Mindful Relationships Part 4: Presence as a Source of Passion

Passion in relationships is often thought of as a strong emotional or sexual connection to one’s partner. While this is often a start to many relationships, sustaining that intense enthusiasm can be difficult over time. In fact, relationships that are based on passion alone often struggle because they do not make room for the reality that our feelings often wax and wane.

Relationships founded on passion alone also tend to struggle with the fact that partners see an idealized version of one another and there is sometimes little room for the variety of feelings both positive and negative that one can feel for someone that they are in a long-term relationship with. Passion-based relationships can also can also struggle with a competitive or tit-for-tat quality that has partners playing for opposites sides rather than working together as a team (Walser and Westrup, 2009).

While having a strong emotional connection to your partner can feel amazing, it can be more helpful to build a sense of connection that is focused more on vitality rather than on raw emotion or sexual chemistry. In this case, vitality refers to a sense of liveliness or active engagement in the relationship (Walser and Westrup, 2009). This level of investment in the relationship can help your bond to stand the natural ups and downs that all relationships face as changes take place and stress comes and goes.

There are some helpful practices that allow you to focus on building a sense of connection and vitality in your relationship (adapted from Walser and Westrup, 2009):

Be mindful of the sound of your relationship. Pay attention not only to what your partner says but to the sounds of laughter, tears or the voice crack of pure excitement.

Appreciate your partner’s physical presence such as the warmth you feel as you sit next to each other on the couch or the calm you feel when experiencing a forehead kiss or touch on the shoulder.

Be thankful for the opportunity to grow old together including the ways in which you each age over time. For example, notice the laugh lines that mark the many smiles and good times that you have shared or even a few extra new pounds from a string of delicious meals shared. Be aware that aging with someone is an honor and a very intimate experience.

Notice the cute things that your partner does. This can take effort because we often attend more to the annoying things than the good ones. Maybe you will start to see things you have missed such as a funny expression or a loving, idiosyncratic gesture.

Take the time to ask your partner about something that he/she finds interesting or important and really listen to the response that is shared both verbally and non-verbally.

Lie next to one another with mindful awareness simply noticing what it feels like to be physically close or hold hands and simply notice the sensations of touching.

Learn about a hobby your partner enjoys and join him/her with sincerity and a curiosity about the joy he/she finds in this activity.

Purchase a small gift that your partner would find meaningful, thoughtful or symbolic. Let your partner understand that you see who he/she is.

Ask what you can do to support or help your partner and follow through. Check back to see how he/she felt about the experience.

Dr. Stephanie Davidson is a licensed, clinical health psychologist and co-founder of the Rowan Center for Behavioral Medicine specializing in the use of cognitive-behavioral, humanistic and existential approaches to treat patients with a range of medical and mental health challenges. She has a strong interest in acceptance and commitment therapy and other mindfulness-based interventions to heal the body and mind. Her focus is on collaboration with the goal of assisting patients in adjusting to difficult experiences and achieving a greater sense of well-being, balance and peace in their lives.

REFERENCES

Walser, R. D. & Westrup, D. (2009). The Mindful Couple: how acceptance and mindfulness can lead to the love you want. Oakland, CA: New Harbinger Publications, Inc. 

Mindfulness Meditation for Anxiety Group

The Rowan Center for Behavioral Medicine is offering a 12-week group to teach mindfulness skills to individuals struggling with anxiety. The group will focus on experiential exercises designed to teach mindfulness meditation, breathing retraining, and present-moment focus. Mindfulness has been shown to help people successfully cope with stress and difficult emotions and increase vitality in daily life. 

Day and Time:
Mondays: 6:30 pm  – 7:30 pm

Led by:
Puja Chhabra, LCSW RYT LCS24159

Location:
The Rowan Center for Behavioral Medicine
500 East Olive Avenue, Suite 540
Burbank, CA 91501

Cost:
$50 per session
Some insurance benefits may apply. Please inquire further.

Contact:
Please call our Intake Coordinator at (818) 446-2522 or email info@rowancenterla.com to schedule your free half hour screening. 

Puja Chhabra is a licensed clinical social worker, specializing in psychodynamic, trauma informed and holistic approaches in working with individuals. She is a dedicated yoga teacher, committed to learning about the deep connections between the mind and the body. Puja believes that the combination of psychotherapy and yoga compliments one another and alleviates symptoms related to depression, anxiety and trauma. She specializes in supporting individuals in connecting to their sense of hope, in the midst of life’s stressors, transitions, and challenges. Puja’s unique therapeutic approach is based on reflecting on the past, understanding barriers to living in the present moment, and moving towards self compassion and acceptance.  Puja is committed to sharing simple yet effective tools of mindfulness, body movement and meditative practices to enhance clinical work. 

Please feel free to call the Rowan Center for Behavioral Medicine for further information 818-446-2522 or email info@rowancenterla.com 

 

Mindful Eating in Children

Children can be over- or under-sensitive to many things, including eating, so we must remember that eating is more than just chewing and swallowing food. It is a sensory experience. Eating includes:

  • The External Environment: What is happening around me?

    • The smell of food, people around and the room

    • The lighting of the room

    • The visual presentation of the food

    • The voices of people and noises in the room or outside on the street

    • The feel of the utensils against the lips, hands and tongue

    • The feel of the chair and table against the skin

  • The Internal Environment: What is happening inside my body?

    • The flavor of the food

    • The texture of the food on the hands, on the lips, in the mouth, or on the skin

    • The feeling of being hungry, full or uncomfortable due to pain, reflux or constipation

The lists above may remind you of things to think about when being mindful while you eat. Some children innately are much more mindful of what they are eating than adults. This can result in a strong reaction to new foods, but mindfulness can help work through this. Another unfortunate extreme occurs when children are not at all aware of what is going on when they eat. Innate senses can sort of be drowned out over time by distractions and less than ideal mealtime routines. I work with families on a daily basis to help parents understand what a child may be experiencing when they eat and how to promote a healthy food environment that encourages a nutritious and varied diet. This often includes mindful eating.

All aspects of mindful eating promote satisfaction with food and eating and a healthy approach to food choices, preparation and consumption. Below are ways to be mindful as a family:

  1. Promote family meals. This is not always easy, but having at least one family meal a day can improve a child’s understanding of food.

  2. Cook together! When children participate in preparing the meal, we are allowing them opportunities to interact with foods that do not include the pressure of eating the food. Let them wash the veggies, shake the dressing, use a kid-friendly knife to chop the food. If a child feels more comfortable and safe around a food, they are more likely to eat it.

  3. Explore taste together. Talk about the food you are eating. Tell your child what it feels like, tastes like, smells like, etc. This is a difficult concept for kids at first so having an adult act as an example for fully experiencing a food can help. Start with a food your child loves and encourage him/her to come up with 5 words to describe it.

  4. Slow down! Allow your child to see a new food first, then touch it or smell it. It is important to offer a child a new food and allow them to mindfully interact with it however they feel comfortable. Give them time to work their way up to tasting it. If it is not a new food, encourage your child to take a bite and set the spoon/fork down between bites. There should be no hurry so you want your child to chew their food well.

  5. Decrease mealtime distractions. Technological devices are distracting for anybody, but especially a kid. It can completely remove them from the experience of eating and prevent them from learning to understand their body’s needs.

  6. Grow your own food. This may not be realistic for everyone, but even something as simple as buying a basil plant can help your child understand the process of where food comes from. Natural wholesome foods are more interesting to a child when they watered it themselves and watched it grow every day. It is also a fun project to take on as a family!

One of the main benefits of mindful eating for children is that it can help equip them with the ability to listen to their body, know when they are hungry and stop when they are satisfied. Infants are typically born with this ability. They cry when they are hungry. They stop nursing when they are full. Mindful eating can nurture this natural ability and can help children re-learn these feelings and re-establish a healthy relationship with food. Try it in a no-pressure, positive way. And don’t be surprised if your child begins to show more interest in new foods! 

Jonae Perez is currently a clinical dietitian at Professional Child Development Associates providing nutrition counseling for children with special health care needs. She completed her Master of Public Health and nutrition training at the University of Washington, Seattle. She has a background in exercise science and is passionate about adult and pediatric wellness. 

Life: Slow Down or You’ll Miss It

I was re-reading one of my all-time favorite books, Radical Acceptance by Tara Brach. In it, she shares an observation from a student of hers that he has been “skimming through the surface of life in a race to the finish line – death.” This prompted me to examine my own relationship to rushing. My days are chock-full of goals to accomplish and items to check off my list. Just the other day, I embarked on a walk with my two-year-old son. After several stops to examine rocks, bugs, trees and flowers I found myself growing impatient with the “lollygagging.” I began hurrying him along saying, “Bye-bye flowers.” Then it hit me, here I am with my precious son and his innocent beginner’s mind that is ready to discover new things. Instead of relishing the opportunity to stop and smell the flowers, my mind was on to planning dinner, doing dishes and getting ready for bedtime. Over the next few days, I continued to meditate on rushing, noting when and where it was happening and trying to slow down and savor when possible.

Stress is so ubiquitous in our culture and is characterized by lengthy “to-do” lists, tight schedules, fighting through traffic and never feeling like you’re doing enough. We know that stress is linked to innumerable medical and mental health conditions. It may increase the risk of high blood pressure and heart disease and possibly even certain forms of cancer. From a psychological perspective, rushing can cause feelings of anger, depression, bitterness, resentment and relationship problems. Sadly, rushing can cause a disconnect from the things in life that bring us the most joy and vitality.

It is likely that our continuous busyness builds a habit of rushing that we are practicing without even being aware of it. By becoming more aware of our tendency to rush, we can begin to reduce our levels of stress on a daily basis and arrive more fully in our lives in the present moment. Below, I will present some internal and external practices that can help make our relationships with time more healthy.

Internal Relationship to Time

1.     Body Awareness: Tune in to your body and notice how it feels when you are rushing. Do you find your face tense, your shoulders raised and your arms and legs coursing with tense energy?
2.     Awareness of thoughts: Become aware of the stories that are occurring. Identify and label planning and judging and try to let thoughts go.
3.     Conscious slowing down: Try to consciously slow down. Build three in and out breaths into transitions between activities. It can also be helpful to try three breaths when you notice sensations or thoughts related to rushing
4.     Surrender: When you find yourself in a situation in which you are going to be late or something unexpected has arrived to throw off your schedule, surrender. These moments can be seen as little gifts that remind us we are not in control of the world but can bring kind presence to the now.
5.     Meditation reminders: Set an alarm on your phone or watch to remind yourself to do a brief meditation. Try the Three Minute Breathing Space meditation below or any others you find help you arrive in the present moment.

Three-minute Breathing Space meditation

Step 1: Becoming aware
Deliberately adopt an erect and dignified posture, whether sitting or standing. If possible, close your eyes. Then, bring your awareness to your inner experience and acknowledge it, asking: what is my experience right now? What thoughts are going through the mind? As best you can, acknowledge thoughts as mental events.What feelings are here? Turn towards any sense of discomfort or unpleasant feelings, acknowledging them without trying to make them different from how you find them. What body sensations are here right now? Perhaps quickly scan the body to pick up any sensations of tightness or bracing, acknowledging the sensations, but, once again, not trying to change them in any way.

Step 2: Gathering and focusing attention
Now, redirecting the attention to a narrow ‘spotlight’ on the physical sensations of the breath, move in close to the physical sensations of the breath in the abdomen . . . expanding as the breath comes in . . . and falling back as the breath goes out. Follow the breath all the way in and all the way out. Use each breath as an opportunity to anchor yourself into the present. And if the mind wanders, gently escort the attention back to the breath.

Step 3: Expanding attention
Now, expand the field of awareness around the breathing so that it includes a sense of the body as a whole, your posture and facial expression, as if the whole body was breathing. If you become aware of any sensations of discomfort, tension, feel free to bring your focus of attention right in to the intensity by imagining that the breath could move into and around the sensations.  In this, you are helping to explore the sensations, befriending them, rather than trying to change them in any way. If they stop pulling for your attention, return to sitting, aware of the whole body, moment by moment.

External Relationship to Time

1.     Plan ahead: Regularly schedule specific time to conduct daily and weekly maintenance tasks such as filling the gas tank and preparing your lunch. Get up early enough each morning to allow time to eat breakfast and get ready for your day. Often, this can include a mindfulness practice, which can simply mean paying attention to the experience of completing an activity of the day.
2.     Prepare: Take time to get your clothing and items you need ready for the following day. Allocate some time in the evening to make a list for the next day.
3.     Build breaks into your schedule: Get a daily planner and/or use your smart phone to clearly lay out a schedule. Be sure to give yourself at least 10 minutes between appointments/activities to gather yourself and transition.

Bringing more mindfulness to our relationship with time is a powerful way to reduce our overall stress level and increase a sense of presence and wellbeing in our daily lives.

Dr. Angela Williams is a licensed clinical psychologist, specializing in cognitive-behavioral and humanistic/existential approaches to therapy. She has extensive training in Brief Crisis Intervention as well as mindfulness based therapeutic approaches. Her therapeutic style blends strength-based acceptance with practical skill development. Incorporating mindfulness-based interventions, she helps her clients move through difficult experiences and be more present in their lives.

Mindfulness and Cancer 3: Making Peace with your Body

Patients often feel betrayed by their bodies after a cancer diagnosis. Because it is your own cells that make up the cancer it can leave you feeling as though you are fighting with yourself. Add to the fact that cancer treatments often take a significant toll on the body that can have ripple effects for many years to come, it is not surprising that many of the patients that I treat share with me that they struggle with body image.  These challenges with self-image are not just due to the physical changes that have taken place but also because they view themselves in a different way.

Many of my patients have expressed that their relationship with their body has changed. For some, their favorite feature has been distorted or overshadowed by scars or other physical changes resulting from surgery or radiation. For others, it is a sense of mistrust in their own human condition that has left them feeling shaken and unsure. Whether you are able to clearly explain what has changed or if you simply feel your relationship with your body has changed, mindfulness can help bring you to a greater sense of peace and wholeness.

How to Begin to Use Mindfulness to Change the Relationship

The goal of mindfulness is to learn to pay attention in a different way, which can allow you to begin to appreciate that while things have gone wrong in how your body makes cells, many things have also gone right. Mindfulness is a gateway to the mindset that allows for this new appreciation of your body that does so many amazing things just to keep you upright and walking around each day. From pumping blood to sending complex signals from the brain to tell you to move, the body is a dynamic and amazing thing if you can take the time to appreciate it in that way. If you can make time to try these different exercises, you can find that over time you can change your experience of your body to both understand and acknowledge what has changed and appreciate and value all that your body has done and can continue to do. 

Here are some exercises to try:

The body scan is a traditional way to learn to become aware of the experiences of the body in a mindful way and is a great place to start. I have included two different versions of this exercise as a way to begin.

Body Scan Meditation from UCSD

Body Scan from InsightLA

Another great exercise to try is one that I have mentioned in other posts because it helps with both difficult emotions and bodily sensations.

Mindfulness Meditation for Working with Difficulties

This is a great exercise by Tara Brach that is focused on finding a home and happiness in your own experience moment to moment.

Being Home (Dedicated to Maya Angelou)

Practicing mindfulness regularly can help in the process of reexamining and reworking your relationship with your body. It will not happen in one sitting but will develop over time. So, have patience with yourself. If you find that you are having challenges related to body image or your sense of self related to your cancer experience that are interfering with your day-to-day functioning then working with a therapist may help you to address those difficulties in a safe and nurturing environment.

Additional Resources

UCLA Mindful Awareness Research Center

InsightLA – Mindfulness Exercises and Talks

Guided Meditation CDs by Jon Kabat-Zinn
Guided Mindfulness Meditation Series 1
Guided Mindfulness Meditation Series 2
Guided Mindfulness Meditation Series 3

I sincerely hope that you have found this post helpful. Please look for more upcoming blogs in this series on mindfulness and cancer both on our website and on our Facebook page at www.facebook.com/rowancenterla.

Dr. Stephanie Davidson is a licensed, clinical health psychologist and co-founder of the Rowan Center for Behavioral Medicine specializing in the use of cognitive-behavioral, humanistic and existential approaches to treat patients with a range of medical and mental health challenges. She has a strong interest in acceptance and commitment therapy and other mindfulness-based interventions to heal the body and mind. Her focus is on collaboration with the goal of assisting patients in adjusting to difficult experiences and achieving a greater sense of well-being, balance and peace in their lives.

Mindfulness and Cancer 2: Working with Scanxiety

Scanxiety (scan anxiety) – the peek in anxiety that happens as patients with cancer prepare for a scan such as an MRI, PET. bone scan or CAT etc.

Often the anxiety begins to build in the week(s) before the next scan. It can lead to difficulty concentrating, problems with sleep, fatigue, and a general sense of being on edge. While fear and worry associated with an upcoming scan is normal, it important to manage these feelings so that they do not interfere with your day-to-day life.

Some patients experience symptoms of post-traumatic stress as a result of previous traumas or particularly difficult courses of treatment. For these patients, the fear associated with scans interferes with daily life and leads to sleeplessness, nightmares, changes in mood and avoidance including repeated rescheduling or missing tests.

Mindfulness to Deal with Difficult Thoughts and Emotions

As you prepare for an impending scan, you may find that you experience an increase in feelings of anxiety and thoughts about possible poor outcomes. By observing how your emotions are experienced in the mind and body you can begin to use your mind in a new way to manage those feelings more effectively. Here are two helpful mindfulness meditation exercises that can be used when working with difficult emotions such as anxiety about an impending scan:

http://marc.ucla.edu/mpeg/04_Meditation_for_Working_with_Difficulties.mp3

http://mindfulwaythroughanxietybook.com/wp-content/uploads/mp3/Emotions_and_pSensations.mp3

Another exercise that can be helpful in addressing anxiety is to simply observe your thoughts and emotions as they come. Rather than allowing anxiety-filled thoughts to take over your thinking in the days before a scan, you can use mindfulness exercises to disengage from these thoughts. Here is a helpful exercise for observing your thoughts and feelings:

http://mindfulwaythroughanxietybook.com/wp-content/uploads/mp3/Clouds_and_Sky.mp3

While the days and weeks leading up to scans are often anxiety provoking, having tools to help you manage those emotions can make a big difference in whether you are able to keep your appointment and how emotionally prepared you feel for the day. You may also find it useful to practice some of the breathing exercises found below to help during your test. If you find that you are continuing to have difficulty managing your anxiety post-treatment, it may be helpful to seek out the help of a therapist who can work with you on additional techniques to address your worries.

Additional Resources

For additional mindfulness exercises visit:

The Mindful Way Through Anxiety

http://mindfulwaythroughanxietybook.com/exercises/

UCLA Mindful Awareness Research Center

http://marc.ucla.edu/body.cfm?id=22

I sincerely hope that you have found this post helpful. Please look for more upcoming blogs in this series on mindfulness and cancer both on our website and on our Facebook page at www.facebook.com/rowancenterla.

Dr. Stephanie Davidson is a licensed, clinical health psychologist and co-founder of the Rowan Center for Behavioral Medicine specializing in the use of cognitive-behavioral, humanistic and existential approaches to treat patients with a range of medical and mental health challenges. She has a strong interest in acceptance and commitment therapy and other mindfulness-based interventions to heal the body and mind. Her focus is on collaboration with the goal of assisting patients in adjusting to difficult experiences and achieving a greater sense of well-being, balance and peace in their lives.

Mindfulness and Cancer 1: The Value of Mindfulness for Cancer Patients

In my practice, I often bring up concepts from mindfulness practice in sessions with cancer patients. The question for some is why? What is the reason that mindfulness courses are found in so many cancer centers? The simple answer is that mindfulness practice helps patients with cancer cope more effectively.

In fact, mindfulness has been found to:

  • reduce psychological symptoms including anxiety, stress and mood symptoms (Ledesma & Kumano, 2009; Shennan, Payne & Fenlon, 2011)

  • reduce cancer-related fatigue and sleep disturbances (Ledesma & Kumano, 2009).

  • decrease reactivity to and increase tolerance of strong emotions (Bonadonna, 2000; Ledesma & Kumano, 2009).

  • improve immune function (Shennan, Payne & Fenlon, 2011)

  • decrease cytokine production, which is an inflammatory chemical released in the body that is associated with stress (Shennan, Payne & Fenlon, 2011)

  • improve sexual functioning (Shennan, Payne & Fenlon, 2011)

  • help the partners of cancer patients who are coping with their own stress (Birnie, Garland & Carlson, 2010)

  • improve the quality of life for cancer patients who have reported that they (Bonadonna, 2000; Ledesma & Kumano, 2009; Young, 2002):

    • have a greater appreciation for the meaningfulness of life

    • are more open to new experiences

    • feel a decrease in their vulnerability to stress

    • are better able to accept and deal with negative aspects of themselves and others

So, how do you create these changes through mindfulness? Well, it starts by doing activities that allow you to be more aware of what is happening from moment to moment.  Mindfulness can be practiced in formal ways through meditation and yoga exercises. These activities require that you set aside time each day to practice being present in the moment. The links below provides an introduction to mindful breathing as well as other formal practices. Informal practices are those that you incorporate into your daily activities in order to cultivate mindfulness. The links below will take you to previous posts written by our center on two informal practices that you can use daily.

Formal Practices

Click the audio recording below to listen to a short exercise that can help you to take notice of your breathing.

Mindful Breathing

You will find additional exercises if you click the link below:

More Formal Practices

Informal Practices

STOP is a technique that you can use at anytime to take a moment to be more mindful. Click the link below to view a blog that I have written about how to use this technique.

STOP 

Driving is a great daily activity that can be used to cultivate mindfulness. Click here for a blog written by my colleague, Dr. Angela Williams, about this new approach to commuting.

Mindful Driving

I sincerely hope that you have found this post helpful. Please look for more upcoming blogs in this series on mindfulness and cancer both on our website at www.rowancenterla.com and on our Facebook page at www.facebook.com/rowancenterla.

Dr. Stephanie Davidson is a licensed, clinical health psychologist and co-founder of the Rowan Center for Behavioral Medicine specializing in the use of cognitive-behavioral, humanistic and existential approaches to treat patients with a range of medical and mental health challenges. She has a strong interest in acceptance and commitment therapy and other mindfulness-based interventions to heal the body and mind. Her focus is on collaboration with the goal of assisting patients in adjusting to difficult experiences and achieving a greater sense of well-being, balance and peace in their lives.


REFERENCES

Birnie, K., Garland, S. N. & Carlson, L.E. (2010). Psychological benefits for cancer patients and their partners participating in mindfulness-based stress reduction (MBSR). Psycho-Oncology, 19, 1004-1009.

Bonadona, R. Experiencing impermanence: toward a theory of living mindfully with cancer (dissertation). Nursing, Medical University of South Carolina, Charleston, SC, 2000.

Carlson, L. E. & Speca, M. (2010). Mindfulness-based cancer recovery: A step-by-step MBSR approach to help you cope with treatment & reclaim your life. Oakland, CA: New Harbinger Publications, Inc.

Kabat-Zinn, J. (2013). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. [Bantam Books eBook Edition]. Retrieved from Amazon.com

Ledesma, D. & Kumano, H. (2009). Mindfulness-based stress reduction and cancer: a meta-analysis. Psycho-Oncology, 18, 571-579.

Shenna, C., Payne, S. & Fenlon, D. (2011). What is the evidence for mindfulness-based interventions in cancer care? A review. Psycho-Oncology, 20, 681-697.

Young, R. The experience of cancer patients practicing mindfulness meditation. Saybrook Institute, US. Disseration Abstracts International: Section B: The Sciences and Engineering 2002; 63(5-B): 2603.

Mindful Driving…A New Way to Commute

Living in this bustling metropolis that is Los Angeles offers us some unique opportunities to experiment with daily mindfulness. Traffic – it’s always there and provides endless occasions to look at the way our approach to a stressor effects our experience of it. Any driver confronting the 405 at rush hour is likely familiar with the torrent of negative thoughts and feelings that emerge. Because many of us spend so much time traveling to and from work in traffic-filled commutes, it is very powerful to make the best use of this time. By incorporating some daily mindfulness during our commutes, we can make a profound impact on how the rest of our day goes, which has ramifications that echo through our lives.

Mindfulness is distinguished from “auto-pilot” when we carry out actions without even being aware that we are doing them. Driving is an often-sited example of “auto-pilot” as we tend to tune out the drive, finding ourselves at our destination with little recall of how we got there. Mindfulness, on the other hand, involves paying attention, on purpose, non-judgmentally (Jon Kabat-Zinn, 2006).

Traffic can serve as a crucible to sharpen our present moment awareness. The experience of driving in rush hour is very evocative and typically elicits fairly predictable responses. These include feelings of irritation, frustration, tension and anger and negative thoughts about other drivers and perhaps yourself. We reach these highly aroused states with little awareness about how we got there. By bringing mindful attention to traffic, we can open up a space to make a choice about how we react.

Below are some ways to incorporate mindfulness into your car-time. Experiment with these and notice how they impact your experience of driving and other parts of your day.

1.     Just before turning on your car, take five deep breaths. You can also do this just prior to exiting your vehicle when you’ve reached your destination.

2.     Experiment with skipping the radio or music and allow your other senses to be fully engaged. This means noticing the sights and colors around you, observing the sounds of the cars, or even taking in the smell of the freeway.

3.     Take note of the bodily sensations you are experiencing. Notice the quality of your breath, the grip of your hands on the steering wheel, any tension in your arms and shoulders. If you become aware of tension gently breath into the tense area and allow it to release with the out breath.

4.     Try to expand your awareness. We tend to become myopically focused on what is just in front of us and ignore the entire vista. Try to carefully become aware of the cars and people around you and the nature or scenery in the background.

5.     Take time to notice your attitudes and inner dialogue towards other drivers. You may be competitive or impatient, inwardly ridiculing or berating other drivers.

6.     Smile inwardly and cultivate a friendliness towards your fellow humans on the road. A mantra taken from Buddhist metta meditation that may be helpful is, “May you be well, may you be happy.”

7.     Use stoplights as opportunities to connect more deeply with the present moment, fully becoming aware of what is happening in our bodies and minds.

8.     Try driving in the slow lane, consciously keeping your speed to slightly below the speed limit. 

The reality of living in LA means that we are more than likely to be spending a good deal of time in our cars. We often find traffic inexplicable and overwhelmingly beyond our control. However, using drive time to cultivate mindfulness will greatly reduce stress and improve overall wellbeing. You might find yourself surprised at how much control you do have in the experience of driving.

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Dr. Angela Williams is a licensed clinical psychologist, specializing in cognitive-behavioral and humanistic/existential approaches to therapy. She has extensive training in Brief Crisis Intervention as well as mindfulness based therapeutic approaches. Her therapeutic style blends strength-based acceptance with practical skill development. Incorporating mindfulness-based interventions, she helps her clients move through difficult experiences and be more present in their lives. 

Shots, Shots, Shots! Coping with Injections During Infertility Treatment

One of the most anxiety provoking aspects of infertility treatment is the self-administration of medications. Many people quake at the site of a needle and the prospect of self-injections may seem overwhelming. Prior to beginning any infertility regimen, you are likely to receive instructions from the nursing staff at your fertility clinic. They will give you tips to minimize the pain and discomfort of injections. Despite this, you are now facing the needle(s) in front of you and are terrified. Below are some tips to help minimize the stress and anxiety associated with self-administering shots.

Prior to your first injection, it is important to organize your medications, supplies and instructions. This can help reduce anxiety by minimizing the preparation prior to your shots. It is helpful to complete your injections at the same time each day. Both partners can set an alarm for the chosen time in order to join together for the injection.

One of the most helpful techniques to reduce anxiety is to enlist the support of others. I recommend that couples create an “injection ritual.” By including your partner in the procedures you reduce your own stress and create an opportunity for bonding throughout the process. This is particularly important as it is usually the woman who bears most of the burden of infertility treatment and partners often report feeling marginalized in the process.

To begin creating an injection ritual, set aside a space in your home in which to administer your medications. Some couples find it helpful to decorate this space with candles, incense or even baby-related items. The space should be could be calming and soothing and relatively free from distractions.

Collaborate with your partner about elements to include in your injection ritual. Many couples find it meaningful to incorporate elements from their religious or spiritual traditions. To begin the ritual, take some time to connect with your partner. Check in with each other about your day and any thoughts or feelings that are coming up about infertility. Practice active listening, giving space for each partner to express individual thoughts and feelings. This provides an opportunity for couples to support one another and strengthen their bond.

Following the check-in, practice a brief relaxation, visualization or meditation exercise. Research has demonstrated the effectiveness of all of these methods in reducing anxiety, but experiment and find what works for you. The three-minute breathing space is relatively brief and effective. Please see the link below that provides access to several free guided meditations. Complete this portion of the ritual by setting an intention for your baby and family.

Now that you are hopefully feeling relaxed and connected to your partner, it is time to administer the medications. Decide who will be administering the shots. Some prefer to self-administer the shots while other prefer their partners to do it. There is no right answer and it may take some time to find the best methods for you. A practical suggestion for minimizing discomfort is using ice to numb the area prior to the injection. Warming the medication prior to injections is sometimes helpful. When injecting into a large muscle, massage following the injection is often relieving. Please consult your medical team prior to trying any injection variations.

The most important aspect of working together to create an injection ritual is to communicate with one another about what works and what doesn’t. By creating an injection ritual you are carving out space to discover together how to support one another through this journey towards parenthood.

Click the link below to access free mindfulness exercises:

http://marc.ucla.edu/body.cfm?id=22

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Dr. Angela Williams is a licensed clinical psychologist, specializing in cognitive-behavioral and humanistic/existential approaches to therapy. She has extensive training in Brief Crisis Intervention as well as mindfulness based therapeutic approaches. Her therapeutic style blends strength-based acceptance with practical skill development. Incorporating mindfulness-based interventions, she helps her clients move through difficult experiences and be more present in their lives.

A Simple Way to STOP and be Mindful

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There is a lot of talk about mindfulness these days. According to Jon Kabat-Zinn (1994), the founder of the Stress Reduction and Relaxation Program at the University of Massachusetts Medical Center, “Mindfulness is the act of paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.” Mindfulness is an active process for learning how to manage stress and reaching a greater level of health and well-being (Kabat-Zinn, 2005). 

For many who have become intrigued by the idea of mindfulness the question becomes how to start being more mindful. One of the ways to do this is to begin to incorporate what are referred to as informal practices of mindfulness throughout the day. Informal mindfulness practices are those that are done as we pass through our day and are a way to begin to pay attention moment by moment.

STOP is an exercise that allows you to take a pause and to observe your experience and then proceed in way that is congruent with how you want to spend your time or that is going to be beneficial for you. The exercise challenges you to become more aware of yourself and your thoughts rather than simply drifting through your day without awareness. Taking a moment to stop and reflect allows for the opportunity to respond more effectively (Stahl & Goldstein, 2010)

An important concept in mindfulness is that of beginner’s mind, which essentially asks that you approach each situation as if for the first time. This approach allows us to be free of expectation based on our previous experiences (Kabat-Zinn, 2005). If you can approach this exercise with childlike curiosity, you are likely to learn some new things about how you approach the world including how your thoughts may be influencing your feelings and behaviors in ways that you may want to change. As you practice more often, you are likely to find that you have some room to catch yourself at moments where you are feeling overwhelmed, angry or upset and change direction.

Here are the steps (adapted from Stahl & Goldstein, 2010):

S – STOP. Take a moment to stay still and just be. Taking time is the first step in being more mindful.

T – Take a breath. Breathing is an essential part of being alive so take a moment to just breathe. You do not have to breathe in any special way. Instead, you can simply pay attention to how you breathe naturally. Focus on how your breath comes in and out by noticing the feeling of your breath in your nostrils as you inhale and exhale or how your chest expands and contracts as you breathe. For those who may find watching the breath difficult – simply take a few deep breaths.

O – Observe your thoughts and feelings. An important aspect of mindfulness is getting the option to break out of old habits. Taking the time to observe gives you the opportunity to choose new ways to react.

One important aspect in the definition of mindfulness is the goal of approaching the exercise with a nonjudgmental awareness. It is important to note that the judgmental thoughts will come, but the exercise asks that you take time to notice and question whether the judgments are facts or just simply your mind’s biased commentary (McQuaid & Carmona, 2004). When a non-judgmental stance is combined with taking the time to observe a powerful opportunity is created for finding peace by quieting the critical messages that the mind often sends (Kabat-Zinn, 2005).

P – Proceed. This step is about moving forward with a new awareness. It is not about simply moving on with your day but instead is about taking what you have observed and using that to inform how you choose to act and react after the exercise is over.

Using the STOP technique is a first step into exploring what mindfulness has to offer. It can be used at any time but is particularly helpful in moments of difficulty when you can benefit from taking a moment to gather yourself and move forward with clear intention.

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Dr. Stephanie Davidson is a licensed, clinical health psychologist and co-founder of the Rowan Center for Behavioral Medicine specializing in the use of cognitive-behavioral, humanistic and existential approaches to treat patients with a range of medical and mental health challenges. She has a strong interest in acceptance and commitment therapy and other mindfulness-based interventions to heal the body and mind. Her focus is on collaboration with the goal of assisting patients in adjusting to difficult experiences and achieving a greater sense of well-being, balance and peace in their lives.

REFERENCES

Kabat-Zinn, J. (2005). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness: Fifteenth anniversary edition. New York: Bantam Dell.

Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion Books.

McQuaid, J. R. & Carmona, P. E. (2004). Peaceful mind: using mindfulness & cognitive behavioral psychology to overcome depression. Oakland, CA: New Harbinger Publications, Inc.

Stahl, B. & Goldstein, E. (2010). A mindfulness-based stress reduction workbook. Oakland, CA: New Harbinger Publications, Inc.

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