MINDFULNESS
USING THE MIND TO CHANGE THE MIND
Dr. Eng-Kong Tan MBBS, MPM, FRANZCP
keynote address to
17th Annual Hunter Mental Health Conference
At Noah’s on the Beach, Newcastle, NSW
Fri 13th May 2011
MINDFULNESS
In Daily Life
 as
a practice
 as an attitude
 as a mental set
 as a mode of being
In Therapeutic Setting
 as
a technique
 as a presence
 as a therapy
 as coaching
The Eight Fold Path
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Right speech
Right action
Right livelihood
Right effort
Right mindfulness
Right concentration
Right view
Right thought
Ethics
Meditation as a
Mental Development
Wisdom
4 FOUNDATIONS of MINDFULNESS
4
1.
2.
3.
4.
Contemplation of
Contemplation of
Contemplation of
Contemplation of
the Body
Feelings
Mind States
Teachings
(Dharma)
AWARENESS
INTERACTIONS
Using the Mind to Change the Mind
5
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.
WHAT IS THERAPEUTIC MINDFULNESS?
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-Zinn
6
PSYCHOTHERAPY REBUILDING the BRAIN
Safe & Empathic Relationship
emotional/neurobiological context
conducive to neural reorganisation
Positive and attuned relationship
biochemical changes
neural plasticity
and learning
(Schore 1994)
7
NEUROSCIENCE of MEDITATIVE PSYCHOTHERAPY
-1-
During Intense Emotions
Traumatic Memories
Amygdala overactive
Hippocampus underfunctions
Cortex shuts down
8
NEUROSCIENCE of MEDITATIVE PSYCHOTHERAPY
Calmness
Slowing Down
neural nets activated
heightens imagery
Mindfulness
on body
neuropeptides useful
information digested
Focused attention
Sense Immediacy
UC is accessed
CONSCIOUS
implicit memory
explicit memory
memory trace
re-coded
vulnerable
in hippocampus
9
NEUROSCIENCE of MEDITATIVE PSYCHOTHERAPY
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)
10
MINDFULNESS-BASED THERAPIES
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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)
11
WORK STRESS in NURSES


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Intensive support in the face of pt’s suffering
Insufficient power & control
Dealing daily with pain, loss and trauma
Changing work environment
SYMPTOMS & SIGNS
of Burnout and Compassion Fatigue
13
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Boundaries Blurred – between work & private life
Feeling Unsafe – hyper vigilance, hypochondrias
Overcritical – of self & others
Pessimistic – cynical, hopelessness
Alienation – withdrawing, isolating
Powerlessness – anxious, loss of control
Meaninglessness – indecisiveness, depression
BUILDING RESILIENCE
BUDDHIST TEACHINGS & PRACTICES
14
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MINDFULNESS Training –
improved concentration
managing counter transference
BRAHMA VIHARAS – Cultivation of:
loving-kindness
true compassion
altruistic joy
equanimity
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.
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 issues
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
NURSE LEADER Mindfulness Meditation Programme (cont’d)
RESULTS:
SCL – 90 R : significantly more improvement
in 10 out of 14 measures
 Depression, Anxiety
 Positive Symptom Total
 Caring Efficacy Scale
CONCLUSION:
Mindfulness is a way of caring and nurturing self
so that LEADERSHIP can be more effective