10 books that are good for your health: Mindfulness, Self-Compassion & Happiness

As we enter the New Year, let’s make 2015 a year of exploring the many gifts from skilled researchers and clinicians which can support our resolution to live better. The participants of the Mindfulness-Based Symptom Management, Burnout Resilience and Pain Management programs at the Ottawa Mindfulness Clinic have one wish in common: a desire to find a way to live their lives differently. In fact, this wish is not only that of the participants but also of everyone who works at the OMC. We share together the realization that despite our best intentions, we falter in caring for ourselves and others in a way that is kind, nourishing and supportive. We have strong values and tend to be committed to making ethically informed choices and yet we find ourselves wondering where all the wisdom went as we choose against those exact purposes.

If you’ve taken a mindfulness course, good start! You know over eight classes there can be shifts in your thoughts, actions and speech. You also know it’s not a quick fix and that the Ninth Class is the toughest! So to help with the rest of your practice life, here’s a collection of books that we recommend to support, boost and sustain your practice!

Mindfulness Starts Here: An eight-week guide to skillful living by Lynette Monteiro & Frank Musten. Now you didn’t think I would miss a chance to prop up our own book? If you’ve taken the 8-week program at the OMC, this is a great way to extend your practice. It also helps to come to the monthly Alumni groups! Nuff said. Let’s get on to the books you really need to get for yourself!

Leaves Falling Gently: Living fully with serious life-limiting illness through mindfulness, compassion & connectedness by Susan Bauer-Wu.  This is likely my all-time favourite. Bauer-Wu is an expert in the field of pain, oncology and mindfulness. The book is infused with compassion and an open-hearted approach to the vagaries of chronic pain. The exercises are easy and helpful, realistic and encouraging. The sections on the impact of chronic illness on memory, attention, emotions, etc. is invaluable. This book also is unstinting in its honesty about life-threatening illness and offers opportunities to change our rigid stance to the reality of living and dying.

The Practicing Happiness Workbook by Ruth Baer. This is a terrific book that brings together Dr. Baer’s skills as a clinician, methodical approach as a researcher and clear understanding as a mindfulness practitioner. I loved the set-up of the workbook because it … well, it works. Start with a nice pithy overview and then jump in at your own pace. The second section explores four very important traps that can derail our practice:  rumination, avoidance, emotion-driven behaviours and self-criticism. The section following on mindfulness skills is clearly written and I truly appreciate the inclusion of values and goals. The chapters are punctuated with stories about people with whom we can identify and the worksheets are very user-friendly. It makes me happy just to read it!

Hardwiring Happiness: The new brain science of contentment, calm, and confidence by Rick Hanson. Neuropsychologist Rick Hanson is well-known for his ability to pull together neuroscience and psychological mind states in a way that is immanently understandable by most of us non-neuroscientists. There are so many catch phrases used in the mindfulness circles that originate with his teachings and in his books! Velcro for bad/Teflon for good, HEAL yourself, metaphors for resilience and vulnerability, the list is endless. What is important though is his ability to explain why we act the way do and how this is hard-wired. The section “Paper Tiger Paranoia” is my favourite and has helped me out of many a flight reaction! Mostly, in this book, we get to practice the ways in which to make changes to those survival instincts and hard-wire responses to experiences that sustain and help us. If you find this book helpful (or if you’re curious), also try his new program called Foundations of Well-Being which is a year-long on-line program and worth taking.

Living Well with Pain & Illness: The mindful way to free yourself from suffering by Vidyamala Burch. This book is written by and is based on the Breathworks program developed by someone who truly understands the challenge of physical pain. Vidyamala Burch’s history is unlike anyone I’ve read about and her strength is apparent throughout the book. Chapter 2 explains what is pain and is one of the clearest and most useful descriptions available. The use of research-based information is well-placed and does not overwhelm the information in each chapter. I totally fell in love with the third chapter. It’s my favourite allegory of how we create our suffering out of pain. And Burch patiently tells the story in gentle sequences making it come alive. The exercises and case stories are accessible and very user-friendly. I prefer the book to the e-book simply because the text set up is more compelling.

Empathy: Why it matters and how to get it by Roman Krznaric. This is an important book to keep the practice of mindfulness from becoming a self-centered practice. While we start our practice because we suffer the effects of personal difficulties, it is important to see that we are created, and can be undone, in a social context of family, community and global events. Mindfulness brings our awareness to our suffering and we practice so that we don’t repeat the same cycles of interactions with ourselves and others. However the deeper intention of mindfulness is to create a compassionate world and that change can’t happen without seeing that others too want to be free of the same suffering we endure. Empathy is the capacity to walk in their shoes, to make choices that are informed by understanding that what others need is not what we think they need. The exercises and examples in the book are wonderful and challenge us to find a different way to know the world. Grow your connection with those you love and beyond!

Mindful Compassion by Paul Gilbert & Choden. Paul Gilbert is well-known and respected for his work on compassion and cultivating the compassionate mind. In this book, he teams with Choden, a Buddhist monk who helped develop the graduate program in mindfulness and compassion at Aberdeen University. I particularly like the way they organize the book so that the arising of compassion is a natural outcome of how we organize the world as we know it. Gilbert’s perspective of compassion as a social mentality which helps us negotiate through relationships and interactions is an important understanding. In other words, being compassionate is far from being soft and squidgy or a door mat. The exercises are nicely explained and inviting. The definitions of compassion clear up misconceptions. The development of a compassionate self (Chapter 10) is probably the most important part of the book. However, it rests on all that precedes it; I especially liked that the exercises in this chapter are also empathy cultivating ones. An important addition to your mindfulness practice!

The Mindful Way Workbook: An 8-week program to free yourself from depression and emotional distress by John Teasdale, Mark Williams & Zindel Segal. This book is a user-format version of the previously published A Mindful Way through Depression. The first section lays out the foundations and the next section takes us through the eight weeks. I liked how the issue of traps and obstacles is re-framed as “another way of knowing” which opens up the thought patterns and is subtly a practice in cognitive flexibility. It is focused on addressing depression through mindfulness however, the various exercises also might be useful for anxiety and general stress. I had trouble with the layout of the book (too many boxes for a book that wants us to get out of our mental boxes) and the excessive number of balloon quotes are distracting (not cool for a mindfulness book). I have used it as a guidebook with individual patients and found it organizes the sessions well. Be patient when you use this but do try it!

The Mindful Path to Self-Compassion: Freeing yourself from destructive thoughts and emotions by Christopher Germer AND Self-Compassion: The proven power of being kind to yourself by Kristin Neff. These two books come as a perfectly balanced pair. Germer approaches self-compassion with a clinical understanding of the emotional impact of our often harsh inner critic. Neff comes from the perspective of a research-based understanding of what self-compassion means and how it works. With both the experiential practice and the knowledge base to ground it, I find the practice of self-compassion inviting and easy to integrate into my life. As both Neff and Germer remind us in their workshops: don’t chose a practice that sets off an argument in your mind about it. Folded into both books is also the much-needed practice of forgiving ourselves for not being that superhuman being we think we need to be.

The Mindful Way to Study: Dancing with your books by Jake Gibbs & Roddy Gibbs. For all you students out there and those of us who are perennial students, this is a terrific guide to setting down and getting the work done. And more. I like the way this book addresses the various obstacles we encounter (traps) by setting the perspective of “gumption”. Just do what needs to be done! Well, it’s not that easy and Gibbs & Gibbs walk us through a number of gumption traps. The first one was ego (but I figure I already know how that works so I skipped it… no, not really). Check out the section on procrastination though; it’s not just about boredom or priorities! Gibbs & Gibbs’ focus on Right Effort (the last section) is helpful and has a nice balance of meditative practice with insight to our actions.

 

Credible Teachers of Mindfulness: How can you know?

Mindfulness-Based programs have become the go-to treatment around the world and their popularity has made treatment more accessible in many ways. Despite the popularity or maybe because of it, several articles have argued against mindfulness because it  (1) seems to be the fix-it for many ills, (2) doesn’t stay true to its Buddhist roots and (3) understates its “dark side”. There is concern that mindfulness therapies and programs are often sold as much better than the traditional methods of treating depression, anxiety, and other psychological disorders. Such concerns were supported when a recent study showed that statistically mindfulness-based therapies (MBTs) have a moderate effect when studied in comparison with wait-list controls and when participants are compared to their pre-post scores. More than that, MBTs are not better than traditional cognitive behavioural therapy or pharmacological treatments. The deepest concern however relates to the qualifications of those who teach mindfulness as more and more programs are offered by individuals and groups with little or no training in mindfulness concepts and approaches.

Elisha Goldstein, writing for the magazine Mindfulness, re-stated some of these issues that constitute a “mindfulness backlash” in his recent blog post which claimed that there is little evidence for a backlash. What stands out in his discussion about the issues facing programs that offer mindfulness is the emphasis on trusting that “skilled mindfulness teachers” will neither over-sell the treatment scope and that “credible teachers” will walk participants through their misunderstanding of what is mindfulness. Goldstein goes on to say – even more emphatically – that it is important to seek out teachers who are well-trained. He adds a link to finding qualified teachers via the Center for Mindfulness at the University of Massachusetts, the birthplace of Mindfulness-Based Stress Reduction (MBSR).

What is left unsaid however is that the focus of all discussions and debates of mindfulness programs are anchored in the original one, Mindfulness-Based Stress Reduction (MBSR). This particular program was developed by Jon Kabat-Zinn and the acronym has taken on an iconic status much like the terms Xerox or Kleenex. When most professionals discuss mindfulness programs they are typically referring to MBSR unless it is clear from the outset that the topic is related to Mindfulness-Based Cognitive Therapy (MBCT). This assumption leads to confusion because MBSR, while being the original, is not the only mindfulness treatment program.

Does it matter? Absolutely. While most programs have a similar format (8-10 weeks, groups, meditation and yoga, etc.), significant aspects of the program will differ. Even more than that, the type of training and confirmation of skills of the teacher will differ considerably. And since Goldstein makes a very good point that we need to find credible teachers, it is important to note that not all qualified mindfulness teachers will have been trained in MBSR itself.

Recently, the Center for Mindfulness at the University of Massachusetts (CFM-UMass; the home base for MBSR and training of MBSR teachers) announced a format of teacher training that includes training those who will train teachers. While it’s perfectly understandable that CFM-UMass has taken a firm stand in cultivating MBSR teachers, this move is not without its detractors. However, it will filter those who have been teaching without full training at CFM-UMass and passing their programs off as MBSR. Nevertheless, this raises a difficult issue for those who have been trained in approaches that are not MBSR but which are legitimate approaches; the cachet of the term MBSR now takes on a more serious tone because many identify it as THE treatment program and may be confused by others.

That being the case, it is important to know that there are a number of other training centres that train teachers for mindfulness programs.

The M4 Program, Ottawa Mindfulness Clinic. The M4 (includes Mindfulness-Based Symptom Management; MBSM) training is in-depth and takes as long as a year. It requires applicants to have a clear rationale for wanting the training and expects a high level of participation. They attend the 8-week program as participants and do twice the expected formal and informal practices. They must attend a silent retreat in the year of their training. Current research and topics in mindfulness treatments are researched especially in their area of interest of specialization. They attend a training in the specifics of the delivering the program and in cultivating teacher qualities. Before teaching the M4 potential teachers must teach under supervision (qualification level) and then teach for 3 sessions with senior teachers in the clinic for Certification.

MBSR, University of Massachusetts, Center for Mindfulness. This is the original MBSR program and the training is extensive.

MBCT, The Centre for Mindfulness Studies. The training in MBCT is offered through various forms of study and teacher development. This program is supported by the Factor-Inwentash Faculty of Social Work (University of Toronto) which offers a certificate in MBCT.

MiCBT, Mindfulness integrated Cognitive Behaviour Therapy. An approach to mindfulness that weaves together Western psychology with Eastern principles of mindfulness. Training is comprehensive and a graduate diploma is offered for teachers.

Applied Mindfulness Meditation, Faculty of Social Work, University of Toronto. This program offers what is likely one of the most extensive trainings in mindfulness, meditation, and all its attendant components.

Training in the UK. This website lists various programs that train mindfulness teachers, including MBCT teachers. Rebecca Crane and her colleagues at Bangor University have also developed a teaching assessment protocol for the cultivation of mindfulness teachers which is a gold standard for any teacher who is dedicated to cultivating their skills.

Mindful Self-Compassion, Center for Mindful Self-Compassion. Developed by Christopher Germer and Kristin Neff, Mindful Self-Compassion (MSC) has developed a following in the last year as the teacher training becomes more available globally.

UCSD Mindfulness-Based Professional Training Institute. For training in various mindfulness-based programs such as Mindfulness-Based Relapse Prevention, Mindful Eating, etc.

Institute for Meditation and Psychotherapy offers a certificate program in mindfulness and psychotherapy. The founding practitioners include Paul Fulton, Christopher Germer, Ronald Siegel, Trudy Goodman – all well-regarded in the field of meditation and clinical psychology.

If you intend to take a mindfulness program, ask the sticky questions. It’s your health and your wellbeing. Be informed. The program may not be MBSR. And it may be something valid and well-supported in its own right.

 

Is Mindfulness the same as Buddhism?

DSC_0049There’s been a lot of chatter on the internet these days about Mindfulness and Buddhism. In a nutshell, practitioners, writers, and philosophers of Buddhism have expressed concern about the potential misuse of Buddhist beliefs and concepts by mindfulness-based interventions or programs. There is much merit to these concerns although the discussions tend to become bogged down with a lot of arguments that missed the central point. There are important issues about Mindfulness and Buddhism as well as Mindfulness itself that anyone considering a program should take the time to investigate. Below are some of these issues that may be helpful to consider.

Are Mindfulness-Based Programs and Interventions the same as Buddhism?

The answer will vary depending on the framework we use to address it. At one level, mindfulness is a Buddhism-based concept so it is unavoidable that the core principles guiding any Mindfulness-Based Intervention or Program will reach into a Buddhist conceptualization of its meaning and practice. However, mindfulness has moved far enough away from Buddhist philosophy and has begun to draw from various fields of psychology such as Cognitive Theory, Positive Psychology, Motivational approaches, Organizational Psychology, that it can be said to be a new “wave” in the genre of psychological and organizational approaches.

If you are considering a mindfulness program, there are some underlying concepts and frameworks you may wish to know that will inform your decisions. In our course intakes, we are often asked if the program is Buddhist. We are also asked if there are aspects of the program that would interfere with the person’s religious views or practices. People also want to be assured that the program won’t impose values and beliefs on them that may not fit with their own values and beliefs. These are important questions and need to be addressed openly and all the more important with the debates going around on the Buddhist nature of mindfulness and the potential dangers of teaching it as a secular or psychological modality.

Is Mindfulness the same as Buddhism?

Not completely. We can organize mindfulness programs into two categories: Mindfulness-Informed (MI) and Mindfulness-Based (MB) approaches (edit: See Shapiro & Carlson’s book The Art and Science of Mindfulness). Mindfulness-Informed approaches will draw from Buddhist philosophy using concepts of impermanence, adaptive self (non self), and the reality of suffering. They can also introduce concepts of lovingkindness and compassion. MI approaches may not use meditation practices specifically. Typically, the professional is trained in Buddhist theory and/or practice and therefore understands how our attitude and interpretations of our difficulties leads to our sorrow and suffering. Mindfulness-Based approaches draw from Buddhist practices such as sitting and walking meditation, breath awareness, etc. and build from this a state of steadiness so that the issues that plague us can be faced in a skillful manner. (edit) Additionally, Mindfulness-Based approaches draw from current understanding of stress theory and other psychotherapeutic models. (edit end) The final intention of both MI and MB approaches is the same – the reduction of suffering. Neither approach requires nor relies on a belief in Buddhist religious concepts.

Are all Mindfulness Programs the same?

No. For clarity, I refer to interventions separately from programs. A Program is offered over a time period, typically 8-weeks and may or may have a psychological intent; it may be conducted individually or in a group. “Programs” may be offered for stress management, lifestyle changes, spiritual growth, personal wellness or development. An Intervention refers to the medical- or psychological-based intent of the approach; this may be delivered as a time-framed process in a group or individually. “Interventions” may be offered to deal with physical or psychological issues such as depression, anxiety, chronic pain, physical pain or injuries, etc. These typically require a registered health care professional to supervise or conduct the intervention. Research articles on mindfulness will refer to Mindfulness-Based Interventions (MBIs) or their specific label such as Mindfulness-Based Cognitive Therapy.

There are many, many MBIs! Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, Mindful Self-Compassion, Mindfulness-Based Relapse Prevention (for addictions), Mindfulness-Based Mind Fitness Training, Mindfulness-Based Eating Awareness Training, and so on. And of course, just to add to the confusion, each of these will be taught under different “company” names. The M4 Program we offer at the OMC is a psychologically-based MBI and designed as an intervention for psychological issues such as depression, anxiety, chronic illness etc.

Are Mindfulness Instructors or Teachers accredited, certified or trained professionally?

Not all are. Most professionals will have taken at the very least a 5-day intensive training in the specific area of interest. Some will have continued from this to take on-going training with specialists in their field. (edit) All MBI teachers are expected to have a personal meditative/contemplative practice to support their teaching skills and personal development. (edit end) Health Care Professionals who work in the Mindfulness-Informed approaches will likely have trained in their specific treatment modality (CBT, EFT, etc.) and also continued with a Buddhist or other contemplative practice tradition. Others will have obtained accreditation from specific organizations.  The Center for Mindfulness at the University of Massachusetts offers a teacher certification program for Mindfulness-Based Stress Reduction Programs. Mindfulness-Based Cognitive Therapy accreditation is available from the Factor-Inwentash Faculty of Social Work, University of Toronto. The Center for Mindful Self-Compassion offers teacher training in Mindful Self-Compassion. The University of California at San Diego is developing a Professional Training Institute that will allow teacher-development programs in several streams of Mindfulness-Based Interventions.

One aspect of the training/accreditation question is to consider whether the facilitator or instructor is accredited in their own field of expertise. All health care professionals have a regulatory organization which certifies their training; mindfulness can be viewed as a therapeutic intervention that they provide as a trained health care professional. Other professionals such as educators, coaches, and spiritual care professionals,  will have professional organization that verify their credentials as a trained professional.

Do all Mindfulness-Based Programs have the same positive effect?

It depends. Research shows that MBIs have a positive impact for many issues. Whether an individual experiences the expected positive change depends on the “good fit” between the individual and the program. If the issue is depression, then a “stress” program may not do the job. If there are issues of anxiety that are not disclosed at the intake (yes, there should be an intake!), then this can have an impact on their experience of the program. What can increase the probability of a “good fit” is asking lots of questions at the information session or the intake appointment. The most frequent issues that derail the program for participants are as follows:

  • Realizing that there is a certain amount of sharing that happens in the course
  • Finding out it is not like a school course where we get all the answers from the teachers
  • Not realizing how much time the practices take
  • Wanting a “quick fix”
  • Needing certainty that the practices will work
  • Wanting to “get rid” of the problem

These are all important questions to consider and to ask if you are thinking of taking a Mindfulness-Based Program. It is about your health and well-being. Be proactive. Understand the scope and limits of MBIs. Most of all, know the people offering the programs.

Starting to Dance Again

Book review: Mindfulness: An eight-week plan for finding peace in a frantic world by Mark Williams & Danny Penman

Mindfulness: An eight-week plan for finding peace in a frantic world by Mark Williams and Danny Penman is a book that you want on your side.  You want it in your back pocket, in your knapsack, in your briefcase.  You may not want it on your iPad – although I have it on mine.  Nor might you want it in any form that prevents you from having a full-embodied experience of the lessons it offers to wade through this crazy, harried, frantic world.  Pick it up, turn the pages, dog-ear it, breathe in the possibility of change it offers.

Professor Mark Williams is well-known as one of the co-developers of Mindfulness-Based Cognitive Therapy – a treatment protocol to prevent relapse into depression.  He is the Director of the Oxford Mindfulness Center and the co-author of two books on MBCT which have offered rich wisdom to therapists treating and those seeking relief from depression.  In this book, Williams takes us on a different journey addressing the issues of daily living that tie us in knots and prevent us from living a fulfilled life.  From the very first chapter, Chasing your tail, the book sets a compassionate and understanding tone that invites us to explore these sticky points in our life.  The eternal question of “Why can’t I be rid of anxiety and sadness so I can be happy?” is addressed directly: these are not problems to be solved so we don’t need to feel bad about “failing” to do so.  The issue is not how to fix our emotional state but rather to see that we often use the wrong tool to manage the problem.  Mindfulness gives us the opportunity to step back and choose the best tool for the situation.

Mindfulness does not negate the brain’s natural desire to solve problems.  It simply gives us the time and space to choose the best ways of solving them.  Some problems are best dealt with emotionally – we select the solution that “feels” best.  Others need to be slogged through logically.  Many are best left alone for now. (p.12)

This capacity of mindfulness to open space around us is often overlooked in the typical wish we have to get to the outcome or to attain a state of understanding of our difficulties.  The practice of mindfulness doesn’t change the fact of having a problem; it offers an opportunity to meet it in a way different from our typical habitual reactions.

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MBCT at 10 Years Old – onwards and upwards

Zindel Segal, co-founder of Mindfulness-Based Cognitive Therapy (MBCT), reflects on the future directions of MBCT as it approaches its tenth anniversary. With the establishment of reliable outcome data for the efficacy of MBCT treatment, we now need to look at the actual way in which MBCT effects these positive changes.

Clarifying mechanisms of action is of more than just academic interest, as it will likely inform the approach taken to training the next generation of MBCT practitioners.  The fact that these are questions being asked shows how far we have come from the early days when MBCT was described as a form of attentional control training.

And it doesn’t stop there.  Segal writes more on the use of technology to make the treatment more accessible for the benefit of many more people who need it.

You can read the entire article on the UCSD blog page.  Click.

Mindfulness Meditation and Mental Health – news article on CBC’s The Journal

Zindel Segal discussing his recent research results from the recent MBCT study.

Great comments by a practitioner, Suzanne Simoni, who has a very realistic appraisal of what mindfulness does.

MBCT course at Kripalu

Our dear colleagues Susan Woods and Miv London are teaching a weekend-long course in MBCT at Kripalu.  From the Kripalu site:

The Mindful Heart of Psychotherapy: An Introduction to Mindfulness-Based Cognitive Therapy

Presenter(s)

Susan Woods and Miriam London

Susan Woods, MSW, LICSW, is a mindfulness-based psychotherapist in private practice. She has worked in a variety of clinical settings since she began practicing in 1989. Susan provides supervision and consultation in mindfulness-based approaches to…
Full Bio & Programs

  

 

Miriam “Miv” London, PhD, received her doctorate in clinical psychology from Yale University in 1984 and has held a variety of clinical and academic positions. Since 1994, she has worked at the University of Vermont…
Full Bio & Programs

For mental-health professionals and students.

Mindfulness is an approach that allows both clients and therapists to relate to themselves and their lives with wisdom and equanimity. The role and usefulness of mindfulness-based interventions in clinical practice has been the subject of much research and discussion. Less understood is the role of a personal mindfulness practice for clinicians. If we take the view that mindfulness is more than a prescriptive technique, and is a valid way of life, then the potential transformative aspect of this way of being for the clinician is a significant factor in the delivery of mindfulness-based approaches.

This 2-day training for professionals interested in the interface of mindfulness in clinical treatment will be both didactic and experiential. We will discuss the structure and delivery of a Mindfulness-Based Cognitive Therapy (MBCT) program and practice various MBCT skills with an emphasis on their application to cases of preventing depression relapse. The workshop will also include time for personal mindfulness practice.

Recommended reading Zindel V. Segal, J. Mark G. Williams, and John Teasdale, Mindfulness-Based Cognitive Therapy for Depression (Guilford Press) and Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn, The Mindful Way through Depression (Guilford Press).

CE Credits

This program is eligible for :
  • 11.5 credits for social workers (SW), $20 additional charge
  • 11.5 credits for certified counselors (NBCC), $20 additional charge
  • 11.5 credits for psychologists (PSY), $20 additional charge