Minding the Guilt

Guilt is an interesting emotion with many nuances worth exploring. 

Guilt came up recently in a caregiver support group I help facilitate. One woman felt guilty for not being there for her husband 100 percent of the time. I explained that we often set ourself up with unrealistic expectations of ourselves, 'should-s' that demand from us more than we can humanly give. And we end up with this yucky feeling in our stomach, a mixture of self-hate, confusion, and powerlessness. This is false guilt, a toxic emotion to be disposed of promptly as soon as we can see it for what it is.

Guilt can also be of the rightful kind. There are a few major decisions I have made in the past that have come back to haunt me, both in terms  of negative outer consequences, and also the pain from a tormented heart. There is no escaping such guilt. I have found it needs to be endured with great tenderness, and also the determination to learn from it. Rather than lingering in biting remorse, better yet is to mine the wisdom buried in one's earlier mistakes. Whenever guilt raises its ugly head, I meet it like this:

First, I feel the guilt completely, including the slew of other, all very unpleasant mind states attached, the sadness, the remorse, the regret, . . . I feel them all. Guilt is a blow to the ego. It crushes one's inflated view of one self, and as such, can be seen as a very good thing. Guilt opens one's heart.

Second, I move on to a state of self-compassion. I revisit what happened, and the circumstances that led to the original action. A state of limited consciousness and heart not being opened, for sure. I forgive myself. 

Third, I step out of myself, and I feel the pain of those I unwittingly hurt. I use that intimate knowledge to build up the necessary resolve to not repeat such hurtful acts. Part of that resolve is a renewed commitment to mindfulness and loving kindness practice, the two best safeguard I know against negative karma. 

Fourth, I take a forward thinking stance. The past is the past that cannot be undone. All I can change is how I think, feel, and act in this present moment. The opportunity to love is right now. Today is the first day of my remaining life.

How do you deal with guilt?

6 Mindfulness Strategies For the Busy Person

It's been hard finding the time for formal practice. Work has not let up, and every day, same questions. What time to set the alarm? How much sleep do I really need? Does time spent meditating make up for loss in sleep? Do I meditate first thing, or wait until I come home, some time late? How long do I sit for? How about breaking into two smaller sittings? 

I finally have come up with a plan, and it's been working - sort of . . .

Here it is:

1. Set up my alarm to 6am every morning.

2. Always sit, no matter what. That part never changes day to day.

3. Depending on how early I need to leave, morning sitting practice may be 5, 10, 15, 30 minutes. I always set my timer.

   5 or 10 minute practice is simple awareness of breath 

   15 minute practice is loving kindness meditation

   30 minute or more practice is sitting with breath

4. In the case when morning practice is less that 30 minutes, I leave with the redoubled intention of using whichever ensuing activities as mindfulness practices: walking to my car, listening to Ayya Khema's talks while driving, walking from car to work, etc . . . I am also fortunate to incorporate mindfulness into my work, and get to have several 5 minute mindful check ins with the people I work with. 

5. I also try to make up at night with some loving kindness or simple sitting practice.

6. I use weekends to boost my practice with longer sittings, 45-60 minutes. 

How do you manage to squeeze in some mindfulness into your busy day?

Of course, the real solution lies elsewhere, in a rethinking of one's priorities. Not giving into the craving for more work, being content with less money, less accomplishments. Keeping it more simple . . .

Launching Mindfulness-Based Dementia Care at UCSF

'Mindfulness' and 'dementia', two words to do with mind:

mindfulness

dementia, from Latin word demens, which means 'without mind'

Mindfulness and dementia are not just connected in words. Mindfulness also happens to be a key element of successful dementia care, working on two fronts: 1) to reduce caregiver's stress, 2) to help the caregiver be present for the person in their care. Facts gathered by the Alzheimer's Association show the extraordinary stress suffered by most family caregivers:

• 61 percent of dementia caregivers suffer from high emotional stress.

• 33 percent report symptoms of depression.

• 43 percent experience high physical stress.

• 75 percent are concerned about maintaining their health.

• Dementia caregivers are more likely to have adverse physiological changes such as high levels of stress hormones, reduced immune function, increased hypertension, coronary heart disease.

• In the last year of their loved one's life, 59 percent feel they are on duty 24 hours a day.

This goes on for an average of 4 to 8 years post-diagnosis. It is no wonder 72 percent of caregivers express relief after their loved ones die. For professional caregivers and health care providers, the stress is also intense and can lead to burnout. 

Until recently, most mindfulness-based approach to dementia care referred to Mindfulness-Based Stress Reduction for dementia caregivers. Having observed numerous times the unique challenges as well as mindfulness practice opportunities in dementia care, I realized the need for a mindfulness-based program specially tailored to dementia caregiving. Hence began the Presence Care Project, a non-profit initiative aimed at promoting a new form of dementia care training. In the Presence Care approach,  mindfulness, informed by experiential understanding of the person with dementia, becomes the foundation upon which a caregiver can rest, moment-to-moment, day after day, during the long journey of dementia. UCSF OSHER Center for Integrative Medicine has now taken on this new approach and recently launched its new Mindfulness-Based Dementia Care (MBDC) program.

MBDC builds upon the now very well proven model of Mindfulness-Based Stress Reduction (MBSR),  and combines solo mindfulness practices, interactive mindful care practices, lectures, and group sharing. Throughout, aspects of mindfulness practice and dementia care are interwoven. The emphasis is on practice during and between classes. The end goal is for participants to experience a radical shift in attitude from mostly doing and reacting, to being skillfully present for themselves and the person in their care. MBDC is appropriate for the whole range of persons involved in dementia care: family and friend caregivers, professional caregivers, elder care professionals, nurses, doctors, and other health care providers. 

MBDC rests on this central premise: mindfulness, that which helps dementia caregivers reduce their stress, is also what can help them provide the best care for the person with dementia. 

The first series of 8-week classes is starting next week and will be taught by myself and Dr. Kevin Barrows, physician and director of mindfulness programs at the OSHER Center. 

The Man At the Grocery Store

During Ayya Khema's Flower Garden metta meditation, his face came up. An almost stranger. A clerk at the neighborhood grocery store. The nun asked that I pick up a beautiful bouquet of flowers from the garden in my heart, and that I hand it to the man. 

I felt the hesitation, the mind's reluctance, the heart closing its gate. The mind, my mind said, this man, you barely know him. He does not fit the criteria for so much love. A smile, a kind word, that you can give, just as you do whenever he rings you up and the two of you do some small talk. But boundless love, as much as you would give to your daughter, my mind had a problem with that. 

The mind's got ideas about what's needed to be worthy of my love. Never mind that we are the first one to suffer. Why not open the gates? Let it flow . . . 

Earlier today, I was listening to a talk from Ayya Khema, and she talked about how pretty much all of us are not capable of unconditional love. We've got limits, and the trick is in recognizing when we don't love, because then, we can change and correct our stinginess. We are in trouble if we delude ourselves into thinking that we love everybody. 

The man at the grocery store showed me the work I have to do still in the area of love. 

Leigh Brasington on the Body Scan

I just reviewed my notes from Leigh's talk during the retreat about the body scan:

We start at the top of the head. Our job is to just notice the sensations that arise in various parts of the body as they are being scanned. Those include body sensations, and sometimes also emotional sensations that may be buried in the body. In some parts, we may not notice anything. We are mostly staying on the surface, and we go top down, and right left. When switching from one arm to the other, we put the attention out into the room and then back onto the other arm. Same with the legs. This order can be changed to fit one's preference. The sweeping just has to be systematic and cover the whole body.

It is not unusual to get nauseated the first time one does the body scan. It is actually a good sign that toxicity is being released from the body. It may happen once again at the most. 

35 to 45 minutes is optimal.

The body scan is a good practice when feeling agitated or sleepy, or when one is feeling least inclined to practice. Also, if one doesn't like the body scan, it is usually because of a lack of being in touch with the body, and of not picking up sensations.

Body scan, loving kindness, two great practices when the mind is dull, or not settled enough for 'just sitting' . . . One really has no excuses for not doing formal practice.