MBSR Workbook PDF
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MBSR Workbook Mindfulness-based Stress Reduction Mind Full or Mindful? used with permission Material on this site is licensed under the Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 License* See notes, page 104, for explanation of usage and limitations of this workbook and its contents. Written (except where otherwise noted), compiled, and edited by Renée Burgard LCSW, Mindfulness & Health, 300 Plaza South, Los Altos, CA 94022 (650) 269-4807 . [email protected] . www.mindfulnesshealth-psychotherapy.com © 2017 Renée Burgard 1 MBSR WORKBOOK Table of Contents Cover 1 Program Overview 2 Categories of Practices Chart 3 Organization of Course Content, by week 4 Guidelines for Course Participation/Intention 5 Research on Mindfulness – Graph and Links 6 Mindfulness/MBSR Overview Article by R. Burgard 7 MBSR Class #1 Resources 8 MBSR Class #2 Resources 21 MBSR Class #3 Resources 26 MBSR Class #4 Resources 30 MBSR Class #5 Resources 36 MBSR Class #6 Resources 40 MBSR Class #7 Resources 46 APPENDIX I: MBSR Practices Guide 50 STOPping 51 Present Moment Awareness 52 FORMAL PRACTICES 53 Awareness of Breathing Exercises 54 Body Scanning and Mindful Yoga 55 Sitting and Walking Meditation 58 ATTITUDINAL PRACTICES Non-judging Awareness/ Don’t-Know Mind 61 Awareness of Judging Charts 62 Don’t-Know Mind Practice 64 Non-Striving 69 Mindful Acceptance Practices: [REACTING vs RESPONDING] Pleasant/Unpleasant Events Calendars 74 What’s Not Wrong and Mindful Acceptance 76 Responding and Reacting Booklet 77 Difficult Communication Calendar 84 AFFECTIVE PRACTICES Gratitude Mini-Booklet 85 LovingKindness Booklet 89 APPENDIX II: Resources for Continuing Practice 95 Instructor Bio 104 Note on Creative Commons License 105 (on sharing materials from this MBSR Workbook) © Renee Burgard, Mindfulness & Health February 2017 MBSR - Program Overview The faculty of voluntarily bringing back a wandering attention, over and over again, is the very root of judgment, character, and will. No one is compos sui [master of himself] if he have it not. An education which should improve this faculty would be the education par excellence. But it is easier to define this ideal than to give practical directions for bringing it about. William James, Principles of Psychology, 1890 Mindfulness is : ● Paying attention, on purpose, in a particular way ● in the present moment, ● with non-judging awareness (Jon Kabat-Zinn) ● and with curiosity, openness, and kindness Jon Kabat-Zinn combined secularized practices from 3 traditions, in what continues to be a unique way, when he created MBSR: Meditative Practices Breathing & body sensation awareness training (“body scanning”), and “insight,” or “mindfulness” meditation (sitting & walking meditation) from some of the oldest known meditation traditions in Southeast & East Asia Mindful Movement: Yoga (or Qigong) Practice from India (or China) Attitudinal and Affective Practices (paradoxical thinking and cultivation of positive emotions) from East Asia Ongoing research on MBSR since 1982 demonstrates that a combination of these practices, done for 30 minutes to 45 minutes, daily, leads to great benefits in mental, physical, and emotional health and well-being. Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom. Viktor Frankl 2 ● Awareness of Breathing ● Body scanning ● Mindful Yoga ● Mindful Meditation Sitting Meditation, Walking Meditation Bringing mindfulness to everyday activities: paying attention, on purpose, with present-moment awareness, knowing what we’re doing while we’re doing it, while: STOPping with red lights or cell phones ringing; eating, brushing teeth, showering, driving, emailing, listening, talking - you name it! Non-Judging Awareness (Awareness of Judging) Being aware of, but not caught in or driven by, judging; NOT not-judging; "Don't believe everything you think!" Don’t Know (Beginner’s) Mind We don’t know what we don’t know; doesn’t mean being wrong - just not as right as we think! Non-Striving (Non-Insisting) Doing our best, but not insisting, not forcing: doesn’t mean not trying Letting Go / Letting Be Non-clinging: Releasing the tightness of our grip on what we cling to, both negative and positive; Be Curious! Mindful Acceptance Seeing what is, and responding, not reacting; non-resisting; not necessarily “it’s OK with me” or being resigned Mindful Patience "Feeling the itch and not scratching it;" doesn’t mean feeling patient; creating a gap between the spark and the flame of reactivity and "minding the gap" Trust as Self-Reliance Comes with increased inner awareness - of body sensations, thoughts & emotions - the ability to make wiser choices/ to respond instead of react… Everything can be taken from a man but one thing: the last of the human freedoms - to choose one’s attitude in any given set of circumstances, to choose one’s own way. Viktor Frankl Gratitude/Appreciation/What’s Not Wrong ½-Smiling Taking in the Good LovingKindness Compassion Equanimity (including: “Just Like Me” practice) When we are no longer able to change a situation, we are challenged to change ourselves. Viktor Frankl 3 Resources you will be receiving for the class include: ● MBSR Workbook: Introductory Materials, Exercises, Poems, Cartoons ● MBSR Website: A complete set of resources to support your practice and learning – now and in the future. Most importantly, during the class, guided audio tracks for you to use on a daily basis for home practice ● Full Catastrophe Living, by Jon Kabat-Zinn, a text for the class to read as you like; a secondary support (as all reading is during the course) to your daily formal practices 4 Structure of the 8-Week Course Class # Formal Practice Attitudinal Practice Affective Practice All will be included in every class, These paradoxical attitudes Cultivating the qualities leading in changing proportions. build on one another to greater happiness and ease Awareness of Breathing Non-Judging Awareness Gratitude and ½-Smiling Intro to Body Scanning (Awareness of Judging) “What’s Not Wrong” 1 Retreat - Awareness of Breathing Awareness of Judging Self-LovingKindness Exercise Body Scanning + Mindful Yoga Beginner’s Mind LovingKindness/Compassion/ usually Sitting + Walking Meditation Non-Striving “Just Like Me” Equanimity after Class Letting Go/Letting Be Guided Practice #6 in 8-wk Patience program Awareness of Breathing Don’t-Know Mind Gratitude/½ Smiling Body Scanning (Beginner’s Mind) “What’s Not Wrong 2 MIni-Meditation Taking in the Good Awareness of Breathing Non-Striving Basic Lovingkindness Body Scanning (Non-Insisting) Wishing ourselves and others 3 Awareness Scan/ Letting Go, Letting Be safety, health, happiness, and Mini-Meditation ease of well-being Mindful Yoga Awareness of Breathing Practicing Awareness of Recording Pleasant/Unpleasant Body Scanning + Mindful Yoga Judging, Don’t-Know Mind, Experiences 4 (Each One Teach One) Non-Striving, Letting Be Sitting Meditation Awareness of Breathing Mindful Acknowledging/ Difficult Communications Chart Body Scanning + Mindful Yoga Acceptance Review 5 Sitting Meditation PxR=S Intro to Walking Meditation R.A.I.N. Mindful Acceptance Awareness of Breathing LovingKindness/Equanimity/ Hand Model of the Brain Body Scanning + Mindful Yoga Compassion Practice 6 Aikido/Curiosity /Exercise Sitting + Walking Meditation Mindful Communicating Cultivating independence for an Mindful Patience LovingKindness/Equanimity/ 7 ongoing practice Trust as Self Reliance Compassion Practice 8 All Formal Practices All - review and integration All - Review and Integration 5 Guidelines for Participation in MBSR This is a program that requires your participation and effort. Your instructors will be serving as your guides, pointing the way for you, without “instructing.” Attendance at all sessions - weekly classes and the retreat - is important. (Unavoidable absences are fine.) If you know you’ll have to miss 2 or more sessions, we recommend you plan to take the class when you anticipate being able to attend more fully. A minimum of 20 –30 minutes of “formal” practice (of your choosing) each day, at least 5 to 6 days/week for the duration of the course, is essential for getting the most from the program. This is the minimum amount of practice required of participants in the MBSR courses on which the large body of 30 years of research evidence is based. The research indicates that MBSR leads to great benefits for physical, mental, and emotional health and well-being. At the same time, we encourage you to “start where you are.” For many people, the 20 - 30 minutes requirement can seem daunting at first, and starting with shorter practices is all they can do. The reality is that building a practice of any duration is what’s fundamental for experiencing the benefits from the mindfulness program. Developing a “habit of practice” is key. The more regularly you practice, the more mindfulness will take root in your life. If you practice a lot you will likely realize great benefits from the class. If you practice a little, you will likely get something from the class. Mindfulness practice requires effort and consistency for the realization of its potential. Although you may not feel like practicing each day, when you do it can lead to unexpected benefits, including some you may not appreciate immediately. We recommend that you practice with an open mind (a “beginner’s mind”), bringing curiosity to what may happen, rather than holding on to an expectation of specific results. It’s important that we maintain conscientious confidentiality in the course, so that all of you will feel a sense of safety and comfort, and create that for one another. MY INTENTION for PRACTICE: I commit (to myself) to doing the mindfulness practices daily, each week. My intention is to practice for ______ minutes each day. (Practice does not have to be done all at once) I understand that what’s most important is to cultivate a practice that I can and will do. I will return to this intention periodically, and re-adjust my intention, so that I’m doing what I can and will do, rather than insisting on adhering to ideas about what I should do. (Signature) (Date) 6 Science: Research on Mindfulness and MBSR An enormous and ever-increasing number of studies have been done since Jon Kabat-Zinn published his research on the effects of the MBSR course for people with pain in 1982. For a comprehensive collection of studies on mindfulness and MBSR, with abstracts and links to full reports, as well as a free monthly emailed newsletter, go to: https://goamra.org David S. Black at UCLA created this site in 2010, and maintains it, offering updated links to new research every month, and an archive of past research. It is a fantastic resource if you’re interested in reading the studies…or just for getting an idea of the depth and breadth of research on mindfulness and MBSR since 1982. A program (MINDFO) is available, on a donation basis, for searching the database. David S. Black M.P.H., Ph.D., Founder, Mindfulness Research Guide, Cousins Center for Psychoneuroimmunology Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles Articles on the science/neuroscience of stress, and most of the practices you’ll be learning can be found at www.mindfulnesshealth-psychotherapy.com. Please enjoy reviewing them when you have the time, but only if you also practice. It’s often easier to read than to body scan, do yoga, or meditate on your own, but practice is the only way to gain the benefits this class offers. Practicing with others is very helpful, and the Headspace App is a great support for learning and practicing basic mindfulness meditation. 7 To Your Health! Community Health Resource Center Newsletter Mindfulness How an Ancient Practice Reduces Stress, Improves Health, and Increases Happiness and Compassion Renée Burgard, LCSW, PAMF Education Division The way we perceive stress, and how we react to our perceptions, “Mindfulness is: paying attention, on purpose, in a particular can determine how stress affects us – physically, mentally, and way, in the present moment, with nonjudging awareness.” Jon emotionally. KabatZinn Imagine two people anticipating a ride on the historic wooden roller Stopping coaster in Santa Cruz. The first – let’s call her Andrea – is looking forward to the ride. Her friend – let’s call him Phil – dreads it, but The worldrenowned Vietnamese mindfulness teacher, Thich has come along to keep her company. The ride begins. As their car Nhat Hanh, says that the practice of stopping is the first ratchets steeply upward and precipitously plummets, Andrea – practice of mindfulness. It can help us interrupt and break the thrilled – is enjoying her adrenaline rush; while Phil – terrified – is unconscious habits that keep us stuck in reactivity and cause flooded with the adrenaline and cortisol (stress hormones) that are suffering to others and ourselves. hardly pleasant for him, will not fully subside for hours, and may . recur whenever he remembers the ride. . Over time, the negative stresses we experience – many much worse than a rollercoaster ride! – may harm our bodies’ systems, our ability to learn and remember, and our psychological health. Conditions that may be triggered or exacerbated by stress include: heart (including high blood pressure), rheumatologic, autoimmune (e.g. arthritis, fibromyalgia, multiple sclerosis), neurologic, gastrointestinal (e.g. IBS), and chronic pain conditions. Stress also impacts skin problems (e.g. psoriasis, excema, acne), diabetes, breathing difficulties (e.g. asthma, emphysema), headaches, colds and flu, chronic worry, anxiety, panic, depression, post traumatic stress reactions, insomnia, fatigue, disordered eating, and addiction to harmful substances. © The New Yorker Collection 2005 John Kane from cartoonbank.com Twentyfive years of research on Mindfulnessbased Stress All Rights Reserved Reduction demonstrates that breathing, body awareness, yoga, meditation, and attitudinal mindfulness practices – when done Learning how to pay attention to what we are doing while we consistently – can improve resilience and stress tolerance, and are doing it – noticing what we are experiencing in our bodies, physical and mental health; increase kindness and compassion, thoughts, and emotions – requires the practice of inner as well happiness and peace of mind; and decrease suffering. as outer stopping. Imagine you’re getting ready to ride a horse. As you’re climbing into the saddle, the horse takes off at a full These practices derive from teachings that are 2500 years old. They gallop, and you struggle to hold on. You don’t fully have your were modernized and brought into the health care mainstream by seat, or the reins. As you hang on for dear life, someone calls pioneering scientist Jon KabatZinn and his colleagues at the out to you from the side of the road, asking “Where are you University of Massachusetts, beginning in the late 1970s. going?!” You say, “I don’t know – ask the horse!” In this story, the horse represents what we call habit energy – the reactive WHAT IS “MINDFULNESS?” thinking/feeling patterns that are part of our genetic inheritance, and have been established and taken root throughout our lives "The root [of mindfulness] is experiencing the itch as well as the urge to scratch, and then not acting it out." Pema Chödrön 8 When habit energy drives us like that galloping horse, we aren’t in control “Meditation is a way of being, not a technique. Mindfulness of ourselves. By stopping, we can regain our seat and pick up our meditation is the embrace of any and all mind states, in (inner) reins. Breathing consciously, briefly focusing attention on awareness… from Coming to Our Senses, by Jon KabatZinn nonthinking by scanning body sensations, it is possible to interrupt the habit energy, calm and soothe distress, and observe thoughts and emotions During eight weekly 2½hour sessions and an allday retreat, the with greater objectivity. Mindfulness teaches us to respond instead of program trains participants in mindful breathing, body scanning, reacting to stress in our lives. yoga, meditation, informal daily awareness practices, and in mindful attitudes and new ways of thinking. Conscious Breathing Today, the MBSR program is offered in hospitals and medical One mindful stopping practice that can be done anywhere, anytime, is centers, mental health settings, corporations, nonprofit called “conscious breathing.” organizations, law schools and medical schools, public and private schools (preschools through high schools), colleges and universities, Try this: Notice where you feel the physical sensations of air as you retirement and assisted living centers, government offices, prisons, breathe in and out. [It is often easiest to feel this on the inside of the and retreat centers. nostrils – but it’s important to find out where you feel it, if you can.] Now, say to yourself: “breathing in, I know I’m breathing in” as you The Story of MBSR breathe in, feeling the inbreath; and “breathing out, I know I’m breathing out” as you breathe out, feeling the outbreath. Do this three Jon KabatZinn is an MIT–trained molecular biologist who began to five times. Now, check: Are you focused here, in the present moment, practicing and teaching yoga and meditation in the mid 1960s. In or in the past, or the future? What are you feeling in your body? What the 1970s, after receiving his Ph.D., he worked at several jobs, thoughts can you identify? What emotions or moods can you name? including in an anatomy lab, instead of going straight into an academic science career. A common misconception about mindfulness is that it should create a state of relaxation and feeling good. Mindfulness practices do build skills During this period, on the final day of a silent 10day meditation in calming and can generate a sense of wellbeing and peace of mind. retreat, KabatZinn had the idea that he could help people reduce However, if the object of our increased awareness is unpleasant, instead their pain and stress by creating a meditation and yoga program of avoiding or fighting or resisting it, we train ourselves to recognize and right in the medical center – a radical idea in those days. In 1979, allow ourselves to be aware of what we are experiencing, what we don’t with the support of the head of Internal Medicine at the University like. This helps in building tolerance for whatever presents itself. This is of Massachusetts Medical Center, he founded the first mindful acceptance, a cornerstone of mindfulness practice for stress (mindfulnessbased) Stress Reduction Clinic. reduction. As the poet Rumi wrote in his poem The Guest House: The MBSR program KabatZinn created brought together four This being human is a guesthouse Every kinds of practices: 1) awareness of breathing and physical morning a new arrival. sensations (body scanning), 2) gentle mindful yoga, 3) mindfulness A joy, a depression, a meanness, some meditation – sitting and walking, and 4) the cultivation of momentary awareness comes as an paradoxical attitudes, such as nonjudging awareness, beginner’s unexpected visitor. (or “don’tknow”) mind, mindful acceptance, mindful patience, Welcome and entertain them all! Even if letting go/letting be, and trust as selfreliance; and mindful qualities, they’re a crowd of sorrows, who violently including gratitude, compassion, and kindness. sweep your house empty of its furniture, still, treat each guest honorably. He In a world where yoga and meditation have become part of the may be clearing you mainstream, and are now household terms, the combination of these out for some new delight. four elements of practice – taught in weekly classes over a 2month The dark thought, the shame, the malice. period – is what continues to make MBSR uniquely effective, to meet them at the door laughing, and invite them in. Be this day. grateful for whatever comes, because each has been sent as a By the early 1980s, KabatZinn was publishing the results of his guide from beyond. research on the effects of MBSR on chronic pain and other chronic medical conditions. He published his bestselling first book, Full Jelaluddin Rumi, translation © 1997 Coleman Catastrophe Living, a text for the course, in 1990. A few years Barks later, journalist Bill Moyers included MBSR in his Healing and the Mind series, broadcast widely on national public television. WHAT IS “MINDFULNESSBASED STRESS REDUCTION (MBSR)?” Together with KabatZinn’s prescience in grounding the program in research from the beginning, MBSR’s enormous success in Mindfulnessbased Stress Reduction (MBSR) is a program founded in improving people’s health has led to its ever expanding replication the late 1970s at the University of Massachusetts Medical Center by in contexts of all kinds, with widely different populations, in many Jon KabatZinn. countries around the world. 9
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