the integration of compassion-based theory with ......–paul gilbert: “ deep awareness of the...
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The Integration of Compassion-Based Theory with Biofeedback Treatment
Urszula Klich, Ph.D.
Shepherd Pain Institute
Atlanta, Georgia
(678) 310-8228
(Urszula Klich, 2014)
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Overview
Introduction Experience with complex medical problems
Unique considerations
Compassion and Meditation Protocols Meditation, and compassion protocols
How does biofeedback fit in
Teaching Breath for Life Case study
Compassion fatigue
Personal Practice
Global Compassion Movement The What, Why, and How
Charter for compassion
(Urszula Klich, 2014)
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Bringing Compassion into Biofeedback Treatment
Biofeedback practitioners are in a prime position to bridge the gap of technology and wellbeing
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What is Compassion?
• Definitions– Latin: “suffer with”– Merriam Webster: “sympathetic consciousness of others’ distress together
with a desire to alleviate it”– Paul Gilbert: “ Deep awareness of the suffering of oneself and other living
beings, coupled with the wish and effort to alleviate it” – Kristen Neff: Common humanity, kindness, and mindfulness
• Components– The common experience and interdependence– Historically strong associations with doing something to help
(Urszula Klich, 2014)
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Why Compassion?
• Technology, consumerism, has radically changed how we live our lives, relate to others, and understand ourselves. It has become, not only de-centering, but rather dehumanizing.
• This generation: self centered or self preserving?
The bottom line:
People are starving for effective ways to live more consciously
(Urszula Klich, 2014)
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Biofeedback, Mindfulness & Compassion: The Overlap
Biofeedback Entrain successive changes in performance Goal is to train self-awareness & skill
Mindfulness-Based Meditation Awareness Non-Judgement Acceptance
Compassion Use of awareness of self and other, interconnected and empathy
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Mindfulness-Based Meditation
Growing scientific research
Reduction in negative mood states
Reduction in perceived pain
Increased immune response
Activation of left prefrontal cortex
Reduced thickening of amygdala
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Compassion as a variable?
• Self-compassion has been found to be a major factor in the therapeutic benefit of mindfulness-based techniques
• Compassion mitigated stress reduction for health care professionals taking MBSR (Shapiro et al., 2005)
• Increased self-compassion reduced the correlation between cognitive reactivity and depression (Kuyken et al., 2010)
(Urszula Klich, 2014)
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Meditation and Compassion Protocols
• Mindfulness Based:
– MBSR (Jon Kabat-Zinn, 1991)
– MBCT (Zindel Segal, Mark Williams, John Teasdale, 2002)
• Compassion Based:
– CBCT (Geshe Lobsang Tenzin)
– CFT (Paul Gilbert, 2010)
– MSC-(Kristin Neff and Chris Germer, 2012)
– Loving-Kindness (Sharon Salzberg, 1995)
(Urszula Klich, 2014)
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CBCT Research
Lutz, Brefczynski foundCompassion meditation increases concern for others and enhances processing of emotion and response to distress (sounds of distress of others)The state of loving-kindness and compassion is described as an “unconditional readiness and availability to help living beings.”
Davidson et al. (2003) found left-sided anterior activation associated with happiness and increased antibody titers to a flu vaccine, translating into a stronger immune system response to vaccine.
Larose et al. (2010) found reduced perceived stress and burnout, nonsig trend in improvement in absenteeism and turnover , in a Heartmath transforming stress curriculum, 6hr training (4hr & 2hr f/u). N=83 (69%completed both training.)
Kupferschmidt, K. (2013). Tania Singer studies compassion and empathy, concentrating on kindness. Empathy does not imply we have the same emotions as others.
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CBCT ongoing Research
Current Projects
CBCT in the community- Berkley 3rd round
Medical areas such as dermatology, autism
Children, woman’s center camp
Schools
Woman’s prison
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Metta/Loving Kindness PracticeAbout “relearning loveliness”
The budStands for all things,Even for those things that don’t flower, For everything flowers, from within, of self blessing,Though sometimes it is necessaryto reteach a thing its loveliness,To put a hand on the brow Of the flower,And retell it in words and in touch,It is lovelyUntil it flowers again from within, of self-blessing
-Galway Kinnell
(Urszula Klich, 2014)
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Metta/Loving Kindness Practice
• May I accept my pain, without thinking it makes me bad or wrong.• May I remember my consciousness is much vaster than this body.• May all those who have helped me be safe, be happy, be peaceful.• May all beings everywhere be safe, be happy, be peaceful.• May my love for myself and others flow boundlessly.• May the power of loving-kindness sustain me.• May I open to the unknown, like a bird flying free.• May I be free of danger, may I be peaceful.• May I be peaceful and happy, at ease in body and mind.• May I be free from anger, fear and worry.• May I live and die in ease.• May I accept my anger, fear and sadness, knowing that my vast
heart is not limited by them. (Reprinted with permission, Salzberg, 2008)
(Urszula Klich, 2014)
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Compassion fits with Core Objectives of MBB
• Increase somatosensory awareness of bodily sensations/ feelings/thoughts
• Increase awareness of choice in responding to situations
• Relapse prevention for mood difficulty
• Promote acceptance of change in bodily functioning
• Facilitate integration of all aspects of the physical, cognitive, and emotional being
(Urszula Klich, 2014)
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Bringing Compassion into the Treatment room
• Language– “Isn't it interesting”– Open to loving-kindness statements
• Emphasis – Understanding the journey– Use experiential learning to understand other’s struggles
• Homework– Assessment: Neff Self-Compassion Inventory– Physical and emotional discomfort is accompanied by
thoughts, which in turn often increase the discomfort– Observing gut and reactions to self-talk along with
biofeedback-driven goals will likely lead to more effective treatment outcome
(Urszula Klich, 2014)
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Cultivation of Compassionate Attitude
• Acceptance• Non-judgment• Non-attachment • Beginner's Mind• Letting Go• Patience: compassion for self and others• Observation• Kindness• Noting of common experience• Interdependence
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Compassion Fatigue: Signs Avoidance of activities or people
Self-doubt of ability to help
Secretly wishing clients don’t show up!
Irritability, anxiety, depression, or lassitude
Resenting co-workers or other people
Missing meetings or forgetting ordinary tasks
In short, not attending to those things you claim are your priorities
Decline in relationships, job performance or satisfaction,
Redirecting clients from emotional material to avoid your distress
Conflict about how much to work and when to call it a day
Thoughts of quitting or changing career
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Compassion Fatigue: Contributing Factors Nature of the Work
Case load and type: Stress and pace of environment Perceived level of support by other colleagues or employers Dwindling resources- client’s needs vs system availability
Nature of the Client Clients often project intense negative feelings onto us They can be demanding and never satisfied Litigious Working with stress emotions
Nature of the Helper Work Satisfaction Healthy coping strategies Current life stressors Self and mental health, awareness
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Compassion Fatigue to Compassion Growth
• Assess– Neff (2003) Self-Compassion Inventory
– Monitor fatigue and resilience- “Provider Resilience”
• Address– Self-Care VS Other-care balance
– Engage Self-Compassion Exercises
RELAX, RELATE, RELEASE
(Urszula Klich, 2014)
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Simple Starting Points Incorporate during temperature checks
Quieting reflex
Hourly 3- second diaphragmatic breath break
Compassionate self-talk
Mindfulness of self-judgment in everyday tasks
How would I treat a friend with this issue
How would ____ treat themselves
In a sense get to the “yoga” of self care
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Compassion Growth
Love your enemies video
http://www.youtube.com/watch?v=L0HhHLHLHaA
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Global Compassion Movement-What?
• Karen Armstrong (2008) was awarded the TED Prize for her work which allowed her to carry out her wish for a better world through starting the Charter for Compassion.
• The mission is to foster cultures of compassion locally and globally through diverse initiatives—education, cities, business, religious and spiritual communities, and the arts.
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Global Compassion Movement- Why?
• Why Compassion
– Secular
– The heart of all
spiritual, religious,
and ethical practices
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Can we track/map compassion?
http://charterforcompassion.org
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Charter for Compassion- Status
• Over 100,000 people have signed the charter
• 12 universities signed, 20 in process
• 40 cities have signed the charter for compassion
• 232 cities in 39 countries are actively organizing to become compassionate cities
• Close to 900 partners in several sectors (business, education, environment, healthcare, peace, religion, science, research, and soon to be announced in arts).
• Botswana- The world's first country to sign 12/12/3http://charterforcompassion.org
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Overall Goal
Help Yourself,
Help Patients&
Help Patients Help Themselves
And keep breathing…
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Recommended Reading
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Recommended Websites
http://www.compassion-training.org
http://www.compassionatemind.co.uk
http://www.self-compassion.org
http://www.mindfulselfcompassion.org
http://www.ronaldalexander.com/pdf/books/bookCh3.pdf
https://www.MyMindfulWayOfLife.com
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