Mindfulness, Mental Health, and the Brain Richard W. Sears, PsyD, PhD, MBA, ABPP

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1 Mindfulness, Mental Health, and the Brain Richard W. Sears, PsyD, PhD, MBA, ABPP Clinical Psychologist, Private Practice Alliance Institute for Integrative Medicine UC Center for Integrative Medicine

2 Stress Response Adrenalin & cortisol Heart rate & blood pressure Digestion stops Muscles tighten

3 Stress Response short-term helpful then relax long-term many problems 90% of doctor s visits have a stress component

4 What is Mindfulness? the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment to moment (Kabat-Zinn, 2003, p. 145)

5 Being vs. Doing Being: Present focused Doing: Future focused

6 What is Mindfulness? Relating differently to stress Worry Getting stuck in vicious circles Diving into the swimming pool Stepping back from thoughts Exercising the brain

7 Neurological Findings 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

8 Neurological 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

9 Neurological 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)

10 Children - MBCT-C (Strawn et al, 2014)

11 Research-Supported Treatments (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

12 Mindfulness-Based Stress 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

13 Mindfulness-Based Cognitive 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

14 Mindfulness-Based Relapse Prevention (MBRP) Pioneered by Alan Marlatt & Sarah Bowen 8-week program, based on MBSR/MBCT Person-Centered / Rogerian Approach Motivational Interviewing style Urge surfing

15 Dialectical Behavior Therapy (DBT) Pioneered by Marsha Linehan > 6 months Team Approach Indiv Th, Skills Group, Support Group, Crisis Line Four major modules: Mindfulness (Wise Mind) Interpersonal Effectiveness Emotion Regulation Distress Tolerance Mindfulness exercises are very brief Radical Acceptance

16 Acceptance and Commitment Therapy (ACT) Pioneered by Steven C. Hayes Relational Frame Theory / Cognitive Fusion / Psychological Flexibility Acceptance/Mindfulness Formal exercises are less emphasized Commitment Move toward values Behavioral activation

17 Other Interventions Under Development 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

18 3-Minute Breathing Space Minute 1 Noticing this moment Body, feelings, thoughts Minute 2 Breathe Mind wanders, just bring it back Minute 3 Be in your body If it s already here, just feel it

19 Mindful Living Notice what you re doing Remember to breathe Let go of struggle Be kind to yourself

20 Suggested Readings Full Catastrophe Living -Jon Kabat-Zinn Mindfulness: Living through Challenges and Enriching Your Life in this Moment -Richard W. Sears

21 Contact Richard W. Sears MIND (6463) Alliance Integrative Medicine

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