San Diego Therapist Blog: Regina Huelsenbeck, PhD

I lead a basic meditation class/group twice monthly in Encinitas, and also use the practice a great deal in individual psychotherapy due to the mental health benefits of regular practice (see some of my other blog articles for mindfulness meditation research).

I've found the greatest misconception regarding the practice of mindfulness meditation is an expectation for relaxation and total peace. People often imagine they are "supposed to" experience a blank mind. This rarely - if ever occurs, even with long time meditators. Pema Chodron commented in one of her lectures on meditation that she's actually a bad meditator- if you are judging on activity of the mind. She laughed, "I have a pretty active mind.. "and here I've devoted my whole life to it" (the practice of meditation).

Essentially mindfulness meditation is about paying attention to your experience, whatever that might be: bodily sensations, thoughts, impulses, desires. All of these will float by when one decides to sit Zazen. The practice is simply being present to one's experience, all of it.

Want to get started in mindfulness meditation ...?

Deepak Chopra is offering a free teleseminar on Wednesday August 11th on the basics of meditation. It's touted as a user friendly, step by step informational session on meditation. Meditation Seminar Link

This morning in my yoga practice, the teacher asked the students for any special requests. The responses often consist of requests to focus on the back, shoulders or hip area, commonly tight painful areas for many people. A woman at the back of the room hollered, "stress reduction". The teacher smiled and said, "we'll try to rush through some other stuff so we can get to stress reduction". We all laughed and then she quieted us down to begin formal practice.

As we were guided through breathing meditation, my instructor called our attention to the space at the end of the out breath. At the end of each breath cycle, there is a natural pause before the body moves into inhalation (take a minute to see for yourself, don't force it, just put your attention on your breath). Here she said, "you will find a natural space, the opportunity for stress reduction is innate to every breathing cycle. This calm space is there to be experienced at the end of every out breath, you just have to notice it".

There is indeed a natural pause at the end of each out breath, before the body naturally moves to the inhalation. At this pause, which often goes unnoticed, there is a space, a bit of nothingness, an instant of "mindlessness" if you will, to be experienced.

For the rest of the practice she would periodically call our attention to the out breath. We were in various poses, some more difficult than others, and she would continually remind us of this opportunity, this connection that is always there, regardless of the pose, state of mind or stress. The breath space was always there. 

I appreciated this gentle reminder to connect to the breath and experience the space within my practice. I have been mindful of this space today and have connected with it several times. I also appreciated my instructor's lesson for how it relates to mindfulness based therapy and mindful living. Life has such twisted predicaments, relationships and challenges, so often we are contorted, upside down and inside out, feeling lost, disappointed, stressed or hopeless.

But the calm space remains, untouched. 

The opportunity to experience it is up to us.

"To live with courage is the highest form of practice...It is interesting that both love and courage are said to reside in the heart. When we live by consciously choosing courage, we express life's spirit. Today express your courage by choosing something difficult to say or do. It need only be a small thing, but it will open your heart." 

The italicized excerpt was taken from "A year of living your yoga: daily practices to shape your life", by Judith Hanson Lasater, Ph.D., P.T.

When our lives are not going well, we may be more in touch with fear than with courage. Many people enter my office hoping to eliminate fear and find courage. Fear and courage however, are not mutually exclusive. You can feel both. Many people imagine that if they could stop feeling afraid, they could be change their lives.

But in reality, we can feel afraid and still practice courage. We can choose to stand up in courage and act courageously.

In yoga this morning, we were attempting a new trick, and my teacher gently reminded the class, "remember, yoga is a practice, not a perfect". Although I was feeling afraid, I decided to act with courage and try the new pose. It was indeed, not perfect, but I noticed I smiled a bit as I transitioned to the next asana. If you decide to practice courage today, do it with a gentle and compassionate attitude.

"...Today express your courage by choosing something difficult to say or do. It need only be a small thing, but it will open your heart." 

I am no longer afraid of mirrors where I see the sign of the amazon, the one who shoots arrows. There was a fine red line across my chest where a knife entered, but now a branch winds about the scar and travels from arm to heart.
Green leaves cover the branch, grapes hang there and a bird appears. What grows in me now is vital and does not cause me harm. I think the bird is singing.
I have relinquished some of the scars.
I have designed my chest with the care given to an illuminated manuscript.  I am no longer ashamed to make love. Love is a battle I can win.  I have the body of a warrior who does not kill or wound.
On the book of my body, I have permanently inscribed a tree.

________________________________________________

These are the words of cancer survivor and poet Deena Metzger...If you haven't read any of her books, I highly recommend them.

Healing is unique. Metzger's path to healing was intense, fierce and some might say radical, but it was Metzger's unique path. No one else could have dreamed it.

Every human being who traverses serious illness or trauma is tasked with finding a way through the darkness. It's beyond chemotherapy. I am talking about listening/seeing/experiencing and respecting the truth inside. It has been and continues to be the best guide through healing and transformation. Learn to listen...

How do you listen? The first session of  "The Integrative Oncology Lounge" is Tuesday March 30th from 4 to 5pm. We will learn mindfulness meditation attitudes/benefits and practice listening/seeing/experiencing.

Location: The Pacific Oncology and Hematology Associates 477 North El Camino Real, Suite D200 Encinitas, CA 

Cost: Free to all oncology patients (you do not have to be a "pacific oncology and hematology" patient). The group is supported by a grant from the Wings of Care program

Questions/RSVP/Comments: Regina@Ritualsofhealing.com or 858.880.0145

Many years ago, Integrative Medicine may have seemed "alternative". Today, it has gained acceptance in mainstream medicine because it works.

Integrative Oncology is a branch of integrative medicine (if you're into Andrew Weil his first book in the integrative medicine series is about Integrative Oncology). Integrative Oncology is a philosophy of healing which "focuses on the complex health of people with cancer and proposes an array of approaches to accompany the conventional therapies of surgery, chemotherapy, molecular therapeutics and radiotherapy to facilitate health".

On Tuesday March 23rd, Oncologist Dr. Steve Eisenberg and I will be discussing Integrative Oncology, engaging in treatment, healing, and your life. Expect to learn about Integrative Oncology and experience the benefits of mindfulness meditation. The talk is open to patients, family and loved ones.

This discussion will be held at Pacific Oncology and Hematology Associates in Encinitas. Tuesday March 23rd, 2010 3:30pm-4:30pm.

Whatever you may be feeling internally is simply passing through at this moment. 

Breathe in and breathe out.

Your feeling state does not make you personally right, wrong, weak, strong, good or bad. Feeling states and thoughts float through us all day long. We are in a constant state of change. Nothing is permanent and nothing lasts forever. Thoughts, feelings, and even our basic biology is constantly in a state of change. Cells are changing every single minute. Some say we get cancer many times a day through flub-ups in cell DNA replication, but this does not always become a diagnosis of "cancer" per say, because we are constantly in a state of repair, replication and change. And the same is true for thought and feelings. They come and they go. Nothing is permanent. They float in and they float out.

It is only when something stops the stream, the flow, that things get out of whack. With thoughts, when we identify with the content of a thought, we get into trouble. For example, pretend the thought: "I can't do this" floats by. If I notice this thought for what it is: just a thought, then I can release it and the thought is free to continue floating by, and another thought will float through and so on and so on. However, if I get "hooked" or identify with the thought content by saying, "yes!, that is me, I can't do this... and...actually... in the past I could not do those other things...", then the spiral begins. The mind has gotten stuck in this content, hooked into the thought and a spiral has begun. This is one way depression or despair begins (which is anger turned inward)....through faulty thought identification.

To stop this spiral from happening you can pull out the hook. You can practice releasing thoughts. They are not really yours anyway. They are simply thoughts and feeling states. They come and they go. Getting hooked means identifying with or conversely fighting a thought or feeling (trying to push it down, deny it, or anesthetize). Either way, through identification or avoidance, you have engaged the thought/feeling state. It will usually stick around until you cut bait or gently release it. Try the fisherman's practice of Catch and Release.

Also note, there is usually a quality of rigidity and self-judgment to this downward spiraling. Add compassion and flexibility, to catch and release and see what happens.

A word on compassion from Pema Chodron:

Resource: Get out of your mind and into your life by Steven Hayes, PhD.  

Today, let's talk briefly about the Serenity Prayer...

God* grant us the serenity

to accept the things we cannot change,

The courage to change the things we can,

And the wisdom to know the difference.

Most of us are familiar with this prayer and have probably heard it or said it several times. The prayer is short, sweet and empowering.

But what does "Serenity" really mean?

Serenity is a state of mind. Serenity is the state or quality of being calm, or tranquil, having composure, calm, peacefulness, or peace. Serenity is having the presence of mind, or said another way, having the presence to your own mind, to your surroundings, and to your life.

The prayer is essentially saying, God grant me the "presence" of mind to see my circumstances, my mind, and my life clearly today. God grant me this presence, so that I may see the truth, and make choices from this clear and present state.

The prayer also asks for acceptance. Accepting one's current position or set of circumstances can be one of the most difficult things we must learn do. It is VERY HARD sometimes to accept exactly where you are at this moment. We often want to manipulate it, eat something, drink something or somehow change it. We want to jump over ourselves and get to where we are going. But first, we must accept. We must start from where we are. ONLY then can we begin to move with compassion and grace into changing or moving from this current position.

God* grant me presence to whatever my life holds for me in this moment. Allow me to be fully alive to my life, fully here for all of it. I wish you full, gentle, and complete presence in your life today.

 *Note to reader, please substitute whatever word for God which is meaningful for you.

The cancer experience includes many many elements. It's not just being afraid of dying and feeling physically sick, although those pieces are also present. There may also be relationship problems, daily living challenges, children to care for, emotional issues, treatment decisions, side-effects of treatment, insurance debacles and on and on. It feels like a big cyclone of chaos at times. The cancer experience is kind of like a really rough, whipping, bumping, and turning roller coaster ride, the kind you're praying will end soon. You just can't wait till the car pulls to a stop, the safety bar lifts and you can get the hell off of it!

Unfortunately you can't get off the ride, but you can find a way to be where you are at this moment in time. Can you find a way to ride the coaster?

Mindfulness meditation practice can help.

Don't take my word for it. In a randomized clinical trial, cancer patients completing the 7 week meditation condition reported a decrease in depression, anxiety, anger, and confusion AND additionally they reported an increase in Vigor! The patients also reported fewer symptoms of stress and less emotional irritability. If you've ever been on chemotherapy and some of the steroids they give you along with it you know that emotional irritability can be a real challenge. Overall the cancer patients completing the 7 week meditation condition reported a 65% decrease in mood disturbance & 31% reduction in symptoms of stress.

But don't take their word for it. Experience it for yourself...

1. Join this group: "Mindfulness Meditation: A Cancer Support Group". This group meets in Encinitas on the 1st and 3rd Tuesday of every month. Click here for more information.

2. Go to my coping resources page: see books on Mindfulness Meditation and also cancer. A great starting place: "Full Catastrophe Living" by Jon Kabat-Zinn

3. If you want to read more on the study discussed above:     Speca, M., Carlson, L.E., Goodey, E., and Angen, M. (2000). A randomized, wait-list controlled clinical 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

Understanding our emotions, tolerating them, and expressing them appropriately is a skill. It's both a learned and a practiced skill. We first learn this skill during childhood. Just like we learn how to use the potty, self-soothe, ride a snowboard, and tie our shoes, we also learn how to be emotionally intelligent. Mom/Dad/Guardian teach us how to become conscious of our feelings, how to tolerate them, and express them appropriately.

When we experience an emotion, mom/dad/guardian help us to identify that feeling. "Oh you're crying right now because you're tired", or "You're feeling angry because you can't play with that toy right now". And then how to handle, be with or express that feeling. "I know you're sad, I'm staying with you, I'm here" or "I know you're tired, it's time to go to sleep" or "I know you're angry, it's alright to feel angry, but it's not alright to hit". Over time, the child then learns how to do this for him or herself, just like they learn to recognize the signs that they need to use the potty. The child learns how to identify their emotional state and then communicate it accordingly.

The foundation for emotional intelligence is consciousness. A parent/guardian has to become conscious of the child's experience and be able to identify it for him or her. Likewise, as a adults, we have to become conscious of our own emotional world. The first step is attuning to what we are actually experiencing inside.

You can LEARN and practice emotional consciousness now, regardless of whether or not you had great emotional training as a child. It's important to do so because pretty much Everything (social, familial and romantic relationships, physical health, ability to hold a job, academics/learning ability) is built upon the foundation of emotional intelligence.

As I said at the beginning emotional consciousness is both a learned and a practiced skill. To begin increasing your emotional consciousness check in with yourself a few times throughout your day and take your emotional temperature:

~At work especially after a particularly challenging phone call or meeting. Sit quietly at your desk and just ask out loud, just like a parent might help a child- what are you feeling right now? are you angry? are you sad? are you nervous? are you happy? 

~Become conscious and then just like a loving parent to a child- help yourself to express it appropriately. If you're tired, find a way to get yourself some rest. If you're angry, talk to yourself about it- listen like a loving parent- no judging, no changing it- just acceptance. Then decide, from this conscious place how you wish to handle your situation. 

~If you're not able to identify your emotional state, try identifying how your body feels. Are there any physical pains? What sensations are you having? Any tingling or numbness? Spend time becoming aware of and describing any sensations or lack of sensation to yourself. The body is a great doorway to our emotional states- becoming conscious of body sensations will ground you to where you are at this moment.

Ever get to that point when your mind just won't stop? During the holiday season the mind often has plenty of material to work with. Your mind worries: "The holidays are almost here and you still haven't gotten gifts for half the people on your list??! It's not like you didn't know the holidays were coming! It's the same time every year!!" Or maybe your mind is worrying because you don't have "enough" money for gifts. Or maybe it's worrying about how you will survive your family or lack of family and loved ones this year.

Whatever the thought or worry, whatever your situation may be this holiday season, not enough or too much, if you find yourself in full on "mind spin"----worrying, becoming depressed or anxious about your situation...try a few of these de-mind spin tips:

1. First of all accept that you are not alone. You can be absolutely sure that most people are worrying about something - maybe not the same thing that you are worrying about- but something this holiday season, just like you.

2. Second, take a minute and breathe. Ask yourself right now if you are alright, just right now in this very moment. Not tomorrow, or in the future or yesterday, but right now, are you ok? alive? breathing? This is an important question to ask because, often the pain of the holiday season comes to us because of our worries...and worries are most always about the future or the past. Worries about what the holidays have been like in the past, and are not now. Or what the holidays will be like this year- worries and anxieties usually exist in the present -----but are almost always about the future and or the past.

Another way to take yourself out of the worries or "mind spin" is by changing your focus. #3 and #4 are hands on mind tools:

3. Mindfully take three deep breaths. Take three slow deep breaths and pay attention only to your breath for just 3 full breaths---following the sensation of the breath the entire time.

4. Another option: Go outside or look out a window and focus fully on every detail of the object you are looking at. If it's a tree, what color is it? What about the leaves? Describe the tree bark. How tall is the tree, can you see the roots, how is it sitting in the ground etc.? Focus your mind fully on describing the object. Spend a few minutes on this.