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California State University, Northridgedgehart@mac.com

www.dianegehart.comAuthor Mindfulness and Acceptance in Couple and Family Therapy

MindfulnessPractice:InaNutshell

• Observing a single phenomenon (e.g. the breath) • while compassionately and non-judgmentally

• quieting the inner chatter in the mind

• Jewish Meditation

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Isn’tCultural Values/Reinforced Behaviors§Immediate gratification§Multi-tasking §Goal-oriented: Valuing Productivity

§ Chronic pain § Cancer: Psychological,

biological, and sleep outcomes

§ Cardiovascular disorders§ Epilepsy§ HIV/AIDS§ Psoriasis§ Rheumatoid arthritis§ Fibromyalgia§ Organ transplant

§ Type II diabetes§ Multiple sclerosis§ Sleep disturbance§ Mixed medical diagnoses

§ Depression§ Depression relapse § Bipolar Disorder§ Anxiety and Panic§ Substance Abuse § Eating Disorders§ Borderline Personality§ Attention Deficit Disorder (ADD/ADHD)§ Oppositional and Conduct Issues§ Trauma and PTSD (emerging)§ Couples enrichment

PsychologicalBenefits• Increased Positive Emotion

and Wellbeing• Reduced Stress• Increased Emotional

Regulation• Increased Metacognitive

Awareness• Decreased Rumination• Improved Attention• Increased Acceptance and

Decreased Avoidance• Clarification of Values• Increased Self Compassion

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Relational Benefits• Increased Marital Satisfaction• Increased Empathy and Compassion• Increased Acceptance of Self and Partner• Increased Awareness of Interactional Patterns• Increased Ability to Respond with Awareness• Greater Sense of Freedom and Safety in

Relationships• Greater Sense of Unity and Separation

• Stress Response• Amygdala scans for danger • Triggers an autonomic response

• Fight, flight, freeze response• Prefrontal cortex only to shut off

• Mindfulness • Increases capacity to shut off

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§Dan Siegel proposes mindfulness increases neural integration§ Correlated with §Mindful states§Secure attachment

• 9 Characteristics Neural Integration• Body Regulation• Attuned Communication• Emotional Balance• Fear Modulation• Response Flexibility• Insight• Empathy• Morality• Intuition (Siegel, 2009)

Trauma and Neural Integration• Trauma

• Greatly impedes neural integration

• Trauma experience scatters memory• Hippocampus unable to develop explicit memory• Amygdala “sears” trauma into implicit memory• Trauma memories stored primarily as implicit memory• Implicit memory

• Automatic, little consciousness• No distinction of time and place• Feels like happening now

• Resolving trauma• Link explicit to implicit memory into coherent

memory/narrative

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www.umassmed.edu

§Sitting Meditation for Youth§ Similar (but slightly smaller) effect size compared to

adults§ Feasible and acceptable treatment§ Increasing research

ADHD: Corrective Potential

§ Mindfulness and ADHD§ Potential to “rehabilitate” prefrontal context§

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§Conduct and Oppositional Issues§Reduces internalizing and externalizing behaviors§

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Mindfulness-Based Program for Children§A Still Quiet Place

§8 week curriculum for children 4-18§ Well organized and easy to use

§Based on MBSR§For mental health setting (e.g. agency, private

practice)§www.stillquietplace.com

School-Based Programs§ MindUP: K-5th Graders: Goldie Hawn Foundation

§ Improved § prosocial behavior § self regulation§ empathy§ peer acceptance

§ Less depression and aggression§Format

§ 15 lessons§ “Core Practice”: Used everyday to incorporate brief practice

multiple times per day.§ Integrated with daily class activities§ Focus on neuroscience aspects§ thehawnfoundation.org/mindup/

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Mindful Parenting Programs

§Mindful Parenting Program§ Teaching parents to self regulate§ Bring greater acceptance and compassion

§Mindfulness-Based Parent Training § Reducing rigid, “mindless” interaction patterns

§Evidence base§ Reduced depression, ADHD symptoms § Improved child-parent communication§ Reduced risk behavior, including drug use and sex§ Reduced negative expression by parents