Fall 2015
Resilience

What Do We Feed? Mindfulness and Resilience in Successful Aging

About the Author

Lucia McBee, LCSW, MPH, CYI, is a geriatric social worker and certified yoga teacher who integrated mindfulness and complementary therapies with elders and their caregivers for more than 30 years. She is adjunct faculty at the Columbia School of Social Work, and a freelance speaker and consultant in New York City. She is the author of Mindfulness-Based Elder Care (New York: Springer Publishing Company, 2008).

Lucia McBee, LCSW, MPH, CYI

What do we feed?
One evening an old Cherokee told his grandson about a battle that goes on inside people. He said, “My son, the battle is between two wolves inside us all. One is Evil. It is anger, envy, jealousy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego. The other is Good. It is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion and faith.” The grandson thought about it for a minute and then asked his grandfather: “Which wolf wins?” The old Cherokee simply replied, “The one you feed.”   —A Native American Tale

No matter what our circumstances, we will experience the good and bad, and there will be circumstances outside our control. This is increasingly apparent as we age and face losses of friends and family, physical health, and even living environments. Aging Life Care Professionals™ / care managers face these losses both personally and professionally. We cannot change this fact, but we can change how we respond to it. Our innate capacity to face and handle life’s challenges-resilience– is an important factor in living a satisfactory life.

Mindfulness, the ancient art of paying attention non-judgmentally, can be an important key to cultivating resilience. We may be born with a greater or lesser capacity for it, but we can also nurture this quality through our behaviors. Human survival is based on our hypersensitivity to negative and intense situations or, as Rick Hanson says, “The brain is like Velcro for negative experiences, but Teflon for positive experiences. “ (quoted in Bergeisen, 2010).  We also know, however, that we can change our brains by our thoughts and behaviors, and that intentionally focusing on the positive can create new habits that will increase resilience. In other words, we get better at what we practice.

Consider this: Imagine something unexpected, unwanted, and unfortunate happens to you. It could be a client who fires you; an argument with someone in your own family; a higher than expected tax bill; or any other event. What are your thoughts? What are your feelings? Do you notice physical sensations? If you are aware of them, it is a great start to noticing your habits. The next step might be to consider if these responses are helping you or not. Is your first thought, “I am a loser”? Do you clench your fists? Is it helpful? Since you have learned and practiced these habits over many years, it may be challenging to change.  But mindfulness practice brings awareness of our habits, teaches us that we have choices, and nurtures our natural capacity for resilience.

What is mindfulness and mindfulness practice?

Mindfulness-Based Interventions (MBIs) offer a mind/body approach to health and healing that teaches coping skills for physical and emotional trials.  It offers a shift from the conventional emphasis on curing to living with what cannot be changed. Jon Kabat-Zinn, the pioneering creator of Mindfulness-Based Stress Reduction (MBSR), describes mindfulness as:

Moment-to-moment, non-judgmental awareness, cultivated by paying attention in a specific way, that is, in the present moment, as non-reactively, and as open-heartedly as possible.

Bringing awareness and compassion to our moment-to-moment experience is challenging when the experiences are unpleasant or uncomfortable. Mindfulness teaches us to increase our comfort with this discomfort. There are skills, like deep breathing, that we can use at critical moments, so that when distress or disaster arrives unexpectedly we are better prepared to cope with it.

Mindfulness is learned through personal practice, the same way we learn to play an instrument or ride a bike. There are many classes, books, and online apps to learn mindfulness. The most widely used and researched program for teaching mindfulness, is MBSR. It was introduced in 1979 by Kabat-Zinn at the University of Massachusetts Medical Center. MBSR is an intensive 8-week class that teaches participants to connect with and encourage their innate capacity to find balance, reduce stress, and heal using daily assignments of secular, yet often deeply transformative, practices. Practices include formal exercises such as meditation and yoga, and informal exercises that integrate self-compassion, and invite you to pay attention to all aspects of your life.

How do we know it works?

Initially created to help people with chronic pain, MBSR has been shown, in multiple evidence based research studies, to improve mood, sleep, and stress levels, as well as reduce inflammation, impacting multiple chronic conditions (www.goamra.org). Mindfulness has been taught to all ages and in a wide variety of settings such as yoga studios, hospitals, schools, and prisons. Groundbreaking studies of participants following an 8-week MBSR class include:

•    Strengthened immune systems (Davidson, et al, 2003)
•    Increased brain grey matter (related to intelligence, skill, memory and emotion) (Holtzel, et al, 2011)
•    Slowing of cellular aging (Epel, et al, 2009)

Mindfulness interventions have also shown the following benefits for older adults:

•    Improvements in memory and attention (Meta-analysis by Marciniak, et al, 2014)
•    Reductions in anxiety and depression (Young & Baime, 2010)
•    Reduction in pain (Marone, et al, 2008)

What are the practices and where can we learn these?

Mindfulness courses (MBSR or similar ones) are taught in most major cities in the US and around the world. These courses are a great way to begin a regular practice. The courses traditionally begin with awareness of the body and breath. Students are asked to spend time each day paying attention, moment-by-moment, to their breath and physical sensations. This focus can be challenging, but helps participants stay in the present moment. Most notice that their attention is attracted to thoughts, and thoughts reflect the past or the future.

Mindful movement is another important way of bringing awareness to the present via body experience. Yoga, Tai Chi, and Qui Gong are all mindful movement practices, as well as mindful slow walking. In fact, informal mindfulness is available at every moment, just by paying attention. Cultivating a non- judgmental attitude is another important aspect of mindfulness. When learning to pay attention, many people begin noticing harsh, critical thoughts. Letting these thoughts go, and returning to physical awareness, begins to shift habitual negative thinking patterns. An intentional practice of lovingkindness can also be helpful as an antidote to self-criticism and judgment.

The brilliant aspect of mindfulness practices is that they benefit both the professional and the client. In addition to personal stress, Aging Life Care Professionals / care managers may absorb the stress of their clients. Interestingly, stress is contagious. Remember the last time you were around someone who was highly stressed? Did you feel more stressed? If you are stressed, you may find it impacts your clients. Consider the opposite. Would it be possible to de-escalate a stressful circumstance just by using mindfulness practices to calm yourself?

Despite the powerful historical and scientific evidence supporting the benefits of mindfulness and meditation, the final evidence is personal. We can participate in our own healing. Try the exercise described below throughout the day. Notice what you feel immediately following this practice, and after practicing for several days. There is no right or wrong answer—become the scientist of your own life!

Basic Breathing Exercise

The following three-minute breathing exercise is from Mindfulness-Based Cognitive Therapy:

First minute: Awareness

Observe—bring the focus of awareness to your inner experience and notice what is happening in your thoughts, feelings and bodily sensations. Describe, acknowledge, identify—put experiences into words.

Second minute: Redirecting attention

Gently redirect your full attention to your breath. Follow your breath all the way in and all the way out.

Third minute: Expanding attention

Allow your attention to expand to the whole body—especially to any sense of discomfort, tension, or resistance.

As best you can, bring this expanded awareness to the next moments of your day.

Remember, as the song writer Roger Miller said: “Some people feel the rain, others just get wet”.

References

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