Nurturing Wellbeing in COLORADO

Tony BiglanSenior Scientist

Oregon Research Institute

Nurturance in 3 minutes

• NurtureEffect_Final_youTube.mp4

2

Science Has Changed Our World

• A quick trip from Eugene to Denver• In 1850 it took two months to get a letter from

Utah to California• Cholera in London in 1854

3

4

Human Conflict: The Fundamental Process Driving Most Problem

Development• Involved in the development of

aggressive social behavior• Involved in marital discord• Involved in the interactions of

depressed people with those around them.

5

Effect of Maltreatment and Poverty on Health

• Meta-analysis of 24 studies – Adults with a history of maltreatment were 2.77 times

more likely to have stroke or myocardial infarction. • Poverty in childhood leads to adults having

– A 20%–40% Increased risk of all-cause mortality: – Excess risk of 30-60% for CVD across studies – Effects even among those who have increased their

SES as adults; 20-40% range for CVD– Maternal nurturance prevents these effects!

6

HOW AND WHY OUR MINDS GET IN THE WAY

7

Better to miss lunch than to be

lunch8

The physiological stress responseThe physiological stress response

9

10

Threat Rewires the Brain Threat Rewires the Brain for Evolutionary Reasonsfor Evolutionary Reasons

• Genetic, epigenetic, neuroscience, and behavior analysis are converging to show that stressful and threatening environments result in – Impaired self-regulation, – Hyper vigilance– Mistrust of others, – Poor social relationships, – Deviant peer group formation– Early childrearing32

– Depression33

– Obesity – Cardiovascular disease

• This pattern of behavior further increases the chances of stress and further physiological harm. (Miller, Chen, Fok, et al., 2009). 11

“The scientific foundation has been created for the nation to begin to create a society in which young people arrive at adulthood with the skills, interests, assets, and health habits needed to live healthy, happy, and productive lives in caring relationships with others.”

12

13

Nurturing EnvironmentsThe Generic Features

• Minimize toxic social and biological conditions• Teach, promote and richly reinforce diverse forms of

prosocial behavior• Limit influences and opportunities for problem

behavior• Promote psychological flexibility—a mindful approach

to pursuing one’s values– More than 100 randomized trials showing the value of

psychological flexibility for a wide variety of psychological, behavioral, and health problems.

14

Teach, Promote, and Richly Reinforce Prosocial Values and Behavior

• Every day in virtually every interaction with a young person (or an older person), we have an opportunity to recognize, appreciate, and make more likely social behavior that helps others, contributes their self-development, or helps their community.

15

Limit Influences and Opportunities Limit Influences and Opportunities for Problem Behavior for Problem Behavior

• Influences: Tobacco, Alcohol, and Unhealthful Food Marketing

• Opportunities: Deviant Peer Influences

16

PROMOTING PSYCHOLOGICAL FLEXIBILITY

A Mindful Approach To Living A Valued Life That Can Prevent And Ameliorate The Effects Of Trauma

17

Suppose That the Wide Variety of Consequences of Trauma Are All for the Purpose of Avoiding Distressing

Experience?• Drinking• Taking Drugs• Getting Angry• Avoiding “difficult” situations• Staying in bed• Worrying• Self-denigrating• Complaining

18

Experiential AvoidanceAcceptance and Action Questionnaire (AAQ)

1. I am able to take action on a problem even if I am uncertain what is the right thing to do.

3. When I feel depressed or anxious, I am unable to take care of my responsibilities.

6. When I evaluate something negatively, I usually recognize that this is just a reaction, not an objective fact.

8. Anxiety is bad.

19

Experiential Avoidance is associated with

– Higher anxiety– More depression – More overall pathology– Poorer work

performance– Inability to learn– Substance abuse– Lower quality of life– Trichotillomania

– History of sexual abuse– High risk sexual behavior– BPD symptomatology

and depression– Thought suppression– Alexithymia– Anxiety sensitivity– Long term disability– Worry

20

The Traditional Moves

• Think positive thoughts• Control those negative thoughts and feelings• Get your psychological ducks in a row• When you are confident you can move

mountains• Shake it off

21

But

• Learning never subtracts.• Efforts to control unwanted thoughts and

feelings just magnify them.

22

Try this

Don’t think about chocolate cake

23

CULTIVATING PSYCHOLOGICAL FLEXIBILITY

24

OpeOpenn

AwareAware

EngageEngagedd

Def

usi

onCon

tact

with

the

Pres

ent M

omen

t

Self-as-context

ValuesAcceptance

Com

mitted

Action

ACT Made Simple (Harris, 2009)25

Psychological Flexibility

DOING WHAT MATTERS: VALUES, GOALS, AND COMMITTED ACTION

26

What do you want your life to be about?

• Values are chosen life directions. They’re the compass headings you choose to guide the direction you want to travel in life

• Values are not what others want for you. They’re what you want for yourself.

• Values are not something to be right or wrong about. You don’t need to explain or defend them.

• Values are continuous. • They are the answers to the question “In an ideal world how

would you choose to act on an ongoing basis. What do you want to keep on doing (verbs) and how do you want to keep on doing it (adverbs)?

27

What do we want to keep doing?• Playing• Acting• Behaving• Interacting• Working• Being• Performing• Getting along• Helping• Living• Learning

• Giving• Applying• Serving• Relating• Connecting• Caring• Nurturing• Loving• Speaking up• Sharing• Communicating• Embracing• Engaging• Contributing28

29

A Celebration

• If five years from now, there was an event where a group of the people you have worked with had a gathering to celebrate your work, what would you like them to be saying about the qualities of your work with them?

• Notice the thoughts that come up for you.

30

Committed Action

• Argyle socks• Goals• To Do lists

31

Open—Making Room

• Acceptance– Falling into a hole– A tug of war?

• Defusion– “I’m having the thought that…”– Writing them on a piece of paper– Wear a name tag…

• Willingness

32

MINDFULNESS, THE PRESENT MOMENT, AND PERSPECTIVE TAKING

33

Where do you spend most of your time?

Mindfulness

Paying Attention On Purpose

In the Present and

Without Judgment

So what is mindfulness, then?

• Choosing to pay purposeful, curious attention to the present moment

• Noticing with your five senses• Noticing thoughts as “mental weather”• When you get “hooked” by a thought, gently

noticing and bringing yourself back to the present moment

• Making room for all of your sensations, thoughts, and emotions as they are

• Saying “yes” to the present moment

37

The Benefits of Mindfulness

handling pain connectionless worryingless judgmental less reactive

Notice Five Things

• That you see• That you hear• That you feel

38

The Self and Perspectives

• Glimpses of your life• Who is watching?• The Other:

– Someone who troubles you in some way?– What are they

• Seeing?• Thinking?• Feeling?

39

Self-CompassionTake care of ourselves first

Put on our own oxygen mask before we help others

The heart first pumps blood to itself

40

Problems Affected by ACT

• Anxiety• Depression• Smoking • Epilepsy• Drug abuse• Exercise • Weight Loss• Pain

• Hallucinations• Prejudice• Trichotillomania • Obsessive thinking• Stigma• Stress • Innovation

41

NURTURING NURTURING RELATIONSHIPS

It’s Turtles all the way down!

42

Thinking about Our Relationships with Others

• What do you want your relationships with other people to be like?

• What thoughts and feelings come up that pull you away from nurturing those relationships?

• What behaviors do those thoughts and feelings engender?

• What actions can you take in the service of your values?

43

Forbearance and Forgiveness

• When Charles C. Roberts stormed an Amish school house and killed five young schoolgirls before he killed himself, the Amish community expressed its forgiveness by attending his funeral and raising money for Roberts’s widow and three small children. Those three small children must live out their lives knowing that their father committed a horrendous act. They will face difficulties in any case. But which will be better for them: knowing that the families of their father’s victims hate them, or knowing that those families have forgiven their father and care for them?

44

Ghandi• When Mohandas Gandhi vowed to fast

until all violence between Hindus and Muslims ended, a Hindu man came to him and confessed that he had killed a Muslim boy as revenge for the killing of his son. He implored Gandhi to end his fast because he didn’t want to have Gandhi’s death on his soul. Gandhi told him that he could atone for his sin by finding a Muslim child whose parents had been killed in the religious riots and raising that child as a Muslim (Gandhi 1998).

45

The Civil Rights Revolution

• During Martin Luther King’s nonviolent movement to end segregation, civil rights activists subjected themselves to violent attacks. In so doing, they inspired the sympathy and support of enough Americans that segregation ended.

46

In South Africa • Under Nelson Mandela’s leadership, a

Truth and Reconciliation Commission was created to address the many wrongs that had been done during apartheid. The commission invited victims of apartheid to give statements about their experiences. Perpetrators of violence were also invited to give testimony and could request amnesty from both civil and criminal prosecution. The process is generally credited with having prevented a great deal of retaliatory violence.

47

And at home:

• A mother patiently changes the dirty diaper of a crying child.

48

Compassion and Acceptance

• Compassion is a basic human kindness, accompanied by an awareness of the suffering of oneself and other living beings, coupled with a wish and an effort to relieve it. Paul Gilbert

• “Acceptance is not merely tolerance – it is the active non-judgmental embracing of experience in the here and now. Acceptance involves undefended “exposure” to thoughts, feelings and bodily sensations as they are directly experienced to be.” Steven C. Hayes

49

COMPASSION TOWARD OURSELVES AND OTHERS

50

TWO KEY BEHAVIORAL SKILLSThe Glaser Strategies

51

Responding to Criticism• Get More Information

– Active Listening• Nonverbal attention—A posture of curiosity • Paraphrasing—Listening to the message; Reflecting it back;

Discovering the speaker’s intent– Ask for Details—Requesting clarifying information– Guess—When the other person can’t think of a

specific example, you come up with one. • Agreement—Seek it out wherever it exists

– Agree with facts—Be explicit in your agreement– Agree with critic’s perception—acknowledge the

critics perception is reasonable.

Raising Delicate Issues• Ask for the opportunity to discuss your concern.

– Indicate that you have a concern, while making clear that your intention is not to hurt the other person.

– Edit out accusative language and red flag terms• Pinpoint Details

– Describe exactly what the other person said or did, when they said or did it

• Acknowledge your part– Search for and communicate what you may have done that

contributed to the problem• Agree on a solution

– Develop a solution that you both create and both implement