Categories
Mindfulness Meditation

Progressive Muscular Relaxation

Anxiety: a feeling of dread, related to fear and panic, yet not as strong.  It’s a feeling we can carry with us, whether there is some cause in our environment or not.  Sometimes anxiety is generated by a thought or a concern that we have.  And the longer we remain fixed on this thought or concern, the longer we carry the bodily feeling of anxiety. Sometimes anxiety arises spontaneously, filling the body with uncomfortable feelings.  And the bodily feeling of anxiety itself can set the mind in motion, activate all kinds of thoughts and memories that are congruent with the anxiety, but may have little if anything to do with what is happening right here, right now.

One of the primary effects of anxiety is to cause muscular tension.  It can be very subtle tension, such as jaw clenching or teeth grinding.  A sore back or neck, fatigue in our torso or limbs, all can be the result of muscles kept tensed throughout much of the day.  When the feeling of anxiety permeates our self, the muscular tension that ensues can be exhausting.

One antidote for anxiety is to relieve the muscular tension.  Many people find that the process of relaxing the muscles systematically not only brings on a peaceful feeling, but that it actually relieves the anxiety itself.  And if you combine the work of muscular relaxation with some simple mental corrections concerning those activated thoughts and memories, then the anxiety can truly be relieved and relinquished.  But it takes lots of practice and commitment.

Progressive Muscular Relaxation (PMR) is a technique pioneered by Edmund Jacobson, an American psychiatrist and physiologist, in the 1920’s.  Jacobson’s work, and the work of many of his disciples (especially Joseph Wolpe), laid the groundwork for treatment of anxiety disorders.  You can find a good introduction to Jacobson’s work in the Wikipedia article about PMR (http://en.wikipedia.org/wiki/Progressive_muscle_relaxation).

I’ve recorded a simple, 15 minute script that will lead you through a PMR session.  All you need is a quiet comfortable place where you can listen to this script and practice PMR.  It’s really simple; after doing this practice by the recording a few times you won’t need to listen to it, you’ll simply know how to relax your muscles in this manner.  You might find cultivating this skill quite helpful.  Imagine mindfully noticing the beginning of some anxious feelings during the day, and being able to recognize which muscles are tensing and then, with a very simple and conscious effort, relaxing those muscles and letting go of the anxiety.

Here’s the recording: Progressive Muscular Relaxation

And here are the simple directions to follow before you listen to the recording:

1. Find a time and place that will allow you 20 minutes of relatively undisturbed quiet.  Padded earphones may be of assistance in tuning out the world.  Some people find it helpful to have recorded music of a relaxing nature in the background.

2. Develop a habit of relaxing in the same place at the same time every day.  Make it part of your daily schedule.  Relaxation is a skill that requires practice.

3. Get as comfortable as you can, preferably sitting in a recliner with your entire body and head supported, or lying down.  Wear loose clothing that will assure a sufficient warmth, or cover yourself with a light blanket.  Remove eyeglasses or contact lenses before beginning to relax.

4. Avoid doing the relaxation exercise immediately after eating a full meal or when you are tired, as you may actually fall asleep and not benefit from the relaxation practice.  However, relaxation in itself may be used to substitute for a nap as a source of renewed energy, or it can be used to combat insomnia which is associated with anxiety.

5. After you have relaxed to the recorded script several times, you will find you are able to obtain the same deep state of relaxation without actually tensing your muscles at all.  If you find yourself becoming impatient with the length and sequence of the tape, you might try starting your relaxation sessions midway through the tape, beginning with the deep breaths.  It is also recommended that you occasionally go through the entire relaxation sequence on your own without the tape.  Eventually you will be able to achieve the same deep relaxed state merely by imagining your calm scene.

I hope you find this useful; I know I have, especially during those times when there’s a lot of stress in my life.
And I would love to hear back from you about this practice, the good, the bad, and (let’s hope not) the ugly.
Peace,
Jim
Categories
Mindfulness Meditation

Be Mindful Now

If not now, when.

Actually, the entire quote is “If I am not for myself, then who will be for me? And if I am only for myself, then what am I? And if not now, when?”

These are the words of one of the greatest Jewish scholars, Rabbi Hillel, also known as Hillel the Elder.  Hillel lived in the beginning of the common era, roughly 2000 years ago.  His admonition, “if not now, when,” is taken to refer to the necessity to attend to obligations now, in this moment, and to not put off that which is essential.

Be mindful now.  Such a simple injunction.  Taken with Hillel’s admonition, what am I waiting for if I do not direct my intentionality to the present moment?  When do I want to live?  Next year?  Back when I was 12 years old?

I only have now.  So why do I fret?  Tomorrow isn’t here.  Why do I regret?  Yesterday is over; I can’t change it.

When is the time to be mindful?  What am I waiting for?  How about you?  Did you sit today?  Did you walk mindfully?  Eat mindfully?  What excuse did I give myself?  Was I at least able to be mindful of my mindless excuse?

If not now, when.  Be mindful now.

Peace,

Jim

Categories
Mindfulness Meditation

“I Love You” Therapy

Good morning!

I’ve been away a while.  Life gets busy, and priorities shift.  It’s my intention to blog regularly, as I’m usually coming across information that fascinates me and helps me one way or the other, and I love to share that material.  One day soon the time will be available more regularly, I’m certain.

But for now, I’d like to direct you to this link: http://well.blogs.nytimes.com/2012/02/13/lifes-frailty-and-the-gestures-that-go-a-long-way/?ref=science

Tara Parker-Pope is a NYTimes writer who frequently contributes to the Tuesday “Science Times.”  She writes today about the frailty of life and the importance of expressing our love for one another.  I agree.  You just don’t know when it’s the last time you’ll see someone.  I know that sounds morbid, but it’s a truth that bears acceptance.  But there’s another reason for expressing our affection: it feels good.  It fills the heart.  If you’re not certain of this, take it to a meditation.  After you’ve steadied your mind somewhat, simply find two words to accompany your breathing.  Something like “soft” on the in breath and “heart” on the out breath.  Or “loving” and “kindness.”  Or “gently” and “caressing.”  The only limit is your imagination.  Once your mind has settled on this breathing intonation, bring to mind’s eye the image of a loved one.  Dwell with this image.  Perhaps reinvent this image to this loved one as a seven year old.  Or yourself, perhaps.  Then examine your heart.  Feel your body in this mindset.

If your body has softened, become loving, then take the experiment further: tell that person of your softened heart, caressing touch, or lovingkindness.  Be vulnerable, expect no return.  And if that person wonders “what’s this about” you can always tell them “it’s cheaper than a Valentine’s Day card”!

Peace and love to you,

Jim

Categories
Mindfulness Meditation

Layers of Forgiveness: Relieving Trait Anger in the Compulsive Gambler

Hello,

The material available in this post includes the slides, handout, and original research article used in my workshop on trait anger and treatment of addictions, particularly Pathological Gambling.  Feel free to use these materials, and feel free to contact me about them if you have any questions (walshjm54@yahoo.com).

These are the Powerpoint slides I used in the workshop:  Trait Anger Gambling Workshop Slides

The questions we considered as part of our work in the workshop are included in this document: Trait Anger Gambling Workshop Questions

This is the research article that I presented during the morning portion of the workshop:  Gambling & Anger Outcomes Study

The Powerpoint slides and questions are my original work.  If you choose to use them please give attribution.  The journal article has its own copyright protection.

Jim

Categories
Mindfulness Meditation

On Human Satisfaction

Hello again!

Is there a topic of greater interest than Human Satisfaction, especially as we grow older?  What does it mean to be satisfied with your life?  So many variables go into this equation.  My family’s happiness certainly comes to mind first.  My health, the health of those I love must be considered.  Are my basic needs met?  (What are my BASIC needs anyway?)  Do I have a career that feels more like play than work?  Do I have friends who bring my joy and comfort?  Do I find delight in the day-to-day events of my life?

For a great perspective on this issue, here’s a wonderful article from Jane Brody, one of the great science writers of our time.  It appeared in the Science Times section of the NY Times yesterday, January 10, 2012.  It’s worth reading.

http://www.nytimes.com/2012/01/10/health/elderly-experts-share-life-advice-in-cornell-project.html?ref=science

More later.  But Ms. Brody’s article provides much food for thought.

Peace,

Jim

Categories
Mindfulness Meditation

Did you run today….?

Or perhaps garden.  Or read a good book.  Or try a  new recipe.  What did you do today for your mind?  What did you choose to do today that would allow your mind to become focused, non-judgmental, calm?

There are two ways to reduce your stress level.  The first is the most obvious but probably the least utilized: reduce the number of stressors in your life.  Now, that’s not easily done.  After all, you can’t put your teenaged child up for adoption!  And you probably can’t quit your job or your post in the Home and School Association or tell your sister-in-law to never speak again.  But if you can eliminate a stressor or two, do it.

The other way to reduce the stress in your life is to reduce the stress in your body.  For me, it’s take a good, long run.  Or schedule an afternoon or evening alone, brew a good cup of Earl Grey or Green tea, curl up with a good book and enjoy the quiet.  Or work in the yard.  Or paint a room (yes, I find painting to be VERY relaxing).  What each of these activities have in common is that each is conducive to mindfulness.  Being present, not judging, staying focused.  Hit the meditation cushion, immerse yourself in prayerful silence, whatever it takes to get outside of your self and allow your mind to get into flow.

So, when I’m getting a bit kerfuffled I have to ask myself this question: Did I run today?  And if I didn’t, or get mindful in some other way, then I will have to pay a stress-based consequence, and wait until tomorrow to hit the trail.  But let today’s stress be a wake up call, or even a warning: get mindful again!

Peace,

Jim

Categories
Mindfulness Meditation

Meditation and Preoccupation with the Self

Special thanks to Scott Caplan for sending this link:

Meditation and the Self

The opening of the article about changes in brain function is very interesting, but be sure to read the text below.  A regular meditation practice changes the brain’s “default” mode.  Makes us less “self-centered” and more “other-centered.”  Not a bad way to live!

Peace,

Jim

Categories
Mindfulness Meditation

Ego Strength and Mindfulness

Any meditator will tell you to be very cautious about putting the words “ego” and “mindfulness” in the same sentence, unless there’s a negation wedged between them!  So it is with great caution that I proceed, acknowledging the spiritual contradiction of working to enhance ego strength while supporting and deepening a mindful spirit.

What does it mean to have “ego strength”?  It’s a tricky idea, in my opinion, because of rampant narcissism.  To have a “strong ego” may imply that somehow my needs are more important than yours.  We see this in many ways, some ridiculous (think the recent Kardashian wedding), some mind-boggling (think of athlete’s salaries), and some tragic (think “Penn State football”).  But having a strong ego in the narcissistic sense is really a rather weak way to live.  The narcissist can only see his/her own situation, has little if any perspective taking skills, and cannot form a true and meaningful relationship.  What a way to suffer.

Ego strength, on the other hand, refers to being resilient.  The resilient person says “I can bend but I won’t break.”  The brittle ego is rigid and snaps under pressure; the resilient ego is flexible and adjusts to the ebb and flow of demands.  Resilience is a state (“I get it together again after a rough day”) and a trait (“I stay calm, cool, and collected even when things get really rough”).  The resilient person bounces back with skill after losing equilibrium (i.e. goes easily from ego depletion to ego replenishment) AND, at times, does not lose equilibrium even in the face of great adversity (i.e. able to sustain ego strength).

Here’s a video from ABC news that makes a great case for meditation as a way to build ego-resilience:

ABC News Report on Meditation

I love the little boy in the video who says that his sister is screaming, mom is cussing, and he’s meditating!  But what’s truly impressive is that with even a little practice, the meditative brain functions differently, in ways that strongly suggest that the mind comes to a state of comfort and ease more readily, even in difficult situations.

I hope this series on ego-depletion, ego-replenishment, and ego-resilience has been helpful.  I’ve enjoyed going back and reading this literature again, and have taken away several “lessons learned” for myself.  First, I’m going to run out of “mental” gas sometimes; accept it, it’s natural.  Second, if I can recognize when I’ve run out of gas AND accept it, then I can mindfully decide to “cease and desist” in further activity, and give my mind the rest that it needs.  And if resting in that moment isn’t possible, at least I can be mindful in guarding against a total meltdown that might offend or hurt someone I love.  Third, I know the antidotes: rest, nutrition, and fun.  Fourth, I have a great tool to build up that “mental muscle” so that ego-depletion is minimized.  Any activity that allows me to practice self-regulation, no matter how trivial, builds up my strength.  Finally, my meditation practice gives me the insight to be aware, accepting, and able to act to replenish and strengthen.  And the more I meditate the more my brain is readied to be aware and accepting.

The spiritual paradox in this practice of mindful ego-strengthening is that with this resilience comes the realization that what I conceptualize as my “self” is very transient.  There’s an abiding “sense of self” but the actual activity of a “self” comes and goes, and changes so easily.  As I let go of clinging to this “self” I find something that lasts within, something that is hard to define, but is there through each moment.  I don’t know what to call it.  I suppose “sense of self” will have to do for now.  Perhaps that “sense of self” is transient also; I don’t know.  But there’s strength and peace in the realization that I don’t have to cling to an ego that demands that life conform to my perceived needs in this moment.  This painful ego state has happened before and will happen again, but it’s not permanent.  It has flowed; it will ebb.  In that moment I can have clarity that my “sense of self” remains untouched; this painful ego state is not about “me,” whoever or whatever that is.

Happy Thanksgiving!  I hope that you’re able to experience deep gratitude this week and throughout the coming holiday season.

Jim

Categories
Motivational Interviewing Audio Tracks

Motivational Interviewing Audio Samples for Addictions Counseling

These audio samples are intended to demonstrate Motivational Interviewing skills.  The individuals in each interview include the author (Dr. Jim Walsh) and three students, who are role-playing the part of a young woman recently diagnosed with Alcohol Dependence With Physiological Dependence.  In the vignette she was treated in a detox unit and then experienced a 28 day residential treatment.

In the first interview the patient is being seen for a first visit in an Intensive Outpatient (IO) facility.  Here’s the audio track:

MI First Recording

In the second interview the patient is being seen for a second visit at the IOP.  Here’s the audio track:

MI Second Recording

In the third interview the patient is being seen for a third visit at the IOP.  Here’s the audio track:

MI Third Recording

One final note, I’ve used the first names of the students playing the role in each interview, but the intention is to illustrate working with a single patient in order to demonstrate therapeutic progress in motivational factors.  So don’t be thrown off by the different first names used in each interview; it was simply easier to keep in the role by doing so.

My thanks to the three students, Nan, Monica, and Megan, who gave generously by immersing themselves into this role playing exercise.

Categories
Mindfulness Meditation

Ego Resilience II

Life is challenging.  Is it just me, or have you noticed that too?  Things go really smooth for a while, then things fall apart.  Just when you think “I’ve got it all figured out,” the banana peel of life slips under your foot and you find yourself flat on your “you know what.”  The only antidote to life’s inevitable pratfalls is persistence.

In June of 2006 Zina and I travelled with our friends Andi and Keith to beautiful Santa Fe, NM.  Serene, artistic and ancient (by American standards), set between the majestic Sangre de Cristo mountains to the east and the Jemez mountains to the west, Santa Fe is a desert sitting at 7000 feet above sea level.  The awe one feels surrounded by cascades of burnt color with a backdrop of Alpine forests co-mingles with shortness of breath in that rarified atmosphere.  And those mountains?  Another 5000 feet above Santa Fe they loom, calling for these aging legs to make the climb.

And climb we did, or at least tried.  Confident in my lungs, accustomed to running long distances (but at sea level!), Keith and I began a 2000 foot ascent with the certainty of two rather ignorant fools!  Two hours later, gasping for air and parched with thirst (yes, we didn’t even bring hydration for a desert hike!), we came to our senses and descended quickly.  Five days later we were successful, having acclimatized to the altitude, starting the climb very early in the day, bringing sufficient energy bars and, yes, a good supply of water.  Here we are at the top of a 9200 foot summit, tired, sore, but VERY happy:

We flew home a day later and embellished the accomplishment with skill and delight.  The story became more bold and intrepid with each telling, but anyone who knows us just laughed, rolled their eyes, and humored us.  Such is the fate of men married to women who know them all too well!

Now, the main reason we traveled to Santa Fe was to visit our son Phil, who was completing a Masters degree in Eastern Classic Studies at St. Johns College in Santa Fe.  Unlike his elders, Phil kept himself in great shape and had done much biking and climbing during his year at this altitude.  His graduation was coming up just 6 weeks after our visit and I decided to go, solo, to his commencement exercise.  Before we left from our June visit Phil suggested that on my return we climb Deception Peak, starting from the parking lot of the Santa Fe ski basin (elevation approximately 10,000 feet) and ascending to about 12,200 feet.  I decided to do it, and began preparing as soon as we returned to Delaware.

For the next 6 weeks I ran daily on the David English Trail in White Clay Creek State Park.  It’s only about 2.5 miles long, but it ascends sharply, about 160 foot, in less than a mile.  Day after day, two laps, three laps at a time, up and down that steep hill.  Twice a day sometimes.  Taking care to hydrate regularly (this was during July and August), eating a diet rich in protein to help build muscle mass, replacing lost electrolytes and carbs, until I could cover that distance comfortably.  Off to Santa Fe in mid August; joyfully watching my son receive his degree; then rising early to climb.

We made it to the top of that peak!  Phil and and his best friend Doug had hardly a change in their breathing.  This old man?  Breathing hard, but making it all the same.  Stronger from the persistence of practice.  Experiencing the felt sense of resilience.

Resilience.  To be able to endure, to bend, to sustain.  Ego resilience, not losing our sense of self in the midst of intense challenge.  How can we build this resilience?  It’s simple, but it’s difficult.

If we are to build ego resilience we must choose tasks that require persistence.  We must organize those tasks, set schedules, understand limits, but endeavor to exceed those limits.  Persistence is a virtue, a gift that we can cultivate through disciplined inquiry, commitment, and action.  Every act of persistence forms a deeper and firmer foundation of ego strength.  It doesn’t matter if the persistence is physical, as in exercise, intellectual, as in education, emotional, as in extending compassion to another’s suffering, or behavioral, as in establishing or breaking a habit.  ANY act of persistence builds ego strength, and enables us to bring greater endurance to future events that challenge.

Back in 2008 I organized my life around building physical resilience for a difficult challenge.  When I returned in mid August it was to a world in which my father was living his final 6 weeks.  The work I had done preparing for that climb turned out to have also strengthened my spiritual and emotional resilience.  With the loving support of my wife, my children, my family and friends (especially my fellow meditators), I sustained and endured.

What projects can you take on that will build ego resilience?  Any endeavor that requires persistence will do.  Here’s an easy one to start with: sitting meditation.  Committing yourself to 10 minutes, and when the wandering mind says “enough,” redirect your attention again to breath, to living, and persist mindfully to the end.  Here’s another: listen.  The next time someone natters on and on and you don’t think you can remain present and patient, redirect your attention to that person, and persist mindfully to the end.  Every day of every person’s life presents opportunities to direct our attention in a way that demands persistence, and each act of persistence “strengthens the muscle” of ego resilience.

Well, just going this far reading this material about ego-depletion, replenishment, and resilience is an act of persistence!  See, it’s that easy!  There’s one more point to make about building resilience, and that will come in a few days.  I hope these reflections have been helpful.  I know that re-learning this material has helped me tremendously, and I wish the same help for you.

Peace,

Jim