious  Calming  A means to stop being “emotional”  A means to being a “good person”

“ There are two ways to wash the dishes. The first is to wash the dishes in order to have clean dishes and the second is to wash the dishes to wash the dishes.” Thich Nhat Hanh The Miracle of Mindfulness

MINDFULNESS: STATES of MIND Reasonable Mind Emotion Mind WISE MIND

MINDFULNESS: Taking Hold of Your Mind  “How” Skills –Non-Judgmentally –One-Mindfully –Effectively  “ What” Skills –Observe –Describe –Participate

MINDFULNESS: “How” Skills  NON-JUDGMENTALLY

MINDFULNESS: “How” Skills MINDFULNESS: “How” Skills  ONE-MINDFULLY

MINDFULNESS: “How” Skills  EFFECTIVELY

MINDFULNESS: “What” Skills  OBSERVE

MINDFULNESS: “What” Skills  DESCRIBE

MINDFULNESS: “What” Skills  PARTICIPATE

MINDFULNESS takes -  Practice

DISTRESS TOLERANCE SKILLS  Sources of Stress  Crisis Survival Strategies

SOURCES of STRESS  Environmental  Social Stressors  Physiological  Thoughts

Stress Reactivity  Automatic  Flight vs. Fight  Goal: regain immediate control  Fight: aggression; hostility  Flight: withdrawal into substance abuse, over-work; over-eating

Stress Responsiveness  Openness  Allows 100% mental capacity  Taps creativity and imagination  Cognitive set

Feeling Thermometer

CRISIS SURVIVAL STRATEGIES  Distraction –BEAR IT  Self Soothing –Five Senses  Focused Activity –IMPROVE the moment

DISTRACTION  B = Breathing focus  E = Exercise  A = Activity  R = Relaxed muscles  I = Imagery  T = Thought stopping

THOUGHT STOPPING

SELF SOOTHING  Vision  Hearing  Taste  Smell  Tactile

FOCUSED ACTIVITY: IMPROVE the moment  I = Image of a safe or soothing place  M = Mindfulness  P = Prayer  R = Relaxation  O = Out of the situation (time out)  V = Volunteer  E = Encouragement (cheerleading)

Practice

References  Davis, Martha, McKay, Matthew, Eshelman, Elizabeth.: The Relaxation & Stress Reduction Workbook; New Harbinger Publications; 5th edition, September  Hanh, Thich Nhat: The Miracle of Mindfulness; Beacon Press; May  Kabat-Zinn, Jon: Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life; Hyperion; Kabat-Zinn   Linehan, Marsha: Skills Training Manual for Treating Borderline Personality Disorder; Guilford Press; 1993.

QUESTIONS?