Friday, 31 May 2013

#332 Who Treats Suffering?

     "Eric Cassel has written movingly of the way in which medicine’s failure to pay appropriate attention to the non-physical aspects of treatment can lead to suffering. Suffering is what a person, rather than a bare biological organism, experiences. It is an existential concept, resulting from consideration of the patient’s life, which is an attribute of them as a person, not just of their body. It occurs when the impending destruction of the person is perceived. ‘Most generally, suffering can be defined as the state of severe distress associated with events that threaten the intactness of the person.’"          Wilson B. Metaphysics and medical education: taking holism seriously. J Eval Clin Pract 2013; 19(3): 478-84.

      If the above makes you cringe, you're not alone. The thought of one's own and one's loved ones' death is the most difficult thing to contemplate, for everyone, including doctors. What we fear, we tend to avoid. But one cannot avoid reality, after all we're all in it. And, pushing things out of our consciousness just drives them into our subconscious, where it festers and plays havoc with our lives, surfacing in varied unexpected but invariably unpleasant ways like symptoms that mimic physical disease, headaches, anxiety, sleep disturbance, angry outbursts etc etc.
     Avoidance doesn't work. The Mindful approach is intentionally embracing reality as it is. It's much easier and infinitely more effective than avoidance.
     Who treats suffering? We all self-manage our own. Mindfulness practices alone are powerful. Some people require additional help from mental health professionals, counselors etc.

Samish Island, WA

Thursday, 30 May 2013

#331 Thoughts, Energies, Actions - Choices, Choices, Choices

     A sponge is porous, all of the stuff in the water passes through a sponge immersed in the water. Likewise, each of us is immersed in the thoughts and energies of our current global culture. It ALL passes through each of us, whether we realize it or not, want it or not. Humans are completely interconnected at ALL LEVELS (thoughts, emotions, energies, communications, financially, ecologically etc).
     A massive problem is the fact that our human family is so diverse in terms of psychosocialspiritual development - from stone-age blood feuds to the Dalai Lama's message AND embodiment of forgiveness of current persecutors. We are in the age of BOTH the basest of child-soldier massacres AND Nelson Mandela's soaring example of what a human being can and MUST evolve to. 
     ALL levels of thoughts and energies pass through each of us - hideous & inspired - WE CHOOSE which ones to cultivate, which ones to enact in our lives, in this our one and only world. WE ALONE CREATE OUR REALITY, moment-by-moment. We must take great care about what we choose to occupy our minds, and what activities to feed with energy.

     “Wisdom traditions, the paths followed by our patients and our own experiences suggest that a sense of integrity comes through establishing healing connections. That’s not quite it. It wasn’t that the wave needed to establish connections. It was connected — part of a greater whole. Its challenge was to recognize the connectedness that was already there.”     Mount BM. The existential moment. Palliat Support Care 2003; 1(1): 93-6.

     Movement on the quality of life “continuum toward an experience of integrity and wholeness may be thought of as healing, and toward suffering and anguish as wounding.”
     Mount BM et al. Healing connections: on moving from suffering to a sense of well-being. J Pain Symptom Manage 2007; 33(4): 372-88. 

     “The key to self-development … is the experience of … a state of relaxed concentration in which the individual neither freezes out of fear nor clings due to desire. … the free flow of vital energy within the body and between the body and the universe.”
     Sayama MK. “Samadhi. Self-development in Zen, swordsmanship, and psychotherapy.” State University of New York Press. 1986.

Dale Chihuly

Wednesday, 29 May 2013

#330 Mindfulness Practices - Simple but Not Easy

     "taking time out to sit in silence and bring attention to something like the breath, there is an opportunity for a degree of relaxation, or ‘slowing down’. Secondly there is a perhaps more counter-intuitive opportunity to simply notice - as non-judgementally and non-analytically as possible - the experiential flow of thoughts, feelings and sensations. In other words, there is an attempt to cultivate awareness of one’s moment-by-moment experience ... a ‘post-modern’ meta skill.
     Straight away in this two-fold description, one may appreciate why it could be said that mindfulness is ‘simple, but not easy’. The process of sitting and bringing some light attention to the process of breathing (or in other mindfulness practices it may be for example the process of walking, or eating), is not technically complicated and may feel a welcome relaxation. Alternatively, being invited simply to notice one’s experience, can feel tremendously challenging. One can come up closer to previously less noticed streams of negative, painful, or fearful thought, or at the very least one can feel unsettled by noticing for perhaps the first time, how ‘all over the place’ our experience can be, veering in the space of a few moments, from wild fantasy, to profound sleepiness, for example. It is not something we may ever have done before, in such a direct way, and it can feel anything but relaxing at times. Thus, mindfulness could be said to be a more radical practice, of learning to be with both positive and painful experiential states, in the present, without loading this with strong expectations, of an outcome."
       Moss D, Waugh M, Barnes R. A tool for life? Mindfulness as self-help or safe uncertainty. Int J Qual Stud Health Well-being 2008; 3(3): 132-142.
Studio 21 Art Gallery, Halifax, NS

Tuesday, 28 May 2013

#329 Judgmental : Grateful Ratio - Impacts your Quality of Life

     It's good to learn to be aware of when we're being judgmental - harshly critical of ourselves, first & foremost. Why? Because when we're hard on ourselves, we're almost certainly hard on others as well. And we may not be aware at all of our self-criticism, and it may be "business as usual" when it comes to criticizing others. How often are YOU harshly judgmental of others?
     It's also a good idea to become aware of when our hearts are open, and aware of the fact that we owe a massive debt of gratitude to so many people for being alive, for all that we have, etc. None of us can cause ourselves to be born, to grow up, to survive. This is a thoroughly interconnected incredibly complex web of life - we depend on each other far more than we can possibly realize. Gratitude should be common, normal, dominant emotion for all of us. How often are YOU overwhelmed by loving gratitude?
     What's the ratio of times when you're judgmental vs when you're grateful? Which is more realistic ie more appropriate to or in tune with reality? Which of the two is going to make you deeply satisfied, filled with joy? Think deeply about this. You have far more control over your quality of life than you realize!

Fredrik Lonnkvist

Monday, 27 May 2013

#328 Enhancing Quality of Care, Quality of Caring & Resilience - Workshops for Clinicians & Educators

Mindful Practice: Enhancing Quality of Care, Quality of Caring & Resilience

Two separate 4-day workshops designed to improve the quality of care that clinicians provide while improving their own resilience and well-being. These retreat-like workshops offer an experiential learning environment, with a focus on developing the capacity for mindful practice – attentiveness, situational awareness, self-awareness, teamwork and self-monitoring in stressful and demanding situations. Session themes include communication with patients/families, difficult decisions, errors, professionalism, medical education, self-care and burnout.

Designed for medical practitioners (physicians, NPs, PAs) and others involved in medical practice and education.

Session I is designed for those who have not previously attended a mindful practice workshop.
Session II will offer advanced mindful communication skills, hands-on experience in facilitation, and attention to promoting mindful practice activities at participants’ home institutions.

Course directors: Ronald Epstein MD and Mick Krasner MD

Location/Accommodations: Chapin Mill Retreat Center, Batavia, NY

Information & Registration: Please call 585-275-4392 or visit the session sites below:
Session 1: October 9-12, 2013 -
Session 2: May 7-10, 2014 -

Dale Chihuly

Saturday, 25 May 2013

#327 Ideas about Happiness vs the Real Thing

     We all hold ideas about what it takes to make us happy. These concepts are cultural, familial, as well as those that are unique to us as individuals. We are constantly comparing current reality with this potent ball of 'must haves' - the closer the match, the greater our happiness ... and vice versa.
     To the extent that these requirements for happiness are unexamined, unconscious, and thus NOT of our own choosing, they have a stranglehold on our life.
     My late aunt repeatedly said that as long as her only daughter remained with her partner (whom my aunt disliked), my aunt could never be happy. This type of vow is common and effective. My aunt died unhappy.
     This is tragic AND completely unnecessary. We need to become consciously aware of all the barriers *** we ourselves erect to keep us from embracing life fully. We need to become consciously aware of all the hounds that chase us, as if we were rabbits - and - all the rabbits that we chase, as if we were hounds. Most of us, most of the time, without any apparent choice in the matter, are in fact flipping between hound and rabbit roles. This is both exhausting and miserable.
     Fortunately, we know the PHYSICAL FEELING of chasing, and also of being chased. When we become aware of this common form of being OUT OF CONTROL, of "being driven" instead of doing what we want to do, we can pause, center ourselves with the feel of our breath in our belly, bring ourselves into the present moment, and choose to do what is appropriate to the present circumstances. FRESHLY EMBRACE THIS VERY MOMENT. This is the definition of sanity by any standards.

***      "Growth fundamentally means an enlarging and expanding of one's horizons, a growth of one's boundaries, outwardly in perspective and inwardly in depth. ... Growth is reapportionment; re-zoning; re-mapping; an acknowledgment, and then enrichment, of ever deeper and more encompassing levels of one's own self."

        Wilber K. "No boundary. Eastern and Western approaches to personal growth." Shambhala, Boston, 1979.

Wong Heng Meng

Monday, 20 May 2013

#326 Classical Japanese Centeredness & Mindfulness

      Profound awareness of, being fully at home and thoroughly grounded in one's own body, anywhere, under any circumstance, is relatively rare these days, perhaps even in the East. Nevertheless, this mind-body-universe integrity is an important quality to regain, and mindfulness practice is an excellent way to do so.

     “Japanese women … their way of sitting still – knees together, resting on their heels, withdrawn into themselves and yet completely free and relaxed. If with a swift and supple motion they rise from this position to do something such as pouring out the rice wine, they return immediately and without loss of poise to the quiet sitting posture, upright and attentive, completely there, yet not there at all, and just wait until the next thing has to be done. … but so also sits the ballad singer, and the singing geisha, and so sits the male choir in the Kabuki, the classical theater, and so the Samurai – so they all sit and stand like symbols of life, collected and ready for anything. And as they sit and stand, so also do they walk and dance and wrestle and fence, fundamentally motionless. For every movement is as though anchored in an immovable center from which all motion flows and from which it receives its force, direction and measure. The immovable center lies in Hara.”

       Durckheim KG. “Hara – The vital center of man.” Inner Traditions, Rochester VT, 1975 (originally published 1956). 

     For more on Hara see:

Tai Chi on Samish Island, WA

Sunday, 19 May 2013

#325 Why Comfort, Pleasure and Happiness are Elusive

     We're becoming increasingly anxious to secure our own personal pleasure, comfort and security from external sources. And, it's not working!
     Wisdom traditions have consistently shown that self-centeredness causes only suffering, and that happiness is an inward journey. Western psychology and philosophy support these ageless truths.

     See also:

Bill & Melinda Gates Foundation, Seattle WA

Saturday, 18 May 2013

#324 Physical and Emotional Presence

     We underestimate the impact of stable awareness of our current physical sensations. To stabilize awareness, we need to be relaxed and receptive - embracing what is.
     What if embracing, unconditionally, all that the present moment holds, in itself brings ease and joy?
     It can take years to realize this for oneself, but persistence pays.
EMP Building by Frank O. Gehry, Seattle WA

Wednesday, 1 May 2013

#323 Promoting Positive Health: Autonomy, Resilience, & Independence

     "The emerging discipline of positive health, which has developed from the field of positive psychology, proposes that a focus on wellness, rather than illness, leads to decreased health costs, improved mental and physical health in ageing, better prognosis when illness strikes, and longevity. This ‘asset-based paradigm’ provides an alternative perspective for strengthening psychological resilience." 
       Wand T. Positioning mental health nursing practice within a positive health paradigm. International Journal of Mental Health Nursing. 2013; 22: 116–124.

     It's essential to concentrate at least some of our efforts on thriving, flourishing, and finding true contentment & joy in life. Clearly, there's far more right than wrong with human beings (otherwise, we'd be extinct).
     Intelligent, non-pathologizing approaches that effectively encourage human flourishing include:

• Mindfulness-based interventions eg MBSR, MBCT etc
• Solution-focused therapy (SFT)
• Internal family systems (IFS)
• Appreciative inquiry (AI)
• Non-violent communication (NVC)

     These evolved approaches benefit clinicians and patients! It's a welcome, hope-inspiring relief to be skillfully bringing out the best in people (vs "waging wars" on diseases).

    See also: