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Mindful Pain Solutions News
Fall/Winter 2015 Edition
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“It’s not a matter of letting go: you would if you could. 
Instead of “let it go” we should probably say, “let it be”.
—  Jon Kabat-Zinn


“People have a hard time letting go of their suffering.
Out of fear of the unknown, they prefer suffering that is familiar”.
—  Thich Nhat Hanh

 

Fall in Presqu'ille Park, Ontario

Welcome to Fall and Winter. Hopefully we are all mindfully, safely, adapting as the seasons change.

2015 Fall/Winter Edition

Update on NNC activities

Book review: An Epidemic of Absence

Teaching Through Practice: Reflections on Mindfulness Meditation

You asked? 
The Range of Meditations in the MBCPM™ courses?

Did You Know That? 
The British Parliament: Training in Mindfulness

The new MBCPM™ Maintenance Class: “Mindfulness Matters” 

Retreat options for 2016

MBCPM™ Courses for Winter 2016
 
 

Update on our Activities at
The NeuroNova Centre (NNC)


What have we been up to, at NNC, since Dr. Jackie stopped delivering MBCPM™ courses directly to patients? 

Our mandate at NNC is to enhance access for chronic pain sufferers to mindfulness strategies, and reduce suffering. Worldwide.

The team at NeuroNova Centre has been supporting and training health care professionals in facilitating the Mindfulness-Based Chronic Pain Management (MBCPM™) courses, to bring Mindfulness strategies to chronic pain sufferers throughout Ontario.  During Fall 2015, thirty sites across Ontario were receiving MBCPM™ courses from Facilitators who trained with NNC. 

Quebec now has its first MBCPM™ facilitator, and the workbook for the Level 1 and 2 courses is being translated into French. 

The MBCPM™ course is also being taught within a hospital corporation to their staff, by embedded facilitators trained and mentored by NNC, to enhance staff wellness. 

Dr. Gardner-Nix has been giving presentations to the public, and “Rounds” (meetings) to medical staff, around Ontario, to increase awareness of mindfulness, the MBCPM™ courses, and their role in pain and stress management. She was the keynote speaker for the Pain Society of Alberta in October 2015. Delivering a professional training in MBCPM™, out West, is a goal NNC now has, given the interest expressed there.

She is scheduled to do a professional MBCPM™ training in California in May of 2016, under the University of California (UC) San Diego Center for Mindfulness Program: http://mbpti.org/mbcpm-mindfulness-based-chronic-pain-management/

If you would like Dr. Gardner-Nix to speak in your area, contact team@neuronovacentre.com, or email dr.jackie@neuronovacentre.com.


 

Help Us Grow

There is still a need for more MBCPM™ courses across the country and even in Toronto. Please help us to find more applicants for our facilitator training and health care professional training programmes:

http://neuronovacentre.com/mbcpm-facilitator 

http://neuronovacentre.com/mindfulness-programs-for-health-care-professionals 

Or contact us at team@neuronovacentre.com

 


 

From an Alumni of
the MBCPM™ programme

In preparation for the 2016 San Francisco MBCPM™ Professional Training scheduled for May 2016, we were invited to contribute to their blog, for the UCSD Center for Mindfulness, which recounts interesting anecdotes arising from our mindfulness training.

Our first contribution was from an alumni of one of our courses, Adam, who recounts how going through our programme led to publishing a children’s book—read here for his heartwarming story:

https://ucsdcfm.wordpress.com/2015/11/12/the-mindfulness-solution-to-pain-read-the-story-of-adam-mbcpm/    

Book Review

 

An Epidemic of Absence
A New Way of Understanding Allergies
and Autoimmune Diseases


– Moises Velasquez-Manoff Scribner
 (New York, London, Toronto, Sydney, New Delhi)

 

Reviewed by Jackie Gardner-Nix
 

This was an interesting read for me, written by a science journalist about his investigation into the possible causes of autoimmune diseases, starting with a startling account of how he was attempting to manage his own autoimmune condition alopecia areata (the autoimmune disease causing, in him, complete hair loss), asthma and eczema. In his first chapter he recounts how he intentionally gets infected with a parasite, an intestinal worm: hookworm, in Mexico! That might cause many readers to raise their eyebrows and carry on to another book—but wait—he had some logic in doing so. And a few months later, Peter Mansbridge, on “The National” reported how asthma was being improved by changing the bacteria in the gut—though during the first 3 months of life.

The basic message in this book is as follows: When we became clean societies after eradicating parasites such as worms from our intestines, living in cleaner environments, changing the bacteria in our intestines because we no longer encountered a broad range as we would have had decades ago on farms, we became vulnerable to new health hazards: allergies and autoimmune conditions.  These were epidemics, due to the absence of the bugs our ancestors were used to being exposed to, and somehow “managed”, over centuries. Parasites and farm microbes taught our immune systems to call a truce with them—if they didn’t kill you first. The deal was: they wouldn’t kill us (or at least, some of us) if our immune systems learnt to live with them—at least somewhat. Further, in return, our “peace corps” of “regulator T cells”—important in our immune defenses—could defend us better against such terrifying diseases as malaria, TB, and other infectious killers of bygone years, because our immune systems’ collaborative skills had been enhanced by the parasites and gut microbes.

These “regulator T cells” have been functioning for centuries like the peace corps of an army. Without them, our immune systems can switch to being hyper-alert and attacking normal environmental substances and even components of self—as in allergy and autoimmune conditions.  The author dealt with various autoimmune diseases such as Crohns and  Celiac disease, Multiple Sclerosis, and even Autism: thought to be due to inflammatory processes in the brain. He cited some reports of improvement in autism when infected by parasites. He told anecdotes about amazing remissions in these conditions. One about a teen with autism, whose behaviours became more normalized after being away at camp, returning to his parents covered in chigger bites. And as they faded and healed, the autistic behaviours returned. The mechanism, he suggested? During infection, the “peacekeeper” T regulatory cells generated in response to the chigger bites were at work damping down inflammation in other areas, such as the brain in autism. 

There is more to autoimmune diseases and allergies than just this; not every person growing up in ultra-clean environments has such health problems. Not every parasitic infection works on modifying allergies and autoimmune conditions. Genetics and prior histories of responses to stressful events are known to be involved too.  Plus, the adverse effects of the parasites can prove far more trouble than they are worth. In the final chapter he shares some of the ghastly symptoms of his hookworm infection, but how, a couple of months in, he saw clearing of his allergies and an improvement in his eczema, asthma and, ever so slightly, his alopecia areata. And then: a recurrence of all of that when he spontaneously expelled the parasite. Months later, the parasite returning, after seemingly lying dormant, his autoimmune conditions remitted again.

It makes sense in modern day medicine to infect those suffering with Clostridium Difficile (a nasty, sometimes, life-threatening, organism which causes diarrhea and other symptoms, usually after treatment with antibiotics have wiped out good bugs from the gut) with normal gut organisms, so that the sick gut taken over by the nasty microbe has the normal ones replaced to establish their territory again.  A process called fecal transplant.

But it is it is now looking strangely like this might be a treatment for many other non-gut conditions too, including asthma! A life-long prevention perhaps, when exposed to a wide range of bugs in childhood—no wonder babies put stuff in their mouths! They are training their immune systems against more than just infectious agents: allergy and autoimmune conditions maybe being prevented too--- 

Which brings us back to Peter Mansbridge and the National. 
www.cbc.ca/news/health/asthma-microbes-gut-infants-1.3250510   

This article is offered by its author for our newsletter and was originally published in Winter 2012 Issue of The Health Professional magazine. Kate has been running MBSR and MBCT courses in London, Ontario.

Teaching Through Practice:
Reflections on Mindfulness Meditation


By Kate Partridge, Ph.D.


The term “mindfulness” has recently become a buzzword in the health field, and with it comes the implication that it can be a panacea of some kind. Many health professionals hear the term and wonder what mindfulness is or how it might be helpful, even transformative, for their patients – and often, for themselves. The growing body of scientific research literature about the benefits of mindfulness is easily accessed through the Internet. In addition to numerous studies showing significant physical and emotional benefits to patients with a wide range of health problems, recent very exciting neurological studies are revealing the structural and functional brain changes that are associated with these mindfulness-related clinical improvements. An excellent resource in this regard is the Mindfulness Research Monthly.  www.mindfulexperience.org   

Mandy (name changed) is a woman in her 50s whose leg was crushed under the wheel of a moving bus about five years ago. In addition to becoming significantly disabled, she has suffered severe and unremitting pain. She is also highly sensitive to medications of all kinds and has been unable to take a number of medications that might have been helpful, including anti-depressants. Three years ago Mandy took an eight-week course in mindfulness meditation and she has continued in individual counselling. The mindfulness meditation has been an enormous help to her. “My personality type is hyper and anxious, and I’m a worrier. Paying attention to what is going on helps me to stay calmer. It’s a wonderful reprieve from all the stress. I’ve also learned to relate to my leg and to the pain with kindness and sympathy, not with the anger and fear I had before. This has allowed me to accept the pain for what it is and feel more relaxed about it, and it has also helped to diminish the pain itself.

“It gives me a lot of pleasure to know that I can bring myself out of that anxious hyper state without having to depend on drugs – and I’ve tried a lot of them. Mindfulness meditation is very real, something I can do for myself, and with practice I’ve gained some control over my situation and can impact it positively. It has been a huge breakthrough for me to learn to accept the pain rather than resisting and fighting it.”

Susanna (name changed) is in her 40s and has suffered from fibromyalgia for the past 16 years, as well as painful recurrent bladder cancer. After only eight weeks of daily mindfulness practice, she noticed a significant reduction in pain. Now that she has been practicing meditation daily for nine months, she has been able to make a huge reduction in the amount of pain medication she is taking: she stopped the fentanyl patch completely and her consumption of narcotic medication has decreased to about an eighth of what it was. Susanna is sleeping better, and she feels happy and content even though she still has some pain.

“I’ve made peace with the pain. We were at war – I was angry and resentful about it – I had gone from being an accomplished athlete to zero because of the pain, and I hated it. Now I don’t do this. I treat myself and my pain with compassion. This has given me the drive to get out and help others move in the same direction, and I’m taking courses now to become a meditation teacher.”

In health and rehabilitation settings, mindfulness meditation can be invaluable in helping patients to better regulate their health. Within two or three weeks of daily meditation practice, patients begin to experience a marked improvement in their ability to relax physically. More importantly, many patients notice they are less emotionally reactive to the stresses of their illness, injury or chronic pain. Over time, they become kinder to themselves and they are less likely to be angry with or frightened by their illness or pain, which significantly reduces their stress load. What is changing and improving is their relationship to their pain or illness. Finally, they become more aware of the connections between what they think, feel or do and their health or pain status. This makes it easier for them to take more responsibility in regulating their own health behaviours. For a helping professional to be able to effectively teach clients mindfulness skills, there is a very important prerequisite: the professional herself or himself must have a personal daily practice of mindfulness meditation. Reading about mindfulness meditation is not a substitute for developing the language of awareness that grows with the practice. It isn’t possible to understand the gentle but powerful changes that arise from mindfulness practice without doing it yourself, on a regular basis. When you cannot understand this, you cannot properly support your clients in their practice. 

To understand how it might be useful to you, as a health professional, to learn to practice meditation, think about the stress in your own busy life. How do you keep your nervous system balanced – both energetic and calm – in the face of this stress?

One central skill is to be able to recognize when your nervous system has been spending too much time being stimulated by the sympathetic nervous system and not enough time being restored by the parasympathetic nervous system. The sooner you can notice this imbalance, the easier it is to re-establish your centre, which is where you will have the best access to both your energy and your calmness. Mindfulness meditation and other mindfulness practices are designed to cultivate this ability.

A very useful definition of mindfulness comes from Dr. Jon Kabat-Zinn, the founder in 1979 of the first hospital-based mindfulness program (Mindfulness-Based Stress Reduction or MBSR). You are being mindful when you are paying attention, on purpose, in the present moment – without making any judgments about yourself or what you are attending to. This seems pretty simple, but in fact it is not at all easy to do in any sustained way. And yet there are enormous benefits, psychological and physical, to being able to bring a sustained mindful and non-judgmental presence to whatever you are doing. Mindfulness meditation is a systematic way to cultivate mindfulness. Although it is derived from the 2500-year-old practice of Buddhist meditation, it is not a religious practice, nor does it require any particular belief system. In fact, it is more useful to think of mindfulness meditation as a kind of physiotherapy for the mind. Through the practice, you become very intimate with the patterns of flow of thoughts, emotions, physical sensations and actions that make up your here-and-now reality. This increased awareness allows you much more choice in how you respond to the circumstances of the moment.

Several different mindfulness techniques are taught in MBSR, and to be effective, they must be practiced on a regular basis. They each cultivate the ability to focus attention deliberately (that is, to concentrate) in a fluid and flexible way that stays alert to the nuances of moment-to-moment changes in the field of awareness, including sensory experiences, body sensations, emotions and thinking. In the body scan, there is a systematic scanning of sensations throughout the body. In sitting meditation, the focus of attention is a specific area (usually somewhere within the chest or belly) and on the sensations that ebb and flow within this area as the breath goes in and out. There is no attempt to breathe in any particular way nor to deliberately relax the body (although this is often a side effect of these practices). The benefits are broader and deeper than mere relaxation.

In these practices, there is no attempt to stop thinking. This is a common misconception about mindfulness meditation. People say, “I could never meditate because I can’t slow my mind down.” However, meditation was designed for the purpose of slowing the mind down; a slowed-down mind is not a prerequisite. We call it the “practice” of meditation because we’re not naturally skilled at paying attention, on purpose, non-judgmentally. Developing any skill takes practice.

From a more subjective viewpoint, the benefits of mindfulness meditation include an increase in emotional stability or equanimity – being able to stay calm and grounded regardless of what is going on around you and inside you. At the same time, you have the luxury of much fuller and richer sensory experiences of food, music, art and sex, for example. Perhaps most beneficially, the practice of mindfulness leads to a broader, deeper awareness of and compassion for oneself and for other people, thereby enhancing your personal and work relationships. If you are a helping professional, your work can be transformed by your increased inner calm, your open, clear and non-judgmental awareness of clients, and your compassion.

Here are a couple of very practical reading resources that may kick-start your meditation practice, each accompanied by a CD with guided meditations: 
• Real Happiness: The Power of Meditation by Sharon Salzberg
• A Mindfulness-Based Stress Reduction Workbook by Bob Stahl and Elisha Goldstein 

Dr. Kate Partridge is a registered psychologist in private practice in London, Ontario. In addition to working in groups and with individual clients within the framework of mindfulness-based cognitive behaviour therapy, she teaches workshops to train health professionals of all kinds to develop a mindfulness approach to stress and pain management with their own clients. She also offers a certification course called Rehabilitation Stress Management.  www.drkatepartridge.com 
 

Why is there such a range of Meditations for the MBCPM™ Mindfulness course?

Answered – by Dr. Jackie Gardner-Nix:


Different people respond differently to each meditation. Even the time of day, the stress of the day, the time of the year, the phase in your life, may lead a meditator to choose a different meditation for their formal practice of meditation.
 

Meditations for the Mindfulness Solution to Pain: A 2 CD box set.  This is the main one accompanying the course teachings. It graduates the new meditator up in tolerance of time, from five minute meditations to as long as 20 minutes, or longer if combining 2 tracks. It also has the meditation called the Body Scan which re- acquaints us all with our bodies, a process which is healing for those who have been disengaged from their bodies, such as through frank disappointment or anger. There is a guided imagery meditation too, which trains us to reduce our pain through focused attention. Plus there are movement meditations on this CD. These can be particularly welcome for those who cannot sit or lie still. 



Sleep Meditation is 37 minutes long. Many working with this one have never heard the end of the track! There are no meditation bells to start or finish the meditation. About half the participants of our courses who have used this CD report reducing or eliminating their sleep meditations—with the collaboration of their prescriber, of course, and it is particularly important to taper over many months or even years if sleeping pills were used over years to decades. It’s useful to hear it once or twice through  before using it for sleep. There are “sleep phones” available from various websites such as  www.sleepphones.com. These assist in wearing something comfortable at night to allow listening to CDs with headphones.


Nature CD takes advantage of the properties built into natural structures: the Mountain and the Lake. The mountain has its strength and partial resilience in all weathers, a metaphor for the challenges we encounter in our lives. We are guided to embody those properties of the mountain if we feel comfortable doing so. Similarly the Lake also encounters all weathers, and allows the metaphor of drifting to the bottom when the weather above its surface is challenging, and rising to the surface when the weather is serene. It is a way of becoming aware of how much we may choose to expose ourselves to challenging people and situations, and wisely retreat when our bodies would be too challenged by the chaos surrounding us when our efforts would be futile. It becomes more possible to see it as a choice we can make.

Loving Kindness meditation: Chronic pain sufferers, and others with many other health challenges, often hate their “brokenness” and intentionally ignore or even hate dysfunctional or painful parts of themselves for changing their life plans. This deters healing and can make their health situations worse. The Loving Kindness meditation coaxes back the attention to these parts of ourselves, and encourages compassion for them.  This has proved very helpful in reducing suffering and pain, and probably promotes healing.

Room Meditation is provided to those attending class 11 in the level 1, entry level, MBCPM™ course and who have been attending consistently: it is not part of the bundle bought at the beginning of the course. This is because we believe it can only be tackled with emotional safety when course work has been done, and some resilience installed from the mindfulness practices. The person in chronic pain has often lost their identity in the maelstrom of suffering. Once there is more order in their life and an understanding of the mind/body connection, it can be timely to check in with who they feel they are, in this moment, at this time in their life. Having a personal space to do so provides some serenity and safety. The Room guides us to design such a space though it can be an outside one, not necessarily a “Room”.    

For all these meditations excluding the Room meditation, as CDs or downloads, please go to http://neuronovacentre.com/books-and-audio   

Dr. Jackie Gardner-Nix at the Mindfulness Conference in Chester, UK, July 2015.


Did You Know That . . .
The British Parliament has their own
Mindfulness Trainer ? 


As reported at the UK International conference: “Mindfulness in Society”, in July 2015, more than 100 British parliamentarians and parliamentary staff have been trained in Mindfulness. The initiative resulted from a coalition of three university mindfulness and research centres: Oxford, Exeter, and Bangor, and the Mental Health Foundation. 

In May 2014 an all party UK parliamentary group (APPG) on mindfulness was set up, and has looked at the role of mindfulness in 4 key areas: education, health, criminal justice and the workplace. The enquiry has involved more than 8 hearings, with over 80 speakers giving reports on their work in mindfulness. The Inquiry’s report is due to be launched in the British parliament later this year.

Some European parliaments are also forming special interest groups on Mindfulness.

http://neuronovacentre.com/
wp-content/uploads/2015/
12/Brampton-ON.pdf

 

As Dr. Jackie Gardner-Nix wound down her work delivering courses to patients directly, including her weekly maintenance “drop in” class, she puzzled over what could be done to continue to provide such a resource: important to many for keeping up their practice and their sense of belonging to a mindfulness community. So she created 20 themes, which could pair with the existing bank of meditations that had been developed for the courses, and produced a Maintenance “kit” calling the Maintenance classes: “Mindfulness Matters”. Themes included: Attachment to Outcomes; Anticipation; The Mindfulness Attitudes; Managing Tragedy; Guided Imagery; Impermanence, Transitions, and many more.

NeuroNova Centre made this kit available in September 2015. The twenty themes in the “Mindfulness Matters” binder are accompanied by carefully designed guidelines, visible on every page facing the theme page being worked on that week. Guidelines include how to manage latecomers to class, class conduct, cellphone use etc. There is also a “Helpful Tips” page, and another which helps with such aspects as meditation positioning. 

Also included in the class binder are initial class registration forms and physician/facilitator referral documents, to be completed on first attendance. Plus weekly sign-in sheets, and prototypes for copying all of these when they run out, and laminated copies of the Guidelines, Helpful Tips, and Meditation Positioning pages, to be left out for attendees when class is in session.

The manual for the site where the class is held is dispatched with the CD bundle to accompany the classes (the same bundle used in Level 1 and 2 courses), so that the CDs can be played at the site, even when sharing the class with other sites.

This kit has allowed groups to run the class without a trained facilitator present, so a self-management group, all of whom have been through the MBCPM™ courses, can meet weekly, on-going, and participants can either drop in, or be a consistent attendee. Any participant can lead for that week. For those who want their own copy of the Mindfulness Matters themes, there is an inexpensive, downloadable version on the NNC website without the repeated guidelines. Mindfulness Matters Kit and downloads are now listed on our main website under “books and audio”.

Four Mindfulness Matters “Chapters” in Ontario are currently using this resource: two on-site (Kingston and Thunder Bay), and two using Ontario telemedicine to connect several sites. There is a mix of self-management, and rotating facilitator-led models. The Self Management model got off to a shaky start but is now thriving—it took some “beginners mind” and some tweaking!


For more information please contact the NeuroNova Centre. We act as an information centre for the MBCPM™ initiatives, and connect you to the resources you need, if available in your area.

True North Insight (TNI)
is our resource for many residential retreats, in both French and English, in Ontario and Quebec, and one in Manitoba. It also lists sitting groups in many locations.

www.truenorthinsight.org/
index.php/en/



Kate Partridge, the author of the article in this newsletter, also organizes Dharma retreats
www.dharmaretreats.ca

An upcoming one of these is in Toronto:  June 10th to 17th, 2016 - a 7 day Vipassana Meditation retreat with Winnie Nazarko.


Please note that now MBCPM™ courses are being offered more widely, they are not being covered by OHIP where facilitators are not MDs or being funded within a Health Care Facility budget. If you have extended benefits your facilitator may be an eligible health care professional covered under your plan.
 



MBCPM™ Level 1 Courses:
Aurora, Barrie, Brampton, Carleton Place, Cobourg, Cochrane, East York, Espanola, Haliburton, Milton, Mindemoya, Noelville, North Bay, Orangeville, Parry Sound, Sarnia, St. Charles, Scarborough, Sudbury, Thunder Bay, Toronto (SMH), Toronto West and Vaughan. For details please go to 
http://neuronovacentre.com


MBCPM™ Level 2 (Revision) Courses:
Orillia and Orangeville. For details please go to http://neuronovacentre.com


MBCPM™ Maintenance: "Mindfulness Matters"  - Drop In Class
Aurora, Bracebridge, Brampton, Cobourg, Cochrane, Elliot Lake, Haliburton, Kingston, Noelville, Orangeville, Orillia, Picton, Toronto West, Thunder Bay and Victoria Park (Scarborough). For details please go to 
http://neuronovacentre.com

 



Professional Trainings

MBCPM™ Facilitator Training
(January and April 2016)
Toronto 
For details please go to http://neuronovacentre.com

MBCPM™ Professional Training
(May 2016)
San Francisco, California, USA 
For details please go to http://mbpti.org/

 


 

Not all courses are listed, as some have not yet been scheduled. Please check our website for updates 
http://neuronovacentre.com/
course-locations

As always, we welcome your submissions! Please send any articles, book reviews, or contributions for the Newsletter to:  www.admin@neuronovacentre.com

 

All previous issues of our Newsletter are available at www.neuronovacentre.com/blog

 

Mindful Pain Solutions News is published by The NeuroNova Centre for Mindfulness-Based Chronic Pain Management

www.neuronovacentre.com

www.shopneuronova.com

 

Newsletter Staff

Dr. Jackie Gardner-Nix MB.BS., Ph.D., MRCP(UK), Editor-In-Chief

NNC Inc. Publisher

Dawn Friesen, Graphic Designer

 

Copyright © 2015 NeuroNova Centre for Mindful Solutions Inc., All rights reserved.


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