Mindful Happiness

Anthony Quintiliani, Ph.D, LADC

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“i Rest” Yoga Nidra Practice (Richard Miller, Ph.D.)

“i Rest” Yoga Nidra Practice (Richard Miller, Ph.D.)

All regular meditation and yoga practices are capable of bringing us closer to our true self and our relationships in the world. A by-product is deep relaxation and equanimity. Richard Miller, Ph.D. (Clinical Psychologist, yogic scholar, spiritual teacher), has created a yoga nidra practice that promises to return us to our authentic self and provide deep, relaxation and inner peace in the process. The iRest method is based on long-term practice and research. Yoga nidra is a pathway to improved health, awareness, and inner healing. It has been effective in problems related to stress, anxiety, sleep, trauma, and physical pain. I suggest it may be equally effective in all psychological pain. In neuroscience theory yoga nidra may reset your central nervous system, improve coping capacity, and open doorways to spiritual development.  In the following yoga nidra meditation I have integrated my own yoga nidra practices with the iRest method presented by Dr. Miller. Let’s begin!

  1. Place your body in a comfortable positions sitting, lying down, or standing. Enjoy silence in the pause. Close your eyes if ok.
  2. Allow your body to settle down and simply notice your full awareness. Notice silence in the pause.
  3. Open up your senses without evaluation, and notice delicately your body contact with parts of the world beyond the body boundary. Pause.
  4. Be open to noting the contact experience, and prepare to go inward inside your body. Notice as we pause in silence.
  5. Gently notice without evaluation the sensations you feel as we move up and down the body. Quickly at first. Up and then down!
  6. Starting with your toes, simply notice sensations; then move up slowly all the way to your hips, noticing sensations as you move your intentional kinesthetic awareness. Be with the silence in the pause.
  7. Continue your inner, private body scan moving from the hips all the way up your chest and to the top of your head. Silence!
  8. Just notice sensations and continue to be aware without judging.
  9. Now move  slowly from the head back down your back to the hips. Notice the quality of the silence in the pause.
  10. Again, with intentional attention without thinking move down from the hips all the way back to the toes. Remain silent inside.
  11. Now ever so gently notice your intentional in and out breaths. Breathe deeper, slower. Notice.
  12. Notice and allow the sensations of breath passing into your nostrils, down the throat, into the chest and lungs. Notice the rise of the belly on the in-breath.  Do all this without thinking – only noticing the sensations your feel. Enjoy this silent pause. Let go.
  13. Now notice the out-breath and follow the same sensation track as your exhale. Notice! Remain silent inside and outside.
  14. At this point in our process, bring attention gently to an area of the body where you feel discomfort, pain, or suffering.
  15. Simply allow and welcome this sensation as if it were simply sensations – like those you just experienced. Pause in silence.
  16. Blend the earlier pleasant sensations with this uncomfortable sensations. Notice!  Settle deeply into the silent pause.
  17. In your effort to accept all sensations, notice the discomfort and note if it is stronger at its center or at the periphery. Where?
  18. Focus more attention where there is less discomfort. Go deep into the silence here.
  19. Does your unpleasant sensation have a color? Focus on the color. Now focus on an opposite color or your favorite color. Notice.
  20. Let go of reactions to the discomfort on each and every exhalation, and especially in the gaps/spaces between breaths and awarenesses.  Be with the silence now.
  21. Continue to let go in the longer silence here.
  22. Does the sensation have a character texture?  Is it dense or loose? Heavy or light? Sharp or dull? Go to where there is less discomfort. Be in your inner most silence now.
  23. Radically accept all your bodily sensations – the pleasant along with the unpleasant. It is only sensation; it is your reaction to it that causes you problems. We wish to flee discomfort and hold onto pleasure. Just be with what is!  Just be in silence now.
  24. Allow your body to remain aware, accept, integrate all the forms of sensation you are experiencing.
  25. Examine your control by bringing focus to the pleasant sensations, now to the unpleasant sensations. Accept them all as simply sensations without evaluating. This may be challenging. Find some peace in the silence.
  26. Now allow your senses to open up and notice what you feel, hear, see, taste, smell. etc.
  27. Use the power of your inner spirit to help you improve this moment of perfect being. Empower spirit! Sit in silence now.
  28. When you feel ready slowly bring yourself to a full alert state. If your eyes have been closed, gently open them.
  29. Now just rest!!!!! Enjoy the silence. I will cue you when we are ready to end yoga nidra.

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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New Edition of Mindful Happiness in Production…Coming soon!

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The Deep Courage to Let Go

The Deep Courage to Let Go

Pema Chodron, now recognized as a world leader in the Chogyam Trungpa Shambhala tradition, has presented a wonderfully clear method for letting go of personal blockages and impediments to enlightenment,  the bodhisattva way of life, and awakened bodhichitta (clear mind, soft heart). She teaches us how in “The Joy of Letting Go.” It is similar to accepting “choiceness awareness” in one’s own life experiences. Chodron suggests that we radically accept whatever arises in our path in life as our opportunity to practice. Our job is to reduce the suffering of the world – one person at one time. This practice may be achieved through the Paramitas. The practice of being patient, disciplined, generous, energetic – all in meditation and life behaviors – sets the stage for our inner and outer growth. As we practice greater compassion, we care more deeply about the welfare of others. This can be an antidote to the pandemic of greed in America (and the world) today. So much greed that we may inflict great pain and suffering on others. How much wealth is enough?

One way to experience this process is to be highly generous as a personal life aspiration. By giving to others we will notice the inner emotional reactions in letting go of things we value. This implies letting go not only of the “things” but also of the attachment to the things we value. Our wholesome actions in giving allow us to experience first-hand the reality of holding on. Just how difficult is it for you to let go, give away that thing you value so much? Our improving discipline in practices tames the wild mind and expands open-hearted compassion for others, especially others who lack what we have. This awareness enhances personal gratitude for it all. We humans sometimes “own” many things; sometimes this property restricts own flexibility in life. It certainly adds fear of loss. It increases our level and intensity of grasping and competing. If you go hiking while carrying an armful of firewood, you will soon realize it is very inefficient. So to go through life with a household of “stuff” is a logical understanding of this hiking metaphor. It is in the giving away, the letting go, that true and personal liberation is experienced.

Taming our reactive minds and bodies is another important practice in letting go. Can we really be “like a log of wood” (influence of Shantideva and others) when emotionally powerful experiences occur? This does not imply suppression, repression, or being a doormat; it implies building better emotion regulation skills through practice. Slow it all down, clarify your discernment, and allow enthusiasm for making such positive personal changes. It is all up to you.

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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New Edition of Mindful Happiness in Production…Coming soon!

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Essential Knowledge for Clinical Supervisors

Essential Knowledge for Clinical Supervisors

This post will include information and skills dealing with research on role induction practices, quality of clinical supervision, psychodynamics of alliance, and progress measurement.  Since the information and skills for all these topics is complex, I will do my best to keep it as clear as possible. This information aims to improve existing clinical supervision practices.

Reducing anxiety of less experienced supervisees by role induction strategies

  1. First of all clarify both supervisee and supervisor roles, expectations, behaviors, skills, rights, responsibilities, and clinical development.
  2. Support supervises via clear information on process and skills training about cognitive, behavioral and emotional processes, skills, and clinical expectations.
  3. Include lowering anxiety and improving competence as ongoing clinical supervision activities. Measure them!
  4. Work directly on supervisees self-awareness capacities.
  5. Clinical and psychological development issues may exist; adjust clinical supervision to fit these parameters.
  6. Improvement in supervisees clinical competence and psychological health are ongoing goals.
  7. Important variables that impact success or failure are supervisor competence and supervisee openness to growth and emotional regulation patterns.
  8. Keep the quality of supervision in mind, and participate in mutual evaluation and openness to feedback. For best results keep supervisee input about the supervisor as anonymous as possible. Otherwise, supervisee anxiety will increase.
  9. Recall that ethics requires that there be a reasonably detailed supervision contract.
  10. Effective clinical supervision often translates into effective psychotherapy, which leads to improved client progress, better job satisfaction and self-esteem.

The Importance of clinical, evidence-based and psychodynamic training

  1. Perhaps the single most important aspect of effective clinical supervision is the quality of the alliance. This is a parallel process with the therapy itself.
  2. With improved training in psychodynamic alliance-building skills comes client self-reports of experiencing a stronger therapeutic alliance in therapy. Keep in mind the training is cognitive, behavioral, and affective in nature. It is experienced!
  3. Research is mixed about the differences in alliance quality regarding psychodynamic training vs other training (CT, CBT, humanistic, interpersonal, etc.). The study noted suggests that improved emphasis on psychodynamics skills and processes ends with a better therapy alliance, which is consistent with better outcomes for clients. Although other studies refute this finding, it does appear to be logical that a training program specializing in psychodynamic therapy would produce better outcomes for psychodynamics, thus perhaps a better clinical alliance.
  4. Manualized psychodynamic therapy training also showed substantial improvement in the clinical alliance and the amount of psychodynamic skills being used in therapy.

Comparative quality of clinical supervision and its implications

  1. Research including over 300 clinicians concluded that 69-79% received inadequate clinical supervision.
  2. What is more concerning is that the same research noted that 25-40% of clinicians received harmful clinical supervision.
  3. At other measurement times 51-55% of clinicians noted that they received exceptionally helpful clinical supervision. Last I heard a 50% range is a grade of F. We need to work on improving this reality!
  4. Research also supports that there are great differences between supervisee perceptions vs objective criteria used effectively to measure comparative quality of clinical supervision. So the indication is to use both – supervisee anonymous evaluation and direct observation and measurement of clinical performance.
  5. 86-92% of clinicians did receive some form of clinical supervision but both the regularity and quality varied.

The reality of using progress monitoring measures for clinician development

  1. The use of clinical progress monitoring measures regarding client clinical change improves outcomes. However they are used rarely.
  2. Clinicians noted that the use of such measures in therapy required technical expertise, additional costs, time in the session,  some
  3. increased anxiety, and was sometimes accompanied by negative responses from clients, other clinicians, and managers.
  4. There were few differences in use and barriers between agency clinicians and private practice clinicians.
  5. Since the benefits of progress monitoring in clinical practice is well established and is often part of evidence-based endorsements for therapies, it is important to increase the use of progress monitoring.
  6. Furthermore, the lack of progress monitoring may have negative impacts on clients and third-party payments for therapy.

For more information refer to Ellis, M. V., Hutman, H., Chapin, J. (2015). Reducing supervisee anxiety…Journal of Counseling Psychology, 62, No. 4, 608-620. Hilsenroth, M. J., Kivlighan, D. M., Slavin-Mulford, J. (2015). Structured supervision of graduate clinicians in psychodynamic psychotherapy…Journal of Counseling Psychology, 62, No. 2, 173-183. Ellis, M. V., Creaner, M., Hutman, H., Timulak, L. A comparative study of clinical supervision… Journal of Counseling Psychology, 62,  No. 4, 621-631. Ionita, G., Fitzpatrick, M., Tomaro, J., Chen, V. V., Ovington, L. (2015). Challenges in using progress monitoring measures…Journal of Counseling Psychology, 63,  No. 2, 173-182.

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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New Edition of Mindful Happiness in Production…Coming soon!

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Self-Care to Reduce Compassion Fatigue

Self-Care to Reduce Compassion Fatigue

First let’s begin with what some people do to counteract the stressors of living in a hurried,“over-technologized” world. Technically, “technologize” is not a popularly accepted word, but it is a sad  reality. We live in a time when texting while driving may become the new addiction-based cause for many, many deaths. This addiction is so strong people do it in situations that could case their injury or death, or the injury or death of others. Sound familiar! It should. Cellphone “abuse” is not so different from the plans of cigarette producers to “hook” us on something we will pay for during many years. So here is a partial list of what people tend to do when faced with severe stressors.

What people tend to do that does NOT improve their stress reactivity long-term:

  1. “Smoke and Coke” – a phrase referring to smoking nicotine and drinking sugary soft-drinks when you cannot cope well and feel dragged down with your stressful life and want to feel stimulated.
  2. Of course there is always excessive alcohol and/or drug use as self-medication.
  3. Sleeping – too little or too much, including late onset and too early awakening.
  4. Eating – too little or too much, and may include binging and purging.
  5. Hoarding for whatever security it brings.
  6. Obsessive compulsive  behaviors – as behaviors for security actions to make us feel better.
  7. Being aggressive when it is not necessary to defend yourself.
  8. Insulating yourself from contact with others.
  9. Living under a “victimhood” self-identification. This can change everything!
  10. Participating in self-harming behaviors to activate neurologic, chemical and hormonal changes in your brain and body.
  11. Engagement in unsafe sexual activities to feel “excitement” and/or “loved.”
  12. Spending too much time online or on my “I-Smart” phone. The phone becomes your life!
  13. Doing too much exercise, especially when injuries occur.
  14. Being a person of uncontrollable empathy – a clear boundary issue that wares you out.
  15. Making your job too much of your life – workaholism or compensation for poor self-esteem?
  16. Making do with professional, work stagnation.
  17. Remaining stuck in impaired practices – the most common one being emotional dysregulation.

What people can do that does improve stress reactivity and may even increase joy in life:

  1. Taking brief breaks from the “grind” of work.
  2. Recognizing and contemplating personal gratitude for what you DO have.
  3. Noticing and correcting unhelpful thoughts, emotions, behaviors and communications.
  4. Learning to hold a positive, optimistic mindset and attitude.
  5. Liberating yourself from “stuckness” in anxiety, depression, addictions, and trauma. This most often requires professional help and/or self-help.
  6. Cutting way back on your online time. Researchers suggest anything beyond 3-4 hours/day is a habitual pattern. What do our jobs, schools and parents contribute to the habitual tendencies of habit-forming digital/electronic devices?
  7. Ignoring FOMO!
  8. Spending time reading, writing,  journaling about helpful things.
  9. Spending time listening and/or playing music.
  10. Spending time dancing and/or doing regular exercise.
  11. Spending time doing regular practice of meditation, yoga, tai chi, qi gong, mindful walking.
  12. Petting your dog or cat – or horse. Looking into their eyes when they allow it.
  13. Spending time walking in nature.
  14. Learning to give/get social-emotional support.
  15. Learning to leave work at work – learn to build emotional boundaries.
  16. Practice limit-setting regarding your boundaries and what you do to help others.
  17. Making a firm commitment to improve your wellness.
  18. Taking part in constructive self-reflection.
  19. Paying more attention to positives ( natural for the brain to do the opposite).
  20. Helpful nutrition, sleep and exercise practices.
  21. Learn to play more; learn to be active in creative expression.
  22. Participating in regular spiritual practices.
  23. Spending more quality time with loved ones and good friends when helpful.
  24. Leaving some time to just be in quiet, silent solitude.
  25. Seeking professional help as soon as you “feel” you MAY need it, or when others who care about you “think” you need it.

You will notice that the helpful list is longer than the unhelpful list. However, the unhelpful behaviors are often more automatic, and the helpful behaviors REQUIRE considerable effort to carry out. Your wellness must be a priority for you.

For more information refer to Bray, B. (2019). Counselors as human beings not superheroes. Counseling Today (October, 2019), 18-25

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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New Edition of Mindful Happiness in Production…Coming soon!

 

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Using Creativity in Clinical Supervision

Using Creativity in Clinical Supervision

Effective clinical supervision is a combination of hearable direction about clinical practice, gentle-direct leadership, clinical “Know-How,” evidence-based skills, complex psychodynamics, and the willingness to work with others on their developmental processes. There are risks involved. I have provided clinical supervision and consultation to other clinicians for 43 years without a legal or ethical issue. I do not think you should allow your creative spirit to run wild; there are many very serious ethical and legal implications in supervision.  These are not benign; most states hold clinical supervisors 100% accountable for the actions of their supervisees, whether those actions were known and recommended by the supervisor or not.

Here we will look at the work of Leonardo DaVinci, the genius in art, science, engineering, and humanities. He saw art as science and science as art – most clinicians recognize these combinations in their own clinical work. I will simply note a list of documented attitudes, values and behaviors that DaVinci mastered. Here is the list. Courage may be needed to move off your comfort-path.

 

  1. Practice intense curiosity and deep awareness about the specific details of your work. As you do this apply a sense of wonder about your observations and  different possible perspectives you encounter. Multiple realities of perspectives do exist. There may not be one absolutely correct response.
  2. Observe! Observe! Observe! Notice how your supervisees do their work, and how their idiosyncratic personalities and attitudes influence that work and your supervision. Be certain to pay close attention to the facts of reality, but better to procrastinate a bit before making big decisions. Be sure you have all the correct facts. You may need to test your hypothesis.
  3. Use your personal imagination more, and visualize the situations that cause you the greatest concerns. Remember: Do No Harm! In some situations it may actually be ok to use day dreaming and helpful fantasy for new perspectives for problem solving.
  4. Be sure to keep written lists of all the things you need to do. Also, write in your own “supervision development journal” about new things you learn and lessons you wish you already knew. Review selected parts of that journal with your own supervisor.
  5. It pays to be a little obsessive when dealing with supervisees and the welfare of their clients. Your growth also depends upon being a bit obsessive with learning new clinical processes and evidence-based interventions. However, remain creative and highly responsible in your role. Document everything you do in your role.
  6. For more see Isaacson, W. (2017). Leonardo DaVinci…New York: Simon & Schuster.

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!