S6E21 Webinar Highlights: Reducing Stress through meditation and mindfulness with Dr Phil Startin

Phil Startin  00:00

That’s very consistent with the definition of the Jon Kabat-Zinn. His operational definition of mindfulness, which he calls paying attention in a particular way, on purpose and with no judgment. But there’s a lot more to mindfulness. And there are other ways of thinking about mindfulness.

Overcoming MS  00:23

Welcome to Living well with MS. This show comes to you from Overcoming MS, the world’s leading multiple sclerosis healthy lifestyle charity, which helps people live a full and healthy life through the Overcoming MS program. We interview a range of experts and people with multiple sclerosis. Please remember, all opinions expressed are their own, Help others discover Living Well with MS. If you enjoy the show, please rate and review us wherever you listen to podcasts. And now let’s meet our guest. Today’s episode features highlights from the Reducing Stress Through Meditation and Mindfulness webinar with Dr. Phil Startin recorded live in front of our global audience as part of the Refresh with OMS webinar series. To join us live for the next webinar. Or to watch the original presentation, head to our website, overcomingms.org.

Phil Startin  01:22

So Hello, good evening, from a slightly rainy, west of Scotland from the West Coast in Scotland, I’m going to talk briefly about the fourth of the OMS steps and specifically about stress, and mindfulness and meditation. So hello to all of those that know me through my being involved with OMS. And being on a number of retreats over the years, I’ve got to know quite a large number of OMSers. And it’s just been that’s just been wonderful. So for those that don’t know me, just a few kind of words of introduction about myself. I have Primary Progressive MS. I was diagnosed in 2007. I started following OMS in about 2012. And then I was fortunate to be on the first OMS retreat outside Australia and New Zealand, which was designed in the UK in 2013. And I say and I’ve done quite a lot with OMS, and am now a facilitator. And my mindfulness journey started back in about 2011. And I was I was really skeptical at the beginning. And I’m kind of a background in science in business. And it just kind of didn’t make sense. But I found a course that worked. And I just loved it. And it’s become a huge part of my life. So I’ve been trained to teach the Mindfulness Based Stress Reduction Program. And I now teach that to people with MS and to the general population. I go on a week long, silent retreats every year. And it’s insights from some of those retreats that I kind of wanted to share with you this evening. Just give you a slightly different perspective on meditation and mindfulness.  And certainly, anecdotally, from all the retreats and I’ve ever been on, it seems to be the hardest of the steps to adopt. And I certainly found out that way as well. I mean, sunlight, vitamin D was pretty straightforward. And you’re either getting sunshine, which doesn’t really work that often here in Scotland, but there’s always tablets or sprays, you can take. The diet, there’s actually huge amounts of guidance out there. And I think the diet is just a sensible way of eating anyway. So it’s not too bad. And we’ve all been told all the time that we need to do lots of exercise. So that’s all good. But but meditation and mindfulness just seems yeah, maybe slightly, slightly harder. For many of us, there are their real worries and stresses over our health or our family’s health, over job security income, perhaps other big concerns. And prolonged elevated levels of anxiety and stress are bad for everyone. So regardless of whether you’ve got MS or not, it’s bad for us all. And why is that was partly because that the mind and the body are linked. So what we think our stress responses, our worries or concerns, our nervousness, our emotions, all effect us physiologically, and one of the ways in which the mind and the body are linked is through the fight or flight response to how we respond to stress and the feelings of a being being attacked is through the fight or flight response. And that was identified almost exactly 100 years ago now in the US by by Dr. Walter Cannon. And this this response works by activating the sympathetic branch of the autonomic nervous system, which basically prepares our body to either fight or to flee in response to a threat or response to an attack. And it does things our body then automatic produces a number of different stress hormones, including things like adrenaline, which increases the heart rate, pumps more blood into our muscles. So we can prepare ourselves to attack or to defend ourselves or to flee. But that’s an inflammatory response. And our body’s really clever. So what it also does, it slows down and turns off a unnecessary bodily functions, like the digestive system, which is one of the reasons why we sometimes feel like we’ve got butterflies in the stomach in the tummy, when we’re under stress is because the digestive processes are being turned off, the sexual function gets turned down. Some of the executive functioning parts of the brain get turned down, which is one of the reasons we can feel almost like we’ve got tunnel vision or tunnel mind when we’re under extreme stress. That’s the body actually turning off part of the brain. But it also through a different axis to the HPA axis, the hypothalamic pituitary adrenal axis, down regulates the immune system. So this hardwired fight or flight response is really effective in dealing with physical threats. And it’s life saving response. But our brain really can’t distinguish between say, a real threat, something that really can kill us. And an imagined threat, or a worry, or a concern, or some anxiety, sitting there worrying about all of this kicks off the fight or flight response. And on top of that, we’ve got, we’ve got a hardwired negativity bias. So our brains are hardwired to pay more attention to negative events than to positive events. And again, this from a survival perspective, that’s great, because it’s more important that we learn from things that can literally kill those than for positive experiences, that might be nice, but I’m not going to bring us anything. So these negative memories, then are fixed more strongly, more easily into our minds than positive memories. There’s a book by a chap called Rick Hanson called Hardwiring Happiness, which is actually an excellent book worth a read. And he’s got a little phrase in that. He says that the mind is like Velcro, for bad experiences, and Teflon for good experiences. So this just adds to the stress levels ads to our stress reactivity. And this all impacts our health and our mental health matters. And particularly when we have MS. As I suspect, virtually everyone on this call has, it really does matter. Because stress exacerbates onset of symptoms. I certainly know it myself, and I suspect that pretty much all of us can testify as well, it increases relapse rates, potentially even contributes to the onset of the condition itself. And maybe the reasons for that are pretty obvious. MS is an inflammatory degenerative demyelinating condition that affects your immune system. Anxiety and stress, cause inflammation, and disregulate our immune system. I think what’s quite interesting is that people with MS have three times the rate of depression compared to the general population. And we actually have high levels of depression than people with other chronic conditions. And scientists actually think this is an example of the mind body connection working in the opposite direction to the flight or fight response. So rather than the mind stimulating changes in, in our body actually here, it’s actually that changes in our body to changes literally in our brain caused by the MS is causing change in mind states, it’s actually causing the Depression itself.  So what can we do? What we need to do is learn how to switch off the stress response and switch on the relaxation response. And we’re so lucky to have George Jelinek, who 20 years ago when he created the OMS approach. He knew this, which is why OMS step four is meditate for 30 minutes daily. Now, when George actually first wrote his his wrote his first book, there wasn’t a huge amount of research around the effectiveness of meditation. He got a lot of insights from his time with Ian Gawler. So with Ian Gawler’s experiences, but certainly over the last few years, there’s been an almost exponential rise in academic research into the effectiveness of meditation and its impact on reducing stress, reducing anxiety. So it’s now really proven clinically, that meditation can actually help but but sometimes we can find it hard to actually take the time for these longer practices. Even 10 minutes 20 minutes, can feel hard to do. We’re all busy people. And we’ve got lots to do in our day, maybe even even right now you might be busy or with work, or you might have children at home or family at home. So actually finding time to do a 20 minute practice every day could be really, really hard. But also think about why do we practice. And it’s really not to try and relax for 20 minutes or 30 minutes. But it’s really so we can be mindful and cope better for stress for the other 23 hours and 40 minutes for the day. So we can manage our stress levels more, just better.  So perhaps rather than doing as well as doing a longer meditation every day, then think about adding some mini meditations into your day. And you can do these various points during the day, you can kind of almost sort of hardwire them into the day and do them at set points, let’s say when you make your first cup of tea in the morning, when you make your coffee, or when you turn on the computer or turn off the computer and just do a mini meditation, you might want to do it, just whatever you feel like it, you might want to do it in response to just feeling thing a bit down or feeling a bit upset or feeling things just a bit stressed. And choose to do it then. And these can be really, really short, they can be just for a few literally a few seconds, or they can be for a few minutes. So really don’t take it very much time at all. What are the different kind of mini meditations can you do, you can do what’s called kind of grounding, just just focusing on a particular sensation, let’s say in the breath, say in the belly, focusing on the feet, sensations in the feet, or the hands, when the shoulders or just just whatever works for you. There’s something called a breathing space. So three step reading space. And that’s often illustrated like by an hourglass figure, so wide at the top, and then narrow in the middle, and then wide at the base. So what that describes it’s a little meditation, where we start by having a wide open focus, just in terms of how are you how are you doing, what emotions are with you what feelings are there, just overall state state of yourself at that moment. So you do that. Just think about that for blessing, 30 seconds or a minute. And then you focus in on the breath to narrowing your focus, just focusing on the breath. Do that for another 30 seconds or a minute or so. And then expand again, to just taking the sensations throughout the entire body. And again, just do that for 30 seconds, a minute, a minute or so. So it’s just a three step breathing space, where you could even do things like called micro meditations. And that’s literally just being aware. So to just bring your moment your awareness into the present moment, being aware of what’s happening here. So I’ve got to pick up a cup of tea they’ve got in front of me here, and just taking moment to let’s say feel the mug, the weight of the mug, the smell of the tea, and the taste of the tea. Just even just taking a few moments like that, just to be aware of whatever you’re focusing on is a little mini practice in its own right.

Overcoming MS  13:31

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Phil Startin  13:49

So can I invite you now to join me in a mini meditation practice. And we can do this either sitting down or standing up and I’ll stay seated but if you wish to stand, please do so. And I am going to invite you to close your eyes. So if your balance is as dodgy as mine is then you may want to hold on to something to stop you falling over and if you’re sitting then just uncrossing the legs, just putting both feet on the ground and if it’s comfortable for you sitting slightly forward in the chair. So your back is supported. Resting your hands just on the thighs or in the lap which is whichever is better for you. Then whether you’re standing or sitting, just having the back up right and just softening the shoulders, letting the shoulders relax. Having the head up right and tucking the chin in gently. Then just gently close the eyes if you wish. Just moving your attention out down the body and all the way down to the feet. Just become aware of sensations in the feet. So if you’re standing, feeling the weight to the whole body, driving down through the feet, you’re sitting the weight of the legs, perhaps feeling the points of contact the feet with the ground, heel, both feet, ball of the foot, the edges of the feet, that’s the toes touching the ground is gonna get a sense of how the feet feel perhaps a little bit tired, if it’s towards the end of your day or alive and awake perhaps if it’s a bit earlier on in the day just resting your attention on the feet and just gently bringing the attention up legs and up to the hips and up to the belly. So to the lower abdomen. Just sensing the breath in this time region of the body so just feeling the belly expand and stretch as we breathe in and fall back. Relax as you breathe out just letting your attention just rest the way you sit the breath the belly just letting the belly and the breath breathe itself. Feeling the belly expand and then relax as you breathe out. We’re not trying to control the breath in any way. We’re just resting here with the breath was just slowing everything down for a few moments. Just taking our lives now just one breath at a time just curious to the sensations with each in breath and each out breath. Then gently expanding your awareness to take in the whole of the body sensing the space that your body occupies in the room you’re sitting or standing, spinning the body in quite elegant quite grounded as we sit or stand here. Does it seem possible to bring a sense of kindness to the body just viewing the body through a lens or a filter of kindness. Just feeling your wholeness, your completeness even getting a sense of wholeness OMS community wherever we sit in the world sense of connectedness right across the world. And then when you’re ready, just gently open your eyes about stretching a little wee with the fingers, the toes and sitting back down again. If you wish, if you’ve been standing. So let me come back to to mindfulness now. What Mindfulness is since I share something with you that I took away from a wonderful retreat that I did here in Scotland in March this year, and the retreat was led by extremely experienced meditator who’d been on long, silent retreats on mindfulness, both in the Far East, and at the Insight Meditation Center in the US, and she’d been taught by some really excellent teachers. And when we talked on the retreat about what is mindfulness, and I think this this, this little cartoon, that Craig Hassed uses a lot. So you quite possibly seen it before. I think it actually kind of sums up the normal definition of what mindfulness is pretty  nicely. So you’ve got the human being on the left, whose mind is full, and full of thoughts about the things they’ve got to do and the worries and, the people and interactions and possibly regrets about the past. Just just that, that whole gamut of thoughts that typically goes through our head. So there’s this the kind of human doing rather than a human being. And then you’ve got the dog on the right, who is is being mindful, just very much aware of they can see the sun and the trees. And that kind of view of what mindfulness is, it’s kind of when you read a it’s quite common view of so if you read a kind of magazine or an article about what mindfulness is, and isn’t, that’s kind of the typical definition you’ll get. It’s very consistent with the definition of the Jon Kabat-Zinn, his operational definition of mindfulness, which he calls paying attention in a particular way, on purpose. And with no judgment. But there’s there’s a lot more to mindfulness. And there are other ways of thinking about mindfulness. So another way of thinking about mindfulness that that might be helpful for you is, it’s like awareness. So perhaps, when you think about you’re doing a mindfulness practice, or a meditation practice, you’re really doing an awareness practice. And even during the day, you can just bring awareness to what you’re doing. And that, in itself is just like another mini meditation. And as you practice, then your awareness changes over time, perhaps should practice a little bit more, reflect more, have some good teachers, your mind, your awareness deepens, it develops, it changes. So when typically, when we first start meditating, and first start with a mindfulness practice, we really try and grow the attention muscle, just develop that base awareness, as Jon Kabat-Zinn said, just managing our attention, keeping it deliberately in the present moment, and without judging. And if we do that, really quite quickly, and really, literally over a space of a few weeks, we can find just more stability in the mind, the mind does actually feel a little bit a little bit calmer. That’s partly through because we are stimulating the vagus nerve, and the parasympathetic branch of the autonomic nervous session, and switching over into the relaxation mode. And that is a great way to start. And it’s achieved many of the benefits of switching off the stress response and switching on the relaxation response.  But if we keep practicing, we find that actually our awareness develops and we start to really have a better understanding of our experiences might find that we reconnect with sensations in the body start to become aware of what our breath in is telling us. So when we feel tightness in the chest, or in the throat, or wherever it is different as different sensations in the body, become more aware of thoughts of a different mind, states have a different emotions. And awareness can deepen even further. We start to become aware of just our habitual thinking, and our conditioned responses, how we always potentially respond and react in certain ways, to specific situations to specific stimuli. We tend just to react in certain ways. We notice the things that we like, and how we perhaps hold on to those things that we don’t like, or push those away and our minds really do start to feel a little bit more spacious at this point. And we do start to develop a slight roleplay more resilience, just just an inbuilt resilience at that point.  And as the awareness deepens even further, we get to the point of actually, not only just being able to notice reactions to certain situations, but being able to let them go to change them and make better choices for ourselves make better choices for other people choose just just actions that options, they’re better for us. And this literally is rewiring our brain. This is changing our normal learned way of behavioral conditioned responses, and making better choices. And this literally does say rewire the brain and just continue on and furthering the depth of awareness. Then just seems to sit all the time, meditation almost becomes really quite easy, incredibly, incredibly light. Almost no, no effort whatsoever. And certainly those last two steps. When you sit and meditate, there are huge insights that can arise just naturally, as part of the meditation, the meditation itself just comes just becomes far more fluid, such as nature can maybe just draw that picture out for you that meditation is it’s an awful lot more than just being in the present moment, intentionally, and nonjudging. And it can develop it kind of fold over time. And every person will have a kind of a different pathway, a different journey in terms of their aware awareness. But it’s mainly just to just to draw on that a little bit.  I don’t know if anyone else has seen Shannon Harvey’s latest film my year with mindfulness. I saw it a couple of days ago. And I think she she really gets it or really understands it. And if you do have an opportunity to watch it, just coming back to this, I think with through meditation, through mindfulness, we can do an awful lot to actually help look after our minds. But I think there’s a question, is it enough? I mean, certainly the the environment we’re in right now is hugely uncertain. It’s, I think, I mean, at times, it’s just not clear what’s gonna happen next month, next week, even tomorrow, certainly sometimes here in the UK, it’s really seems just changing so much. And I guess if any of us have to think forward, what’s what’s what’s the word going to look like? What how we’re going to look like in six months time, is just very unclear. And, and we’re living with MS. Which itself is unpredictable. And I think that we know that we’re doing everything we can do to give a positive trajectory of our MS condition through following OMS. But it is still unpredictable.  So is there anything else we can do to look after our mental health? So some of the things that that that I’ve learned to do myself, so simply go through a few of those. So at night, after I got into bed, and before I start falling asleep, I just do a little kind of gratitude practice, think about just three things for which I’ve been really grateful for the day. And they can be just really, really small things just tiny into things, perhaps just things I might have seen or heard, or chat with my wife or whatever it is. And just having to think about those, fixing those in my mind puts me in a great place to sleep. So it’s just very nice to do. Then when I wake up in the morning, before I get up, I think about my intention for the day. And that’s that’s not my to do list. That’s not all the things that I should be doing. I need to tick it off during the day. It’s more about how do I want to behave during the day? What kind of attitude I want to have actually going, how do I want to speak How I want to sound one of those kinds of behaviors, again, just again, just helps set me up for the day and just kind of puts me in the right frame of mind for the day ahead. And kindness, just throughout the day, just remembering to be kind. That’s kind to myself, and kind to others. And to me kindness absolutely is at the heart of meditation and mindfulness. And I know how tough I am on myself sometimes and I again, I noticed with a lot of people with MS and I think particularly OMSers are so tough and hard on ourselves sometimes so and I just give ourselves a break being be nice to ourselves sometimes. And it’s okay. So so those three little things I find just really Be helpful. But also then as part of a guess where we are in this in this pandemic, and how I mean, we I think we’ve probably going through the biggest change in our lives, possibly a generation or two, in terms of how the world’s going to alter, just think about, I think our values what’s important to us. I do try and do this every year or so. But it’s just to sit back and reflect on what’s important to me in terms of my relationship, or my family’s and my interests or my work. And think about goals. Just think about goals around that, and just take a bit more control of it. One of the phrases that Trevor Wicken of the MS gym users, and I use the MS Gym, and most days and I love it, but he talks about living a life by design and not by diagnosis, which is a phrase I really like. So let me end with another quick quote. I think the one that’s particularly appropriate quotation from Jon Kabat-Zinn, that we can’t stop the waves, but we can learn to surf. And we can’t we can never stop the waves of change, but we can learn how to surf, how to live with the changes how to still enjoy our lives.

Overcoming MS  31:24

Thank you for listening to this episode of Living Well with MS. Please check out this episode’s show notes at overcoming ms.org/podcast you’ll find useful links and bonus information there. Don’t forget to subscribe to the podcast so you never miss an episode. And please rate and review the show to help others find us. This show is made possible by the Overcoming MS community. Our theme music is by Claire and Nev Dean, our host is Geoff Allix. Our videos are edited by Lorna Greenwood, and I’m the producer Regina Beech have questions or ideas to share? Email us at podcast at overcoming ms.org We’d love to hear from you. The Living Well with MS podcast is for private non commercial use and exists to educate and inspire our community of listeners. We do not offer medical advice for medical advice please contact your doctor or other licensed healthcare professional.