On the Frontline During COVID – Self Caring for the Carers

Professor Cynda Hylton Rushton and Rheanna Hoffmann recently engaged in a moving video podcast conversation that highlighted the scars and distress of what it means to be a frontline nurse during the COVID pandemic.  They covered not only the impact on nurses physical and mental health but also explored strategies that could be adopted by nurses to manage their distress.  Cynda will be a key presenter at the free, online Healing Healthcare Summit in early February 2022. 

Cynda is incredibly well-informed about nurses experiences during the pandemic, being a nurse herself and working with nurses to develop what she calls “moral resilience” – the ability of an individual to “restore or sustain” integrity in the face of the onslaught of challenges to their inner harmony and capacity to align their words and actions with their values and deep commitments.

Cynda, whose focus includes clinical ethics and contemplative practice, brings to the conversation penetrating insight and deep caring and compassion – characteristics that are manifested in her faculty work with the clinicians training program, Being with Dying.  Cynda is the author of Moral Resilience: Transforming Moral Suffering in Healthcare.

Rheanna is an emergency nurse who is also a meditation practitioner and teacher with extensive experience in mindfulness and its benefits.  During the worst of the pandemic in the US, she volunteered to work in New York City.  Her personal recollections of this experience can be found in an interview where she shares an intimate insight into what happened for herself and others during the overwhelming crisis.  Her presentation is part of the Mindful Healthcare Speaker Series which is readily available as a “resource for challenging times”. 

In her discussion with Cynda, Rheanna provided an expose of her emergency nursing experience during COVID that is raw and vulnerable but manifests her openness and courage.  I have previously reported on Rheanna’s interview about death and the dying process with Frank Ostaseski, Founder of the Zen Hospice Project.  Rheanna herself is the Founder of The Whole Practitioner designed to help nurses “to rediscover health, balance and their core values” after experiencing burnout, exhaustion and deeply personal frustration.

The distress of frontline COVID nurses

Rheanna recounted in telling detail the nature and extent of distress experienced by COVID nurses, especially those who were engaged in emergency wards.   She spoke emotively about the following experiences and sensations:

  • Reaching the limit of effectiveness of personal resources – whether that be yoga, friends or colleagues
  • Experiencing isolation and loneliness – tendency to withdraw physically and mentally to deal with the overwhelm
  • Feeling incredibly bare and vulnerable – the challenge of people dying and grief (that of relatives/friends and your own grief)
  • Physical exhaustion – tired beyond belief and suffering from lack of sleep, resulting from replaying adverse incidences
  • Feeling chronic hopelessness and helplessness – the challenges were beyond the capacity of individuals and the health system itself; exposure to personal limitations in the face of so much death and suffering.  Associated with this sense of helplessness are nightmares, flashbacks, randomly crying and insomnia.
  • Separation from self – the natural consequence of traumatic experiences.
  • Loss of a sense of balance –  impacting how time, health and relationships are valued or devalued (because of lack of time allocated to them)
  • Burnout – on physical, psychological and moral levels.  Rheanna described this as “acute burnout” reducing the energy for self-care and potentially leading to thoughts of suicide.

Rheanna pointed out that nurses, including herself, were normally able to “compartmentalise” their  adverse experiences and do so in a way that was healthy,  However, the adverse experiences from the pandemic were “unrelenting”, leading to chronic distress.  Part of the frustration was the inability of frontline nurses to help others at times when they were feeling so “fragile”.

Self-caring strategies for frontline COVID nurses

Cynda offered several self-care strategies for COVID nurses during her conversation with Rheanna.  Some covered ways of addressing negative self-talk while others focused on adopting a changed perspective and mindset or instituting a mindfulness practice: 

  • Mindfulness practice: Cynda offered a mindfulness practice that could be used by COVID nurses experiencing distress and burnout.  This focused initially on the breath with the out-breath being viewed as a release of stress.  In the exercise, the exhale stage was lengthened to accentuate and support release.  Participants were encouraged to rest in the gap between the in-breath and out-breath and, where possible, extend this gap between breaths.  A slow body scan was the next step with emphasis on identifying and releasing points of tension.  Participants were encouraged to focus on an anchor of choice to stop their minds addressing their extended to-do list or diverting into worrying.   Cynda suggested that nurse participants become conscious of how many miles their feet have travelled in pursuit of their daily caring and the level of support that their feet  have provided.  Lastly, she encouraged the nurses to employ statements such as:
    • May I trust the wisdom of this moment consciously and fully.
    • May I have the courage, honesty and openness to see things clearly and without judgment.
    • May I be willing to let go of what impedes me rather than helps me.
    • May I encounter a wise mentor to assist me to deal with these challenges.
  • Confronting your own limitations: Rheanna pointed out the sense of guilt and shame that she experienced that were driven , in part, by her self-talk – “you could have done more”, “if only you had acted faster”, “if you had paid attention more fully you could have saved more people”, “if only you had been able to convince people to make different decisions”, etc.  Our minds are very creative when it comes to self-denigration and negative self-evaluations.  It is important to acknowledge that no one could have handled the challenges for nursing presented by the pandemic and not experience their debilitating effects.  Cynda suggests that nurses need to “turn towards their limitations” and do so “with as much compassion “ as they extend to others.  There is scope here for loving-kindness meditation for oneself.
  • Changing your perspective: Cynda stated that the tendency in these crisis situations is to think that you are carrying the load by yourself because there is a natural tendency to turn inwards to cope with what is happening.   She argues that what is required is a change in perspective.  For example, she asked Rheanna to think about “Who else is carrying the load of the pandemic? “Who has your back? (e.g. friends, family, colleagues local and abroad & mentors).
  • Separate effort from outcomes: Cynda maintained that a form of self-care is to acknowledge that  the health outcomes are often beyond the control of a nurse.  She stated that In her own work she does the best she can in the circumstances to meet an identified need but recognises that the specific outcomes are not in her control – there are too many intervening aspects impacting the final outcome.  Cynda maintains that freeing yourself from expectations and outcomes is crucial for a nurses’ welfare.  In the pandemic, COVID nurses such as Rheanna attempted to “fix unsolvable problems”.  Nurses’ health outcomes were not the result of lack of effort or smarts but because the pandemic situation exceeded the capacity of individuals and the health system itself.  
  • Savour achievements – Cynda reinforces the view that the brain has a natural negative bias and is more likely to “mull over” what did not go well rather than “honour what we are able to do in the moment”, given the circumstances thrust upon us.  She stated that nurses need to focus on how they made a difference in people’s lives, e.g., holding someone’s hands as they were dying, gasping for breath or having a tube inserted to enable them to breathe.  This thought expressed kindly by Cynda precipitated a chain reaction from Rheanna who began to identify numerous moments when she “deeply showed up with people” and , in the process,  rediscovered “what it means to be a nurse” and gained insight into the very core of her being and who she was.  The other aspect that Rheanna savoured was her deep connection with people who were suffering – in spite of what was happening around her independently of her best efforts.

Reflection

Much of what Cynda proposed as strategies to help nurses deal with the extraordinary level of stress of frontline work during the pandemic can be incredibly useful for all of us to manage stress and resultant distress in our daily lives.  As we grow in mindfulness through meditation, reflection and other mindfulness practices we can reshape our perspective and expectations, savour the positive in our lives (including being alive), confront our grief and limitations and achieve the freedom of separating outcomes from effort in our chosen endeavours.

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Image by Gerd Altmann 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 Training in Compassion

The Science and Wisdom of Emotions Summit conducted online from 2-5 May 2021 provided access to 30 of the world’s experts in the areas of compassion, mental health, well-being, wisdom, neuroscience, emotional intelligence and trauma counselling.  Access to the full recordings and transcripts are thoughtfully provided on a sliding scale, generosity-based pricing structure – with all levels of purchase receiving the full package together with the gift of free access for a friend, colleague, or family member.

There was so much covered in the Summit that is relevant to mindfulness.  However, in this post I want to look at compassion from the perspective offered by a one of the presenters.

Research into developing compassion

I have mentioned earlier in this blog the work of Richard Richardson and Daniel Goleman, authors of Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body, whose review of research studies confirmed that compassion meditation developed the traits of kindness and compassion.  In the Summit, Dr. Sona Dimidjian, Professor of Psychology and Neuroscience, shared her own research work on the development of compassion. 

Sona had been concerned about the lack of research into the transfer of compassion training to the practice of compassion in daily life and set about establishing a participative research project to find out what works and for whom.  She was particularly interested, especially in our current environment of racialism and inequity, to establish what are the “barriers and facilitators” of bringing compassion into everyday life.

Fundamental to Sona’s approach, was engaging participants in her research in every phase of the research process – formulating questions, deciding the methodology and collaboratively undertaking the research.  She involved educators, young people and those experiencing mental health issues.  One such collaborative study led to the conclusion that brief compassion training (20 minutes a day compassion meditation practice) increased participants compassion while daily exposure to images of people suffering actually led to a decline in compassion.

One unexpected result from the study was that teachers, one of the core groups that Sona sought to help, became particularly concerned about the impact of their daily exposure to the suffering of their students and their parents.  The teachers indicated that they lacked training in self-care and care for their student children and yet they aspired to be kind and compassionate.   

This concern of the teachers led to another collaborative research project with educators to co-design a course in compassion that would lead to compassionate action on the part of the teachers.  The resultant program, Masters in Teacher Leadership, is available through Colorado University and incorporates a Certificate level component on Cultivating Compassion and Dignity in Ourselves and Our Schools.  Sona’s hope is that teachers become true models of compassion while teaching their students to be compassionate.

Compassion and dignity

While the abovementioned course incorporates self-compassion, fundamental to the content and approach is the recognition that compassion involves “honouring dignity within each other” – recognising the dignity of each person, irrespective of their race, religion, skin colour, gender (or identification as non-binary or non-gendered), sexual preference, culture or country of origin.  Compassion is inclusive and non-discriminatory.  It actively works against the prevailing ethos, created through “systematic conditioning”, that fails to see our common humanity and connectedness.

Compassion involves deep listening and the capacity to hear the perspective of another while seeking to understand and value the learning and diverse experiences of other people.  It involves curiosity blended with tenderness and caring.  Compassion training through mindfulness incorporates “mental training’ (involving both thinking and emotional elements) and serves to preclude reactive responses to those who are suffering (which Sona points out sometimes aggravates the suffering of others through a lack of understanding).  The mindfulness training involved in compassion training, on the other hand, enables the participant to “act more skilfully” and take compassionate action in their day-to-day interactions.

Compassion involves “seeing one another in our fullness”, in all our diversity and complexity.  Surprisingly, Sona found that the digital world, accessed through programs like Zoom, enables participants to have greater access to each other’s life – you get to see the bookshelves, dogs coming in and out of a room, children demanding attention or partners moving about undertaking their daily activities, the room layout and house surrounds (in some cases).  Sona points out that this is a much richer perspective than the perception of a person created by the role that they occupy – you get to see and engage differently through a more complete perception of a person in their natural environment.

Reflection

Reading something of Sona’s clinical research history and work on the ground with educators, new mothers and expectant mothers and youth experiencing mental health issues, you begin to appreciate that her life and work epitomises compassion-in-action.  In fact, one of her personal goals is to strengthen her own mindfulness practices to enable her to pursue compassion in her own life by avoiding the interference of her own biases and living with integrity and congruity with the compassionate values that she promotes.  Sona generously shares her research and insights through her Mind & Life Podcast.

Sona’s life and dedication pursued in a spirit of humility, openness and curiosity provides an exemplar for how we could pursue compassion through our own life and work and daily interactions with others.  As we grow in mindfulness, we can develop the insight and commitment to enhance our deep listening skills and build the courage to take compassionate action in a skilful way.

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Image by Juanita Foucault 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 Self-Sabotage through Social Media

Hugh Van Cuylenburg has developed the GEM pathway to happiness which entails three core elements – gratitude, empathy, and mindfulness.   In his book, The Resilience Project, he describes the origins of his approach, the impact of practising GEM and its effectiveness in helping people to move from depression about the past or anxiety about the future.  He has found that his approach has been effective for school children, elite sportspeople, and businesspeople in small and large organisations.  At the heart of his approach, is the tenet that happiness lies in “being” and appreciating what we have, not in “having” and resenting what we do not have.  Hugh gives concrete examples of where practising the simple process of a gratitude journal has enabled people to overcome suicidal thoughts and find happiness in their life, their relationships, their business accomplishments and/or their sporting endeavours.

Developing mindfulness practices

Hugh described how his school children in India looked forward to their daily 30-minute meditation each morning at school.  In Australia, he had his students take a mindful walk around an oval before school started and observe and record “five things they heard, saw and felt” on their walks each day.  He basically encouraged them to pay attention to their senses so that they could live their day more fully, with increased awareness.  Hugh highlighted the studies that demonstrate the positive impact of mindfulness practices (e.g., meditation, body scan, mindful breathing) on adolescent stress, depression, and anxiety.  These impacts have explained the global development of mindfulness in schools, including the MindUP Program developed by Goldie Hawn and her foundation.

I have written earlier about the benefits of mindfulness meditation for adults, including the development of wisdom, calmness, clarity, and self-awareness.  Mindfulness practices can also help to “mind  your brain”, an otherwise neglected resource.  The challenge is to find a way to practise mindfulness daily in whatever form suits us personally.  Regularity, repetition, and practice build capability, provide constant positive reinforcement, and develop “unconscious competence”.  Hugh demonstrated through his real-life stories how we become what we focus on – the simple act of a daily gratitude journal leads to gratitude-in-the moment; practising loving-kindness meditation develops kindness and compassionate action; and regular reflection-on-action enables the capacity for reflection-in-action.

Self-sabotage in the pursuit of mindfulness

Despite our best intentions in practising mindfulness, we can easily sabotage our own efforts.  Self-sabotage can take many forms, including obsession with the news, overuse of our mobile phones or addiction to social media.  We can grab for our phones when we are waiting for something or someone, instead of using the opportunity to develop awareness. 

Hugh warns about the negative impacts of social media and its harmful effects on our minds.  He explains how social media giants like Facebook, Google, and Twitter use “persuasive technologies” to distract us and capture our attention – because “eyes-on-a-page” readily translates to revenue dollars through advertising.  Your likes and dislikes are tracked continuously so that you can be fed advertisements for what you most likely desire and are willing to buy.  The benefits of any particular product or service are embellished – you do not buy a car, you buy “envy”, “status”, “luxury” or “visibility”.  

Hugh points out that social media and constant, easy access via mobile phones have become integral to the “attention economy” that feeds off our tendency for distractedness – distraction from ourselves, our pressures. and relationships.  Disruptive marketing through “pop-ups” and “behavioural retargeting” are designed to pull your attention away to what social media advertisers want you to pay attention to.  By engaging endlessly in consuming social media, we are self-sabotaging our mindfulness – our capacity to pay attention on purpose in the present moment with wonder and awe and an openness to what is real and meaningful in our life.

Hugh recommends several strategies to reclaim “what the attention economy has taken from you”:

  • Delete Facebook from your phones
  • Turn off notifications on your phones
  • Rearrange your home screen to display what you want to focus on and delete what you are unhealthily addicted to
  • Leave home without your phone (at least occasionally when it is not necessary to have it with you).

Our level of resistance to any or all of these recommendations reflects our level of capture by the psychological manipulation of the attention economy.

Reflection

As we grow in mindfulness, we can access a wide array of benefits that enable us to live more  happily and aware.  However, if we obsess over the news or social media and become captured by our mobile phones, we will sabotage our efforts to mind our brains, build emotional resilience and achieve tranquility and ease.

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Image by Thomas Ulrich 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.

Developing Awareness to Live More Fully

Diana Winston, Director of Mindfulness Education, at MARC, UCLA offers a meditation podcast where she introduces a range of meditation practices.   Her guided meditation covers The Spectrum of Awareness Practices.  During the meditation, Diana likens the different practices to changing the lens and focus of a camera – from narrow to broad to panoramic.  Her aim is to open us up to the possibilities inherent in meditation practice so that we can choose a preferred awareness focus as a regular practice or seek variety by consciously “changing our lens”.   It is not her intention to provide an exhaustive list of meditation practices but to show that there is a broad spectrum in terms of what we can pay attention to and the resultant focus of our awareness.

The telephoto lens – narrow focus

The first meditation practice Diana introduces is what she describes as using a telephoto lens – homing in on a specific object of awareness and leaving awareness of other things in the background (as you would when you focus your camera on a bird in a tree in a distant location).  The focus can be your breath (the rise and fall of your abdomen), specific body sensation or a noise within your room.  As your mind wanders from this chosen anchor, you can bring it back into focus (as you would when adjusting a lens for greater clarity of an image).  This form of awareness meditation develops concentration, calmness, and clarity. 

Wide lens – broader focus

We can broaden our focus beyond our breathing to a particular body sensation or a difficult emotion that draws our attention away from our breath.   We could pay attention, for instance, to the sense of groundedness in our feet, the warm tingling in our fingers or the tightness in our shoulders.  With a difficult emotion, such as resentment, we could focus not only on the nature and intensity of the emotion but also its bodily manifestation, e.g., tightness in the chest, stiffness in the  jaw or pain in the neck.  We can name the emotion and describe its intensity to better tame it and bring it under control.  This broader form of awareness practice can help us to understand our emotions and our triggers, develop emotional regulation, build body awareness and increase our awareness of our mind-body-emotion connection.

Panoramic lens – being conscious of awareness itself

Here we broaden our attention beyond a chosen focus to what exists both within and without us.  It involves tapping into our natural awareness – a consciousness of what is going on inside us as well as around us, without any specific focus.  It requires opening up fully to our inner landscape and our external environment – taking in the sights, sounds, smells, touch, and taste of what we experience.  This is the spaciousness in which we become conscious of awareness itself.   Natural awareness helps us to cultivate openness and acceptance, curiosity and appreciation and a sense of wonder and awe.

Reflection

Diana introduces the spectrum of awareness as a way to broaden and enrich our meditation practice, increase our understanding of the nature of awareness and its pervasiveness, and enrich our daily life so that we can live more fully, engaging with ourselves and the world with heightened awareness and gratitude.  David Sinclair in his book, Lifespan, describes something of the richness of openness to natural awareness when he describes the experience of bushwalking with his family as “Searching for serenity.  Hearing stories. Finding Beauty. Making memories. Sharing wisdom.”

Diana describes natural awareness and other mindfulness practices in more detail in her book, The Little Book of BeingAs we grow in mindfulness through different forms of meditation, we can experience life more fully and enrich the lives of others from the fullness of our own life.

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Image by Manfred Antranias Zimmer 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-Healing through Energy Techniques

Tami Simon of Sounds True provides a podcast of her interview with Amy Scher, energy therapist and author of How to Heal Yourself from Depression When No one Else Can.   The interview is part of the podcast series titled, Insights at the Edge.

In the conversation with Amy, Tami explores the origins of her interest in “energy psychology”, experiences a number of energy techniques, and discuses the implications and efficacy of the energy processes.

Amy’s interest in energy psychology

Amy was motivated to explore the whole field of energy psychology when she found that nothing worked in terms of being able to treat her own severe illness, including chronic Lyme disease.  She experienced all kinds of debilitating and energy-draining symptoms, including difficulty with walking, being bedridden and suffering from headaches, nausea, and other severe symptoms.  Amy even tried the risky procedure of an “experimental stem cell transplant”, which required her to travel to India.   While this latter treatment worked for a while, her symptoms started to reappear, albeit with less severity.   This symptomatic recurrence and the fear that her condition would worsen again provided the motivation to explore self-healing as an alternative to doctor-controlled treatments.

The mind-body-energy-emotion connection

Energy psychology recognises that throughs, emotions, and beliefs impact the physical systems of the body, e.g., the digestive system and nervous system.  Our emotions and thoughts can create ill-health and physical dysfunction.   So, the associated process of “energy therapy” works with the body’s own self-healing processes by stimulating the internal energy system of the body – an approach that is consistent with that of other healing modalities such as  acupuncture, Reiki, acupressure, and Japanese Seitai Massage.  While the latter treatment modality focuses on the musculoskeletal system to remove physical blockages to energy flow, energy psychology involves “working with the emotional landscape” and its connection to the energy system of the body, thus helping to “heal body, mind and spirit”.

Energy techniques

Fundamental to a wide range of energy techniques provided by Amy in her book is a recognition that our thoughts, emotions and beliefs impact our body’s welfare, e.g., we might say, “I’m feeling really uptight just thinking about what might happen”.  Negative self-stories about self-worth, how others view us and what we are capable of, all add to the stress experienced by the body and manifest in different ways depending on the emotions involved.  The challenge is accepting that we play a significant part, consciously or unconsciously, in our physical health.   This is a difficult concept to swallow and even Amy talks about the strength of her own resistance to this idea of personal contribution to her own ill-health.  The techniques she discusses primarily involve listening to your own body.

Listening to your own body

Amy indicated that the real breakthrough for her occurred when she started to be still and quiet and to listen to her own body and what it was telling her.  She maintains that physical symptoms are the “body’s communication system” and that emotions convey a message.  We just need to listen with openness and curiosity to begin the process of self-healing.  In her book mentioned above, she identifies the “most common subconscious blocks” to energy flow in the body, exploring the body’s messages, symptom by symptom.

Practising energy techniques

One of Amy’s own foundational energy blocks was the belief that “If I express my true self, I’ll be unlovable” – a damaging belief that had its genesis in her Jewish origins and the generational trauma passed down through her grandfather and father who lived through the Holocaust.  Both Amy and her father experienced deep depression – hence, the motivation for her recent book.

Amy provided a sample of energy techniques during the podcast and enabled podcast listeners to experience three techniques:

  • The Sweep – a particular narrative that is spoken or read to “sweep” unconscious, harmful beliefs from the mind.  Amy maintains that this process can lead to a shift, however small, in perspective or belief. 
  • Tapping – this is an increasingly recognised healing technique that is part of the repertoire of energy therapists and is described by Amy as one of her “micro-movements” – a recognition that a shift happens in small steps, especially for someone experiencing depression.  Amy provides a specific tapping technique that involves focusing on the emotion that you are experiencing in the present moment while tapping on your chest.  She suggests that you can strengthen the freeing effect of tapping by saying over and over, “let go, let go, let go”. 
  • Accepting yourself – Amy suggests that an approach you can use when you are tending to “beat up on yourself” is to challenge the thought that generated the emotion by saying something like, “Was I really that bad or unforgivable?”  She maintains that a shift can happen if you focus instead on “the next less shitty thing that you can think about yourself”.  Again, this practice constitutes a micro-movement.

Amy explained that her book provides a wide range of energy techniques that readers can practice to help them achieve their own energy shifts and self-healing.

Reflection

Research confirms the negative impact of stress and trauma on our immune system and the tendency of the body to experience various forms of inflammation.  The current challenging environment is contributing to “emotional inflammation” as well.  Amy highlights the impact of these stressors as causing “energy suppression”.  Her energy techniques are designed to release the trapped energy and enable the body to heal itself.  The process of self-healing generates a sense of agency for the person engaged in the relevant energy practices.  Some people have found that the vibrations involved in singing too can be a form of self-healing along with the positive emotions expressed in sung mantra meditations.

As we grow in mindfulness through energy techniques, meditation, and other mindfulness practices we can develop openness and curiosity, deepen self-awareness, and learn to heal our self.  Movement towards healing is possible if we sustain our practices.

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Image by Antonio López 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.

Alzheimer’s Disease and Disconnection from the Present Location

One of the symptoms of Alzheimer’s Disease that is not often spoken about is “disorientation” – an “altered mental state” where the sufferer loses track of their identity and location and/or the time and date.   Disorientation can have multiple causes but with Alzheimer’s sufferers it can be part of the confusion arising from “abnormalities in the brain structure or functioning”. 

Disorientation in layman’s language is about making associations amongst events, time and location that do not exist in reality, but only in the brain of the Alzheimer’s sufferer.  It is as if neural pathways that usually connect data, information and emotions become cross-wired or mixed up so that unassociated events become wrongly associated.  The Alzheimer’s sufferer, for example, may hear something mentioned in conversation (e.g., a past event, location, or time) and relate that to the present moment as if it was real now.  

Being exposed to this disorientation by an Alzheimer’s sufferer makes you appreciate the wonder of the brain when it is functioning properly – the ability to make order and sense of millions of stimuli and associations in the passage of everyday life.  We take so much of this for granted and exposure to Alzheimer’s disorientation reminds you that you really do need to “mind your brain”.

Impact of disorientation on the Alzheimer’s sufferer

There really is not enough space to traverse the full extent of the impact of disorientation on the Alzheimer’s sufferer.  Suffice it to say that the disorientation can be very disturbing for the individual involved.  They may be firmly convinced about what they are thinking and experiencing as reality and become upset when others contradict them.  They may start to lose confidence in their ability to understand what is going on.  This can lead to increasing anger, frustration, and hostility.  Poet, Mark Doty, in his poem, This Your Home Now,  reminds us how unsettling the “loss of the familiar” can be even when the loss relates to something as simple as the routine of visiting a familiar barbershop.  There can be a real sense of grief associated with disorientation.

People like Professor Deborah Reed-Danahay have made a lifetime study of what identity and “home” mean to an individual and their capacity to become grounded and at peace.  Her ethnographic study of the concept of “home” for Alzheimer’s sufferers reinforces the influence of context and continuity to enable a person to transfer the concept of “home” from their normal place of living to that of a nursing home.  She discusses an individual in a nursing home who is constantly asking for her car to go “home”.  The Alzheimer’s sufferer may confuse previous homes with their existing location and may constantly ask for someone to give them “a lift home” – sometimes, resulting in a well-meaning visitor to a nursing home inappropriately offering them a lift.

Confusion about time and place can be compounded by recent events and newspaper reports.  Stories can be mixed up in terms of time and place and people affected, e.g., stories about beach accidents can be wrongly associated with close relatives.   Even the presence of a dementia clock can be a source of confusion – an easy-to-read clock designed to overcome confusion about time and date can be misinterpreted as a medication schedule (possibly precipitating unintentional overdose of medications).

Impact on the carer

When a person is caring for an Alzheimer’s sufferer, they can experience the sufferer’s disorientation as deeply disturbing and a constant source of disruption and agitation.  The Alzheimer’s sufferer may constantly ring them with misinformation about their location or what is happening around them.  They may imagine that they are someplace else other than the aged-care facility, and seek a lift to return “home”.  They could ring up frantically seeking assistance with lost young children (a situation that is a total figment of their imagination).  However, negative emotions are contagious, no matter how much you tell yourself that the situation described by the Alzheimer’s sufferer does not exist.

What also makes it very difficult for the carer is the constant change in the condition of the Alzheimer’s sufferer.  They may be incredibly lucid at one moment and in touch with current events and, in the next moment or day, be totally confused about events, location and timing.  They may have a very clear recollection about some past event or location and yet be unable to remember what they said a few moments previously.  The impact of this constant change and confusion can itself be disorientating for the carer.

The carer needs to develop endless patience and tolerance while maintaining self-care practices so that they are able to continue to provide effective support and help to the Alzheimer’s sufferer.

Reflection

The experience of the disorientation of an Alzheimer’s sufferer really makes us appreciate what our brain actually does for us on a moment-by-moment basis as we take in millions of stimuli and sensations.  It makes us appreciate our brain and motivates us to want to properly care for it through mindfulness practice and avoiding obsession with the news and social media.  It also reinforces the need for a carer to consciously strive for effective self-care.

As we grow in mindfulness, we can progressively become more self-aware and be really grateful for the functioning of our brains whether at work or home or when participating in sports.  Mindfulness becomes a way of being really grounded in the present moment, of finding a refuge that provides calm and tranquility amongst the turbulence of daily life.

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Image by Muhamad Suhkry Abbas 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.

Sustaining a Daily Practice of Tai Chi

While my focus here is on Tai Chi practice, some of the principles I will discuss have relevance to other forms of mindfulness practice.  For some time now, I have been practising Tai Chi on and off, with a few periods of sustained daily practice over several months.  In my current sustained effort at daily practice, I have changed a number of strategies to help me maintain the momentum of practice – and often it is about developing a momentum like I have been able to achieve with my blog (over 500 posts).

I am acutely aware of the research that establishes the benefits of Tai Chi for my physical and mental health and overall sporting fitness.  I devoured Dr. Peter Wayne’s research into the active ingredients of Tai Chi.  So, intellectually, I know about the many benefits of Tai Chi.  However, sustained daily practice requires a commitment – an exercise of both mind and heart, incorporating an emotional attachment to the end goal(s).

Strategies you could adopt to sustain a daily practice

Commitment to a daily practice also involves flexibility, adaptability and adjusting your thinking.   The strategies identified in the following list are based on what is working for me at the moment:

  • Flexible timing – most of what you read about habit forming advises you to adopt a set time each day for your practice.  However, some days it is not possible to achieve a set time owing to other commitments of work or family (or writing a blog).  The tendency then is to drop the practice for the day, rather than adopt a more flexible approach and work out a time when you can fit in the practice despite other commitments taking up your allocated time slot.  Being flexible about timing and location enables you to sustain your daily practice.
  • Prioritising – as you build up awareness of how important your daily practice is to your overall life, you can tell yourself to give your practice a priority in your daily schedule – in other words, no matter what else you have to do, somehow you have to fit in your daily practice.  It becomes a “must do” rather than a “nice-to-do”.
  • Establishing a personal mnemonic – capture the benefits of your practice in the form of a mnemonic so that you can quickly recall the benefits as an added motivator.  This requires you to research the benefits of your daily practice and to keep them uppermost in your mind.
  • Mentally linking the benefits to a recent or forthcoming event – relevancy aids motivation, so if you can think about something that has happened or is about to happen and focus on what benefits your practice would bring, you are adding to your motivation.  For example, if you have recently heard about the impact of Alzheimer’s disease on a relative, you are reminded of the benefit of Tai Chi for improving your mind and body and developing your mind-body connection.  If you are about to play a game of tennis, you could think about the benefits that Tai Chi would bring to your tennis playing, e.g., timing, coordination, balance, flexibility, and concentration.
  • Being adaptable as circumstances change – the need to work from home as a result of enforced isolation brought on by the pandemic, has necessitated a lot of adjustments, especially when both partners work from home.  As part of your negotiations about how things will operate in this home/work environment, you can negotiate time(s) and location for your daily practice.  Instead of putting off your practice, you could choose to close the door of your practice room for the required period so as not to disturb, or be disturbed by, your partner.  Negotiating arrangements with your partner is an essential aspect of maintaining positive mental health when forced to work from home.

Reflection

Over time circumstances change, so to maintain a daily practice requires flexibility, adaptability, and strategies to keep the benefits of your practice at the forefront of your mind (so that you will have the motivation to overcome obstacles as they arise).  As you grow in mindfulness through Tai Chi, meditation, yoga or other mindfulness practices, you can become more self-aware about what causes you to procrastinate or put off your practice.  You can also strengthen your motivation through the reinforcement that comes with practice and the development of unconscious competence in your practice activity.

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Image by MichaelRaab 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 Mental Health Professionals

In his book, Trauma Informed-Mindfulness With Teens, Sam Himelstein stresses the need for self-care for mental health professionals dealing with traumatised teens.   His final chapter is devoted to self-care and professional practice.  Dr. Cirecie West-Olatunji, counsellor educator,  also stresses the need for self-care for professionals working with people experiencing traumatic stress.  Her video presentation is available as part of the courses provided by the Mental Health Academy.   Both experts in the area of counselling for trauma highlight the impact of vicarious trauma, especially the risk of mental health professionals experiencing compassion fatigue.

Mindfulness for self-care

Sam himself experienced trauma in his early 20s when he lost his sister through suicide. He makes the point that most health professionals will have experienced trauma of some kind and that this experience leaves them open to triggering their own traumatic response through exposure to the trauma stories of other people.  Cirecie highlights the fact that the trauma stimulus can be exacerbated where the professional has previously experienced combined or cumulative trauma. 

Sam emphasises the role of mindfulness in helping the professional to deal with their own re-traumatisation as a result of interaction with others and their emotionally draining stories.  He stresses the role of a personal mindfulness practice in helping him deal with the trauma of his sister’s suicide.

Sam  suggests that a personal approach to mindfulness as a protective mechanism could involve the following:

  • Silent retreat(s): Sam found these exceedingly helpful because they enable you to fully experience your emotions, gain a deep insight into your inner landscape and develop strategies to maintain or regain your equilibrium.
  • Formal practice: this entails inculcating a regular mindfulness practice (either sitting, standing, or walking) where you engage in some form of formal meditation.  This helps to build your concentration to enable deep listening, empathetic response, and the ability to promote wise action.  It also assists you to deal with your own difficult emotions (such as anger, resentment, or frustration), challenge self-defeating narratives and develop resilience in the face of challenging interactions.
  • Beyond meditation: Sam suggests that bringing mindfulness into your everyday life (in daily activities such as walking, washing clothes, eating, shopping), is effectively “mindfulness-in-action”.  It is particularly relevant to your relationships and interactions with others, especially in times of conflict.  One way to develop the necessary calmness and equanimity in the face of emotional challenges is to practice reflection-on-action to eventually cultivate the capacity to reflect-in-action, in the course of something adverse happening to you (whether that adversity is real or imagined).  Sam stresses the importance of daily mindfulness practices in controlling the “ego” which can get out of hand when  it perceives a threat (physical, emotional, or intellectual).

Professional development

Both Sam and Cirecie stress the importance of professional development to build competence and confidence to enable you to operate effectively within your chosen arena of professional practice.  For Sam this is the arena of traumatised youth, especially those who have been incarcerated.  He offers specialised training for health professionals through his Center for Adolescent Studies.  Cirecie’s professional arena includes trauma stress service delivery and training professionals who provide counselling in different countries following disasters such as earthquakes and pandemics.  She conducts research and training through her Xula Center for Traumatic Stress Research.

Cirecie stresses the need to gain control over your workload and, where necessary, seek to negotiate a lighter load (for your psychological welfare and that of your clients).  She maintains that every mental health professional, irrespective of their level of experience and training, has their window of tolerance beyond which they are unable to function effectively.  She gave an example of how a racist client triggered her and how  her experience in working in South Africa with a community where people were consistently dying from AIDS took her outside her window of tolerance and led to a severe illness.  In both cases, she sought professional counselling and recommends this form of professional development for other mental health professionals.

Cirecie highlights the importance of self-knowledge and self-awareness as critical factors in professional counselling, particularly understanding your own negative triggers.  She encourages too the development of your own professional support network that you can draw on for knowledge, experience, resources, and emotional support.  

In Cirecie’s view, personal and professional development extends to conscious awareness of the physical and psychological health risks inherent in the role of a mental health professional.  She urges appropriate preparation for the role through education which will provide motivation for health self-care (e.g., exercise, stretching (to release physical tension), diet, and drinking water).

Reflection

There are many reasons why mental health professionals do not undertake adequate self-care.  When working with clients who have suffered trauma or are currently experiencing trauma, it is critical that the health professional takes time for self-care to enable them to function at their best for the sake of their clients, as well as for their own welfare.  Mindfulness practice is recognised as a key component of this necessary self-care.  As mental health professionals grow in mindfulness, they are better able to identify personal triggers, develop resilience for their challenging work and build the capacity to engage in deep listening.  However, mindfulness practice needs to be supported by an appropriate lifestyle. 

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Image by Vanessa Kenah 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.

Making a New Year’s Resolution

At this time of the year, we are encouraged to make New Year’s resolutions covering each of the major areas of our life, e.g., relationships, health, fitness, work, and finances.  What we typically do is end up with a list of things to improve on.  Sometimes they remain just a list and are not actioned.  Other times we add them to our very full to-do list and they become another stressor and ammunition for beating up on ourselves if we don’t achieve them. 

It is interesting that experts in the area of habit formation suggest that we focus on a single habit in a single arena of our life and make an achievable resolution in relation to one aspect of this arena.  Leo Babauta, creator of the Zen Habits blog with a readership in excess of 2 million, is a strong advocate of focusing on a single habit and he reinforces this approach in his book, The Habit Guidebook: My Most Effective Habit Methods & Solutions.  Seth Godin, famous internet marketer and author of more than a dozen New York bestsellers, argues that you should start small, start now.

The role of mindfulness in habit formation

Leo maintains that mindfulness has a role to play In helping us to pursue our focused resolution and develop a new habit.  Mindfulness helps us to overcome negative thoughts, avoid procrastination, develop self-reinforcing strategies, appreciate our achievements (however small) and improve our overall self-management.  Leo argues that the self-awareness that we gain through mindfulness makes us conscious of the things that trigger undesirable habits, enables recognition of habituated responses, and serves as a refuge when the habit-pull becomes intense.  So, there are many ways that mindfulness can underpin and strengthen our New Year’s resolution.

Developing a habit of mindfulness

The advantage of concentrating on a mindfulness practice is that the benefits flow into all arenas of our life because so much of our life is interconnected.  We can see this in operation when we begin with a single habit in other arenas, e.g., our daily walk.  If we walk regularly, we tend to want to eat better, we get fitter, our mood improves and we are better able to relate effectively with others.  As mentioned above, mindfulness has this overflow effect through its power to develop focus, self-awareness, and self-regulation.

There are some key strategies that facilitate developing and sustaining a habit of mindfulness:

  • Start small – Chade-Meng Tan, author of  Search Inside Yourself and one of the creators of Google’s course of the samename,recommends starting with one breath at a time
  • Develop a daily routine – build towards a daily practice.  This may take some time – choosing an appropriate practice and finding the right part of the day to practice.
  • Link the mindfulness practice to other things that you do daily  – this ensures that at least daily you are engaged in your mindfulness practice.  For example, I link a mindfulness practice to waiting time (which occurs often throughout a day, e.g., waiting for traffic lights to change).
  • Don’t beat up on yourself – if you miss a day here or there, do not cultivate negative self-talk such as “I’m hopeless, I can’t even maintain a single, small habit”.
  • Appreciate and reinforce your newly acquired habit – remind yourself of the benefits that you are gaining through your new habit. One way to reinforce your practice and maintain your motivation is to develop a personal mnemonic that captures the benefits you are experiencing.

Reflection

Focusing on one small habit initially provides flow-on benefits and tends to permeate many aspects of our life.  As we grow in mindfulness, we can be more present to what is happening around us, more able to engage in deep listening to others and be increasingly appreciative of the benefits that a new habit brings to our daily life.

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Image by alexvi82 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.

Maintaining the Christmas Spirit

Christmas is a time when we can experience strong positive emotions such as kindness, joy, gratitude, generosity, empathy, and compassion.  We can also be more considerate, thoughtful, patient, and understanding. The difficulty is maintaining the Christmas spirit throughout the rest of the year – how can we continue to experience these positive emotions and engage in these positive behaviours when we encounter the daily pressures of work, relationships, and expectations (our own and those of others)?

Tailoring mindfulness practice

There are many ways to build positivity and maintain positive emotions and behaviours.  Diet and exercise are two of the most popular approaches.  Seeking silence in a busy life amid the noise pollution of the surrounding world is another.  Mindfulness practice can help us to find the balance and equanimity necessary to manage the daily challenges that can upset our peace of mind and positivity.

What helps to sustain mindfulness practice is finding and tailoring a practice that meets our needs in an arena where we would like to improve ourselves and our reactions, and that can be embedded in our daily routine.  It is important that the mindfulness practice, however brief, is conducted on a daily basis so that it can become a habituated behaviour.

I have found, for example, that one arena where I can become frustrated and annoyed is when playing social tennis.  Part of the issue is my own expectations about how well I should be able to play.  Having played tennis for more than fifty years, with many of those years engaged in competitive tennis, I have the expectation that I should be able to play better than a lot of people.  This expectation, however, does not consider the decline in flexibility, reflexes, strength, and mobility that occurs as we age.  So, I need to manage my expectations, strengthen my sense of gratitude (e.g., about being able to move and play tennis at all!) and learn to manage my reactions to  personal disappointment with the way I am playing on a particular occasion.

What I have found is that mindfulness practices help me to improve my gratitude, reduce my expectations and manage my reactions.  What has been of particular benefit to me is Tai Chi – a form of mindfulness practice that directly impacts my tennis playing in a positive way.  The desire to play tennis well and enjoy the experience adds motivation to my Tai Chi practice. It has become a practice that meets my needs at the moment for self-regulation and that enables me to improve my positive experience in an arena (social tennis) that I thoroughly enjoy.

Developing a personal mnemonic

People often use affirmations to help embed a belief, a behaviour, or an orientation.  Another way to achieve these outcomes is to develop a personal mnemonic that captures the core benefits that you are seeking.  For example, with Tai Chi I have developed the following mnemonic that keeps the benefits of this practice at the forefront of my mind, strengthens the desire to practice and reinforces the positive outcomes that I experience.

My mnemonic for capturing the benefits of Tai Chi for my tennis is as follows:

  • F – flexibility in muscles and overall movement is increased considerably
  • R – reflexes are improved and increased in speed of response
  • A – awareness is heightened of every aspect of tennis play (e.g., movement of the ball, environmental factors, other players)
  • I – intention, integration and interaction are strengthened
  • C – coordination and concentration (which go hand-in-hand) are enhanced along with balance
  • H – heart health improved through better circulation and improved breathing
  • E  – energy and motivation are improved.

The mnemonic stands for “fraiche” – a term which itself has positive connotations when viewed as a delectable dessert.  

Reflection

Developing our own mnemonic is one way of reminding ourselves of the benefits of a personalised mindfulness practice and will enable us to maintain our motivation and increase the frequency of our practice.  As we grow in mindfulness through our personalised practice, we can maintain the positive emotions and behaviours that are characteristic of the Christmas spirit.

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Image by monicore 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.