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Transcript of Mindfulness, Mental Health, and the Brain Richard W. Sears, PsyD, PhD, MBA, ABPP Clinical...
Mindfulness,Mindfulness,Mental Health, Mental Health, and the Brainand the Brain
Richard W. Sears, Richard W. Sears, PsyD, PhD, MBA, ABPPPsyD, PhD, MBA, ABPP
Clinical Psychologist, Private PracticeClinical Psychologist, Private PracticeAlliance Institute for Integrative MedicineAlliance Institute for Integrative Medicine
UC Center for Integrative MedicineUC Center for Integrative Medicine
Stress ResponseStress Response
Adrenalin & cortisolHeart rate & blood pressureDigestion stopsMuscles tighten
Stress ResponseStress Responseshort-term – helpful – then relax
long-term – many problems
90% of doctor’s visits have a stress component
What is Mindfulness?What is Mindfulness?““the awareness that emergesthe awareness that emerges
through paying attention through paying attention
on purpose, on purpose,
in the present moment, in the present moment,
and nonjudgmentally and nonjudgmentally
to the unfolding of experience to the unfolding of experience moment to moment” moment to moment”
(Kabat-Zinn, 2003, p. 145)(Kabat-Zinn, 2003, p. 145)
Being vs. DoingBeing vs. DoingBeing: Present focusedBeing: Present focused
Doing: Future focusedDoing: Future focused
What is Mindfulness?What is Mindfulness?
Relating differently to stressRelating differently to stressWorryWorryGetting stuck in vicious circlesGetting stuck in vicious circlesDiving into the swimming pool Diving into the swimming pool Stepping back from thoughtsStepping back from thoughts
Exercising the brainExercising the brain
Brain Changes After 8 Weeks(Sara Lazar, PhD)
“Participating in an 8-week mindfulness meditation
program appears to make measurable changes in brain
regions associated with memory, sense of self, empathy and stress”
www.sciencedaily.com
Neurological FindingsNeurological Findings
Neurological FindingsNeurological Findings
The Nine Middle Prefrontal Functions(The Mindful Brain, Dan Siegel MD)
• Body Regulation• Attuned Communication• Emotional Balance• Response Flexibility• Empathy• Insight, or self-knowing awareness• Fear modulation• Intuition • Morality
Neurological FindingsNeurological Findings
Children - MBCT-C (12 wks)
Increased activation of structures that subserve interoception and processing of internal stimuli
Increased mindfulness predicts decreased amygdala activity during fear processing
•Increases in bilateral insula, lentiform nucleus, thalamus, & left anterior cingulate while viewing emotional stimuli.•Increased mindfulness associated with increased activation in bilateral anterior cingulate & insula during emotional stimuli.•Post-tx decreases in right amygdala activation
(Strawn, Cotton, Luberto, Patino, Stahl, Weber, Eliassen, Sears, & DelBello, 2014)
Research-Supported Treatments
http://www.psychologicaltreatments.org/ (APA Div 12)
Behavior Therapy and CBT• “modest to strong research support”
Mindfulness-Based Cognitive Therapy• “strong research support” (with CT-Depression)
Acceptance and Commitment Therapy• “modest to strong research support”
Dialectical Behavior Therapy• “strong research support”
Mindfulness-Based Stress Mindfulness-Based Stress Reduction (MBSR)Reduction (MBSR)
•Pioneered by Jon Kabat-Zinn (Full Catastrophe Living)• 8-week program• Large groups• Daily homework• Incorporates yoga• Initially used for stress & chronic pain
Mindfulness-Based Cognitive Mindfulness-Based Cognitive Therapy (MBCT)Therapy (MBCT)
•Pioneered by Segal, Teasdale, & Williams • 8-week program, based on MBSR• Smaller groups• Daily homework, CBT assignments• Incorporates CBT elements (recognizing cognitive
distortions, relapse prevention plan, etc)• Initially used for prevention of depressive relapse
Mindfulness-Based Relapse Mindfulness-Based Relapse Prevention (MBRP)Prevention (MBRP)
Pioneered by Alan Marlatt & Sarah Bowen
8-week program, based on MBSR/MBCT
Person-Centered / Rogerian Approach
Motivational Interviewing style
“Urge surfing”
Dialectical Behavior Therapy Dialectical Behavior Therapy (DBT)(DBT)
Pioneered by Marsha Linehan
> 6 months
Team Approach Indiv Th, Skills Group, Support Group, Crisis Line
Four major modules:Mindfulness (Wise Mind)Interpersonal EffectivenessEmotion RegulationDistress Tolerance
Mindfulness exercises are very brief
Radical Acceptance
Acceptance and Commitment Acceptance and Commitment Therapy (ACT)Therapy (ACT)
Pioneered by Steven C. Hayes
Relational Frame Theory / Cognitive Fusion / Psychological Flexibility
Acceptance/MindfulnessFormal exercises are less emphasized
CommitmentMove toward valuesBehavioral activation
Other Interventions Under Other Interventions Under DevelopmentDevelopment
•Mindfulness-Based Eating Awareness Training (MB-EAT)
•Mindfulness-Based Elder Care (MBEC)•Mindfulness-Based Childbirth & Parenting (MBCP)•Mindfulness-Based Relationship Enhancement
(MBRE)•MBCT-C (children)•MBCT for Cancer•MBCT for PTSD
3-Minute Breathing Space3-Minute Breathing Space
Minute 1 – Noticing this momentMinute 1 – Noticing this moment Body, feelings, thoughtsBody, feelings, thoughts
Minute 2 – BreatheMinute 2 – Breathe Mind wanders, just bring it backMind wanders, just bring it back
Minute 3 – Be in your bodyMinute 3 – Be in your body If it’s already here, just feel itIf it’s already here, just feel it
Mindful LivingMindful Living
Notice what you’re doingNotice what you’re doingRemember to breatheRemember to breathe
Let go of struggleLet go of struggleBe kind to yourselfBe kind to yourself
Suggested ReadingsSuggested Readings
Full Catastrophe LivingFull Catastrophe Living-Jon Kabat-Zinn-Jon Kabat-Zinn
Mindfulness:Mindfulness:Living through Challenges and Living through Challenges and
Enriching Your Life in this MomentEnriching Your Life in this Moment--Richard W. SearsRichard W. Sears