Alexandra Arbogast, LICSW, RYT, CMT
Program Coordinator & Therapist
Mind-Body Medicine Program
Internal Medicine / Warrior Clinic / NICoE
WRNMMC
301-319-4960 / Alexandra.S.Arbogast.ctr@mail.mil
 Based on the premise that the mind and body are
intimately interconnected. Utilizes techniques to optimize
this relationship for improved health and wellbeing.
 Teach mindfulness-based skills that can be integrated into
daily life to reduce stress, manage pain, enhance sleep,
strengthen positive qualities, and improve overall quality of
life.
 Offers a low-cost, self-directed, complement to traditional
medical care.
 Mindfulness
 Attention training to cultivate qualities of concentration, clarity,
and equanimity. The common thread connecting all other skills.
 Relaxation
 Techniques to elicit the relaxation response in mind and body
 Yoga
 Movement and breathing strategies to synchronize mind and body
and release tension.
 Positive Psychology
 Practices to cultivate and strengthen positive mind/emotional
states.
 Resiliency Training
 Techniques for balancing the nervous system, processing trauma,
and strengthening the ‘resilient zone’.
“Mindfulness means paying attention in a
particular way; On purpose, in the present
moment, and nonjudgmentally.”
-Jon Kabat-Zinn
Founder of Mindfulness-Based Stress Reduction (MBSR)
Regular Practice Cultivates 3 Core Skills
 Concentration: The ability to focus and stabilize one’s
attention.
 Sensory Clarity: The ability to keep track of the
components of sensory experience as they arise in various
combinations, moment-by-moment.
 Equanimity: The ability to ‘be with’ experience with an
attitude of gentle matter-of-factness.
 Many techniques! Depends on teacher and tradition
 Restrictive or open attention
 Noting option
 Beginner practices:
 Restrictive focus, such as breath meditation
 Develops/strengthens core skills of concentration,
clarity and equanimity
 Intermediate / advanced practices:
 Open awareness to increasing amount of sensory
experience, such as “choiceless awareness”
 Formal and informal practices
 In the 19th century, mindfulness was used to translate the
Pali word Sati. Pali is the canonical language of
Theravada, a form of Buddhism found in Southeast Asia.
 “Establishing Mindfulness” (Satipatthana) is a primary
practice of Theravada Buddhism.
 It is said to lead to insight into the true nature of self and
reality (impermanence, the suffering of conditioned
existence, and non-self)
 In the 60’s and 70’s, Westerners began going to Southeast
Asia to learn mindfulness practices. They brought those
practices back to the West and began to teach them within
the framework of Buddhism.
 In the 80’s and 90’s, it was discovered that those practices
could be extracted from Buddhism and the cultural matrix
of Asia and used within a secular context.
 Mindfulness awareness practices started to be used
within a secular context to develop useful attentional
skills.
 These practices became ever more prevalent in clinical
settings for pain management, addiction recovery,
stress reduction, and as an adjunct to psychotherapy.
 In 1979, Jon Kabat-Zinn created Mindfulness-Based Stress
Reduction (MBSR) at the University of Massachusetts Medical
School to treat chronically ill patients.
 Subsequently, a number of other psychotherapeutic
modalities centering around mindfulness were developed:
Acceptance and Commitment Therapy (ACT); MindfulnessBased Cognitive Therapy (MBCT); Dialectical Behavioral
Therapy (DBT).
Increasingly, it is being understood that mindful awareness is
a cultivatable skill with broad applications through all
aspects of society, including education, prison system,
politics, business, and even the training of soldiers.
The Benefits of
Mindfulness
Changes the Brain in Positive Ways
Shows how the brain changes in positive ways
with meditation!
Old Brain
Vs.
New Brain
• Recent research in neuroscience shows that we have the
power to influence our brains.
• When we think certain thoughts, it strengthens those
neural circuits. Mental States Become Neural Traits!
• Self-Directed Neuroplasticity =
Nurture positive states of mind
to strengthen and build those neural
networks. Make Happiness a Habit!
The brain is like a muscle that we can
build through practicing skills.
 Impulse Regulation
 Emotional Awareness
 Compassion & Empathy
 Forgiveness
Stanford University’s
School of Medicine
The Center for Compassion
and Altruism Research and
Education (CCARE)
Helps Balance the Nervous System
Central Nervous System
Autonomic Nervous System
Perception - Narrowed
Memory - Coarse, Imprecise
Learning - Blocked
Conditioning - Defense
Tendency - Regress or Perseverate
Tone – Fight or Flight
Heart rate increases
Blood pressure increases
Oxygen need increases
Breathing rate increases
Palms, face sweat
Blood sugar increases
Adrenalin flows
Digestive tract shuts down blood to
muscles
Blood vessels constrict in hands, face
Muscular System
Tension
Ready for Action
Jaws Clench
Body Braces for Action
Improves Self-Regulation
The Resilient Zone
charge
Release
charge
resilient zone
In our “Resilient Zone” we have the best capacity for
flexibilty and adaptability in mind, body and spirit.
Mindfulness helps deepen the Resilient Zone
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Stuck on “High”
Hyper-arousal
Hyperactivity
Hypervigilance
Mania
Anxiety & Panic
Rage
Pain
resilient zone
Stressful/Traumatic
Event
or
Stressful/Traumatic
Triggers
Depression
Disconnection
Exhaustion/Fatigue
Numbness
Stuck on “Low”
Hypo-arousal
Graphic adapted from an original graphic of Peter Levine/Heller
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Let’s Practice!
Breath-Focus Meditation
Trains the mind to settle, let go of mental clutter, and
focus in the present moment. Connects mind with body.
 Find a comfortable position either lying down on your
back, in a chair, or on a cushion on the floor. Spine should
be erect but not rigid.
 Scan through the body and release unnecessary tension.
 Bring attention to the body with an attitude of friendly
curiosity.
 Tune into the sensations of your body breathing and focus
your attention on the feel of the breath coming in and out.
 When your mind wanders, notice, and gently guide
attention back to the breath (over and over again).
 Practice for 5-30 minutes daily for lasting positive results.
Body Scan Meditation
Connects mind with body. Increases ability to track body sensations.
Grounds attention in the present moment. Increases insight into changing
nature of sensation. Trains mind to tolerate sensation with greater
equanimity.
 Bring curious, friendly attention to the sensations in your feet. Feel vs think.
 Gradually move your way up the body…feeling the ankles, lower legs, knees,
upper legs.
 Feel sensations in the buttocks, the lower back, middle back, and upper back.
 Notice sensations in the pelvis, abdomen, and chest.
 Sense the fingers, hands, wrists, forearms, elbows, and upper arms.
 Feel sensations in the shoulders. Notice any tension without judging it or
trying to change it.
 Notice sensations in the neck, throat, jaw, and mouth.
 Sense the nose, eyes, forehead, ears, and head.
 Feel sensations in the whole body at once. The whole body as one universe of
sensation.
Next Steps
 Create ‘Mindful Pauses’ throughout your day.
 Take 1-5 minutes to practice slowing down, feeling the body,
breathing more fully, letting go of thoughts, and returning to
the present moment with gratitude and acceptance.
 Set aside 5-30 minutes a day for meditation, yoga, art, or another
mindful activity you enjoy.
 Surround yourself with support. Get books, audio, phone apps to
learn more and keep you motivated in
the practice.
 Take a mind-body class
 Do a meditation retreat