Honoring Veterans and Addressing PTSD

As Veterans Day arrives, it's not just a time for gratitude but also a moment to shine a light on the mental health challenges faced by those who have served in the military. On a recent episode of KSL’s Dave & Dujanovic, hosts Debbie Dujanovic and Dave Noriega delved into the topic of Veteran mental health, particularly post-traumatic stress disorder (PTSD), with Numinus therapist John Ellis.

The discussion opens with personal stories, including Dave's revelation about his grandfather's World War II experience, emphasizing the often unspoken struggles that veterans carry. John Ellis, a therapist with a background in the United States Air Force Reserves, shares insights into the importance of storytelling for veterans and the therapeutic value of sharing experiences.

"A lot of veterans do keep things inside. But they have stories to tell. And when they start to tell them, it does help." John says.

Fostering an environment of connection, empathy, and emotional understanding, the need for vets to share their experiences is paramount. Our collective society's attentive listening becomes pivotal in acknowledging the importance of veterans' narratives. So, what first steps can we take? 

Let’s start with compassion. Creating a safe and supportive environment to empower veterans to openly express their feelings will help them navigate the path towards healing.

But it isn’t all that simple to create this safe space. Veterans face challenges when opening up about the past, particularly the painful memories. These experiences don’t always flow from the memory into a story - they are sometimes haunting, and dig up old wounds. "We need to help them start telling their stories a little bit. And when they do, we need to listen. It does help them, and it's hard to tell them. Even the good ones." John continues to say. Many people feel sensitive about asking questions, fearful of saying something wrong or triggering. However, there is a balance, and approaching the conversation with delicacy, kindness, and respect can make a veteran feel appreciated. Think about starting by saying something like this: “I understand that talking about your experiences in combat can be challenging, but I want you to know that if you ever feel the need to share or discuss anything, I am here to listen without judgment. Your feelings and experiences are important, and if you choose to open up, this is a supportive space. I appreciate what you've done, and I'm here whenever you're ready.”

For veterans, the emotional connection formed through shared narratives can also be built through engagements such as individual therapy, group sessions, or community resources. "There's that emotion and empathy that can be formed in connection. I think that's really where it starts, whether it's in a therapeutic relationship, just one-on-one with a family member, or amongst veterans - combat or otherwise."  John explains. 

When discussing signs of PTSD,  common indicators include flashbacks, hypervigilance, night terrors, existential dread, and fear that can linger, making it difficult for veterans to feel safe. To begin working through these unwanted feelings, starting with the Veterans Affairs (VA) system is always a solid first step. 

The door is wide open at Numinus, where we provide therapy and utilize treatments like ketamine-assisted therapy, known for its effectiveness in reducing symptoms of PTSD and suicidal thoughts. Many Numinus therapists and staff are veterans themselves, and we always do our best to pair vets-to-vets for an added layer of empathy.

At Numinus, we strongly believe in the power of psychedelic therapy. Ongoing research favors ketamine and other psychedelic medicines, such as psilocybin and MDMA, in treating mental health conditions. Numinus is helping carry the torch for this work, alongside and partnered with long-standing companies like MAPS (Multidisciplinary Association for Psychedelic Studies). The promising results from recent studies show psychedelics, when coupled with talk therapy, have a highly positive impact in relief from depression, anxiety, PTSD, and more.   

“We really have learned, from the 70s to now. There really is a lot of research and some real expertise – and there are people that really know how to help navigate your experience," John says. "We’re [Numinus] really helping people rewire their brain from that trauma - that medicinal kind of regeneration of neurons that happens during a psychedelic experience." 

As we reflect on Veterans Day, let's carry forward a renewed commitment. Acknowledging the struggles of veterans and the importance of mental health, we extend our gratitude and encouragement. Together, let us foster a compassionate environment, embracing the healing potential of both shared narratives and therapeutic interventions. 

If you or someone you know is a veteran facing mental health challenges, remember, seeking support is a courageous and vital step. Your well-being matters, and the journey towards healing is a shared endeavor.

 

World Suicide Prevention Day: Resources

We've put together a list of Suicide Prevention resources. We're here to support you.

Emergency/Crisis Support

Whatever you’re facing, you are not alone. If you’re currently in crisis, experiencing suicidal thoughts, or need immediate help, please seek support through the following channels: 

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Resources

On-Going Support

We offer non-emergency traditional and alternative mental health therapies, including treatment resistant conditions that could contribute to suicidality. Click here to view our services and book an informational call with a health navigator.

The Impact of Psychedelic Harm Reduction In Therapy

3 Benefits of Using a Harm Reduction Framework in Your Therapy Practice

According to a recent study by the National Institute of Health, psychedelic use is on the rise. The percentages of young people who said they used hallucinogens in the past year had been fairly consistent for the past few decades, until 2020 when rates of use began spiking. In 2021, 8% of young adults said they have used a psychedelic drug in the past year, the highest proportion since the survey began in 1988. Reported hallucinogens included LSD, mescaline, peyote, shrooms, PCP and MDMA (aka molly or ecstasy).

With this increase in recreational psychedelic use, there is a growing need for mental health professionals to expand their practices to support harm reduction and psychedelic integration needs. Here are the top 3 reasons practitioners should adopt a harm reduction framework in their therapy practice.

 

1. Builds Trust & Rapport With Clients

By maintaining a non-judgemental, accepting, compassionate, curious, and positive stance when exploring a client’s substance use, as well as other risky or harmful behaviours, you are directly contributing to the trust that client has with you. Being open and curious signals to the client that they are safe to walk through their thought process and current decision-making around psychedelic use, where you can gently advise on any dangers and practices they should take into consideration. When supported in this way, these clients are more likely to stay with you long-term and if you decide to provide psychedelic-assisted therapy in the future, they may feel comfortable turning towards psychedelic care provided by you. 

 

2. Helps Clients To Make Informed Decisions

When psychedelic medicines are used outside of clinical settings, proper education, preparation, and support can mitigate potential harms and increase the likelihood of clients having productive experiences (Gorman et al., 2021).  

Particularly with the medicines used in psychedelic-assisted therapy, clients may start treatment with some inaccurate information about the psychedelic medicine being used. The internet (particularly social media platforms) is full of misinformation about psychedelic medicines, their effects, adverse effects, and anticipated experiences. 

When a client has a more fulsome understanding of experiences and the decisions associated, potential benefits and harms are affected in ways that can enhance and protect their experiences, further contributing to trust this client has with you. 

 

3. Presents A Unique Opportunity To Work With Your Clients

When discussing psychedelic use, an important role you can play with your clients is to help with the integration work. Working on integration is your opportunity to keep the positive changes engendered by psychedelic experiences alive. In this regard, good integration work with your clients will help facilitate lasting changes and could reduce the need for ingesting medicines recreationally outside of a clinical setting. Not only is this an opportunity to work more with your client, but it’s a unique opportunity to really dive into positive and meaningful changes that are important to your client, which can facilitate deeper connection and meaning making as part of your regular appointments. 

 

In Conclusion: 

“Using a harm reduction framework in your clinical practice allows you to support your clients with non-judgmental, compassionate, and acceptance-oriented care. We should expect that clients may choose to use substances outside of the clinical setting, and that providers can play an important role in mitigating any harms associated with that, through building trust and rapport. We teach a harm reduction framework in our Psychedelic-Harm Reduction and Integration course at Numinus, which includes transparent discussions around the legal and ethical responsibilities in doing this work. Psychedelic use is going to continue to rise as more folks seek the healing potential of these medicines, so education in this area is going to become increasingly important.” 

- Amanda Giesler, Director of Training

 

Learn More: 

Join us for a 2-day introductory workshop on the practice of Psychedelic Harm Reduction and Integration (PHRI) and learn the tools needed for educating clients about altered states of consciousness and how to integrate these experiences. Click here to learn more.

 

*The continuing professional development program in no way promotes, condones, or facilitates illegal activity, and is strictly for educational and harm reduction purposes only. Please be aware that certain psychedelic substances still remain illegal in many jurisdictions, including Canada. This program and the contents of this website do not constitute medical advice, and are not a substitute for professional medical advice and treatment.

Concussion and Exercise: The Importance of Exercise in Recovery

= Authors =

Aarchie Soni, BHSc Health Sciences Candidate 2024, McMaster University
Jenni Diamond, OT Reg. (Ont.)

 

Recovery after Concussion

A concussion is a type of traumatic brain injury, occurring from an impact to the head or body and resulting in concussion symptoms. Spontaneous recovery from a sports-related concussion typically occurs within 2-3 weeks, however, up to 30% of patients may have longer recovery times.1 You can read more about concussions in general on our previous blog post here. Guidelines for recovery after concussions and symptom management have changed quite a bit in the past few years, especially when it comes to exercise and concussions.

Previous Guidelines: “Rest is Best”

Previous guidelines for recovery after concussion favoured a “rest is best” approach, partially driven by the finding that excessive activity soon after concussion interfered with and prolonged recovery. As such, past consensus-based recommendations emphasized physical and cognitive rest until complete symptom resolution before training or sport.2

However, it is now understood that prolonged rest is not particularly effective after a concussion. In fact, prolonged rest and social isolation may exacerbate symptoms and delay recovery.2 Instead, moderate levels of prescribed physical activity by your healthcare provider may be beneficial in recovery after concussion.1

The most recent Concussion in Sport Guidelines statement in 2016 also acknowledges that there is insufficient evidence to support the effectiveness of prescribing complete rest. Instead, it is recommended that a brief rest period of 1-2 days after injury be followed by a gradual and progressive sub-threshold (which is at levels below the onset or worsening of concussion symptoms) return to activity, determined in consultation with your physician.3

____________________________________________________________________________

…it is recommended that a brief rest period of 1-2 days after injury be followed by a gradual and progressive sub-threshold return to activity…

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Current guidelines: “Exercise is Medicine”

Physical exercise within days of a TBI has been shown to assist in recovery in several ways. A way in which exercise may assist in recovery after concussion includes the induction of factors that promote neuron growth and repair such as brain-derived neurotrophic factor (BDNF).2

Some resulting effects of exercise on recovery may include:

____________________________________________________________________________

…exercise may … [induce] factors that promote neuron growth and repair such as brain-derived neurotrophic factor…

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What type of exercise works best?

Concussion can often cause exercise intolerance, which is the inability to exercise to the level predicted for one’s age and fitness due to an increase in concussion symptoms. The cause of exercise intolerance is unknown, but it is hypothesised that this may occur due to changes in the autonomic nervous system, cardiac stroke volume, and blood flow to the brain.1 Symptom worsening secondary to exercise may also deter patients from exercise.2

Research has shown individualized subthreshold aerobic exercise to be an effective intervention for recovery. Subthreshold exercise is exercise at an intensity that does not exacerbate symptoms. Walking, running, and stationary cycling are all examples of aerobic exercise that can be done to support recovery.7

Research done on this particular intervention has shown that subsymptom aerobic exercise treatments prescribed in the first week after concussion safely speeds recovery.7 Aerobic exercise has also shown to increase factors for growth such as BDNF as early as 5 weeks after starting training.2

______________________________________________________________________

…research has shown that exercise can be thought of as an effective medicine to help in recovery after concussion.

______________________________________________________________________

So, research has shown that exercise can be thought of as an effective medicine to help in recovery after concussion. However—as is the case with any other medicine—it is important to consult with your healthcare provider to determine the appropriate dosage for you. Excessive or intense exercise can potentially be harmful, but by working with your healthcare provider to develop a personalized training regimen, you can get on the road-to-recovery faster! For more information on concussions, interventions, and current research, be sure to check our past blog posts.

 

 

References
  1. Bezherano I, Haider MN, Willer BS, Leddy JJ. Practical Management: Prescribing Subsymptom Threshold Aerobic Exercise for Sport-Related Concussion in the Outpatient Setting. Clin J Sport Med. 2021 Sep 1;31(5):465–8.
  2. Leddy JJ, Haider MN, Ellis M, Willer BS. Exercise is Medicine for Concussion. Curr Sports Med Rep. 2018 Aug;17(8):262–70.
  3. McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med [Internet]. 2017 Jun 1 [cited 2022 Dec 31];51(11):838–47. Available from: https://bjsm.bmj.com/content/51/11/838
  4. Itoh T, Imano M, Nishida S, Tsubaki M, Hashimoto S, Ito A, et al. Exercise increases neural stem cell proliferation surrounding the area of damage following rat traumatic brain injury. J Neural Transm [Internet]. 2011 Feb 1 [cited 2022 Dec 31];118(2):193–202. Available from: https://doi.org/10.1007/s00702-010-0495-3
  5. Itoh T, Imano M, Nishida S, Tsubaki M, Hashimoto S, Ito A, et al. Exercise inhibits neuronal apoptosis and improves cerebral function following rat traumatic brain injury. J Neural Transm (Vienna). 2011 Sep;118(9):1263–72.
  6. Seo TB, Kim BK, Ko IG, Kim DH, Shin MS, Kim CJ, et al. Effect of treadmill exercise on Purkinje cell loss and astrocytic reaction in the cerebellum after traumatic brain injury. Neuroscience Letters [Internet]. 2010 Sep 13 [cited 2022 Dec 31];481(3):178–82. Available from: https://www.sciencedirect.com/science/article/pii/S030439401000861X
  7. Leddy JJ, Haider MN, Ellis MJ, Mannix R, Darling SR, Freitas MS, et al. Early Subthreshold Aerobic Exercise for Sport-Related Concussion: A Randomized Clinical Trial. JAMA Pediatrics [Internet]. 2019 Apr 1 [cited 2022 Dec 31];173(4):319–25. Available from: https://doi.org/10.1001/jamapediatrics.2018.4397

 

 

Meet Dr. Hyehyun Paek: Psychiatrist in Montreal

Honouring yourself and what drives you.

Meet Dr.Hyehyun Paek, Psychiatrist for Numinus in Montreal! We recently sat down with Dr.Paek and discuss her role at Numinus, her tips for self-care, and her love for the mission at Numinus. 

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What brought you to Numinus?

I stumbled upon Numinus serendipitously when I started my psychiatry practice out of Mindspace in Montreal. Soon after, Numinus began their psychedelics-assisted program here. I was impressed by the dedication to advance this field and all the different facets of Numinus such as research, training and client-oriented services. Most importantly, I truly felt that Numinus was doing it right by respecting and honouring the history and origins of psychedelics and plant medicines, which stems back to Indigenous roots.

 

Could you describe your role in 1-2 sentences?

I screen potential clients to see if they are eligible for psychedelics-assisted therapy by performing a clinical interview and provide them with an opportunity to ask questions. I try to capture a glimpse of each client’s history, personality, coping styles, life experiences, influences, strengths and their motivation during these assessments.

 

How do you act in service to yourself to make your mental health a priority?

- I actively prioritize my mental health - active, being the key word. I check in with myself regularly and engage in practices that recharge my battery like yoga, meditating, listening to music, journaling, walks in nature, pleasure reading and scheduling alone time.

- I try to set healthy limits and say ‘no’ as often as I can. Instead of feeling guilty when I say no, I try to celebrate it. It’s hard but it’s very important because if I’m not well, I cannot help others be well either.

- When I notice that I’m not doing well, I seek out help from friends or other professionals.

 

What do you love about Numinus?

I love being part of a big team whose values align with my own. We share a common goal and I feel that we are all in this for genuine reasons - because we really believe that what we do can truly help. We are all unique and have different approaches but I love that we can always come to an understanding and have respect for each other.

 

What inspires you the most about the field of psychedelics and mental health?

I am most inspired by the anecdotal stories of people whose lives have been changed by psychedelics. When I first learned about psychedelics in this context, I felt a deep sense of knowing that this was truly transformative. Hearing others share their journey of healing motivates me to expand on this work. Additionally, I am inspired by all healers and practitioners that have courageously advocated for the use of psychedelics in mental healthcare.

 

What has been the most transformative experience in your career so far?

Reconnecting with my spirituality has opened so many doors and possibilities for me in my career. Through this, I discovered that emotions live in the body and this re-shaped my entire conceptualization of mental illness. When emotions are not overwhelming, we can see that our bodies also hold inner wisdom that knows how to heal itself. From this understanding, I now have the tools to work with individuals, no matter how complex their story may be.

 

What advice would you give someone wanting to start a career in your field?

I am still new to psychiatry so this is a hard question to answer. But I was given advice early in my career that has stuck with me. I was told ‘Don’t take risks with your career, play it safe. Don’t be a pioneer’. I remember my body going completely cold when I heard this because it was like being told to ignore my authentic nature. So my advice would be: When it comes to patient safety, always err on the side of caution. As for the rest, follow your intuition, no matter what others say.

Meet Cory Cooperman: Clinic Director in Montreal

Technology, Tools, and Changing Lives For The Better

 

Meet Cory, Clinic Director for Numinus in Montreal! Cory's dedication as Clinic Director provides transformative psychedelic-assisted therapies to those seeking healing and growth.

We recently sat down with Cory and discuss his role at Numinus, his passion for psychedelics and mental health, and his invaluable advice for anyone considering a career in this groundbreaking field.

What brought you to Numinus?

I came to Numinus as part of the Mindspace acquisition in February 2021. I was eager to join a company so aligned with our mission and values, pushing forward at the cutting edge of mental health care services.


Could you describe your role in 1-2 sentences?

As Clinic Director for Numinus in Montreal, I oversee the day-to-day operations of the clinic spaces in Montreal by managing the Care Coordinators and Personal Health Navigator, recruiting new practitioners (e.g., therapists, nurses, doctors), and administering our electronic medical record, billing and client scheduling system. Ultimately, when it comes to turning new programs into reality, such as our new Group Ketamine-Assisted Therapy pilot project, I am the lead in making sure everything is taken care of.


How do you act in service to yourself to make your mental health a priority?

I am blessed with a partner who happens to be a psychologist, as well as extensive training myself as a therapist, and it all starts with a strong work/life balance. I love to use technology (like Focus Modes in iOS) to help me maintain good work/life balance.


What do you love about Numinus?

I love the feeling of making a difference that comes from being part of Numinus, which is strongly felt when you connect with your co-Numis during meetings and see brilliant, caring people coming together to solve problems.

 

What inspires you the most about the field of psychedelics and mental health? 

I have concretely seen the difference mental health care, provided in a timely and evidence-based fashion, can make. It changes lives for the better, and there’s nothing more rewarding than that.

 

What has been the most transformative experience in your career so far?

I have been lucky to enough to get to transition from being a student therapist to someone who gets to enable practitioners in the field to do their very best for their clients. It brought me full circle, back to my roots in technology and management, while still getting to use my knowledge gained during my clinical training.

 

What advice would you give someone wanting to start a career in your field?

Curiosity is your best tool, and if you approach challenges with a genuine openness to learning something new, even if you don’t solve a particular problem, you’ll come away with something that will help you the next time around.

 

Interested in joining the Numinus team? Check out all of our open roles HERE.

 

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Technologie, Outils et Changer des Vies

Rencontrez Cory, Directeur de clinique chez Numinus à Montréal ! L'engagement de Cory en tant que directeur de clinique permet de proposer des thérapies assistées par les psychédéliques à ceux qui recherchent la guérison et la croissance.

 

Nous nous sommes récemment entretenus avec Cory pour discuter de son rôle chez Numinus, de sa passion pour les psychédéliques et la santé mentale, ainsi que de ses précieux conseils pour toute personne envisageant une carrière dans ce domaine révolutionnaire.

 

Qu'est-ce qui vous a amené à Numinus ?

J'ai rejoint Numinus dans le cadre de l'acquisition de Mindspace en février 2021. J'étais impatient de rejoindre une entreprise si alignée avec notre mission et nos valeurs, poussant vers l'avant à la pointe des services de soins de santé mentale.

 

Pourriez-vous décrire votre rôle en une ou deux phrases ?

En tant que directeur de clinique pour Numinus à Montréal, je supervise les opérations quotidiennes des espaces cliniques à Montréal en gérant les coordonnatrices de soins et le navigateurs de soins, en recrutant de nouveaux praticiens (p. ex. thérapeutes, infirmières, médecins) et en administrant notre système de dossier médical électronique, de facturation et de prise de rendez-vous. Enfin, lorsqu'il s'agit de concrétiser de nouveaux programmes, comme notre nouveau projet pilote de thérapie de groupe assistée par la kétamine, c'est moi qui veille à ce que tout soit mis en œuvre.

 

Comment se mettre au service de soi-même pour faire de sa santé mentale une priorité ?

J'ai la chance d'avoir un partenaire qui est psychologue, ainsi qu'une formation approfondie en tant que thérapeute, et tout commence par un bon équilibre entre vie professionnelle et vie privée. J'aime utiliser la technologie (comme les modes de concentration dans iOS) pour m'aider à maintenir un bon équilibre entre vie professionnelle et vie privée.

 

Qu'aimez-vous chez Numinus ?

J'aime le sentiment de faire la différence qui découle de mon appartenance à Numinus, sentiment qui est fortement ressenti lorsque vous vous connectez avec vos co-Numis pendant les réunions et que vous voyez des personnes brillantes et bienveillantes se réunir pour résoudre des problèmes.

 

Qu'est-ce qui vous inspire le plus dans le domaine des psychédéliques et de la santé mentale ?

J'ai vu concrètement la différence que peuvent faire des soins de santé mentale fournis en temps opportun et fondés sur des preuves. Cela change des vies pour le mieux, et il n'y a rien de plus gratifiant que cela.

 

Quelle a été l'expérience la plus transformatrice de votre carrière jusqu'à présent ?

J'ai eu la chance de passer du statut d’étudiant au doctorat en psychologie à celui de personne qui permet aux praticiens sur le terrain de donner le meilleur d'eux-mêmes à leurs clients. Cela m'a permis de boucler la boucle, de revenir à mes racines en matière de technologie et de gestion, tout en continuant à utiliser les connaissances que j'ai acquises au cours de ma formation clinique.

 

Quels conseils donneriez-vous à quelqu'un qui souhaite entamer une carrière dans votre domaine ?

La curiosité est votre meilleur outil, et si vous abordez les défis avec une réelle ouverture d'esprit pour apprendre quelque chose de nouveau, même si vous ne résolvez pas un problème particulier, vous repartirez avec quelque chose qui vous aidera la prochaine fois.

Vous êtes intéressé(e) à rejoindre l'équipe de Numinus ? Consultez tous nos postes ouverts ICI.

How Psychological Flexibility is Cultivated Through Mindfulness

By Benjamin Schoendorff, Contextual Psychology Institute

I was first introduced to formal meditation practice in a Zen dojo in 1994. At the time, my life was chaotic and it would remain so for another 10 years. On several occasions over these ten years, I tried to build a regular meditation practice. Although I never managed more than meditating intermittently, I have no doubt that what little practice I did manage helped me. It helped me by giving me a direct experience of distancing from my thoughts. I had previously experienced what I thought as being a part of my essence, as what was defining me, and thus of the utmost importance.

Through meditation I experienced that my thoughts came and went. They were more like clouds in the sky of my consciousness than what defined that sky. The second thing I experienced was closely related. It was a sense that I was more than my thoughts and emotions, more than my experiences. That there was a part of me that was not affected by my experiences, that remained an observer no matter how painful the feelings of the moment or hooky the thoughts.

When I started getting my life in order and, after a brief course of psychotherapy, decided to make myself useful by becoming a therapist, I made a commitment to being guided by science and to somehow integrate my meditation experience into my work. I naturally gravitated toward behavioural therapies, due to the strong empirical support they enjoyed and their commitment to a scientific approach to the alleviation of human suffering. I just as naturally became interested in Mindfulness-Based Cognitive Therapy which, was then gathering its first research data supporting its possible effectiveness for depressive relapse. However, try as I might I simply could not build a daily mindfulness practice. I felt uneasy recommending it to my clients. I suspected many would, like me, not be able to engage in daily mindfulness practice.

In February 2007, I came across Acceptance and Commitment Therapy (ACT), an emerging mindfulness and acceptance-based approach that seeks to help people develop their psychological flexibility. Psychological flexibility is the ability, in contact with everything that shows up in the moment, to choose and do actions to move toward one’s values, who and what matters most.

In dozens of studies, psychological flexibility has been linked both to positive life functioning and life satisfaction and to a reduction in suffering associated with depression, anxiety, trauma, relationship difficulties and a host of other disorders. The way ACT seeks to train psychological flexibility is by cultivating mindfulness, distancing from unhelpful thought patterns, acceptance of unwanted feelings, identification of one’s values and moving toward them through deliberate actions. You could say it uses mindfulness skills to get folks to behave like the person they want to be.

And here was the catch for me. The person I want to be builds a regular mindfulness practice, but couldn’t. That fed my interest in ACT which seeks to train mindfulness skills even absent a formal mindfulness practice. ACT sees mindfulness as composed of four main elements: the ability to distance from thoughts (a.k.a cognitive defusion), the willingness to experience whatever is present (a.k.a. acceptance), the ability to be present to whatever arises in the moment (a.k.a. contact with the present moment) and, finally, the ability to contact an experience of self as an observer of all experience and transient thoughts, emotions and behavior (a.k.a. self-as context). In ACT these can be trained as discrete processes that together promote the ability to move toward one’s values. One of the most effective ways to do this is through using the ACT Matrix, a simple diagram with two intersecting lines that create four quadrants. The upper left-hand side represents actions to move away from unwanted inner experience (bottom left) and the right-hand side actions (top right) to move toward whom or what is important (values, bottom left). Sorting our behaviours and experiences in these four quadrants gradually helps build our psychological flexibility.

In my case, it has helped me gradually build a daily mindfulness practice that I have been able to keep up for over four months now. I was greatly helped by joining the Numinus team in the Mindful in May challenges for the past two years. Central to the ACT model and standing as a testament to its flexibility is the fact that ACT processes are based in mindfulness, while ACT can also, as was the case for me, help with engaging in more regular mindfulness practice. This is why I believe that mindfulness-based approaches should continue to dialogue and seek integration.

Reflections on a Silent Retreat

By Sarah Roberts, Assistant Director of Numinus

Insight Meditation Society

Last week, I drove to Barre, Massachusetts with Numinus Clinic director Joe Flanders and Numinus Clinic teacher Julien Lacaille to attend a six-day silent meditation retreat at the Insight Meditation Society (IMS). Founded in the 1970s by American Buddhist teachers Sharon Salzberg, Jack Kornfield, and Joseph Goldstein, IMS is one of the oldest meditation retreat centres in the West. The centre is housed in a beautiful old mansion, and runs regular retreats dedicated to the cultivation of vipassana (insight) and metta (lovingkindness). Our retreat was run by Kittisaro and Thanissara, Buddhist teachers who live and teach primarily in the US and in South Africa.

Orientation

On Monday evening, we gathered with one hundred retreatants from all over the United States and Canada for our orientation session. We were given a tour of the centre, and each retreatant was assigned a small dorm room (single bed, sink and mirror, wardrobe and chair) and a daily job that would contribute to the functioning of the centre. I was assigned to a team of after-lunch pot-washers; fellow retreatants were assigned various gardening, housekeeping, and food preparation jobs.

Noble Silence

Following the orientation session, Thanissara and Kittisaro rang a bell and Noble Silence was officially in session. Noble Silence simply refers to a commitment to remain silent for a certain extended period; the silence is designed to still our mouths and therefore our minds; making it easier to sit calmly; observe the workings of our minds and bodies; and cultivate perception, clarity, and wisdom.

Retreat Schedule

Starting Tuesday morning, the format of the retreat was as follows: at 5am, a bell-ringer walked through the halls of the dorms, ringing a bell to wake us and call us to gather in the meditation hall at 5:10 for chanting and sitting meditation. I usually took the opportunity to sit outside and enjoy the lightening sky instead, joining the group for the next meditation period at 6am. At 6:30, we ate breakfast. At 8:15am, we reconvened in the meditation hall for alternating periods of sitting meditation and walking meditation until lunch at noon. The afternoon schedule was very similar: alternating periods of sitting and walking meditation, until a light dinner (soup with crackers or bread) at 5:30pm. All meals were vegetarian, and each period of sitting, walking, or eating was indicated by bell-ringing.  At any time, retreatants could choose to meditate in the meditation hall, in the dorm rooms, in alternate designated meditation areas, or outside; we were also free at any time to nap, take a walk, have a cup of tea, or otherwise rest or rejuvenate.

Dharma Talks

Every evening, Thanissara or Kittisaro gave a “dharma talk.” The word dharma refers to the underlying order of nature and human life, and to behaviour considered to be in accord with that order. The word is also often used to refer to the entirety of the teachings of the Buddha, and a “dharma talk” simply means a talk on Buddhism by a Buddhist teacher. Kittisaro and Thanissara’s dharma talks were excellent. Some referred to Buddhist teachings that were not familiar to me, but the underlying themes of compassion, acceptance, and non-striving were very familiar from my experience as an MBSR participant and teacher. The teachers were warm, engaging, and funny. In particular, Kittisaro’s description of his early life as an incorrigible striver (Rhodes’ Scholar, wrestling champion, medical student) made us laugh.

Buddhism and MBSR

For me, one of the pleasures of the retreat was hearing Thanissara and Kittisaro teach many of the concepts we teach in our mindfulness-based stress reduction (MBSR) program, but from their unique perspective. Mindfulness is a Buddhist concept only quite recently popularized and secularized in the West as a tool for physical and emotional health and well-being. Although Western mindfulness teachers are educated in Buddhist principles and cognizant of the roots of mindfulness, the MBSR curriculum is specifically designed to be secular, and does not explicitly refer to Buddhist teachings.  Although the retreat teachers only used the word mindfulness a handful of times during the week, the themes of awareness via body sensations, allowing experience to be as it is, turning toward rather than away from pain, and cultivating compassion for personal and others’ suffering were unmistakable. Furthermore, many of the dharma talks touched upon the seven foundational attitudes to mindfulness practice (acceptance, non-judgment, non-striving, beginner’s mind, patience, trust, and letting go) identified by MBSR founder Jon Kabat-Zinn, and explicitly taught in MBSR.

Retreat Life

Being on retreat is in some ways demanding (waking up at 5am, meditating for extending periods) and in some ways relaxing (no phones, internet, email, shopping, cooking, or demands on your time), but it’s above all interesting. Noticing what your mind does when the usual demands are absent is like sitting behind the window of a laboratory. I became extremely sensitive to the operations of my mind, immediately noticing each time a stray thought caused a twinge of anxiety or stab of fear; and acutely aware of the precise moment I became itchy, hungry, or otherwise physically uncomfortable. I had the space and time to observe my mental habits, noticing each time my mind latched onto one of its usual topics of rumination, or reacted to some nonverbal behaviour from a fellow retreatant. In some instances, the heightened awareness allowed me to behave more skillfully; in other instances, I observed myself repeating unhelpful patterns.

Post-Retreat Life

Now the retreat is over. I’m back in Montreal, back at work, and meeting with the usual demands and pleasures of my regular life. What’s different? First, I have retreat jet lag, which means that I’m going to bed and waking up about two hours earlier than usual. Second, I regularly stop and ask myself “How is it now?” This is a phrase Kittisaro and Thanissara encouraged us to use to check in with ourselves. Third, I’ve been speaking more slowly and less often, and listening more, realizing that everything that crosses my mind doesn’t need to be spoken out loud. Fourth, I’ve noticed that I’m more sensitive than usual to my own and others’ emotions, to the sounds in my environment and to the loveliness of nature.

I hope all of these changes last, but I’m prepared for them to fade or fluctuate. After all, if there’s any one lesson to take from Buddhist teachings, it’s the impermanence of all things.

Reflections on Difficult Times and How Mindfulness Can Help

The last 6 months have been difficult for my family and me. In fact, I can’t recall another period in my life in which I felt so overwhelmed, depleted, and discouraged. Thankfully, the worst of it has past. I’ve since had time to reflect on this period and, in particular, how my mindfulness practice helped me cope. While much of what follows is an account of my personal experience, I believe the value of the practice as it is applied here is universal.

I’ll try to get you up to speed on what happened without boring you to death with the minutiae of my “first-world” problems: My wife and I live with our 2 little kids (M, 4 years old & G, 1.5 years old) in a condo in Montreal. Last spring, we discovered a significant mould infestation in our basement. The problem was so bad that it was compromising the structural integrity of our kitchen and bathroom floors (we were lucky the floor didn’t caved in while M & G were in the bath) and poisoning the air quality in our home. Imagine: G had been breathing this toxic air since she came home from the hospital at 2 days old! The upshot was that we had to: move out; hire specialists to decontaminate the crawlspace; rip out the floors; dig up our yard to fix the water infiltration problem; and then rebuild and refinish everything. To make matters worse, we had to pursue 3 separate lawsuits if we wanted to recoup the 6-figure costs of the job.

In the middle of all of this, I got some devastating news from my mother: her cancer relapsed. It had been under control for 3 years thanks to an amazing new drug, but sadly, the disease had progressed and the drug was no longer effective. We didn’t know how much longer she had to live.

I have learned over the years that when I’m processing emotion or feeling overwhelmed, the primary symptom is irritability. I am easily frustrated by minor setbacks and impatient with people around me. What I lived over the summer was the perfect storm of triggers for me in my vulnerable state: we moved in and out of 6 different homes, supported our children through the change, managed the financial burden of all the work on our home, had countless meetings with contractors and lawyers, all while having to process this troubling news about my mother’s health.

Because we moved around a lot over the summer, it was tough to keep track of our stuff. I’d go to the bathroom to shave before work, only to realize I’d left my shaving stuff in another bag at home; my daughter wanted to sleep with her 2nd favorite stuffed animal, but that one was in storage; my wife wants to charge her iPhone, but I forgot to pack it at the other apartment. On and on like this for 3 months. And each each of these little frustrations would infuriate me. I would tighten up, growl inside, and think (over and over again) “This is so irritating! I can’t deal with all this frustration! I can’t believe I have to buy yet another iPhone charger!” As you can imagine, my head was not a fun place to be.

In one of my more acute moments of discouragement, it occurred to me that the magnitude of these challenges superseded my capacity to practice and cope with them. So I looked for inspiration from Pema Chodron, whose books had helped me through difficult times in the past. I picked up Living Comfortably with Uncertainty and Change and was reminded of one of her most compelling theses: that moments of difficulty offer the best opportunities to deepen insight and wisdom.

According to Pema, when things don’t go according to plan – when things fall apart to use her phrase – we typically react with some form of resistance such as frustration, disappointment, sadness, or indignation. We are attached to having things the way we want them and all of these reactions involve emotionally doubling-down on the plans that have not worked out.

When things don’t go according to plan, we typically react with some form of resistance such as frustration, disappointment, sadness, or indignation

Rather than tightening our grip on what has already slipped away, Pema invites us to let go and relax into the “fundamental groundlessness of being.” That phrase is fancy spiritual jargon referring to the impermanent and unsatisfying nature of reality. The fact is that my desire to have my “stuff” in order is bound to be unsatisfied because “stuff” invariably falls out of order again. iPhone chargers get lost and found; the soothing presence of stuffed animals comes and goes; apartments floors rot and get rebuilt; relationships fall apart and come together; even human life itself arises and passes. So as long as we are attached to having things a certain way, we will inevitably experience that dissatisfaction. In Buddhism, this is called dukkha.

Most of us, myself included, can’t really help it. Our brains evolved to make us feel more at ease in familiar environments that are predictable and under control. It requires more effort and energy to adapt to novel, unpredictable circumstances – and who knows what unknown threats lurk in the disorder? So adaptation to change is often accompanied by stress, anxiety, and depletion. Stretching beyond our evolutionary heritage and working skillfully with dukkha requires significant practice.

According to Pema, we can open up and ease into moments of frustration and stress. This practice begins with mindfulness. The idea is to drop into the moment-by-moment unfolding of an awareness that is not hooked or shaped by our preferences or judgements. The resistance itself can be used as an invitation to shift into openness and curiosity. In my case, that refers to the tightness in neck and shoulders, accelerating frustrated feeling, and racing thoughts about how my circumstances. Any of these elements could serve as a cue to stop and say “wow, resistance is here; let’s see what this is like.” At one level, this attitude disrupts the automatic habitual reactions of irritation and rumination and makes it possible to relate to the moment differently, such as with kindness and self-compassion. At a deeper level, it also opens the door to the experiential insight of impermanence, a deep and clear understanding that conditions change and sustainable well-being arises from a willingness to accept and work with what shows up.

We can open up and ease into moments of frustration and stress. This practice begins with mindfulness.

Of course, a lot of repetition and deliberate practice is required to move from a momentary insight to new way of being. And I have to admit I did fail to make this shift more often than I succeeded. But I do have one interesting experience to share.

One morning in the middle of the summer, I took my daughters out for a walk so my wife could catch up on sleep. The weather was lousy, but it hadn’t started raining yet and the kids needed to get out. So we went and had a reasonably good time. On the way back, the whining started: “I’m huuunnngry. I’m tiiiiirred. I don’t want to walk anymore, etc.” Shorty after that, it started pouring rain (obviously) and the whining escalated to crying.  Somehow, despite headache, fatigue, and own wet clothes, I managed to not react. I didn’t say or do anything except observe the moment unfolding. To be clear, this wasn’t an act of suppression or self-deception; there were simply no other “strategies” available to me aside from letting go of my preferences and working with what was present. After a minute or 2, the kids calmed down and walked along quietly. Then, the rain actually let up. And as we approached our home, I noticed a feeling of peaceful gratitude set in as the beauty of my surroundings registered, as well as a sense that everything was going to be ok.

For a brief moment I was attuned to the “fundamental groundlessness of being.” And as hard and complicated as that sounds, it actually involved little effort or technique – just slowing down and tuning in. So here is your invitation to try relaxing into those moments (big or small) when you’re feeling stuck in reactivity. It may help bring back intentionality and a deeper appreciation of impermanence.

Photo by Michael Dam on Unsplash

 

Montreal Brain Imaging Study Shows Reduced Reactivity with Mindfulness

Mindfulness largely refers to a state of awareness characterized by a particular attitude of acceptance and non-judgement towards ‘events’ occurring in the realm of our attention.

These events may constitute thoughts, feelings, physical sensations, emotions, recursive thinking patterns, etc. The challenge in cultivating mindfulness lies in acknowledging these thoughts/feelings/sensations/perceptions, instead of reacting to them in habit-formed ways. Therefore, mindfulness allows us to adopt a more detached perspective on our experiences, promoting greater objectivity in selecting responses and behavior.

Mindfulness is cultivated through the practice of meditation, and has its roots in ancient Eastern traditions. Research has shown that mindfulness reduces the extent to which we react to emotional events, which is reflected not only in the way we perceive these events but in the way our body physically responds to them.

This may potentially explain why mindfulness is beneficial when introduced in treatments targeting depression and anxiety. The way in which the effects of mindfulness on emotional events are reflected in brain function, however, is not clearly established.

Therefore, our research group at Université de Montréal (laboratory of Dr Mario Beauregard) conducted a study examining brain function changes underlying a mindfulness state of awareness while processing emotionally charged pictures.

To do this, we examined a group of individuals having practiced meditation for more than 1000 hours, and another comparison group with no prior experience in meditation (but which was trained for one week before the experiment). The participants viewed pictures depicting negative emotional (eg.: war scenes), positive emotional (eg.: a grandfather smiling and hugging his grandchild) and neutral content (eg.: a common object, such as a lamp). At the same time, their brain activity was recorded inside an MRI scanner. Each group viewed these pictures in a state of mindfulness, as well as in a regular (non-mindful) state of awareness.

Essentially, both experienced meditators and non-meditators reported that they felt less emotionally aroused from the pictures when viewing them in a mindful state of awareness than when they were not in a mindful state.

Also, brain function recorded from the long-term practitioners in comparison to the non-meditators revealed the following results. While viewing the emotional pictures in a mindful state of awareness did not reduce activity in a relatively ‘primitive’ fear and arousal-related brain structure, i.e. the amygdala, mindfulness was related to reduced activity in thought-related brain areas, i.e. within the prefrontal cortex.

This potentially indicates that, with long-term meditation experience, the mechanism through which mindfulness attenuates arousal to emotional events is not attained through the initial primitive reaction, but through the secondary thoughts and judgements triggered by arousing events.

This interpretation however, needs to be validated with behavioral tasks specifically assessing mindfulness and thought-related elaboration towards emotional events.

In a second report, we also observed differences between our group of long-term meditators and non-meditators in the way their brain activity was organised during a state of rest, i.e. when participants were not engaged in a specific task. Thus, this may indicate that meditation is related to brain organisation changes which extend beyond a meditative state of awareness per se.

It is important to point out, however, that cause and event conclusions cannot be derived from the results of these studies, and that further research projects examining a group of participants before and after having acquired mindfulness experience are needed to support our findings.

Nonetheless, our studies shed light onto the brain mechanisms operating when individuals experience emotional content in a mindful way. As researchers and scientists persist in studying and uncovering these processes, we will gain a better understanding of the impact that emotional experiences and meditation have on our psyche, our body, and our brain.

Finally, with a better understanding of these processes, mindfulness can be more efficiently implemented into treatment options for disorders related to stress and emotional lability.