Tag Archives: mindfulness

24Sep/18

Getting the best of athletes at the ACPSEM Symposium 2018

Chronic pain, Mindfulness, Pain, Pain Coach, Pain Education, Sports Injuries, , , , , ,

getting the best of athletes

Getting the best of athletes

Yesterday I was excited to speak at the ACPSEM Symposium 2018 at The Imperial War Museum — an inspiring place to inspire our best selves! Having been asked to talk about sensorimotor training, mindfulness and using hands for treatment, I shifted the title slightly: getting the best of athletes. To prepare the participants, not passive listeners, I wrote a brief premise: problem pain in sport.

Starts with the best of you

Getting the best of athletes and patients necessitates you getting the best of you. For athletes to reach peak performance they need those around them to also be at their peak. For physiotherapy this means delivering the best care, which we can only be doing in our own way when we are top of our own game. How can we achieve this?

Self-coaching is something we do all the time, primarily featuring what we tell ourselves — our inner dialogue. Now of course just because it is your dialogue based on your thinking and beliefs, does it mean that it is right? The art of self-coaching requires us to be skilful with our mind from where our actions follow. It seems easy to convince ourselves of something through simple repetition together with cognitive dissonance. Becoming familiar with the way your (embodied) mind works is a most valuable skill, as it is in the athlete to focus on performance.

You have probably noticed how the skills of self-coaching are the same as those we can use to get the best of our athletes and patients. In that we are also practicing makes it authentic.

What do you want?

What is your picture of success? We need to know where we are going and what we want to achieve. To really embed this within our thinking and actions, we must take the time to picture and feel it. Otherwise it is a mere doff of the hat and off we go again in a vague direction leading wherever.

Take a moment to write down your picture of success — what does it look like? What are you doing? Where? Who with? 

What are your strengths?

When you use your strengths you achieve results. Do you know your top 5 strengths? One way to clarify your strengths is to think of an example of when you were successful. What did you achieve? How did you achieve it? What part did you play?

Further useful questions to ask yourself could be, when am I in flow? When do I feel at my best? When do I quickly see the answers and a way forward?

Take a few moments to write a list of your strengths on a blank piece of paper. You can then establish your top 5

Like working a muscle, you can choose a strength each day to flex and practice.

Strengths-based coaching

Blending strengths based coaching with the latest understanding of pain is an approach to working with people suffering chronic pain, which I devised and continue to sculpt. This work will never be completed as we continue to develop our understanding on a route of mastery. To truly understand pain takes a working knowledge of neuroscience, biology, cognitive sciences, social sciences, consciousness, perception and more. This is not enough for then we need the wisdom to best use this knowledge.

Wisdom + knowledge = best actions

The essence of this approach is to focus on an individual’s strengths, whilst managing the consequences of their weaknesses. This is always about getting results by aiming to get the best out of the person and their circumstances. It is also about concentrating on what we can control and not what we cannot control.

What is pain?

We touched on this most vital of topics. Not in the detail of a full day Pain Coach Workshop, but to highlight the pinnacle of current thinking. I always emphasis the size of the global problem of pain as a backdrop. The understanding of pain must move forward in society where the problem is embedded in terms of personal suffering and the enormous cost.

There is no adequate brief explanation of pain. Pain is the greatest example of a conscious experience flavoured by individual stories, past experiences, expectations, emotions, context and meaning. Love is another. To understand a person’s pain to help them to understand their pain is to understand them and their style of life. How do they do life? How do they do pain?

ACPSEM Symposium 2018 at The Imperial War Museum

The question to ask, having listened deeply and compassionately to the narrative, is why have they not got better? Why the hold up? What is limiting their progress? We are always moving onwards, it’s the direction that is key. Which direction is the person going in and why? Establishing this allows us to create a new way forward together.

Pain is part of the way we protect ourselves. It is a perception and like all perceptions, can be thought of as an inference. Or our brain’s best guess based on a need to protect us, often just in case. Like anything that gains momentum, this builds over time as the perceived threat builds and the range of cues, triggers, contexts widen. Some may assume we are assuming that because of this understanding we are saying it is somehow unreal. This is definitely not the case. Pain is always real. Pain is always embodied. Pain is always individual, and what the person says it is. Let us never confuse this again.

Examples

The examples I used to demonstrate the Pain Coaching approach were those I was asked to discuss: sensorimotor training, hands on and mindful practice. Now of course these are not exclusive to Pain Coaching, which is the arching way of getting results. Pain Coaching is not a technique in itself so to speak.

Here is a short summary of the important points. Each example is about changing the person’s state. We practiced bounding and breathing in the session as a way of experiencing and feeling state change. Such change is always happening, but we are often unaware. The body is ever-present, yet our minds are often elsewhere. We can never be truly ourselves or well without being whole and connected, which is one of the reasons for being mindful.

As clinicians we are state changers, encouraging and inspiring others to change in their desired direction, day-to-day, moment to moment. This is why self-coaching is so important. The person has to be able to encourage and enable themselves in their world to get results.

Mindful

To be mindful is to be present in yourself, in this moment whilst being open to what is happening, whatever that may be. Mindfulness is accepting, non-judgemental and seeing things for what they are instead of being biased by the mind’s presuppositions. So often we worry about things that never happen that way.

How do you look after yourself? Each day?

Mindful practice enables us to become familiar with our mind, to face our suffering and transform it with compassion rather than try to avoid it or cover it up, which leads to more suffering. Change is what someone in pain wants, and to do so takes awareness, understanding and focus, all of which mindful practice nurtures. This can be through mindful breathing, mindful movements and body scans as examples.

Movement

Movement is fundamental for survival. In persistent pain, protect and survival states predominate, usually just in case as opposed to true need. This is one reason why being in touch with reality is so important. To be in touch with reality means you can perform a more accurate risk assessment, considering that we have no direct access to our biology, just inferred states (what I experience as my perception and reality).

Movement enables us to create our reality. The brain needs movement to actively gather sensory information from the world, thereby creating my perceptions. Anything that threatens my ability to move and act in the world is a threat and will maintain a state of protect. The perceived threat could be restriction, a thought (anticipating pain) or a lack of control due to altered body sense.

On moving we are fulfilling a prediction that has already been made. To re-train normal movement that features ease, action in perceiving (rather than thought about) and flow, is a necessary part of the programme. This starts with body sense training and re-establishing the clear boundary of me and the world, gradually building towards meaningful movements and activities, bringing in elements of control, strengths, endurance and flexibility.

Hypnotic hands

I jokingly talk about hypnotic hands. But in essence we are talking about the use of meaningful touch to bring about a state change. We can see and feel the change in someone when we use touch skilfully. This is a most useful state change that creates a new and pleasurable experience in an area of the body only ever thought of negatively. We also see changes in engagement with the body, re-interpretation of experiences, reduction in threat, and parasympathetic states. All of these are important steps in the right direction. We explore this is detail, creating experiences for each other, in the workshops.

Wrapping up

I like the talks I give to be interactive and experiential.This is one way to emphasise messages. Making it real. Being told something and experiencing something are completely different. Immerse yourself!

As physiotherapists we are pattern breakers, disruptors, state changers, perceptual sculptors. That is the reality and we must forge forward in the profession as we are in a great position to encourage and inspire people to achieve success and live their best lives.

On a route to mastery we seek to grow and develop ourselves as the knowledge tree ever-blooms. We must match this with wisdom, which is why I suggest kaizen and the beginner’s mind at the top of the session. We are each following our own MAP: mastery, autonomy and purpose.

‘Make each day your masterpiece’ John Wooden

If you are looking to develop your practices, to get the best of you and your patients and athletes, The Pain Coach Workshops give you the knowledge, skills and know how:

London 20th October

University of Central Lancashire, Preston 3rd November

 

13Mar/17

3 ways to ease suffering

Chronic pain, Mindfulness, Pain, Pain Coach, Pain Education, , , , ,

We all suffer. Suffering is part of living and so is unavoidable. There are many reasons for suffering and they are unique to that person and the way that they view life. The Oxford Dictionary defines suffering as “The state of undergoing pain, distress, or hardship”. We are all subject to these states regardless of age, gender, culture or class. In fact, we could say that humanity is connected by the universal experience of suffering. Bearing this in mind and essentially normalising suffering as part of life, it would be prudent to develop some skills that allow us to face suffering, transform, learn about, and ease it. Here are 3 ways to ease suffering.

These are simple practices for everyone that can be integrated into day to day life. Moment to moment awareness creates the opportunity to practice healthy habits resulting in living well.

Acceptance

Accepting what is happening right now dissolves any resistance. Resistance results in suffering because we are not happy with how we are or where we are or what we have. This is a common cause of discomfort and resistance can certainly drive tension and pain in the body. Accepting is NOT giving up. Instead it is actively being open to what exists now as a lived experience, allowing it to transform as it always does with each passing moment. Acceptance allows us to move forward in a chosen direction whereas resistance does not.

Mindful practice

There are simple mindful practices that give us insight into the way we think and feel, help us to be acceptant, allow us to let go of unhelpful thoughts and to be open to experiences as they unfold. By the very nature of these practices, a sense of well being emerges as we fully engage with the joys of life as well as think clearly about how to surmount the inevitable challenges we face. Here are a few examples:

  • take 4-5 slightly deeper breaths at regular intervals during the day, being fully aware of the ‘in’ and ‘out’
  • pay full attention to what you are doing, whatever that happens to be
  • formal practice of mindfulness meditation ~ this is best done with a coach or instructor to start, or in a group
Practicing gratitude

There are great benefits of practicing gratitude as a skill of well-being. Next time you are feeling glum, in pain, feeling anxious, try thinking about something you are grateful for. This does not need to be anything momentous, instead something more day to day such as the clothes on your back, the sun in the sky or a text from a friend. It needs to have some kind of meaning to you. Practicing gratitude can change the way we relate to an issue of concern. We release some important and healthy chemicals by actively generating the feeling (the feeling is underpinned by those chemicals as best we know), which creates the conditions for more clarity. Clarity of thought means we can focus on the thinking/actions that can result in face a challenge successfully.

The Pain Coach Programme to overcome pain and to live well | t. 07518 445493

05Mar/17

Mindfulness in brief and 5 easy practices

Chronic pain, Mindfulness, ,

Mindfulness in brief and 5 easy practices ~ there are many books and articles available on the topic of mindfulness so I thought I would write a brief summary. Just to add to the existing and vast literature….

This is how Thich Nhat Hanh answers the question ‘What is mindfulness?’ in his book for children ‘Is nothing something?’:

“Mindfulness is energy. This energy helps us enjoy what is happening right now. Mindful energy can bring us a lot of joy. It helps us suffer less and learnt from our suffering. A good way to get some mindful energy is to close your eyes and breath easily. Just pay attention to your breath. If you can enjoy your in-breath and out-breath, you are creating mindful energy.”

Simple.

“Mindfulness is energy ~ Thich Nhat Hanh

To practice mindfulness you do NOT have to do any of the following:

  • Become religious or change religions ~ mindful practice is not about being religious.
  • Wear an outfit.
  • Pay money.
  • Change anything about yourself.
  • Go to a special place

In other words, anyone can practice, wherever they find themselves and gain the benefits of being mindful, although one of the key points about being mindful is that you are not actually ‘doing’ anything.

Being mindful means you are aware of what is happening right now, accepting what is happening right now, accepting who you are and how you feel and what you are thinking right now, without judgement. This observation and experience of what it is like to be you creates insight into you and the world, seeing reality and seeing things for what they are rather that being judged or clouded by unskillful thinking. Instead of striving to be somewhere else or someone else, we accept who we are and cultivate compassion towards ourselves and others. Both are very important skills for being healthy.

We can simply practice mindfulness by paying attention to our (normal) breathing, which means that we are present in this moment. Much suffering comes from either dwelling or repeating the past, or from anticipating a future that is not pleasant. Some of the thoughts can stem form being hard on ourselves, telling ourselves that we are not good enough or worthy of happiness and health. This is wrong thinking and mindfulness allows us to see this and let go.

Further suffering comes from wanting to be somewhere else whilst not accepting where one is now. Similarly with material goods: wanting something but not being grateful of satisfied with what you have now. It comes down to the same thing really, that is accepting yourself and current circumstances with compassion. Acceptance is certainly not giving in, instead seeing things for what they really are and letting go of resistance. Letting go of resistance immediately eases suffering.

Of course you can download an app or buy a book, but by far the best is to be instructed by someone who knows the practice. The group dynamic is often a good start point, gaining the benefit of practicing together. Questions inevitably arise and it is important that these be answered so that you understand what you are doing and why. Having said that, here are some simple practices to start right now.

Mindfulness in brief and 5 easy practices ~

1. Set a reminder, and every few hours stop and pay attention to 4-5 breaths. This brings you to the present moment, allowing you to realise the effects of thoughts; and they are just thoughts. How do they differ from reality and what is actually happening right now?

2. Ask yourself how you are choosing to think right now?

3. Name the emotion you are feeling.

4. Pay full attention to what you are doing, whatever that happens to be.

5. Check in to your body and see what is going on — tension? warmth? comfort? etc etc. Notice the ‘what it is like’ and the thoughts that you have about the experience — the two are different and there is great value in knowing the difference.

~ mindfulness practices are part of the Pain Coach Programme developing insight, calm and compassion to create the conditions for recovery and living well.
Pain Coach Programme to overcome chronic pain t. 07518 445493
21Jan/17

Engaged physiotherapy for pain

Chronic pain, Compassion, Mindfulness, Pain Coach, Uncategorized, , , , ,
Engaged physiotherapy for pain and the modern world

Engaged physiotherapyEngaged physiotherapy is an approach embracing full awareness of oneself as a clinician, full awareness of the person you are working with, full awareness of the context and past, compassion (self and others), insight, and modern sciences (the facts ~ what we know). I have ‘borrowed’ the term from Thich Nhat Hanh who describes engaged Buddhism, which is the practical use of the philosophical principles such as mindfulness, mindful breathing and mindful walking.

Cultivating our awareness as clinicians and gaining insight into the causes of suffering affords us the opportunity to think clearly about the best action for the individual, in this case in pain. Together with an understanding an use of modern sciences, especially pain science, cognitive science and neuroscience (there is vast overlap of course), and philosophy, we can consider each person’s story and create a way onward that is grounded in understanding, compassion, belief and the right attitude to succeed.

There are simple practices that clinicians can use each day that develop and grow awareness and insight. Here are some examples:

  • The greeting
  • Being present during a consultation using the breath
  • Deep and active listening
  • Compassionate speech
  • The creation of a calm and peaceful environment
The greeting

The initial contact often sets the scene. We can think about how we present ourselves with posturing, gestures, language and the simple smile. I would suggest always going to the patient to greet them in the waiting area, and behaving very much like you are welcoming an old friend into your home.

Being present

Using the breath we remain present and aware of what is happening right now. What is passing through me (my mind)? Any bias? Preconception? Judgement? Being aware allows us to let these go so we can focus on active and deep listening. Practicing mindful breathing each day formally for 5-10 minutes helps us to develop this skill that we can use through the day, every day for professional and personal relations to benefit

Deep listening

One of the most valuable gifts we can give to another person is ourselves and our time. Being fully present to listen to the patient (or colleague or family member or friend) creates the conditions for a meaningful interaction. All involved parties benefit from meaningful interactions as we release certain healthy chemicals in these contexts. In deep listening we can hear and understand the suffering of the other, enabling the best and wisest course of action, which may simply be to continue to listen without interruption. Learning to be comfortable with silence is a valuable skill. Much can emerge from moments of silence. (Reading here)

Compassionate speech

Choosing our words carefully, considering their effects, is an important skill to develop. The words we utter have potent effects on others as they hear, process, imagine, think and react. Of course using kind, compassionate words can create the conditions for calm and insight, enabling the person to see a way forward. A focus on health and being well maintains the desired direction, hence the use of words that encourage this thinking and vision helps the person to orientate themselves towards a desired outcome.

We have the spoken word and we have the inner dialogue. Being skilful with both is important as we need to consider which thoughts we are fuelling, or which seeds we are watering by the way we think and what we say. An example would be the effects of engaging in idle gossip. In the long-term, gossip can create issues of trust and miscommunication that breeds suffering.

As a clinician, we should always be thinking about delivering the right messages based on truth, and that provide a compassionate way forward. Helping the patient develop their skills of self-compassion is frequently needed in cases of chronic pain. Understanding that self-compassion is one of the skills of well being helps individuals to practice and benefit from the nurturing of the care-giving systems in the body that play such a big part in our health and happiness.

Creating a calm environment

We are very responsive to the environment. Consider how you would feel working in an office with no windows and in the basement of a block compared to an office with a view over a park or a river.

Clinicians need to think about how the patient might think and feel coming into the clinic. We seek to create a peaceful space for people to experience feelings of calm and gain insight into how they can be, how they can transform their state of being and how they can use these practices in their day to day lives.

The simple practices are just some of the ways we can use our knowledge and skills to create the conditions for people to get better. We no longer have to think about managing or coping, instead use engaged physiotherapy and approaches to give people the belief, understanding and skills to coach themselves, fostering independence and a sense of agency, restoring choice and meaningful living.

****

These practices are part of the Pain Coach Programme, which is a focus upon getting better and achieving success in overcoming pain. The programme for patients is a comprehensive way forward addressing a pain problem by focusing on getting healthy and well, and the programme for clinicians is to develop their skills and knowledge to coach patients. If you would like further information, please email us: [email protected] or call 07518 445493.

15Jan/17

Creating peace

Chronic pain, Mindfulness, , , , ,
Creating peace is vital for suffering individuals and for society

Creating peaceCreating peace should be the aim of all society but of course peace must reside in each individual for this to happen. One of the greatest proponents of peace is Thich Nhat Hanh, a Vietnemese monk who works tirelessly to bring engaged Buddhism to the world. This means simply teaching simple practices that can be used by everyone, not in a religious sense, but instead as a way of creating peace through compassion and insight. Mindfulness is the main vehicle, and to be mindful is to be fully present, to be aware, to have insight, to have clarity, to experience emotions and thoughts in this moment, to be judgmental, and to be accepting.

Mindfulness is a simple practice ~ anytime, anywhere

Mindfulness is a practice that can be used through each day in different ways to gain these healthy benefits. Some describe a practice like this as a skill of well-being, or the skill of being well. These skills form a major part of the Pain Coach Programme, which is a comprehensive approach not only to overcome pain and chronic health issues but to create the best health to live a meaningful life within our ever-changing circumstances. It is much like learning to sail a boat when the sea is sometimes calm and the sea is sometimes ferocious. The wandering mind is an unhappy mind, read the title of a well-publicised piece of research. Whilst we also know that to permit mind wandering can be useful for ideas and creativity, having control over when this starts and finishes maybe important. Certainly being able to attend to what you are doing in this moment is a valuable health skill afforded by mindfulness practice.

Those who have practiced mindfulness will know that creating peace is one of the emerging experiences. We cannot quieten our mind directly, but the mind can calm within the context of being mindful. Thoughts just come, and we cannot stop them much like King Canute could not stop the sea. Yet we learn how to become insightful and skilful as these thoughts pop in, seeing them as just thoughts and opinions that are often very different from reality and truth. Being observant and curious about our thoughts, or the story that we tell ourselves, gives us space to choose how to respond. How can you respond? You can decide to re-focus your attention on what is happening now by using your breath, you can let the thought go (they pass by anyway), you can purposely generate a positive feeling, you can engage in a meaningful interaction or you can perform an act of generosity. All of these you can do in a way that is informed with self-compassion, being kind to yourself, a key skil of well-being.

Individually we are responsible for creating peace within ourselves. It is an error to think that somehow peace or happiness comes from somewhere or someone else. Mindfulness teaches us that we can come back to ourselves at anytime in order to feel at home and secure. That sense of safety, warmth, comfort and peace we can generate ourselves with increasing effect by practicing the skills of being well and cultivating our awareness and insight. In doing this, we are regularly promoting our own health by activating the care-giving systems in our bodies. These play a vital role in day to day physiological functioning: nourishing body systems, diverting resources to healing, repair, refreshing and renewing, digesting food and building energy levels that we need to live and feel well. This is in contrast to the protect and service systems that are designed to work in short bursts. It is when the protect mode is operating consistently that we can develop a wide range of common ailments: IBS, migraine, pelvic pain, wide spread aches and pains, chronic pain, fibromyalgia, and fertility issues to name a few. Choosing to lead a hectic life full of habits that promote survival without adequate deep relaxation only results in health issues. However, we can always make the choice to make a change in a new direction.

We are changing every moment, you just need to choose your direction in line with your vision of the well-you and groove new habits

There are many issues with modern society and its impact upon the health of all, however we also have a great deal of knowledge we can use to make an impact. There are many simple practices that we can use each day to improve our world. This all begins with a shift in thinking beyond oneself towards a mindset of how we can best give and serve our world and the people in the world. We are interconnected in many ways and collectively we can be responsible for social developments that benefit all. We are seeing this increasingly with social enterprises emerging in different sectors. This work is vital for all of us.

Creating peace within ourselves with a simple practice each day is the basis for a collective peace within society. On an individual basis, the creation of peace within is the same as creating the conditions for health as the parasympathetic nervous system predominates. There is so much to be gained from practices that can be learned by all ages (children, teenagers, adults and seniors) in different environments (nurseries, schools, workplaces, homes and healthcare facilities). Low cost, easily implemented and science-based there are a number of initiatives across the world that we can build upon and develop. However, it starts with the individual.

Pain Coach Programme to overcome chronic pain by using the skills of being well to lead a meaningful life | t. 07518 445493 or contact us using the form below.

14Dec/16

In pain ~ what is said, what is heard?

Chronic pain, Communication, Mindfulness, Wellness, , ,
In pain ~ what is said, what is heard?

Anyone who has tried to describe their pain knows how incredibly difficult it is to find words that truly represent what they feel. The same could be said for many lived experiences, the ‘what it is like to……’ that we attempt to transmit to another person. But of course the other person cannot actually know or feel what you feel. We only know what it is like to be ‘me’.

Acknowledging this issue, when we ask people to describe their pain, they are permitted to use any words from their own vocabulary and any comparison or metaphor that emerges from their thinking because this is as close as they will get. Whilst they are telling us what they feel, as well as words that attempt to describe the raw feel of pain, others will demonstrate the degree of suffering and emotional distress that are the additional factors, or second arrow in Buddhism terms. We experience a raw feel, which would be the first arrow, and then the thoughts and emotions that have their own ‘feel’ and typically are the source of the greatest suffering, which are the second arrows.

The raw feel of pain is the raw feel of pain. The add ons are all the thoughts and feelings associated with the pain that are the cause of great suffering. 

Active or deep listening allows us to really hear what the person is saying to us. This is sitting in a state of calm and non-judgement, allowing the person to express themselves in their own unique way. Silence maybe part of this ‘exchange’ that the clinician can become increasingly comfortable residing in, with the knowledge that from silence can emerge important dialogue. Only through deep listening can we hear the words of the other that emerge within a particular context that must also be recognised ~ i.e. the difference in the way someone behaves in different situations such as the clinic when they may be anxious. We must get as close as we can to hear what the individual is saying: have I truly heard what they have said?

We can enhance the flow of communication with our posture and the way we move within the dialogue. A simple movement towards the person shows engagement whilst eye contact can be used judiciously. It is worth considering that for some people eye contact can be challenging or threatening, hence awareness and being present are important.

Our way of being, when filled with compassion and empathy, creates the opportunity for the person to speak and tell their story that is full of all the information that we need as clinicians to gain insight into their suffering and the causes of their suffering.

Pain Coach Programme for chronic pain | skills of well being to live a meaningful life | t. 07518 445493
23Oct/16

Is mindfulness for everyone?

Chronic pain, Mindfulness, , ,

MindfulnessWalk into a bookshop and you cannot help but notice the ever-increasing number of books about mindfulness filling the shelves, which begs the question, is mindfulness for everyone?

In my opinion, mindfulness is a practice that everyone could choose to incorporate into their lives, however, not everyone will wish to make that choice. It is also the case that the route to mindful practice can be different for different people. For example, sitting or lying and being mindful or meditating can be result in greater suffering in some circumstances and hence that person needs something else at that time. An individual suffering PTSD for instance, could discover that mindful practice leads to a greater state of stress and anxiety. There are several possible reasons for this, including whether they have been instructed in the right way about what mindfulness really is and how we go about the practice. With so many people offering mindfulness at the moment, it can be difficult to know who best to listen to or follow.

Starting any new practice is a challenge and requires dedication and perseverance. In so doing, one learns and realises that each moment there is an opportunity to get better at what you are doing. As Ajahn Brahm says, ‘there’s no such thing as a bad meditation’ — we can always take something from the practice, and the fact that you have practiced has created a learning opportunity. Sometimes the practice results in a great feeling of serenity as the inner dialogue quietens, and sometimes the voice chunters away. Good? Bad? It is what you think it is!

Mindfulness is simply about being aware of your thoughts, feelings and sensations as they pass by, which they always do. The realisation of impermanence is an important one as moments continuously flow. Noticing what you are thinking and feeling without judgement means that you begin to see things for what they are and the causes of your, and other’s suffering. This insight is invaluable for our health. One is tempted to say emotional health but this would suggest some kind of separation between body and mind. There can be no separation between body and mind as we are a whole person living experiences that are unified of cognition, perception and action. The practices of mindfulness provide a way of ‘doing’ this, although really when being mindful, we are not actually doing anything other than being aware, using our attention. To add compassion to this means that you have the intention to be kind to others and yourself with all the accompanying health benefits from positive social interactions and kindness to self.

Mindfulness is a practice with several straightforward methods (below), which is why it is accessible to all. However, actual practicing is the challenge as we have so many existing habits of thought. Our minds do wander and are filled with chaotic thoughts that inform feelings, emotions, actions and perceptions, yet all of these dimensions inform each other. This complexity defines the challenge and how one day we can quieten down the inner chat and another day it seems to make no difference. Remembering that it is not the thought or series of thoughts that is the issue, instead it is recognising that this is the content of the mind, which is not me per se. I am not the contents of my mind, and being able to realise that is hugely empowering.

Two common practices are mindful breathing and mindful walking, both if which are accessible at any moment to most. Paying attention to what arises in this moment is at the essence of the practice that develops one’s ability to focus, choose what to attend to, to reappraise a thought pattern, see things for what they are, realise that anger or another emotion is present yet you can remain focused on your intention. Keeping a focus on your intention is a great skill demonstrated at a time when an argument ensues. Instead of emotional reactions with hurtful words, maintaining a course for the intention that is usually a kind action towards another, you listen deeply and understand the other party, allowing for effective communication towards a resolution. Be able to see the reasons for the other person’s actions provides great opportunity for transforming the situation. This would be a good example of using mindfulness and compassion, the two differing.

Returning to the primary question, I believe that mindful practices can be integrated practically into people’s day to day living if the person makes the choice to do so. Potentially, this is the case for anyone. However, each person needs good instruction and guidance, in essence to become their own coach to transform their inner dialogue to one of kindness and compassion toward self and others. Mindfulness creates the awareness within which this can happen through attention training (mindfulness is about attention whereas compassion is my motivation or intention ~ there’s a difference). Some will need other ways into the regular practice by using breathing and movement, some will need different explanations to be guided and supported, but the the aim is always to develop ways to reduce suffering.

RS

Mindfulness practice is a part of the Pain Coach Programme for overcoming pain | contact us by email: [email protected] or call us 07518 445493

12Sep/16

Mindful commuting

Anxiety, Mindfulness, , , ,

Mindful commutingMany people commute to work creating a great opportunity to create calm, focus and prepare for a top performance, simply with mindful commuting. In London, a huge number of commuters use the tube, which is rammed with people (in a rush), often smelly and particularly hot in the summer. How can one create calm and focus in those circumstances you may wonder?

As a commuter you join thousands of others, some of which push you, breathe on you, lean on you, rest their paper on you (I once saw a woman rest her newpaper on a man’s back, which she quickly moved when he turned, only to put it back when he looked away — it was quite amusing), stare at you and nudge you. Today there was a small space next to me and a man forced his way into it creating discomfort for everyone, including himself. So there are just a few incidences that could challenge one’s patience and yet what a great opportunity to develop the skills of patience and compassion towards others. In doing so, you feel better versus feeling anger, frustration or annoyance. We can choose.

Over and above developing a compassionate outlook for the day ahead by looking deeply at a situation (we can consider that the other person may be suffering for a range of reasons and hence behaving in a certain way), we can use the following practices to orientate ourselves towards positive emotions. Being aware of and acknowledging positive emotions broadens our thinking and receptiveness as well as enhances our resilience in the face of a challenge, all of which impact upon our performance at work based on how we communicate with ourselves and others.

  • each time you find yourself becoming irritated on your commute, take 3 breaths and in particular notice your out-breath
  • walk mindfully, paying attention to each step and just be curious as to what is going on around you. Notice how it makes you feel and return your attention to your walking
  • if you cannot get through the crowd because it is busy, return your attention to your breathing to create calm and then walk mindfully
  • be aware of those around you and wish them well in your thinking, noticing how this makes you feel and how the world then appears
  • as you pay attention to your breathing, think kindly about your colleagues and boss so that when you encounter them, you communicate with skill and not on a background of feeling stressed and anxious
  • if you feel stressed and anxious it is because your thinking (embodied) has drifted into the past or future, thereby flavouring the present. Take 3 breaths and see things for what they are; be aware of this moment
  • listen to a mindful app on the journey
  • practice mindful breathing when you simply pay attention to your breath that holds you in the present moment

There are many more ways of practicing but in essence just using one or two will help you create calm and focus. Try it and see!

Mindfulness is a very practical way of being that creates calm, peace and allows you to to see things for what they are as you are consistently aware of the present moment, you listen deeply and speak with skill to communicate understanding and compassion. This is transformative in all situations and achievable for all.

Mindfulness practice forms part of the Pain Coach Programme for pain and chronic pain | t. 07518 445493

28Aug/16

Simple skills

Chronic pain, Pain, Pain Coach, , , ,

simple skillsThere are a number of simple skills that can be practiced to become a better clinician. In essence, when we are fully present and engaged, we are communicating this to the patient thereby creating a nourishing environment. This environment sets the scene for new understanding and new habits, beginning the transformation of the suffering person.

We are not separate from the environment in which we reside and hence we, the clinicians, have a role in how the environment supports the person getting better. Arranging the treatment space is important then, enabling the patient to feel welcome, heard, comfortable and free to express themselves. This expression is the story to which the clinician must listen deeply as all the information is contained within the narrative. Allowing the person to speak in their own language with occasional prompts and guidance is the basis of the onward journey towards their vision of a desired outcome.

For the clinician to practice mindfulness is a simple way of maintaining presence and engagement with the patient. This simply means that you are listening deeply and using insight to see the causes of suffering that are revealed as the person speaks freely. Add to this compassionate speech and the communication facilitates the way forward. Communication is part of the treatment as the clinician helps the patient understand their pain and suffering — what has happened so far, what is happening now, what is influencing their pain, what they can do, what the clinician will do and how they will go about it.

Practicing mindfulness is a simple skill. As a starter, the clinician can take 4-5 breaths between patients, paying attention to the rise and fall of their chest. On the out-breath you can consciously let go of unhelpful and distracting thoughts. As soon as your mind drifts into the past or future, you are no longer present and your engagement dissolves. During the session, recognising this happening and bringing your attention back to your breath is a way of re-engaging once more.

Taking a break midway through the day to move, breath and nourish is an important refresh and renew point. A period of deep relaxation for 10-20 minutes gives us energy to be present once more and focus on the patient: their words, their gestures, their messages. We must develop our abilities to gain insight into the causes of the patient’s suffering so that we can guide and treat, enabling them to get better and ease their pain and suffering. In fact, by gaining insight ourselves, we can then help the patient to develop their insight into the causes of their own suffering and create new healthy habits around their thinking, choices and actions to actively infer new experiences.

Practical point: start by taking 4-5 breaths between patients, and at the start of the day express gratitude for the opportunity to help people get better.

********

Pain Coach 1:1 Mentoring Programme — develop yourself and your insights to coach people overcome their pain | t. 07518 445493

08Jun/16

Space

Chronic pain, Environment, RSI, Space, Uncategorized, , , ,

SpaceThere are things that we know are good for us: sleep, water and space. Of course then we need quality sleep, water and space. I’m interested in space, and not the kind that is out there, but rather the space we choose to place ourselves day to day and how this impacts upon us consciously and subconsciously. In particular I am keen to understand how we associate with certain environments and in fact how our brains predict the meaning of a given environment and the experiences that emerge.

Here are a couple of classic examples that I hear about:

1. RSI — repetitive strain injury: I am using this term for ease, although I have issue with it, but that’s for another time. I refer to pain and other symptoms that people attribute to repeated use such as typing, clicking a mouse and texting. In the vast majority of people I see with this burdensome condition, we can evoke their symptoms by just thinking about certain environments! Their desk at work for example. When we close our eyes and think about a place, we are in essence there and it feels like it. When a place or space becomes associated with a threat value because of a link that has been established, then it makes sense to feel a warning when we think about it. However, when this persists, this becomes an increasing problem due to the behavioural aspects — altered movement, restricted use and guarding, all of which perpetuate the threat value and hence the on-going pain. Thankfully, this cycle can be broken with the right understanding and training.

* This is not unique to RSI, but any pain problem is contextual and becomes associated with certain places, positions, movements, activities etc etc. A significant part of overcoming persistent pain is by creating new habits.

2. A place in nature: a pleasant image comes to mind, unified with feelings of comfort in the body to make it an overall calming and soothing experience. This is why visualisation is so effective as we can choose to shift into our resource state whenever we need: when anxious, stressed or in pain for example. This is a technique that I blend with others to create the necessary calm we need to refresh and renew, particularly if we are suffering pain or tiredness.

Placing ourselves in an environment has enormous effects upon us as we become part of that very environment. In fact, what you experience as that environment you are creating using at least your brain, your mind and your body, and importantly how they unify. Using a film analogy, you are the film maker, the script writer, the star and the audience all rolled into one. Wow! How do we explain that? Using the very same unified processes to explain themselves! So, in becoming part of threat environment, the importance of choosing the right space is vital. Each day we should absorb ourselves in a nourishing place such as a park, by a river, in a forest or at least in a space where there is plenty of exactly that, space! And if you can’t do this on a particular day, then you can use imagery and visualisation and feel the resulting great feelings.

On a moment to moment basis, where we spend a lot of time, perhaps home and office, these spaces need to be nourishing and promote the feelings we want to feel — e.g./ at work to concentrate, focus, think, write, communicate; at home to feel comfortable, warm, safe etc. This may take some thought and some re-organising but it will be worth it — see here, a professional organiser: Cory Cook. Remember that the environment you choose to put yourself in impacts upon you enormously: the way you feel, the way you think, the way you interact. Something similar could be said for the people you spend time with.

So, when you are at work, at home, choosing a new job or accommodation, think carefully about the environment in which you will be living moment to moment experiences, because they will be shaped somewhat by that very environment. Get out into a big open space and move around in it, see it, smell it, feel it, using all your senses. And if you can’t, then take a deep breath, slowly let it go, do it again, close your eyes and take yourself to a space where you will feel great.

Pain Coach Programme for persistent pain | t. 07518 445493