Trauma-Sensitive Mindfulness-Based Recovery Maintenance

Trauma-Sensitive Mindfulness-based Recovery Maintenance

SCRIPTS for 5 Practices

AngelaThomasJones.com 6036162019

INTRODUCTION:

A mind – body approach

for Substance Misuse & Mental health disorders treatment & recovery

note to facilitator:

remember to slow your pace of speech when reading this script and allow for natural pauses between concepts.

It helps to take several long, deep breaths before starting. Over time, you will develop your own style that works best for your setting.

History despite its wrenching pain

cannot be unlived,

but with courage,

need not be lived again

Maya Angeleou, 1993

note to facilitator:

adjust your script to fit your circumstances and time frame – however, always include a review of agreements regarding safety and conduct in the room during practice

What is it? Paying attention

in a particular way

in the present

on purpose. Jon Kabat-Zinn, 1994

cont. INTRODUCTION: Where does Mindfulness come from?

We have known for decades recoveryfrom substance use and co-occurring mental health disorders involve the whole self; mind, body, and spirit.

The field of western psychology and addiction treatment is moving towards a more holistic approach to illness, intervention, and recovery. The merging of this process with eastern culture influenced therapies is changing the way the field views clinician, client, evidenced-based practice, current and future research direction.

Though it has its roots in Buddhist meditation, a non-religious practice of mindfulness entered the American mainstream in recent years. Thousands of studies have documented the physical and mental health benefits of mindfulness in general. All of this research isinspiring programs to adapt Mindfulness based models for schools, prisons, hospitals, veterans centers, and beyond.

Examples;

Mindfulness-based Stress Reduction, Jon-Kabot Zinn.
University of Massachusetts School of Medicine
The Relaxation Response, Herbert Benson; founder Mind Body Medical Institute.Harvard Medical School

Free downloadable Mindfulness Exercises

WHY do it?

Mindfulness helps us develop the ability to be . . .

Responsive rather than Reactive . . .

a Recovery Maintenance skill is a copingstrategy for how to live in balance with the stress of drug & alcohol use triggers, cravings, urges and the mental health challenges that often co-exist with the substance use.

cont.INTRODUCTION: More reasons why . . .

Mindfulness is a foundational skill for Recovery Maintenance

Because it is a skill of self-awareness-- the first step into recovery.

Recognizing need for change

Herbert Benson, the author of The Relaxation Response,(2000)says;

The Relaxation Response is a physical state of deep rest that changes the physical and

emotional responses to stress... and the opposite of thefight or flight response.

The breath and mind go together . . .

if the breath is calm , steady, and even,

so are we . . .

Swami Karunanda

note to facilitator:

handout with anatomical description of the lungs and rib cage (page 62)

use other illustrations or examples you might find or from the experiences of your group participants.

This also has another version of Mindful Practices: See How Slow You Can Go printed on it

Homeostasis & WHY the Mechanics of breathing are important

Our biological system is designed to keep itself in balance (homeostasis). The purpose of the lungs is to provide oxygen to the blood. Learning to regulate our breathing helps to calm down the fight/flight reaction (slows the heart rate, reduces production of stress hormone cortisol and adrenaline). Then we are able to RESPOND rather than REACT. Learning to read the signs and symptoms of our body and the difference between a craving vs healthy biological necessity is developing the mind – body connection. For example; a headache is a physiological symptom of dehydration. A healthy response would be to drink clean fresh water. A craving reaction might be to drink soda, coffee, or to take a pain reliever (something with caffeine)

cont. INTRODUCTION: . . . HOPE

Brain Plasticity & why it is important to understand

Neurobiology research has given us new understanding – and most importantly - HOPE

for change for the good that is recovery. Brain Plasticity means we can change neuro-network connections in our brain through practicing new skills like mindfulness. The 12-step Recovery Movement has given testimony to this reality before the neuroscientists could prove it expressed in slogans like; It works if you work it

Start by doing what’s necessary,

then do what is possible,

and suddenly,

you are doing the impossible

Saint Francis of Assisi, 1181-1226

For people living with histories of trauma regardless if the “trauma incident” was short-term, a one-time incident or an ongoing period in their lifetime, mindfulness skills are a direct link to freedom from the bonds of the emotional baggage that lingerin our bodies and in our minds from the trauma experience.

Dr. Bassel von der Kolk (founder of the Trauma Institute and Justice Resource Center and member of the original research committee that established clinical definition of PTSD in the DSM) says

The core issue in treating Post traumatic Stress Disorder is

traumatized individuals are prone to experience the present with

physical sensations and emotions

from the past 2009

note to facilitator: 2:03 Brain Plasticity video type in your search menu bar “Youtube Sentis Neuroplasticity Cartoons”

MINDFUL PRACTICE: getting started

First – prepare yourself and the room

note to facilitator:

see pages 72-77 of the powerpoint for more details about preparing the room & establishing agreements

Introduction – prepare the participants

Explain what to expect

“this is an invitation by your choice”

Participate when you are ready

Remember to respect those around you if you need to get up and move around

Introduce how to use the 0-10 severity rating scale

Explain why learning mindfulness is part of the foundation of recovery and recovery maintenance

Learning to respond rather than react

Calm breath calms the mind

Building muscle memory & new pathways in the brain

Explain “this is an invitation by your choice”

Participants may choose when to engage

Learning Home Base as an Anchor creates safety

Each practice builds on the other and

Can be done at anytime independently

note to facilitator: optional background music

or type into your search menu bar “youtube music alpha waves for relaxation, study, focus

*important to use music without lyrics to help calm the mind (lyrics can be a “hook” that pulls the mind away from current focus as well as unexpected “trigger”)

Mindful Practice 1:

Home Base & Your Anchor

Now, find a comfortable seated position in a chair

Pick a number from 0 – 10 describing how you are feeling in general right now

0 = no stress/worries, etc - 10 = worse day ever

Remember this number

note to facilitator: Remember to SLOW the pace of speech. Your speech sets the pace.

Take a deep breath and let it go . . .

Both feet are resting flat on the floor. Your feet are directly below your knees. Your knees are directly infront of your hips. Your spine is gently stretching up toward the sky with your head and neck resting ontop.

note to facilitator: demonstrate this seated position

Now, take in another deep breath and lengthen your spine up toward the sky. Long spine, Relaxed throat, Soft jaw.

Now, exhale . . . one round of breath is inhale and exhale . . .

note to facilitator: Remember to allow time for yourself to Pause and Breath

When you are ready, choose a soft gaze, a focal point, or close your eyes

A soft gaze is looking at the floor about 6 feet directly infront of you – these choices help our mind focus here and now

Remember, our minds are naturally curious and will wonder.

When this happens, your breath is your Anchor back to here and how

There is no need to look at me during this practice - just listen and breath

~ pause ~

Remember, you are observing your experience here and now . . . this means no judgment of good or bad, pass or fail . . . When you find yourself judging . . . take in a deep slow breath in and let it go with your exhale

Now, watch your breath- without judging- watch with your senses, the sensation of breathing . . . listen and feel . . . breath 3 rounds . . . one round in inhale and exhale

You have now completed a basic seated practice and established your Home Base- remember to use your breath as your Anchor back to Home Base at any time during our Mindfulness Practice classes when you find you are feeling anxious or uncomfortable.

It is important to feel safe in here and you always have a choice to participate

note to facilitator: mark the transition between practices with a pause then say something like check in with yourself and if you are feeling you would like to continue remain focused on my voice and continue to watch your breath or you may choose to get up and move around and join us later. Please remember to respect the space of your neighbors while you are up.

Mindful Practice 2:

See how slow you can go AND “cool the soup”

Now, let’s begin Mindful Practice 2: See How Slow You Can Go also called cool the soup
Remember, your breath is your Anchor to Here and Now. When you begin to feel anxious or uncomfortable, use your breath as an Anchor and return to your Home Base.

Reconnect with your Home Base now . . . feet flat on the floor, knees directly infront of your hips, one your inhale breath up your spine lengthening it up toward the sky . . . exhale and let go of any tension you might be holding in your jaw . . . return your eyes to either a soft gaze, closed, or fixed

Long spine, Relaxed throat, Soft jaw

Breath 3 rounds – inhale and exhale is one round

note to facilitator: remember to also breath 3 rounds to maintain your S L O W pace

Now, on your next exhale pretend you are cooling a hot cup of coffee, tea, or soup and continue cooling the soup for 3 rounds – inhale and exhale is one round

While you are cooling the soup, watch how your body is responding . . . notice your heart rate, notice how the weight of your body feels resting in your chair

Remember you can return to Home Base anytime you being to feel anxious or uncomfortable and your breath is your Anchor back to Here and Now

If you would like, continue breathing 3 more rounds of Cool the Soup and See How Slow You Can Go

When you discover an edge of discomfort – and if you feel safe to explore this place – begin to return your breathing pattern back to what feels like your normal pattern and watch how your body responds . . . notice your heart rate . . . notice where your body tenses . . . notice if the moisture in your mouth has changed . . . a dry mouth could be a side effect of medication or a signal your fight or flight instincts are being activated . . . notice changes and remember, return to your Home Base as you need to

Breath

note to facilitator: continue to watch your participantsto let them know youare also mindful of their individual experience. Depending on your setting, it might be helpful to make arrangements prior to class for another staff member to be available outside your classroom in the event anyone requests to leave the room.

You are building positive muscle memory by doing these Mindfulness Practices and making another pathway for health in your mind by focusing your thoughts here and now on your breath

Remember, your body knows what it needs to be clean, healthy, and strong . . . this knowing is built into our biology . . . Mindfulness Practice builds your minds ability to listen to your body to find its way to balance

Now, breath 3 rounds of a breath pattern comfortable for you right now

~ pause and breath ~

You have now completed See how slow you can go and Cool the Soup

note to facilitator: mark the transition between practices with a pause then say something like check in with yourself and if you are feeling you would like to continue, remain focused on my voice, continue to watch your breath or you may choose to get up and move around and join us later in the next practice. Please remember to respect the space of your neighbors while you are up.

Mindful Practice 3:

Three Part Breath

Now, let’s begin Mindful Practice 3: Three Part Breath . . . continue to breath
Remember, your breath is your Anchor to Here and Now. When you begin to feel anxious or uncomfortable, use your breath as an Anchor and return to your Home Base.

Reconnect with your Home Base now . . . feet flat on the floor, knees directly infront of your hips, one your inhale breath up your spine lengthening it up toward the sky . . . exhale and let go of any tension you might be holding in your jaw . . . return your eyes to either a soft gaze, closed, or fixed

Long spine, Relaxed throat, Soft jaw

Breath 3 rounds – inhale and exhale is one round

When you are ready, imagine your torso and rib cage being like a balloon expanding with your lungs on the inhale and relaxing with the release of your exhale

Now, on your inhale remember the picture we saw earlier of the lungs. That picture showed us the back of the lungs, under the shoulder blades is the largest capacity of the lungs. Breath now into that part of your lungs. Notice your rib cage expanding – like a balloon – in every direction, into the back of the body, down toward the bottom of your torso, into your armpits, up to your throat

Breath 3 rounds like this

Feel the power of your breath expanding every inch of your rib cage and your torso

Remember if you have any discomfort, back off or return to your Home Base

Now, imagine your torso is like an empty glass

Next, imagine your breath is like water being poured into that glass

Fill every inch of your lungs with rich oxygenated blood

Feel your heart circulating this rich life giving force into every cell and tissue

Now, imagine while you continue to breath . . . filling this vessel that is your body from

the bottom up to the middle all the way to the top

Notice the natural pause in your breathing at the top of your inhale

Keep to your own pace of breathing

Release your inhale . . . notice the emptying sensation . . . emptying from the top . . . down to the middle of your rib cage . . . all the way to the bottom

Notice the natural pause at the bottom of your exhale

Now, if you like, give yourself a small cough

note to facilitator: demonstrate a couple of small coughs

Feel the diaphragm muscle pulling up and into the bottom of the rib cage and pushing all that residual air out . . . making room and space for another inhale

Think of the diaphragm muscle as those people or things that help you get rid of the barriers to your Recovery.

The purpose of coughing is to expel contaminants from the lungs

With each exhale . . . let it be a symbolic letting go or expelling of something you no longer need . . . something you know gets in your way of being in Recovery

Breath imagining filling from bottom to top

Emptying from top to bottom

Continue breathing and letting go

I will be quiet for 6 rounds of breathing – inhale and exhale is one round

note to facilitator: Remind the group everyone is breathing at their own pace and be watchful of your group members while you are also breathing 6 rounds. Let them know when you are at your 5th round

Continue your Three Part Breathing if you wish

You have several choices here; continue Three Part Breathing, return to cool the soup and see how slow you can go or return to your Home Base

Notice how your body is responding and make adjustments as you need

~ pause ~

You have now completed Mindfulness Practice 3: Three Part Breath

Mindful Practice 4:

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