Practicing mindfulness helps us meet life’s challenges with gentleness and clarity. By fully engaging in the present moment as best we can, we nurture our capacity to approach difficulties with less judgment and water the seeds of wisdom and openheartedness in ourselves. This book offers a concise and thorough immersion in the eight-week Mindfulness-Based Stress Reduction (MBSR) course developed by Dr. Jon Kabat-Zinn. It features straightforward instruction in the main exercises of MBSR sitting meditation, walking meditation, eating meditation, yoga, body scan, and informal, everyday practices. MBSR has been shown to help alleviate symptoms associated with chronic illness, anxiety, pain, burnout, cancer, and other stress-related conditions.
The authors, two leading MBSR teacher trainers, provide step-by-step instructions as well as illustrative real-life examples. Readers embarking on a course in MBSR will find clear guidance, trainers will gain a valuable tool for their teaching, and anyone experiencing or receiving treatment for challenges of mind, body, or spirit will find practical, inspirational help.
|Publisher:||New World Library|
|Product dimensions:||5.90(w) x 8.90(h) x 0.60(d)|
About the Author
Linda Lehrhaupt, PhD, is the founder and executive director of the Institute for Mindfulness-Based Approaches and one of Europe’s most senior MBSR teachers.
Petra Meibert, Dipl. Psych., is a psychologist and one of Germany’s leading experts on MBSR, MBCT (Mindfulness-Based Cognitive Therapy), and the applications of mindfulness in medicine and psychotherapy.
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Mindfulness-Based Stress Reduction
The MBSR Program for Enhancing Health and Vitality
By Linda Lehrhaupt, Petra Meibert
New World LibraryCopyright © 2017 Linda Lehrhaupt and Petra Meibert
All rights reserved.
What Is MBSR and Who Can Benefit from It?
Mindfulness-Based Stress Reduction (MBSR) is taught as an eight-week course of usually two-and-a-half- to three-hour sessions, with a full day of silent mindfulness practice between the sixth and seventh meeting. Dr. Jon Kabat-Zinn developed MBSR at the University of Massachusetts Medical Center in Worcester. Inspired by his own experiences with Vipassana and Zen meditation, as well as yoga, Kabat-Zinn taught the first MBSR course in 1979. MBSR was part of the then-emerging field known today as mind-body, or integrative, medicine.
At its core, MBSR is an intensive training in mindfulness, which Kabat-Zinn has defined as "the awareness that arises by paying attention on purpose, in the present moment and non-judgmentally." The most detailed training and study of mindfulness occur in Buddhist traditions, particularly Vipassana, but mindfulness is expressed in other contemplative traditions as well. Since the 1970s it has been integrated into Western health care, education, and other fields and is seen as a nondenominational, nonreligious training available to everyone, whatever their belief. As Kabat-Zinn notes, mindfulness
is a way of looking deeply into oneself in the spirit of self-inquiry and self-understanding. For this reason it can be learned and practiced, as is done in mindfulness-based programs throughout the world, without appealing to Asian culture or Buddhist authority to enrich it or authenticate it. Mindfulness stands on its own as a powerful vehicle for self-understanding and healing. In fact, one of the major strengths of MBSR and of all other specialized mindfulness-based programs such as mindfulness-based cognitive therapy (MBCT) is that they are not dependent on any belief system or ideology.
Shortly after Kabat-Zinn began teaching MBSR, the Stress Reduction Clinic at the University of Massachusetts Medical Center opened with MBSR as its flagship program. During a one-year trial phase, the clinic held stress-reduction courses with up to thirty participants in each class, many of them chronic-pain patients. The course proved effective in that participants learned to handle their pain in a better way. Their personal suffering diminished, and in some cases their pain levels were reduced in intensity.
From the outset, Kabat-Zinn and his coworkers did research studies. MBSR has been shown to be helpful in reducing symptoms and improving the quality of life for people experiencing a wide range of conditions.
MBSR was the first of what are now known as mindfulness-based interventions or approaches. Programs whose formats (including course length and emphasis on practice at home) are modeled on MBSR include, among others, Mindfulness-Based Cognitive Therapy (MBCT), Mindfulness-Based Eating Awareness Training (MB-EAT), Mindfulness-Based Relapse Prevention (MBRP), and Mindfulness-Based Cancer Care. The main difference between MBSR and these more specialized programs is that the latter generally target people with a specific condition — for example, chronic pain, multiple relapses of depression, substance abuse, cancer, and so on. MBSR courses address participants who have an array of conditions but who are not separated according to their diagnosis or situation.
MBSR is being taught throughout the world by a wide range of professionals, including physicians, psychologists, psychotherapists, schoolteachers, social workers, coaches, physiotherapists, nurses, occupational therapists, chaplains, yoga teachers, and many more people in a wide variety of environments and institutions, including hospitals, psychiatric clinics, universities, private practices, schools, hospices, adult-education institutes, corporations, prisons, counseling centers, medical schools, the armed forces, and many other settings.
MBSR is suitable for people who want to learn to cope with stress using their own resources to improve the quality of their lives. A key element of the course is seeing that it is possible to shift the way we view events or conditions in our lives. In the MBSR course, participants learn that practicing mindfulness can help alleviate their symptoms by creating a wider context for their condition. Rather than focusing on the situation itself, we learn to observe the way we relate to it on emotional, intellectual, and behavioral levels. In the case of relating to pain, for example, some clients in our classes report that the emotional pain (anger, blaming, resignation, a sense of helplessness) they experienced before the course no longer dominates their waking moments. While participating in the course they have practiced being aware of thoughts as thoughts rather than facts, enabling them to create some distance rather than be carried away by them. By practicing the formal MBSR exercises, and particularly the body scan, pain patients can begin to shift their relationship to pain from "I am my pain" to "My body is experiencing pain, but it is not all of me." They may still experience physical pain, but it does not narrow their life choices or dominate their thoughts as much as it did before.
In summing up the relationship between scientific studies and the way we see ourselves, Kabat-Zinn points to the health-enhancing qualities that mindfulness of thoughts and emotions can support:
If we can be aware — especially in our own personal experience, as well as from the evidence from scientific studies — that certain attitudes and ways of seeing ourselves and others are health-enhancing: — that affiliative trust, compassion, kindness, and seeing the basic goodness in others and in ourselves has intrinsic healing power, as does seeing crises and even threats as challenges and opportunities, then we can work mindfully to consciously develop these qualities in ourselves from moment to moment and from day to day. They become new options for us to cultivate. They become new and profoundly satisfying ways of seeing and being in the world.
Alleviating symptoms of illness and stress is an important aspect of an MBSR course and an understandable motivation for many to join, but practicing mindfulness and making it part of our daily lives goes far beyond reducing the symptoms of an illness. Mindfulness is more than a problem-solving technique. It is a fundamental shift in attitude toward ourselves and whatever our condition might be. It helps us tap into our inner resources and capacities and access the potential for healing that we all have. This in turn creates the basis for an inner orientation toward a wholesome way of life. In this sense, mindfulness is a fundamental attitude and way of living.
Developing a kind and compassionate attitude toward ourselves is a key factor in the healing power of mindfulness. By healing, we do not mean curing an illness or getting rid of debilitating symptoms. Healing in this context is related to experiencing wholeness, and we can experience a sense of wholeness, even in the midst of serious illness.
Karin, an MBSR course participant who has multiple sclerosis (MS), speaks of this. She regularly attends MBSR follow-up days offered for former students. She expressed the value of mindfulness practice for her life in the following way: "It's becoming increasingly clear what the MBSR course did for me in terms of the way I deal with MS. At the beginning of the mindfulness journey, I saw myself as someone who 'suffered' from MS. Thanks to the training I now say: 'I live with MS.' Perhaps this new attitude, and the ability to experience the difference, is the point of mindfulness practice; but for me it is also about the possibility of suffering and living, both at the same time."
A study at Basel University Hospital in Switzerland supports Karin's personal experiences of the benefits of MBSR for her. The study shows that MS patients who took part in an MBSR course experienced more vitality and better quality of life and suffered less frequently from depression.
There has been an explosion of scientific studies on MBSR and mindfulness-meditation training in recent years. In his pioneering research at the University of Wisconsin, Dr. Richard Davidson documented that mindfulness-meditation training can stimulate neuroplasticity, which he defines as "a capacity of the brain to change its structure and function in significant ways." He goes on to note,
The amazing fact is that through mental activity alone we can intentionally change our own brains. Mental activity, ranging from meditation to cognitive-behavior therapy, can alter brain function in specific circuits, with the result that you can develop a broader awareness of social signals, a deeper sensitivity to your own feelings and bodily sensations, and a more consistently positive outlook.
In 1999, Dr. Davidson and his team conducted an important study on MBSR. Participants took part in an eight-week MBSR course; a control group did not take part in this class (but was offered the same course when the study was over). Results of the study included a reduction of anxiety symptoms of about 12 percent (as opposed to a slight increase in the control group). According to Dr. Davidson, the MBSR course participants showed that the level of left-side activation of the prefrontal cortex had tripled after four months. This was significant because it reflected "the fact that people practicing this form of mental training learn to redirect their thoughts and feelings[,] ... reducing activity in the negative-emotion right prefrontal cortex and ramping it up in the resilience- and well-being-boosting left side."
All of the study participants, including the control group, were also given a flu shot, and the MBSR students' production of antibodies in response to the vaccine was 5 percent higher than that of the control group. For Davidson this was "an indication that their immune systems responded more effectively than those of the control group."
In the 2013 revised edition of his book Full Catastrophe Living, Jon Kabat-Zinn summarized other studies he considered significant for documenting the effects of MBSR. They included the following:
A study at Massachusetts General Hospital and Harvard University showed that after an eight-week course, density increased in regional gray matter of the brain. These regions, according to Kabat-Zinn, are "associated with learning and memory, emotional regulation, the sense of self, and perspective taking."
A study at the University of Toronto showed increases in neural activity in a region of the brain associated with experiencing the present moment. At the same time, decreases in the area of the brain known as the "narrative network" were also recorded. According to Kabat-Zinn, "These findings imply that by learning to inhabit the present moment in an embodied way, people can learn how not to get so caught up in the drama of their narrative self, or, for that matter, lost in thought or mind wandering — and when they do get lost in these ways, that they can recognize what is happening and return their attention to what is most salient and important in the present moment."
A study at UCLA and Carnegie Mellon University showed that loneliness was reduced in a group of participants aged fifty-five to eighty-five who took part in an MBSR course. This is significant because loneliness is one of the emotional states implicated in greater health risks.
MBSR has been shown to be helpful in improving the quality of life and reducing symptoms for people in every age group and in a wide range of conditions. One of the many examples of how MBSR can help a particular section of the population is the improvement of the quality of life for seniors, including those suffering from dementia, as well as for their caregivers. Lucia McBee, who led MBSR groups with elderly people in nursing homes in the United States for more than seven years, reports that following an MBSR course, participants experienced, among other things, pain relief, general well-being, and, in dementia patients, reduced restlessness.
Taking part in an MBSR course also helped caregivers better cope with the double burdens of earning a living and attending to someone who needs care. The same was true for nurses and other staff members in psychiatric hospitals, nursing homes, and acute care clinics. One way MBSR has been helpful for those dealing with occupational stress in general is by teaching people how to be more in touch with themselves and to recognize and respect their own boundaries.
When Would Participation in an MBSR Course Not Be Advisable?
In some situations or conditions, participation in a course is not generally recommended. This includes when a person is actively addicted to a substance or in a state of acute depression. (When participants are stable in a nondepressive phase or have been substance-free for a significant period, MBSR may well be suitable for them.) Taking part in an MBSR course as presented in this book is also contraindicated for those with serious psychiatric disorders such as schizophrenia and psychosis. Clinical trials with mindfulness have been conducted for patients with severe psychiatric disorders; however, this is beyond the scope of our book.
Cancer patients undergoing chemotherapy treatment, and others suffering from severe physical symptoms, may find an MBSR course too physically taxing during their treatment phase. It is advisable for such individuals to wait until their condition is stable enough to permit them to attend class each week and complete the weekly course assignments at home.
Similarly, if you have recently experienced a profound life event, such as the death of a loved one or a life-threatening diagnosis, it may be advisable first to seek support at a counseling center from a psychotherapist or a support group. Once a degree of emotional stability is present, an MBSR course can be a wonderful support for your situation. MBSR is also very helpful as a complement to psychotherapy.
We suggest seeking contact with an MBSR teacher and discussing your personal situation. She or he will be very happy to help you determine whether an MBSR course is an appropriate choice and to assist you in reflecting on your own intentions and motivation.
An intention to participate as fully as possible during the program, and to commit yourself to a healthy and well-balanced lifestyle, is the most important aspect of enrolling in an MBSR course. If you are not personally convinced of the possible value of a course of action, then recommendations or persuasion by others — including well-meaning loved ones, friends, or even your doctor — will not provide the motivation necessary to keep you on track during the course.
What Is the Difference between Mindfulness Practice and Relaxation Methods?
Some participants experience a sense of relaxation while practicing mindfulness of the body or mindfulness of sensations, or while doing other exercises within the MBSR course, but not always. Bringing mindfulness to all areas of our lives — including the difficult ones — can also mean that we are initially more aware of dissatisfaction or stress or pain than we were before, simply because we are turning our attention to these areas. This also explains why, during the early stages of an MBSR course, participants often report that they are more conscious of just how restless their minds actually are and how often they find their thoughts drifting off to the past or future. Some say they are more aware of pain in the body or disturbing thoughts. In truth, mindfulness does not cause more disturbing thoughts or painful sensations. We are simply more attuned and sensitive to these elements, noticing something we were not conscious of before or had been pushing into the background.
A short exercise like the following one on awareness of the body and breath can help illustrate the difference between mindfulness and a relaxation exercise.
When we do exercises like "Awareness of the Body and the Breath," a question the MBSR teacher might ask afterward is: "What did you experience?" You probably noticed while doing the exercise that your thoughts jumped to other objects or activities several times, perhaps continually. This is entirely normal and shows, in fact, how little our attention is anchored in the present moment. This is precisely what we need to observe at the outset of our practice: the mind is often restless.
If we are intent on achieving relaxation, we may instead find that we have tightened up or become sharply focused on the breath. This can lead to shortness of breath or other physical symptoms related to tension. We may then sense that we have failed to do the exercise properly, as well as feel disappointed that relaxation has not occurred.
If we see this as a mindfulness exercise, we practice noticing the breath and anything else that might occur, including our intention to relax or our attempt to physically control our breathing. If we notice we are tense, we stay with exactly what we experience (sensations, thoughts, emotions) as best we can, without trying to change anything. We are focused not on results but on what is happening from moment to moment.
Excerpted from Mindfulness-Based Stress Reduction by Linda Lehrhaupt, Petra Meibert. Copyright © 2017 Linda Lehrhaupt and Petra Meibert. Excerpted by permission of New World Library.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
Part 1 Getting Started in MBSR: Background Basics
Chapter 1 What Is MBSR and Who Can Benefit from It? 3
Chapter 2 What Is Mindfulness? 15
Chapter 3 Stress, Life's Challenges, and Mindfulness 35
Part 2 The Eight-Week MBSR Course
Chapter 4 Beginning the Journey: The Mindfulness Compass 55
Chapter 5 The Eight-Week MBSR Program 75
Week 1 Exploring Mindfulness 79
Week 2 How We Perceive the World and Ourselves 91
Week 3 Being at Home in Our Own Body 105
Week 4 What Is Stress? 113
Week 5 Stress: Reaction or Mindful Response 121
Week 6 Mindful Communication 139
A Day of Mindfulness: Deepening the Practice in Stillness 149
Week 7 Taking Care of Ourselves 155
Week 8 Looking Backward, Going Forward 167
Recommended Reading 185
The Institute for Mindfulness-Based Approaches 209
The Ruhr Mindfulness Institute 211
About the Authors 213