1. Mindfulness and Self-Compassion in Times of Stress Holly Hazlett-Stevens, Ph.D. Associate Professor Department of Psychology University of Nevada, Reno hhazlett@unr.eduhhazlett@unr.edu (775) 682-8702

2. What Is Mindfulness? “The awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment to moment” (Jon Kabat-Zinn, 2003, p. 145) “An inner discipline for learning to meet and enter with awareness the challenges inherent in taking care of ourselves and serving others” (Saki Santorelli, 1999, p. 1)

3. Essential Elements and Qualities (Germer, 2005, p. 7) Essential elements of mindfulness definitions: - awareness - of present experience - with acceptance Qualities of mindful moments: - Present-centered - Non-judgmental - Intentional - Participant observation - Non-verbal - Exploratory - Liberating - Non-conceptual

4. Origins of the Term “Mindfulness” English translation of the Pali word sati found in the Anapanasati and Satipathana Sutras Definitions from contemporary Buddhism : “Keeping one’s consciousness alive to the present reality” (Thich Nhat Hanh, 1976, p. 11) “The clear and single-minded awareness of what actually happens to us and in us at the successive moments of perception” (Nyanaponika Thera, 1972, p. 5)

5. Mindfulness-Based Stress Reduction Developed at the University of Massachusetts Medical School Jon Kabat-Zinn, Ph.D. founded the Stress Reduction Clinic in 1979 Since 1979, over 19,000 UMass medical patients have completed MBSR for: - chronic pain - chronic medical conditions and illness - grief - life stress - psychological distress (anxiety, panic, depression) - sleep disturbance - health enhancement and wellness (prevention) Currently over 600 MBSR clinics worldwide

6. Overview of MBSR Public health intervention rooted in mind/body medicine Teaches mindfulness meditation and mindful movement practices Eight-week long program consists of: - 8 weekly sessions, lasting 2.5 to 3 hours each - One all-day session (7 hours) during the sixth week - Daily formal home practice assigned (45-60 min. per day) - Informal practice and other home exercises assigned Typical session format includes: - Formal meditation and/or mindful movement practice - Group discussion of formal and informal practice experiences - Instructor-led discussion of new material

7. Self-Regulation Theory (Schwartz, 1984; 1990) Grounded in systems theory Complex system viewed as a nonlinear dynamic “whole” Capacity to self-regulate via feedback loops Maintains stability while allowing for adaptability Conscious self-regulation amplifies feedback Pathway model: attention > connection > regulation > order > health/ease disattention > disconnection > disregulation > disorder >disease

8. Intentional Systemic Mindfulness (Shapiro & Schwartz, 2000) “the key to fostering self-regulation lies in the nature of the intention to direct attention” Intention as an initiating antecedent: intention>attention>connection>regulation>order> health Intention toward mindfulness qualities and systemic perspectives “Implementation” or process intention “Reductionistic” self-regulation techniques focus on symptoms or isolated goals and ignore the system

9. How Might Mindfulness Reduce Stress?

10. Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom. - Viktor Frankl

11. From: Kabat-Zinn, J. (1990). Full catastrophe living (p. 265)

12. Applying Mindfulness in Daily Life and in Stressful Situations: STOP Stop Take a breath Observe (What’s happening now?) Proceed (What’s called for now?)

13. MBSR Outcome Research Chronic Pain (Kabat-Zinn, 1982; Kabat-Zinn et al., 1985; 1987; Randolph et al., 1999; Plews- Ogan et al., 2005; Morone et al., 2008) Cancer (Speca et al., 2000; Carlson et al., 2000; Matchim & Armer, 2007) Other medical conditions (Kaplan et al., 1993; Goldenburg et al., 1994; Astin et al., 2003) Mixed clinical populations (Kutz et al., 1985; Roth & Creaser, 1997; Reibel et al, 2001; Biegel et al., 2009) Non-clinical populations (includes medical students and health care staff) (Astin, 1997; Shaprio et al., 1998; 2005; Davidson et al., 2003)

14. Kindness and Compassion

15. Lovingkindness Our natural inclination to care for ourselves and others Barriers: 1)“Near enemy” of attachment 2)Aversion to unpleasant qualities of another Rainer Maria Rilke: “Perhaps everything terrible is in its deepest being something that needs our love.” Barriers to self-care and kindness toward one’s self

16. Compassion Allowing an open heart in the face of pain or suffering Concern for the alleviation of suffering Barriers: 1)“Near enemy” of pity 2)“Compassion fatigue” – Misnomer for feeling/fearing being overwhelmed “The helping profession can be extremely hazardous to your physical and mental health.” - J. Gill (1980)

17. Self-Compassion Opening to our own pain or suffering with kindness Bob Stahl and Elisha Goldstein: Lack of self-compassion as “the great unnamed epidemic” Self-compassion vs self-esteem: - Self-worth does not have to be contingent upon being “better than” - Self-compassion as kindness toward self when suffering or in pain

18. Equanimity A quality of balance that allows us to be fully present with all the different changing experiences of life “Teach us to care and not to care…” Ash Wednesday, T.S. Eliot Barriers: 1)“Near enemy” of indifference

19. Phrases to Practice Equanimity “I have my path, you have your path, and I care about you.” Phrases from Sharon Salzberg (2002), Lovingkindess: “I will care for you but cannot keep you from suffering.” “I wish you happiness but cannot make your choices for you.” “No matter how I might wish things to be otherwise, things are as they are.”

20. Suggested Reading Germer, C.K. (2009). The mindful path to self-compassion: Freeing yourself from destructive thoughts and emotions. New York: Guilford. Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Dell Publishing. Neff, K. (2011). Self-compassion: Stop beating yourself up and leave insecurity behind. New York: William Morrow. Santorelli, S. (1999). Heal thy self: Lessons on mindfulness in medicine. New York: Three Rivers Press. Stahl, B., & Goldstein, E. (2010). A Mindfulness-Based Stress Reduction workbook. Oakland, CA: New Harbinger. (Contains mp3 recordings of guided mindfulness meditations)

21. Suggested Websites http://www.umassmed.edu/cfm Center for Mindfulness in Medicine, Health Care, and Society http://marc.ucla.edu UCLA Mindful Awareness Research Center http://ccare.stanford.edu/ The Center for Compassion and Altruism Research and Education http://www.self-compassion.org/ Dr. Kristin Neff, University of Texas at Austin http://greatergood.berkeley.edu/ Greater Good Science Center