Mindfulness Matters

Mindfulness Matters

Oliver Sacks Writes his Pre-Obituary

posted by Dr. Arnie Kozak

oliversacksThe neurologist and author Oliver Sacks recently wrote an op-ed piece in the New York Times about his impending death and the light this news casts on his life. His reflections are the epitome of equanimity. What we hear from him is not anxiety, rancor, or regret but rather gratitude, love, and resolve.

 It is up to me now to choose how to live out the months that remain to me. I have to live in the richest, deepest, most productive way I can.

Of course, we don’t have to wait until we have a terminal diagnosis to embrace life richly, deeply, and productively. Of course again, we already have a terminal diagnosis–it was given to us the moment we were conceived. We are always in the process of dying. Each breath we take is one closer to our eventual demise. Still, an actual medical diagnosis can put a fine point on it.

 I feel a sudden clear focus and perspective. There is no time for anything inessential. I must focus on myself, my work and my friends. I shall no longer look at “NewsHour” every night. I shall no longer pay any attention to politics or arguments about global warming

While there are always some things that we must do in our lives, we have vastly more discretionary power than we ever exercise. If we never examine the patterns of our lives, we can’t know what we are really committed to. Without asking questions, we can’t hope to change. Then, we must be willing to make the choices to set our lives in accordance with what is actually most important to us.

It’s a work in progress. It’s hard to know what our actual wanting is since there are many sources of interference–most notably the sense of what we should want or should do. We inherit and adhere to these senses of want from the culture, from growing up, and from the people close around us.

It often takes an act of courage and faith in ourselves to say no to a popular thing. With so little time left to live, Sacks is able to give himself permission to be self-full in this regard. His choice not to watch the news is a gift to himself.

Imagine that you had a year to live. What would you do differently? Imagine that year is now a month, what then? How do you want to spend that time? Only a week left; what now? Just a day?

The closer we get the less we want to collect things and experiences and the more we just want to experience being. Sacks puts it eloquently, when he concludes:

Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.

Getting Out of Our Own Way: Finding Liberation in the Moment

posted by Dr. Arnie Kozak

If you are like me, you spend more time than you would like caught up in imagined stories that don’t feel good and keep you stuck. How can you get out of your own way and stop beating yourself up with regrets. My mind can sometimes get stuck and I’d be in big trouble if I didn’t have a mindfulness practice that gives me the skills and wisdom to deal with it.

To free ourselves, it helps to have tools such as my Story Art method, perspectives like those provided by Buddhist psychology, and practices such as meditation and good self-care.

I’ve done a lot of work with perfectionism. I’ve come to the realization that perfection has appeal to us because it is a cheat against impermanence. If we can exert the control required to be perfect, perhaps we’ll be protected from the difficulties of life.

Due to my own struggles to find peace, I’ve come in deep contact with the teachings of the Buddha and have tasted the liberation from anguish that they offer when we embrace them.

My calling has been to write and teach about these discoveries and to convey what I’ve learned to others through my books and workshops.

The program I offer at Kripalu is focused on delivering the tools and perspectives that can help you to get unstuck and out of your own way, be more self-compassionate and forgiving of your imperfections, and let go of stories that keep you

If you have the time available, come join me at Kripalu for this five-day journey called Mindfulness A to Z: Liberating Regret, Stuckness, and Perfection. Kripalu is a wonderful place that I am happy to have as one of my spiritual homes. It’s beautiful, spacious, and friendly. The energy is buoyant. The food is healthful and delicious. Just being there is good for your heart, spirit, and body.

For more information and to register, click here >>

 

Living in the Present Moment of Clinical Work

posted by Dr. Arnie Kozak


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There are a number of name brand mindfulness-based interventions for use in clinical work, starting with Mindfulness-Based Stress Reduction (MBSR) in 1979. Since then, we’ve seen the emergence of Mindfulness Based Cognitive Therapy (MBCT), Mindfulness Based Relapse Prevention (MBRP), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and a growing list of others. Basic mindfulness skills are integral to each of these interventions.

Clinical encounters are, by their very nature, matters of presence. When we can fully embody the moment that presence can promote healing, connection, and insight. Mindfulness can facilitate this presence and has a three-fold purpose: 1) enable clinical presence and other features of emotional intelligence such as compassion, emotional regulation, and acceptance; 2) mitigate stress and burnout; and 3) augment your your clinical repertoire of tools to offer clients and patients.

Based on my mindfulness-based psychotherapy work with patients and in my teaching clinicians, I have developed seven principles to guide the application of mindfulness in the clinical setting that touch on the three-fold purpose enumerated above. These are: Be Present; Be Still, Open Your Heart, Transmute Affect, Negotiate the Now, Teach What You can Own, Give What Can be Taken, and Make Yourself Vulnerable.

 Be Present, Be Still: Our first task as clinicians is to show up for the person sitting in front of us. To do this, we must be present and able to sit still in both body and mind. This skill of inner and outer quiet is one that is facilitated by our own meditation practice—a key feature of mindfulness-based interventions.

Open Your Heart: When we are able to be still and let go of self-preoccupation, it is easier to open our hearts with empathy, compassion, and even love. Indeed, being fully present is a rare act that conveys the depth of care that a psychotherapeutic relationship should embody.

Transmute Affect: Clinical work involves energy exchanges whether we are aware of them or not. The process is saturated with feelings and often very strong emotions. Grounded in mindfulness, we can open ourselves without losing boundaries and taking on burdensome affect. I have a saying that when we are present to the moment, we don’t receive unwanted presents of distressed patient emotions. Sustaining mindfulness in real-time as we work with people, helps us to be connected but not afflicted by the intensity of clinical work thereby reducing stress and the risk for burnout. Of course, this skill applies in any interpersonal situation, not just clinical ones.

The first three of these principles are privately held and are relevant whether you bring mindfulness explicitly into your clinical work. The next four are relevant when you introduce mindfulness concepts and practices into your clinical work.

Negotiate the Now: Is the process of bringing present-moment phenomenon into the fold of mindfulness. For instance, if the person you are working with is experiencing an intense emotion stemming from a distressing story, you redirect their attention from the narrative driving the feeling and behavior to the experience in the body. This helps people to become mindful of their emotional reactivity and is the gateway to being less reactive. It is also helpful in de-escalating situations in session.

Teach What You can Own: When Jon Kabat-Zinn started training instructors for MBSR, he decided not to make it a protocol driven approach. Instead, teachers would draw from their own practice experience to make the process their own. Teaching mindfulness cannot be an intellectual affair. The prerequisite, then as it is now, was a personal meditation practice. Kabat-Zinn recommended a daily practice and at least two long silent sitting retreats. The more you embody the practice, the more you can provide to others.

Give What Can be Taken: People span a range of openness to mindfulness practices. As the popularity of mindfulness grows, perhaps even to revolutionary proportions, more people are familiar with mindfulness. Some people, though, may have concerns about conflicts with their religion because mindfulness stems from and is associated with Buddhism. Others will be quite open to deeper wisdom traditions that inform mindfulness meditation. Mindfulness-based psychotherapy starts from a secular, psychological approach to mindfulness and can be scaled up into explicitly Buddhist psychology depending on the needs of each individual participant.

Make Yourself Vulnerable: This is, perhaps, the most counterintuitive of the seven principles. Patients and clients may readily idealize our mindfulness capacities and create a sense of separation. It is important for us to let people know that we have not perfected our practice and that we struggle to be mindful daily, just as they do.

These seven principles, the mindfulness practices they include, and the Buddhist wisdom traditions that inform them provide a radical approach towards the alleviation of suffering, both for ourselves and the people we treat. We can offer more than just helping patients and clients to have better tuned narrative selves, we can open them to a world of experience beyond this storied self that can change their relationship to the vicissitudes of life from one of resistance and anguish to one of acceptance and peace.

Arnie Kozak is a clinical assistant professor in psychiatry at the University of Vermont College of Medicine. He will be leading a retreat, “Living in the Present Moment of Clinical Work: Mindfulness Skills for Mental Health Professionals,” March 13-15, 2015 at Copper Beech Institute, Connecticut’s premier retreat center for mindfulness and contemplative practice. For more details, visit: http://copperbeechinstitute.org/clinical-work/

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Happy Nirvana Day

posted by Dr. Arnie Kozak

Yesterday was Valentine’s Day; today is Nirvana Day or Parinirvana Day. It is the day that celebrates the Buddha’s death or his release into the final state of nirvana. A few years ago, in a post about Nirvana Day, I commented on the assumption regarding rebirth that this description requires. Today, I’ll focus on the concept of nirvana itself.

Nirvana is hard to describe. In fact, it’s impossible to explain it adequately with language. It is a phenomenon that defies concepts, which of course require language. The Buddha did his best to capture it with a metaphor. Nirvana means to blow out as you would blow out or extinguish a candle flame.

It’s not life that blows out or ceases but the conceptual and language based processes that give rise to dukkha–the experience of suffering, stress, dissatisfaction, anguish, and so forth. The ultimate language-based concept is that of self. When we stop engaging in mind activity that affirms and pursues the desires of this self, we are closer to nirvana, whatever that phenomenon might be.

The history of Buddhism and popular culture have given a mystical, transcendental feel to nirvana. It is an abode of bliss. It is special and requires special circumstances to achieve. That specialness, itself, becomes an impediment to the experience of nirvana.

We can cut through this mystification of nirvana and go back to the original metaphor–the cessation of a fire. The fuel for the fire is the activity of our minds as they pursue desire. Every moment that we cling to something that we want or push away something that we don’t is wood for that fire. Every moment we seek comfort, predictability, and reassurance as if our well-being depended on it, more is added to the pile.

If we stop doing these things and, instead, accept what is happening now with equanimity, then there is nothing more being added to the fire and it will go out. Not like a candle flame, but like a bonfire it will diminish and eventually go out. To experience nirvana is to awaken to the reality of the moment.

Of course, it is very difficult, almost impossible to not add anything at all to the fire. Our minds are very active and have a lifetime of habit and conditioning behind them. So, we can look for mini-cessations and little hits of nirvana. We can aspire to keeping the fire more like a smoldering camp fire rather than a raging bonfire. This is a choice that we have in every moment.

Equanimity is another term that could benefit from some explanation. Equanimity is the prerequisite for nirvana. It does not seek to eliminate the discomforts, uncertainties, and disappointments in life nor does it passively acquiesce to them. Rather, equanimity is a way of experiencing what is happening with clarity, openness, and an absence of a compelling sense of self. It’s not that we are necessarily self-less, instead, we are just not making the value of ourselves in that moment contingent upon any of the prevailing conditions.

Equanimity allows us to be right there in the middle of things, dealing with them as necessary without adding layers of perturbation. In other words, when we can be equanimous, we don’t add any wood to the fire. We can cool our minds with mindfulness in the moment. We don’t compound dukkha.

We will be exploring equanimity and even little hits of nirvana in my upcoming workshop at the Kripalu Center for Yoga and Health called Mindfulness A–Z: Liberating Regret, Stuckness, and Perfectionism. I hope you can join me there .

Previous Posts

Oliver Sacks Writes his Pre-Obituary
The neurologist and author Oliver Sacks recently wrote an op-ed piece in the New York Times about his impending death and the light this news casts on his life. His reflections are the epitome of equanimity. What we hear from him is not anxiety, rancor, or regret but rather gratitude, love, and reso

posted 2:23:00pm Feb. 25, 2015 | read full post »

Getting Out of Our Own Way: Finding Liberation in the Moment
If you are like me, you spend more time than you would like caught up in imagined stories that don't feel good and keep you stuck. How can you get out of your own way and stop beating yourself up with regrets. My mind can sometimes get stuck and I'd be in big trouble if I didn't have a mindfulness p

posted 7:44:24pm Feb. 23, 2015 | read full post »

Living in the Present Moment of Clinical Work
There are a number of name brand mindfulness-based interventions for use in clinical work, starting with Mindfulness-Based Stress Reduction (MBSR) in 1979. Since then, we’ve seen the emergence of Mindfulness Based Cognitive Therapy (MBCT), Mindfulness Based Relapse Prevention (MBRP), Acceptance an

posted 10:38:43am Feb. 18, 2015 | read full post »

Happy Nirvana Day
Yesterday was Valentine's Day; today is Nirvana Day or Parinirvana Day. It is the day that celebrates the Buddha's death or his release into the final state of nirvana. A few years ago, in a post about Nirvana Day, I commented on the assumption regarding rebirth that this description requires. Today

posted 10:24:27am Feb. 15, 2015 | read full post »

Finding Our Place in the World
There is no such thing as "nature" if we are part of all things. To seek nature sets us apart from the natural world. In the Tao, there is no separation. Any separation we feel is conventional and not based upon a deep analysis of the how the material world is put together. Everything is bound b

posted 2:49:18pm Feb. 14, 2015 | read full post »


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