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Mindfulness Practice in Clinical Work


Mindfulness Practice in Clinical Work Steve Gonzalez, LISW Our breath is the bridge from our body to our mind (Hahn) Objectives Participants will learn ways to ... – PowerPoint PPT presentation

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Title: Mindfulness Practice in Clinical Work

Mindfulness Practice in Clinical Work
  • Steve Gonzalez, LISW
  • Our breath is the bridge from our body to our
    mind (Hahn)

  1. Participants will learn ways to apply mindfulness
    in clinical practice
  2. Participants will learn how to apply mindfulness
    in personal life
  3. Participants will gain an understanding how
    mindfulness promotes balance, healing, and

A mindful verse
  • We can not do anything about Yesterday, it is
    gone forever. The future is a mystery. Today
    however, is a precious GIFT.
  • That is why we call it the PRESENT.

Lyrics Right Now Van Halen
  • Right now
  • Theres no tomorrow, right now
  • Come on its everything, right now
  • Its a magic moment
  • Do it right here and now
  • It means everything
  • Right here and now

What is Mindfulness?
  • A quality of present moment awareness, openness,
    acceptance, and being nonjudgmental
  • Experiencing the moment as it happens- it is the
    only moment that exists
  • Human Being/not human doing
  • Fully engaged in the moment-right here and now

You must be present to win
  • Many times we live our lives mindlessly,
    mechanically on automatic pilot
  • We all have experiences of being/living in the
  • The door to the present moment, to true
    appreciation of our entire lives, is cultivation
    of the practice of mindful awareness-an intimate
    relationship with the present Jean Smith

Common Elements-Mindfulness (Germer, 2005)
  • Non-conceptual awareness without absorption in
    our thought process
  • Present-centered thoughts about our experience
    are one step removed from the present moment
  • Nonjudgmental no right or wrong, good/bad
  • Nonverbal mindfulness not captured in words,
    awareness occurs before words arise in the mind
  • Intentional continuous redirection to the
    present moment

Common Elements-cont.
  • Exploratory mindful awareness is always
    investigating subtle levels of perception
  • Participant observation experiencing the
    mind/body more intimately versus detached
  • Liberating mindful awareness provides freedom
    from conditioned suffering

Mindfulness Based Practices
  • 1979 Mindfulness Based Stress Reduction
  • 1993 DBT Linehan
  • 2000 Mindfulness Based Cognitive Therapy
    Teasdale et al
  • 2002 Mindful Recovery Bien
  • 2004 ACT Hayes

Mindful presencetherapeutic Alliance
  • Fully being present with the client leads to
    empathy, warmth, understanding, acceptance,
    attention, and compassion
  • Research shows these qualities improve the
    therapist/client relationship

Advantages of Mindfulness
  • Prevent Clinician Burn-Out
  • Complimentary to Clinical Models
  • Theoretical Frame Work
  • Self-growth
  • Life starts with a breath and ends with a
    breath (Yogi Bhajan)

The Breath
  • We are not in touch with our breath-its just
    there. In mindfulness we get in touch with it and
    notice how the breath changes with our moods. We
    dont control the breath. Just notice it,
    observe, watch, and feel the breath.
  • Karen Ryder, instructor, Stress Reduction Clinic,
    UMASS Medical Center

Mindfulness of the Breath
  • Serves as your anchor point
  • Brings you back to the here now moment
  • Helps to broaden your perspective

Mindfulness form of meditation
  • Developing 3 qualities of attention
  • Withholding of Judgment
  • Intentional Awareness
  • Focus on the present moment

1. Withholding Judgment
  • Natural tendency to evaluate/judge our
    experiences and attach meanings
  • These judgments can get in the way (neutral,
  • All experience is accepted and all judgments are
    let go
  • Acceptance-acknowledging the reality of your

2. Intentional Awareness
  • Choosing to focus your attention on a particular
    experience and keep your attention there
  • Becoming aware of the mind wandering
  • Bring your mind back to the present moment

3. Focus on the Present Moment
  • Awareness of breath
  • Focus on body sensations
  • Pay attention to the flow of thoughts/feelings
  • Notice thoughts as thoughts and feelings as
    feelings-do not get caught up on content
  • Each moment is a series of new beginnings

  • Scientists study it. Doctors recommend it.
    Millions of Americanspractice it everyday. Why?
    Because meditation works.
  • (Time. August 4, 2003).

Studies on Meditation
  • Various research studies have proven the
    effectiveness of meditation and how practice can
    positively impact emotional and physical health.

Benefits of meditation
  • Improved concentration and focus
  • A greater sense of peace and well-being
  • A feeling of calmness
  • Simple drug free stress reduction
  • Improved mental and physical health

Misconceptions of Meditation
  • 1. Meditation is too complicated
  • 2. Meditation takes up too much time
  • 3. You have to have absolute silence to meditate
  • 4. Meditation is not a religion
  • 5. Meditation is an excuse to escape reality and
  • 6. There is only one way to meditate

Meditation is for anyone
  • Meditation can be practiced by anyone regardless
    of age, gender, orientation, occupation,
    nationality or religion
  • The best part- it can be done for free

Establishing a meditation Practice
  • Find a comfortable and quiet place
  • Chose a time of day that is right for you
  • Make a commitment to practice on a consistent
  • Sit in manner that allows you to be relaxed and
  • Let yourself settle in and get centered
  • Find a focal point for your attention

Establishing Meditation-continued
  • Wear comfortable clothing
  • Trust the process
  • Continue for a comfortable period of time
  • Set no goals-just meditate
  • Practice, Practice, Practice

counting the BreathDeveloping awareness of
  • Good Posture-deep belly breathing
  • Count to ten in-breath one, out-breath one
  • Count from 10 to 1 in same manner
  • In-breath- out breath
  • Mind training to develop concentration and
    getting to know yourself
  • Lose your focus start back at one

2. Follow your breath
  • Notice your breathing is long or short, deep or
    shallow, cool or warm?
  • Just notice and observe
  • Make no judgments
  • Be present in the moment
  • Advanced practice-notice and observe your thoughts

  • Pain is inevitable suffering is optional
  • Pain does not equal suffering
  • Pain x resistancesuffering (Siegel, 2005)

Transforming Feelings Practice(Braza, 1997)
  • Begin mindful breathing
  • Thoughts lead to feelings anger
  • As the feeling anger enters consciousness
  • Simply become aware of anger and bring attention
    back to the breath
  • Awareness reduces the power of anger
  • In the moment accept anger. Do not resist.
    Embrace anger

Transforming Feelings cont.
  • Befriend anger and become one with it
  • Breathe in and out, observe and study the anger
  • Begin to calm anger-mindful breathing
  • Experiencing the feeling of anger in me, I
    breath in .
  • Smiling at the anger in me, I breath out.

Another Example of Mindful Verse working with
  • Breathing in, I recognize my anger
  • Breathing out, I am aware of how angry I am
  • Breathing in, I see my anger overwhelming me
  • Breathing out, I recognize that anger affects my
    entire body
  • Personalize phrases is key-same method can be
    used for walking meditation

Informal Practices Daily-Life Mindfulness
  • Engaged attention of present moment activity
  • Examples-washing dishes, sweeping, jogging,
    driving, waking-up, brushing teeth etc
  • Take mindful breaths before, during, and after an

Eating Meditation
  • Mindful or mindless activity?
  • Think about your last meal. Can you recall the
    various tastes, smells, and textures you

Steps for Mindful Eating
  • Remember purpose-to eat and become aware of
  • Slow down the eating process-chew your food
  • Involve all your senses sight, hearing, taste,
    smell, touch
  • As your mind wanders bring your awareness back to
    the moment of eating

Walking Meditation
  • Become aware of your breathing
  • Stepping with your left foot and while breathing
    in say, In.
  • As your right foot moves forward, breath out and
    say Out.
  • Vary your pace and breathing to suit your needs
    and environment
  • As your mind wanders bring your attention back

Loving-kindness Meditation
  • Purpose is to develop compassion for self and
  • Chant for self, family, friend, neutral person,
    difficult person, universal
  • May I enjoy happiness and the root of happiness
  • May I be free from suffering and the root of

Standing Meditation
  • Become aware of your breath
  • Stand in straight comfortable posture
  • Focus on your breath to stay in the moment
  • Feel the body sensations
  • Connect with the ground, air, sounds, light,
  • Metaphor-Tree

Think About
  • Exploring ways in which you can apply mindfulness
    in your daily work and or personal life.
  • How do you plan to be more mindful while driving,
    using the computer, with colleagues, routine

  • Mindfulness has many applications in the clinical
  • Mindfulness practice can be used to prevent
  • Mindfulness practice is research based
  • Practice, Practice, Practice
  • Clients can gain freedom when they recognize
    that thoughts are not facts they are just

Book Resources
  • Braza, J. (1997) Moment by moment The art and
    practice of mindfulness.
  • Hayes, S., Follette, V., Linehan, M (2004)
    Mindfulness and acceptance Expanding the
    cognitive-behavioral tradition.
  • Linehan, M (1997) Skills training manual for
    treating borderline personality disorder.
  • Nhat Hahn, T (1975) The miracle of mindfulness A
    manual on meditiation.
  • Smith, J. (2004) NowThe art of being truly

Book Resources p.2
  • Bien, T, (2002) Mindful recovery A spiritual
    path to healing from addiction.
  • Brantly, J., (2003) Calming your anxious mind
    How mindfulness and compassion can free you from
    anxiety, fear, and panic
  • Kabat-Zinn, J., (1990) Full castastrophe living
    using the wisdom of your body and mind to face
    stress, pain, and illness.
  • Mruk, C., Hartzell, J. (2003) Zen and
  • Rosenbaum, R., (1998) Zen and the heart of
  • Segal, Z., Williams, J., Teasdale, J., (2001)
    Mindfulness-based cognitive therapy for

Journal Articles
  • Kabat-Zinn et al. Effectiveness of a
    meditation-based stress reduction program in the
    treatment of anxiety disorders. American Journal
    of Psychiatry, 1992 149936-943
  • Kabat-Zinn, et al. Four year follow-up of a
    meditation-based program for self-regulation of
    chronic pain Clinical Journal of Pain, 1986
  • Miller, J et al. Three year follow-up and
    clinical implications of a mindfulness-based
    stress reduction intervention General Hospital
    Psychiatry, 1995 17192-200

Journal Articles p.2
  • Shapiro et al. Effects of mindfulness-based
    stress reduction on medical and premedical
    students Journal of Behavioral Medicine 21581-97
  • Teasdale et al. Prevention and relapse in major
    depression by mindfulness-based cognitive therapy
    Journal of Consulting and Clinical Psychology
    2000 68615-623
  • Speca et al. A randomized, wait-list controlled
    clinical trial the effect of a mindfulness
    meditation-based stress reduction program on mood
    and symptoms of stress in cancer patients
    Psychosomatic Medicine 62613-22

Contact Information
  • Steve Gonzalez, LISW
  • Des Moines Public Schools
  • Children and Families of Iowa
  • 515-242-8276
  • Steven.gonzalez_at_dmps.k12.ia.us
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