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Living Well with Multiple Sclerosis
Webinar Highlights: Reducing stress through meditation and mindfulness with Dr Phil Startin | S6E21
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Is very consistent with the definition of Jon Kabat Zinn, his operational definition of mindfulness, which he calls paying attention in a particular way on purpose and with no judgment. But there's a lot more to mindfulness, and there are other ways of thinking about mindfulness.
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Welcome to Living well with Ms. This show comes to you from Overcoming ms, the world's leading multiple sclerosis healthy lifestyle charity, which helps people live a full and healthy life. Through the Overcoming Ms. Program, we interview a range of experts and people with multiple sclerosis. Please remember, all opinions expressed are their own. Help others discover Living well with Ms. If you enjoy the show, please rate and review us wherever you listen to podcasts. And now let's meet our guest. Today's episode features highlights from the Reducing Stress Through Meditation and mindfulness webinar with Dr. Phil Starton, recorded live in front of our global audience as part of the Refresh with OMS webinar series. To join us live for the next webinar or to watch the original presentation, head to our website overcomingms.org so hello.
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Good evening from a slightly rainy west of Scotland, from the west coast in Scotland and I'm going to talk briefly about the fourth of the OMS steps and specifically about stress and mindfulness and meditation. So hello to all of those that know me. Through my kind of involvement with the OMS and being on a number of retreats over the years, I've got to know quite a large number of OMS's and it's, it's just been, that's just been wonderful. So for those that don't know me, just a few kind of words of introduction about myself. So I have primary progressive Ms. I was diagnosed in 2007. I started following Ms. In about 2012 and then I was fortunate to be on the first OMS retreat outside Australia and New Zealand which was in the UK in 2013. And I say I've done quite a lot with OMS since then and now a facilitator and my mindfulness journey started back in about 202011 and I was really skeptical at the beginning and I of a background in science and business and it just kind of didn't make sense. But I found a course that worked and I just loved it and it's become a huge part of my life. So I've been trained to teach the Mindfulness Based Stress Reduction program and I now teach that to people with Ms. And to the general population. I go on kind of week long silent retreats every year and it's insights from some of those retreats that I kind of wanted to share with you this evening just to give you a slightly different perspective on meditation and mindfulness and certainly anecdotally from all the retreats I think I've ever been on. It seems to be the hardest of the steps to adopt. And I certainly found it that way as well. I mean, sunlight of vitamin D was, was pretty straightforward. And you either get into sunshine, which doesn't really work that often here in Scotland, but there's always tablets or sprays you can take. The diet, there's actually huge amounts of guidance out there. And I think the diet is just a sensible way of eating anyway, so it's not too bad. And we're all being told all the, that we need to do lots of exercise. So that's all good. But meditation, mindfulness just seems, yeah, maybe a little slightly harder. And for many of us there are real worries and stresses over our health or our family's health, over job security, income, perhaps other concerns, other big concerns, and prolonged elevated levels of anxiety and stress are bad for everyone. So regardless of whether you've got Ms. Or not, it's bad for us all. And why is that? Well, it's partly because the mind and the body are linked. So what we think our stress responses, our worries, our concerns, our nervousness, our emotions all affect us physiologically. And one of the ways in which the mind and the body are linked is through the fight or flight response. So how we respond to stress and feelings of being attacked is through the fight or flight response. And that was identified, identified almost exactly 100 years ago now in the US by Dr. Walter Cannon. And this response works by activating this sympathetic branch of the autonomic nervous system, which basically prepares our body to either fight or to flee in response to a threat or in response to an attack. And it does things. And our body then automatically produces a number of different stress hormones, including things like adrenaline, which increases the heart rate. Blood pumps more blood into our muscles so we can prepare ourselves to attack or to defend ourselves or to flee. Now that's an inflammatory response. Our body's really clever. So what it also does, it slows down and turns off unnecessary bodily functions like the digestive system, which is one of the reasons why we sometimes feel like we've got butterflies in the stomach, in the tummy when we're under stress, is because it's digestive processes are being turned off. The sexual function gets turned down. Some of the executive functioning parts of the brain get turned down, which is One of the reasons we can feel almost like when we've got tunnel vision or tunnel mind when we're under extreme stress, that's the body actually turning off part of the brain, but also through a different axis, through the HPA axis, the hypothalamic pituitary adrenal axis down regulates the immune system. So this hardwired fight or flight response is really effective in dealing with physical threats and it's a life saving response. But our brain really can't distinguish between, let's say a real threat, something that really can kill us, and an imagined threat or a worry or a concern or some anxiety sitting there worrying about. All of this kicks off the fight or flight response. And on top of that we've got a hardwired negativity bias. So our brains are hardwired to make more attention to negative events than to positive events. And again, this from a survival perspective, that's great because it's more important that we learn from things that can literally kill us than for positive experiences that might be nice but not going to bring us anything. And so these negative memories then are fixed more strongly, more easily into our minds than positive memories. There's a book by a chap called Rick Hanson called Hardwiring Happiness, which is actually an excellent book and worth read. And he's got a level phrase in that. He says that the minds like Velcro for bad experiences and Teflon for good experiences. So this just adds to the stress levels as to our stress reactivity. And this all impacts our health and our mental health matters, and particularly when we have ms, as I suspect virtually everyone on this call has, it really does matter because stress exacerbates our symptoms. I certainly know it myself, and I suspect that pretty much all of us can testify as well. It increases relapse rates, potentially even contributes to the onset of the condition itself. Maybe the reasons for that are pretty obvious. Ms. Is an inflammatory, degenerative, demyelinating condition that affects our immune system. Anxiety and stress cause inflammation and dysregulates our immune system. I think what's also quite interesting is that people with Ms. Have three times the rate of depression compared to the general population. And we actually have higher levels of depression than people with other chronic conditions. And scientists actually think this is an example of the mind body connection working in the opposite direction to the flight or fight response. So rather than the mind stimulating changes in our body, actually here it's actually that changes in our body. So changes literally in our brain caused by the Ms. Is causing change in mind states, it's actually causing the depression itself. So what can we do? What we need to do is learn how to switch off the stress response and switch on the relaxation response. And we're so lucky to have George Jelinek, who 20 years ago when he created the Hermes approach, he knew this, which is why Hermes Step four is meditate for 30 minutes daily. Now, when George actually first wrote his first book, there wasn't a huge amount of research around the effectiveness of meditation. He got a lot of insights from his time with Ian Gorla and some of Ian Gorler's experiences. But certainly over the last few years, there's been an almost exponential rise in academic research into the effectiveness of meditation and its impact on reducing stress, reducing anxiety. So it's now really proven clinically that meditation can actually help. But sometimes we can find it hard to actually take the time for these longer practices. Even 10 minutes, 20 minutes can feel hard to do. We're all busy people and we've got lots to do in our day. Maybe even right now, you might be busy with work, or you might have children at home or family at home. So actually finding time to do a 20 minute, 20 minute practice every day could be really, really hard. But think about why do we practice? And it's really not to try and relax for 20 minutes or 30 minutes, but it's really so we can be mindful and cope better for stress for the other 23 hours and 40 minutes of the day, so we can manage our stress levels just better. So perhaps rather than doing as well as doing a longer meditation every day, then think about adding some mini meditations into your day. And you can do these at various points during the day. You can kind of almost sort of hardwire them into the day and do them at set points. Let's say when you make your first cup of tea in the morning, when you make your coffee, or when you turn on the computer or turn off the computer and just do a mini meditation. You might want to do it just whenever you feel like it. You might want to do it in response to just feeling a bit down or feeling a bit upset or feeling just bit stressed and choose to do it then. And these can be really, really short. They can be just for a few, literally a few seconds, or they can be for a few minutes, so really don't take it very much time at all. What are the different kind of mini meditations can you do? You can do what's called kind of grounding, just focusing On a particular sensation, let's say the breath, feeling the breath, say in the belly, focusing on the feet, sensations in the feet or the hands or in the shoulders or just whatever ever works for you. There's something called a breathing space, a three step breathing space and that's often illustrated like by an hourglass figure. So wide at the top and then narrow in the middle and then wide at the base. So what that describes is a little meditation where we start by having a wide open focus just in terms of how are you, how are you doing, what emotions are with you, what feelings are there, just, just you over, just overall state of yourself at that moment. So you do that and just think about that from let's say 30 seconds or a minute and then you focus in on the breath. So narrowing your focus, just focusing on the breath, do that for another 30 seconds or minute or so and then expand again to just taking the sensations throughout the entire body and again just do that for 30 minutes, 30 seconds, a minute or so. So that's just a three step breathing space or you could even do things like call them micro meditations and that's literally just being aware. So to just bring your moment, your awareness into the present moment, being aware of what's up here. So I've got to pick up a cup of tea that I've got in front of me here and just taking a moment to let's say feel the mug, the weight of the mug, the smell of the tea and the taste of the tea. Just even just taking a few moments like that, just be aware of whatever you're focusing on is a little mini practice in its own right.
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So can I invite you now to join me in a mini meditation practice? And we can do this either sitting down or, or standing up and I'll stay seated, but if you wish to stand, please do so. And I am going to invite you to close your eyes. So if your balance is as dodgy as mine is, then you may want to hold on to something to stop you falling over. And if you're sitting, then just uncrossing the legs, just putting both feet on the ground and if it's comfortable for you, sitting slightly forward in the chair so your back is supporting, resting your hands just on the thighs or in the lap, just whichever is better for you. Then whether you're standing or sitting, just having the back upright and just softening the shoulders, letting the shoulders relax, having the head upright and tucking the chin in gently, and just gently closing the eyes if you wish, just moving your attention now down the body and all the way down to the feet, just become aware of sensations in the feet. So if you're standing, feeling the weight of the whole body driving down through the feet, if you're sitting with the weight of the legs, perhaps feeling the points of contact, the feet with the ground, the heel, both feet, ball of the foot, the edges of the feet, perhaps the toes is touching the ground. It's giving a sense of how the feet feel. Perhaps a little bit tired if it's towards the end of your day or alive and awake, perhaps if it's earlier on in the day, just resting the attention on the feet and just gently bringing the attention up the legs and up to the hips and up to the belly, so to the lower abdomen. Just sensing the breath in this region of the body. So just feeling the belly expand and stretch as we breathe in and fall back. Relax as you breathe out, just letting your attention just rest the waves of the breath in the belly, Just letting the belly and the breath breathe itself, feeling the belly expand and then relax as you breathe out. Not trying to control the breath in any way. We're just resting here with the breath was just slowing everything down for a few moments, just taking our lives. Now, just one breath at a time, just curious sensations, each in breath and each our breath. Then gently expanding your awareness to take in the whole of the body. So sensing the space that your body occupies in the room you're sitting or standing, almost feeling the body, feeling quite elegant, quite grounded as we sit or stand here. Seem impossible to bring a sense of kindness to the body. Just viewing the body through a lens or a filter of kindness, just feeling your wholeness, just your completeness, even getting a sense of the whole of this Hermes community wherever we sit in the world. Sense of connectedness right across the world. And then when you're ready, just gently open your eyes and about stretching a little, maybe the fingers, the toes, and sitting back down again if you wish, if you've been standing. So let me come back to mindfulness now, what mindfulness is and share something with you that I took away from a wonderful retreat that I did here in Scotland in March this year. And the retreat was led by extremely experienced meditator who'd been on long silent retreats on mindfulness, both in the far east and at the Insight Meditation center in the US and she'd been taught by some really excellent teachers. And when we talked in the retreat about what is mindfulness. And I think this little cartoon that Tony Craig has sadly uses a lot, so you've quite possibly seen it before, I think actually kind of sums up the normal definition of what mindfulness is pretty, pretty nicely. So you've got the human being on the left whose mind is full and full of thoughts about the things they've got to do and the worries and. And other people and interactions and possibly regrets about the past. Just. Just that whole gamut of thoughts that typically goes through our heads. So this is the kind of human. Human doing rather than a human being. And then you've got the dog on the right who is being mindful, just very much aware of what they can see, the sun and the trees and that kind of view of what mindfulness is. It's kind of, if you read a. It's quite a common view. So if you read a kind of magazine or about what mindfulness is and isn't, that's kind of the typical definition you'll get. It's very consistent with the definition of. From John Kabat Zinn, his operational definition of mindfulness, which he calls paying attention in a particular way on purpose and with no judgment. But there's a lot more to mindfulness, and there are other ways of thinking about mindfulness. So another way of thinking about mindfulness that might be helpful for you is it's like awareness. So perhaps when you think about you're doing a mindfulness practice or a meditation practice, you're really doing an awareness practice. And even during the day, you can just bring awareness to whatever you're doing. And that in itself is just. Just like another mini meditation. And as you practice, then your awareness changes over time. Perhaps you practice a little bit more, reflect more, have some good teachers, your mind, your awareness deepens, it develops, it changes. So when, typically, when we first start meditating and first start with our mindfulness practice, we really try and grow the attention muscle, just develop that base awareness, as John Kabat Zinn said, just managing our attention, keeping it deliberately in the present moment and without judging. And if we do that really quite quickly and really literally over a space of a few weeks, we can find just more stability in the mind. The mind does actually feel a little bit calmer, and that's partly true because we are stimulating the vagus nerve and the parasympathetic branch of the autonomic nervous session. And switching over into the relaxation mode. That is a great way to start. And it achieves many of the benefits of switching off the stress response and switching on the relaxation response. But if we keep practicing, find that actually our awareness develops and we start to really have better understanding of our experiences, might find that we reconnect with sensations in the body, start to become aware of what our bearing is telling us. So when we feel tightness in the chest or in the throat or wherever different age, different sensations in the body, become more aware of thoughts, of our different mind states, of different emotions. And awareness can deepen even further when you start to become aware of just our habitual thinking and our conditioned responses. How we always potentially respond and react in certain ways to specific situations, to specific stimuli. We tend just to react in certain ways. We notice the things that we like and how we perhaps hold onto those things that we don't like and push those away. And our minds really do start to feel a little bit more spacious at this point. And we do start to develop a slightly more resilience, just an inbuilt resilience at that point. And as the awareness deeps us even further, we get to the point of actually not only just being able to notice reactions to certain situations, but being able to let them go, to change them and make better choices for ourselves, make better choices for other people, choose just actions that options that are better for us. And this literally is rewiring our brain. This is changing our normal learned way of behaving our conditioned responses and making better choices. And this literally does say rewire the brain and just continue on and furthering the depth of awareness. Many just seems to sit all the time. Meditation almost becomes really quite easy, incredibly light, almost no, no, no effort whatsoever. And certainly those last two steps when you sit and meditate, there are huge insights that can arise just naturally as part of the meditation. The meditation itself just becomes, just becomes far more fluid. So I just wanted to maybe just draw that picture out for you. That meditation is an awful lot more than just being in the present moment, intentionally and non judging. And it can develop, it can unfold over time. And every person will have a kind of a different pathway, different journey in terms of their awareness. It's maybe just to, just to draw on that a little bit. I, I don't know if anyone else has seen Shannon Harvey's latest film, My Year with Mindfulness. I saw it a couple of days ago. I think she, she really gets it and really understands it. And if you do have an Opportunity to watch it just coming back to this. So I think through meditation, through mindfulness, we can do an awful lot to actually help look after our minds. But, and then there's a question, is it enough? I mean, certainly the environment we're in right now, it's hugely uncertain. I think at times it's just not clear what's going to happen next month, next week, even tomorrow. Certainly sometimes here in the UK it really seems just changing so much. And I guess if any of us have to think forward, what's the word going to look like or our world going to look like in six months time? It's just very, very unclear. And we're living with ms, which itself is unpredictable. And I think that we know that we're doing everything we can do to give a positive trajectory of our Ms. Condition through following ms, but it is still unpredictable. So is there anything else we can do to look after our mental health? So some of the things that I've learned and do myself, so I'm just going to go through a few of those. So at night after I got into bed and before I start falling asleep, I just do a little kind of gratitude, practice, think about just three things for which I've been really grateful for the day. And they can be just really, really small things, just tiny little things, perhaps just things I might have seen, heard or chat with my wife or whatever it is. And just having to think about those, fixing those in my mind puts me in a great place to sleep. So that's just very nice to do. Then when I wake up in the morning, before I get up, I think about my intention for the day and that's not my to do list, that's not all the things that I should be doing I need to tick off during the day. It's more about how do I want to behave during the day, what kind of attitude do I want to have, perhaps, you know, how do I want to speak, how do I want to sound more. Those kind of behaviors, again, just again just helps set me up for the day and just kind of puts me in the right frame of mind for the day ahead. And kindness just throughout the day, just remembering to be kind, that's kind to myself and kind to others and to me. Kindness absolutely is at the heart of meditation and mindfulness. And I know how tough I am on myself sometimes. And again I noticed with a lot of people with Ms. And I think particularly oms, which is so tough and hard on ourselves sometimes, so, and I just give ourselves a break being nice to ourselves sometimes and it's okay. So those three little things I find just really, really helpful. But also then as part of, I guess where we are in this pandemic and how, I mean we, I think we're possibly going through the biggest change in our lives, possibly generation or two in terms of how the world is going to alter. Just think about, I think our values, what's important to us. I do try and do this every year or so, but it's just sit back and reflect on what's important for me in terms of my relationship was on my families or my interests or my work and think about goals. Just think about goals around that and yeah, just take a bit more control of it. One of the phrases that Trevor Wicken of the Ms. Gym uses and I use the MSG most days and I love it, but he talks about living your life by design and not by diagnosis, which is a phrase I really, really like. So let me end with another quick quote. I think the one that's particularly appropriate quotation from John Kabat Zinn that we can't stop the waves, but we can learn to surf and we can't. We can never stop the waves of change, but we can learn how to surf, how to live with a chain, how to still enjoy our lives.
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Thank you for listening to this episode of of Living well with Ms. Please check out this episode's show notes@overcomingms.org podcast. You'll find useful links and bonus information there. Don't forget to subscribe to the podcast so you never miss an episode. And please rate and review the show to help others find us. This show is made possible by the Overcoming Ms. Community. Our theme music is by Claire and Mab Dean. Our host is Jeff Alex. Our videos are edited by Lorna Greenwood and I'm the producer, Regina Beach. Have questions or ideas to share, email us@podcastvercomingms.org we'd love to hear from you. The Living Room with Ms. Podcast is for private, non commercial use and exists to educate and inspire our community of listeners. We do not offer medical advice. For medical advice, please contact your doctor or other licensed healthcare professional.