San Diego Therapist Blog: Regina Huelsenbeck, PhD

I had a professor in my graduate education who always said to us, “be prepared”. He said it so often in fact that I don’t know if I ever really heard him. However, I think now that it’s likely one of the very best pieces of advice I ever had the privilege of hearing.

"Being prepared" for life and it’s challenges is really a fairly simple thing, we just have to keep our instrument tuned up- our mind, body, and spirit. It is simple, but it not necessarily easy. Preparation takes practice, commitment and discipline. Sort of like clean teeth, if you want clean teeth, you brush and floss every day, not just right before your dentist appointment or whenever you have a toothache. Nope, you brush now, you prepare now, a little bit, every day.

Being prepared for life is the same thing. You never know when you’ll be hit with a crisis, a major decision or a serious conversation. But I'm certain that you will want to have  every bit of your brain power, wisdom and emotional equilibrium in check - accessible for use.

How can you “be prepared” for what life will serve up?  It takes daily attention, and it takes practice. When we routinely pay attention to ourselves, our patterns, our pitfalls and abilities, we are better suited to withstand the storms when they come rolling in. When we aren’t taking good care of our mental and emotional health, the storms crash down much harder, much, much harder, because we aren’t prepared.

A few tips to tune up your emotional and mental instrument:

1. Exercise, a recent study out of Duke University cited as regular exercise as more effective at alleviating depression than some antidepressant medications.

2. Journal, begin to record your thoughts and emotions, your daily life, you will begin to see patterns and get to know how you’re moving through the world- essentially become more conscious of relationship patterns, mistakes  or coping mechanisms that you regularly use (the good and the ugly). Plus it’s also a great way to purge what is rumbling around in your mind.

3. Take inventory of your day. What were you most grateful for today? What would you like to have handled differently?  You can also begin to record these things in your journal. It's also a great practice to share with a loved one.

4. Take a time out each day either in the morning or at lunch, or even in the heat of an argument and breathe. Especially elongate the outbreath. This alleviates a bit of the amygala activation in the brain and will help you think a bit more clearly. 

5.Try this mindfulness meditation exercise: After accumulating a few dishes, fill your sink with very warm soapy water, and begin to wash your dishes- only this time- pay extremely close attention to cleaning each dish - clean them like you've never cleaned them before- with your full attention. If you find yourself thinking about other things, simply bring your attention back to what you're doing. Take notice of how the water feels, how the dish feels in your hand, and take care to place each one delicately into the rack. This can be very pleasurable and relaxing- believe it or not- and it's a great way to re-tune yourself!

Keep your instrument tuned and you will likely play beautiful music. Rock on!

This is Jeff's story:

"My wife, Mary, and I were invited by an old friend, Steven, to join his balloon crew at the annual hot air balloon festival...We said yes enthusiastically. As crew members, Mary and I joined a team of several others, all of whom were needed to handle our balloon...

Now, to be perfectly honest, I have never been that comfortable with heights...[but] I have learned to work with it over the years, and it has not limited my activities...

Everything was fantastic for the first few minutes, as the ground fell away and I looked around, feeling the cool air and captivated by the spectacle of other balloons rising in the beautiful Albuquerque dawn. Then I felt the basket move sideways as the balloon caught a wind current. I looked down over the railing and saw the ground crew, the vehicles, buildings, everything, shrinking. Then I felt the first wave of fear. 

My experience of fear was the usual one. There was a feeling of slight dizziness, some weakness in the knees, a sense of my heart pounding, and a tightening in the throat and gut. My hands were already clutching the railing. I didn't want to move in any direction and wasn't sure that I could...

I wished I had stayed on the ground, but knew at that point there was no going back.

The realization that I had to cope was actually helpful.
There was no choice except to deal with the fear. There was literally no way to get relief until the balloon landed. I remembered that I did have many years of meditation experience and decided that I would likely need all of it! So I began to focus my attention very deliberately and sharply on the experience of my breathing.

Just as I had been taught and had done in my own meditation practice over the years, I let the breath be just as it was and let the situation be just as it was.

I directed my complete attention to the unfolding sensations of my breath, especially my outbreath. After just a few breaths, I noticed some relief. I was able to locate the feelings of fear in my body. I was able to breathe in and out with the fear, holding the sensations in the cradle of the breath. I was able to soften some around the sensations and the situation...I started to move about in the basket and began to take more interest in the ride.

I rode quite a distance with fear that morning. In fact, fear came and went and came back again many times. But each time it came, I was able to meet it the same way, using awareness of the breath as an anchor and consciously breathing in and out with the unfolding experience.

Through this practice of mindful breathing, I was able to change my relationship to the fear experience in a fundamental way. I was able to stop relating from the fear, or as the fear, and instead relate to the fear..."

I tell Jeff's story because I think it is an excellent example of effectively utilizing mindfulness practices in real world situations.

Jeff was completely stuck in this situation, there was literally no way out but through (as is such in so many of life's challenging experiences, we often can't just stop the ride!).

Jeff stopped fighting against his experience and essentially surrendered to it; he began breathing through it. He remembered the ANCHOR - his breath. He surrendered & took control simultaneously in remembering and using this ever constant friend. 

Jeff Brantley's above experience was quoted directly - almost verbatim- from his book "Calming your anxious mind". This book is an excellent resource for coping effectively with fear, anxiety and even panic disorder.

Dr. Jeff Brantley is the founder of the Mindfulness Based Stress Reduction Program at Duke University's Center for Integrative Medicine.

Have you ever heard people say that the psyche speaks another language? Psyche's language consists of images, symbols, music, and poetry. For this reason, many analysts encourage their clients to draw and paint. The active use of this imaginal muscle gets things moving inside. For this same reason people are encouraged to pay attention to dream images. Dream images are theorized to be important and decodable messages from the unconscious--- they are spoken in psyche's imaginative symbolic language...

"What we call a symbol is a term, a name, or an image which in itself may be familiar to us, but its connotations, use, and application are specific or peculiar and hint at a hidden, vague, or unknown meaning...A term or image is symbolic when it means more than it denotes or expresses" ~Carl Jung  

Symbolic language and images point beyond themselves.

These elements (images, poetic and symbolic language) have the power to shift us from the inside out. Sometimes, actually often times, the shift takes place without conscious comprehension/understanding of what has taken place, just like poetry.

"Love after Love"  by Derek Walcott

The time will come
when, with elation,
you will greet yourself arriving
at your own door, in your own mirror,
and each will smile at the other's welcome.

and say, sit here. Eat.
You will love again the stranger who was your self.
Give wine. Give bread. Give back your heart.
Take down the love letters from the bookshelf,

the photographs, the desperate notes,
peel your own image from the mirror.
Sit. Feast on your life.

~Derek Walcott
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

"Feast on your life",

Regina

After surviving or while living with a life threatening illness such as cancer, people typically feel estranged from life (work, friends, colleagues, family members, and even alienated from themselves). 

This disconnected feeling is normal. Cancer is a traumatic experience: one which stirs questions about some of the most foundational elements of life: things that most of us take for granted: namely one's body and continued existence.

How can we re-connect? How can we come back to life- feel connected to things and others again?

The first step begins with reconnecting to yourself. Believe it or not, almost everything we experience in relationship to others is fundamentally nurtured by the relationship we hold with ourself.

A simple way to strengthen the connection and intimacy with yourself is through telling your story. Buy a journal and begin at the beginning. Begin to write down the bones of your story-- and do not leave one little thing out- this is for you. Scribble onto the paper, write with abandon, without censor, tell her everything. Allow the paper to feel what you truly experienced. 

When you are done writing down your cancer story, you can continue with this tool and use it to befriend yourself each day, for the rest of your life story.  

Connecting back into life and with others will be less of an ordeal when you aren't afraid of what is hiding inside of you.

Warmly,

Regina

 CHECK OUT THIS BOOK: "Writing down the Bones" by Natalie Goldberg

Suffering is a part of being human...

Certain types of suffering are unavoidable: examples of unavoidable suffering include aging, death, illness, and natural disasters. The suffering associated with these examples is often simply unavoidable and a necessary part of human life.

Some types of suffering may be more avoidable than others...

These forms of suffering are often mediated more by the stories that we tell ourselves than actual events. This is not to say that this sort of suffering is not valid, real, or painful. Indeed, it is all of these things. Suffering fueled by the mind is very very real, and very very painful...however it may not be "unavoidable".

The mind is constantly at work and a great storyteller. Often we are mesmerized by it's stories- like children listening to a fairytale...

Here's a very simple example of this phenomenon: It's Monday morning, You're on the way to a new job. You're in traffic, but your mind- and thus you- are already at the office. You see yourself meeting your new boss and he is rude and condescending towards you. You begin to feel nervous and amble your way to your new office, which is actually not an office at all, but a cubicle with dank lighting...you begin feeling sick. Snapping back into the present moment, you pull the car into the office driveway and notice that your heart is beating quickly and your palms are sweaty-and you suddenly don't want to go to this new job....you don't understand why....but your body is saying, "no way".

This example was fairly innocuous, no real harm done here, but you get the idea- the mind's thoughts- if unchecked/unfiltered can become a pretty big part of how you experience life...

Sometimes we listen to the mind's various tales, without a filter, for an entire lifetime. In some cases, these tales are not even original; they're heirlooms from our parents. They are our parents fears, thoughts and beliefs- not ours. But we experience them as our own.

Who ever gave them to us isn't really the issue per say- you may not need to lounge on Freud's couch for years to get relief. However, you might want to step out of these stories of the mind from time to time- re-set yourself- check your mind....find out:

what stories am I spinning? Is this really true? What record is my mind playing today?

In slowing down, and listening to your mind- writing down your thoughts in a journal is really helpful- you can begin to see what your mind focuses upon. You can begin to see what it naturally gravitates towards. This is really empowering. You don't have to be a slave to your mind's stories.

Story spinning is what minds do, they are busy little guys. There is nothing innately wrong with this activity- every human mind does it.

To avoid "avoidable" suffering however, begin to take time to listen to your mind. Slow down, join a meditation group, journal, or attend mindfulness therapy and begin to take control of your mind and thus your life experiences.

~Dr. Huelsenbeck

"A life of reaction is a life of slavery, intellectually and spiritually. One must fight for a life of action, not reaction."
- Rita Mae Brown

Yesterday in my blog article, "Mindfulness- what is it and why should I do it?" we discussed Richard Davidson's research on mindfulness practices. Davidson found that regular mindfulness practice over a period of just 8 weeks significantly increased immune system functioning and additionally increased left-brain activity (furthermore, increases in the left-brain functioning directly mediated the increases in immune system functioning). I wanted to take a quick minute today to explain a bit about left-brain activation.

The following is quoted directly from Daniel Goleman's article in the NY Times Feb. 3, 2003 where he discusses some of Davidson's general research on the brain asymmetry (left versus right):

The functional M.R.I. images reveal that when people are emotionally distressed -- anxious, angry, depressed -- the most active sites in the brain are circuitry converging on the amygdala, part of the brain's emotional centers, and the right prefrontal cortex, a brain region important for the hypervigilance typical of people under stress.

By contrast, when people are in positive moods -- upbeat, enthusiastic and energized -- those sites are quiet, with the heightened activity in the left prefrontal cortex.

Indeed, Dr. Davidson has discovered what he believes is a quick way to index a person's typical mood range, by reading the baseline levels of activity in these right and left prefrontal areas. That ratio predicts daily moods with surprising accuracy. The more the ratio tilts to the right, the more unhappy or distressed a person tends to be, while the more activity to the left, the more happy and enthusiastic.

By taking readings on hundreds of people, Dr. Davidson has established a bell curve distribution, with most people in the middle, having a mix of good and bad moods. Those relatively few people who are farthest to the right are most likely to have a clinical depression or anxiety disorder over the course of their lives. For those lucky few farthest to the left, troubling moods are rare and recovery from them is rapid....

By chance, Dr. Davidson had the opportunity to test the left-right ratio on a senior Tibetan lama, who turned out to have the most extreme value to the left of the 175 people measured to that point.

Results from Davidson's mindfulness research provides evidence for the use of meditative practices to reduce negative mood states - and furthermore shows that positive mood states are more likely to become a part of a person's natural state if they meditate regularly- and it doesn't sound like you have to become a Tibetan lama to do so (although it may help) - but from Davidson's research, it seems like just 8 weeks of practicing can effect change.

~Regina

Jon Kabat-Zinn, who has been researching the benefits of mindfulness practices since the 1970's at the University of Massachusetts Medical Center says, mindfulness is "The awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment" (2003).

Regularly practicing mindfulness/meditation has been shown to decrease stress levels, decrease the recurrence of depression, decrease anxiety, decrease chronic pain/fibromyalgia difficulties, decrease symptoms of psoriasis and also increase immune functioning. These findings are important for all of us, but especially for people coping with high levels of stress and/or a physical illnesses like cancer.Conversely, high chronic stress levels have been shown to decrease or down regulate the immune system.

When trying to measure the immune system's responsive to different conditions- researchers get pretty creative. Measuring antibody responses to flu vaccinations seems to be a popular way:

In one study on chronic stress: researchers tested long-time dementia caregivers (the chronic stress group) versus a control group. The two groups were otherwise matched for age, sex, and socioeconomic status. Each group was given a flu vaccination. The researchers hypothesized that the caregiver group, who was obviously more stressed, would not respond as well to the vaccine as the control group. Their hypothesis proved to be true: The immune response of the chronic stress group (caregivers) was less responsive to the vaccine than that of the control group. (See Kiecolt-Glaser et al., 1996)

Likewise, a cancer diagnosis is associated with high levels of stress (See Stefanak, Derogatis, & Shaw, 1987). The person diagnosed feels they can no longer trust their own body. They often feel alienated from friends and family, wonder if they will continue to exist and often feel completely hopeless/powerless over their situation. Obviously, living with cancer is stressful. However, practicing mindfulness has been shown to increase cancer patients ability to cope with their situation. Cancer patients who practiced Mindfulness vs. control group: decreased depression, anxiety, anger and confusion as well as increased vigor (See Speca et al., 2000).

Davidson, Kabat-Zinn and friends (2003) also found that practicing mindfulness could increase left-brain activity (see more of Davidson's research for left-brain relevance) and significantly INCREASE IMMUNE FUNCTIONING. They randomized two groups- one group to an 8 week meditation training and another to a wait list control group. At the end of 8 weeks, both groups were given the flu vaccine. The meditation group's immune system response was significantly greater than that of the control group, and so was their left-brain activity.

Practicing mindfulness regularly can clearly change your life- not just psychologically- but also physically. But don't take my word for it...practice...

Need help getting started with a mindfulness practice? Give me a call 858.880.0145. I have a mindfulness meditation group every Friday morning from 8:00 am till 9:30 am. I also have individual sessions open. You can also go online and order guided meditation CD's by Jon Kabat-Zinn or Jack Kornfield. Both are excellent.

Dan Rather recently covered a story on the power of meditation and it's usefulness. Davidson's work - one of the researchers we talked about above is part of the story- he actually does studies with long time meditators- Buddhist Monks. The Dalai Lama actually encourages them to participate! You can listen to the report on mindfulness here. After clicking this link scroll to the link in the middle of the page and select "April 8th, 2008 - Mind Science" show and then hit Watch Now. You can also find this video on facebook or download the podcast at this link.

Below are the studies that I cited:

Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., Urbanowski, F., Harrington, A., Bonus, K., and Sheridan, J.F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine. 65, pp. 564-570.

Kiecolt-Glaser, J.K., Glaser, R., Gravenstein, S., Malarkey., W.B., and Sheridan, J. (1996). Chronic stress alters the immune response to influenza virus vaccine in older adults.

Speca, M., Carlson, L.E., Goodey, E., and Angen, M. (2000). A randomized, wait-list controlled trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine, 62, pp. 613-622.

Once depressed, you are fairly likely to experience depression again. The first depressive episode often surfaces in response to a trauma or loss of some sort. However, the negative feeling states and thought patterns seem to get wired together and can recreate depressive states more easily the next time, and easier the next time...and so on and so on.

Researchers have found that regular mindfulness practice significantly decreases the relapse/recurrence of depression (Teasedale et al., 2000).

How does this happen? Why do mindfulness practice help someone who suffers from depression?

The brain is filled with billions of neurons- These billions of neurons are connected to each other via synapses- specifically about 10,000 different synapses connect 100 billion neurons. A neuron fires whenever we have an experience.

IF you begin to practice mindfulness REGULARLY- you could, over time, by repeating this mindfulness experience INCREASE "synaptic densities in those regions that were activated with mindful practice" (Siegal, 2007). In essence, re wire your brain....making it more likely that you will be in the mindfulness territory of your brain when new stresses or potentials for depression arises.  

In fact, "mindful awareness is a form of experience that seems to promote neural plasticity". Neuroplasticity is essentially brain rewiring- "neuroplasticity is the term used when connections in the brain change in response to experience" (Siegal, 2007).

If you are interested in more information on mindfulness and neuroplasticity get David Siegal The Mindful Brain. Siegal is an MD out of UCLA who has been researching this brain stuff for years. He's also a great speaker and writer- who takes tricky brain concepts and puts them into digestible terms----and soooooo interesting.

Love & Light,

Regina 

Today, let's talk about Sally's recent experience with meditation. She's been practicing more and more lately, but today she didn't have time to practice her meditation before leaving the house, so she decided to do it at work. She shut her office door and set the alarm on her cell phone for 10 minutes. She pushed herself away from the computer, put both feet on the floor, sat up very straight, closed her eyes and began following her breath. She barely made it through one in-out breath cycle before a thought came in. She got caught in the thinking about the thought for a bit, started worrying, and then brought her attention back to her breath. A second or two later, another thought came up and she began chasing that one too, planning something that she could do to "fix" the situation. Then she realized that she had drifted away from following her breath and pulled her attention back again. This pattern continued for a while. Soon her 10 minute timer went off and she returned to work.

Honestly, it was one of those meditation sessions that Sally pretty much pushed herself into because she wanted to keep her commitment to the process and she thought she might feel better afterward. Meditation is sometimes like punching the clock at the gym- whether you feel like it or not- at that particular moment, keeping the commitment to yourself is important.

After her timer went off, Sally did feel a sense of calm. She also noticed that she was able to think a bit more clearly. This phenomenon occurs because the orbitofrontal cortex relaxes when it's not stressed out by the amygdala. The amygdala is the stress response center which bombards the orbitofrontal cortex when we feel overwhelmed.

When we meditate- the orbitofrontal cortex, our executive control center which modulates emotions, social reactions, and other decision making and memory areas- gets to chill out and operate at full capacity. Thus, we are better able to operate at full capacity. We are able to think more clearly and respond the way we truly intend to respond. With a regular mindfulness practice, this relaxed, high functioning state becomes more frequent.

Chogyam Trungpa Rinpoche explained to his son, Saykong Mipham Rinpoche the rationale for mediation. "It's easier to put on a pair of shoes than to wrap the earth in leather".

When we meditate we help ourselves let go of the expectation that the environment (others and circumstance) will change. We realize that what we experience has much to do with the mental shoes we are wearing. The world in fact, is not wrapped in leather; to experience a less stressful reality, we practice.

Love & Light,

Regina

What really causes cancer? Is it lifestyle and genes? Is it just a random unexplainable thing? Do my thoughts have something to do with it? Does my relational history and/or my trauma history have anything to do with it? Why did I get ill?

These questions plague people living with cancer, and they plague them sometimes, even after they survive. In my doctoral research with cancer survivors, 87% of the participants shared that they had often wondered "why" they got cancer. Many had come up with different theories to try to understand WHY they could have possibly gotten cancer. These theories ranged from toxins in the food they ate, surgeries they had, the water pitcher they drank from, bad genes, God picked me, pesticide and herbicide exposure (which actually has been linked to lymphoma), to a loss of meaning and depression in their life prior to diagnosis

Theorizing and questioning is extremely normal. Although many people, even clinicians, tend to be uncomfortable with the why question, it is completely NORMAL. Other researchers have found that asking and wondering why often served individuals in their coping with cancer (See Shelley Taylor's research out of UCLA on coping/breast cancer). These researchers explained that this questioning seemed to be an adaptive step in the process of finding meaning for their experience.

It is however useful to discuss these uncomfortable questions and existential questions with a therapist, trusted friend or counselor. Often, people facing a life threatening illness like cancer feel very alone and sometimes find it difficult to share what they are really thinking and feeling with others. At other times, people report feeling very understood by their friends and family and may not choose to get additional support. If however, you are feeling alienated, reach out- spill your beans and boost your immune system in the process. Don't do it alone.

Love and Light,

Regina