PRESENTED BY: COLLEEN CAMENISCH, MBA Mindfulness Based Stress Reduction

What is Mindfulness? Mindfulness helps one to stop and notice how things are in an objective way. Rather than getting caught up in thought or problem solving mode, one is noticing where the mind is going and is being fully aware of the present moment as it is happening. Mindfulness allows us to have awareness about our thoughts and habitual patterns. Seeing things without filters, lenses or judgments. Having the ability to step back and see things clearly as they are. Finding a way to re-center ourselves and move out of the chronic stress cycle. Helps one to stay in the present moment rather than getting caught up in thoughts of the past or future.

History of Mindfulness Based Stress Reduction Kabat-Zinn – U. Mass. Medical School – Mindfulness Based Stress Reduction (MBSR) clinic (1979)  Secularized eastern meditation practices - Kabat-Zinn was (and is) an MIT trained molecular biologist and long time meditator who worked at U. Mass Medical School  Started a clinic where U. Mass doctors sent their patients who were in chronic pain when all traditional treatments proved ineffective!  Created the intervention called Mindfulness-Based Stress Reduction Program  This intervention has been one of the most widely studied programs in secular based meditation practice. It is highly evidence based.  It is an eight-week course where participants meet 2.5 hours 1 time per week and are encouraged to meditate at home daily. There is also a full day silent retreat as a component of the course.  In order to facilitate this course, one needs to have completed the requirements through the University of Massachusetts Medical School and must have their own meditation practice. * Thanks to Bill Kuechler, Ph.D. professor of Information Technology at the University of Nevada, Reno for a portion of this slide.

My Experience Colleen Camenisch  Fully certified mbsr-instructor through the University of Massachusetts Medical Schools – Center for Mindfulness (235 hours of program training)  Have taught over 35 cycles of MBSR – Have taught for 7 years in NV  Taught MBSR for over a year at the Center for Mindfulness  Taught programs for survivors of the Boston Marathon Bombings and their physicians, physical therapists and LCSW’s at Spaulding Rehabilitation in Boston  Have partnered with the Nevada Psychology Association offering CEU programs for psychologists, LCSW’s and MFT’s  Have taught a program to nursing staff at Carson Valley Medical Center  Teach courses on-going at UNR – open to the community  Teach at a variety of business with my colleagues Dr. Yvonne Stedham and Bill Kuechler  Presented at the National Collegiate Recovery Conference in 2015

Benefits of Mindfulness It helps us to come out of chronic stress by stopping, non-doing, and being fully present with how things are from moment to moment. Mindfulness increases:  One’s ability to deal with stress leading to an increase in Stress Hardiness  One’s ability to develop a way to observe difficult thoughts and emotions rather than getting caught up in them  Sense of acceptance of one’s emotions  Feelings of being connected  Awareness of patterns of behavior Mindfulness decreases:  The chances of relapse associated with addiction and co-occurring disorders  Anxiety  Chronic Pain  Depression and recurrent depression  A number of other physical and psychological symptoms  Effective in treating those with trauma in a modified format  Many VA’s have programs specifically designed for veterans

Clinical Applications: There are many therapeutic interventions based in mindfulness  Acceptance Commitment Therapy  Dialectical Behavior Therapy  Mindfulness Based Cognitive Therapy – Adaptation of MBSR  Mindfulness Based Relapse Prevention – Adaptation of MBSR Mindfulness and Clinicians  Evidences based research shows mindfulness skills training as an effective method to foster clinician attention, affect regulation, attunement and empathy.  Clinical Social Work Journal June 2009, Volume 37, Issue 2, pp

Mindfulness Finding Specific to Diabetes An article in Diabetes Spectrum September 21, 2009 vol. 22 no highlights the fact that, “diabetes poses a major life stress that requires considerable physical, emotional, and psychological accommodation and coping.”  People with diabetes were 20% more likely than those without the disease to have an anxiety condition at some point in their life time, about 25% of adults with diabetes will experience depression at some point and that depression in people with diabetes is often long-lasting. The same article also offers effects of MBSR with this population and references research conducted by Rosenzweig et al.,  “This uncontrolled study found a reduction in A1C of 0.5% and reduced mean arterial pressure of 6mmHg; decreases in depression, anxiety and general psychological distress in patients completing the program were observed.” Another article published in the Diabetes Care 35: , 2012 showed “MBSR led to better health status and lower levels of depression. Among regular attendees, psychological stress also decreased significantly.” Mindfulness Meditation allows one to cultivate the practice of being with and observing unpleasant emotions or thoughts rather than avoiding them. Meditation can change how one relates to dysfunctional thoughts and negative affect rather that changing the states themselves. (Breslin et al. 2002)

Mindfulness Findings Specific to Depression For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence.  Journal of Consulting and Clinical Psychology, Vol 68(4), Aug 2000, MBCT was more effective than Anti-Depressant Medication in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains.  Journal of Consulting and Clinical Psychology, Vol 76(6), Dec 2008, For depressed patients achieving stable or unstable clinical remission, MBCT offers protection against relapse/recurrence on a par with that of maintenance antidepressant pharmacotherapy  Arch Gen Psychiatry. 2010;67(12): doi: /archgenpsychiatry

Mindfulness Findings Specific to Anxiety “A previous study of 22 medical patients with DSM-III-R-defined anxiety disorders showed clinically and statistically significant improvement in subjective and objective symptoms of anxiety and panic following and 8-week outpatient physician-referred group stress reduction intervention based on mindfulness meditation. The same study showed Twenty of the subjects demonstrated significant reductions in Hamilton and Beck Anxiety and Depression scores post intervention and at a 3-month follow- up”  Gen. Hos. Psychiatry Gen. Hosp. Psychiatry 17: (J. Fletcher, K. and Jon Kabat-Zinn, J. 1995).” Mindfulness helps undercut the compulsiveness and reactivity that accompanies active addiction and the anxiety resulting from a long history of trauma. *Moment by Moment in Women’s Recovery: A Mindfulness-Based Approach to Relapse Prevention Researchers at the UMASS Center for Mindfulness are currently evaluating:  In collaboration with Drs. Lori Pbert and Elena Salmoirago-Blotcher, we are investigating whether mindfulness training can promote healthy diet and physical activity in teenagers  Working with Drs. Emily Levoy, Asimina Lazaridou, and Carl Fulwiler, we are exploring the efficacy of MBSR for weight maintenance after weight loss  All information is from the UMASS Medical School’s Center for Mindfulness website.

Single brain components have specific functions but rarely act alone. While the functioning is below consciousness, the effects can be detected and modulated to some degree. More next class.

Neuroplasticity An article published in Psychiatry Research: Neuroimaging 2010, showed: “A controlled pre and post study using MR images of 16 participants who attended the UMASS MBSR program showed that, MBSR is associated with changes in gray matter concentration, in brain regions involved in learning and memory process, emotional regulation, self-referential processing and perspective taking.” (Britta K. Hölzel et al. 2010)  Self referential processing has to do with the amount of stimulus we take in and how we interpret that in reference to ourselves. The practice of mindfulness helps develop such qualities as non- judging and non-attachment, while at the same time increasing one’s ability to let be and develop acceptance.  It can help us not get stuck in old ways of seeing ourselves

Screening Criteria: Is it the right time?  Have you had any recent very large life changes?  Do you have a current history of significant depression?  Have you experienced post traumatic stress disorder, and have you been treated by a mental health professional for this?  Have you been in recovery for six months or longer?  Any persons that have psychosis would not be good candidates for mindfulness.  There could be exceptions to some of the above criteria (with the exception of psychosis) if the clients are working with a therapist.  MBSR can be a great secondary step after completing therapy for a variety of conditions

Standards of practice: It is critical for a mindfulness teacher to have a deep practice of their own  Because meditation is a highly experiential process, it is critical for the teacher to lean into their own practice to be able to answer participant questions, provide guidance for participants, and adapt the curriculum to the participants’ needs.  An article published in American Psychological Association by J. Kabat-Zinn (2003) states, “From our point of view Mindfulness meditation cannot be taught to others in an authentic way without the instructor's practicing it in his or her own life.” There are times when mindfulness isn’t right for participants or isn’t right – right now Wording and phrasing are very important to support the process Meditation is a highly experiential process  Mindfulness has many subtleties which grow with practice and allow the teacher to meet the needs of the participants in an informed and authentic way

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