Tension and Energy The TMC Approach to Mindfulness and Self-Regulation Some Reflections and An Opportunity to Practice Christine (Chris) Robinson B SC. OT, Reg. (ON) OTR Clinical Development Director The MEHRIT Centre Ltd. Toronto, ON Christinerobinson.tmc@gmail.com © 2013-2014 The MEHRIT Centre, Ltd

What is traditional mindfulness? Something that some people do to relax A Buddhist religious practice Non-judgmental observation of one’s thoughts, emotions and sensations Used by people who have difficulty slowing down their “monkey mind” Used as a de-stressor for physical, emotional and psychological stress What is traditional mindfulness to you? What experience have you had with it? Share with a partner. © 2013-2014 The MEHRIT Centre, Ltd

If traditional mindfulness is… Shifting your attention from your thoughts to the gentle predictable and rhythmic sensations of your own breathing Again and again To engage the PNS so as to calm the body and To stop the “monkey mind”, de-stress, and enjoy life more… Then how do we think about it in our study and practice of self-regulation at TMC? © 2013-2014 The MEHRIT Centre, Ltd

Some questions we are exploring at TMC.. How does mindfulness as a practice and a state of being relate to the six stages of arousal? Is mindfulness the same as embodied self-awareness? What’s the difference? Can we use mindfulness as a tool for self-regulation? If so, with what kinds of clients? Are there limitations when using mindfulness as a self-reg and/or therapeutic tool? Does mindfulness relate to the development of the social engagement system and if so how are they related? Can we use mindfulness as a therapeutic tool to challenge cognitive beliefs and emotional blockages? © 2013-2014 The MEHRIT Centre, Ltd

Beginning insights informing our mindfulness approach at TMC Because we humans have difficulty knowing our arousal state And because we seem to increase adrenaline as our primary self-reg strategy (with consequences always following) We wonder if noticing whatever comes into our awareness might be a strategy we can use to give us information about our arousal state We have found that mindfulness can be an effective self-reg strategy and self-monitoring tool, but you have to be regulated “enough” to access it, It develops with the SES and can be a powerful tool to support therapeutic transformation © 2013-2014 The MEHRIT Centre, Ltd

Embodied self-awareness and mindfulness – what’s the difference? Traditional mindfulness, is non-judgmental “observations” of internal, external and environmental sensations, (with a focus on the sensations of breathing), primarily used to settle down “monkey mind” Embodied self-awareness is a continuous necessary unconscious biological process of being aware of movements, sensations and emotions to maintains our healthy engagement in the world and with others, but we can access it at least partially with mindfulness Mindfulness as a self-regulation tool, involves accessing embodied self-awareness to become aware of one’s bodily sensations, emotions, thoughts, energy and tension states in any given moment, so as to be able to change one’s arousal state Therapeutic mindfulness involves focusing attention on one’s embodied awareness in order to release emotional and cognitive blockages and restore physical, emotional and psychological health © 2013-2014 The MEHRIT Centre, Ltd

What does mindfulness do in the brain and body? Engages PNS when exhale and SNS when inhale Provides oxygenation to the body and brain, slows the HR, and releases PNS hormones Flips a switch in the brain from the default narrative circuit thinking parts (DLPFC and hippocampus) to direct experience thinking parts (VMPFC including the insula for bodily sensations, and the Anterior Cingulate Cortex for attention) During self-regulation and therapeutic mindfulness additional areas of the brain are accessed including the vagus nerve and the right brain intuitive and SES Fogel, The Psychophysiology of Self-Awareness, Norton and Company, 2009 Rock, D., The Neuroscience of Mindfulness, Psychology Today, Oct 11, 2009 © 2013-2014 The MEHRIT Centre, Ltd

Situations where mindfulness is difficult and might even be harmful… When in a hypo, hyper or flooded state When having difficulty breathing When traumatized – present or past When living with chronic stress When experiencing great pain or distress When one’s cognitive beliefs are in direct conflict with the practice; e.g. “getting in touch with your sensations and emotions is touchy feely or is for weak people” © 2013-2014 The MEHRIT Centre, Ltd

© 2013-2014 The MEHRIT Centre, Ltd What about using traditional mindfulness in the classroom? Lessons from our work at TMC Be aware that there are many reasons why children are unable enter into traditional mindfulness Always give kids an option of leaving the mindfulness practice Offer quiet “dimmer switch” activities as an alternative Learning to become aware of arousal state is more important that the actual practice Check in with kids about their awareness of their arousal state before and after practice © 2013-2014 The MEHRIT Centre, Ltd

How do I teach mindfulness for self-regulation? Offer a menu of things to notice in the mind and body to begin. How do you feel in your body? worksheet from Lillas and Turnbull, Infant/Child Mental Health, Early Intervention, and Relationship-Based Therapies. Norton and Company, Inc. 2008. Must buy the book to use. Teach sensation vocabulary such as: www.larisaloehn.com/sensations © 2013-2014 The MEHRIT Centre, Ltd

Some suggestions for beginning to teach traditional mindfulness Direct teaching: Explain that you don’t have to be BELLY breathing to calm. Talk about how we sometimes hold our breath or only breathe in the top of our chest, but that we can learn to use breathing to help us to calm and to stop thoughts that keep coming back. Show the basic anatomy of the chest, including the ribs and diaphragm and the purpose of breathing in the body, focusing on breathing as a way to oxygenate and that the brain uses it’s calming system when we EXHALE and alerting system when we INHALE. Position: ask the children to make themselves comfortable either sitting or lying down, supporting their backs and heads as needed. Often children can’t feel the sensations of their breathing until they have their backs supported. Encourage them to try out different positions to see which ones work best. © 2013-2014 The MEHRIT Centre, Ltd

More suggestions for the classroom… Teach paying attention to breathing rather than making a BIG Belly. Don’t worry about diaphragmatic breathing to begin. Thoracic breathing also involves the PNS in exhale. Can you feel your breath inside your mouth as you exhale? Can you feel the breath inside your nose as you inhale? Where do you feel breathing? In your belly? In your chest? At the front of your chest? At the sides? At the back? Can you feel your breath filling up your chest and/or belly like a balloon? Is the balloon big or little? Can you find where you feel the balloon the most on your body? Encourage self-discovery about the connection between thinking and breathing: Do experiments such as what are you thinking about now? Now do some mindfulness breathing and see if paying attention to your breathing stops the thinking. Does your thought keep coming back? Are you able to gently bring your attention back to the breathing? Start small: set a timer for 2 minutes to start. Set up daily routines for practice. © 2013-2014 The MEHRIT Centre, Ltd

References and Thank you! Chan, Mindfulness Meditation Benefits: 20 Reasons Why It’s Good for Your Mental and Physical Health, Huffington Post, April 8, 2013 Fogel, The Psychophysiology of Self-Awareness, Norton, 2009 Kabat-Zinn, Full Catastophe Living, Wherever You Go There You Are, (and anything else by him), Random House, Trade Paperbacks or e-books Lillas and Turnbull, Infant/Child Mental Health, Early Intervention, and Relationship-Based Therapies. Norton and Company, Inc. 2008. Odgen, Trauma and the Body, Norton, 2006 Porges, The Polyvagal Theory, Norton, 2011 Rock, The Neuroscience of Mindfulness, Psychology Today, October 11, 2009 © 2013-2014 The MEHRIT Centre, Ltd