meditation

The Healing Power of Sound

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The Healing Power of Sound

Photo credit: Blue Heron Crystals and Minerals

by Dr. Leona Kashersky & Nicolina Santoro, MA

The crystal bowls can assist in reducing stress, anxiety, and pain, promote happiness, peace of mind, and help you hear the music of your life-purpose.

The next class is on May 27th at Healing Pathways Psychological Services. 

For registration call: 916-595-7233
Email soundhealinghpps@gmail.com for registration details
Cost $140 3 hour instruction and experiential didactic

Please enjoy the following snapshot of some of the theory and practice used in the facilitation of sound healing at Healing Pathways! 

The Chakra System, in yogic practice

The seven chakras, in the yogic tradition are the centers in our bodies in which life sustaining energy flows through.It is thought that blocked energy in our seven chakras can often lead to illness, so it’s important to understand what each chakra represents and what we can do to keep this energy flowing freely.

The Chakras In Summary

  • Root Chakra — Represents our foundation and feeling of being grounded.
  • Location: Base of spine in tailbone area.
  • Emotional issues: Survival issues such as financial independence, money and food.

 

  • Sacral Chakra — Our connection and ability to accept others and new experiences.
  • Location: Lower abdomen, about two inches below the navel and two inches in.
  • Emotional issues: Sense of abundance, well-being, pleasure and sexuality.

 

  • Solar Plexus Chakra — Our ability to be confident and in control of our lives.
  • Location: Upper abdomen in the stomach area.

Emotional issues: Self-worth, self-confidence and self-esteem.

  • Heart Chakra — Our ability to love.
  • Location: Center of chest just above the heart.
  • Emotional issues: Love, joy and inner peace.

 

  • Throat Chakra — Our ability to communicate.
  • Location: Throat, just above the collar bone.
  • Emotional issues: Communication, self-expression of feelings and the truth.

 

  • Third Eye Chakra — Our ability to focus on and see the big picture.
  • Location: Forehead between the eyes (also called the Brow Chakra).
  • Emotional issues: Intuition, imagination, wisdom and the ability to think and make decisions.

 

  • Crown Chakra — The highest chakra represents our ability to be fully connected spiritually.
  • Location: The very top of the head.
  • Emotional issues: Inner and outer beauty, our connection to spirituality, wonder, and pure bliss.

 

EMDR 

EMDR is an acronym for Eye Movement Desensitization Reprocessing, a tool to process traumatic experience. EMDR works through bilateral neural stimulation or brain stimulation to integrate traumatic material. The singing crystal bowls create a sense of bilateral stimulation, while the meditation focuses on reprocessing, and altering core belief patterns. The bilateral processing is not only possible using the eyes; we can use sound, touch, and movement of any bilaterally moving body parts with a split timed rhythm. Some psychologists conceptualize EMDR as a form of ‘Exposure Therapy’, desensitizing people to traumatic material and thus relating it to exposure therapy. A more accurate description would be that it integrates the traumatic material.

“Memories evolve and change. Immediately after a memory is laid down, it undergoes a lengthy process of integration and reinterpretation—a process that automatically happens in the mind/brain without any input from the conscious self. When the process is complete, the experience is integrated with other life events and stops having a life of its own. As we have seen, in PTSD this process fails and the memory remains stuck—undigested and raw.” ~ by Bessel Van Der Kolkata, M.D. In The Body Keeps the Score chapter entitled Letting Go of the Past: EMDR

 

Three summarizing factors about EMDR:

  1. EMDR loosens up something in the mind/brain that gives people rapid access to loosely associated memories and images from their past. This seems to help them put traumatic experience into a larger context or perspective.
  2. People may be able to heal from trauma without talking about it. EMDR allows them to observe their experiences in a new way, without verbal give-and-take with another person.
  3. EMDR can help even if the patient and the therapist do not have a trusting relationship. This is intriguing because trauma, understandably, rarely leaves people with an open, trusting heart.

 

 

Physiological and Therapeutic Effects of Drumming

Recent studies have shown physiological benefits to drumming meditation practices such as, the reduction of the physical symptoms of anxiety, stress, the body’s immune system, brainwave activity, dual cerebral hemisphere activation, and connection with the present moment.

Because of the deep sense of tranquility that the act of drumming facilitates within the Central Nervous System, the effects of stress, and the accumulation of trauma stored within our cellular memory can be processed and integrated through this non-confrontational and deeply personal act even in group settings. This form of mindfulness based attention has also shown to activate the cells themselves, allowing for deep trauma to be released from cellular memory with little interference from the mind’s protective measures and defenses as the trauma is engaged and released by group participants. The chemical messengers of the brain or neurotransmitters reinforce this practice by stimulating alpha wave activity, inducing feelings of well-being and happiness.

The shared experience of drumming in groups is observed to facilitate a shared space of connection and consciousness among its members, alleviating common feelings of isolation, social fear, and inhibition.

Drumming seems to provide a platform for people to experience religious or spiritual connection through a universal practice that has been used by all cultures in some form or another. Through this connection, a space is created to access the deepest parts of our human condition.

 

 

References

  • The Body Keeps the Score science grounding in sound, breathe, and movement as a healing modality. Bessel Van Der Kolkata, M.D
  • R. Damasio, The Feeling of What Happens: Body and Emotion and the Making of Consciousness (New York: Random House, 2000) 28
  • K. Holzel, et al., “Mindfulness Practice Leads to Increases in Regional Brain Grey Matter Density,” Psychiatry Research: Neuroimaging 191, no. 1 (2011): 36-43.
  • K. Holzel, et al., “Stress Reduction Correlates with Structural Changes in the Amygdala,” Social Cognitive and Affective Neuroscience 5, no. 1 (2010): 11-17.
  • W. Lazar, et al., “Meditation Experience Is Associated with Increased Cortical Thickness,” NeuroReport 16 (2005): 1893-97. Pesso
  • N. Demos, Getting Started with Neurofeedback (New York: W.W. Norton, 2005).
  • J. Davidson, “ Affective Style and Affective Disorders: Prospectives from Affective Neuroscience,” Cognition and Emotion 12, no. 3 (1998): 307-30.
  • J. Davidson, et al, “Regional Brain Function, Emotion and Disorders of Emotion,” Current Opinion of Neurobiology 9 (1999): 228-34.
  • Bittman, M.D., Barry, Karl T. Bruhn, Christine Stevens, MSW, MT-BC, James Westengard, Paul O Umbach, MA, “Recreational Music-Making, A Cost-Effective Group Interdisciplinary Strategy for Reducing Burnout and Improving Mood States in Long-Term Care Workers,” Advances in Mind-Body Medicine, Fall/Winter 2003, Vol. 19 No. 3/4.
  • Winkelman, Michael, Shamanism: The Neural Ecology of Consciousness and Healing. Westport, Conn: Bergin & Garvey; 2000.
  • Bittman, M.D., Barry, “Composite Effects of Group Drumming…,” Alternative Therapies in Health and Medicine; Volume 7, No. 1, pp. 38-47; January 2001.
  • Winkelman, Michael, Shamanism: The Neural Ecology of Consciousness and Healing. Westport, Conn: Bergin & Garvey; 2000.
  • Friedman, Robert Lawrence, The Healing Power of the Drum. Reno, NV: White Cliffs; 2000.
  • Mikenas, Edward, “Drums, Not Drugs,” Percussive Notes. April 1999:62-63.
  • Diamond, John, The Way of the Pulse – Drumming with Spirit, Enhancement Books, Bloomingdale IL. 1999.
  • Winkelman, Michael, “Complementary Therapy for Addiction: Drumming Out Drugs,” American Journal of Public Health; Apr 2003, Vol. 93 Issue 4, p647, 5p
  • Mikenas, Edward, “Drums, Not Drugs,” Percussive Notes. April 1999:62-63.
  • Friedman, Robert Lawrence, The Healing Power of the Drum. Reno, NV: White Cliffs; 200

 

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Come Join the Healing Pathways Team at 2017 Sacramento Earth Day!

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The Annual Sacramento Earth Day Celebration is held every April at Southside Park, downtown

Healing Pathways Psychological Services is excited to join the celebration of Sacramento Earth Day 2017. Our contribution to the event not only educates people about what we’re up to in our city, but we will be putting smiles on their faces with fun activities and prizes. We are so delighted to share these festivities with all of you and look forward to sharing this rare opportunity to spend the day together.

As always, the Sacramento Earth Day Celebration is FREE!

Parking:
During the event, parking meter spaces adjacent to the park may be available, but the meters are limited to two hours.  The two hour parking limits at sites that do not have meters, on nearby neighborhoods streets, are not applicable on weekends.

Food and beverages will be available for sale at the park during the event.  Sacramento Earth Day 2017 will be hosting food vendors in the northwest corner of the park during the event.  Compostable waste, recyclable waste, and landfill waste containers will be stationed in triads throughout the event venue.  Containers at each station will be marked by printed labels and event volunteers will be present at most stations to advise attendees, vendors, and other volunteers on waste separation requirements.

The Annual Sacramento Earth Day Celebration is filled with wonderful food, entertainment, interactive activities and business, non-profit, cultural and government organizations with invaluable and practical information, goods and services for saving money, living healthier, and protecting and celebrating the environment and the Sacramento region.

Additional Links:

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Using Meditation to Tame this Mind of Ours

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 Using Meditation to Tame this Mind of Ours

family yoga on the beach at sunset

 

By Nicolina Santoro, MA

Mahayana Buddha, the progenitor and prophet of the middle way, had encapsulated an entire philosophy into short, clear directives. “Commit not a single unwholesome action, Cultivate a wealth of virtue, To tame this mind of ours; this is the teaching of all the Buddhas” (Rinpoche, 1993). Meditation is part of the practice of taming the mind. Often described as the still mind, or still waters of the mind, meditation appears to be a kind of martial art for one’s thoughts. To even begin to feel the stillness of mind that comes with the practice of meditation, one must endure the onslaught of thought as it runs through the beginning meditator’s mind rampantly. Even more interesting, is the realization that this pattern of thought is a regular occurrence in the mind. Meditation highlights the never-ending barrage of thought, as the student tries to negotiate the noise to a place of quiet within the mind (Fontana, 1992).

Meditation is actually a common practice among many different platforms of faith, although called many different names throughout time, but the goal of calming the turbulence in the mind remains the same. The practical applications of meditation have far reaching benefits to those who suffer from a variety of illnesses. Mental illnesses such as anxiety, depression, obsessive-compulsive disorder, and manias have all shown to be positively affected by the regular practice of meditation. Some of the therapeutic benefits of regular meditation practice include enhanced self-esteem, reduction in feelings of hopelessness and depression, and a sense of spiritual connection (Lindgren & Coursey, 1995).

Since the mind, by its various sense mechanisms can create and maintain a subjective reality, one seems to be at the mercy of the mind and its myriad of emotional states of being. Thoughts create emotional experiences based on the electrical impulses that send messages to various chemical centers to whip up recipes for certain emotional states. These emotional states hold tremendous power over self-efficacy, and emotional well-being. Most people have had the experience of having a “bad” day, or a lack of desire to get out of bed. These types of feelings and their sources are often overlooked by people experiencing them, as the emotional tide they create has a strong influence in coloring one’s perceived reality. Over time, the continuing pattern of similar emotional states can create long-term relationships between neurons in the brain. In other words, relationships between a thought and the subsequent emotional state that the thought triggered become a learned response with different chemical markers for different emotional states (Berger, 2006).

Meditation is the act of awareness, noting a thought as it travels through the mind’s eye, rather than grabbing on to it for dissection. It is in the act of dissection that the emotional response is created. A sort of fixation then occurs, making it very difficult to regain a sense of calm detachment which is the focus of the meditation practice. Observe, but be not of the waves of thoughts that roll through the ocean of conscious awareness, and breathe which is certainly not as easy as one might think.  Buddhism imparts that suffering, and dis-ease are certainly inevitable in life however, there is an opportunity for personal transcendence in the observation rather immersion in this state of suffering  (Rinpoche, 1993). A meditation posture is grounded, comfortable yet deliberate. One may elect to sit on the floor with legs crossed in front of them, arms relaxed and poised comfortably in the lap, eyes closed. One then begins to notice their breath, every inhalation and exhalation is noted in the awareness space. As this practice begins, the mind seems utterly flooded with thoughts, worries, randomness, and chaos. However, through each breath, the subject becomes accustomed to the flow of thoughts which become a sort of background noise, and the central focus of breathing creates an altered or trance like state in the consciousness of the meditator. This altered state of being allows the meditator to observe self from a place of detached compassion which is the place of mindfulness that the Buddha described (Rinpoche, 1993).

Common mistakes that people make when entering into the practice of mediation exists in the misapplication of the quiet mind concept. The term is slightly misleading. The mind, it seems, is never truly quiet. Thoughts run constantly because the mind is always taking in information, processing it, encoding it, retrieving it, and deciphering it. The stillness of mind exists in the unfettered observance of this process. Unfettered meaning that one never holds on to, or tries to single out the thoughts as they steadily move through conscious awareness of the subject. As meditation becomes familiar to the mind itself, the thoughts no longer control the emotional state of the meditator, and stillness is observed by a state of total acceptance, and symbiosis  (Fontana, 1992).

The meditation process has been reported to be difficult, and even frustrating to those who are new to the experience, but long term benefits have also been relayed by those who were able to get through the frustration, and experience the trance-like state where feelings of calm and clarity exist. Meditation as a response and treatment for stress is now common advice from health practitioners even in the west because of the positive impact it has on the central nervous system (CNS), (Fontana, 1992).  The effect that mediation has on the body is noted further in the American Psychological Association’s book entitled Integrating Spirituality into Treatment. Meditation lowers respiratory rate, heart rate, and brain wave states, placing the body in a state of rest which is very helpful in dealing with chronic anxiety. Meditation has also been used frequently in the redirection of addictive behavior because of the altered state that it can enhance bio-chemically. In behavioral and cognitive behavioral types of therapeutic interventions, meditation is also useful in the reprogramming of negative thinking, through the natural change in thought patterns that are facilitated by the practice (2006). 

Research conducted by Lindgren & Coursey, published in 1995 shows a strong positive correlation between the use of meditation practice and increased feelings of well being among those who suffer from severe forms of anxiety and depression.  Those who are being treated for more severe mental illnesses such as schizophrenia and bipolar disorder have also reported positive cognitive effects on mood and self-esteem (Psychosocial Rehabilitation Journal, Vol. 18(3), pp. 93-111). These trends can enhance the level of care that practitioners bestow upon their clients, giving them the tools to help alleviate some of the distress associated with negative automatic thinking, placing some of the control back in their hands with regard to better self-care.

Self-care is something that even mental health practitioners overlook for themselves. In the mental health fields, burn-out among therapists and social workers is high. The culprit seems to be a lack of self-care and over extension according to the (APA). Regular meditation practice can also help alleviate the stress that in the field of mental health seems almost inevitable to its practitioners. Self-care processes that the (APA) advocates include the awareness of the levels and types of stress in the practitioner’s environment, case load management, outside support networks, and extra-curricular activities that promote a sense of health and well being. A professional support network, boundaries, and realistic expectations upon the self are also highlighted as areas to which the practitioner should attend for optimum results. The clarity that accompanies regular meditation can also invigorate a flagging practitioner, providing a sense of calm and clarity toward the greater good of all concerned (American Psychological Association, 2006).

 

References

American Psychological Association. ed. by Miller, W.R. (2006). Integrating Spirituality into Treatment: Resources for Practitioners. Washington: American Psychological Association.

Berger, K. S. (2006). The Developing Person. New York: Worth Publishers.

Fontana, D. (1992). The Meditator’s Handbook. Rockport: Element Books, Inc.

Lindgren, K., & Coursey, R. (1995). Spirituality and Serious Mental Illness: A Two-Part Study. Psychosocial Rehabilitation Journal, 18(3), 93-111. Retrieved from EBSCOhost.

Rinpoche, S. (1993). The Tibetan Book of Living and Dying. New York: HarperCollins Publishers.

 

 

 

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Enhancing Resilience

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Enhancing Resilience

by
 Dr. Jennie Lorena Thomas

resilience-pic (Photo Credit: Danielle Kambrey)

Most of us may not like to be reminded of this, as being human means we will face pain at some points during our journey through this world. Unfortunately, we cannot avoid this life’s truth no matter who we are. Fortunately, we now know that the sooner you internalize this truth and grieve your losses, the happier, less stressed, and healthier you will feel and live.
Thus, while you journey towards this truth, let me reinforce the truth of the strength our resilient spirit is capable. This spirit or energy essence can allow us to stand up to, and breathe through any adversity; it allows us to shine both inside and out. In fact, Change Basics (Russell and Russel, 2006) contains resiliency tips that solidify this point.

  • Proactive people actively engage change and shape their own vision, keep their locus of control focused internally, preserve their self-efficacy, have a strong self-confidence and self- assurance, and are aware that their choices influence their response to challenges
  • Develop a personal meaning and vision so they have a clear belief and vision of what they want to create. They allow that purpose to propel them forward, so when adversity approaches, they can see it through hopeful eyes as a possible opportunity and stay focused on the larger more realistic view of life beyond it
  • They nurture interpersonal competence, our ability to truly empathize with others, thus magnifying their social awareness and interpersonal efficacy
  • They remain flexible and adaptable by staying aware of what’s happening around them so they can then make sensible adjustments in response.
  • They take a moment to think before acting. The more you practice the skill of organizing your thoughts and feelings; the result tends to yield an inner focus and outward stability. (Prioritizing to-do lists, and then following that prioritization, will enable you to manage your time effectively)
  • Strive to problem solve by analyzing and breaking down complex challenges to discover and explore their root causes. Recognize and clearly define the interdependence of these challenges within the larger system, and then set manageable goals.
  • Connection with community is important in attracting healthy caring and supportive relationships that create love and trust, provide effective mentors, and offer encouragement and reassurance. This is a foundation for continued personal efficacy.

 

Ways to Strengthen Resilience

After reading through these examples, perhaps select one tip a day and work with it a bit. For example, take the flexibility concept and consciously work on growing your awareness of your surroundings for a day. See the ways you’re less flexible and perhaps choose to let that some of that rigidity go. Alternatively, be that problem-solver for a day by taking a problem and breaking it into its constituent parts, then analyze how the parts fit together, and see how your various responses can be part of the problem and solution. Just observe how things can become more manageable. And add an extra kick of self-confidence to your day. Speak from your belly, look people in the eye, straighten your spine and put your shoulders back a bit. Feel yourself grow taller.
What everyone needs to know is that we actually have access to everything we need for a balanced life: awareness, determination, vision, creativity, love, passion, faith, and intuition. These human endowments begin to be realized when we focus on them, and they come into full bloom when we let them ripple through us, further building our innate resilience.
Admittedly, the journey as life students is sometimes arduous, often working full-time, and/or going to school while taking care of our families, maintaining ourselves, working to complete our degrees, get that position, that promotion, or that bonus. Let me now acknowledge each of you—great job for your hard work and continued effort. Keep smiling and know you are not alone.

Acknowledgments

I would like to gratefully acknowledge the following contributors to this publication:
Mary K. Alvord, PhD, Director, Group Therapy Center at Alvord, Baker, and Associates, LLC, Silver Spring, MD
Robin Gurwitch, PhD, University of Oklahoma Health Sciences Center
Russell and Russel, (2006) Measuring Employee Resilience, Published in the 2006 Pfeiffer Annual Training
Jana Martin, PhD, private practice, Long Beach, CA; (2003) President of the California Psychological Association
Ronald S. Palomares, PhD, Assistant Executive Director, Practice, American Psychological Association

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World Sickness and the Thirst for God

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World Sickness image

By Nicolina Santoro, MA, IMF 77972

Once upon a time, in the vast kingdom of the helping professions, there lived a therapist whose thirst for knowledge and desire to aid in the process of personal and interpersonal change was unrivaled in all the land. This therapist had taken it upon herself to rewrite the story of her own history in a manner that changes the context of painful past experiences from blockages into tools that create a larger understanding and empathy for those she has chosen to serve in her work.

This constantly evolving therapist became immersed in theory and work of great minds such as Carl Rogers and William James. Realizing that human potential is vast, she wanted to understand how important stories and fairy tales were to constructing the memories that colored the landscape of reality, a reality that seemed to have the power to dictate how people see themselves and live their lives.

These dominant fairy tales permeate the fabric of our perceptions which also bump up against the lives of others we come into contact with out in the world. Personal narratives or “life styles” are filled with characters that are archetypal in nature, influencing us to play out repetitive sequences in life. These characters tend to take on the personas of stereotypical themes that are reinforced by learning them at a young age, or by the social referencing effect of our dominant culture.

William James calls the mental fatigue effect of living in an environment laden with unrealistic scenarios or fairy tales “world sickness.” It appears as though living in a world dominated by stereotypes and fairy tales could be implicated in the aggravation of many types of mental health issues.

How can we address the fatigue, depression, anxiety, and thought distortions that world sickness creates and impacts?

Let’s start with being gentle with ourselves. When we imagine a supreme spiritual being, the embodiment of certain characteristics seems to be present across many cultures. Some of these characteristics include unconditional love (a love that exists beyond judgment), a superconscious presence that never dissipates or abandons, and the ability to create out of seemingly thin air. For the scientists who have a different path, god could also be described as the picture of what we theorize as the highest human potential. We have the potential to express this in our own reality by living our lives in accordance to our deepest and strongest values while moving away from comparing ourselves to the unrealistic standards or “fairy tales” woven into the fabric of our society, loving ourselves and others through the lens of acceptance and vulnerability, a gentler version of happily ever after.


References
James. W. (1902). The Varieties of Religious Experience: A Study on Human Nature. Longmans, Green & Co. London, UK.

Miller, W.R. (2006). Integrating Spirituality into Treatment: Resources for Practitioners. Washington: American Psychological Association.

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School Refusal Solutions for Parents and Teachers

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school kid

By Christine Brady, M.A.,
Intern of Marriage & Family Therapy

What parent among us has not experienced the plaintive pleas of little ones, their little voices crying out, “I don’t want to go to school!” Sometimes these requests are due to vague physical complaints such as, “I don’t feel good”, or “My tummy hurts”. Other times, the range of reasons can vary from mean teachers to lack of friends, or perhaps an exam is scheduled for that day. For a lot of children these occurrences are few and far between. For others, this is a pattern which seems to happen almost daily, increasing family stress, and causing harried parents to count down the days until graduation (a daunting task if your child is in elementary school).  School refusal, if left unchecked, this pattern can escalate lead to chronic lateness, repeated absences, and consequences from truancy officials at school.

Consistently truant children often attempt to conceal their absence from parents and spend their day away from home while children typically termed as school refusers tend to stay home during all or part of the day with parental knowledge. School refusing children commonly become upset at the prospect of going to school and may show signs of fearfulness, crying, temper tantrums, unexplained physical symptoms, or other behaviors, such as stalling, missing the bus, or oversleeping. Children who are refusing to attend school may be attempting to avoid a fearful experience. Being bullied, the structure and discipline of the school setting are common reasons for avoidance. Another motivation for school refusal could be pursuing a positive experience like staying at home with access to video games, access to the internet, or gaining parental concern or attention.

School refusers can have anxiety around specific situations such as the bus ride, cafeteria, restrooms, or locker rooms thereby increasing the desire to avoid school. A child may or may not be able to identify their specific fear, only knowing that they don’t want to be at school because it makes them feel awful. Another group of school refusers may find the social or performance aspects of school such as interactions with peers, writing on the board, being called on in class, tests, or performance classes such as PE make the prospect of attending school frighteningly unbearable. Some children experience school as a place where they are constantly reminded that they are not good enough to achieve at a normal level, let alone, excel.

Dr. Haarman further relates in his book, School Refusal Behaviors, that the most important factor in increasing the likelihood of success with children who can’t or won’t go to school is to return to school as soon as possible. The longer the child avoids a normal school day routine, the more difficult and traumatic it will be to return to school.  A viable starting point for the effective exposure therapy of the child returning to regular school attendance may be to build tolerance to the anxiety provoking activity by attending some portion of the school day whether attending particular classes for a limited time period, or certain days until the child’s anxiety returns to near normal levels. This may require cooperation of school administration, such as a modified schedule change, a teacher change, or allowing the child to arrive late or leave early.

Treatment of School Refusal

This chart is adapted from research conducted by Kearney and Albano, identifies a number of possible intervention strategies most suited for each of the four types of school refusers.
Function Treatment Components
(crying, nausea, distress, sadness, and various phobias, i.e. bathrooms, cafeteria, teachers, bullies, etc.) Somatic control exercises such as breathing retraining and muscle relaxation

Gradual re-exposure to school

Reduce physical symptoms and anticipatory anxiety

Self-reinforcement, self-talk, self-esteem

To escape aversive social and evaluative situations (social phobia, test anxiety, shyness, lack of social skills) Role play restructuring of negative self-talk

Gradual exposure to real life situations

Social skills training and reduction of social anxiety

Coping strategy templates

To get attention  (tantrums, crying, clinging, separation anxiety) Parent training in contingency management

Clear parental messages

Evening and morning routines

Use of consequences for compliance/noncompliance

For positive tangible reinforcement  (lack of structure or rules, free access to reinforcement, avoidance of limits) Family contingency contracting to increase rewards for attending school and decrease the rewards for missing school

Curtail social and other activities for nonattendance

Alternative problem solving


References and Further Reading:

Albano, A.M., Chorpita, B.F., & Barlow, D.H. (2003). Childhood anxiety disorders. In E. Marsh and R. Barkley (Eds.), Child psychopathology (279-330).New York, NY: The Guilford Press.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Washington, DC, American Psychiatric Association, 2013.

Berg, I. (1996). School avoidance, school phobia, and truancy. In: M. Lewis (ed.), Child and Adolescent Psychiatry.  Baltimore, MD: Williams and Wilkins.

Berg, I. (1997). School refusal and truancy. Archives of Disease in Childhood, 76, 90-91

Bernstein, G.A., Helter, J.M., Burckhardt  C.M., & McMillan, M.H. (2001). Treatment of school refusal: one-year follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 206–213.

Broadwin, I.T. (1932). A contribution to the study of Truancy. American Journal of Orthopsychiatry, 2, 253-259.

Coolidge, J.C., Hahn, P.B., & Peck, A.L. (1957). School Phobia: Neurotic crisis or way of life? American Journal of Orthopsychiatry, 27,296-306.

Dube, S.R. & Orpinas, P. (2009). Understanding excessive school absenteeism as school refusal behavior. Children and Schools, 31(2) 87-95.

Duckworth, K. & deBug, J. (1989). Inhibiting class cutting among high school students. High School Journal, 72, 188-195.

Evans, L.D. (2000). Functional School Refusal Subtypes: Anxiety, avoidance, and malingering. Psychology in the Schools, Vol. 37(2), 183-191.

Fremont, W. P. (2003). School refusal in children and adolescents. American Family Physician, 68, 8, 1555-1560.

Haarman, G.B. (2012). School Refusal: Children who Can’t or Won’t go to School, Foundations: Education and Consultation Press. Louiseville, KY.

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Stop and Smell the Roses: What is Mindfulness, Anyway?

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(Photo Credit: Gromovataya)

By Melanie Ernould, Psy.D.

Have you ever driven somewhere and arrived at your destination thinking that you have no recollection of the actual drive? Have you ever realized the amount of time you spend on your mobile phone to the exclusion of the world around you? Or perhaps you’ve realized you’ve lost touch with important people in your life because you’ve gotten caught up in the tasks of your everyday life? What about spending time doing something to realize that you’ve spent most of that time worrying about something else, like your to-do list or your messy house? These are all common ways that we miss out on being in the moment in front of us.

You may have heard the term “mindfulness” being tossed around in conversations about staying in the present moment, but have you wondered exactly what this means or how to apply the concept to your life?

Mindfulness was once an obscure Buddhist concept but has become a wildly popular psychotherapeutic intervention in the past 10 years. This is due to the popularity of successful mindfulness-based stress reduction (MBSR) programs and the mindfulness component of dialectical behavior therapy. The term mindfulness can mean a “moment-by-moment awareness”  or a “state of psychological freedom that occurs when attention remains quiet and limber, without attachment to any particular point of view,” according to Jeffery R. Martin, Ph.D.

In the article What are the benefits of mindfulness? (from the July/August APA Monitor on Psychology), the authors Daphne M. Davis, Ph.D. and Jeffrey A. Hayes, Ph.D. define mindfulness as a “moment-to-moment awareness of one’s experience without judgment,” and claim that this is the definition that is most often used in the research. Jon Kabat-Zinn, Ph.D. was the first to develop a modern definition of mindfulness, and defined it as “paying attention in a particular way, on purpose, in the present moment, and non-judgmentally.”

The application of mindfulness meditation in the field of psychology was not a huge leap. According to Mindfulness-based Approaches: are they all the same? (from the 2011 Journal of Clinical Psychology) by Alberto Chiesa, M.D. and Peter Malinowski, Ph.D., the goals of mindfulness meditation and psychological health are related: both Buddhist philosophy and psychology discourage behaviors that bring on and maintain negative emotions, and encourage positive emotions. Mindfulness is considered an acceptance-based therapy, where there is not an attempt to change thoughts or emotions no matter how unpleasant they may be. Well, how does it work then, you might ask?

Perhaps paradoxically, it is through acceptance that change is brought about. In other words, the less you try to change how you think, the more you are able to then change how you think. You focus on being rather than always trying to do. This works because you are not trying to force change; you are accepting yourself as you are and creating a freedom in your thoughts in the process. It takes practice to be truly mindful but this practice has helped treat and prevent people with problems, such as anxiety and depression. Below I outline a few exercises to aid in your mindfulness practice.

Paying Attention

To start the practice of paying attention mindfully, try this practice next time you are eating something that you would normally take for granted or not think about, a chocolate or M&M candy for example:

  1. Before you put the food in your mouth, bring your attention to seeing the food as if with new eyes. What do you see? What color is it? What is the shape? What texture do you notice?
  2. Now feel the food with your fingers. What does it feel like? Is the surface smooth or bumpy?
  3. Notice whether you have any thoughts that might be coming up for you about the candy, food, or eating in general.
  4. Now smell the food and pay attention to what you notice about the experience of smelling it.
  5. Bring the food item to your lips, noticing how your hand is holding the item and moving it toward your mouth. How does your body respond to the food moving toward your mouth?
  6. Now put the food in your mouth and leave it in your mouth for a while, noticing how it tastes and what happens to it as you suck on it.
  7. Pay attention to the impulse to swallow. Imagine the food item entering your body, like you are one M&M or ____ heavier.
  8. Finally, what are your reactions and observations about this experience? How did this compare to how you usually eat?

We tend to eat mechanically and for emotional comfort without paying attention. However, if we can slow things down, we start to notice and enjoy our experiences, and act with purpose. This is what meditation is: paying attention to your experience from moment to moment.

Stop and Smell the Roses

Pay attention to one pleasant event each day as it is happening. Write in a journal the answers to these questions:

  1. What was the experience?
  2. Were you aware of any pleasant feelings while the event was happening or only later?
  3. How did your body feel during the experience? Describe this in detail.
  4. What moods, feelings, and thoughts were present as the event was actually happening?
  5. What thoughts are in your mind now as you write this down?

I’m Stressed!

When you notice that you are feeling stressed about something, start by bringing your attention to your breathing. In… and out… In… and out… Then, ask yourself these questions:

  1. How does my body feel?
  2. How fast is my heart beating?
  3. Am I tense? Where am I holding my tension?
  4. What am I thinking about?
  5. What am I feeling? How do I know I’m feeling this?

References and Further Reading:

Allen, M., Bromley, A., Kuyken, W., & Sonnenberg, S. J. (2009). Participants’ experience of mindfulness-based cognitive therapy: “It changed me in just about every way possible.” Behavioural and Cognitive Psychotherapy, 37, 413-430.

Chiesa, A. & Malinowski, P. (2011). Mindfulness-based approaches: Are they all the same? Journal of Clinical Psychology, 67, 404-424.

Davis, D. M. & Hayes, J.M. (2011). What are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychotherapy, 48, 198-208.

Ernould, M. (2012). Addressing lesbian, gay, and bisexual bullying: A mindfulness-based intervention manual. Retrieved from aura.antioch.edu

Germer, C.K., Siegel, R.D., & Fulton, P.R. (2005). Mindfulness and psychotherapy. New York: Guilford Press.

Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57, 35-43.

Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York: Dell Publishing.

Martin, J.R. (1997). Mindfulness: A proposed common factor. Journal of Psychotherapy Integration, 7, 291-312.

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