Mindfulness Evaluation John Kennedy 2015

Evaluation of the MBLC Course

John Kennedy

The Evaluation is of an 8 week Mindfulness Based Living Course and illustrates the benefits of Staff who work within the NHS/Local Authority in terms of learning mindfulness skills becoming more Mindful in daily life and improving their psychological well-being.

Introduction

Mindfulness has its roots in Eastern spiritual traditions where conscious attention and awareness are actively cultivated.

Mindfulness is a widely recognised life-enhancement skill and approach to living, which can deepen a person’s sense of well-being and fulfilment. Mindfulness is developed by purposefully paying attention in a non-judgemental way, to what is going on in your body and mind, and in the world around us.

Mindfulness-based classes are intended to teach people practical skills that bring about a shift in awareness and may lead to seeing things differently, perhaps to feeling less stuck, or to a sense of having more options, more strength and more confidence in your possibilities. This in turn helps with physical and psychological health problems and ongoing life challenges.

In this way the course will be supporting the aims of recently published mental health and well-being policy, “to ensure that all employees are provided with the opportunity to participate in mental health promotion activities by promoting a culture based on trust, confidentiality, support and mutual respect”. The course will also be looking to empower colleagues in dealing with mental health problems such as stress, depression and anxiety.

Evaluation of the MBLC Course:John Kennedy 20151

The Mindfulness GroupThe main aim for the group is that it might help participants develop different relationships with their experiences of their thoughts, feelings and physical sensations through learning the skill of mindfulness and simply being here in the present moment.

The most common working definition of Mindfulness is:

“paying attention on purpose in the present moment non-judgmentally”. (Kabat-Zinn, 1994).

According to Rob Nairn his definition of mindfulness is:

“…… knowing what is happening, while it is happening, without preference.” (Nairn, R 2010)

Both of these definitions emphasise intentionally knowing what is happening, as it is happening, in the present moment. This way of being is done through a particular way of paying attention with particular attitudes such as non- preference and non-judgemental. It involves consciously attending to ones moment to moment experience. It could be said that mindfulness is paying attention in a particular way to an immediate experience.

Mindfulness is a faculty.

Mindfulness training offers simple steps for developing mindfulness based on the understanding that it is a skill like our other skills and abilities. If we neglect it, it remains dormant. If we work on it, it develops, grows and stabilises. When this happens our lives can change for the better.

Method and Attitude

Mindfulness training has two levels:-

the method of how we train and what steps we learn in order to settle the mind, come into focus, remain in focus, and recognise and avoid distraction.

an attitude of acceptance and kindness towards ourselves so that when the effects of mindfulness reveal deeper levels of psychological activity we are able to integrate these in a healthy and natural way.


The Participants and the Setting Up of the Group

An e-mail would be sent to line managers throughout HSCP and local authority, mainly in the Inverclyde area, outlining how evidence suggests that Mindfulness practice and developing Mindfulness skills can benefit course participants in the following ways:-

increase performance in the workplace improve communication and problem solving increase concentration and focus increase the ability to manage conflict achieve balance and resilience both at home and at work enhance clarity and creative thinking promote physical and mental well-being reduce stress address burn-out and compassion fatigue reduce automatic and habitual reactions reduction of pain for those suffering chronic pain improve energy levels increased perception of control for long term anxiety disorders lessens over all psychological distress improve professional practice and working relationships

Interested people would be asked to contact the group facilitator to book a place on the course.

Twenty two people expressed an interest in the group and 16 started on a first come first serve basis.

A pre-group meeting would have been advantageous in answering any queries and explaining what Mindfulness is but due to staff time this was difficult.

When beginning it is made clear that the group is an experiential group to learn the skill of Mindfulness rather than a discussion group about Mindfulness or a therapy group where problems are the main focus.

There are also ground rules and boundaries set; this is done with the collaboration of the group.

There was an emphasis put on using the word “I” when sharing our experience rather than using the word”You”this made the experience more personal to participants.


Group participants’ Expectations and Aims were discussed and these can be seen in the table below. It was made clear in the beginning that, when practicing Mindfulness, it was important to form the intention of practice, practice, practice but expect nothing (Let go of any goals aims or outcomes).

It was explained that if one holds an expectation or goal in their mind and that expectation or goal is not achieved it creates tension in the mind.

In general peoples’ main interest in attending is that they already had some knowledge or experience of mindfulness or meditation and were curious to learn more and develop more skills.

It was also noted, through group enquiry, that almost the entire group wanted to be Kinder to themselves.

Participants were also from a mix of disciplines; from Band 2 through to Band 7s.

The Facilitator

The group was facilitated by one person, John Kennedy, who has been practicing Mindfulness for four years. The course witch John is facilitating is designed by the Mindfulness Association.

John has been trained in Mindfulness by the Mindfulness Association and has attended their one year’s Mindfulness Practitioners course, one year’s Compassion course and one year’s Insight course.

John also attended two Teacher Training weekends and a five day MBLC teaching retreat and will also attend their CPD teaching weekends and one week Mindfulness based Retreat every year. John also receives regular supervision.

The Group Programme

Intention and Motivation

Participants are asked to find their own form of words surrounding their Intention and Motivation for practicing mindfulness ie (I intend to be Mindful and practice Mindfulness with the Motivation that this will genuinely be of benefit to my own well-being, as well as benefit those whom I come into contact with in daily life).

The group was run as a set programme consisting of 8 planned Sessions which taught different skills each week. It was designed in such a way that foundation skills were taught at the beginning with more complex skills being developed later. Evaluation of the MBLC Course:John Kennedy 20154

Group dynamics were facilitated and managed in ways that might maximise learning and home practice of the skills. For example, in the opening session people introduced themselves by talking about their wishes for coming on the course and their interest in mindfulness, but if they started to discuss other things (eg talk in detail about their life or problems) they were gently brought back to focus on mindfulness. This helped create norms where our attention always returned to the group task of learning mindfulness skills. A very cohesive group, that usually kept on task, quickly developed. Similarly, in the ending sessions thoughts and feelings about the group coming to an end were addressed by incorporating them into a mindfulness exercise (rather than discussed).

Session 1 Start Where We Are

To understand that often we are not fully present to our experience, we are not getting our ‘moment’s worth’ because we are on ‘automatic pilot,’ is the first step in developing mindfulness. The ‘raisin exercise’ (used regularly in mindfulness-based therapies) was used to facilitate an experiential understanding of both automatic pilot and mindfulness.

In this exercise participants are each given a raisin and encouraged to explore this with their senses, as though they have never seen anything like it before. By eating the raisin in a ‘mindful’ way, participants usually experience something very different from what they experience when they eat a raisin in their usual ‘automatic’ way. Home practice involved learning the skill of ‘noticing’ and being ‘fully aware’ whilst doing another everyday activity (eg brushing your teeth).

Recognising the Unsettled Mind –Settling the Mind

Participants are introduced to the unsettled mind and notice how unsettled it can be. They quickly realise that unless we choose our thoughts they arise by themselves, therefore they arise involuntarily. The first step of practicing how to settle this unsettled mind (Monkey mind or Butterfly mind) is to work with the breath as a support and show how energy follows focus (if we focus on a thought or emotion we then direct energy there). Participants begin to experience that, by using the breath as a support, we can notice when we are lost in thinking, we then simply notice this and gently shift our focus back to our breathing which holds us in the present moment experience.

Session 2 Body Scan - Body as a Place to Stay Present

A body scan exercise was introduced in the session which involved participants being directed to focus upon each part of the body in turn and simply notice what they were experiencing. Participants are encouraged to bring an attitude of curiosity and friendliness to whatever they were experiencing, for example, sensations such as aches and pains, clearly defined feelings such as guilt or excitement, or other less clearly defined sensations such as a tightness in the Evaluation of the MBLC Course:John Kennedy 20155

stomach or emptiness in the chest (which may be difficult to put into words). By focussing on the body and its changing sensations participants begin to see more clearly the ‘chatter of the mind’. This exercise also introduces the idea that we are able to move our attention around at will and begins to encourage participants to be with whatever they are experiencing moment by moment without the need to change it.Felt Sense of Kindness - Cultivating the Intention of Kindness

Participants are asked to reflect on when they were kind to someone when someone was kind to them and when they were kind to themselves.

Recognising our negative bias and developing an attitude of Acceptance, Openness and Kindness.

Session 3 Introducing Mindfulness Support

Provides a structure for Practice and an Anchor

Mindfulness of the breath was the central exercise practised throughout the rest of the group (both in sessions and at home practice).

This session focussed on using the breath as an anchor to be able to stay present to feelings and sensations experienced in the body. By holding both the breath and the body in awareness at the same time, participants begin to develop ‘somewhere else to stand’ from which to view their experience and begin to relate differently to their thoughts, feelings and sensations. The ‘3 minute breathing space’ (which is a condensed version of this process) was also introduced. This exercise is more portable for use in everyday life.

Session 4 Working with Distraction

Introducing to participants their patterns of distraction when getting lost in thinking.

Noticing patterns of striving/inner critic/judgement, adopting an attitude of curiosity, kindness and welcoming of our experience.

Continuing to use our breath as an anchor which is always there

Mindful Movement - Mindful Walking

A practice where participants can use the body to stay present while moving/linking between body movement and noticing our attitudes eg striving being in “being mode” whilst doing.Evaluation of the MBLC Course:John Kennedy 20156

Session 5 Exploring the Undercurrent

Participants are introduced to the constant stream of chatter that is going on just under our normal mind focus.

Introducing the Undercurrent as a concept and becoming familiar with the coarse thought activity of the mind.

Recognising the autonomous Self arising, Self Displaying thoughts, recognising our habitual pattern of jumping in and engaging the content of the undercurrent.

Encouraging participants to witness the thoughts coming and going without the need to get involved with them (Cultivating an impartial Observer).

Thoughts are not facts.

Understanding that the content of the undercurrent cannot be changed and that it is a product of our own experience of Body, Speech and Mind.

Participants also learn to build their capacity to accept that we have an Undercurrent and learn to be with it.

Loving Kindness for Other -To cultivate an Attitude of Kindness and Openheartedness and Link and Connect with our Shared Humanity.

In this session guided meditation was used to introduce the concept of loving kindness. The guided meditation asks participants to work with the intention or have a felt sense ofa time when they have felt loved and to rest in the feelings this invokes. The meditation continues through several stages until participants are asked to imagine being the source as well as the object of these feelings and to direct feelings of loving kindness to themselves. Loving kindness is a quality of the heart and is central to mindfulness practice. Whilst loving kindness for oneself can feel uncomfortable and be difficult to develop, it can also be very transformative, softening our relationship with very powerful feelings, when simple observation, staying present and allowing them to be is not enough.

Session 6 Attitude - Attitude of the Observer

In this session participants are continued to be made aware of the Observer/Undercurrent model the Observer being part of the mind who knows and the undercurrent the part of the mind that is known.


By understanding how the observer is driven by a strong preference system, and how all of our attitudes are reflections of subtle thought, and it is this subtle thought process that drives us to engage the content of the undercurrent, participants begin to gain some insight (through reflective practice and written journal) into the workings of their inner environment.So participants begin to find out what their observer’s attitude is to the content of the undercurrent and from there they begin to train the observer to become an impartial witness. To observe the content of the undercurrent without judgment and without preference, therefore become able to both hold it in awareness and stand back from it; recognising that we have a self reflective consciousness.

Loving Kindness for Self

Working with the intention to cultivate loving kindness for self and to make life and self investigation safer and easier. Guided the same way as session 5.

Session 7 Self Acceptance

Participants are introduced to the RAIN practice, an acronym developed by Michele McDonald, a senior mindfulness teacher, to summarise a very effective way to expand our self awareness. Tara Brach, another senior mindfulness figure, calls RAIN Mindfulness in times of difficulty. (Brach 2003)

Beginning to deal with difficulty in a subtle way, within a supportive structure, and working with the pull of difficulty in our lives and developing Acceptance.

R -Recognising what is going on in the moment.A -Allow the experience to be there just as it is.I - Intimate Attention Investigate with an attitude of kindnessN - Natural awareness comes from not identifying with the experience.

Evolved Brain

Participants are also introduced to the evolved brain and Paul Gilbert’s theory of the three emotional systems. (Gilbert,Choden,2013).

Threat system, threat focused-emotions of anger, anxiety and disgust-behaviours of fight, flight, freeze, and submit.

Drive system - incentive/resourced focused-driven to achieve.


Content system -Safe-connection-soothing and safeness-the ability to sooth ourselves in times of difficulty, the ability to approach another for soothing, the ability to feel safeness in our world.

Participants experience that the evolved brain is not designed for happiness or contentment and that we are hard wired for survival. This lets us off the hook, knowing we are stuck with a tricky brain.Self Compassion Break

In this practice, participants are Cultivating Kindness and Compassion, or being with difficulty and reinforcing the “Self” in self Compassion.

Session 8 Round Up

Participants were encouraged to use the skills that they had learned, eg of mindfully observing their thoughts, feelings and body sensations, to identify how they were experiencing the closing session. There were Opportunities to review what people felt they had and had not gained from the group, to discuss ways of incorporating mindfulness into their daily lives and discuss the possibility of having follow-up meetings.

Evaluation of the Group

The group was evaluated by means of pre-group and post-group Questionnaires which were filled in anonymously.

Table 1 below shows a list of Aims which were filled in for a post group questionnaire, requesting participants to assess whether each aim had been:-

(i) Not achieved (ii) Achieved to some extent(iii) Fully achieved

14 Scale Mindfulness Inventory

A Generic 14 Scale Mindfulness Inventory designed by Walach, Buchheld and Schmidt which was designed to evaluate an individual’s own Mindfulness experience.

Mindfulness practice is an individual experiential journey where some group participants’ journeys will travel further than others. That is not to say that the others have not travelled.


The average self assessment chart below shows a 20.5% increase in the Group as a whole in terms of the Mindfulness questionnaire. The pie charts also indicate an increase in three of the selected questions.

The final chart shows the difference between two of the participants’ experiential journeys. One had started from a different point from the other but both had made an increase.

Participants Comments

“I have noticed a change in the way I cope with and think about situations”

“Have had a great deal of insight into my personal feelings and reactions to stressful and difficult situations”

“Able to be present and acknowledge stressful events”.

“Have noticed a massive change in myself. I’m less critical of myself, calmer all round”.

“I have experienced a couple of traumatic experiences in my life and have been, in the past, referred to counselling, psychology and psychiatrist. None of these services were of benefit to me. This is an experience that has truly helped me”.

“I have learned more about myself; how to cope with situations and other staff members, be more accepting of others and able to let go of stress.”

The majority of participants taking part on this short eight week course found it really helpful, with 100% of them recommending it to their colleagues.


Aim

Not Achieve

d

Achieved to

some extent %

Fully Achieve

d %

Total Participant

s %

To feel better than I do 0 1 8.33% 11 91.67% 12100.00

%

To manage better when I feel low 0 3 25.00% 9 75.00% 12100.00

%

To stop trying to be a perfectionist and don't be so hard on my self 0 5 41.67% 7 58.33% 12100.00

%

Be/live in the present 0 3 25.00% 9 75.00% 12100.00

%

To improve my concentration 0 5 41.67% 7 58.33% 12100.00

%

More able to calm myself down 0 2 16.67% 10 83.33% 12100.00

%

Judge myself less harshly 0 3 25.00% 9 75.00% 12100.00

%Be able to react less negatively to intense and difficult emotions, images and feelings 0 4 33.33% 8 66.67% 12

100.00%

A positive change or difference in myself since starting the 8 week MBLC course 0 0 0.00% 12 100.00% 12

100.00%

Staying in the here and now 0 6 50.00% 6 50.00% 12100.00

%

To be Compassionate to myself 0 3 25.00% 9 75.00% 12100.00

%

Recover more quickly from stress 0 2 16.67% 10 83.33% 12100.00

%


Chart Title

0 0 0 0 0 0 0 0 0 0 0 01

3

5

3

5

23

4

0

6

32

11

9

7

9

7

109

8

12

6

910

0

2

4

6

8

10

12

Not achieved Achieved to some extent Fully Achieved


Average Self Assessment Pre and Post Scores 20.5% increase

(Maximum Possible 56)

29

44

0

9

18

27

36

45

54

Pre Course Average Score forGroup

Post Course Average Score forGroup

Max

imum

Ave

rage

Sco

re 5

6


Whole Group Increase (13%) - 4. I am able to appreciate myself.

13%

87%

Whole Group (13%)- 6. I see my mistakes and difficulties without judging them.

.

13%

87%

Whole Group (11%)- 11. In difficult situations, I can pause without immediately reacting.

89%

11%


Participant 6

10.00%

20.00%

30.00%

0

0.5

1

1.5

2

2.5

3

3.5

4. I am able to appreciatemyself.

6. I see my mistakes anddifficulties without judging

them.

11. In difficult situations, Ican pause without

immediately reacting.

Increase

Participant 6

Participant 12

20.00% 20.00% 20.00%

0

0.5

1

1.5

2

2.5

3

3.5

4. I am able to appreciatemyself.

6. I see my mistakes anddifficulties without judging

them.

11. In difficult situations, Ican pause without

immediately reacting.

Increase

Participant 12


Documents

Mindfulness Evaluation John Kennedy 2015