Mindful Happiness

Anthony Quintiliani, Ph.D, LADC

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COVID-19 Means Higher Stress and Emotion Dysregulation

COVID-19 Brings Higher Stress and Emotion Dysregulation

The Book of Job notes “Man is born unto troubles as the sparks fly upward.”

Current stress surveys indicate Americans are stressed out due to COVID-19 concerns, work stress (money needs), imbalance in life-work experience, and lack of support (social, emotional, financial).  The 2020 American Psychological Association national survey of stress in America indicates similar finding. Stress is getting the best of us! Of special concern are the physical, emotional (psychological), and behavioral implication of such high levels of stress reactivity. Higher stress reactivity is particularly recorded in families; stress is also related to educational concerns, basic needs, health care services, and missing out on major developmental milestones of children and youth. In 2019 Americans were experiencing stress levels noted at the 4.9 level; in 2020 that number rose to 5.9.  Now 74% of respondent noted their stress dealt with fears and concerns about coronavirus; this same number had concerns about how the government was responding to this mega-crisis.  Additionally, 71% of respondents noted that managing their child’s education was a major source of increased stress. The concerns and stress do not appear to be highly related to political party affiliations: 63% of Republicans, 67% of Independents, and 73% of Democrats were worried/stressed about coronavirus concerns. Stress appears to be impacting more so on people of color. Hispanic adults noted stress levels between 8 and 10 regarding the virus. When one compares the levels of stress for people of color with whites, there is no doubt people of color are suffering more – having higher levels of stress reactivity: fear of getting the virus 71% vs. 59%; meeting basic needs 61% vs, 47%; and, access to health care services 59% vs. 46%.  For more information Stress in America 2020 may be found at www.apa.org.

Another important reality is COVID-19 fatigue. Johns Hopkins Medicine has published a helpful article about dealing with this reality. The federal government, state governments, hospitals, healthcare workers,  patients, and the general public may be suffering from COVID-19 fatigue. This condition is similar to burnout under high stress conditions.  Important outcomes may be habituation to death, emotional exhaustion, strong fears, auto-pilot routines, reduced energy of health care providers, and increased errors in care. This pandemic is surely one of the most serious challenges this nation (and the world) have faced. It does not appear that the crisis will end soon.

If you are experiencing serious stress reactivity, you might want to practice the following self-care strategies. Eat well, sleep well, and exercise well as much as is possible for you.  Staying connected to loved ones and friends is also highly important. Use mindfulness skills to be in the present moment; realize it will change due to impermanence. Note it will change either for the better or worse. It may also be helpful to make formal plans to DO positive activities, no matter how small. Get out into nature; if you cannot do this regarding forests and mountains, at least spend more time outdoors. Regular daily walking is a good idea.  Doing good things to help others is also a way to feel better about yourself; in hard times, it is not easy to feel good about yourself. Learn and practice various tried-and-true breathing techniques (usually from meditation, yoga, athletics, etc.). If you are in fact doing some of these self-care practices, but you still feel overwhelmed, defeated, anxious, depressed – it may be best to see professional for psychological help. Before you decide to work with a mental health provider, do a search about them, their practice, and their ethics.

For more information refer to Hanlon, P. (Summer, 2020). COVID-19 means different approach to stress in American surveys. New England Psychologist (Fall, 2020). pp. 4 and 7.

https://psych.ly/covidfatigue.

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  

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Personal Experiences When in Longer-Term Silence

Personal Experiences When in Longer-Term Silence

The luxury (or horror depending on your perspective and psychological structure) of being in long-term silence is a rare thing in today’s noisy, super-active and reactive world. The experience is difficult to describe verbally. The best we can do is count on our own experiences and the writings of others with similar quietudes. I have noted that conveying such an experience may be indescribable, so we’ll look at what others have noted.  I may add my own experiences.

  1. There is often an intensification of both physical and psychological sensations – mind-body effects.
  2. Sometimes one experiences disinhibition and a sense of total freedom.
  3. There may be a sense of being given a special connection to nature, the world, higher powers, and the gods.
  4. In rare cases, one may experience auditory hallucinations – often voices. Other psychosis-like experiences are relatively rare. Much of this depends on baseline mental health status.
  5. It is common to notice boundary confusion.
  6. In the best situations, one may experience exhilarating awareness and joyfulness.
  7. Sometimes the nature of the silent environment may produce feeling of being at risk, possible danger.
  8. An ultimate outcome would be the experience of deep bliss and safety.
  9. Being at one with it all – all the aspects of the experience – is a unique outcome.

I am certain there are more such experiences to convey. However, here we do have a good set of outcomes.

For more information refer to Maitland, S. (2008). A Book of Silence. Berkeley, CA: Counterpoint, pp. 43-79.

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

 

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Clinical Practice in Times of Uncertainty

In Times of Uncertainty; Clinical Practice

H. Colodro and J. Oliver provide sound advice in their new book, A Guide to Self-Care for Practitioners in Times of Uncertainty. This 2020 New Harbinger publication is loaded with helpful suggestions on surviving, even thriving, in our time of struggle. Their core questions include: What do my clients need most now? Am I able to provide what is needed and do so effectively? What might I do regarding my own uncertainty and struggles? Here are some of their suggestions.

  1. Spend some time daily practicing self-compassion.
  2. Know what you are facing, and if you are in a position (emotionally) to provide what is needed.
  3. Recognize the effects of chronic stress on yourself and your clients. Make adjustments as needed.
  4. Work smart! Work with only what you have some control over and not what is beyond your control.
  5. Be sure to take good care of yourself: sleeping, eating, attending, worrying, being aware, obtaining social-emotional support, meditating/doing yoga, and holding onto a strong sense of consciousness.
  6. Check in with yourself. Ask: How am I doing right now? Why did I react emotionally to that? etc.
  7. Release yourself from a “fix-it” mentality. Rather focus on emotion regulation, stability, and safety.
  8. Be there with your own, personal losses, sadness and fear. Deal with these and seek help when needed.
  9. If appropriate, include happiness-enhancing activities and skills in your therapy.
  10. Recognize the reality of impermanence in all things, including current problems and yourself.
  11. Settle into a more self-caring flexible outlook. If possible, work less. Take breaks! Do not over-extend.
  12. If you experience psychological exhaustion or failure in behavioral activation, seek support and consider doing more telehealth rather than live, person-to-person therapy. Cut back if necessary.
  13. Follow all guidelines regarding masks, gloves, social distancing, disinfecting, etc.
  14. Consider using “good enough” standards in your work in these times. See D.W. Winnicott for details.
  15. Remain safe, calm, competent, and helpful in your work.
  16. Consider using the same breathing training techniques you teach to your clients on yourself.
  17. When you feel stuck or sucked-into the craziness of the times, use CBT-M (CBT with mindfulness) on yourself.
  18. If you feel overwhelmed, hopeless, etc. seek your own clinical help.

Refer to Colodro, H. and Oliver, J. (2020). A Guide to Self-Care for Practitioners in Times of Uncertainty. 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!

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Mindfulness Skills and Psychotherapy Outcomes

Mindfulness Skills and Psychotherapy Outcomes

There are at least ten good reasons why mindfulness training and regular practice may improve psychotherapy outcomes. These reasons assume the training is presented by a well-trained clinician-mindfulness practitioner. Of course improved outcomes also depend upon the client’s motivation and energy to actually practice mindfulness skills on a regular basis. One way to ensure this is to integrate such practices into every therapy session. Here is the list.

  1. Intention: Mutual intention to learn and practice mindfulness skills is required. Intention may also carry over to the client’s desire to make changes for the better. For both parties regular practice opens doorways to improved emotion regulation and awareness as well as possible spiritual development.
  2.  Attention: Attention is required for regular mindfulness practice. Such attentional improvements may help clients notice more clearly unhelpful patterns in cognition, emotion, behavior, and sensation. This also applies to therapists, who may find these skills improve their acuity in noticing small but important problems and changes in client behaviors.
  3. Awareness: Intention and attention tend to improve one’s level of awareness – for both positive and negative experiences. Awareness skills may be open or focused. Improved awareness of unhelpful experiences may challenge clients, but it will also help both parties to see more clearly what is important and what changes are needed. When awareness is matched with behavioral task analysis, it allow clear measurement of progress.
  4. Emotion Regulation: Improvement in emotion regulation is, perhaps, the single most beneficial change for both clients and therapists. Integrating various approaches from mindfulness-based therapies will ensure ample opportunity to practice emotion regulation, which is the single most problematic issue in most common problem areas (anxiety, depression, trauma, addictions, chronic pain).
  5. Mindfulness-Based Skills: Mindfulness-based therapies (MBSR, MBCT, ACT, etc.) offer a wide array of skill practices for both clients and therapist. Therefore, it is possible to match client needs with appropriate skill practices in sessions and  at home. Also the “self” of both parties is more strongly present in such practices. Who is this observer experiencing these conditions and situations of life.
  6. Subject-Object Observation: In the many problems people experience it is possible to match client needs with a specific set of mindfulness skills. The ongoing practice of subject-object observation (often without evaluation) allows various transformational experiences for clients. One that is most common is that thoughts, emotions, behaviors, and sensation are internal and external experiences that the “I” is having.  However, such experience is NOT-ME, they are simply current experiences in life. They are impermanent. The same is true for therapists. Also therapist may be able to use this formal process to investigate the quality of the therapeutic relationship and its core alliance. Transference and countertransference responses are Important!
  7. Interoception: Along with emotion regulation interoception skill, or the ability to recognize internal body sensations arising and the emotions that follow, is highly valuable in therapy. This allows both clients and therapists to recognize precursors to problematic thoughts, emotions, behaviors, and sensations. It enables a short window of time to act to prevent or mitigate negative experiences. It also brings in awareness of somatosensory experiences. Our sensory experiences are what we “are” in life.  Awareness os the “me.”
  8. There is ample, high quality research supporting the use of mindfulness skills in improving both depression and anxiety. Google it.
  9. There is high quality research supporting the use of mindfulness skills in improving chronic pain. Google it.
  10. There is good evidence supporting the use of mindfulness skills in improving both trauma symptoms and challenges, as well as improving addictive behaviors. These improvements come mainly from improved awareness,  emotional self-regulation, and interoceptive practices.

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!

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ACT – The Absolute Basics; Acceptance & Commitment Therapy

ACT – The Absolute Basics; Acceptance & Commitment Therapy

In this post I begin a series of writing dealing with ACT, Acceptance and Commitment Therapy. The details below are basic, but perhaps just enough to develop more interest in learning about ACT. Here we go!

1) Act, developed mainly by Steven Hayes Ph.D.and based on a foundation of Relational Frame Theory, uses both language and cognition as key components of therapy. However, ACT goes much further than RFT.

2) Act utilizes the Hexaflex Model to ground the therapy process. Within this model ACT focuses on flexible contact with the present moment, no matter what that contact is. It suggests that acceptance of difficulties works better than avoidance of them, in fact showing how avoidance of personal problems often makes condition worse emotionally. Self-as-context is emphasized. The focus is on cognition, emotion, and behavior of the person seeking help. Values are used in congruence with motivation, and cognitive diffusion is taught to free the person from deep “stuckness” in unhelpful thoughts. Finally, once a behavioral action plan is agreed upon, ACT works to obtain clear commitment to action by the person who is suffering. In summary, ACT does its best to reduce/eliminate cognitive and behavioral inflexibility. Ultimately, ACT strives to enhance and expand psychological flexibility on the part of the person seeking help.

3) ACT emphasizes the utter importance of a strong clinical relationship, alliance and trust in therapy. Without such a therapeutic relationship, it is unlikely there will be constructive, positive change.

4) Act utilizes helpful metaphors and reinforcing clinical interventions to support positive change. Act intends to reduce the power on unhelpful verbal rules used by the person hoping to change. For example, ACT notes the hopeless futility of avoiding personal problems and works to get the person unstuck from unhelpful thoughts, emotions, and behaviors. With both personal acceptance of your own cognition, emotion, and behavior (they are important but they are NOT you) – and commitment to valued actions – ACT hopes to improve what needs to be changed in a collaborative relationship.

5) ACT skill building occurs in interactive experiential actions and experiments; ACT pays close attention to positive changes that may occur. In the process ACT is both interpersonal and intrapersonal in nature. With costs-benefits analysis and various forms of behavioral functional analysis, ACT supports personal goals and improved stimulus control via contingencies of reinforcement (very behavioral here).

6) ACT has shown effectiveness in dealing with depression, anxiety, and addictions. More recently, ACT has modified its approach to improve outcomes in trauma treatment. In this process ACT recognizes self-medication contingencies, the role of avoidance in making things worse, as well as intrusive cognitions, emotions, and behaviors. Act hopes to use skillful means (mindfulness in acceptance and defusion) to reduce rigid reactions and fears. Act is flexible enough to complement other forms of evidence-based therapies.

For more information refer to Harris, R. (2019). ACT Made Simple. Oakland, CA: New Harbinger Publications or the various articles and book written by Steven Hayes on this topic.

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!