This 2.5-hour session includes a review of the approach and the establishment of a learning contract with the participant. The theoretical underpinnings of mindfulness within the context of Mind-Body and Participatory Medicine and the application of self-regulatory skills related to the individual’s stressors are established. The participant is experientially introduced to mindful eating, some standing yoga stretches, mindfulness of breathing and the body scan meditation. Home practice is assigned using the first guided (body scan meditation) as a means of beginning to learn to become familiar with mindful awareness of the body.
From our point of view, as long as you are breathing, there is more right with you than wrong with you, no matter what challenges you are facing. Challenges and difficulties are workable. Mindful awareness, defined as the awareness that arises from paying attention, on purpose, in the present moment, non-judgmentally, (Kabat-Zinn, J, Full Catastrophe Living, 1990, 2013) is fundamental to this approach since the present moment is the only time anyone ever has for perceiving, learning, growing and transforming.
Building trust within the group and beginning to sense a community; defining and applying mindfulness to our life experientially; opening and starting to explore; acknowledging alternative perspectives; trusting the possibility to see oneself with fresh eyes.
Perception / Creative Responding
This 2.5-hour session includes one hour of experiential mindfulness training and skill development, and one hour or more of focused dialogue and reflection on home practice and, thematically, on the role of
perception and conditioning in the appraisal and assessment of stress. The pivotal role of self-responsibility in the positive development of short and long-term changes in health and health-enhancing behaviors is introduced. Home practice is assigned with an emphasis on the regular daily practice of the body scan for a second week, plus introduction of short periods of sitting meditation, and the application and integration of mindfulness into the participant’s everyday life.
Perception and creative responding: How you see things (or don’t see them) will determine in large measure how you will react or respond to them. This ties in with how people see their participation in the program; how they see their pain, their illness; the stress and pressures in their lives; the level of commitment they will bring to the program and to the personal discipline it requires. Making the connection to automatic habitual stress reactivity and recovery from acute stressors, and the principle that
“It’s not the stressors per se, but how you handle them” that influences the short and long-term health effects they may have on your mind, body and overall sense of health and wellbeing.
The Pleasure of Being Present
In this 2.5-hour session, participants practice several distinct yet interrelated formal mindfulness practices -- mindful hatha yoga (ending with a brief body scan), sitting meditation and optional walking meditation -- for a minimum of 90 minutes. This extended formal practice period is followed by inquiry into and exploration of participants’ experiences with in-class and assigned home practices. Typical topics
include challenges and insights encountered in formal practice and in integrating mindfulness into everyday life.
There is pleasure and power in being present. Attending to and investigating the way things are in the body and mind in the present moment through the practices of yoga and meditation.
Physiological and Psychological bases of stress reactivity / Exploring More Effective Means Responding to Stressful Situations
During this 2.5-hour session, participants engage in a combination of the three major formal mindfulness practices that they have also been practicing at home during the preceding three weeks. These include:
mindful hatha yoga, sitting meditation and the body scan. In this class, a brief guided body scan can be practiced before the start of the sitting practice (this is optional and lying down is not necessary). Instruction emphasizes the development of concentration, embodiment, the capacity to train and re-direct attention, and the systematic expansion of the field of awareness.
Conditioning and perception shape our experience. By practicing mindfulness, we cultivate curiosity and openness to the full range of experience and through this process cultivate a more flexible attentional
capacity. We learn new ways of relating to stressful moments and events, whether external or internal. Exploration of mindfulness as a means of recognizing and reducing the negative effects of automatic, habitual stress reactivity as well as the development of more effective ways of responding positively and pro-actively to stressful situations and experiences are addressed with increasing depth and dimensionality. The physiological and psychological bases of stress reactivity are reviewed and in-depth discussion is directed toward using mindfulness as a way of working with, reducing, and recovering more quickly from stressful situations and experiences. Daily practice aimed at recognizing and experientially inquiring into automatic habitual reactive patterns is assigned for home practice.
Self-limiting Behaviors (option: respond vs. react)
During this 2.5-hour session, participants engage in a combination of the three major formal mindfulness practices that have also been practiced at home during the preceding three weeks: The body scan, mindful hatha yoga and sitting meditation. This session marks the halfway point in the course. It emphasizes the capacity of participants to adapt more rapidly and effectively to everyday challenges and stressors. Experiential practice of mindfulness continues with an emphasis on responding (vs. reacting) to
stressors and the value and utility of mindfulness in learning to stop, step back and see more clearly / objectively and to then be in a better position to make informed choices (responding) in meeting various situations. To further the capacity to respond, problem-, emotion-, and meaning-focused coping strategies may be delineated (See Lazarus and Folkman, and Folkman.) A central element of the session is oriented around the participant’s capacity to recover more rapidly from stressful encounters when they occur. Strategies continue to be developed with emphasis on the growing capacity to attend more precisely to a variety of physical and mental perceptions and to use this awareness as a way of deliberately interrupting and intervening in previously conditioned, habitual behaviors and choosing more effective mindfulness-mediated stress responses. (See: Kabat-Zinn, Full Catastrophe Living, 2013, pgs 335-349). Neuroscience research may be appropriately included here, and is best introduced in relation to what is being reported by participants regarding their actual experience. Daily mindfulness practice is assigned, with an emphasis on the observation and application of mindful awareness in daily life.
Awareness of being stuck in one’s life or in particular situations in one’s life, highlighting the conditioned patterns often encountered in highly demanding situations in which one finds oneself (i.e. fight, flight, and
freeze – stress reactivity/automaticity/mindlessness.) Investigation of the ways people often cope including: numbing, denial, passive-aggressiveness, suppression of feelings, substance dependency, thoughts of suicide etc. Recognizing and honoring the fact that these coping methods may have been protective and supported survival, and that they may now be counter-evolutionary and limiting, if not self-destructive.
Note: These topics may have arisen in class four as automatic habitual stress reactivity and the biology of fight, flight and freeze were unpacked. This theme may continue as participants explore and describe what it was like to bring a close and caring attention to their automatic habitual stress reactions without trying to change them.
In this 2.5-hour session, experiential training in MBSR continues with an emphasis on the growing capacity to self-regulate and cope more effectively with stress. Discussion is oriented around the continued
development of "transformational coping strategies": Awareness, attitudes and behaviors that enhance the psychological characteristic known as “stress hardiness" or resilience. Theory is linked directly to the
MBSR methods and skills being practiced and grounded in the actual life experiences of the participants. The emphasis continues to be on the broadening of participants’ inner resources for developing health-
enhancing attitudes and behaviors and the practical application of such competencies into participants’ particular life situations and health status.
Daily mindfulness practices continue to be assigned for home practice with an emphasis on the observation and application of these skills in everyday life. Participants engage in an in-depth exploration of stress as it presents within the domain of communications – particularly, difficult and challenging interpersonal exchanges. The focus of this strategy-building session revolves around the application of previously learned mindfulness/MBSR skills and methods in the area of communications. A variety of communication styles are examined both didactically and experientially, and strategies for more effective and creative interpersonal communication is developed.
Stressful communications; knowing your feelings; expressing your feelings accurately; developing a greater awareness of interpersonal communication patterns, and barriers to doing so are all explored. Interpersonal mindfulness: remaining aware and balanced in relationships, especially under conditions of acute or chronic stress, the strong expectations of others, past habits of emotional expression/suppression and the presentation of self in everyday life are investigated using a wide range of “embodied” methods. Based on the skills that we have been developing through the entire program, all instructional processes emphasize cultivating the capacity to be more flexible and to recover more rapidly during challenging interpersonal situations.
The intensive nature of this 5-hour session is intended to assist participants in firmly and effectively establishing the use of mindfulness across multiple situations in their lives, while simultaneously preparing
them to utilize these methods far beyond the conclusion of the program.
Cultivating a sense of presence from moment to moment, and being open to any experience, whether evaluated as pleasant, unpleasant or neutral, as an opportunity to practice mindful attention.
Keeping up the Momentum (both formal and informal practices)
All Day Class (silent retreat) is reviewed and discussed. There may be a continuation of the discussion of communication that began in class 6. Participants are asked to exercise greater personal latitude in the choice of formal mindfulness practices done as home practice during the week leading up to class eight. Emphasis is on maintaining 45 minutes of daily practice, without recorded instructions. Participants are encouraged to create their own blend of the various practices. (For example, 20 minutes of sitting, 15 minutes of yoga, 10 minutes of body scan.) The intention is to further maintain the discipline and flexibility of a personal daily mindfulness practice by encouraging people to become attuned to the changing conditions in their lives and to ask themselves questions like: “What is called for now/today? “What do I need to take care of myself now?”
Integrating mindfulness practice more fully and personally into daily life. Participants are asked to purposefully reflect on life-style choices that are adaptive and self-nourishing as well as those that are maladaptive and self-limiting. Participants are given ample opportunity to inquire into and clarify any
lingering questions about the various practices and their applications in everyday life. A review of the program is included with an emphasis on daily strategies for maintaining and deepening the skills developed during the course of the program. Time is also allotted for a satisfying closure by honoring both the end of this program and the beginning of living one’s life informed with mindfulness. Participants have an opportunity to speak to the group much as they did in the first class, but this time, to acknowledge what has been most salient, what they are taking away, or what has been discovered. It is important for all participants to know that all their comments are welcomed in this segment of class 8. By example,
nothing may have been “salient.” Perhaps they were completely disappointed by the course...or found the instructor defensive or unavailable to them. This is not meant to be a time for testimonials but instead, for open, honest appraisal of their experience of MBSR. Note on length of last class: Even with smaller groups, a three-hour class offers ample time and opportunity for practice, discussion of home practice and how participants will continue after the course is over, as well as time for each person to speak to the whole group (Group Go Around) about their learning and discoveries (as they did in the first class about their intentions for attending). If class size exceeds 18, it may be more advantageous to lengthen the last class a full hour longer than usual, to 3.5 hours.
In this 2.5 – 3-hour, experiential training in mindfulness continues and participants are given ample opportunity to inquire into and clarity and lingering questions about the various practices and their applications in everyday life. A review of the program is included with an emphasis on daily strategies for maintaining and deepening the skills developed during the course of the program. Time is also allotted for a satisfying closure by honoring both the end of the program and the beginning of living one’s life informed with mindfulness. Participants have an opportunity to speak to the group much as they did in the first class, but this time, to acknowledge what has been most salient, what they are taking away, or what has been discovered. It is important for all participants to know that all their comments are welcomed in this segment of class 8. By example, nothing may have been “salient.” Perhaps they were completely disappointed by the course … or found the instructor defensive or unavailable to them. This is not meant to be a time for testimonials but instead, for open, honest appraisal of their experience of MBSR.
Keeping up the momentum and discipline developed over the past 7 weeks in the mediation practice, both formal and informal. Review of supports to help in the process of integrating the learning from this program over time: local drop-in options, books, recordings, graduate programs, future silent retreats for graduates; local retreat and yoga centers, and other pertinent resources available to support practice.
MBSR Curriculum Guide, Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School.