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Anthony Quintiliani, Ph.D, LADC

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January 22, 2021 By Admin

Loss, Grief and Suffering in America

Loss, Grief and Suffering in America

By Anthony R. Quintiliani, Ph.D., LADC

Other than our nation’s suffering during The Civil War, The Great Depression, and World War II this past year has been one of the most stress-filled, fear-filled times in our history. Here is a list of the reasons behind it all: the COVID-19 pandemic, racial injustice, legal reactivity, massive unemployment, loss of housing, quarantines, closed schools and colleges, powerful political demonstrations, and a “president” who betrayed his trust and incited riotous violence against the Capital of the United States. Also a “president” who has been impeached not once but twice by The U.S. House of Representatives. What a year!

Types of Loss, Grief and Suffering

Along with the above, we have witnessed increased anxiety, depression, fear, anger and traumatic stress. Although death (loss of a loved one) is by far one of the most severe stressors, we also suffer from the virus, separation/divorce, developmental stress, incarceration, and the loss of the way of life in pre-COVID-19. Americans are suffering from various bio-psycho-social-spiritual dimensions of stress, loss and grief. Perhaps the correct words to use are “complicated grief.” Our current experiences with loss and grief go far beyond the stage-based versions of E. Kubler Ross; our current complex grief does not follow neat linear progressions, and includes more serious symptoms. For those who also experienced childhood trauma of various forms or developmental regressions the current experience is more exasperating and dangerous. When loss is catastrophic reactions may include nightmares, shame, guilt, regret, hopelessness and suicide. Cultural differences also play roles in loss and grief as well as its treatment. Therapists must also be aware of the influence of race, gender, sexual orientation, and age.

Treatments for Loss and Complex Grief

Treatments for loss and complex grief are many, but with varying levels of success. Matching treatments to client characteristics, and developing a powerful clinical alliance are important for therapeutic success. Below, I list (only) various treatments, most supported by empirical research and practice. I will leave it you the reader to look more deeply into treatments or interventions they may prefer. Here is the list: Trauma-Informed Cognitive-Behavioral Therapy, Mindfulness-Based therapies/practices (breath work, meditation, yoga, tai chi, qi-gong and MBSR or ACT), Continued Bonds Theory – the changed internal relationship with the lost person, and Attachment-Informed Grief Therapy – utilizing attachment styles of secure, insecure, anxious or avoidant.

Many therapeutic interventions may be helpful: social-emotional support, recovery journaling, music, exercise, imagery, play therapy, and sand tray work. Generally especially strong empathy is required. Self-care of the therapist is a must. Using Maslow’s Hierarchy of Needs may be helpful.  Other active interventions include empty-chair work (sitting in the “worry chair” or the lost person chair), self-talk or out-loud talk using stimulus words like relax, breathe, not me, etc. Social networking with new people in groups is often helpful. Improving client self-care and participating in activities associated with joy or satisfaction moves the mind to other things.

In the end, if so many various interventions fail to meet needs, people should consider joining a formal, therapeutic bereavement group. Loss is emotionally tough, and recovery requires complete emotional activation.

For more information refer to: comments of A. Bodner, Ph.D. in The New England Psychologist, p. 2 (Winter, 2021). Hanlon, P. (2021). The Many Faces of Complicated Grief. The New England Psychologist, pp. 1 & 4 (Winter, 2021). Cormier, S. The Transformative Power of Loss. Psychotherapy Networker,  pp. 17-18 (January-February, 2021). Cacciatore, J. (2020). Grieving is Loving: Compassionate Words for Bearing the Unbearable. Boston, Wisdom Publications, pp. 1-8.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

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New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Coping, Covid-19, E.Kubler-Ross, Featured, Grief, Happiness, Healing, Human Needs, Inner Peace, Joy and Suffering, Personal Suffering, Practices, Relational Suffering, Self Care, Suffering, Tools, Treatment Tagged With: AMERICA, COPING, COVID19, E. KUBLER-ROSS, EMOTIONAL, GRIEF, HOPE, JOURNALING, JOY, LOSS, LOVING, MINDFUL, MINDFUL HAPPINESS, MINDFULNESS, PRACTICES, SELF, SOCIAL, SUFFERING, THERAPISTS, TREATEMENTS, TREATMENT

August 15, 2019 By Admin

Advanced Practice in Tara Brach’s RAIN Protocol

Advanced Practice in Tara Brach’s RAIN Protocol

So often we humans find ourselves in a state of limbic disarray, with ego defenses stimulating our need to protect ourselves from others – even from ourselves. We feel something is very wrong in this moment, and we allow separateness to pull us into a frenzied effort to escape pain and suffering. At such times our most deeply hidden negative self-views strengthen and dominate. We will do almost anything to escape the aloneness and self-alienation. Endless impulses to seek what is wrong and forget what is right take over our emotional lives. It is at such times of strong emotional challenge that we need to take refuge in the Buddha, the Dharma, and the Sangha. Tara Brach’s creation of the RAIN process is a huge leap in a sane direction. According to Brach, RAIN helps us overcome tendencies to activate the “second arrow” of suffering; our second arrows are caused by unhelpful thoughts, feelings, emotions, body sensations, and behaviors related to the “first arrow.” The first arrow is the original event or experience that caused our pain and suffering. Often our reactivity to it makes matters worse – we suffer more in our own minds and bodies. Below I will review the RAIN process and make additional comments on its usefulness and versatility in ongoing self-care and emotional self-regulation. The practice of RAIN skills is appropriate for all people – helpers and helpees.

  1. The first step of RAIN is recognition of what we are experiencing in this moment. What is happening now and how am I experiencing it in mind, body, heart and soul? This focus is on our inner emotional experience, and the causes and conditions creating them. Strong attention is necessary here. Recognition requires a cognitive shift from the auto-pilot of fear, pain, and desire to escape into a mental state of mindful attention in the now. We recognize our thoughts, emotions, sensations, behaviors, and habitual action urges.  This momentary shift into control helps our prefrontal executive brain to take action, and reduces limbic dominance in unpleasant experiences. For now, we are no longer at the mercy of negative emotional events and experiences. In fact we are at the starting point of liberation. We are participating in the experience and our responses to it. Like in DBT, we may find ourselves describing what we have now recognized. Tell yourself what you are experiencing and remain strong, emotionally. We may notice that anxiety, fear, depression, addiction – even some aspects of trauma – begin to transform slightly via the relatively simple cognitive act of recognition.
  2. The second step of RAIN is radical acceptance of the experience of pain and suffering in this present moment. This means that we allow whatever pain and suffering we are experiencing in this moment. With self-kindness we may place our hand over our heart (Thich Nhat Hanh) and breathe into the accepted experience of suffering. We learn to hold ourselves in loving self-presence within the limited space and time of the negative experience. We may experience self-compassion in this process. The act of allowing implies a strong “yes” to whatever is happening now, and it also implies an intention to become capable of handling the experience. This is similar but not exactly what D. W. Winnicott described in how humans are “going on being.” With self-compassion and self-acknowledgement, we allow ourselves to be in this unpleasant experience of suffering. This process, obviously, takes some courage to do. If the suffering involves other people, Winnicott’s view of “intersubjective space” and Kohut’s view of “experience-near empathy” may apply. We have moved from fear and suffering to recognition and now emotional oneness with the experience. Now it is time to add more cognitive control to the process, thus expanding emotional regulation.
  3. The third step  of RAIN is to investigate why now. This is a more cognitive intervention of analysis, analysis of our environment, belief, needs, and strengths. This shift enables us to stop negatively judging ourselves and others; this shift bring a more true presence into the emotional feeling state. Again, the cognitive intervention brings more stability to mind and body in the experience of suffering. Investigating enhances the meditative stance of the observing mind: I am not this experience (anxiety, fear, depression, anger, small-self, marginalization, etc.) , but I am experiencing this! At times this one realization can bring relief from negative emotional triggers embedded in our lives. We may experience pain and suffering in the process, but we are doing so with great mindful discernment. We are NOT the experience, but we are in the experience. It is not us, but it is happening to us. When we investigate, we may ask: Why now? Why me? With self-kindness and mindful strength we reduce reactivity and tendencies to escape or self-medicate. The strong large self is taking charge.
  4. The last step of RAIN non-identification with the experience as self, and more realization that the experience is happening to me and is not me (no-self). Here we practice BEING the true-self, the larger self, the expansive self. We slowly and gently open up a calm, secure space in our hearts. We realize we are not fused with the negative experience or its causes and conditions; we dis-identify with the small escaping self, and over-identify with the stronger, defused, more capable self. With a little luck and skill, we may even experience spiritual transcendence and/or feeling of liberation. We may realize that the self experiencing the suffering is a temporary, small piece of being in this life; the self that is recognizing, accepting, investigating, and not over-identifying is stronger and expanding into the emptiness of ultimate reality. Time and space may be altered. We may become our spiritual experience. We are ready for our next steps.

For more information refer to Brach, T. (2013). True Refuge: Finding Peace and Freedom in Your Own Awkward Heart. New York: Bantam Books. See also Tara Brach’s other works – Radical Self-Acceptance: A Buddhist Guide to Freeing Yourself from Shame.  See also Meditations for Emotional Healing: Finding Freedom in the Face of Difficulty.

Anthony R. Quintiliani, PhD., LADC  

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

 

Filed Under: ANTHONY QUINTILIANI, Buddhism, Coping, Emotions, Featured, Healing, Healing, Inner Peace, Meditation, Mental Health, MIndfulness, RAIN Skills, Self Care, Tara Brach, Training, Well Being Tagged With: ANTHONY QUINTILIANI, MINDFUL HAPPINESS, RAIN SKILLS, TARA BRACH

April 30, 2018 By Admin

Mindfulness-Based Therapy for Trauma

Mindfulness-Based Therapy for Trauma

In line with the thousands of studies now available supporting the use of mindfulness-based interventions in depression, anxiety, chronic pain and addictions (via emotion regulation and interoception), this post will review recommended mindfulness interventions for trauma and PTSD. The post will note information from two recent books on this topic. Also recognize that meta-analytic research in 2004, 2010, and 2014 have found that mindfulness-based interventions improve depression, anxiety, chronic pain, and emotion regulation. These are common conditions co-occurring with addictions and trauma. Such interventions may be carried out as part of various Western therapies: cognitive, behavioral, cognitive-behavioral, dialectical-behavioral, and even psychodynamic.

Follette, Briere and others (2015, 2018) note the many benefits of using mindfulness-based skills as part of trauma therapy. Here is their summary. Mindfulness interventions when implemented by a mindfulness practitioner:

  1. Improves compassion, self-compassion, and radical acceptance;
  2. Improves the negative effects of deprivation, oppression, loss, and harm;
  3. Enhance contemplative responses;
  4. Integrates trauma-informed care with yoga and meditation;
  5. Clarifies emotion mind from reasonable mind;
  6. Empowers personal embodiment and being with one’s conditions;
  7. Expands loving kindness;
  8. Enables effective use of RAIN skills;
  9. Softens harsh, self-critical views of self;
  10. Reduces over-identification with traumatic experiences;
  11. Softens anger and blame;
  12. Brings people to the present – leaving “stuckness” in the past;
  13. Reduces apprehensions about the future;
  14. Strengthens meta-cognitive awareness of thoughts and images as triggers;
  15. Improved emotion regulation – less reactivity and impulsivity;
  16. Teaches breathing retraining for vagal and para-sympathetic activation;
  17. Teaches thoughts and emotions are only thoughts and emotions – not the self;
  18. Improves one’s sense of well-being and happiness; and,
  19. Often enhances self-esteem and empowerment.

Davis (2016) adds the following mindfulness-based effects:

  1. Improves balance in mind-body-heart (soul;);
  2. Empowers better stress reduction practices;
  3. Reduces the personal struggle to control cognitions, emotions, and behaviors;
  4. Enhances one’s observational capacities to just be present and “see” via mindful abiding;
  5. Allows people to recognize experience and life as pleasant, neutral/boring, and unpleasant as norms; and,
  6. Enhances the ability to be grounded when triggered.

For more information refer to Follette, V. M. , Briere, J. et.al. (2015, 2018). Mindfulness-Oriented Interventions for Trauma: Integrating Contemplative Practices. New York: Guilford Publications. See also Davis, L. (2016). Meditations for Healing Trauma. Oakland, CA: New Harbinger Publications.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: ANTHONY QUINTILIANI, Benefits of Meditation, Featured, Healing, Mindful Awareness, MIndfulness, PTSD, Trauma Tagged With: ANTHONY QUINTILIANI, MEDITATION, MEDITATION FOR TRAUMA HEALING, MINDFUL HAPPINESS, TRAUMA

January 14, 2018 By Admin

Healing Meditation for Destructive Emotions

Healing Meditations for Destructive Emotions

Based on the mountain of research supporting the use of regular meditation practices and yoga, it is safe to say that Buddhism and its practices have merged with modern scientific investigation. From the early days of Mindfulness-Based Stress Reduction (the MBSR of Jon Kabat-Zinn) and Dialectical Behavior Therapy (the DBT of Marsha Linehan), clinical and scientific mindfulness/meditation practices have advanced into successful interventions for a plethora of psychological and physical conditions. Among the thousands of studies, most are of “good enough” quality regarding designs and controls. Buddhism and science recommend that we evaluate by direct observation of outcomes and not solely by traditions in both research opinion and the sutras. According to The Dalai Lama in his Science and Philosophy in the Indian Buddhist Classics, the primary purposes for both Buddhism and science is the improvement of cherished human life and the experience of personal happiness.  Since our mood, happiness and perhaps long-term health may depend on how we react to emotions, strong mind training is required. When we experience pleasant feelings (sukkah vedana), we are happy. When we experience unpleasant feelings (dukkah vedana), we are unhappy. We chase happiness, but we find endless cycles of ups and downs, the samsaric cycles.  The goals of better health and emotional happiness can only be met by deeper understanding of how the human mind works and how to work with our destructive human emotions. The Buddha pointed out that reactions to our impermanent feelings cause us harm.

According to Josh Korda’s Unsubsribe: Opt Out of Delusion, Tune in to Truth, goals of improved human existence and enhanced happiness cannot occur when we use meditation for escaping our pain and suffering. This spiritual bypassing (simply a more sophisticated way to self-medicate pain) may bring us short-term relief, but it always brings long-term stuckness. No matter what form of meditation we practice (Anapansati, Vipassana, Samatha, Metta, or Mantra), the goal is NOT to escape suffering but to be one with it and understand its deeper meaning and possible benefits. Thus meditative bliss alone fails to bring true, deep relief from personal emotional suffering. We do not heal by way of avoiding difficult emotional realities in our lives. True liberation comes from not being impulsively reactive to emotional responses to objects and experiences in life. Best to be with all your feelings and emotions in meditation to “see” why they are there and what you can do to befriend them.  The painful emotions in meditation have the potential to become our allies, but we need to stop spiritual bypassing and self-medication to get there.  You need to make your own judgment here; if you feel that you are too fragile emotionally to be with your emotional experiences, DO NOT DO IT.

Now we will select a meditation form and become fully aware of emotions/feelings; we will simply be with them no matter if pleasant or unpleasant. We will be one with them to get to know them better. According to A. Brahm’s Bear Awareness: Questions and Answers on Taming Your Wild Mind, all meditation forms in regular practice ultimately lead to equanimous and happier experiences. The single binding force is to “let go” and be with whatever comes up. Letting go of conditioned reactions can be a struggle. Let us practice!

  1. Practice of Anapansati – Breath Meditation. Simply practice breath awareness deeply enough until your body awareness is reduced or eliminated. ALLOW full mindfulness attention to any difficult emotions that arise. Be with them to understand them. Work at befriending them. What could you learn here? How might your pain help you?
  2. Practice of Vipassana – Insight Meditation. Through the regular practice of Insight Meditation we become more aware of the ultimate truth about life. Strong attention points our awareness to impermanence, suffering as a fact, interdependent origination (nothing arises from nothing), and The Eight Fold Path to enlightenment. Once we are into this practice deeply, we experience insights, inner peace, and joy. What do your insights teach you about your suffering?
  3. Practice of Samatha – Equanimity Meditation. Here meditation brings on a  state of inner calm and peace – sometimes perfect stillness. In this personal and private experience of quietude, we may be ready to discover arising insights about life and mind. In such a state of equanimity, allow yourself to be with your emotions as they arise.
  4. Practice of Metta – Loving Kindness Meditation. Wishing well to ourselves and all others as the root of this meditation practice brings peacefulness, inner quiet, and deep insights. We directly experience joy while we practice. Apply self-compassion to your suffering.
  5. Mantra Meditation – Six-Beat Mantra of Yig Drug. Say the following mantra to yourself as you meditate in any form you wish: OM, MANI, PADME, HUM. Continue! Now shift to a modern mantra, a modified Louise Hay mantra – “I now choose to love and accept myself.” Continue! Now as you say this to yourself in your meditation, slowly and firmly complete the Thymus Thump practice. See what happens.

For more information refer to The Dalai Lama (2017). Science and Philosophy in the Indian Buddhist Classics. Boston: Wisdom Publications. Korda, J (2017). Unsubscribe: Opt Out of Delusion, Tune in to Truth. Boston: Wisdom Publications. Brahm, A. (2017). Bear Awareness: Questions and Answers on Taming Your Wild Mind. Boston: Wisdom Publications. Hay, L. (1984). Heal Your Body: The Mental Causes of Physical Illness. Carlsbad, CA: Hay House -eventually.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Benefits of Mindfulness, Destructive Emotions, Featured, Healing, Healing, Meditation, MIndfulness Tagged With: DESTRUCTIVE EMOTIONS, HEALING MEDITATIONS, MEDITATION, MINDFUL HAPPINESS, MINDFULNESS

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