A fresh look at making New Year’s resolutions work…

Another year is beginning… We could just go with the flow, take life as it is, and be ourselves. 

But then, feeling completely at ease with ourselves, and with the way our lives are unfolding, may be a step or two away. There may well be things we would like to be different… 

Time for another New Year’s resolution? If so, how to make it stick? 

This week, a new approach that really does work, but first 

       Thought for the day

Taking life seriously does not mean spending our whole life meditating 

As if we were living in the Himalaya Mountains or in the old days in Tibet. 

In the modern world, we have to work to earn our living,

But we should not get entangled in a nine-to-five existence, 

Where we live without any view of the deeper meaning of life.

Our task is to strike a balance, 

To find a middle way, 

To learn not to overextend ourselves 

With extraneous activities and preoccupations, 

But to simplify our lives more and more. 

The key to finding a happy balance in modern life is simplicity.

                     Sogyal Rinpoche

 

The wonderful thing about New Year’s resolutions is they always seem so sound, so logical. 

This year I will meditate more. This year I will drink less, exercise more, be kinder, more tolerant, more aware, more forgiving… all so sound, so logical; how could we not take up on any of that? Yet for many, a week or two into January, not only has the change not been accomplished, it is probably even forgotten!

So… how to actually make personal change? How to work with our mind? 

Having helped people with this for decades, many readers will probably be familiar with the Three Principles of Positive Thinking. These Principles have helped many people to set goals, follow through and accomplish them. Changing habits, changing environments, changing ways of relating – these 3 steps really do work. But in this post, a new take; another way of making personal change. 

(You can check out the Three Principles in The Mind that Changes Everything or You Can Conquer Cancer).

The fresh approach? 

Answer these 5 questions: What?, Why?, How?, When?, and How much?

1. What - Set Your Goal. Three important points:

i) Goals can come to us courtesy of whims, emotions, rational thought, contrariness, contemplation – or because somebody tells us what to do! 

Best be clear where your goals are coming from, and make a deliberate choice. 

Experience is pretty clear here; the best goals come from combining the use of the intellect and contemplation. Details are in The Mind that Changes Everything.

ii) A goal can be focussed upon an outcome or an action. Both are valid, but quite different. 

An outcome might be catching a plane overseas and as such is quite time dependant and uncompromising. The actions required to purchase the ticket and get on the plane may change over time and benefit from a flexible approach, but the time of departure is fixed. 

Many goals are like that; the outcome is fixed, the actions required to accomplish the outcome may well need to change to adapt to evolving circumstances and as such, are best to be flexible. Here, the goal is uncompromising, the actions are flexible. 

An action might be to meditate daily – no wriggle room there – you either do it or you do not. You may relapse and need to recommit, but basically, the aim is to be doing the action as intended. Here, the goal is the action and as such it is inflexible.

iii) Aim to reduce your goal to a few words, and express it as an affirmation – in the first person, present tense, as if it has already happened. And in a way that is joyful!
Example? Not I hope to meditate daily and with a bit of luck maybe I will some time off in the future, but it seems a bit unlikely, I have tried it before and it was pretty difficult… ; rather I really enjoy meditating daily, now. The mind responds to hearing this - first person, present tense, as if it has already happened, not the previous vague waffle.

2. Why?

Why is it time for this change? 

Example? Maybe you have been meditating off and on… Very common… But maybe it is becoming even clearer: when I do meditate everything seems easier, everything seems to work out better. Funny that… 

Maybe you do need to heal something? Maybe you do aspire to becoming a better person? Maybe it is time to get to know yourself a little more deeply?

The stronger the Why, the easier the How.

3. How?

What will it take to accomplish this goal? 

What do I need to do? 

Example? Meditating daily. 

If you have good personal discipline, you probably do not need to read on; just do it. 

However, many I have helped over the years did have good, clear goals, and yet they struggled to accomplish them. 

If this is you, you need to plan.

Consider supports like establishing a routine, setting up a good practice space, starting small and building, providing yourself with rewards once landmarks are passed, seeking contact with teachers and like-minded company you can learn from, share your goals and your progress with, consider writing a journal, record your practice and share your results with those close to you. What does it take?

4. When?

Some goals have a definite timing to them, like catching a plane; others are more flexible.

Unless the goal is time dependant – like the plane trip – it is preferable to keep the time for accomplishment open. This is not a cop out; some goals might take longer than planned, others be accomplished quicker. It works to keep the time open where possible.

5. How much?

This may well be the most important step to get clear. Is this goal, this new resolution, a matter of life and death? Will you do absolutely everything possible to accomplish this goal? Or is it a matter a little importance? If it works out, all to the good; but if not, who cares???

This question when answered brings the previous 4 together into an intention – that motivating force that can be casual or unstoppable depending upon how much you want it. 

I remember in my sporting days, training each day was a non-negotiable; it was what I did every day and all else needed to fit in around that. When I was really ill back in the 70’s, healing was my priority and all else needed to fit in around that.

When the goal is clear and the intention is strong, amazing things happen. “Miracles” happen. 

May 2023 be a year of personal miracles for you and all you care for and about…

 

RESOURCES

Allevi8 App – free meditation practice app with options for online group teaching/mentoring

 

Digital downloads – Mind training

 

The Mind that Changes Everything

 

You Can Conquer Cancer

Mindfulness as effective as an antidepressant for anxiety

If you have some anxiety, you are not alone. Whilst in 2022, 63.4% of adults were estimated to have no anxiety, 25.5% had low level anxiety, 7.1% medium anxiety, and 4.1% were claimed to have high anxiety.

So what to do? What does the evidence say? New research published just last month has shown a guided mindfulness-based stress reduction program was as effective for patients with anxiety disorders as the gold-standard drug - the common antidepressant escitalopram. So this week, how to apply this knowledge and details of the study itself, but first

         Thought for the day

   One forgets the self, 

   Zen teachers say, 

   By becoming one with the task at hand. 

   At such moments, 

   Released from the burdens of selfhood, 

   One glimpses, however briefly, 

   A state of spiritual wholeness that underlies 

   And supports one’s everyday consciousness.



                         Andrew Cooper

Common side effects of escitalopram are listed to include trouble sleeping, nausea, sexual dysfunction, drowsiness and feeling tired. More serious side effects may include suicidal thoughts in people up to the age of 24 years.  It is unclear if use during pregnancy or breastfeeding is safe.

Research establishes common effects of mindfulness include better sleep, good digestion (and with use of our Allwevi8 app, a specific and significant drop in nausea for those affected by it), sexual satisfaction and increased energy levels. When used during pregnancy, there is likely to be increased calm and ease in both mother and baby, and breastfeeding is likely to be facilitated for the better due to this increased calm and ease.

Of note, approximately 15% of the U.S. population tried some form of meditation in 2017.

This said, anxiety disorders can be very tough. Anxiety disorders include generalized anxiety, social anxiety, panic disorder and fear of certain places or situations, including crowds and public transportation, all of which can lead to an increased risk for suicide, disability and distress. Therefore, these disorders when severe are commonly treated in psychiatric clinics. 

In October this year, the United States Preventive Services Task Force for the first time, recommended screening for anxiety disorders due to the high prevalence of these disorders.

Drugs that are currently prescribed for the disorders can be very effective, but many patients either have difficulty getting them, do not respond to them, or find the side effects as a barrier to consistent treatment.

Elizabeth Hoge, MD, director of the Anxiety Disorders Research Program, associate professor of psychiatry at Georgetown and lead author commented:

"Our study provides evidence for clinicians, insurers, and healthcare systems to recommend, include and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders because mindfulness meditation currently is reimbursed by very few providers." 

"A big advantage of mindfulness meditation is that it doesn't require a clinical degree to train someone to
become a mindfulness facilitator. 

Additionally, sessions can be done outside of a medical setting, such as at a school or community center."

Standardized mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR), can decrease anxiety, but prior to this study, the interventions had not been studied in comparison to effective anti-anxiety drugs. 

The clinicians recruited 276 patients between June 2018 and February 2020 from three hospitals in Boston, New York City and Washington, D.C., and randomly assigned people to either MBSR or escitalopram. MBSR was offered weekly for eight weeks via two and a half-hour in-person classes, a day-long retreat weekend class during the 5th or 6th week, and 45-minute daily home practice exercises. 

Patients' anxiety symptoms were assessed upon enrolment and again at completion of the intervention at 8 weeks, along with post-treatment assessments at 12 and 24 weeks after enrolment. The assessments were conducted in a blinded manner -- the trained clinical evaluators did not know whether the patients they were assessing received the drug or MBSR.

At the end of the trial, 102 patients had completed MBSR and 106 had completed their medication course. The patients were relatively young, with a mean age of 33 and included 156 women, which comprised 75% of the enrolees, mirroring the disease prevalence in the U.S.

The researchers used a validated assessment measure to rate the severity of symptoms of anxiety across all of the disorders using a scale of 1 to 7 (with 7 being severe anxiety). Both groups saw a reduction in their anxiety symptoms (a 1.35 point mean reduction for MBSR and 1.43 point mean reduction for the drug, which was a statistically equivalent outcome), dropping from a mean of about 4.5 for both, which translates to a significant 30% or so drop in the severity of peoples' anxiety.

"It is important to note that although mindfulness meditation works, not everyone is willing to invest the time and effort to successfully complete all of the necessary sessions and do regular home practice which enhances the effect," Hoge said. 

"Also, virtual delivery via videoconference is likely to be effective, so long as the 'live' components are retained, such as question-and-answer periods and group discussion."

Trial enrolment was wrapping up as the COVID pandemic started in early 2020 but most enrolees completed their eight-week course of treatment before the pandemic started. 

The researchers conducted a second phase of the study during the pandemic that involved moving the treatments to an online, videoconference, and that will be the focus of future analyses. The researchers also hope to explore the effects of MBSR on sleep and depression.

Reference: Hoge AE et al. Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults with Anxiety Disorders. JAMA Psychiatry, 2022; DOI: 10.1001/jamapsychiatry.2022.3679

NOTE The Allevi8 app with its attendant online personalised, live mentor/teaching sessions, includes mindfulness techniques as well as meditation, contemplation, guided imagery and deep relaxation.

The MYRIAD trial. World’s largest mindfulness trial, early adolescence, mostly negative results… What can we make of it?

The MYRIAD study, the largest mindfulness study ever, and just published, has trialled a particular approach to mindfulness training as a universal intervention. It was a very large, well-designed English study that included over 8,300 children between the ages of 11 and 13. It was run by a high-quality research team with a big budget. 

The results were mostly negative.

Therefore, the MYRIAD trial results pose a clear challenge to the generally high levels of confidence and enthusiasm for using mindfulness practices in school programs—which often bring with them strong claims of being ‘evidence- based’. In this study, the mindfulness intervention did not do any better than Treatment as Usual (established social and emotional learning training).

The study’s authors concluded: Universal SBMT is not recommended in this format in early adolescence. Future research should explore social−emotional learning programmes adapted to the unique needs of young people.

So how do we interpret the results? This week we take a deep dive, and also include recently published studies examining mindfulness in schools programs that did record positive findings. My own limited experience with young children in schools has been very positive, so it would be good to hear comments from any teachers or parents with their own direct experiences, but first

  

 Thought for the day

     Acquire inner peace 

     And a thousand persons around you 

     Will find peace.

St. Seraphim of Sarov, 18th Century Russian Hermit

 

Clearly, we cannot ignore the MYRIAD study; its results do fly in the face of a good body of research attesting to the positive benefits of school-based mindfulness programs for adolescent mental health and behaviour problems (see the results of three evidence-based review papers below). So, what conclusion are we to take from the MYRIAD study? Is it that mindfulness does not work, or that mindfulness works but not for people of this age group, or that mindfulness works but the program delivered was not a good program, or that the research was poorly done and therefore delivered a false finding? Well, the research team were high quality and it was a thoroughly designed and well thought through study, so it is unlikely to be the latter. Then let us explore the other possibilities.

There seem to be several issues:
1. The results could be accurate and a warning signal.

2. The study focused upon children 11 – 13. So it really says nothing clear about younger children or adolescents aged 15 – 16 etc. It may be children in primary school could usefully be grouped together, and be considered separately from those in secondary or tertiary education, but this remains to be seen.

3. The real challenge for running mindfulness programs for children is to make them interesting, relevant and to contextualise them to their lives and what is important to them. It seems many children in this study did not like the practice and did not spend time doing it. 

It appears, those who did like it, and did practice, did gain significant benefits. Perhaps they needed to be engaged better, or the children will need an opt out clause, or maybe mindfulness interventions are particularly challenging to deliver successfully to whole cohorts of students rather than just those who self-select to do it.

4. This study taught one style of mindfulness to over 8,000 children. Previous studies, where results were positive, were much smaller and may have adapted more to their limited audiences. It may be one learning from this study is the need for more prior consultation and then to adapt promotion and methodology to fit individual schools, communities and children. This is a need experienced in most public health initiatives. In other words, if mindfulness is to be adopted widely, there may be a need to be flexible with delivery and teaching styles.

5. The training provided for teachers in this study was comprehensive. Many current programs have much lighter trainings. It seems likely a high level of training is likely to be important. Some studies have shown results are better when programs are presented by external experts, rather than internal teachers. 

6. There was a small increase in some negative outcomes (e.g. more reporting of attentional problems, more obsessional traits, becoming less mindful) for some participants in the mindfulness group. Whether that is a negative outcome of the mindfulness intervention or simply an outcome of students being more aware of something they were previously not noticing is a question that is hard to answer. If the children are becoming more aware of what they were previously not noticing, then the solution is not necessarily to stop teaching them mindfulness but rather to help them to gently but mindfully work with these challenges. Possible responses to this observation might be to include better support for those students who are really struggling, and that the way we work with children be adapted to different needs.

Finally, whether this paper answers all the questions or whether it raises more questions than answers (e.g. why this program did not work, what kinds of school-based programs do work for adolescents and why?) is hard to say. It certainly cannot be ignored, but it is likely to provide a lot of impetus to naysayers, and at the same time be a challenge to people delivering whole of school mindfulness programs to reflect long and hard on what they are delivering and how they do it. 

It is clear much more research is needed – soon.

ACKNOWLEDGEMENTS

Gratitude to Professor Craig Hassed of Monash University’s Centre for Consciousness and Mindfulness Studies, and Assoc-Professor Nicholas Van Dam of the University of Melbourne’s Contemplative Studies Centre for their assistance in collating and reviewing this post.

RECENT RESEARCH

Here are recently published studies examining mindfulness in schools programs that did record positive findings.

Meta-analysis of Randomized Controlled Studies (RCTs) shows Mindfulness-Based Interventions improve the mental health and wellbeing of youth – 2019.

Mindfulness based interventions (MBIs) are an increasingly popular way of attempting to improve the behavioural, cognitive and mental health outcomes of children and adolescents, though there is a suggestion that enthusiasm has moved ahead of the evidence base. Most evaluations of MBIs are either uncontrolled or nonrandomized trials. 

In this study, a systematic literature search of RCTs of MBIs was conducted up to October 2017. Thirty-three independent studies including 3,666 children and adolescents were included.  Across all RCTs the research found significant positive effects of MBIs, relative to controls, for the outcome categories of Mindfulness, Executive Functioning, Attention, Depression, Anxiety/Stress and Negative Behaviours, with small effect sizes (Cohen's d), ranging from .16 to .30. However, when considering only those RCTs with active control groups, significant benefits of an MBI were restricted to the outcomes of Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18) only. 

Conclusions: This meta-analysis reinforces the efficacy of using MBIs for improving the mental health and wellbeing of youth as assessed using the gold standard RCT methodology. 

Dunning DL et al. Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents - a meta-analysis of randomized controlled trials. J Child Psychol Psychiatry. 2019 Mar;60(3):244-258. 

Update for the Dunning meta-analysis – 2022

The previous meta-analysis from this team (2019), suggested that MBPs show promising effectiveness, but highlighted a lack of high-quality, adequately powered randomised controlled trials (RCTs). This updated meta-analysis assesses the-state-of the-art of MBPs for young people in light of new studies.

Sixty-six RCTs, involving 20 138 participants (9552 receiving an MBP and 10 586 controls), were identified. Compared with passive controls, MBPs were effective in improving anxiety/stress, attention, executive functioning, and negative and social behaviour. Compared against active controls, MBPs were more effective in reducing anxiety/stress and improving mindfulness. In studies with a follow-up, there were no significant positive effects of MBPs. No consistent pattern favoured MBPs as a universal versus selective intervention.

Conclusions The enthusiasm for MBPs in youth has arguably run ahead of the evidence. While MBPs show promising results for some outcomes, in general, the evidence is of low quality and inconclusive. We discuss a conceptual model and the theory-driven innovation required to realise the potential of MBPs in supporting youth mental health.

Dunning D, Tudor K, Radley L, et al. Do mindfulness-based programmes improve the cognitive skills, behaviour and mental health of children and adolescents? An updated meta-analysis of randomised controlled trials. Evidence-Based Mental Health 2022;25:135-142.

Mindfulness leads to less disruptive behaviour - 2017

The purpose of this meta-analytic review was to add to the literature by synthesizing single-case research on Mindfulness-Based Interventions (MBIs) with children and adolescents. Specifically, the effect of MBIs on youths’ disruptive behaviour was examined in 10 studies published between 2006 and 2014. Results indicated that, on average, MBIs had a medium effect on disruptive behaviour during treatment. The average effect of MBIs during maintenance phases was larger. Potential moderators of intervention effects were also explored. Implications for future research and practice regarding MBIs with youth and in schools are discussed.

Klingbeil D et al. (2017). Effects of Mindfulness-Based Interventions on Disruptive Behavior: A Meta-Analysis of Single-Case Research. Psychology in the Schools. 54. 10.1002/pits.21982.

How well do Mindfulness-Based Interventions work for school children? - 2022

This systematic review published in 2022 set out to assess the current literature on mindfulness-based school interventions (MBSIs) by evaluating evidence across specific outcomes for youth. 

The researchers evaluated 77 studies with a total sample of 12,358 students across five continents, assessing the quality of each study through a robust coding system for evidence-based guidelines. The highest quality evidence ('A Grade') across outcomes indicated that MBSIs increased prosocial behaviour, resilience, executive function, attention and mindfulness, and decreased anxiety, attention problems/ADHD behaviours and conduct behaviours. 

The highest quality evidence for well-being was split, with some studies showing increased well-being and some showing no improvements. The highest quality evidence suggests MBSIs have a null effect on depression symptoms. 

Conclusion: This review demonstrates the promise of incorporating mindfulness interventions in school settings for improving certain youth outcomes. The authors urge researchers interested in MBSIs to study their effectiveness using more rigorous designs (e.g., RCTs with active control groups, multi-method outcome assessment, and follow-up evaluation), to minimize bias and promote higher quality - not just increased quantity - evidence that can be relied upon to guide school-based practice. 

Phan ML et al. Mindfulness-based school interventions: A systematic review of outcome evidence quality by study design. Mindfulness (N Y). 2022 Jul;13(7):1591-1613. 

Discriminating Awareness

Everyone loves a good story. What follows is one of the best, that is then garnished with a particularly fine piece of political spin. But is comes too with a caveat that is worth pondering, so this week, enjoy a great story and what it has to offer, but first

Thought for the day

The teachings of the Buddha are skilful means; 

They are not absolute truth. 

The Buddha said,

“My teachings are a finger pointing to the moon. 

Do not get caught in thinking that the finger is the moon. 

It is because of the finger that you can see the moon.”

JUDY Rudd, is an amateur genealogy researcher in southern Queensland and has been doing some personal work on her own family tree. She discovered that Prime Minister Kevin Rudd's great-great uncle, Remus Rudd, was hanged for horse stealing and train robbery in Melbourne in 1889.

The only known photograph of Remus shows him standing on the gallows at the Melbourne Gaol.

On the back of the picture Judy obtained during her research is an inscription: 

Remus Rudd, horse thief, sent to Melbourne Gaol 1885, escaped 1887, robbed the Melbourne-Geelong train six times. 

Caught by Victoria Police Force, convicted and hanged in 1889.

So Judy emailed Prime Minister Rudd for information about their great-great uncle.

Believe it or not, Kevin Rudd's staff sent back the following biographical sketch for her genealogy research:

Remus Rudd was famous in Victoria during the mid to late 1800s. 

His business empire grew to include acquisition of valuable equestrian assets and intimate dealings with the Melbourne-Geelong Railroad.

Beginning in 1883, he devoted several years of his life to government service, finally taking leave to resume his dealings with the railroad.

In 1887, he was a key player in a vital investigation run by the Victoria Police Force. 

In 1889, Remus passed away during an important civic function held in his honour, when the platform upon which he was standing collapsed.

Sounds believable; almost appealing...

But then, there is truth, there is political spin, and there is fake news.

Sad to say, this story comes under the heading of fake news. Much as we might like to think dear Mr Rudd would spin a story about an errant ancestor, it just ain’t true.

Although the man in the picture was indeed a train robber, his name was not Remus, nor was he Australian. Thomas “Black Jack” Ketchum was a train robber in America, hanged in 1901 in Clayton, in the US state of New Mexico. 

The photo became famous partly because, according to a Colorado Encyclopedia entry none of his executioners were experienced at hangings, which led to Ketchum’s decapitation when his body fell through the gallows.

While Ketchum did have siblings it is unlikely he is related to any of the politicians that this long-running internet hoax has linked to the photo of his hanging.

So a great story. Not a true story, but a great story; and all the better as it can provoke us to reflect upon how readily we might take a story to be true, to be spun or to be false. 

Separating fact from fiction... Discriminating awareness.

 

Contemplating death can bring you more alive

Consider this an odd title? Maybe… However, we all know that one day we will die; and that leaves us all with a fundamental choice. Do we live our life in fear and denial of death, or do we live a life informed by death? It is obvious our attitude to death heavily informs how we live.

The basic proposition is that while the first option has more immediate appeal, the latter will actually serve us much, much better. 

Contemplating death can bring you more alive. 

Contemplating death can change your life for the better...

So this week, how to contemplate death constructively? How to plan for a good death? All prompted by me speaking on this theme for the Vajrayana Institute’s free online conference Dharma in Daily Life on Saturday the 8th October, but first

     Thought for the day

         What a beautiful and what a healing mystery it is 

         That from contemplating, continually and fearlessly, 

         The truth of change and impermanence, 

         We come slowly to find ourselves face to face, 

         In gratitude and joy, 

         With the truth of the changeless, 

         With the truth of the deathless, unending nature of mind!

                                             Sogyal Rinpoche

Reflect for a moment… 

It is clear… Fear and denial of death lead to either a defensive life, or a cavalier one. To withdrawal, to holding back, to anxiety and instability. Or to extravagance, bravado, risk taking, to the eat, drink and be merry for tomorrow we die style of living.

By contrast, a life informed by death means we take nothing for granted, we appreciate all we have, we make the most of relationships, we leave as little undone as possible. We are more present, more engaged, more grateful. More truly alive.

Most of us reach adulthood with little real reflection upon death. If, and when, we do realise the merit of doing so, then the question arises, how do we do it? 

Having worked with thousands of people facing life-threatening illness over 4 decades, what follows is a summary of the guidelines we shared in our self-help, lifestyle-based programs, and is reproduced from my book You Can Conquer Cancer - available as an audio book or in hard copy. 

May this checklist be of use for you, and if you follow through, you may well come to experience how contemplating death can bring you more alive.

END OF LIFE CHECKLIST                           

i) The practical matters - “getting your affairs in order”  

·            Prepare or update your will.

·            Attend to your financial affairs and ensure your partner can access joint accounts and other key financial and legal matters if necessary.

·            Create an Enduring Power of Attorney (a simple Power of Attorney ceases if you become incapacitated).

·            Consider establishing a Living Will or Enduring Power of Attorney – Medical Treatment form. This will set out your preferences and directions for end of life treatment options. These directions would provide guidance to medical staff and family if you become incapacitated, are not likely to recover, and choices need to be made regarding being left to die naturally or to have major interventions. You can also mention the levels of pain medication desired (maximum or minimal) and whether you would elect to have CPR (cardiopulmonary resuscitation) if your heart were to stop in this end stage of life. You could also nominate who you might want present (or absent) at the end of life and indicate a preference for being at home, in hospital or a hospice.

·            Consider your possessions. Do you prefer for some items to go to particular people? If so, make sure this is clear; maybe consider giving some things away while you are alive.

·            Designate who you wish to look after any children, parents or other dependants if you and / or your partner were to die. Make sure the designated people know and agree.

·            Complete as many of the tasks in your life as possible. Give priority to your “Bucket List”. Aim to die free of regret for things left undone – either do them or let them go.

ii) Communicate. Do not die leaving people wondering!

·            Express your love. You may think they know, maybe they are psychic, but tell them anyway!

·            Consider leaving messages for significant people to be read or viewed at significant times. This can be particularly useful and comforting if you have young children now. Ideally, your write or record your messages and deliver them in person on the 18th birthday or at the wedding; but if you are not there, the message will have real meaning.

·            Consider documenting your life. You could simply create a photo album from childhood on, or collate any old videos or DVD’s. Or you could be more personal and specifically record your insights, reflections, regrets, passions etc.

·            Forgive. Forgive. Forgive. Resentment is like a cancer in itself. Forgiveness heals the heart and sets us free. Review the forgiveness section in the Healthy Emotions chapter and do it! Forgive others. Forgive yourself.

iii) Immediately after death

·            What preferences do you have for your body? Should it be left undisturbed for a while, and if so, for how long? In hospitals especially, there is often a need to clear beds for the next person (a tough reality), but family and friends may find great value in being able to sit quietly with the body after death. Also some spiritual traditions indicate there is real benefit for the person who has died if the body is left undisturbed for even up to 3 days after death. This length of time may not be practical, but you may choose to indicate your own preference.

·            What procedures do you want carried out with your body? Have you registered for organ donation? Embalming is a highly invasive procedure and only legally required if the body is being transported internationally. Have you a preference for who should wash the body and what clothes it will be dressed in?

·            Have you a preference for a particular type of coffin or casket?

·            Burial or cremation? Where?

iv) Funeral Service

·            Do you want one? If so, will it be closed to include only the immediate family, or open for everyone who wishes to attend? Be reminded a funeral can help those left behind a great deal and consider wherever possible what will help them.

·            Where will the service be held and who will officiate – a civil celebrant or a member of your religious tradition?

·            What style of service? Traditional according to your religion? Themed such as New Orleans Jazz? What emphasis will there be on the celebration of life and the grief of loss?

·            What music, poems, readings to include? 

·            Who will speak? Who gives the main eulogy? Will others reflect on your life, offer readings etc?

·            Are there particular interest groups to include and feature such as sporting or service clubs?

·            What about after the funeral? Will there be a wake? If so where, who organizes it and how will it be financed and provided?

v) Anything else important?

If so add it to your list.

A healthy lifestyle makes for a good death

A surprising number of people make the mistake of approaching death in an unhealthy way. Some people tell me “I tried the diet and the meditation. It helped for a while, but now I am approaching death I am going back to my old way”. This is a crucial point. Eating well makes it easier to die well. Why? 

Because heavy foods and junk foods add a burden to your system. High fat diets make for sticky blood and lead to higher risks of embolism, stroke and heart failure. Bad diets promote inflammation that is both uncomfortable and is likely to aggravate any health issues you have. Bad diets are degenerative, whereas our healthy diet is regenerative and anti-inflammatory. Meditation is also anti-inflammatory and regenerative, whilst it also clears the mind, reduces anxiety and pain and helps us connect with who we really are.

If I thought I was really closer to dying rather than just the fact of knowing I could die any day, I would be even more particular about what I ate and drank, and I would meditate even more than the average one hour per day I do currently.

Be gentle on yourself. 

Live well and die well.

Contemplating death can bring you more alive. 

The Allevi8 meditation app is changing

One of the few constants in life is change. 

Many of you who read this blog have downloaded the Allevi8 meditation app I have been involved in developing, so thank you for the support.

This is to advise of significant changes we plan around Allevi8’s content, the opportunities it will provide to meet online with experienced meditation teachers, and how the pricing will change, but first

   Thought for the day

           Happiness is your nature.

           It is not wrong to desire it. 

          What is wrong is seeking it outside

          When it is inside

                      Sri Ramana Maharshi

Our Allevi8 app has been developed to help people with a serious intention to meditate, to do so regularly and well. We are particularly focussed upon sharing techniques well proven to assist those affected by physical or mental illness; including stress and anxiety.
Two years on since our launch, we have received a good deal of positive feedback, whilst the evidence-base provided by published research grows stronger and stronger. However, we realise there is more we need to do to best meet our aims. 

Maybe you can relate to the big issue… 

We all know, and the research makes it very clear; the more we meditate, the more we benefit. 

No surprise there. 

However, over decades now, I have asked 2 important questions of literally thousands of people during meditation workshops, conferences and retreats, with disconcerting results. 

First question: Over the last few weeks, who feels they have done as much meditation practice as they would personally have liked? 


A. Only a very small percentage say Yes

Second question: Over the last few weeks, who feels well satisfied with the quality of their meditation practice? 

A. Again, only very small percentage say Yes; the rest, an often forlorn NO.

So Allevi8 was actually born out of this knowledge. 

We knew many people would like to practice more, and many feel their experience of meditation could be better. 

We had hoped the accessibility of the app, the targeted techniques for specific issues such as anxiety and sleep disorders, along with our innovations of the weekly group meditation and the more recently introduced online mentoring would make a difference. 

And while the feedback has been good, and the numbers of people using Allevi8 builds steadily, our own research makes one thing very clear. 

Those who do engage with our online mentors are practicing significantly more often than those who do not. Also, they are feeling better about their experiences in meditation, and perhaps of greatest significance, they are reporting significantly better health and wellbeing outcomes.

So we can make a common observation… We each take up meditation with good intentions, but then all too often life gets in the way, and the resolve to practice daily slides into the reality of occasional practice. Worse, it is when we are stressed or unwell we need to meditate more, and often at these times we put off our practice even more.  

How then to turn this around? 

Because all of us at Allevi8 are passionate about meditation, we want to provide the best service through the app that we feel is possible. We envision Allevi8 as a high quality, innovate app committed to providing the best outcomes for its users. We are not so interested in just having more people use the app, we are committed to providing a meditation app with related services that provide the best possible support to build regular and satisfying practice.

With this in mind, we plan to continue to provide access to all the tracks on Allevi8 for free. However, for those who want the full benefits, for those keen to practice regularly and well, we are introducing a new 'Group Mentoring' offering. This will provide access to the weekly group meditation sessions: Allevi8@8, along with access to a small group mentoring session once each month. It seems clear from our feedback and internal research, that providing access to online support from our trained meditation teacher/mentors makes a significant difference.

To be transparent, we also need a system that will enable Allevi8 to become financially sustainable. For example, over the past 2 years, all our mentors have donated their time to contribute to Allevi8@8. We hope you will appreciate and understand the need to change the cost structure at the same time that we are increasing what we are offering through the app. 

Along with the option of the free Allevi8 app, we feel this new paying model is an ideal, cost-effective combination to provide ongoing support that in turn leads to sustained and effective practice. 
Priced at AU$30 per month (inc GST), the new offering will include the weekly Allevi8@8 sessions (which will no longer be free as of November 2022), and a further practice session each month in a smaller group of up to 6 participants, also led by one of our Meditation mentors. 

The Allevi8@8 sessions will continue as they are now - in that they will focus on a particular practice within the Allevi8 app and feature one of our meditation teachers sharing some interesting background, theory and tips before leading us through the practice.

For the new monthly teaching and practice sessions in small groups, we will make available multiple sessions through the month at different times, with each session geared to focus upon one of the seven issues featured on the Allevi8 app. Each of these groups could contain anything from one person up to six as a maximum. You will receive an e-mail at the beginning of each month, showing you the available sessions for the month. You can simply choose which issue you wish to work on that month and book yourself into a corresponding session. 

Also, we will continue to provide mentoring on a one to one basis for those who would like even more personalised attention and support. 

I do hope this new offering is of interest, and invite you to go to allevi8.net  where you can sign up for Group Mentoring. 

With sincere thanks for your continued support and best wishes; may your daily practice flourish...



 

 

How to get the most from treatment

If you have been diagnosed with a significant illness, you will probably have endured enough bad news already… So it is a pleasure to be able to bring you some good news – and to share some wonderful new techniques freely via the Allevi8 app.

I am one of those fortunate people who has been through some very tough health challenges, endured, survived, and learnt from it all. So in the spirit of sharing this good fortune, those of us involved with Allevi8 have added a new section to the app specifically on how to get the best from any treatment you may receive, including how best to prepare for surgery. In all, there are 8 new tracks and these are listed below... And remember, the access to all of this on the Allevi8 app is free, with a Pay it Forward option. 

So this week, how to get the best from your treatment, but first

       Thought for the day

When given a challenging situation
Your brain has not encountered before,
It can reorganise and restructure to respond to that situation.
The more often your brain is exposed to that new challenge – like learning a musical instrument, for instance –  the more it reorganises and makes that path more established.
Our brains are constantly being shaped wittingly or unwittingly – most of the time unwittingly
We are raising the possibility to intentionally train our brains to improve well-being.                          

                          Professor Richard Davidson

 

Consider this...

How much difference can you make to anything you do? Seems to me there is common sense in this. Clearly when it comes to healing, there is what can be done for us – and what we can do for ourselves. If we are fearful, anxious, confused, it may well be we end up working against our treatment. 

So the exercises here are intended to help you to feel empowered; clear in your mind, at ease and relaxed, confident to work with and get the best from your treatment.

But first a little history. As a young veterinarian, I developed bone cancer in my right leg and it was amputated in 1975. The cancer re-appeared later that year and despite a very short prognosis, and with the help of medical and self-help lifestyle based measures (like meditation, good nutrition exercise and so on), I was fortunate to recover against the odds. 

In response to many enquiries around what had helped me, I went on to co-found the world’s first lifestyle-based self-help programs for people affected by cancer and multiple sclerosis.

So by now, the mind-body exercises we share on the Allevi8 app have been well tested through decades of
clinical experience. 

They are well supported by a growing body of research and I have gathered, summarized and made available key research papers on the allevi8.net website.

How then to use this section of Allevi8 and to get the best from your treatment?

The first thing I would encourage you to do is to have some confidence. I have personally witnessed these techniques make a big difference in the lives of many people. I have seen many people who started treatment fearful and anxious, who quite quickly found inner peace and a clarity of conviction.

Clearly with any treatment there is a natural distribution where most people get an average response, some do not so well, and some do particularly well. It is my belief, and my experience, that using these techniques regularly can give you the best chance of getting the best from your treatment.

So what to do? 

If you are dealing with significant illness and receiving treatment, the suggestion is to do two of the exercises in this section of the app daily; if you are really keen, even three.

The suggestion is to practice what we call in this section of the Allevi8 app the Daily Healing Meditation at least once each day. 

This exercise will guide you into a deep relaxation of body and mind. 

As you do relax more deeply like this, your body settles into its own natural balance. 

The key principle behind all this is that when your body is in balance, all your body’s natural healing capacities come to the fore, and as such, they create an ideal inner environment in which to heal.

So this main Daily Healing Meditation is all about relaxing deeply and letting go. 

Some people find it so helpful they actually do it 2 to 3 times daily. 

But there are more possibilities...

In this section of the Allevi8 app, two other key exercises support this main practice. There is Relaxation with Harp (featuring Peter Roberts), and the shorter Rapid Relaxation. This latter exercise is ideal to do discretely when wanting to relax before an appointment, or if you feel tension rising through the day and want to let it go… You can experiment with both and it will be obvious to you whether they are helpful or not for you.

The remaining exercises in this section of the app involve guided imagery that more specifically engage with your treatment, including radiotherapy and preparing for surgery. These exercises use powerful principles of mind-body medicine and can act synergistically with the relaxation-based exercises.

To repeat, the spirit of experimenting is important. People are different and that is why we have different exercise on the app. Best to try the other exercises in this section of the app and notice which ones resonate; which ones you are drawn to and feel good doing. Ideally do one of these extra exercises at least once daily. Also, you may find exercises from other sections of Allevi8 helpful in your healing journey. Let your own inner wisdom guide you here.

Now a heads up… 

We are in the final stages of developing a new model for those wanting more guidance and support with the Allevi8 techniques. Once released, if you join this new Allevi8 Group Mentoring Program you will have access to a monthly small group mentoring session in a group of up to 6 like-minded people. Each group will be led by one of our highly trained and experienced meditation teachers and mentors. Each of these groups will address one of the sections from the app, so it could be Getting the Best out of Your Treatment, or Better Sleep, Managing Stress, Healing and so on… So if you do have questions or need clarification, you will be able to ask there. Also, these Allevi8 Group Mentoring sessions will include a personally guided practice. You will find the link to the new program and these sessions on the app once it is released, and we will notify everyone once it is released.

Next, the Allevi8 Mentoring Program will also include access to our weekly Allevi8@8 sessions, where as many of you will know, in a larger group you will receive extra guidance and support, along with a guided practice led by one of our mentors. 

These Allevi8@8 sessions are presented weekly with a highlight being the very popular Healing Meditation sessions held on the first Monday each month.

Finally, just to say all of us here at Allevi8 have a deep commitment to assisting you in your healing process. We have a deep respect for what can be done for you – and what you can do for yourself. Get the best from both – from your treatment and your own efforts – and truly remarkable things become possible.

Please do give us feedback and let us know how we can support you best.

Our wish is for you to recover quickly and fully, 

That you do gain the best from your treatment, 

And that you do go on to have a long, happy, and fulfilling life.

 

The Allevi8 tracks: Getting the most from treatment

1. An Introduction recorded on video from Ian Gawler

2. The Healing Journey – guided imagery based upon a series of archetypal healing images 

3. Relaxation with Harp – the progressive muscle relaxation exercise without the step of contracting the muscles, but including the wonderfully soothing and healing harp of Peter Roberts

4. Rapid Relaxation – a short deep relaxation exercise using breath and gentle movements

5. Daily Healing Meditation – the full relaxation, mindfulness into stillness meditation practice for regular use

6. Preparing for surgery – what can help develop a positive state of mind plus how to use imagery to make the most of surgery

7. Working with my medical treatment – featuring Cathy Brown, the Allevi8 head of our therapeutic meditation mentor’s group. A series of relaxations and guided imagery pieces designed to get the best from drug treatments; and to minimize any potential side-effects

8. Working with my radiotherapy – similar to the treatment exercise, but here using guided imagery and light to work with radiotherapy; and again, to minimize any potential side-effects.

Mindfulness, compassion fatigue and burnout

Here is a fact. It could be good or bad. Most people who meditate and become more mindful, quite naturally become more aware of the suffering of others and become strongly motivated to help.

When it becomes “bad” is when people overdo helping others while neglecting themselves. This seems to come naturally to many, but is clearly far from ideal.

Burnout is the feeling of chronic and deep-seated exhaustion we can experience when repeatedly we have taken on more than we can handle. 

Amidst all the turmoil of the past few years, burnout has become rife, so this week a little on what burnout is and what might help to prevent or treat it, but first

     Thought for the day

         If the problem can be solved, 

         Why worry? 

         If the problem cannot be solved, 

         Worrying will do you no good.

                                      Shantideva 

This is an unusual blog. 

I had intended to write it myself, but in researching the topic came across this great article from Karen Kissel Wegela PhD, and decided that given the article is in part about avoiding burnout, I would be generous to myself and share her terrific article.

Karen is a psychologist in private practice and a professor in Naropa University’s MA Contemplative Psychotherapy and Buddhist Psychology department. Her most recent book is Contemplative Psychotherapy Essentials: Enriching Your Practice with Buddhist Psychology.  She writes, and I quote:

In the past few months I have been feeling overwhelmed by a variety of events in my personal and professional life. Among other things, I am about to step down after fifteen years as director of the M.A. Contemplative Psychotherapy program at Naropa, and I feel like I am handing “my baby” into other hands.

Transitions, even ones that we seek out, are challenging. I am experiencing what helpers call “burnout,” and it is showing up in my body, my emotions, and my mind.

Burnout refers to the kind of exhaustion or feeling of overload that professional and other helpers sometimes experience when they have taken on more than they feel that they can comfortably or appropriately handle. 

Physically, burnout can manifest in exhaustion, muscle tension, clumsiness and dizziness. 

Emotionally, we might find that we have hair-trigger reactivity. 

Feelings of anger, sadness and even depression are not uncommon.We might feel hopeless and inadequate.

Angry outbursts and tears might pop out at seemingly silly things, and our minds might feel chock full of thoughts that whirl rapidly from one topic to another. One of the most pernicious symptoms of burnout is the belief that there must be something terribly wrong with us to find ourselves in such a state. 

We lose all sense of maitri (unconditional friendliness to all aspects of our experience). Instead we become self-aggressive. This is especially easy for helpers to do. We are likely to habitually buy a storyline about ourselves as being helpful, useful people, and in situations where that storyline is not being supported, it is a blow to our attempts to create an ego based on seeing ourselves as “helpers.” Doubts about who we are get added to our other feelings of distress.

Often the way we deal with what comes our way is at the root of burnout. There is much we can do to work with preventing it, as well as with working with it when it occurs.

One of the biggest causes of burnout is the desynchronization of body and mind.

First we ignore small cues that we are not fully present: we do not get enough sleep or food, or we over-schedule ourselves. 

This leads to still more separation of body and mind, as we speed up to accomplish more. 

If we ignore these initial signs of burnout, we might become physically ill or even more mentally frazzled.

An additional cause is becoming attached to outcomes. 

If we are focusing on what will happen in the future, we lose track of the present moment. This happens a lot for professional helpers: we want so much for the situation to improve, we want the person we are trying to help to feel better. This is exhausting, and it makes us less helpful since we are only partially present.

There are four key ideas in working with and preventing burnout. 

The first is bringing ourselves into contact with nowness. 

The second is learning to make realistic choices about what we can and cannot accomplish. 

The third is cultivating maitri. 

The fourth is getting help from others instead of trying to do it all alone.

If we can bring ourselves gently back to this moment, this body, this place, we can start to slow down our wild minds. Bringing body and mind back into connection in the present moment helps us discriminate between what is actually happening and what we fear or hope is happening. This is an enormous help. Making choices about what we can and cannot realistically do is also based on being grounded in the present moment.

The simplest thing to do is to breathe.

Taking some breaths and paying attention to that experience can help us feel grounded. When we feel burnt out, especially if we are anxious, we tend to hold our breath.

Noticing our sense perceptions can help us reorient to this place in this moment. 

While writing this morning, I suddenly realized I had forgotten to start the crock-pot for dinner. I dashed off to take care of it and then left for my day’s appointments. On the way home, I forgot to pick up the cat and had to circle back to the vet’s.

So, now that I am back at my computer, I am taking some of my own advice. 

I am enjoying some mindful breaths. 

I am looking up and noticing the trees and fields outside the window. 

These things are helping me be right here, right now. 

My mind is slowing down a bit, and my heart is softening. 

As I tell you of the mindless things I did today, I feel some humor and maitri. I am practicing feeling whatever arises and letting it be just what it is, instead of what I would prefer it to be. 

So these are some ways to practice the first three key ideas.

The fourth thing that I can do is to get some assistance and support from my friends, family and colleagues. I can go for a walk with a friend. I can ask someone to help with all of the picking up and dropping off of animals. 

And for professional helpers, it is always important to engage in on-going supervision or peer consultation to prevent personal difficulties from affecting one’s work with others.

Most importantly, I can walk myself into my meditation room and sit down on my cushion. I can let go of the false sense of urgency that there is something else that I must be doing at this second.

A number of years ago I worked with a client who was a Naropa student and a meditation practitioner. He told me something that I often reflect on. 

“You know,” he said, “when I’m really busy and don’t have time to practice meditation, I never have enough time. But if I do practice, then somehow there’s more space, and I have enough time for everything.”

 

A reminder of Allevi8

Allevi8 is an app specifically designed to support people affected by significant physical or mental illness. It has sections directly relevant for anyone seeking to prevent or recover from burnout; especially the sections such as Managing Stress, Finding Meaning and Purpose in Challenge and Better Sleep. 

Search Allevi8 in your App store.

 

Finally, maybe this is also helpful…

Mushim Patricia Ikeda’s “Great Vow for Mindful Activists,” which I invite you to take right now:


Aware of suffering and injustice, I, _________, am working to create a more just, peaceful, and sustainable world. 

I promise, for the benefit of all, to practice self-care, mindfulness, healing, and joy. 

I vow to not burn out.”

Helping others relies upon you helping your own good self

Enjoy

Prevention or Cure? Latest official figures point to a life-changing choice

Almost half of us have one or more chronic health conditions and these conditions make up our leading cause of death. 

Would you prefer to read about statistics – or become one? 

Challenging question maybe, but when it comes to our health, it is clear that collectively Australians are not doing too well. In this post, a summary of the bi-annual report on our national health issued by the Australian Institute of Health and Welfare (AIHW); and then the choice…

Become a statistic, or read about them, and if you prefer reading, details of the one thing most likely to assist you to avoid becoming that statistic, but first, one of my own quotes seems relevant for this topic:

    Thought for the day

        To change your habits - the way you function

        First change your beliefs - the way you think

                     Ian Gawler

Almost half of all Australians have one or more chronic health conditions and these conditions make up our leading cause of death. 

While the cause or causes of any one individual’s health condition is likely to be complex, and having had what is well described as a major chronic degenerative disease myself; this post is not about blaming or shaming those who do have such conditions, but is all about encouraging those who are basically well to truly appreciate their current good health and realise there is plenty you can do to maintain that good health.

Here are 2 simple facts:


1. The major identifiable causes of chronic degenerative disease are lifestyle related

2. Lifestyle changes are known to significantly aid in recovery from chronic degenerative disease.

Here is a simple choice:


1. Get in early, adopt a heathy lifestyle and do all possible to not only avoid developing a chronic degenerative disease, but to experience chronic good health

2. Ignore the connection between lifestyle and health, hope for the best, and if the worst does turn up and a chronic disease ensues, then take up a healthy lifestyle to compensate.

Why is this choice so important? 

A staggering number of people alive today are dealing with major physical and mental health issues.

Every 2 years, the AIHW publishes its analysis of our collective health

 It makes for tough reading – and drove the writing of this post… 

Key points:

• Almost half of all Australians have one or more chronic health conditions

        •      Chronic conditions are the nation's leading cause of illness, disability and death

• Coronary heart disease and dementia are the leading causes of death overall

• For young Australians, accidents and suicide are the leading causes of death

        •      Over one third of Australia's "disease burden" is due to preventable risk factors, such as smoking, physical inactivity and poor nutrition

• Two in three Australian adults are overweight or obese

• Three in 10 adults do not get enough physical activity

• Less than one in 10 adults consume the recommended amount of vegetables

        •      Some good news - smoking rates have fallen to a record low of just 11 per cent

        •      One in two Australian adults experience a mental health disorder during their lifetime

        •      Average levels of psychological distress were higher in 2020, 2021 and early 2022, especially in younger people, and there was also an increase in self-harm and suicidal ideation presentations to emergency departments

• In 2020, an average of nine people died every day by suicide

        •      More than half of all deaths by suicide were among people aged 30-59, and males were three to four times as likely as females to take their own life

• $202.5 billion was spent on health in 2019-20, about $7,900 per person

• Children born in 2020 can expect to live to 83 

AIHW: Australia's Health 2022

About the only statistic listed I would be happy to be associated with is the one where so few people are smoking these days (not that I ever did fortunately).

The rest of these statistics do strike me as something of an inditement against our culture. Almost half of us have a chronic disease. Around half experience mental health disorders during their life! $202.5 billion spent on health on one year. Something is not working…

What to do?      While there is obviously no simple fix, consider this… 

1.     What decides what you eat, and how much of it?

Not who – we know who that is, at least primarily, that would be you. No not who, what decides? 

2.     What decides what you drink, and how much of it?

Is it “just” a
habit? Or a craving? If so, where does that habit or craving reside???

3.     What decides how much you exercise?

Clearly for all these crucial lifestyle factors, it is our mind that decides. And if our mind is confused, mis-informed, agitated, stressed, anxious, depressed, angry, jealous and so on; clearly that mind will not function at its best and is highly likely to make choices that will prove difficult either in the short term, or long term.

Is there a simple answer?

 No. But there is a guaranteed sensible starting point – work on your mind. The more we have inner peace, clarity and contentment, the more likely we are to notice what impact our lifestyle choices have on us and those around us, and the more we are likely to make good lifestyle choices.

Having worked in Lifestyle Medicine for nearly 50 years, I am convinced the best self- help technique, the best act of kindness we can offer to ourselves, is to learn to meditate and then maintain a regular (as in daily) practice.

Hence my commitment to teaching meditation. 

Hence my commitment to developing and making accessible the Allevi8 meditation App. 

Hence my tendency to get carried away as an advocate for meditation! 

But this bit is simple...

Regular meditation does bring mental clarity, inner peace and contentment, and while these 3 are worthwhile in their own right, the more you experience them in your own life, the better choices you are likely to make concerning that life. Good health, as well as healing, starts in the mind...

Happy Meditating!!!