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Anthony Quintiliani, Ph.D, LADC

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May 12, 2018 By Admin

Vipassana for Depression, Anxiety, Trauma, and Addictions

Vipassana for Depression, Anxiety, Trauma, and Addictions

The integration of Vipassana meditation with various forms of therapy has for many years been a standard of treatment worldwide and in Vermont, especially when impulse control and emotion regulations issues are included.  Buddhist Psychology offers clear explanations why this intervention may be helpful for so many suffering people. The four most common clinical conditions of depression, anxiety, trauma, and addictions are strongly and positively influenced by regular practice of this form of meditation. Below I have noted in a very basic manner how Vipassana’s effects may be explained via Buddhist Psychology and the dharma.

  1. Impermanence is a focal aspect of Buddhist Psychology, meditation practice, and dharma. This constant of change may be explained best as the rising and falling of all humanly perceived phenomena. Although arising and falling away in conscious awareness include all phenomena, some clarity is needed regarding use of it in clinical practice. Sense impressions, mental events, sensations/feelings/emotions, impulsive behavior, and compulsive cognitions all relate to the clinical conditions noted here. Therefore, any intervention that brings important insight may be useful.
  2. Humans suffer from habitual behaviors and reactions. It is best recognized in attachment to positive  sense objects or experiences and aversion to negative ones. Sensory impressions and mental events about them lead to active roles on the hedonic treadmill. When we use sensory information and experience awareness of something that we evaluate as pleasant, neutral, or unpleasant we behave according to samsara – we crave for more or desire aversion from such phenomena.  We may not at all realize that our attachment/desire to continue the pleasant – as well as the aversion to continue the unpleasant – is our major cause of unhappiness, pain, and suffering.  Likewise the lack off this awareness or insight has the same unpleasant effects – we suffer. We become stuck wanting  what we want but cannot always get, and hoping to avoid unpleasant experiences that may be unavoidable in human life. We tell ourselves only if I had…then I would be happy. General dissatisfaction, unfortunate as it is, is the human norm.
  3. The information and processes noted above do NOT include a separate, long-lasting, independently arising entity called the Self. We do need to recognize that I am NOT my depression, anxiety, trauma, or addictions. I am simply aware or conscious of the fact that “I” am experiencing or feeling depression, anxiety, trauma, or addictions. It is only in more advanced Buddhist practices that we work seriously on the “no-self” reality. There are significant consequences in over-identification with either pleasant or painful experiences.  Believing that it is “my self” that is trapped disempowers us in many important ways.  The Four Noble Truths and The Eight Fold Path can help us.
  4. In very unique ways Vipassana meditation can help us in all of the above.  Here are some skills recommended by S. N. Goenka (now deceased).  First, anchoring the breath by paying attention to the upper lip and the nostrils as you breathe in and out. In anapana sati we simply pay undivided attention to the feelings/sensations as we breathe in and out. Moment-to-moment bare attention is practiced for at least 30 minutes.  To be successful, you must practice letting go of thoughts, emotions, and memories of past suffering.  When they arise simply note that it/they have come up, and pay no attention to it/them – hold a non-evlautaive stance and stay with your breath. It will require significant practice before you can do this well.  Awareness may then be expanded to the throat and chest areas – just feeling sensations of awareness  as you breathe in and out. Second move into about 30 minutes of loving kindness meditation. Third, complete a body scan with attention only from head to toes and back again for about 30 minutes. Just pay attention to the awareness of sensations and feelings as you are guided slowly down and up the body. When distractions come, simply return attention back to the part of your body you are working with now.
  5. Vipassana (Pali for “seeing things as they actually are”) allows us to learn all there is to know in items 1-3 above, and how to benefit significantly from such understandings. Long-term Vipassana practice may eventually bring you to a more stable self-existence, fully focused on your state of meditative awareness without strong reactivity in life. At some point you will become aware of interoception, the ability to feel sensations in your body before they bloom into emotions and behaviors. In the clinical conditions noted, such a skills can be live-saving.

For more information refer to Follette, V. M. and Briere, J. et.al. (2015). Mindfulness-Oriented Interventions for Trauma…New York: Guilford Press, pp. 273-283, 329-342. See also Ariele and Manahemi (1997). Doing Time, Doing Vipassana (Film); and, www.prisondhamma.org.

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!

Filed Under: Addiction, Anxiety, Buddhism, Depression, Featured, Meditation, Mindful Awareness, Trauma, Vipassana Meditation Tagged With: ADDICTIONS, ANXIETY, DEPRESSION, TRAUMA, VIPASSANA

March 25, 2018 By Admin

Polyvagal Interventions for Anxiety

Polyvagal Interventions for Anxiety

S. Porges and his Polyvagal Theory may provide innovative interventions for both anxiety and depression. Many people become trapped in ruminating about the past or worrying about the future; they cannot seem to keep their mind and body in the present moment.  Some strong, fear-based, bodily defenses may not respond well to “talk therapy” alone. In helping clients with such suffering it is important to include a very strong clinical alliance and relationship, as well as personal narrative on internal introjected messages about their vulnerabilities, fears, and self-doubts. Recall that anxiety is generally a body-based defense from lower brain areas (limbic and brain stem). These areas are often un-affected when just “talk” occurs in therapy. There are certain signs that a person’s anxiety is acting up in a clinical session. These are:

  1. Higher pitched voice, sometimes with speedy delivery;
  2. Prolonged silences;
  3. Tighter, flat face and tight jaw – often with the upper face lifting slightly;
  4. Random nervous body movements;
  5. Rapid, higher-chest breathing;
  6. Problems in awareness, memory, and cognitive comprehension; and,
  7. Sometimes full blown panic.

When such anxious defenses appear, the therapist needs to move to grounding and calm breathing interventions.  Talking it through, working it through may be insufficient to restore emotion regulation. Porges makes the following suggestions to activate polyvagal interference to anxiety. If successful, emotion regulation will be re-established.

  1. Request the client to exhale more slowly, and with more emphasis.
  2. Then have the person extend slightly their exhalation. Be careful not to extend too far; discomfort will follow.
  3. If the person is fearful of public speaking or presenting in a group therapy session, request that they add more words to their sentences. This will require a change in breathing process – thus extending the exhalation.
  4. Practice longer exhalations as the client breathes more slowly and more deeply.
  5. Have the client lay on their back with their slightly bent legs high up on a wall – breathe

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: Breathing, Featured, Interventions, Polyvagel Tagged With: ANXIETY, POLYVAGAL, S PORGES

March 27, 2017 By Admin

Intervention Skills to Calm Your Anxiety

Intervention Skills to Calm Your Anxiety

It is estimated that approximately 40,000,000 American suffer from an anxiety disorders, especially generalize anxiety and panic disorder. Sometimes general “talk therapy” fails to help improve your condition; you may need cognitive-behavioral therapy with research-based mindfulness skills or dialectical behavior therapy.  CBT, MBSR, ACT and DBT are the evidence-based, recommended therapies here. Generally psychodynamic therapies

take way too long to bring about positive effects; meanwhile YOUR suffering continues. I have listed below several action-based skills  (cognitive and behavioral activation techniques) that might be helpful to you.  You will need to practice these approaches – no quick fixes. Some people also benefit from carefully prescribed and monitored medications.  Although the biological interventions is often the first effort in primary care and psychiatry, I suggest you may be better off with trying psychological skills-based interventions first. No negative side-effects.

  1. Mindfulness of the Present Moment is very important. Anxiety is often future-oriented, and depression is sometimes past-oriented. When you feel anxiety coming on, stop and place your complete awareness (intention and attention) into the present moment of the experience.  Allow it; observe it: and, activate skills like calm breathing to reduce the suffering effects.
  2. In more serious suffering, for example panic attacks, you may apply the skills noted in #1 above AND remain highly cognitive. Although it feels like you could die, you will not. In fact you may want to reframe what is happening right now. You are experiencing very strong fight-or-fight reactions in your body and mind. Remain focused on it, and recognize strongly that the F-F reaction is actually in place to keep you alive and functioning. Ground yourself, breathe calmly, and re-focus attention on your capacity to limit the attack and/or shorten its duration.
  3. Get back into cognitive mode by re-cecking your anxious thoughts about some up-coming situation.  Be in charge, cognitively. Do your best to change the valance of your thoughts from negative to neutral or positive. Work to convince yourself that “I can do this!”
  4. Learn and use various relaxation-oriented breathing techniques common in mindfulness, meditation, and yoga.  Deep calm breathing, slightly extending the exhalation, and using imagination to feel the calming breath moving through you – nose, chest, lungs, stomach. If you suffer from untreated or poorly-treated trauma, or if you have some type of polyvagal system malfunction, deep calm breathing may actually make you more anxious.  Sometimes clinicians suggest that you breathe into and out of a paper bag. See if that works for you.
  5. When your body and limbic brain area are on “out-of-control mode, try the 3-3-3 process. Go to your sense and name three things YOU see and hear; then simply name and make attentional contact with three neutral parts of your body. This should ground you.
  6. Do something different! Complete some simple task to get your mind off of the anxiety-provoking conditions and body feelings. Behavioral activation can be helpful here.
  7. As ancient mindfulness texts suggested, change your body posture. Stand up, walk around, sit down, lay down – skip if you want to. Once your body takes over in a task, your anxiety may diminish.
  8. Do not self-medicate your anxiety with alcohol or other depressant drugs, food, sexual behavior, or isolation.  Eat less sugars of all types, and reduce all caffeine intake.
  9. Socialize if you are able to do so. This can be especially helpful if you are with people who care about you.
  10. Humor may help. Smiling and laughing causes brain-based changes that may curb your anxiety (and depression).
  11. If not doing so now, seriously consider regular (daily if possible) practice of meditation, yoga, tai chi or qi gong. For many people, these practices reduce anxiety.
  12. If you are in psychological or medical treatment, but it is not working – get a second opinion or change your provider to someone more expert in anxiety disorders.

For more information refer to Quintiliani, A. R. (2014). Mindful Happiness…Shelburne, VT: Vermont Voices Press. You may want to refer to Chansky, T. E. (2012). Freeing Yourself From Anxiety…Cambridge, MA: Life Long- Perseus Books. See also Hughes, L. (March 8, 2017). How to Stop Feeling Anxious Right Now. WebMD.

Anthony R. Quintiliani, PhD., LADC

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

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Anxiety, Featured, Psychodynamic Tagged With: ANXIETY, MINDFUL HAPPINESS, MINDFULNESS, THERAPY.

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