Healing Grief through Compassion and Love

Frank Ostaseski was recently interviewed during the 2020 Mindfulness & Compassion Global Summit by Rheanna Hoffmann on the topic, Grief and the Healing Power of Love and Compassion.  With so many deaths worldwide from the Coronavirus (410,000 at the time of writing), the issue of grief and its manifestations becomes increasingly prevalent.   Frank is the cofounder of the Zen Hospice Project (now called The Zen Caregiving Project) and founder of the Metta Institute designed to provide creative education in the art of “mindful and compassionate end-of-life care”.

Healthcare professionals may not have lost loved ones through the virus, but they can experience grief too with the loss of patients that they have been caring for – this is in addition to other stressors that challenge their resilience.  In his interview responses, Frank explained the nature of grief and the power of compassion and love to heal people who have experienced profound grief.

The nature of grief

Frank who has supported more than 1,000 people in the process of dying maintains that grief is not a single point but a process – an evolving process of “loss, losing and loosening”.  There is the initial shock of the loss that can result in physical collapse and total disorientation.  Shock impacts people differentially – some people may experience numbness, there is no “one way”.   Beyond the initial shock of the loss, is a process of “losing”, where in the midst of other things an overwhelming sense of loss returns accompanied by strong emotional and physical symptoms.  “Losing” can persist for many years and eventually become an intermittent event.  In the meantime, the process of “loosening” commences with progressive release of the hold that grief has over a person.

People grieve in different ways – some withdraw and have a strong desire to be alone with their grief, others experience tears and crying uncontrollably, while still others may take out their grief by aggression and violence (such as is occurring in the riots in America in relation to the Black Lives Matter movement).  Grief and our response may be aggravated in challenging times such as the pandemic where everyone is experiencing a form of “emotional inflammation”.

Frank maintains that grief has many faces, e.g. anger, rage, sadness, depression, fear and even regret.  He also suggests that grief results not just from the sense of loss of a loved one but also from the associated lost opportunities – a young life cut off in their prime, a missed opportunity to reconcile with a loved one, a lost chance to say goodbye or to be physically present with someone as they were dying.   For people exposed to dying and death as a result of the Coronavirus, there can be a collective grief brought on by the lost opportunity to save lives, as well as the lost opportunity of the lives lost.

Healing grief through love and compassion

The starting point for being able to show compassion towards the people experiencing grief is having an understanding of the nature of grief and its many forms of expression. It is important not to add to the stress of people who are grieving by communicating expectations of how their grief should be expressed.  Grieving is a very personal process and requires compassionate attending and listening, not the projection of personal preference.

Pema Chödrön discusses ”compassionate abiding” in our own grief and suffering as the pathway to expressing compassion for others.  Frank suggests that we need to “metabolize” our own fear and suffering by facing it fully, experiencing it in our body, mind and heart and converting it to compassion for others.  He maintains that when we can explore our own experience through self-observation and self-inquiry we can “build an empathetic bridge to other people’s experience”.  Otherwise we can be working out of our own distress and needs rather than the needs of others who are grieving.  Without this level of self-intimacy we can appear dishonest or disingenuous to others we are trying to help in their grief.

Frank explained that he has difficulty expressing self-compassion but has developed a number of processes that enable him to express compassion for others.  Each night before going to sleep, he focuses on the suffering of others – those who might be suffering through loneliness, those experiencing grief or those who are caring for others who are dying.  Through this process he feels love and warmth towards others and the emergence of his “innate compassion” that is broad and deep enough to absorb or dissolve his own experience of suffering.   In the morning, with his hand on his heart, he asks himself, “What would love have me do today?”

Reflection

Self-intimacy is a key to genuine compassion towards others who are grieving.  Compassion and love help to heal grief because they involve abiding fully with someone who is experiencing grief, not trying to fix them.  Our very presence, uncontaminated by unrealistic expectations of the other person, can be a source of healing just as “listening generously” can be.   As we grow in mindfulness, we can develop self-intimacy, calmness and peace and be better able to be present to and compassionate towards others.

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Image by Gordon Johnson from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Self-Care for Healthcare Professionals

Dr. Reena Kotecha presented at the 2020 Mindfulness & Compassion Global Summit on the topic of self-care for healthcare professionals.  Reena highlighted the irony of healthcare professionals caring for everyone but themselves and, in the process, suffering pain, disillusionment and burnout.  She shared her own story of depression, mental illness and suicidal thoughts resulting from working as a young doctor in an emergency department in a hospital.  She was drowning in self-doubt, suffering anxiety about the future and trying to cope with her present level of stress symptoms such as palpitations and sleeplessness.  Reena found her way out of the dark hole of depression through meditation.

She highlighted the stresses that healthcare professionals are experiencing in these challenging times of the Coronavirus.  Reena spoke of frontline healthcare workers who had to move out of home to protect their family and/or elderly parents, of the sadness and grief they experienced with the death of patients, of the frustration of having inadequate resources (such as personal protective equipment) and of their fear for their own safety in terms of the impact of their work on their mental and physical health.  Frontline professionals experience the intensity and immediacy of Coronavirus-related stress and emotional inflammation as a result of the risks to the life of their patients and their own life.

Barriers to healthcare professionals seeking help

Reena emphasised that healthcare professionals not only tended to overlook caring for themselves but also failed to seek help for their mental welfare when they really needed it.  She spoke of the barriers that stop healthcare workers from seeking professional support (some of which she experienced herself):

  • Training focus – all the focus of their training is on how to care for others, very little of the training is focused on caring for themselves or how to seek professional help for themselves
  • Priority focus – healthcare professionals are singularly focused on caring for others and they fail to give priority to their own mental and emotional health that would actually enable them to care for others more effectively and in a more sustainable way.  As Reena points out, healthcare professionals are much more comfortable and more proficient in the role of caregiver than that of “care-taker”.
  • Career focus – healthcare professionals become concerned about what others, including management, would think of them if they admitted to not coping and experiencing some form of mental illness (which still carries its own stigma).  They can be concerned about how others will judge them and what impact this would have on their career.
  • Expectations focus – the community has highlighted the heroic efforts of the frontline healthcare workers but this brings with it an unrealistic set of expectations that they are all strong and courageous, free from normal human emotions of fear, anxiety and self-doubts and the resultant experience of depression with its concomitant impacts of inertia, exhaustion, reticence and lack of energy.  In the light of this community expectation set, they are reluctant to admit to “weakness and fragility”.

Young healthcare professionals may begin their career with an unerring focus on their patients, giving priority to their caregiver role and ignoring their own needs.  They may feel really uncomfortable about being seen as “needy” or becoming a “care-taker”.  Professionalism is interpreted by them as being strong and efficient, able to cope with any situation.  Gradually, however, the singular focus on patients begins to take its toll and is compounded by the fact that no matter how hard or fast they work, demand continues to outpace resources and capacity.  They begin to experience stress, fatigue and sleeplessness.  Despite these signs of not coping they push on – driven by their own expectations and the perceived expectations of others, including the “worshipping” community.  Burnout results when the gap between what they are putting in and their intrinsic satisfaction with their work widens to the point where they lose belief in the value of what they are doing – burnout occurs on the physical, emotional and spiritual levels.

Mindfulness as self-care for healthcare professionals

Self-care for healthcare professionals is a lifetime passion for Reena, partly generated by her own early professional experience but also reinforced by the healthcare workers who seek her help and support during these highly stressful times.  She is the founder of Mindful Medics – an 8 week course for healthcare professionals incorporating mindfulness, emotional intelligence, neuroscience and positive psychology. Participants in the course have experienced significant benefits for their mental and physical health as well as in their overall personal and professional lives.

Reena is also a highly recognised public speaker on the topic of her lived experience.  For example she presented at the Happiness and Its Causes Conference in 2018 on the topic, Personal Story: Healthcare Starts with Self-Care.   In her Summit presentation, Reena provided a gratitude meditation designed to focus on appreciation for what we have in the present to displace a focus on a disturbing past or anticipatory anxiety about the future.  There is so much that we can be grateful for and savour in our life – nature and our environment, the development of our children, our achievements and rewards and the space of being alone

Reena in an article, titled I am grateful…, recommends strongly that we develop a constant practice of expressing gratitude for the simple things that we have in our lives and highlights the neuroscience research that supports the benefits of gratitude for mental health and wellbeing.

Reflection

It is important to express compassion for others, especially healthcare professionals and those directly impacted by the Coronavirus.  However, we have to recognise the enormous stress healthcare workers are experiencing in these challenging times and be more aware of not adding to that burden by perpetuating the expectation that they, individually and collectively, can cope with any challenge at no cost to themselves.  We can also offer our support for people like Reena who are helping healthcare professionals to develop mindfulness as a means of self-care.  The Mindful Healthcare Speaker Series is one ongoing event that we can support.

As we grow in mindfulness by focusing on self-care through mindfulness practices and gratitude meditation, we can become more conscious of what we are thinking and feeling and be better able to appreciate the present moment and all it has to offer in terms of overall wellness and happiness.  Mindfulness enables us to identify our barriers and expectations, acknowledge when we need help, develop strategies to cope more effectively and progressively build our resilience.

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Building Resilience through Compassion Towards Others

In a previous post, I discussed Pema Chödrön’s ideas of developing resilience through self-compassion by “compassionate abiding” in our own pain and suffering during these challenging times of the pandemic.  This entails abiding in, or dropping into, the full depth of our painful experience through our bodily sensations and conscious breathing.  As we undertake slow, conscious breathing we hold our suffering with self-kindness and warmth.  Lulu & Mischka in their mantra meditation, Warriors of Light, remind us to “breathe into our hearts” because breath is our chariot enabling us to face the unknown and stand on our own.

In her interview podcast with Tami Simon of Sounds True, Pema extended the concept of compassionate abiding by moving beyond self-compassion to compassion towards others.  She maintained that embracing the pain and suffering of others particularly in these times, when everyone is suffering in one form or another, contributes to our resilience – we realise we are not alone and we are able to move beyond self-absorption and “panic storylines” to extending kindness to others.

Pain and suffering: a doorway to compassion for others

In these challenging times of the Coronavirus, we can be very sure that there are millions of people around the world who are experiencing suffering like we are.  People are experiencing all forms of loss – of loved ones, their jobs, their business incomes, their health, their financial security or their homes.  They may have become physically disconnected from their workplaces, their family and their friends, even stranded in a foreign country because of international travel restrictions.  They could be healthcare professionals working on the frontline and/or living away from their families for a number of months to protect their loved ones from cross-infection.  We can be very confident that there are people around the world who are feeling pain and suffering like we are.

Pema argues that abiding with compassion in our own pain and suffering is the doorway opening us to compassion towards others.  In experiencing fully our own suffering, not denying its intensity or pervasiveness, we develop a deep sense of connection with others who are also suffering at this time.  Pema spoke of the principle of Tonglen, a Tibetan word meaning “taking in and sending out” – taking in our own experience of pain and suffering and sending out desire for relief for others.  She suggests that once we become grounded in our own suffering (this may take 10-20 minutes), we can take in the suffering of others.  On our in-breath we can imagine others who are experiencing similar pain and suffering and on our out-breath, wish them relief and insight to enable them to move beyond their own discomfort, distress, grief or loneliness.  Connectedness and resilience lie in this mutual experiencing.

Pema maintains that we do not have to confine this compassion towards others to a time of extreme challenge, we can use our pain and suffering as the doorway to compassion and connectedness at other times.  We may be experiencing distress because a family member is suffering from Alzheimer’s or feeling panic and anxiety because someone we are carer for is experiencing the black dog of depression.  At these times, we can drop into conscious breathing, embracing our distress and anxiety with kindness, and gradually move beyond this abiding self-compassion to compassion towards others who are experiencing the intensity of our own emotions. 

Reflection

I think that Pema’s profound insight into compassionate abiding opens the way to develop self-compassion, compassion towards others and personal resilience.  As we grow in mindfulness through conscious breathing and extending relief to others, we can move beyond our self-destructive narratives, restore our inner equilibrium and peace, and develop the resilience to not only survive these challenging times but also be able to extend help and support to others. 

Compassion towards others can be expressed in many ways even in these times of social distancing – the virtual choir of women physicians singing “Rise Again” is but one example of many where people are moving beyond their own overwhelming challenges and distress to reach out to others.

Pema provides multiple resources including her many books, her free e-book titled, 5 Teachings of Pema Chödrön  and her online course, Freedom to Love, which expands on the principles and practice of compassionate abiding.

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Finding Joy, Beauty and Healing through Nature in Challenging Times

Jon Kabat-Zinn when discussing mindfulness and resilience in difficult times stressed the need to be “still aware of beauty” in the midst of the challenges confronting us during the onset of the Coronavirus.  He suggested that despite the incredible heartbreak of these times, inspiration abounds, particularly in the beauty and resilience of nature.  Jon referred to the words of Thich Nhat Hanh, a Vietnamese Buddhist, who experienced his fellow monks dying from bombing raids by the Americans.  Amidst the grief during the burial of his friends, Thich Nhat Hanh said, “Don’t forget to see the flowers blooming by the side of the road”.  Jon reminds us to lift our eyes beyond the present pain and fear and to be aware of nature and all its beauty and healing power.

Wise@Work recently provided a webinar with Mark Coleman presenting on the topic of Beauty, Joy and Resilience in the Midst of Adversity: the Healing Power of Nature.  Mark is a globally recognised meditation teacher, author of From Suffering to Peace: The True Promise of Mindfulness and the creator of the Mindfulness Institute.  Mark has a particular focus on being healed through nature by finding beauty and joy in experiencing nature mindfully.  He shares his unique insights drawn from mindfulness practices, research and experience in this area through his course, Awake in the Wild Nature Meditation.

Attending to nature and experiencing connectedness

What we pay attention to shapes our lives – our thoughts, feelings, mood and perspective.  In challenging times, we tend to become absorbed in what we have lost, obsess about the news and feel a loss of agency in many aspects of our life.  Our natural negative bias is strengthened, resulting in a continuous scanning of the environment (local and global) for threats, both real and imagined.

Mark maintains that we can restore our sense of equilibrium by paying attention to nature – attention being something that we can have agency over.  Through mindful attending to nature we can experience joy, peace, beauty and healing – experiences that are uplifting and energising.  He argues that as we become connected and aligned with nature, we can find our life purpose and delight in living or, as Jon Kabat-Zinn describes it, “waking up to what is” as the “laboratory of life unfolds”. Mark quoted the words of Mary Oliver’s poem, Mindful, to reinforce his view of the joy in nature.

Nature as a source of sensory awareness and joy

We can refocus our attention by beginning to notice nature as it unfolds daily before us and enlivens our senses – seeing the exquisite beauty of the sun rising in the morning over the water, listening to the echoing sounds of birds as they awake to another day, smelling the ground and grass after a night’s rain, touching a furry leaf or tasting freshly picked fruit, herbs or vegetables.  There are many ways to tap into the beauty and healing power of nature – we just have to be alive to them and willing to create space in our lives to experience this unending source of joy.

Mark reminds us that we don’t have to go out into the wild or visit a rainforest to enjoy nature (the very words we use such as “enjoy” expresses nature’s potential).  We can venture into our yard and observe the blossoms on the trees, notice the first seedlings emerging from recently planted grass seeds, feel grounded on the solidity of the earth, smell the earthiness of the soil and hear the wind gently rustling the leaves of trees and plants.  We can even stay inside and connect with nature through pictures and images – the sunflowers in a field of grass, the small child leaning over to smell a flower in a rockery or the tall poplars lining an expanse of crops.  If we study the painting of the girl, we can observe the colour of the flowers, the shape of the leaves, the fallen branches and the stone paving – things that we may not have noticed before.

Reflection

I have always found trees a source of meditation and an inspiration for poems because they reflect the paradox of human existence – suffering and joy, life and death, disconnection and closeness, weak and strong, flexible and inflexible.

Nature surrounds us and is there before our eyes, ears and other senses – if we would only pay attention.  The time required is minimal and the rewards in terms of mental and physical health and overall wellbeing are great.  Nature is a free, ever-changing resource. 

As we grow in mindfulness through paying attention to nature and meditating on nature, we can experience a calmness, peace and joy amidst these turbulent times.  Like our breathing, nature is a refuge readily available to us to enjoy, a source of connection to other living things and means of healing through alignment.

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Image by Jill Wellington from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Mindfulness and Resilience in Challenging Times

The Awake Network and Mindful.org have collaborated to provide a free resource for healthcare professionals in the form of The Mindful Healthcare Speaker Series.  Jon Kabat-Zinn speaking on Mindfulness and Resilience in Challenging Times was the first in the series of six speakers.   While Jon is not an MD, he has a PhD in Medicine and focuses on mindfulness in medication, healthcare and society.

Jon and host, Dr. Reena Kotecha, spoke of the enormity of the challenges facing everyone with the advent of the Coronavirus and especially the frontline healthcare professionals who, in many instances, lack adequate resources and training to deal with the magnitude of this pandemic.  They spoke of the trauma experienced by these healthcare professionals who are witnessing the suffering and death of so many people.  Reena spoke of one frontline female doctor who had to move out of home to live in a hotel for three months to protect her mother who was suffering from cancer. 

A truly disturbing event was the suicide death of Dr. Lorna M. Breen, an emergency center doctor, who continually witnessed the very worst of the impact of the Coronavirus on people, including people dying at the hospital before they could be removed from the ambulance.   Her heroic efforts to save people through her frontline medical work contributed to her own death.  Jon reiterated that mindfulness does not lessen the enormity of the physical and mental health impact of the pandemic on the lives of healthcare professionals but emphasised that mindfulness acts as a ballast to provide stability in the face of the turbulent winds created by the pandemic.

Mindfulness as ballast for stability

Jon referred to the 25 years of quality scientific research that showed the benefits of mindfulness, extending to positively altering the structure of the brain, increasing functional connectivity (e.g. of the mind-body connection) and enhancing neuroplasticity.   Neuroscientist Richard Davidson co-authored a book, Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body, and demonstrated the powerful effect mindfulness had on building resilience.

Jon spoke of “full catastrophe living” and emphasised that it is truly human to experience fear, anxiety and grief.  He argued that mental health is enhanced by feeling and accepting everything we experience, rather than denying its existence or intensity.  He stated that no matter how emotionally rending our circumstances are we can find refuge in mindfulness, by being “in the present moment, moment by moment”.  In this way, we are better able to recover from the “trauma” of the present reality and to do so without total depletion of ourselves.   

Mindfulness as awareness

Jon maintained that “we are not our narrative” – we are not our negative self-talk that diminishes us and depletes our energy in the face of life challenges.  He argues that our life is “one seamless whole” – our mind, body, thoughts and emotions.  In his view, our breath serves as the integrating factor and energy force.  Awareness of our breath in the present moment enables us “to get out of the wind” and “to recalibrate, recover and respond instead of reacting”.  To reinforce this message, he provided a guided meditation during his presentation focused on the breath for about ten minutes (at the 30-minute mark).

Jon maintained that awareness of our breath can enable us to be fully awake to what is going on inside us and to be more deeply connected to others.  He argued that we don’t have to achieve a particular goal – to become more or better – in his view, “we are already okay”.  In these challenging times, what is needed to help ourselves and others we interact with is to be authentically present, without a “mask” (metaphorically speaking), but with openness and vulnerability. 

Reflection

Jon highlighted the importance of trusting our “human creativity” when confronted with the need to help people who are stressed out by the pandemic.  As we grow in mindfulness through mindful breathing, we not only build our resilience in managing our personal challenges but also “modulate the tendency to put self ahead of everyone else” – we can diminish our self-absorption and self-doubt.  He maintained that awareness of our breathing reinforces our ecological connectedness.  

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Image by Jill Wellington from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Strategies for Couples to Cope While Working at Home during Quarantine

In a previous post I discussed Rick Hanson’s ideas about the intrapersonal and interpersonal challenges facing couples working from home during the quarantine conditions brought on by the Coronavirus.  In his podcast, Coping with Quarantine, Rick also explored strategies for couples to cope with these challenges.  His suggested strategies focused strongly on connection, contribution, control (inner and outer) and compassion.

Strategies for couples to cope with the challenges of working together at home during social isolation

  • Connection with others: the fundamental principle underpinning physical distancing is avoidance rather than contact and connection.  However, this does not prevent us from connecting with each other as a couple, with our family and friends or with colleagues.  All of the remote communication strategies are available to us – online video calls, telephone, social media and email.  There can be a tendency to let the physical distancing principles impact the rest of our behaviour.  However, now is the time to reconnect with others who are also feeling socially isolated.  As a couple, connection can take the form of increased hugs, considerateness, words of love and appreciation and thoughtful touch – all of which builds the relationship. It also involves avoiding the temptation to escalate an argument or conflict to prove you are right or to assuage your pride.  Fundamental to connection with your partner is listening for understanding, not interrupting but being open and vulnerable to the thoughts and feelings of your partner.  As Rick points out, listening provides you with the time to deeply connect with the other person and enables them to experience calm and clarity.  He reiterates Dan Siegel’s view that deep listening enables the communicator to “feel felt by the other person”.
  • Connection to nature:  we are connected to nature on multiple levels and it is possible through mindfulness practices, including mantra meditation, to experience this connection at a deep level.  When we experience our deep connection to nature, we can feel inspired, energised, positive and calm.  The very act of breathing and walking in nature regenerates our physical systems, clears our mind and helps us to reduce the power of our negative emotions.  Nature has its own healing capacity which we can tap into in multiple ways – if only we would stop long enough to let it happen.  
  • Contribution: there are so many people in need as a result of the pandemic.  There are also endless ways to contribute and help others, to draw on our creativity and resourcefulness.  For example, despite the lockdown in the Northern Territory in Australia, Arnhem Land artists are offering a series of free online concerts to lift people’s spirits and reinforce their connection to the land and the resilience of nature.  Thirty of Australia’s top singing stars have also collaborated to provide an online concert from their homes, Music From The Home Front, that is dedicated to people who are in the frontline of the fight against the Coronavirus.  Another exemplar of contribution in adversity is Nkosi Johnson who was born with HIV in South Africa and died at the age of 12.  In his short life, he dedicated himself to fighting, locally and globally, for the rights of HIV affected people in South Africa and beyond.  Nkosi is quoted as saying, “Do all you can with what you have in the time you have in the place you are”.
  • Controlling yourself and your environment: in times of crisis it is important to develop a sense of control over our difficult emotions and our immediate environment.  There is a growing pool of advice on managing anxiety and achieving mental and emotional balance during these times of uncertainty and social isolation.  In times of uncertainty we can achieve a sense of agency by controlling aspects of our immediate environment – whether that be tidying or renewing our garden, removing clutter from our workspace, developing new skills or getting our finances and accounts in order.
  • Compassionate thoughts and action: in the section above on contribution, I stressed the importance of finding ways to help and to take compassionate action.  However, action is not always possible because of our personal circumstances, including being confined to home as a high-risk person.  This is particularly where loving kindness meditation can be used to experience compassion towards others who are suffering and/or experiencing grief.  Everyday there are stories of individuals and families experiencing heart-breaking situations brought on by the Coronavirus.  We can keep these people in our thoughts and prayers and feel with them.

Reflection

Creating connection, making a contribution, achieving self-control and control over our immediate environment and offering compassion and loving kindness are ways forward for individuals and couples restricted to working from home.  Meditation, reflection and mindfulness practices will help us to grow in mindfulness and to develop the necessary self-awareness, awareness of others, self-regulation and presence of mind and body to bring these positive aspects into our lives as individuals and couples.

Chris James captures the essence of connection to nature in the songlet Tall Trees on his Enchant album:

Tall trees

Warm fire

Strong wind

Deep water

I feel it in my body

I feel it in my soul

Image by Andreas Danang Aprillianto from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Trauma-Informed Mindfulness: Relationship Building through Music

Sam Himelstein has developed several basic principles and a series of guidelines to assist mindfulness teachers to sensitively work with people who are impacted by trauma. While these principles have been developed over more than a decade working with trauma-impacted teens, the principles and guidelines are also relevant to anyone working with adults who have experienced trauma. 

Relationship building through music

In his podcast interview with David Treleaven, Sam discussed a particular case that was a primary catalyst to the development of his principles and guidelines.  He provides a more detailed discussion of the case in his blog post, Trauma-Informed Mindfulness with Teenagers – 9 Guidelines.  The case involved a 17-year-old high school student, Jeanette, who had experienced a traumatic childhood with many categories of traumatic events in her life, including drug addiction of her father.  She had approached Sam, a registered psychologist, for help with her trauma-related issues.

During initial psychotherapy treatment, Sam was helping her to locate her estranged father so she could establish a connection with him.  However, before this reconnection happened, the young woman learned that her father had died from a drug overdose.  This intensified her trauma and when she presented at Sam’s clinic after the death of her father, she was unable to talk about her father, follow a line of discussion or formulate coherent sentences.  Sam described this in terms of “her brain down regulating”.

Sam’s first principle – “do no harm” – came into play as he realised that getting her to talk would take her outside her window of tolerance.  As he knew about her interest in music and her favourite genre, he intuitively realised that listening to music that she liked would enable her to establish some degree of equanimity, build trust and reinforce the relationship through a shared pleasant experience. 

As they listened to the music together, she slowly began to move her head in line with the beat and rhythm of the music.  Then, she began to talk.  Sam described the effect on Jeanette of listening to the music as regulating her central nervous system, bringing her back within the window of tolerance and enabling her to access her language ability so that she could express her emotions such as anger, grief and sadness.

Sam had realised that while Jeanette was positive about the utility of mindfulness in the context of therapy, “conventional talk therapy or mindfulness meditation wasn’t going to work”.  This music intervention was in line with what he described as practising an INCRA, an “inherently non-clinical relational activity” that is not a therapy technique in itself but effectively builds the relationship.  Sam discusses case studies where he has used INCRA in a clinical setting with teens in his forthcoming book, Trauma-Informed Mindfulness for Teens: A Guide for Mental Health Professionals.

Reflection

As we grow in mindfulness through meditation and reflection, we can better access our intuition when working with or training people who have suffered trauma.   Being present to the person needing help will enable us to let go of conventional, trained responses and be open to activities that are non-clinical in nature but develop the relationship – the foundation for all helping.  Trauma-informed mindfulness, then, involves not only sensitivity to trauma-impacted people but also the flexibility to depart from habituated responses or processes.  Mindfulness helps us to tap into our innate curiosity and creativity.

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Carers Need Self-Care

Much of the focus in the resources on mindfulness is on ways to help people who are suffering from conditions that are debilitating such as mental illness or chronic pain.  Very little of the resources focus on ways to help carers in their role – ways to manage the physical and psychological toll of caring for someone else on a constant and extended basis.  Carers are the overlooked group – forgotten by others and themselves.

Carers: people who care and support others

Carers come in all shapes and sizes  – adults looking after ageing parents who may be suffering from Alzheimer’s disease; siblings caring for a family member who has a mental health condition such as schizophrenia, anxiety or depression; or anyone caring for someone suffering from a physical condition such as paraplegia, chronic pain or cancer.  According to Carers Australia, carers are people who provide unpaid care and support to family members and friends who have a disability, mental illness, chronic condition, terminal illness, an alcohol or other drug issue or who are frail aged.

The toll of caring

The “burden of care” can be felt both physically and psychologically.  The physical toll for carers can be excessive – they can become exhausted and/or accident-prone, suffer from sleep disorders or experience bodily symptoms of stress such as irritable bowel syndrome, chronic fatigue or related conditions like fibromyalgia. The physical toll of caring can be experienced as cumulative stress and lead to chronic conditions that adversely affect the carer’s long-term health.

The psychological toll of caring can also be cumulative in nature and extremely variable in its impact.  Carers can experience negative emotions such as resentment or anger, despite their compassion towards the person who is being cared for.  They can become extremely frustrated over the paucity of time available for themselves, the opportunity cost in terms of inability to travel or to be away for any length of time, the lack of freedom (feeling tied down), the lack of improvement in the condition of the person being cared for or the financial impost of caring (preventing desired savings/purchases or home improvements). 

Carers do not have inexhaustible personal resources – physical, psychological and financial.  They can suffer from compassion fatigue which can be hastened by emotional contagion resulting from close observation of, and identification with, the pain of a loved one.  Hence, carers can experience depression, anxiety or grief – reflecting the emotional state of their loved ones who are suffering.

The toll on carers has been the subject of extensive research.  For example, Emma Stein studied the psychological impact on older female carers engaged in informal aged care.  Sally Savage and Susan Bailey reviewed the literature on the mental health impact on the carer of their caregiving role and found that the impact was highly variable and moderated by factors such as the relationship between caregiver and receiver and the level of social support for the carer.

Being mindful of your needs as a carer

The fundamental problem is that carers become so other-focused that they overlook their own needs – their need for rest, time away, relaxation and enjoyment.  Normal needs can become intensified by the burden of care and the associated physical and psychological stressors.  Carers tend to neglect their own needs in the service of others.  However, in the process, they endanger their own mental and physical health and, potentially, inhibit their capacity to sustain quality care.

Carers can inform themselves of the inherent physical and psychological consequences of being a caregiver, particularly if this involves intensive, long-term caring of a close loved one (where feelings are heightened, and the personal costs intensified).  Mental Health Carers Australia highlights the fact that people who care for someone with a mental health illness are increasingly at risk of “developing a mental illness themselves”.

Self-care for the carer

One of the more effective ways that carers can look after themselves is to draw on support networks – whether they involve family, colleagues or friends; broad social networks; or specific networks designed for carers.  Arafmi, for example, provides carer support for caregivers of people with a mental illness and their services include a 24-hour carer helpline, carers forum, blog, educational resources, workshops and carer support groups. Carers Queensland provides broader-based carer resources and support groups.

Carers tend to go it alone, not wanting to burden others with “their” problem(s).  They are inclined to refuse help from others when it is offered because of embarrassment, fear of dependency, concern for the other person offering help, inability to “let go” or any other inhibiting emotion or thought pattern – in the process, they may stop themselves from sharing the load.

Carers could seek professional help from qualified professionals such as medical doctors or psychologists if they notice that they are experiencing physical or psychological symptoms resulting from carer stress.

Mindfulness for carers

Carers can use mindfulness practices, reflection and meditation to help them cope with the physical and emotional stresses of caregiving.  Specific meditations can address negative feelings, especially those of resentment and the associated guilt.  Mindfulness practices can introduce processes that enable the carer to wind down and relax – such as mindful breathing, mindful walking, mindful eating or using awareness as the default when caught up with “waiting” (a constant companion of the carer role).

Carers can employ techniques such as body scan to relax their bodies and release physical tension.  Deep, conscious breathing can also help in times of intense stress such as when experiencing panic. For people who are religious, prayer can help to provide calm and hope.

Dr. Chris Walsh (mindfulness.org.au), offers a simple mindfulness exercise for self-care by carers in his website article, Caring for CarersThe exercise involves focusing, re-centering, imagining and noticing (thoughts, feelings and bodily sensations).

As carers grow in mindfulness, they can become more aware of the stress they are under and the physical and psychological toll involved. This growing awareness can lead to effective self-care through social and professional support and meditation and/or mindfulness practices. Mindfulness can help carers develop resilience and calmness in the face of their stressful caregiver role.

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Image by Sabine van Erp from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Accessing Our Inner Resources to Cope With Trauma

Mindfulness through “resourcing meditation” can help us to cope with trauma.  It does not replace the need for therapeutic assistance but complements therapy and facilitates the process of dealing with deeply held fear or grief.

The causes of trauma

Trauma can be experienced by anyone at any stage of life.  The associated experience of profound psychological distress can result from a natural disaster such as a cyclone or earthquake; a personal life event such as the death of a parent. life partner or a child; being involved in a serious car or transport accident; the experience of going to war or being a prisoner of war; experiencing a vicious relationship break-up; being a person displaced by war; experiencing a toxic work environment over an extended period; being a refugee attacked by pirates when trying to flee a war-torn country by boat (the experience of Anh Do).

People in helping professions can experience vicarious trauma by virtue of supporting others who have had a traumatic experience. So midwives in a hospital can experience trauma when a mother and/or baby dies; professionals providing access to legal aid can be overcome by constant exposure to the recounting of traumatic experiences by clients; police, ambulance drivers and paramedics can experience vicarious trauma as a result of the work they do with victims of crime or serious car accidents; and police and their life partners, too, can experience trauma vicariously as a result of the death of a colleague through violence.

The effects of trauma

Just as the causes of trauma can be many and varied, so too are the effects experienced by people who have been traumatised.  Some people experience Post Traumatic Stress Disorder (PTSD).  This usually occurs when a person experiences an event that is personally life-threatening to themselves or others and is more likely in situations where a pre-existing mental illness is present, and/or a series of traumatic events are involved, such as sexual abuse.  People who have PTSD will experience “feelings of intense fear, helplessness or horror” and tend to replay the traumatic event(s) over and over, so that their intense anxiety condition becomes locked in.

The spectrum of responses to the experience of trauma is very wide – from numbness and inertia to aggression and violence.  People who experience trauma can become withdrawn and avoid interactions; experience de-sensitisation to the people and situations they have to deal with; experience on-going depression; become cynical or distrustful in their interactions; or experience a profound and enduring sadness.  They may question their self-worth and accomplishments; experience difficulty in relaxing and sleeping; or be overcome by a deep sense of grief (where someone significant to them has died).

The psychological effects of a physical injury, car accident or injury as a child can easily be overlooked.  In their Guide, How Trauma Affects the Brain,  the Lanier Law Group provides a comprehensive discussion of the psychological effects of such traumatic events and discusses various modalities for healing from trauma.  Their Guide also covers PTSD after an injury and following service in combat areas.

Accessing our internal resources

In a previous post, I wrote about how to use the R.A.I.N. meditation process to deal with fear and anxiety.  However, in cases of trauma and intense grief, we may not be able to plumb the depths of our feelings because the experience would be too painful and/or cause flashbacks to the traumatic event(s).

Tara Brach, in the course on the Power of Awareness, described how to access internal resources to cope initially with the psychological pain experienced with trauma.  Drawing on her own experience with trauma victims and sound research in the area, she suggests a number of ways to resource ourselves:

  • Physical grounding – this involves getting in touch with the feeling of our feet on the ground and our buttocks on the chair.  The physical sensation of contact with the ground or chair is important because it enables us to link the sense of safety and security through sitting or standing with our psychological experience.
  • Breathing deeply and slowly – this could begin with lengthening our in-breath and out-breath and move to mindful breathing, which includes paying attention to the space between.
  • Touch – touching our heart or stomach with some loving gesture that brings warmth to relax our body.
  • Talking to ourselves – we can use comforting and supportive words while engaged in conversation with ourselves.
  • Envisaging our allies – there may be relatives or friends in our life who provide very strong emotional support and constant affirmation of our self-worth.  There are others such as members of a support group for a chronic illness or for loss of a child or loved one.  Bringing these people to mind together with the feelings of kindness and encouragement they engender, can build our inner resources to cope with trauma.
  • Revisiting a place of peace or relaxation – we can do this physically or just by visioning what it was like to be in our favourite place.  It could be by the bay or at the seaside, in the mountains or on the deck in our home-anywhere that gives us strength, renews our spirit and intensifies our feelings of security.

Whatever process we use for inner resourcing, it is important to get in touch with what positive effects we are feeling in our body, as well as in our minds.  Tara Brach, in the Power of Awareness course, encourages us to use resourcing meditations based on the above listed pathways to tap into, and strengthen, our inner resources.   She argues that these meditations are a true refuge, unlike the false refuges of drugs or alcohol.

Being able to deal with trauma through the R.A.I.N. meditation process (plumbing the depths of our fear or grief) may take months of resourcing ourselves before we can confront the depths of our emotions, but Tara’s own counselling experience with people who have suffered trauma (including PTSD) confirms that it is possible to emerge from the depths to live a balanced and happy life.

As we grow in mindfulness through resourcing meditations, we strengthen our inner resources to cope with the profound psychological effects of a trauma and build up our capacity to deal with the resultant debilitating emotions.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of Maialisa on Pixabay

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Facing the Fear Within

We have explored the R.A.I.N. meditation process in a preliminary manner.  Now we will look at how R.A.I.N. can help us deal with those deep-seated fears that take control of us, reduce our capacity to live life fully and prevent us from showing others loving kindness.

The disabling effects of fear and anxiety

Jaak Panksepp, author of Affective Neuroscience, discovered that young rats who had played and frolicked together became totally inhibited when a piece of cat’s hair was introduced into their cage – creating an immediate fear response and disabling anxiety.  Jaak believed that in-depth insight into the behaviour of animals helped us to better understand human emotions.

Anna Steinhenge explored whether fear and the associated anxiety induced a similar inhibiting effect in humans.  She found that in competitive situations where people viewed the outcome with positive anticipation, they were readily able to access clear thinking and creativity; in contrast, where people were anxious about the outcome, their creativity and critical faculties were impeded, and they tended to engage in cheating or unethical behaviour to win.  One only has to look at the behaviour of the leadership group in the Australian Cricket team during the third test in South Africa to confirm this perspective – they were anxious that they could not win the third test, when the score was tied at one test each, so they engaged in ball tampering.

Using the R.A.I.N. meditation process to face and conquer the fear within
Recognise the fear

The first step is to recognise the fear for what it is – to face it fully, understand how it impacts our body and impedes our mind.  Avoiding facing the fear only makes it stronger and weakens our capacity to manage the fear and its disabling effects.

Kayakers, for example, have shown that when caught up in a whirlpool that is sucking them deeper into the water, they need to relax and go with the direction of the sucking force, rather than fighting the whirlpool which only saps their strength.  They need to go to the bottom of the whirlpool to survive.  So too with fear, we need to access the depths of the fear itself before we can be freed from its inhibiting effects.

Accepting the existence of fear

We need to accept that the fear is part of our life but learn how to gradually disassociate from it so that we are not identified with it.  Tara Brach tells the story of a woman suffering from PTSD who, while sitting on a park bench, envisaged her fear beside her while she continued to explore her connectedness to nature – to the birds, flowers and trees surrounding her.

Investigating our fear

Tara suggests that we explore the nature of our fear and even question what it is like, where it lies within us, how deep and dense it is.  She suggests that we explore our relationship with fear and determine what fear is expecting of us and how we want to relate to our fear.  We could question where fear resides in our body and how it manifests itself through pain and physical disturbance – headaches, muscle soreness, cramps, twitching or shaking.

Nurturing ourselves through fear

Trying to discount fear by purely rational processes will not remove the fear but only make it go underground, away from our consciousness.  We need to see the fear for what it is in all its manifestations but treat ourselves with kindness.  This may mean pulling away temporarily from facing our fear and its intensity to rebuild our resources and strengthen our resolve.  This is a gentle way to treat ourselves if we become overwhelmed when facing the depth of our fear.  After rebuilding our resources, we can resume the P.A.I.N. meditation process by again grounding our body and mind through mindful breathing.

Plumbing the depths

Tara Brach suggests that the P.A.I.N. meditation process can be employed to handle any deeply-felt, negative emotion such as grief, anguish or self-disgust, as well as fear.  In the course on the Power of Awareness, Tara discussed Leaning into Fear and highlighted the process of facing fear by quoting David Whyte’s poem, The Well of Grief, which also uses the analogy of “plumbing the depths”:

Those who will not slip beneath
the still surface on the well of grief,

turning down through its black water
to the place we cannot breathe,

will never know the source from which we drink,
the secret water, cold and clear,

nor find in the darkness glimmering,

     the small round coins,
thrown by those who wished for something else.

As we grow in mindfulness through the P.A.I.N. meditation process, we develop the courage to plumb the depths of our fear and enable ourselves to be free of its inhibitions and disabling effects.  This process of inner exploration will gradually unearth the depths of our internal resources and capacity to handle deeply-felt emotions such as fear and grief.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of AdinaVoicu on Pixabay

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.