Mindfulness at TriStar Centennial Medical Center

What is Mindfulness?

Through an ever increasing body of research, we are learning more and more about the practice of Mindfulness and its numerous health benefits. Yet, what does being Mindful really mean? Simply put, Mindfulness can be described as awareness, the act of paying attention to the present moment with purpose.

More specifically, Mindfulness encompasses a series of mental exercises that help one practice this kind of focused attention to the present in a way that positively shapes how the mind and body function. In other words, we can exercise our minds in much the same way that we can exercise our bodies, strengthening both to perform at their best in any situation but especially when experiencing stress, illness, and discomfort.

Some examples of these mental exercises include:

  • Breath Awareness: Paying attention to different aspects of the breath
  • Body Scan: Bringing attention to different muscle groups
  • Awareness of Senses: Focusing attention on the 5 senses

Why Practice Mindfulness?

Multiple research studies highlight the profound benefits that regular, daily practice of these techniques can bring for individuals’ mental and physical wellbeing. Practicing Mindfulness has been shown to:

  • Reduce physical pain
  • Decrease depression and anxiety
  • Improve sleep quality
  • Strengthen the immune system
  • Increase creativity and problem solving
  • Calm the body’s automatic stress response

These benefits can be attributed to changes Mindfulness actually brings about in the physical structure of our brain, by increasing grey matter in areas related to memory, compassion, and self-awareness and decreasing grey matter in areas responsible for the automatic physical and emotional responses to stress. With this in mind, practicing Mindfulness helps us tap into our innate ability to manage pain, fatigue, illness, and stress and thus regain and maintain a higher quality of life both in the hospital and after discharge.

Where is Mindfulness Offered at TriStar Centennial Medical Center?

TriStar Centennial Medical Center employs adjunctive therapists, including Art Therapists, Music Therapists, and Recreation Therapists, that utilize Mindfulness practices in their work with patients admitted to a variety of services on the hospital campus. These areas include:

Practice Mindfulness on Your Own

Mindfulness Introduction

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Hello. My name is Catherine Harris, Board Certified Art Therapist for TriStar Centennial Medical Center. The exercises presented here are designed to help you develop a powerful set of skills called Mindfulness skills.

Mindfulness skills encompass a series of mental exercises that help one practice focused attention to the present in a way that positively shapes how the mind and body function. In other words, we can exercise our minds in much the same way that we can exercise our bodies, strengthening both to perform at their best in any situation but especially when experiencing stress, illness, pain, and discomfort.

While each exercise presented here is different, they will all help you practice the ability to not only focus your attention on the present moment but to do so with a sense of curiosity, openness, and kindness to whatever your present experience may be. It is by practicing awareness of the present moment with these intentions and allowing that moment to be just as it is that we experience the true benefit of Mindfulness. So we can think of each exercise as an opportunity to practice this kind of awareness, as an opportunity to bring kindness and understanding to our experience as well as ourselves in the midst of that experience.

As a disclaimer, often when we try to sit still and focus our attention, our minds will then become very active and produce all kinds of thoughts and inner commentary. Or you may even notice more feeling and sensation present in your body that may be uncomfortable or even painful. In many cases, these thoughts and feelings have been there all along. We just haven’t stopped to listen to them or give them proper attention. So if you find yourself distracted by a particular thought or feeling or sensation during these exercises, use this as an opportunity to practice awareness to yourself in the present moment by simply noticing what distracted you and offering yourself a message of kindness before returning your attention back to the recording you’re listening to. If the distraction is a particular thought, a memory from a previous experience, or worry about a future event, you may simply say “Thanks mind for that information.” If the distraction is an uncomfortable or painful physical sensation, you may say to yourself, “I know my body is working very hard for me right now. And any sign of pain or discomfort may just be my body’s way of telling me to take care of myself.” If you find you’re caught up in an overwhelming emotion, you may tell yourself, “It makes sense that I feel this way given all I’ve been through.”

So if you do find yourself distracted by other things during these exercises and feel it is difficult to focus your attention, do not worry. It does not mean you have quote “failed” the exercise. On the contrary. The aim of practicing these exercises is not to distract you from unwanted thoughts or feelings or get rid of uncomfortable or unpleasant sensations. The purpose of these exercises is to help you truly be present and to engage in this moment in life, to bring your attention back to what is most important here and now. As long as you are aware of what distracted you in the present moment and you are responding to that distraction, and yourself, with openness and kindness, you are practicing Mindfulness and tapping into your own innate ability to manage pain, fatigue, illness, stress, or whatever else the moment may bring.

So let’s practice. Before beginning these recordings, you may bring your attention to your posture and make any adjustments to allow yourself to be as comfortable as possible. If you are sitting up, you may straighten your back while keeping your shoulders relaxed to foster a posture that is alert and dignified but comfortable and relaxed. If you are lying down, you may lie on your back with your feet slightly apart and your hands to your sides. It may help to close your eyes if you feel comfortable doing so, or if you prefer, you can leave them open, finding a fixed point on the floor or the wall in front of you to focus your visual attention. Once your body is settled, take a moment to thank yourself for taking this much needed time to care for yourself and foster this important skill.

Awareness of Breath

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These formal exercises can help you practice the essence of Mindfulness, that is focused attention to the present moment with compassion and non-judgement. In this exercise, we use the breath as the focus of our attention, practicing awareness of different aspects of a single breath without attempting to change the breath. In other words, allowing the breath to be just as it is. It may seem counterintuitive, but if we remove the pressure from ourselves to change our breathing and simply observe what our breath is like, it may naturally become a little deeper and longer on its own, promoting the body’s built in relaxation response.

So wherever you are, find a comfortable position where you feel alert but relaxed. This may be sitting up with your back straight and your shoulders back. Or this may be lying down on your back with your legs placed slightly part and your hands to your sides. And if you feel comfortable, you can close your eyes, let them rest. Or if you prefer to keep them open, you may find a fixed spot somewhere on the floor or wall in front of you to focus your visual attention.

And we’ll start by simply bringing your attention to your breath. Noticing when you inhale and noticing when you exhale. And there’s no need to change anything about your breath, but instead attempt to use your breath like an anchor or magnet for your attention. No matter what thoughts arise in your mind or sounds that may distract you, always returning to that continual rhythm of breathing in and breathing out.

You may notice how long it takes to breathe in, and how long it takes to breathe out. Noting with a sense of curiosity what your breath is like in this moment. If it seems slow, quick, or somewhere in between. You may even place your attention at the very tip of your nose, noticing when the air flows in and when the air flows out. Perhaps observing how a single breath can be made up of multiple parts. How the air feels as you breathe in through your nose. How the air feels as you breathe out. Noting how the air may feel cool in temperature on the inhale and slightly warmer as you exhale. Noting if there is any sound to your breath, as soft or as subtle as that may be. Or if there is no sound. If it’s silent.

And even following the air all the way in and down as you inhale, noticing how it fills your lungs. And following the air back up and out as your exhale. Noticing where you tend to breathe into by noticing what part of your body rises as you inhale and what part of your body falls as you exhale. Noticing when you exhale that your body automatically inhales without you having to think about it or force it, your body automatically continues to breathe in and continues to breathe out. The air comes and goes, and the body breathes itself.

There may be one part of your breath in particular that captures your attention. Whether it’s the rise and fall of your body, the feel or sound of the air, or the continual rhythm of breathing in and breathing out. I invite you to focus your attention in on this one part that stands out to you, noticing the subtle changes of this one aspect of your breath with each inhale and each exhale. Fully inhabiting this part of your breath with your mind’s attention, and letting yourself rest in this awareness. Perhaps even silently saying to yourself as you inhale, “Breathing in” and as you exhale, “Breathing out.” Or offering to yourself what you most need in this moment with the rhythm of the breath. Saying as you inhale, “Breathing in life and energy” and as you exhale, “Breathing out stress and tension.”

And finally, widening your attention to include all aspects of your breath at once, the rhythm of inhale and exhale, the feel and sound of the air, the rise and fall of your body, while noticing your mind’s ability to shift from one thing to the next. Knowing that your breath does the work of healing and relaxation. Knowing that your breath is always with you no matter where you go. That all you have to do is bring your attention to it. That continuous rhythm of breathing in and breathing out.

And gently widening your attention outside of yourself by noticing any sounds around you, thinking about your position in the room, your posture in the bed or chair, what your will see when you open your eyes, and finally opening your eyes when you are ready.

Awareness of Three

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In this exercise, we bring our attention not only to the breath but to sounds around us as well as physical sensations in our hands, thus providing three different anchors for our attention. This can be particularly helpful when individuals are finding it difficult to sit still and focus on a single element like the breath. This kind of focused attention can be a challenge to practice when first learning about Mindfulness. It is a way of being and thinking that we are not readily used to in our everyday experience. As a result, having different items to focus our attention can be very helpful. When we find ourselves losing focus or becoming distracted with one element, we can turn our attention to another to practice.

So we’ll begin once again by bringing your attention to your breath as a way to bring your focus to this moment. Noticing when you breathe in and when you breathe out. Knowing that there is no need to change or alter anything about your breath but instead allowing it to be just as it is in this moment. With a sense of curiosity, noticing what your breath is like. If it seems slow or quick or somewhere in between. Letting your attention fully inhabit the breath and allowing yourself to rest in this focused awareness.

Perhaps even bringing your attention to the tip of your nose as a way to notice when the air flows in and when the air flows out. Beginning to notice all the subtle changes that take place with each breath. The feel of the air as you breathe in through your nose and the feel of the air as you breathe out. Noticing if there is any sound to your breath as soft or subtle as that may be or if there’s no sound. If it’s quiet. And on the next inhale, following the air in and down, noticing how the breath fills your lungs. And as you exhale, following the air back up and out. Perhaps even observing where you tend to breathe into by noticing what part of your body rises as you inhale and what part of your breath falls as you exhale. Noticing when you exhale that your body automatically inhales without you having to think about it or force it, your body in it’s own wisdom continues to breathe in and continues to breathe out. The body breathes itself. So always returning to this continual rhythm of inhale and exhale. Perhaps even saying to yourself as you inhale, “breathing in” and as you exhale “breathing out.” Or simply “in” with the inhale and “out” with the exhale.

After a few breaths, beginning to widen your attention to include any sounds you notice in the space around you. Taking in the entire soundscape of what you can hear. And noticing the details of each sound. When they stop and start. If they seem loud or soft, near or far. And even noticing that background of silence from which all sounds arise. And after a moment, you may notice one sound in particular that catches your attention, that stands out to you, and allowing your attention to hone in on this one sound and noticing the details. When it comes and goes or if it’s continual. How even one sound can be made up of multiple parts, different pitches and tones that come together as one. And even practicing refraining from any judgment on whether this sound is pleasant or unpleasant but simply noticing its presence as a part of this place and your experience. Before widening your attention again to include all sounds at once, noticing your mind’s ability to shift from one sound to the next. 

Before gently shifting your attention to your hands as a way to bring your focus to your physical body and simply noticing any feeling or sensation present in your hands in this moment. Perhaps noticing what you can feel from the outside, the temperature of the air on your skin. The feel and texture of anything your hands may touch. And even noticing what you can feel on the inside in your muscles and bones. Any coolness or warmth. Any tingling or pulsing. Or even if there is a lack of feeling or sensation. Letting your attention fully inhabit the space of your hands and noticing what it’s like for your hands in this moment. Moving your attention into your palms and the back of your hands and into each individual finger. Your thumbs, index finger, middle finger, ring finger, and little finger. Observing what is present and allowing it to be.

And finally, brining your attention to all three of these things at once, any physical feelings in your hands, any sounds in the space around you, and the continual rhythm of your breath, noticing your mind’s ability to be aware of all three of these things at once. And letting yourself rest in this awareness.

Body Scan

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In this exercise, you will be using both the body and the breath as the focus for your attention. This exercise can be especially helpful when experiencing physical pain or discomfort. We can actually think of pain as having multiple factors or causes. First being the initial source, perhaps from an injury or an incision from surgery. Second being muscle tension related to that initial source. When our bodies have been injured, our muscles will tense up around that space, which protects the body at first, keeping it safe from further injury. However, over time, this muscle tension can increase pain. And finally, the third factor being our mental attention. Pain can steal our focus and can often be all we think about when experiencing this kind of discomfort. You may experience recurring thoughts such as, “This is awful. This pain will never go away.” Or “I can’t handle this anymore.” All of which are very common when experiencing pain. However, thoughts like this tend to increase our perception of our pain, and even trigger our body’s stress response, adding to the initial discomfort and making it worse.

So with this exercise, we can address two out of three of these factors. By focusing our mental attention on the breath and using the breath to soothe and relieve different muscle groups, we can relieve our mental attention and actually physically relax our muscles. As in all Mindfulness exercises, the objective of the Body Scan technique includes bringing kind and compassionate attention to the moment, both to ourselves and our experience. We can think of each Mindfulness exercise as an opportunity to practice this type of non-judgmental and compassionate attention, something that is much needed when experiencing pain. The aim of the exercise then becomes not completely eliminating our pain or changing our situation, because so often we can’t, but instead to cease our struggle with it and thus find relief in the present moment.

So as usual, come to a comfortable position, seated upright or lying down on your back, closing your eyes and letting them rest. And we’ll begin the Body Scan by bringing your attention to the present and using the anchor of the breath. Simply noticing when you breathe in and when you breathe out. Noticing that continual and ever-present rhythm of inhale and exhale. And with a sense of curiosity, observing what your breath is like in this moment and allowing it to be just as it is. Noting if it seems slow or quick or somewhere in between. And as we begin this exercise, knowing that there is nowhere else you have to be in this moment. No one you have to please. And nothing you have to do except simply let yourself rest in this awareness of the breath and the body in this moment.

And now, I invite you to bring your attention to the area of your feet, noticing anything you can feel. Any feelings or sensations from the outside. Perhaps the feel and texture of anything touching the skin. Noting where your feet make contact with the bed or floor. And also noticing what you can feel from the inside. Any sense of coolness or warmth, tingling or pulsing. Letting your mind fully inhabit the space of your feet. And on the next inhale, imagining you can breathe into the space of your feet, filling them completely with your breath. However you make sense of that instruction. Breathing into the space of your feet on the inhale and breathing out from that same space on the exhale. Letting your breath soothe and massage your muscles, your bones as you inhale. As if your breath could even flow in and around each individual cell. Breathing into the space of your feet and breathing out from that same space.

On the next exhale, gently moving your attention away from your feet and allowing it to travel up into your ankles, your calves, and your lower legs. Again, simply noticing what you can feel in this area. Noting any feeling or sensations that are present or even a lack of sensation, and allowing what you notice to be just as it is in this moment. Observing how physical feelings and sensations come and go just like the air with your breath. And on the next inhale, imagining you can breathe into the space of your lower legs, filling them completely. And as you exhale, breathing out from the same space. Following the air in and down as you breathe in and up and out as you breathe out. Always returning your attention to the rhythm of the breath. Noticing if you are ever distracted by other thoughts or feelings and knowing that is ok. Simply notice what distracted you and gently return your attention to your breath. Perhaps even thanking your mind for the information as you return your focus. So again, on the inhale, breathing into the space of your lower legs and breathing out from that same space.

On the next exhale, gently moving your attention up into your knees, your thighs, your upper legs and noticing what you can feel in this area. Taking a moment to notice any feeling or sensation present in your upper legs. And on the inhale, imagining you can breathe into the space of your upper legs, filling it completely with your inhale. Allowing the breath to soothe and massage your muscles. And breathing out from the same space, perhaps even feeling your muscles relax and let go as you exhale. With the breath, breathing into your upper legs and breathing out from that same space.

Now taking a moment to notice your entire lower body from the tips of your toes to your waist and imagining you can breathe into the entire space of your legs, filling them completely with your inhale, letting go of any stress or tension as you exhale. Feeling those muscles relax and grow heavy. You may even take a moment to thank your legs and your feet for all the places they have taken you, including this room here today.

And on the next exhale, again gently moving your attention up into your lower belly and lower back. Noticing what you can feel in this area of your body and allowing it to be. Knowing that if you ever notice any feeling of discomfort or even pain, that you don’t have to like it or want it or even approve of it. You don’t even have to fix it or change it in this moment. But instead, following your breath and imagining you can breathe into this space filling it completely. It’s as if your breath can move in and around any areas of discomfort, as if your breath can make space for it. Always returning to the continual rhythm of inhale and exhale.

On the next exhale, gently moving your attention up into your upper body, your chest, your shoulders, your upper back. Again, simply noticing any feelings or sensations in this area. And on the next inhale imagining you can breathe into this space filling it completely. And then breathing out from that same space. Following the air in and down on the inhale and up and out on the exhale. Perhaps even asking yourself, what’s true for your heart space in this moment and allowing that to be. As you inhale, allowing the breath to soothe and massage the muscles of this area, the bones, and as you exhale, feeling those muscles relax and grow heavy.

And, on the next exhale, gently moving your attention down and into your arms, traveling down your upper arms, the bend in your elbow, your lower arms, wrists, palms, all the way to the tip of each finger. Noticing each individual finger, your thumbs, your index finger, middle finger, ring finger, and little finger. Letting your mind fully inhabit this space and letting yourself rest in this awareness. On the next inhale, breathing into the space of your arms and hands, filling them completely and breathing out from this same space. Following the air in and down. And following the air up and out.

Next letting your attention travel back up your arms and into your shoulders and neck, a space that often carries a lot of stress and tension from the day and again noticing what you can feel in this area. Observing any feelings or sensations that are present. And again, imagining you can breathe into this space, filling it completely and breathing out from this same space, letting go.

Gently, moving your attention up into your face, noticing all the tiny yet expressive muscles in this area. Your lips, your jaw, your cheeks, nose, the corners of your eyes and around your eye lids, up into your brow and along your scalp. As if by bringing your very attention to these muscles, you can feel them relax and let go. Then, imagining you can breathe into this space, filling it completely and imagining you can breathe out. Following the air in, soothing and massaging the muscles, the bones, and following the air out.

Now, having gone from the tips of your toes to the top of your head, noticing how your entire body feels in this moment. And on the next inhale, imagining you can breathe into your entire body, filling it completely on the inhale. And feeling your body relax and grow heavy as you exhale. Always returning to your breath, following the air in and down, and following the air up and out.

You may even take a moment to thank your body and all it does for you. Knowing that your body is continually working very hard for you, and if there is ever any presence of discomfort or pain, this may just be your body’s way of telling you to pause, to take a break, and spend some much needed time to take care of yourself.

Finally, taking one more deep breath in, filling your lungs and exhaling everything out completely, letting go. Before gently widening your attention to this room and this space by noticing the sounds around you, getting a sense of your position in the room, thinking about what you will see when you open your eyes, and finally, opening your eyes when you’re ready.

Loving Kindness Practice

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While the previous Mindfulness techniques use physical senses such as the breath and body as the main focus for the exercise, the Loving Kindness practice is a little different, instead using words and phrases of kindness and compassion as the focus for our attention. So we can think of this exercise as a way to cultivate kind, compassionate thought patterns both for ourselves as well as those around us. Now, it may seem funny or awkward even to think about this idea of “practicing” kindness, however this can be an incredibly helpful exercise, especially in times of difficulty or stress.

Our minds tend to have a negative bias, meaning that our minds our built to fix things and solve problems, so as a result, we tend to be continually looking for the next problem to quote “fix” so to speak. And this can be very helpful in many cases in keeping us safe in a threatening situation or in the ability to set goals and plan for the future. However, this tendency can also work against us. When there is no easy or quick solution to our stressors, our minds can then get stuck in negative and often judgmental thought patterns, which in the long run may keep us from thinking clearly, increasing our mental stress and even affecting how we feel physically.

So in a way, we have to actively practice cultivating a sense of acceptance and openness to our situation which comes from fostering kindness and understanding to ourselves, our experience, and others around us. This is especially important and necessary in times of stress and great challenge. By practicing this offering of kindness and compassion during this exercise, we are in a sense retraining our minds to focus on more positive and hopeful perspectives, which in turn helps to calm the mind and body not only during the exercise but throughout the rest of the day.

So we’ll begin by bringing your attention to this moment, inviting the mind and body to settle as you sit. You may do this by bringing your attention to the sounds around you. Observing when they come and go. Allowing each sound to be just as it is. Letting your awareness rest in the entire soundscape around you.

After a few moments, gently shifting your attention to your body, and noticing any physical feelings or sensations present there. Allowing these sensations to be just as they are, noticing how they too arise and pass away.

Perhaps even noticing the rise and fall of your body and bringing your attention to your breath. Noticing when you breathe in and when you breathe out. Noticing how the body breathes itself without you having to think about it or force it, the air simply comes and goes.

Now, I invite you to bring your attention to yourself, picturing yourself in your own uniqueness and goodness in a way that your heart begins to soften to yourself. You may even bring a hand to your heart, noticing the warmth and tenderness of this touch. And beginning to offer yourself the following intentions of loving kindness:

  • May I be safe.
  • May I be at peace.
  • May I be free from suffering.
  • May I be happy.

Then imagine it so. Imagine your heartfelt prayer for yourself has come to pass. Feel in your body what this compassionate intention is like. You may even offer yourself a personal message of self-compassion, nurturing yourself and providing for yourself what you most need in this moment.

Thich Nhat Hanh says, “Darling, I care about this suffering.”

Psalms tells us, “Be still.”

Perhaps you may picture a loved one telling you, “I am here for you.” Letting your awareness rest in this loving kindness you offer to yourself.

Now bringing your attention to someone you care for, perhaps someone who has helped you on your life’s journey. Just as you did before, picture this person in their own uniqueness and goodness, creating a heart to heart connection with that person and picturing them receiving your loving kindness with an open heart. You may even join these phrases with the breath, saying on the in breath:

  • May you be safe.

Saying on the outbreath:

  • May you be at peace.

On the in breath:

  • May you be free from suffering.

On the outbreath:

  • May you be happy.

And imagine it so. Taking a few moments to send any additional messages of loving kindness you would like to send to this person, joining the breath of life to your compassionate wish.

Finally, we send this intention to all beings, imagining we can send our loving kindness out into the world. Casting the widest possible net with our compassion and wishing for all beings everywhere:

  • May all beings be safe.
  • May all beings be at peace.
  • May all beings be free from suffering.
  • May all beings be happy.

And imagine it so. Taking a few moments to send any additional messages of loving kindness you would like to send to all beings today.

Always bringing awareness to your breath, to your body, as you offer these intentions. Noticing if there is ever a presence of resistance or even difficulty when making these offerings and allowing this to be. There is no need to worry. There is no need to judge. If you are unable to offer these messages of loving kindness today, knowing that you are still surrounded by many individuals offering you this wish, sending you loving kindness in this very moment.

Now, gently bringing your attention back to this room, this space by noticing the sounds around you, getting a sense of your position in the room, and what you will see when you open your eyes. Knowing that you take these qualities of mindfulness, openness, and loving kindness with you into the rest of your day.