Learned Mindfulness

Physician Engagement and M.D. Wellness

Frank John Ninivaggi

• Publisher: Academic Press
• Year: 2019
• ISBN:
  9780128166277
• Topic: Psychology
• Subtopic: Psychotherapy Counselling
• Index: Psychology

Learned Mindfulness: Physician Engagement and M.D. Wellness discusses the original technique of "Learned Mindfulness" developed by Dr. Ninivaggi to combat stress and burnout. In this book, Dr. Ninivaggi uses his Integrity Mindfulness model as a tool to manage stress, prevent burnout, and broaden quality of life, ultimately promoting well-being. Helping physicians ultimately helps patients and extends to the public enhancement of greater equanimity. The book provides readers with background information on the origins of mindfulness and details step-by-step directions on how to use the original technique.

• First book to introduce the technique of learned mindfulness
• Useful to psychiatrists, psychologists, physicians, and all suffering from stress and burnout
• Provides step-by-step instructions on how to apply the model to their patients

Part I

Mindfulness in Perspective

Outline

1. Chapter 1. Consciousness and Awareness: East and West
2. Chapter 2. Modern Mindfulness

Chapter 1

Consciousness and Awareness

East and West

Abstract

Consciousness is a state of being aware. The experience of sensations, perceptions, feelings, and conceptions includes self-awareness mentally—in consciousness. The way humans receive and react to experience outside and inside themselves embeds self-awareness, a communicative ability. Self-awareness involves paying attention to oneself and consciously knowing one's attitudes and dispositions. In Western psychology, terms such as “ego,” “self,” “sense of identity,” and “I” describe the way individuals experience themselves in their social context. Meditation and mindfulness practices have complex historical origins in Eastern cultures. Buddhism, Hinduism, and Yoga discuss these approaches while centering on how the self manages its contents. Western attention to mindfulness derives from this but leaves out much cultural context. This chapter fills in those gaps.

Keywords

Awareness; Buddhist mindfulness; Consciousness; Hindu and yoga mindfulness; Meditation; Meditative awareness; Mindfulness; Self-awareness; Thinking architecture

1.1. Consciousness and Awareness

The existence of consciousness as a reactive or aware property, a broad concept, is plausible. In most discussions of mindfulness, consciousness is assumed to be a fundamental given however understood. Its nature and definitions remain imprecise if not elusive. In both East and West, defining consciousness, even the value of the term, remains a continuing query. A few distinguished theoreticians also advance arguments explaining it away (Dennett, 1986, 1992).

This chapter discusses consciousness and awareness from both Western and Eastern perspectives as a scaffolding for understanding mindfulness. The mind uses methods to define experience; models are mental structures like templates or patterns aiming to organize disparate data making information meaningful and useful. Models of consciousness are among the most general semifinished examples that serve this purpose as they are soft-coded, not overly definable, and dynamically modifiable. While Eastern ideas can perplex, this chapter tries to survey core ideas in more than a superficial manner yet lucidly link their relevance to the origins and backbone of modern, mindful themes and practices.

Consciousness is challenging to define because it emerges in different environments having different substrates. Thus, consciousness means not only being aware. Plantlife, minerals, and technologies also react to stimuli, sometimes in complex ways. Awareness and reactivity range from minimal to full responsiveness. Human consciousness entails subjective feelings accompanying awareness of sensory information. Mind typically signifies the container of mental life. Subjective reactions may be virtually devoid of gross physical reactivity. On molecular levels, reactivity is always a part of life. Mental sentience includes degrees of self-awareness in space, about and with other humans, and about time and, importantly, the future. Self-awareness is present in how the mind receives and reacts to experience—with an awareness of these activities. Consciousness is a communicative ability. Whether consciousness, awareness, and self-awareness are identical, similar, or qualitative variants are subjects of discussion. Scaffolding mindfulness with these reference points offers tentative hypotheses.

Consciousness, for example, can be compared metaphorically to mental space housing objects filling the space. In Eastern thought, “objects” is the term for experiences occurring and registered in mind: sensations, feelings, thinking, images, and imaginations. These mental contents or objects are representations of a concrete event, abstract, or imagined idea. Awareness is the ability to sense and perceive an object (e.g., sensation, feeling, thinking, and imagination) within the spectrum of nonconscious and conscious cognizance. This process then results in gained knowledge stored as memory and used for decision-making.

Thus, consciousness leading to awareness comprises a cognitive act, emotions or feelings, and a resultant experience. Whether these processes are localized, generalized, diffuse, or combinations are unclear (Crick and Koch, 2005; Damascio, 2018; Dennett, 2018; Gazzaniga, 2018; Kaku, 2018; Pinker, 2018). Neuroscience perspectives see consciousness arising from the embodied person having a base in the central nervous system or brain. To what extent this localizes consciousness (e.g., “one”?) or results in vast arrays of modules (e.g., “many”?) to produce consciousness remains unsettled.

Searching for neural correlates associated with consciousness is ongoing. Scientific work by Dresler et al. (2012) at the Max Planck Institutes in studies on lucid dreaming hypothesize several ideas. Lucid dreaming is the sleeping subject's ability to know of the contents of a dream and recall them after becoming awake. The validity and reliability of this are measurable by magnetic resonance tomography. The vivid descriptions from lucid dreaming reflect one's inner state of mind or consciousness.

Studies postulate several neurologically associated linkages. The right dorsolateral prefrontal cortex associates with the function of self-assessment and self-focused metacognitive evaluation; the bilateral fronto-polar regions with testing one's thoughts and feelings; and the precuneus with self-perception, self-referential processing, first-person perspective, and the experience of agency or the conviction of ownership of intended actions (Northoff, 2011). Chapter 3 on emotions discusses neuroscience studies associating Brodmann area 10, also called the frontopolar cortex or the anterior prefrontal cortex, with the higher-order capabilities of the mind. Using this biomental perspective, integrative mind-body psychotherapies are now mainstream (Johns Hopkins Medicine, 2018).

The psychological concept of agency underlies many mindfulness perspectives; here, body-mind distinctions between doing and knowing interface one another. Agency entails a sense of control over one's intended thoughts and actions. Agency means “I as the do-er.” This subjective awareness is the conviction of oneself or “I” as being the responsible launcher, executor, and controller of volitional acts. Agency is one's conviction of being a self-governing, self-ruling, and self-dependent person virtually free from external control and influence. The agent has the implicit conviction; they are the sovereign decision-makers and performance implementers of their lives. Agency correlates with the perception of willpower and free will. Free will, for example, has two broad components: (1) volition made up of motivation and planning and (2) agency comprising the conviction of ownership and responsibility for intended thoughts and behaviors.

Volition is the desire to act, and agency is the belief in responsibility for intended actions. Recent studies show that volition is functionally connected to the anterior cingulate cortex, while agency functionally connects to the precuneus cortex. These two brain areas link to decision-making. Brain injury causes impairments marked by disorders such as akinetic mutism and alien limb syndrome (Darby, Juho Joutsa, Burke, & Fox, 2018). In mindfulness, a sense of agency that is moderate is optimal. A mindful orientation is toward the process as a “becoming,” not a frenetic striving toward sovereignly achieving a future goal. It is feeling effective. Gentle nonstriving is an essential core of mindfulness practice and mindful awareness.

Whether consciousness can be understood in a way not requiring a dualistic distinction between the mental and physical body remains an open question. This debate between unity and duality or one versus many is common to both Eastern and Western perspectives. This consideration points to the way each tradition views and manages the physical body with the agency of mind, notably in meditation and mindfulness.

Western views of psychology fully acknowledge the value of the body. They go to great lengths toward advancing its health and well-being by diet, exercise, nutritional, and medical interventions. Hindu and Buddhist systems have developed medical Ayurveda and Yoga to address the significance of the body. Recognizing its importance, Eastern views stress its value as a vehicle for mental and spiritual advancement. Buddhism stresses axioms such as suffering, impermanence, and the insubstantiality or nonexistence of a permanent human core. In doing so, a greater emphasis on meditation arose, at least in the history of Buddhism and its writings.

Human consciousness as the state of being aware of and containing sensations, perceptions, feelings, and conceptions includes self-awareness. Even if it is an awareness of sensory phenomena or feelings, it is self-awareness. When awareness rises to the level of perceptual and conceptual interpretation “about” content, fuller self-awareness arises. “About something” is knowledge around the periphery. Implicit here is an epistemological duality: the subject as “knower” is distinct from and observes the objectified that is to be “known.” Understanding this and remembering it is essential to unlocking the crux of mindfulness mechanisms. For example, in the West, self or ego is typically the processor of information as in critical thinking. In Eastern perspectives, the term “ego” strongly suggests its acting as a block to self-understanding as in egoistic self-centeredness and selfishness. This rec...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• List of Figure
• List of Tables
• About the Author
• Foreword
• Preface
• Medical Disclaimer
• Introduction
• Part I. Mindfulness in Perspective
• Part II. Emotional Awareness and Mindfulness
• Part III. Integrity: Mindfulness Engaged
• Index