Stephanie Rogers, GC-C, CT A marillo H ospice of the P lains amarillohospiceplains@gmail.com

1. Stephanie Rogers, GC-C, CTAmarilloHospice of the Plains amarillohospiceplains@gmail.com

3. The Mustard Seed (Handout #1)

4. I. What Is Mindfulness?

5. I. What Is Mindfulness? • Paying attention “on purpose” • Conscious direction of awareness • Curiosity • Inquisitiveness • Paying attention “in the present moment” • Always gently coming back to now -- away from past/future • Being present in the here and now rather than longing for the past or future • Paying attention without judgment • Being emotionally non-reactive – noticing that thoughts arise, pass through, and cease to exist • In mindfulness, pleasure and pain (and everything else) is treated equally – only with awareness • Allowing yourself to feel what you are feeling

6. I. What Mindfulness Is NOT • Becoming one with the pain • Denying its existence or the difficulty of living with it • Wallowing in it • Torturing yourself in silence/quietly bearing a burden and waiting for it to disappear • “Mindfulness is the antidote to [the] universal, nearly constant bouncing back and forth between attraction to pleasure and aversion to pain.” • ~Sameet M. Kumar, Grieving Mindfully

7. II. The Myth of “Keeping Busy” • Distraction is a temporary Band-Aid • Symptomatic of the futile search for permanence in an impermanent world • Time and energy expended running after pleasure and away from pain • Trying to control suffering in this way only strengthens it • There is no “solution” to grief, because grief is not a problem • “Nothing ever goes away until it has taught us what we need to know.” • ~Pema Chodron

8. II. The Myth of “Keeping Busy” • Distraction never heals • Instead it can encourage unhealthy automatic patterns of thought • Magnification and minimizationOvervaluing the relevance & consequences of distressing events while undervaluing the relevance & consequences of positive ones • PersonalizationAssuming responsibility for negative events that have nothing to do with you. • Black or white/All or nothingNo grey areas • Arbitrary inferenceHaving a fixed idea about the world or a relationship, either without proof or despite proof to the contrary • Selective abstraction Focusing on one detail in a relationship or interaction to the exclusion of all else

9. II. The Myth of “Keeping Busy” • Grief will always return (it never leaves) • Physical ailments • Sleep disturbances • Gastrointestinal upsets • Chronic illnesses • Depression • Anxiety • Self-medicating with substances and/or behaviours

10. II. The Myth of “Keeping Busy” • Cannot heal what is not seen • The more we ignore the pain of grief, the more we become stuck in the illusion of its permanence • The reality is that someone we love is dead. We cannot change that. And until we are willing to look at that reality, to sit with it, to be with it, we cannot truly Live with it.

11. Leaning into the Sharp Points • Trying to soften the pain of grief • Society demands that we forget that death and loss are inevitable and natural parts of life • In the West, we associate grief (and pain) as something “wrong” or “bad” • Pain is not punishment and pleasure is not reward • While we are aware of the impermanence of joy, we are afraid that sadness is permanent • Trying to escape grief • Resisting pain often deepens it • We live as though by denying grief we can escape the pain of loss and/or even death itself

12. Leaning into the Sharp Points • Looking honestly and gently at the pain of loss begins healing • The relationship of grief to fear • The realization that we are more than our bodies • Three misunderstandings about grief • We expect what is always changing and unpredictable to be never changing and predictable • We live as though we are a separate and fixed separate entity • We look for happiness in all the wrong places (Handout #2)

13. Leaning into the Sharp Points • Experiencing grief • Being with the grief without being in its grip and without gripping it • With willingness and gentleness • Without calling it the enemy • Without “shoulds” or “shouldn’ts” • The goal is not to make a “bad” thing “better” but to reconcile ourselves with the way things really are • There is great clarity in sitting with grief, in facing it • “When you react to distress with distress, the result is twice as much distress. In a state of mindfulness, when you feel unavoidable distress you accept it.” • ~Sameet M. Kumar, Grieving Mindfully

14. Leaning into the Sharp Points • Transforming grief • Grief forces us to re-examine who we are • “Radical Acceptance” of all grief has to teach us • Without judgment • Change our relationship to grief/pain • Leaning into/fully experiencing the pain is never as bad as our anticipation of it

15. The Efficacy of Mindfulness in Grief • An individual approach • Can be done alone • Self-paced • Free from the expectations of others • Restores personal power • Assimilation of grief into the New Normal/New Identity • Grief is no long in control • Less tendency to delay the inevitable task of accepting the reality of the death • Cuts down on the manifestation of complicated grief • Disturbing emotions and thoughts • Physical sensations and illnesses • Avoidance behaviours

16. The Efficacy of Mindfulness in Grief • Awareness without judgment engenders positive change • Flashes of calm in the midst of the storm of grief • Gentler attitude with self and others • Diminished suffering • Encourages the unification of the grief experience • Body • Mind • Spirit • Helps develop patience via the awareness and acceptance of the ups and downs of grief • Can stop “Avalanching” • Panic attacks • Inappropriate/dangerous behaviours

17. The Efficacy of Mindfulness in Grief • Peace • Find meaning in grief • Find answers to questions

18. Teaching Mindfulness in Grief • Not diving into or wallowing in suffering • Allow yourself to experience feelings as they arise • Mindful of their causes • Mindful of their impermanence • Mindful of your feelings about them (“Secondary Emotional Processes” - feelings about feelings) • Mindful of your internal dialogue (self-talk) • Awareness without judgment • Learn to notice what you are thinking before your feel it • Hear the thoughts behind the feelings that lead to actions

19. Teaching Mindfulness in Grief • Surrender • Not “giving up” or “giving in” but stopping the fight • Say “Yes” to the pain, the experience, the grief • Become the Detached Observer, the Silent Watcher

20. VI. Mindfulness Practices • Mindfulness in Action • Any activity • Tooth brushing • Walking • Dish washing • Exercise • Anything/Everything • Be aware of all sensations • Sight • Sound • Scent • Taste • Touch • The Silence

21. VI. Mindfulness Practices • Mindfulness Meditation (Handout #3)

22. VI. Mindfulness Practices • Mindfulness Meditation • Meditation is as simple as breathing • Not about controlling thoughts nor imposing quiet on the mind • Benefits are both immediate and long-term and can be experienced in as little as 5 to 10 minutes of daily practice • Requires no special spiritual or religious beliefs and does not mean having transcendental experiences • Requires no special abilities or attributes

23. VII. The Purpose of Grief • We grieve in direct proportion to how much we have loved • Grief and love are inextricably connected • The pain of grief can lead to the deep understanding that all life is subject to profound change • Nothing is permanent • We are all vulnerable • Everything that begins ends • Grief can put us back in touch with the absolute sacredness of love, of relationships, of life • Grief teaches everyone the same lesson: to value the relationships, experiences and time we have in this present moment • “…grief is the price we pay for the priceless chance to love others.” • ~Alan D. Wolfelt

24. VII. The Purpose of Grief • By transforming our pain into compassion we are able to help others • Compassion is not pity or sympathy – it is Empathy • Compassion: “Com” = “with” / “Passion” • When we become truly aware and accepting of the pain of our own grief, we are able to become truly aware of the pain of others • We all share the pain of grief • We lose the idea of Separation • In this realization, compassion is born • Pain is the most fertile ground in which to plant seeds of compassion • Most spiritual growth occurs in the midst of pain

25. VII. The Purpose of Grief • Grief becomes a source of wisdom • We engage with grief with Intent • We become more patient, flexible and resilient • The horrifying becomes a gift • This compassion becomes the way in which we move forward with our deceased loved one. • Allow the dead to become your teacher • Even a difficult or ambiguous relationship can be transformed through how you choose to grieve • It also becomes an eternal memorial to them. • A monument of courage and hope • In our kinship with the grief and pain of others, the spirit of our dead loved one is honoured and never dies

26. VIII. Conclusion Regardless of whether or not we choose to face it, death changes our life forever. “Normal” is gone and we must live our lives differently from this moment forward. Being mindful of our grief, leaning into its sharp points, empowers us as creators of this New Normal. By choosing to fully face our grief, to step into it, we are able to carry our loved ones forward with us into our new future.

27. References • Chödrön, P. (2005). The places that scare you: A guide to fearlessness in difficult times. Boston: Shambhala. • Chödrön, P. (1997). When things fall apart: Heart advice for difficult times. Boston: Shambhala. • Frankl, V. E. (1992). Man's search for meaning: An introduction to logotherapy. Boston: Beacon Press. • Huxter, M. (2010). Grief and the Mindfulness Approach - Meditation. Retrieved August 30, 2013, from http://www.buddhanet.net/psygrief.htm • Kabat-Zinn, J. (2002). Guided mindfulness meditation: Series 1. Boulder, CO: Sounds True. • Kabat-Zinn, J. (2012). Mindfulness for beginners: Reclaiming the present moment--and your life. Boulder, CO: Sounds True. • Kumar, S. M. (2005). Grieving mindfully: A compassionate and spiritual guide to coping with loss. Oakland, CA: New Harbinger Publications. • Nyanaponika (1969). The heart of Buddhist meditation (Satipaṭṭhāna): A handbook of mental training based on the Buddha's way of mindfulness, with an anthology of relevant texts translated from the Pali and Sanskrit. London: Rider. • Rinpoche, S. M. (2008). Shambhala Sun - How to do Mindfulness Meditation. Retrieved July 15, 2013, from http://www.shambhalasun.com/?option=content&task=view&id=2125 • Sagula, D., & Rice, K. G. (2004). The Effectiveness of Mindfulness Training on the Grieving Process and Emotional Well-Being of Chronic Pain Patients. Journal of Clinical Psychology in Medical Settings, 11(4), 333. doi:1068-9583-05-1200-0333-0 • Wolfelt, A. (2012). Companioning the grieving child: A soulful guide for caregivers. Fort Collins, CO: Companion Press.