Mindfulness Interventions A Workshop to Foster Resiliency Saturday

Mindfulness Interventions: A Workshop to Foster Resiliency Saturday, June 10 (12 N – 1: 30 pm)

Introduction Claire V. Wolfe, MD Delegate, AMA-SPS Governing Council © 2017 American Medical Association. All rights reserved.

Speaker’s Disclosure The content of this activity does not relate to any product of a commercial interest as defined by the ACCME; therefore, there are no relevant financial relationships to disclose at this time. © 2017 American Medical Association. All rights reserved.

Speaker Philip H. Cass, Ph. D Consultant & Coach TLP Group, Inc. Columbus, Ohio © 2017 American Medical Association. All rights reserved.

Objectives During this session, you will: 1. Review the latest understanding of the effects that mindfulness meditation has on the brain. 2. Assess the implications mindfulness meditation has for physicians in their practice of medicine. 3. Evaluate how to incorporate mindfulness techniques in daily life. 4. Practice three easy-to-implement mindfulness techniques. © 2017 American Medical Association. All rights reserved.

Polling Question Once a person begins a mindfulness meditation practice, approximately 50% of those people continue on with their practice for many years. 1. Yes 2. No 3. Maybe © 2017 American Medical Association. All rights reserved.

Mindfulness The quality or state of being mindful. The practice of maintaining a non-judgmental state of heightened or complete awareness of one’s thoughts, emotions, or experiences on a moment-to-moment basis; also: such a state of awareness. Merriam Webster © 2017 American Medical Association. All rights reserved.

Practices of Mindfulness Living your life as if it really mattered, moment, by moment. Jon Kabat –Zinn • Yoga • Tai Chi • Qigong • Journaling • Meditation 8 © 2017 American Medical Association. All rights reserved.

Meditation Can have many forms including those that specifically seek to develop love or compassion, a specific mode of thinking or mental state, deal with negative emotions, reduce stress or achieve a form of spiritual enlightenment, growth or insight and awakening. 9 © 2017 American Medical Association. All rights reserved.

Mindfulness Meditation Typically involves the deliberate effort to stabilize attention on specific physical sensations and environmental stimuli, attempting to establish a lock with the present moment when (and not if) the mind begins to wander. This deep engagement with the here and now is combined with an attitude of acceptance and openness, enabling thoughts and emotions to come and go without cognitive evaluation. Focused attention on breathing while maintaining nonjudgmental awareness of thoughts and sensations is the most common activity used in mindfulness training. Theo Winter 10 © 2017 American Medical Association. All rights reserved.

Types of Mindfulness Meditation • Walking meditation • Standing meditation • Lying down meditation • Sitting meditation 11 © 2017 American Medical Association. All rights reserved.

Four Common Elements • A quiet location with few distractions • A specific, comfortable posture • A focus of attention • An open attitude 12 © 2017 American Medical Association. All rights reserved.

Benefits of Mindfulness Meditation 13 • Reduced Rumination • Less emotional reactivity • Stress Reduction • More cognitive flexibility • Pain Regulation • Relationship Satisfaction • Boosts to working memory • Blood Pressure • Focus …and more © 2017 American Medical Association. All rights reserved.

Mindfulness Meditation and the Brain • Long term meditators show more folds in the outer layer of the brain. • Slow, stall or even reverse changes in the brain that take place due to aging. • Can affect activity in the amygdala-different types of meditation have different affects on the amygdala. • Long term meditators show thicker cortical regions of the brain related to attention and sensory processing. 14 © 2017 American Medical Association. All rights reserved.

Mindfulness Meditation and the Brain (con’t) • Advanced meditators showed more activation in those areas of the brain that detect emotional clues. • After 8 weeks of training there was some evidence of increased activity in the region of the brain correlated with positive affect. • After 8 weeks of training there was evidence that the immune system reacts more robustly in antibody production. 15 © 2017 American Medical Association. All rights reserved.

Mindfulness Meditation and the Brain (con’t) • After 8 weeks of training there was evidence of better stress regulation as measured by a faster decrease in levels of cortisol following a laboratory stressful task. • Neuroimaging evidence suggests that mindfulness practice is associated with neuroplastic changes in the anterior cingulate cortex, insula, temporo-parietal, fronto-limibc network and default mode network structures. …and more 16 © 2017 American Medical Association. All rights reserved.

Mindfulness Applications • “There is no price tag on clear mind” Intel launched a mindfulness program • “At Aetna, we are using a CEO’s Management by Mantra. ” • “The Mindful Business” - General Mills • “Why mindfulness works wonders” - Herbert, Smith, Freehills Global Law Firm • “Mindfulness goes to work: Impact of an online workplace intervention” Dow Chemical - • “Examining the protective effects of mindfulness training on working memory capacity and affective responses” -The US Military • “Mindfulness-based interventions in schools” - A systemic review and meta-analysis 17 © 2017 American Medical Association. All rights reserved.

Polling Question Once a person begins a mindfulness meditation practice, approximately 50% of those people continue on with their practice for many years. 1. Yes 2. No 3. Maybe © 2017 American Medical Association. All rights reserved.

Moderator: Paul H. Wick, MD Chair-Elect, AMA-SPS Governing Council © 2017 American Medical Association. All rights reserved.

Questions from Audience Members

Sponsored by the AMA’s Senior Physicians Section 21