Using the Mind to Change the Mind Dr EngKong Tan MBBS MPM FRANZCP keynote address to 17 th Annual Hunter Mental Health Conference At Noahs on the Beach Newcastle NSW Fri 13 th May 2011 ID: 340345
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Slide1
MINDFULNESSUsing the Mind to Change the Mind
Dr. Eng-Kong Tan MBBS, MPM, FRANZCP
keynote address to
17
th
Annual Hunter Mental Health Conference
At Noah’s on the Beach, Newcastle, NSW
Fri 13
th
May 2011Slide2
MINDFULNESS
In Daily Life
a
s a practiceas an attitudeas a mental setas a mode of being
In Therapeutic Setting
a
s a technique
a
s a presence
a
s a therapy
as coachingSlide3
The Eight Fold Path
Right speech
Right action Ethics
Right livelihoodRight effort Meditation as aRight mindfulness Mental DevelopmentRight concentrationRight view Wisdom
Right thoughtSlide4
4 FOUNDATIONS of MINDFULNESS
Contemplation of the Body
Contemplation of Feelings AWARENESS
Contemplation of Mind States
Contemplation of Teachings INTERACTIONS
(Dharma)
4Slide5
5
Using the Mind to Change the Mind
As
the brain changes, the mind changes
.
As
the mind changes, the brain changes
. - neurons that fire together, wire together
- neural pruning and epigenesis We can use
our mind
to change
our
brain to change our
mind for the better:
self-directed
neuroplasticity
.
The practice of MINDFULNESS and MEDITATIONS
are self – therapies.
Slide6
WHAT IS THERAPEUTIC MINDFULNESS?
6
Definition:
the awareness that emerges through
paying attention on purpose,
in the present moment, and
nonjudgementally
to the unfolding of experience
moment by moment -Jon Kabat-ZinnSlide7
PSYCHOTHERAPY REBUILDING the BRAIN
7
Safe & Empathic Relationship
emotional/neurobiological context
conducive to neural reorganisation
Positive and attuned relationship
biochemical changes neural plasticity
and learning (Schore 1994)Slide8
NEUROSCIENCE of MEDITATIVE PSYCHOTHERAPY-1-
8
During Intense Emotions
Amygdala
overactive
Traumatic Memories Hippocampus
underfunctions
Cortex shuts down Slide9
NEUROSCIENCE of MEDITATIVE PSYCHOTHERAPY
9
Calmness
Slowing Down
neural
nets activated
heightens imagery Mindfulness
on body neuropeptides useful information
digested
Focused attention
UC
is accessed
CONSCIOUS
implicit memory
explicit memory
Sense Immediacy
memory
trace
re-coded
vulnerable
in
hippocampusSlide10
NEUROSCIENCE of MEDITATIVE PSYCHOTHERAPY
10
L Brain R Brain
make up causal explanations emotional & sensory data
needs time to be connected together
(understanding and insight)
facilitated by Empathic Attunement (emotional resonance) mediates a new context and meaning via frontal lobes and hippocampus
(recovery/healing)
Slide11
MINDFULNESS-BASED THERAPIES
11
M-B Stress Reduction
(
Jon
Kabat-Zinn
et al)
M-B Cognitive Therapy (Teasdale, et al)Dialectical Behaviour
Therapy (Marsha Linehan)Acceptance & Commitment Therapy (Stephen Hayes)
Hakomi
Therapy
(Ron
Kurtz)
Morita Therapy (Morita)
Core
Process
Psychotherapy
(Maura
Sills)
Meditative
Psychotherapy
(Eng-Kong Tan)Slide12
WORK STRESS in NURSES
Intensive support in the face of pt’s suffering
Insufficient power & control
Dealing daily with pain, loss and trauma
Changing work environmentSlide13
SYMPTOMS & SIGNS of Burnout and Compassion Fatigue
Boundaries Blurred – between work & private life
Feeling Unsafe – hyper vigilance, hypochondrias
Overcritical – of self & othersPessimistic – cynical, hopelessness
Alienation – withdrawing, isolating
Powerlessness – anxious, loss of control
Meaninglessness – indecisiveness, depression
13Slide14
BUILDING RESILIENCE
BUDDHIST TEACHINGS & PRACTICES
MINDFULNESS Training
–
improved concentration
managing counter transference
BRAHMA VIHARAS – Cultivation of: loving-kindness true compassion
altruistic joy equanimity
14Slide15
The Buddha on Lovingkindness
Wishing: In gladness and in safety, may all beings be at ease.
Omitting none, whether they are weak or strong, the great or the mighty, medium, short, or small, the seen and the unseen, those living near and far away, those born and to-be-born: May all beings be at ease.
Let none through anger or ill-will wish harm upon another. Even as a mother protects with her life her child, her only child, so with a boundless heart should one cherish all living beings; radiating kindness over the entire world: spreading upwards to the skies, and downwards to the depths, outwards and unbounded, freed from hatred and ill-will.
One should sustain this recollection.
This is said to be the sublime abiding.Slide16
MBSR for Nurses by Dr Cohen-Katz et al,
Santa Clara University at Lehigh Valley Hospital, California - 2005
8 wks MBSR, 25 nurses, 46 yrs, 21 yrs in Healthcare
RESULTS:
Caring for Everyone SELF-CARE
Positive changes in Relationships
More fully present with Others
Less reactive, defensive
Resolving old wounds and issuesSlide17
NURSE LEADER Mindfulness Meditation Programme by Dr Pipe et al, at Mayo Clinic Arizona, Phoenix
33 High Function Nurse Leaders randomly assigned to Mindfulness Meditation Course (MMC) or Leadership Course
MMC – 4 weeks, 2+1 hr/week,
at workplace and at low cost Slide18
NURSE LEADER Mindfulness Meditation Programme (cont’d)
RESULTS:
SCL – 90 R : significantly more improvement
in 10 out of 14 measuresDepression, AnxietyPositive Symptom Total
Caring Efficacy Scale
CONCLUSION:
Mindfulness is a way of caring and nurturing self so that LEADERSHIP can be more effective