An Introduction to Mindfulness

by Davidicus Wong, M.D.

This is a handout I share with my patients to introduce them to the practice of mindfulness and principles of cognitive behavioural therapy. I consider these to be two fundamental emotional wellness skills that every adult and child should learn.

Like any other skills we wish to master, practice – particularly daily practice – is essential. Through the power of the human brain’s capacity for neuroplasticity (to change itself), we learn new skills – including new ways of thinking and feeling – through repeated practice. In the words of the pioneering Canadian neuropsychologist, Donald Hebb, “Neurons that fire together wire together.”

MINDFULNESS MEDITATION helps us to centre our minds, increase our awareness and calm the nervous system that modulates how we experience pain and other sensations. The practice of mindfulness teaches us a less reactive approach to the rest of our lives. We become open to accept and experience every aspect of our lives, our selves and our sensations, without clinging, aversion or judgment.

We begin meditation by spending 15 or 20 minutes each day just sitting in a quiet place in a comfortable position. We turn our attention to the natural flow and sensations of the breath without trying to control it in any way. This becomes a safe and calming anchor that we can return to at any time.

We can then turn our attention to sounds as they arise in our immediate environment, just attending to the arising and disappearance of different sounds as they come and go from our awareness. We don’t have to label or identify each sound. We simply remain aware of them as they arise.

We can centre our awareness on different physical sensations in the body, perhaps the pressure at points of contact, warmth, coolness, vibrations, pulsations, tingling and even pain. We can move awareness to different areas of the body, and if a sensation such as pain in one part of the body is difficult to manage, we can shift our attention elsewhere, to the part of the body that is most comfortable or back to the anchor of the breath.

With practice, we are able to maintain awareness and attention to every sensation without reacting to it, without aversion, clinging, judgment or identification. With time, we recognize that everything within our awareness is ever changing; nothing is constant – no sensation (not even pain), no mood, no emotion and no thought.

We are able to attend to each thought as it arises without getting carried away in a train of thoughts or a story in the remembered past or imagined future. We can note thoughts as they arise, without judgment or identification and let them go. We can do the same with the transient feelings and emotions that arise without getting caught up and carried away with them. We experience moods, feelings and emotions but we are not our moods, feelings or emotions. We can see them as transient, temporary conditions like a mist, a fog or a shower. They pass through us or we pass through them.

We can be mindful when walking, attending to the sensations of each step, the sounds and pressures on the feet and the movement of the legs. This becomes a mindful anchor from which what we hear, see, feel and think arises in our open and accepting awareness. 

Mindfulness can be practiced while eating, attending to the taste and texture of each bite of food; swimming, attending to the sensations of buoyancy, flowing water on the surface of the skin and rich sounds of moving water and air; and even driving. Mindfulness only begins with meditation. When you apply the healthy attitudes of non-reactive acceptance, gratitude and compassion to everything in your life throughout each day, you will discover a deeper level of peace, happiness and meaning. 

Mindfulness when diligently practiced can bring serenity to your mind and body throughout each day – an open, accepting and nonreactive approach to your life. It can foster in you greater compassion for others and yourself.

COGNITIVE BEHAVIOURAL THERAPY trains us to uncover our underlying beliefs and assumptions, choose our conscious thoughts, reframe our situation and shape our emotions. We can discover that we can improve our moods, thoughts and function in life through healthy self-care – eating regular healthy meals, ensuring adequate rest, daily appropriate physical activity and spending quality time with supportive friends and those loved ones who naturally lift our spirits. Mindfulness meditation can help us identify unskillful thoughts (those that increase suffering) and help us choose skillful ones.

MORE RESOURCES (I’ve put my favourites in bold)

MINDFULNESS MEDITATION

The Miracle of Mindfulness: An Introduction to the Practice of Mindfulness (Thich Nhat Hanh)

Insight Meditation: The Practice of Freedom (Joseph Goldstein)

Mindfulness: A Practical Guide to Awakening (Joseph Goldstein)

Radical Acceptance (Tara Brach)

True Refuge: Finding Peace and Freedom in Your Own Awakened Heart (Tara Brach)

JackKornfield.com, TaraBrach.com Jack Kornfield and Tara Brach’s videos, guided meditations and lectures are available for free on these websites. By listening to these teachers, you will quickly see how the attitude of mindfulness can be applied to your everyday life.

Local mindfulness retreats: Westcoast Dharma Society http://www.westcoastdharma.org

MicrodosingMindfulness.com will show you how to fit in routine mindfulness breaks in just a few minutes a day

THE PRACTICAL SCIENCE OF NEUROPLASTICITY

Hardwiring Happiness (Rick Hanson)

Buddha’s Brain: The Practical Neuroscience of Happiness, Love and Wisdom (Rick Hanson)

COGNITIVE BEHAVIOURAL THERAPY

Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment(Martin E. P. Seligman)

Feeling Good: The New Mood Therapy (David D. Burns)

Mind Over Mood: Change How You Feel by Changing the Way You Think (Dennis Greenberger, Christine Padesky)

Anxietybc.ca has many useful resource including the Mindshift app for smart phones

Checkingin is a free mindfulness app for your smart phones

DIALECTICAL BEHAVIOURAL THERAPY (a synthesis of mindfulness and cognitive therapy)

            The Dialectical Behavior Therapy Skills Workbook for Anxiety: Breaking Free From Worry, Panic, PTSD, & Other Anxiety Symptoms (Alexander L. Chapman)

For an effective technique for establishing healthy new habits, check out TINYHABITS.COM

From Surviving to Thriving During the Pandemic: Managing Our Emotions and Stress

I recently gave a community webinar through Burnaby’s Primary Care Network.

I provided some practical strategies for managing the increased stress and difficult emotions we are all experiencing with all the changes of the Pandemic.

I also provided links to resources for the many of us who need more support.

Please share this information with anyone you know who may benefit.

A Hundred Days To Happiness: Change How You Feel By Choosing What You Do And Changing How You Think

For motivated patients with good insight, I recommend cognitive behavioural therapy for mild to moderate depression and anxiety. It requires a high level of emotional intelligence – awareness of one’s emotional states – and flexible thinking – the ability to look at situations from different perspectives.

To be successful with cognitive behavioural therapy requires some humbleness because one must be able to release one’s attachment to patterns of thought, underlying assumptions and long held core beliefs that perpetuate negative moods.

I recommend to my patients, the book, “Mind Over Mood” by Padesky and Greenberger. I explain to them the concepts of CBT; just as our moods influence our behaviour and our thoughts, our thoughts can shape our moods. Negative thoughts and assumptions about ourselves, the world and the future underlie depressed moods. Catastrophic and “what if?” thinking that exaggerates danger and bad outcomes feed anxiety.

One of the first exercises I recommend from this book is the Activity Record. Each day for a week, you record what you are doing every hour. Beside this, you rate your mood on a numeric scale.  This exercise is easier than it sounds. You would take out your single-page Activity Record at lunch time and review what you did and how you felt throughout the morning. You could do the same at dinner and at bedtime.

Before the week is over, most people recognize that their moods vary throughout the week and over the course of each day. Together, we look at patterns. Most people feel more depressed when they watch television and less depressed after vigorous exercise. A phone call can improve or worsen a bad mood depending on what was discussed and with whom one speaks.

Already after one week, you learn that you can influence your mood by how you spend your time. You may choose to spend less time watching television or doing other passive activities that make you feel down. You may spend more time talking with and hanging out with friends who give you a lift – and less time with those who are downers.

In general, when life feels random and out of your control, you will feel anxious. Over time, helplessness leads to hopelessness and depression. The ability to shape your own emotional states without drugs is empowering. It returns the locus of control to you.

Your happiness exercise: Even if you’re not feeling depressed, keep an Activity Record for one day. Pay attention to your moods throughout the day and how they vary depending on what you are doing and whom you are with. At the times you are feeling anxious, angry or sad, what were you thinking? When did you feel happiest? Will these insights shape your choices tomorrow?