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MINDFULNESS MEDITATION A SIX-WEEK ONLINE INTRODUCTORY COURSE FOR PEOPLE WITH CANCER Instructor: Thanh V. Huynh, M.D. Introduction to Meditation Most of us find life stressful at times. This may be particularly true when we are ill or face difficult situations. At times like this, we tend to be impatient. We may find ourselves lost in thoughts about the past or thinking about what the future may hold, rather than being in the present. We might also tend to react by making judgments, rather than accepting and understanding what is happening. These kinds of reactions can, in turn, create more stress. What is taking place right now is the only "real" moment we have. So, being able to observe the present moment is essential to fully experiencing and appreciating one’s life. This course will help you to learn to pay attention to the here and now and to be completely aware of each moment of every day. Meditation is a form of mental training. Most meditation techniques involve mental concentration, leading to the mind becoming calm and peaceful. They require formal periods of sitting practice in which the mind is trained to focus on a single object. The object can be physical, such as a candle, colored disk, or sound; or mental, such as a mantra: a phrase or word). Usually the person who is doing the meditation, whom we’ll refer to as the practitioner tries to reach a high level of concentration that will be beneficial. Mindfulness, on the other hand, can be practiced both formally (through sitting or walking meditation, which you’ll learn about in this course) and informally during all daily activities. It doesn’t require deep states of mental concentration to achieve benefits. The practitioner usually avoids focusing on a single object, except in the beginning of the meditation when concentration helps in getting started. Mindfulness meditation explores life as it is occurring in the present moment. Mindfulness meditation involves paying attention to every aspect of life that is being experienced, whether pleasant, unpleasant, or neutral. By doing this, a practitioner develops insights into life, and its ever-changing nature. A practitioner can then face the world, including its ups and downs, with more calmness. Practicing mindfulness meditation can help to reduce stress and confusion, and to lead to more joy, and a sense of peace. This form of meditation is traditionally practiced in Buddhist monasteries and in meditation centers in South Asia. In the West, mindfulness meditation is often taught in silent retreats lasting typically ten days. These retreats do not generally have any specific religious component and include people of diverse backgrounds. Some clinics and hospitals offer eight-week Mindfulness Based Stress Reduction (MBSR) courses, which were initially established by Dr Jon Kabat-Zinn of the University of Massachusetts. MBSR also includes yoga and other relaxation techniques.> There are numerous medical publications reporting various medical benefits of this practice for chronic pain, anxiety, stress, and other conditions. These include studies in cancer patients and healthy volunteers and showed improvement of their quality of life and immune function. This six-week course is designed to make this practice available to people who find it impractical or impossible to attend regularly scheduled courses outside of their home, or who would simply prefer an online course. It is offered in the following format: • Online reading materials and pictures
together with voice-guided instruction, There is much more to mindfulness meditation than we can cover in six sessions. Like any field of study, mindfulness meditation has its own special vocabulary. We have included many of these terms, but we have also tried to provide plain language definitions for what they mean. We hope that you may be intrigued by this practice and want to learn more, and knowing some of the technical terminology may be helpful to you. However, you don’t have to know or use the terms in order to do mindfulness meditation. So don’t be put off if some of the words are unfamiliar and different. With practice, you’ll be able to understand the concepts and to be successful in learning how to practice mindfulness meditation. This online course will take less time than most people would need just to commute to and from formal classes outside their home. The formal practice will take less than an hour, and you will also be encouraged to be mindful during other routine activities. However, we realize that undergoing cancer therapy can be uncomfortable and challenging, and some days, you may not feel your best. Try to stay on your mindfulness meditation practice schedule. However, if you miss a day, or can’t complete all the assignments, don’t give up or become discouraged. Do as much as you can, and resume the training when you feel up to it. Although mindfulness meditation is a simple concept, it takes practice. Don’t be discouraged if you find it difficult to do some of the exercises at first. Try again, and be patient with yourself. With practice, you will become more comfortable in meditating. We hope that this program will help you to feel better as you become comfortable with mindfulness meditation and make it part of your life. Mindfulness is preverbal – it affects the way we think even before we form words in our mind. It is the act of attending to our experience, without making choices, comparing experiences from one moment to the next, or making judgments about what is going on. Rather, mindfulness refers to being aware of every aspect of experience that is occurring here and now. When you are mindful, you pay equal attention to the pleasant and the unpleasant. You also are able to respond with understanding, patience, and acceptance toward all that is occurring in the present moment.
1) Body or physical object -Body postures (sitting, standing, walking,
lying) Sometimes people try to feel physical sensations by focusing on the concept of "my body," with its own form or shape. But another way to observe a physical sensation is to be aware of the sensation's texture (hard or soft, rough or smooth, light or heavy), its temperature (warm or cool), its dynamic (motion, vibration, or tension/pressure) and its cohesiveness or fluidity (although this is hard to do, as this is generally too subtle to experience directly). 2) Feeling: Physical and mental objects are associated with feelings – these feelings may be pleasant, unpleasant, or neutral. For example, you may like or dislike something that is going on. 3) Mind or consciousness: This may include awareness of thoughts, such as reflecting or planning. Mental states also include emotions, such as, sadness/joy, fear/hope, aversion/appreciation, anger/love, confusion/clarity) or consciousness itself (“the knowing mind,” that happens when you can step outside and observe yourself). 4) Mental objects: This aspect refers to the observation of your experience, such as, learning to do mindfulness meditation. (For example, you might focus on the difficulties of doing the practice; or as you learn to be mindful, gaining insight or enlightenment.) The experience of your senses, such as seeing, hearing, tasting, smelling, and touching. QUESTION: DR. HUYNH : THIS IS CONFUSING. CAN BE THIS MADE SIMPLER? In practice, you don’t need to figure out which element or foundation a particular object represents. but simply to be aware of them. To begin to learn about the mindfulness practice, it is helpful to make an effort to live a harmonious life, allowing your mind to be peaceful. Be kind to yourself and to others. One traditional way is to follow, as best as one can, the five mindfulness training guides of refraining from: 1) Killing any living being If you fall short of these mindfulness training guides, do not indulge in guilt or remorse; just begin again resolving to do better. You can also take a positive approach to the above mindfulness training guides by making an effort to 1) Protect lives 2) Be generous 3) Keep harmony and commitment in relationships 4) Use comforting and beneficial speech and 5) Live a healthy life. Committing to the five mindfulness training guides helps to protect the mind from disturbing thoughts of regret and remorse. This contributes to greater progress in the mindfulness practice. Loving-kindness (Metta) meditation is a concentration practice that can be complementary to the mindfulness practice; that is, these approaches go together very well. Metta (literally: friendship in Sanskrit) means unconditional love, with care, and without expectation. It is gentle and non-selective - just as rain falls on all subjects on earth, nourishing all it touches regardless of who or what is good or bad. Metta is well-wishing thought toward all beings. It is usually compared to the love of a mother for her only child. It’s helpful to reflect on a good quality of the Metta subject (the person you are about to send love to). You can think of a simple thing that this person has done for you or for someone else before you think about well-wishing (good thoughts) for this person. It’s important to feel Metta in your heart and not just be reciting the words - however, you can start with words, and eventually the feeling of love and connection will come. One traditionally begins with phrases about forgiveness, both asking for forgiveness and forgiving others. For example, “If I have knowingly or unknowingly caused harm to anyone, I ask their forgiveness. If anyone has knowingly or unknowingly hurt me, I forgive them.” Initially the practice of Metta may seem selfish. Reflecting on your own good qualities, on happiness, and your right to be happy is far from being selfish: experiencing and acquiring Metta allows you to fully share it with others. Begin by expressing Metta first to yourself. Allow this feeling of love to pervade your entire being. Extend this feeling to a benefactor (such as a parent or teacher), a dear friend, a neutral person, and ending with a difficult person (if possible). You can also consider Metta more broadly in terms of people in your neighborhood, town, state, country, world and the universe. The four traditional phrases are May I be free from harm* May I be well* May I be happy* May I live with ease" or "May I be safe, well, happy and peaceful" Then substitute "I" for "you," then substitute "all beings" for "you." This practice can be done formally at the beginning or the end of a mindfulness sitting meditation, by itself, or informally during the day whenever applicable. To practice formal sitting meditation, find a relatively quiet place in your home and decorate it with some flowers or a stone or statue to create a comfortable atmosphere that will help you to meditate. You can sit on the floor, on a chair, on a couch, or kneel using a meditation bench, or sit on a "posture-pedic" back-less chair. If you choose to sit on the floor, use a meditation pillow (referred to as a zafu), a firm or folded blanket, or folded large towel placed upon a padded mat (referred to as a zabuton), or large flat cushion. Sit cross-legged or with one leg in front of the other, whichever is more comfortable. Try to form a triangular base with your buttocks and two knees touching the supporting surface. For some people, a taller cushion under the sitting bones (known medically as ischiums) could make this posture easier. Lifting the pelvis up, allows the back to be straight, rather than hunching forward. If a chair is too high, you can place a pillow or a large book under your feet so that they rest flat and avoid pressure on the back of the thighs. You will need to experiment and see what works for you. Your back should be straight and upright but not stiff. Your hands can be placed on your lap or together on your feet. Tuck your chin in slightly to keep the head and neck straight. Meditation cushion (Zafu) on a mat Figure 1 Folded beach towel (or blanket) Figure 2 "Comfortable" posture with one leg in front of the other Figure 3 Traditional "half lotus" cross-legged posture on (the front half of) a Zafu Figure 4 Sitting on a chair (with or without back support), feet on a folded towel (if needed). Figure 5 Sitting on a high bench ("posture-pedic" chair) Figure 6 Avoid lying down or reclining as this can promote sleep rather than meditation. If reclining or lying down is your only option, keep your eyes slightly open. Return to a more upright position when you are able. Keep the eyes gently closed unless you become sleepy. Find a balance between relaxation and alertness. If you need to change posture due to discomfort, try to do so slowly and mindfully after having mindfully observed the physical sensations in your body with interest and care without wishing them to go away. At the beginning of your sitting meditation, simply let go of the past and future, relax and bring your awareness into the present moment by paying attention to your body posture and silently note "sitting". Throughout the practice, make mental notes or labeling. These are tools to help your mind be in the present moment. Feel the how upright your body is, straightening it a little if it slumps and relaxing it if it feels stiff. Try to maintain a balance between the two. Minimize shifting your body during the practice. Feel the pressure, vibration, firmness/softness or temperature where the body touches the sitting surface. Take two or three deep breaths to help feeling the sensations associated with breathing: the expansion (rising) and contraction (falling) of the chest or abdomen with each in-breath and out-breath, one breath at a time. You can place a hand on your stomach to help feel the breath. Breathe normally without controlling your breath. Follow the changing sensations continuously from the beginning to the end of the in-breath, then from the beginning to the end of the out-breath. Make sure to pay particular attention to the end of both the rising and falling movements. Again feel the motion, tingling, pressure, vibration, lightness, heaviness, temperature and so on, rather than paying attention to the superficial form or shape of your abdomen or body. Make a soft mental note of "rising" during the in-breath, and "falling” during the out-breath. If you are used to observing the air coming in and out at your nostrils and have difficulty feeling the rising/falling of your abdomen, it is fine to pay attention to the sensations at your nose. You can label the inhalation and exhalation at the nose by using “in” and “out.” It’s possible to get distracted by other things that are going on. This is referred to as a “secondary object” and might be things like sounds, thoughts, feelings, or physical sensations. If a secondary object starts to take over your awareness, gently bring your attention back to the sensations of your breath. Don’t judge the secondary object, for example, rather than thinking “I shouldn’t be listening to that sound,” make a note in your mind about what’s going on (for example, note "hearing", "thinking" and so on). Then, you will find that the secondary object will fade away or no longer stay obvious, and you’ll be able to return your attention to the sensations of your breath. If you find yourself lost in thoughts, rather than judging yourself (for example, “Uh oh, I shouldn’t be thinking about that”), simply acknowledge those thoughts as "thinking” or “wandering." Then gently focus your attention back on your breath. Patiently begin again and again in the present moment by returning to the primary object regardless how many times you lose it due to wandering thoughts. When your mind becomes quiet, you are able to pay attention to the object that is most predominant, or obvious, at that specific moment. The object that you’re attending to doesn’t reflect a choice or a judgment on your part (for example, “What should I focus on?” “What’s the highest priority?”). Instead, it comes from keeping a mindset that is choiceless (without preferences and preconceptions) and non-judgmental and open to all physical and mental objects that are happening at that particular moment in time. Find a relatively straight and even path (indoor or outdoor) where you can walk for about ten to twenty steps each way back and forth. You can walk with bare feet or with comfortable footwear. Stand at one end, with your eyes gazing slightly downward to see where you are walking. Try not to stare at your feet or investigate your surroundings. Your hands can either be held together in front, in back, or at your sides. Bring your awareness to how you are standing - your standing posture. Feel how your body is upright – its uprightness - the tension in your legs, and the pressure on the soles of your feet. It might be helpful to silently note "standing". Start to walk at a normal pace toward the other end of the path while being aware of each step. Feel the entire movements of the leg, feel your feet touching the ground, and make a soft mental note "stepping, stepping" or "right, left." Keep your steps natural and relaxed. This type of walking meditation can be applied throughout the day, whenever you remember to be mindful. When you reach the end, note "stopping, turning, standing" and again "stepping" while walking back to where you started from. After a few moments, when you feel calmer, slow down a bit and feel the movements of lifting (note "lifting") and stepping (note "stepping") of your foot. If you walk for a period longer than 15-20 minutes, the pace can become slower and you will be noting "lifting, moving, stepping." Feel the most obvious sensations, moment to moment, anywhere in your hip, thigh, knee, or foot. For example, feel sensations such as tension, heaviness, pressure, tingling, or warmth, rather than the form or shape of the leg/foot or the concept of "my leg". If you find yourself lost in thoughts, simply acknowledge it as "thinking." Then gently focus your attention back on the movements of walking. If you need to scratch or cough, stop while mindfully scratching or coughing before resuming the walk. Body scanning is a technique that helps you to focus on your entire body, going from your head to your toes. It is like taking a mental tour of your body to find any signs of stress and relaxing that tension. Body scanning involves concentrating on different parts of your body, slowly moving from one to the next, and relaxing each part of your body as you pay attention to it. Start by bringing your awareness first to the top of your head. Pay attention to any sensations there, and relax the area on the top of your head, Next move your attention to your forehead, scan for sensations, and relax. Progressively move your attention to your eyes, nose, cheeks, neck and then your chest, arms, and so on, all the way to your toes. Pause at each location, noticing the sensations, and then relax each area one by one. This exercise can be done after or in place of the loving-kindness, before a formal sitting meditation, or by itself as a relaxation technique in which case you can lie flat on the floor or in bed. Body scanning helps you to relax and to familiarize yourself with mindfulness of the body. To be relaxed yet alert. Not too tense, not too relaxed, just right! Have no expectations. Let go of controlling. Let it be. Try not to make any thing happen but also not to reject anything, whether pleasant or unpleasant. Accept and watch both good and bad experiences. -Wanting something to happen is attachment. -Wanting something to go away is aversion. -Not knowing what is happening is delusion. The
Hindrances Meditation practice is not always easy, and you might find you experience different challenges at various times. You can learn ways of dealing with these hindrances or difficulties. One way is simply by being mindful of them (awareness and/or mental noting) without judging; in other words, you know that there could be a problem and you accept that. You can also learn ways to counteract these challenges. Mindfulness meditation practitioners refer to this as applying antidotes, or opposite energy, to the hindrances. We have listed some hindrances and antidotes below. These may give you some ideas how to deal with problems you may experience as you are learning to practice mindfulness meditation. Below is the list of hindrances followed by their antidotes.
The best way to counteract all the hindrances is to refocus your attention on the present moment. You can review the four foundations of mindfulness, such as noting mental states or physical sensations. Remember that this too shall pass since everything changes. Judging and suppressing your experience are not effective antidotes to the hindrances. The
Controlling Faculties The meditation practice will progress well when these five faculties (or powers) are balanced. These are all qualities that will help you in learning how to practice meditation, and that you will develop as you spend time doing the exercises. 1) Faith/confidence: this is not blind faith but open-mindedness and trust in the mindfulness practice, and in your own ability to complete the training and achieve good results. As you develop insight, feel the beneficial effects, or experience peace, your faith in this approach will naturally be enhanced. 2) Effort/energy: this is being steady and joyous, and relaxed rather than being tense. 3) Mindfulness: being aware of what is happening here and now instead of being lost in the past or the future. 4) Concentration: one-pointedness of mind. This refers to the ability to focus. 5) Wisdom: insights into the true nature of life. All of these skills are important, and they all work together. Begin with developing confidence by reflecting on the proven benefits of this practice and having faith in your capacity to practice consistently. This will naturally lead to growth of your energy, and so on. As you reach the point of gaining insight and wisdom, this will in turn feed back into your faith and confidence, and the entire spectrum of faculties. |