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Yoga & Mindfulness Based Cognitive Therapy (Y-MBCT):
Use of Yoga in Its Entirety
Basant Pradhan, M.D.,
Assistant Professor of Psychiatry,
Director of Y-MBCT & Trans-cranial Magnetic Stimulation
Programs, Cooper University Hospital, Camden, NJ
Author: Yoga & Mindfulness Based Cognitive Therapy: A
Clinical Guide
Professional Disclaimer
Dr. Basant Pradhan was the PI of a collaborative study on PTSD
with the National Institute on Aging (NIA). He has no financial
relationship with any private company that would constitute a
conflict of interest on this topic.
Objectives:
After this, participants will be able to summarize things below:
Concepts of Yoga & meditation are profoundly distorted,
underused & when used, mostly used in piece meal, not in its entirety
Meditation is part of Yoga
Meditation is a state of mind, not an action
Meditation has 2 components: Concentration & Mindfulness
Yoga in its entirety is three fold: Life Style, Mind-Body Tools &
Meditation
Use of ALL THREE parts together based on authentic
scriptural philosophy, techniques & practice are necessary
for correct use of Yoga & to improve the usefulness
Human Experience is Five Folds: The Five Factor Model
Yoga & Mindfulness Based Cognitive Therapy (Y-MBCT)
through its six evidence based models attempts to bridge these
considerable gaps
Yoga as proposed originally: Ancient India
YOGA in its entirety: Contemplative strategies to gain insight:
About nature of thoughts & experiences (so that wisdom will govern our actions)
To understand things AS THEY ARE (REALITY, Pali. tathata)
To re-access a natural, +ve state of mind (cf. Baby)
to experience wisdom (vs. illusion/maya) & sustained day-to-day
peace of mind (vs. dvanda/unrest), regardless of circumstances
Philosophy of Yoga is based on the facts below:
All human experience created from WITHIN.
Stress: By Cognitive Dissonance (Maya)
Amelioration of stress & change of experience are possible: By
changing internal representations in mind & brain (insight+wisdom)
Meditation is 6th
& 7th
limbs of Eight Limbed Yoga
Meditation is NOT an action: It is a state of mind
Mind & Meditation: As Conceptualized in Scriptures
Locus of all experience: INSIDE
MIND: Always running away from this locus (Projection)
Mechanism of action of Mindfulness: Reversal of Projection.
To Turn mind inwards (the locus of all experiences)
Technique: Con-centration (centering of consciousness) +
Mindfulness (Sati Patthana) +
The Middle Way (The whole life is a meditation)
Basic Tools: You (nobody else) & Your Body & Breathing
Transformation of Breathing to a meditative experience in 7 steps
Generalization to Daily Life is Necessary (Practice Log)
Ongoing standardization by Pradhan (1993 onwards)
The Five
Aggregates in
co-creation of all
Human
Experience:
everything is just
elaboration of
these five
phenomena.
Panic
experience can
be seen as a
prototype of this
model
(Adapted from
Pradhan’s Book,
2014, with
permission)
Mind &
Meditator
are Different
from Each
Other:
Detached
Observation
of Mind is
Necessary.
That is
Meditation
Mind & Meditator :
The Lake Model (Pradhan, 2014)
Three modes of operation of Mind:
DOING Mode: Default mode (On call mode)
BEING mode: (Vacation mode; Being One with experience)
DRIVEN-DOING : Deadline mode (No experience)
GOOD FUNCTIONING: More ‘Being’ mode, less
‘Doing’ mode, much less ‘Driven-doing’ mode
HOW: By upgrading the technology to master the mind
The Three Unmindful Styles in Our Life: Source of All Stress
o Extreme/Non-Middle Way views & life styles
o Clinging to Self (I-dentify)
o Not staying with the present experience (Time travelling)
MEDITATION is a mental state cultivated by
practicing the combination of opposites to above three:
MIDDLE WAY view (an awareness rather than doing the actions),
DETACHED OBSERVATION &
Staying FOCUSED in the PRESENT MOMENT
Goal: To experience things as they are (Pali. tathata)
All done by using the breath (& body) as the anchor for
Meditation (Stations of Mindfulness, Nyanaponika, 1954)
The Chief Theory of Mind & Experience
in the Abhidhamma :
The Five Factor Model of Human Experience
Human Experience is a Co-creation by the Aggregates
One’s Field of Awareness is the Platform to Experience/
Experiment to effect the Change
All Experiences are Temporary & Prone to Change
FIVE FACTORS MODEL OF MIND: Experience as co-creation of these aggregates (Buddha, 6th century BC; Pradhan, 2014)
Will, Urge,
Impulses
Thoughts Feelings
Sensations,
Perceptions
MEMORY
Emotional
outbursts
Somatic
Symptoms,
Hallucination
Amnesia, PTSD
flashbacks,
Drug craving,
Compulsions,
Impulse
Ruminations,
Delusions,
Cognitive
distortions
CHANGE OF EXPERIENCE IS POSSIBLE
Pradhan’s Ongoing Work (Demystification & Standardization of Yoga)
Standardized Yoga meditation Program for Stress Reduction (SYMPro-
SR©): (wellness model, 1993 onwards): piloted on 150 persons
Y-MBCT© (illness models, 1998 onwards): Five Dx specific models
(depression; OCD, PTSD & other anxiety disorders; dyslexia & ADHD;
addiction, anger & impulse control disorders; somatic & conversion Sx)
Online Video:http://www.youtube.com/watch?v=pvHDCZ5D7Xk
Assessment Scale for Mindfulness Interventions (ASMI©, Pradhan, 2012)
Arousal Response during Trauma Memory Reactivation (ART-MR©
Pradhan & Gray, 2013-14): PTSD specific scale
Yoga & Mindfulness Based Cognitive Therapy (Y-MBCT: Book: 2014)
SYMPro-SR & Y-MBCT protocols
are based on: The 4 Original schools of Yoga
(Veda, Vedanta, Buddhism &
Tantra),
Standardized Middle Way Life
Style,
Neuro-biologically informed
meditation (bottom up model of
meditation) &
Standardization of CBT.
Piloted in > 300 subjects (India & US)
SYMPro-SR & Y-MBCT in a Nutshell
Philosophies of Mind & Life: Middle Way & Five Factors Model
Based on meditation as science of attention & empathy
Cognitive & Behavioral tools for standardization & adherence
Standardized sitting posture & Yogic procedures (Kriya)
Conscious Sensory Withdrawal (Sans. Pratyahara: 5th step)
Attaining the meditative states with standardized use of the
2 meditative styles: Concentrative (FA) & Open Monitoring (OM)
Concentrative meditation: TRATAK (fixed gazing)
Open Monitoring: MINDFULNESS (with five factor model)
Practical Tips for Yoga-Meditation:
SYMPro-SR/Y-MBCT: Standardized Practice Log available Routine Practice at Home (Longer version): 15 minutes in AM after waking up 15 minutes at night before going to bed As needed Quick Practice at Work (Shorter version): As needed practice: 5 minutes in different situations in daily life Use of CBT & experiential tools for ensuring effective practice of : Middle Way philosophy in daily life, The Five Factor Model of experience & Mindfulness meditation
SUMMARY: SYMPro-SR & Y-MBCT
Scriptural but scientific: Evidence based & feasible
Psychologically, neuro-biologically & spiritually informed
Feasible for monks as well as modern people: Meditative
Life Style (Middle Way) standardized as well
Compatible with
Illnesses & wellness
Other therapies (Psychotherapies, Medications, TMS)
Huge potential for further collaborations & applications in
multi-center trials examining utility of Yoga & mindfulness
REFERENCES:
Bhante Gunaratana (2009). Beyond Mindfulness In Plain English.
Buddhaghosha (circa. 430 CE): Visuddhimagga (The Path of Purification;
Nyanamoli [Eng. 1976], Berkley, CA: Sambhala.
Dalai Lama (2009). The Middle Way: Faith Grounded in Reason. Wisdom Pub.
Daniel Goleman (1988). The Meditative Mind: Varieties of meditative experience.
Jon Kabat-Zinn (1990): Full Catastrophe Living. New York: Delacorte Press.
Newberg, A.B. (2010). Principles of Neurotheology; Ashgate Publishing.
Nyanaponika Thera (1965). The Heart of Buddhist Meditation; Samuel Weiser.
Pradhan, B.K. (2014): Yoga & Mindfulness Based Cognitive Therapy (Y-
MBCT): A Clinical Guide (Springer).
Pradhan et al (2013-14, unpublished): Ketamine & mindfulness in refractory
PTSD. Pilot study with investigators from Cooper University Hospital & NIA.
Satchidananda, S. (1978). The Yoga Sutras of Patanjali: Translations and
commentary; Yogaville, Virginia: Integral Yoga Publications.
Segal, Z. v., Williams, J. M. G., & Teasdale, J. D. (2002, 2013). MBCT for
depression: A New Approach to Preventing Relapse
Vivekananda (1956). Raja Yoga. New York: Ramakrishna Vivekananda Center.
ARTICLES: Very many to be cited.