User:Tjlavend/mbcpm course

Mindfulness Based Chronic Pain Management Facilitator Course, Aug. 8-10, 2012, Toronto

notes:

August 1010 years experience Knowledge came through osmosis Cp patients felt misunderstood Patients who are ready do better 40 to 60 people per course Patient usually initiates course enrollment Look up Linda Thompson re mindfulness and pain

Use pain catastrophizing scale to measure - significant changes over the course Test with 350 pain patients - randomized, offer to taper off meds

Keep questionnaires brief - patients have low tolerance for them Yoga doesn't work - patients are apprehensive of movements Highly sensitive individuals - see Aron Genetic predisposition to pain but nurture also involved Adversity + predisposition + age 70 percent women, average age of 45 Hyper vigilant individuals - helpers, but don't look after themselves, as too busy looking after others

Sleep prolems, no deep, restorative sleep Hemispheric synchronization - machine helps keep them in delta stage - helps sleep - this is Trudy from Thunder Bay Acceptance is a dirty word, don't tell them they have to accept their condition

Module 1 Get comfortable Ease in during the first four sessions Most will want to sit in a chair, you should do the same Volunteers to help others if the is a large group Keep voice low and gentle Introductions - first name only plus handle - handle not related to either their pain or their occupation Don't talk about your illness Groups of 2 or 3 with a spokesperson

Switch groups after first class Remember: highly sensitive = highly judgmental Breaks are important Quiet bells or gongs to start and finish meditations - cp sufferers are sensitive to sound Some people will have breathing difficulties and will not want to focus on the breath - let them focus on something else This is not distraction - this is pain management Ask them to observer how much they judge over the week Mindful movements remind some of them of the parts of the body that don't work Patients don't like to role-play - makes it more painful

Module 2 - self-care

Genetics - epigenetics - environment - genetics Mild dehydration exascerbates pain - remnd them to keep hydrated Meditation is the foundation - leads to self-care, better nutrition, exercise 300 per course x 3 times a year Up to 30 in one room

Module 3 (chapter 9)

Pain patients may be in abusive relationships Mindfulness can only help so much Responses - flight, fight, fear, fluff Usually only see cp patients on their good days - avoid contact on their bad days Mime or slow motion for aikido 3 You cn't change the other person, you can only change yourself Aikido 4 comes in many forms Lake meditation - can it, should it, lend itself to virtual reality and/or visualization? Peer interaction is very important, but facilitator needs to be there and vigilant

Art therapy - not everyone will do it, and not everyone who does it will be willing to share it - some will share it later, but don't force anyone Thank them for doing it - it takes courage but you and the others will benefit Respond to the art, don't interpret it Okay to feel strong feelings because they will pass

Don't ask about people's handles and don't ask for last names Stress that whatever goes on in the group stays in the group Be the guide on the side, not the sage on the stage Be skillful in preparation for mindful moments - give them permission not to do them if it hurts - humming - loosens people up

Room meditation Dsn't have to be a room Okay if the room changes- think about why it changes

If you can't visualize a room, think about why not The self they look at is sometimes themselves as a young child or otherwise before the pain

Room relates to the artwork Similar to ACT? Remind them that the present strong emotion is not permanent Need to be flexible as to the agenda for each class Last class - have th talk about key words and phrases from the book The future - what are you going to be doing with your meditation?

This is an entry level course - for the majority who can manage Many need to repeat Level 2 course - same book, same sequence but in more depth, e.g., start with 20 minute meditations, not 5 minutes Pain scale is not much use - qualitative changes are more important, though catastrophizing scale shows significance <iPad/iPhone app to help? E.g., which aikido is this, taking meds?>

Populations to exclude: borderline patients not in remission, some mental health disorders, rudimentary English skills, moderate to severe deafness, addicts who are still using, epileptics likely to have seizures

Can videotape with patients' permission

Needs to be slowly and safely rolled out - consult with Jackie by email and Skype Accreditation will come later

Go for 12 people knowing that 3 or 4 will drop out