Mindfulness for Our Ver/go and Tinnitus Pa/ents. From I cant do - - PowerPoint PPT Presentation

Mindfulness for Our Ver/go and Tinnitus Pa/ents.

From “I can’t do this” to…. “I am prepared, and I can” Joanna Remenyi, Ves;bular Audiologist and Mindfulness Educator Seeking Balance Australia

Our workshop!

• Let’s learn a liHle about mindfulness> demo
• Let’s learn a liHle about ver;go> demo
• Let’s look at how we can have a posi;ve impact on the pa;ents we

see in clinic

• Let’s prac;ce some mindfulness tools
• Q & A

About Our Group:

• Who currently prac;ces mindfulness daily?
• Who is interested in mindfulness for themselves?
• Who wants to help clients with difficult thoughts or feelings?
• Describe what a TINNITUS client might “feel” or “think”…
• Describe what a Ver;go client might “feel” or “think”…

What can I do when I am dizzy or ‘ringing’?

• If there is no magic cure
• I can’t predict the future
• I might get it again on any day
• I might not
• How can I best prepare for it?
• What skills do I need to feel confident in my body?

Our message to pa/ents:

• There is something we can do
• We can TEACH SKILLS to help support our immune system and the

process of recovery (PNS)

• We can feel be&er (and think clearer)
• We CAN live a rich and meaningful life despite symptoms
• “this ver*go has really taught me to slow down and think about what

ma7ers in my life- I am grateful for that”

Mindfulness in a NUT shell.

• From ancient tradi;ons of the east (4000 years ago)
• Extensively researched by medical scien;sts, neuroscien;sts psychiatrists and

psychologists

• Umbrella term: CBT, ACT and other models of therapeu;c techniques
• DEFINED: to observe on purpose; with openness to each present

moment; and without judgment.

• Touch, sound, thoughts, emo;ons, sights, ideas, breath…etc
• Mindfulness is a way of life. It is a prac;ce, ongoing. It impacts our neural pathways.

Research… Jon Kabat-Zinn MBSR

(mindfulness based stress reduc/on)

Harvard University and MassacheseHs General Hospital (2010):

fMRI showed thickening of regions in the brain associated with learning, memory, emo;onal regula;on, sense of self and perspec;ve taking. Overall result= stress reduc;on.

• University of Wisconsin collabora;on (2013):

Blister size reduc;on! Comparison of MBSR and control group to psychological stress ‘neurogenic

inflamma<on’… public speaking with an ar;ficially induced blister. (What wonderful volunteers.)

• University of Wisconsin collabora;on (2003):

Anxiety and frustra;on being handled beHer (showed change to electrical ac;vity in lek/right prefrontal

cortex) and stronger an;body response in immune system following flu shot compare to controls.

• UCLA & Carnegie Mellon University (2012):
• Showed reduced loneliness (age 55-85) and reduced expression of genes related to

inflamma;on in immune blood samples

Focus= body + mind ‘in sync’

• Willingness to feel
• Openness to be where I am and how I am now.
• Shiking aHen;on on purpose
• Allowing discomforts rather than struggling
• The rope exercise…

Psychoneuroimmunolgy or PNI

• The immune system is known to be influenced by the brain and the

nervous system (thoughts, beliefs, aptudes… fight/flight/freeze… rest/repair)

• Can pa<ents who focus with purpose and willingness upon the

healing process actually heal quicker? YES!

• Study on UV light therapy for skin disease pa;ents (unknown cause and no

known cure; known to fluctuate and is related to emo;onal stress).

• Mindfulness par;cipants healed 4 <mes faster than controls.
• Par;cipants listened to audio medita;ons whilst standing naked inside a UV cylindrical light box and

visualizing that their condi;on was being reversed. Controls just stood there without medita;on audios.

What it looks like in clinic

• Breath + movement (eg squapng + O2)
• Pause and observe (without judgment)
• Lik up trunk muscles (ac;vate propriocep;ve pathways)
• No;ce thoughts (without judgment)
• Visualise healing pathways
• No;ce anxiety and give it space to calm down

Mr Tinnitus age 44

+ENT +psychiatrist +psychologist + audiologists + /me off work

Mr Tinnitus age 44

+ENT +psychiatrist +psychologist + audiologists + /me off work

Mr Tinnitus age 44

+ENT +psychiatrist +psychologist + audiologists + /me off work

Our pa/ents! Ver/go and Tinnitus

• Mindfulness helps us to beHer relate to our symptoms
• From:

“I can’t live like this, I hate this, I need to be fixed now”

• To:

“It is no big deal, I can pause, take a breath. My body will fix this.

Case Study 1. With a happy ending.

• Ves;bular migraine, Female, age 51- presented with 15-years of

debilita;ng dizziness. Tried meds. Saw Mark Paine in 2000. Comprehensive inves;ga;ons performed and ves;bular rehab tried at the local public hospital. On disability pension. Also has CFS.

• DHI was 82. Normal audio. Normal MRI. Had seen psychologist and

also tried hypno-therapy. Referred for mindfulness from the GP.

• Constant ver;go. +PANIC. + fear of ver;go. It was always on her
• mind. ALL THE TIME. It was there. And she focused on it.

The process of healing.

• Tried very simple Ves;b rehab exercises but she rejected them in panic.
• We moved to very basic mindfulness scans and self-awareness exercises.
• Basic neuroplas;city educa;on: “I can change my brain pathways.”
• Is now living without fear of dizziness and pauses with ‘no big deal’ when she no;ces it.

NOW= DHI 26 … impact = 56% Huge improvement

• Quote:

“I talk to my dizziness and say .... ‘Ok there you my old friend ...come along for the ride I have a life to live ...wholeheartedly’

How did we get there?

Case study 2. Pain, migraine, dizzy for 30 years (age 54).

Referred via GP for mind/body therapy

• Had exhausted inves;ga;ons and tried medica;ons for years.
• Painful migraine (intensity=8/10) for a dura;on of 3-days
• Recurrence of every 10-days
• 3 sessions with 1:1 (breath work, self-compassion, neuro-educa;on)
• NOW: rarely uses drugs. Pain is now described as at 0/10 or “calm”.

13 months on, this pa/ent reflects

• “The first point was really, really taking responsibility for my own pain

& being completely minded that I could make changes to my chronic pain…

• I came to realise that various drugs made it harder not easier , were
• bstruc*ve to me really dealing with pain- they generally distance

yourself from geHng thru pain. I would say with help from people like you I recalibrated my brain aIer 30 years of living with pain! But I really had decided I wanted to change”

Easing the load of unnecessary stressors:

The pa/ent’s role is about learning.

• Interac;ons between stress and ves;bular compensa;on (2012):

Yougan Saman1*, D. E. Bamiou1,2, Michael Gleeson1 and Mayank B. Du=a3

• “Good stress” and “Bad stress”
• Repeated exposure to stressful s;muli or chronic stress can lead to an

inhibi<on of brain plas<city and las;ng detrimental changes in the hippocampus, amygdala, and prefrontal cortex

Mindfulness Tools

• Mindfulness is not a tool to eliminate symptoms…
• It is a resource to help us relax into our body and offer self-support
• POCA: Pause, Observe, Choose, Act
• NOTICING Breath, feelings, thoughts
• PRACTSING Compassion
• ACTING WITH Kindness
• DAILY Gra;tude

Q&A

• How will I know if a pa*ent is ready or suitable for this?
• when the pa*ent is ready, this is quickly effec*ve
• Ask them if they are willing and ready to try these new tools
• CI Clients need visual tools… great idea. Write down your mindfulness

exercises in simple sentences and guide client to read more about it.

• Pema Chodron offers excellent wriHen resources.

Thank You! Come say hello!

• Further 1:1 training available with CPD points- email me.
• FREE Ver;go Recovery Starter Kit available online
• www.seekingbalance.com.au
• info@seekingbalance.com.au Skype therapy sessions available
• Further reading:
• Full Catastrophe living- Dr Jon Kabat-Zinn
• Just One Thing- Dr Rick Hansen
• The Happiness Trap- Dr Russ Harris