Self-compassion - Nevada State Board of Nursing

Report
Mindfulness and Self-Compassion
in Times of Stress
Holly Hazlett-Stevens, Ph.D.
Associate Professor
Department of Psychology
University of Nevada, Reno
[email protected] (775) 682-8702
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)
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
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)
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
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
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
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
How Might Mindfulness Reduce Stress?
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
From: Kabat-Zinn , J. (1990).
Full catastrophe living
(p. 265)
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?)
MBSR Outcome Research
• Chronic Pain
(Kabat-Zinn, 1982; Kabat-Zinn et al., 1985; 1987; Randolph et al., 1999; PlewsOgan 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)
Kindness and Compassion
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
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)
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
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
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.”
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)
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

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