A First Steps guide to Mindfulness First Steps 1 Mindfulness V2
What is in this booklet? Page Contents 2 Using self-help tools 3 What is mindfulness? 4 Why use mindfulness? 5 Mindful breathing 6 Mindful activity 7 Body scan 8 Using mindfulness to cope with negative experiences 9 Contact First Steps 10 First Steps 2 Mindfulness V2
Using self-help tools The strategies/tools suggested throughout your treatment are evidence based methods of managing your wellbeing and reducing the effects the way that we feel has on our everyday life. We are all individuals and respond to situations in different ways therefore not every tool will work for everyone. For example some people find meditation and reading really relaxing, whilst for someone else, this could be a cause of stress and their preferred relaxation method is to go to the gym. There are no set rules for managing emotions. A helpful way of thinking about this could be to think is my current method working for me? If the answer is yes, then great, but if not, these strategies may be an alternative way that is more productive for you. As with any new skill, self help can take time and practice. In the same way that reading a cookery book will not instantly make you a great cook, simply reading this material will not make you instantly happy and healthy. But with time, practice and exploration it is possible for everybody to experience emotional well-being. First Steps 3 Mindfulness V2
What is mindfulness? Jon Kabat-Zinn, a leader in mindfulness meditation and founder of the Mindfulness Based Stress Reduction (MBSR) program at the University of Massachusetts Medical Center, defines mindfulness as: Paying attention in a particular way: on purpose, in the present moment, and nonjudgementally. Paying attention on purpose: Involves a purposeful, conscious decision to direct our awareness to a particular experience such as breathing, eating, walking, our emotions or our thoughts. Paying attention in the present moment: Involves noticing and observing what is happening to you now. So often our minds wander to thoughts about the past (which no longer exists) and the future (which doesn t exist yet), often ignoring the fact that the only moment we can actually experience is the here-and-now. Paying attention non-judgementally: Involves not judging our experiences, thoughts and emotions (i.e. not labelling them as good or bad, positive or negative) but rather just observing them. Mindfulness might simply be described as choosing and learning to control our focus of attention. It is a practical way to notice thoughts, emotions, physical sensations, sights, sounds, smells - anything we might not normally notice. It s important to note that although it has its roots in Eastern philosophical traditions, mindfulness practice does not require any religious or spiritual beliefs and is suitable for, and can help people with any religious beliefs or people with none at all. This booklet aims to provide a straightforward introduction to mindfulness and outline how we can learn to use mindfulness in our everyday lives through a number of mindfulness based practices. First Steps 4 Mindfulness V2
Why use mindfulness? Human minds are easily distracted and routinely examine past events as well as trying to anticipate the future. Because of this, we may not be really present, moment-by-moment, for much of our lives. Events around us and thoughts, feelings and sensations (of which we may be only dimly aware) can trigger old habits of thinking that are often unhelpful and may lead to worsening mood. By becoming more aware of our thoughts, feelings, and bodily sensations, from moment to moment and in a way that suspends judgement and self-criticism, we give ourselves the possibility of greater freedom and choice; we do not have to go into the same old mental ruts that may have caused problems in the past. Incorporating mindfulness into our everyday lives provides us with a scientifically researched approach to creating clarity, insight, and understanding into what s happening in our lives. This can help us develop a greater awareness of the way we routinely react to events which can help us to manage them in a more positive way, rather than becoming overwhelmed. It will not eliminate life's pressures, but it can help us respond to them in a calmer manner that benefits our heart, head, and body. Constantly challenging and struggling with unhelpful and distressing thoughts can at times feel exhausting, especially if we do not have any solutions to our worries. Mindfulness can therefore compliment thought challenging, to help us let go of distressing thoughts and emotions that we do not currently have any solution to. Evidence for mindfulness Mindfulness has been demonstrated to affect both how the brain works and its structure. More specifically, mindfulness practice has been associated with increased activity in the pre-frontal cortex, the area of the brain associated with positive emotion. Furthermore, research has demonstrated that areas of the brain associated with emotional regulation are larger in people who have practiced mindfulness regularly for five years (Mental Health Foundation). Over three decades of scientific research has documented the numerous psychological, social and physical benefits of mindfulness practice. Mindfulness has been shown to be a valuable tool for: Reduced rumination (compulsively focusing attention on one s distress) Coping with stress Improvements in working memory Increase ability to focus Decreased emotional reactivity Improving relationship satisfaction Managing and recovering from mental health problems, including depression and anxiety. It is important to note that mindfulness is a skill that takes time to develop - it requires a lot of practice due to the fact it is so different to how our minds normally operate. Like any skill it requires lots of regular practice (daily practice is preferable) and patience for the associated benefits to be experienced. First Steps 5 Mindfulness V2
Mindful breathing The primary focus in these mindfulness exercises is breathing. The goal is a calm, nonjudging awareness of the breath, whilst allowing thoughts and feelings to come and go without getting caught up in them. This creates calmness and acceptance. Breathing exercise 1 (Kabat-Zinn, 1996) Assume a comfortable posture lying on your back or sitting. If you are sitting, keep the spine straight and let your shoulders drop. Close your eyes if it feels comfortable. Bring your attention to your breathing. Notice the feeling of the air going in and out, and the feeling of your chest and stomach rise or expand gently on the in-breath and fall or recede on the out-breath. Do not try to change your breathing, just notice what is happening. Keep your focus on the breathing, being with each in-breath for its full duration and with each out-breath for its full duration, as if you were riding the waves of your own breathing. Every time you notice that your mind has wandered off the breath, notice what it was that took you away and then gently bring your attention back to your breathing and the feeling of the breath coming in and out. If your mind wanders away from the breath a thousand times, then your job is simply to acknowledge that has happened and to bring you attention back to the breath every time, no matter what it becomes preoccupied with. Practice this exercise for a few minutes and gradually build up the time spent doing this. Be aware of how it feels to spend some time each day just being with your breath without having to do anything. Breathing exercise 2 (Kabat-Zinn, 1996) Tune into your breathing at different times during the day, feeling the belly go through one or two risings and fallings. Become aware of your thoughts and feelings at these moments, just observing them without judging them or yourself. At the same time, be aware of any changes in the way you are seeing things and feeling about yourself. First Steps 6 Mindfulness V2
Mindful activity Mindfulness can also be practiced whilst doing everyday activities. Any activity can be done mindfully by focusing your awareness and attention on what you are doing, using the activity to be an anchor to the present moment. If unhelpful thoughts enter your mind, simply acknowledge them, let them be and bring your focus back to your current activity. The only aim of mindful activity is to bring our attention back to the activity continually, noticing those sensations, from outside and within us. Some examples of how you could incorporate mindfulness into your everyday activities are below. Mindful walking A mindful walk brings new pleasures. Walking is something most of us do at some time during the day. We can practice, even if only for a couple of minutes at a time, mindful walking. Rather than be in our heads, we can look around and notice what we see, hear, sense. We might notice the sensations in our own body just through the act of walking. Noticing the sensations and movement of our feet, legs, arms, head and body as we take each step. Noticing our breathing. Thoughts will continuously intrude, but we can simply notice them, and then bring our attention back to our walking. Mindfulness in your morning routine We can become more mindful during our morning routine by focusing our attention on what we re doing and what s happening. Choose an activity that is a part of your morning routine, such as brushing your teeth, eating breakfast or taking a shower. We can bring our attention to the activity by noticing our bodily movements as well as what we taste, touch, smell, see, hear, etc. For example, when you re brushing your teeth, notice the sound of the toothbrush brushing from side to side and the taste of the toothpaste. Notice the movements of your arms as you brush from side to side. After practicing mindfulness in one morning activity, you can start to practice it in other areas, developing greater awareness and presence to your morning routine. Mindfulness of everyday chores Similarly to the morning routine, choose an activity from your everyday chores, such as washing dishes or ironing clothes, and completely focus your attention on the activity. If we wash the dishes each evening, we might tend to be in our heads as we re washing up, thinking about what we have to do, what we've done earlier in the day, worrying about future events, or regretful thoughts about the past. Washing up or another routine activity can become a routine mindful activity for us. We might notice the temperature of the water and how it feels on the skin, the texture of the bubbles on the skin, and yes, we might hear the bubbles as they softly pop. The sounds of the water as we take out and put dishes into the water. The smoothness of the plates, and the texture of the sponge. Just noticing what we might not normally notice. First Steps 7 Mindfulness V2
Body scan The purpose of this body scan exercise is to simply notice and bring awareness to your body with gentle curiosity. It is not necessarily about relaxing your body, however this may well occur. If, while doing this exercise, thoughts intrude, that is fine just notice the thoughts, notice yourself noticing the thoughts and gently guide your awareness back to your body. Lie on your back, or sit comfortably, legs uncrossed, arms at your sides, eyes open or closed. Loosen any tight clothing, making sure that you do not have any constriction. Focus on your breathing, allowing your stomach to rise as you inhale and fall as you exhale. Breathe deeply for about two minutes, until you start to feel comfortable. Turn your focus to the toes of your right foot. Notice any sensations you feel while continuing to also focus on your breathing. Imagine each deep breath flowing to your toes. Remain focused on this area for one to two minutes. Move your focus to the sole of your right foot. Tune in to any sensations you feel in that part of your body and imagine each breath flowing from the sole of your foot. After one or two minutes, move your focus to your right ankle and repeat. Move to your calf, knee, thigh, hip, and then repeat the sequence for your left leg. From there, move up the torso, through the lower back and abdomen, the upper back and chest, and the shoulders. Pay close attention to any area of the body that causes you pain or discomfort Move your focus to the fingers on your right hand and then move up to the wrist, forearm, elbow, upper arm, and shoulder. Repeat for your left arm. Then move through the neck and throat, and finally all the regions of your face, the back of the head, and the top of the head. Pay close attention to your jaw, chin, lips, tongue, nose, cheeks, eyes, forehead, temples and scalp. Now let your awareness drift gently and slowly back down your body, simply noticing any other bodily sensations, until you awareness settles back at your feet. Then open your eyes slowly and take a moment to stretch, if necessary. First Steps 8 Mindfulness V2
Using mindfulness to cope with negative experiences (thoughts, feelings, events) As we become more practised at using mindfulness for breathing, body sensations and routine daily activities, we can then learn to be mindful of our thoughts and feelings. This is where we can observe them, and then more become more accepting of them. This results in less distressing feelings, and increases our ability to enjoy our lives. With mindfulness, even the most disturbing sensations, feelings, thoughts and experiences can be viewed from a wider perspective as passing events in the mind, rather than as "us", or as being necessarily true. (Brantley 2003) When we are more practiced in using mindfulness, we can use it even in times of intense distress by: becoming mindful of the actual experience as an observer using mindful breathing and focussing our attention on the breathing listening to the distressing thoughts mindfully recognising them as merely thoughts breathing with them, allowing them to happen without believing them, arguing with them or judging them If thoughts are too strong or loud, then we can move our attention to our breath, the body, or to sounds around us. Jon Kabat-Zinn uses the example of waves to help explain mindfulness. Think of your mind as the surface of a lake or an ocean. There are always waves on the water, sometimes big, sometimes small, sometimes almost imperceptible. The water's waves are churned up by winds, which come and go and vary in direction and intensity, just as do the winds of stress and change in our lives, which stir up waves in our mind. It's possible to find shelter from much of the wind that agitates the mind. Whatever we might do to prevent them, the winds of life and of the mind will blow. "You can't stop the waves, but you can learn to surf" (Kabat-Zinn 2004) First Steps 9 Mindfulness V2
Contact First Steps For additional reading and information (including information on local mindfulness courses), visit the First Steps website: www.firststeps-surrey.nhs.uk Further Resources Mental Health Foundation The Mental Health Foundation has a range of mindfulness resources and podcasts. www.mentalhealth.org.uk BeMindful You can search for mindfulness courses in your area via the Be Mindful website. If there are no courses or practitioners listed in your area, speak to your GP, who may be able to help www.bemindful.co.uk/learn/find-a-course Headspace Online mindfulness course and app www.headspace.com Here at Virgin Care we are keen that this information is shared as widely as possible to help support anyone who might benefit from it. However, can we remind you that it is subject to Copyright Legislation so please do let us know if you plan to reuse or reproduce any of the content First Steps 10 Mindfulness V2