[ccolby]

Question 1
Urge surfing is one of the things I learned and got the most use from in yoga practice, to learn to sit with an itch or compulsion to twitch or shift, but I haven’t done yoga in quite a while and this was nice to get back to. And it was hard, as I have been battling sciatica and couldn’t get comfortable, no matter what. I found it empowering to accept the experience, allowing myself to actually feel it, acknowledge it, and gently decline to give into or indulge the impulse to shift. It was a reminder to me that being just an observer of thoughts and emotions is a strange meta duel in my head that requires regular practice. It’s hard to trust that it can really help to see the direct influence thoughts and emotions can have on physical feelings and actions, but that experience and realization can be freeing without having to change or fix anything at all. I will introduce it to patients I work with as a tool, one to consider when they are clear in their goal to prevent or avoid substance use, when facing those triggers that maybe can’t be prevented or avoided, so urge surfing provides another option in those moments.
Question 2
I chose Mindfulness of Emotions without Judgement. I really benefit from and become much more at ease when I mindfully notice and release judgement of my emotions. I became immediately aware that this is something I learned to use in sessions myself with patients when I notice myself over thinking my responses or becoming emotionally reactive to what they brought to the session. I have found it helpful when I notice myself disengaging from the patient and becoming too concerned about the “best” response, “most appropriate”, etc, vs maintaining a sincere connection and being genuinely present. I think it answers the question of “how?” when patients are blocked about letting go of suffering.
Question 3
This class has helped remind me of the value of being intentional vs getting caught up in the day to day grind and that to do this, I really may not even have to change much, other than my perspective in order to get some benefit. I am not one who gives the full 20-30+ minutes to meditation, but I do utilize smaller mindfulness activities multiple times throughout the day to center, recharge, and remind myself of my goals, reprioritize, slow my breathing, and adjust my mindset so I can continue to be present and in the moment for my last patient of the day just as much as I was or my first. It has helped me when I get caught up in the stresses of the world, politics, the pandemic, work/life balance. This has helped me identify and prevent burnout when I have been at risk in this current very demanding time as a MH provider, and this class has brought me back to that as a daily maintenance practice, not just as a life raft or self-care treat when I’m already over my head. This class has reminded me that it is a practice, not a solution, something I can reinforce firsthand for my patients if they are open to it an something to help keep my focus on the larger purpose behind why I do what I do, at work, in my family, how I live my life according to my values.
I envision introducing and utilizing it as a useful tool in moments when finding emotions are getting in the way of enjoyment or otherwise functioning in day to day life, as well as a larger method of reminding oneself of the important things to them, bringing themselves back after dysregulation or crises. I’ve experienced patients who have become defensive of their emotions, almost resistant and holding tighter onto them, seeming to want to prove they are too big, not that easily let go of, as though they feel they are being minimized or dismissed, like the phrase “letting go” is perceived as an offensive external judgement that it is just that easy. I’ve had that response from people before who were not ready to accept coping vs curing or who were still at a place in their recovery where they were missing and even grieving their SU, often as a very effective method for getting rid of the suffering, as they still saw it. I think many people get caught up in the goal of cure or ridding all pain, and I like this tool providing more of a chance at peace by learning to utilize mindfulness as a way of co-existing with our emotions. The fact that the surrender is to themselves, to their inner strengths, to their own sense of peace and connection, so much more than previously thought they were capable of is powerful.

[ccolby]

Question 1
What did you notice about your physical experience during the Soft Belly Meditation? What was it like for you to have a point of focus be the soft belly? How would you evaluate the effectiveness of this meditation to enhance acceptance of feelings and sensations in the moment?
I really like the soft belly meditation and use it often, for myself and with clients. I feel having a physical focus of my core is warming and simpler than throughout other parts of my body. I also found it hard at first to accept softening of an area that we’re always told to tighten, to be unsatisfied with, to somehow change. I find clients will often have that same struggle initially, and so it’s another layer of soothing to add that acceptance of self to the physical activity they are doing together with me doing it as well.

Question 2
What did you notice about your physical experience during the Acceptance Exercise? What was it like for you to have the point of focus be the phrase, “May I accept myself completely as I am right now?” How would you evaluate the effectiveness of this mindfulness exercise to enhance acceptance of self in the moment?
I struggle sometimes with affirmations, often getting stuck in the specific words sounding forced or like someone else’s idea of what I should be feeling. I do, however, respond well to a mantra, so I try to find the spirit of the mediation in my own words, like setting an intention in yoga. I find simple, repeated, positive words to be one more place to ground my thoughts when they inevitably drift.

Question 3
How would you envision adapting and integrating the Soft Belly Meditation and/or the Acceptance Exercise into your clinical work with others, particularly people with addictions? Be specific.
Soft belly is helpful for those experiencing tension, GI distress, and other physical discomfort that can come from cravings, withdrawals, and intrusive thoughts and worries. Having a particular mantra that reminds a person of their goal or purpose to enduring some discomfort or one that simply encourages them to trust their bodies can be particularly helpful in riding the wave.

[ccolby]

Question 1
Body Scan –
I feel like I spend so much of my day disconnected from my body; ignoring hunger, remaining seated when my back or bottom are going numb in a session, wearing too tight shoes, pants, pony tails, etc, that this was awkward, at least initially. For me, the body scan was actually freeing and like a sigh of relief when I got to finally acknowledge these things. I especially noticed for the first time that part of what was freeing was that I wasn’t doing this as an attempt to fix it, just to acknowledge and accept it. By doing that alone, I relaxed a bit more into it and though the discomfort was still there, it didn’t seem like such a big deal, or bothersome, as something that really required my ongoing effort to intentionally work to ignore, only to eventually fail or resent. Accepting it took the intensity of any discomfort down enough to tolerate.

Question 2
focusing on single object –
I found this activity to mostly be boring, but it was clear to me that accepting the boredom, the slowness, low/lack of simulation was the point for me, the place I could focus my intentions to help continue to bring myself back to it every time I considered quitting. I do think it is important to have given myself permission to start with shorter period of time, as if something generally unpleasant is on my terms, is something I invite, I am much more apt to accept and continue with it and actually get something out of it vs fight it the whole way and talk myself out of it as useful. I eventually became aware of being nice to use this intentionally employed “bored” moment in the midst of my very chaotic over stimulated afternoon. When I was done, I was very ware how refreshed I was upon returning to my work.

Question 3

I actually used body scan today with a person I see for co-occurring anxiety and OUD. She was exploring how she has gained a significant amount of weight since stopping using opiates. She said she noticed how she is trading food for opiates, specifically ice cream, and has just kept eating more and more and more at each sitting to the point where today she said if it were opiates, she’d have overdosed. She identified she is using ice cream to meet all the needs she was using opiates to meet; reward, relaxing, taking a break, numbing, celebrating, etc. She had seen that earlier, but today it really freaked her out how she suddenly saw that she was continuing to do it and even escalating, despite how upset it made her, very much like her experience with opiates. Today was the first time she really made that connection on her own and it was her discovery that she feels the need to physically do something different, to invite the discomfort and learn how to be in it vs avoid it, not just intellectually decide to stop using, but learn how to prevent using, was how she put it. In session she agreed to practice body scan to begin to increase her awareness and acceptance of how she is feeling without using a substance to satisfy or numb it in a beginning effort to increase her awareness and acceptance of some levels of discomfort.

[ccolby]

Question 1

I found the concentration practice almost immediately deeply relaxing. I found it easy to fall into and return to when I inevitable became distracted. The breath counting gave me something fairly concrete to continuously direct my attention to, matching my breaths to. I did, however find it almost boring, which was effective in that it wasn’t stimulating, but it made it hard to stick with very long. I was aware I was going to need to start with much less than the suggested 10-20 minutes and would really need to allow myself to build up to that, if I were to stick consider making it a regular practice.

Question 2

I found the mindfulness meditation to help me be more concretely aware of my own skill and ability to develop with practice of expecting that my mind will wander and having the acceptance of that as “normal” and that the skill didn’t necessitate “emptying” my mind, but really in accepting and redirecting it to a calming place of my choice; my breath and body. It helps me let go of the automatic habit of self judgement that I might be doing it wrong, or it’s just not possible for me, etc.

Question 3

For me, concentration practices are quicker, easier to initiate in the moment when I have limited time between patients or am in a public place, whereas mindfulness meditation is more centering overall, helps to regenerate energy, confidence, etc. I do these with patients regularly, concentration at the start of a session or when someone becomes reactive in a session, mindfulness as a skill development for later use and practice. Mindfulness meditation seems to have helped people with cravings or sleep disturbances where they may not necessarily expect to totally eradicate them, but instead develop a stronger sense of managing them more successfully, which involves a great deal of acceptance.

[ccolby]

Hi all. My name is Catherine Colby, I’m an LCSW, and I have worked in Augusta in a large medical residency family practice for 20 years, the last 10-11 providing integrated behavioral health services for our patients, with a particular focus in MAT. I have found over the years a love for addictions and co-occurring work. I would say I already utilize a fair amount of mindfulness in my practice, but have found it more and more critical for patients and also myself and our staff/providers to help get through the day in and day out stress of moving forward in this pandemic.

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