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Attuned Breath

Attuned Breath
Centering
Centering
A Contemplative Practice for A Contemplative Practice for
Cognitive Cognitive Defusion Defusion: :
Integrating Psychology and Integrating Psychology and
Spirituality to Activate Well-Being Spirituality to Activate Well-Being
Presenter: Presenter:
Chaplain Judy Chaplain Judy Seicho Seicho Fleischman MS BCC Fleischman MS BCC
I.
I.
Purpose of this Workshop
Purpose of this Workshop
Learn skills, which complement the methods of Clinical Learn skills, which complement the methods of Clinical
Pastoral Education (CPE), to Pastoral Education (CPE), to
! ! Treat psycho-spiritual distress utilizing a clinically- Treat psycho-spiritual distress utilizing a clinically-
framed method called framed method called Attuned Breath Centering Attuned Breath Centering
(ABC). (ABC).
! ! Care for yourself Care for yourself at the same time at the same time utilizing utilizing ABC. ABC.
! ! Experience and Provide the elements of ABC Experience and Provide the elements of ABC
" " Attuning (identifying intention/ aspiration) Attuning (identifying intention/ aspiration)
" " Breathing (mindfully) Breathing (mindfully)
" " Centering (focussing attention on intention) Centering (focussing attention on intention)
II. What is Attuned Breath
Centering?
! A contemplative practice of paying attention to
intention while mindfully breathing.
! Developed by this writer, in step with Cognitive
Behavioral Therapy(CBT) and its principle of
Cognitive Defusion.
! Activates presence, acceptance, and commitment
as the foundation for transforming psycho-spiritual
stressors and restoring sense of well-being.
! Sustains client(s) and caregiver
" Practice-centered relationship
" Scalable expression of capacity to
Connect
Integrate differences
Function (get needs met)
III. Benefits of ABC
III. Benefits of ABC
! ! Comfort and behavioral shift Comfort and behavioral shift
" " Reduce symptoms of pain and anxiety Reduce symptoms of pain and anxiety
" " Restore sense of well-being Restore sense of well-being
" " Integrate as adaptive intervention or ongoing support Integrate as adaptive intervention or ongoing support
strategy strategy
" " Transform maladaptive behaviors into adaptive Transform maladaptive behaviors into adaptive
coping tools coping tools
! ! Accessibility Accessibility
" " Religious or secular framing Religious or secular framing
" " Language (form of contemplative practice) Language (form of contemplative practice)
Verbal or Written Verbal or Written
Imagery Imagery
Music/sound Music/sound
Movement Movement
III. Benefits of ABC (cont.)
III. Benefits of ABC (cont.)
! ! Scalability Scalability
" " Individual and collective (groups/systems) Individual and collective (groups/systems)
! ! Adaptability Adaptability
" " Settings Settings
" " Populations Populations
IV. How does ABC work?
IV. How does ABC work?
(key elements)
(key elements)
! ! Attuned Attuned
" " Mindful Mindful
" " Reflective Reflective
" " Simple Simple
! ! Breath Breath
" " Presence Presence
" " Contact Contact
" " Acceptance Acceptance
! ! Centering Centering
" " Connecting Connecting
" " Activating Activating
" " Integrating Integrating
Try it out
Try it out
! ! Mindful Breathing Mindful Breathing
" " Noticing next in-breath and out-breath Noticing next in-breath and out-breath
! ! Attention to Intention Attention to Intention
" " Breathing in Breathing in
What keeps me going? What keeps me going?
" " Breathing out Breathing out
What What s important, right now? s important, right now?
! ! Refine until simple statement of core value(s) Refine until simple statement of core value(s)
" " CPE reflective listening CPE reflective listening
" " Non-violent communication (NVC) Non-violent communication (NVC)
" " Voice dialogue Voice dialogue
V.
V.


Psychology meets Spirituality
Psychology meets Spirituality
! Attuned Breath Centering (ABC) is in step with
Cognitive Behavioral Therapy (CBT) and its principle
of Cognitive Defusion (CD).
! What is Cognitive Defusion?
" Experiencing thoughts, images, emotions, and
memories as what they are, not what they appear to be.
" one of six principles utilized in Acceptance and
Commitment Therapy (ACT), a branch of CBT.
! What is ACT?
" ACT uses acceptance acceptance and mindfulness mindfulness strategies
Accept your reactions and be present
Choose a valued direction
Take action
! ABC is a way to ACT
VI. ABC in
VI. ABC in
ACTion
ACTion
:
:
Primary Population Treated
Primary Population Treated
! WHO: Persons living with HIV who report history
of trauma, emotional deprivation, mental illness
and substance use (some in recovery).
! WHEN: Feb. 2006 - Oct. 2009
! WHERE: Housing Works, Inc., New York City
" largest minority-run social service and advocacy
agency in the U.S. for persons living with
HIV/AIDS.
VI. ABC in
VI. ABC in
ACTion
ACTion
:
:
Primary Population Treated (cont.)
Primary Population Treated (cont.)
! WHAT: Individuals and groups
! Partnership with Interdisciplinary (ID) Team
! Integration with Healing Community ID Care Model
" Application within Adult Day Treatment Program
Individual treatment
" Spiritual assessment
" Spiritual Care planning
" Spiritual Intervention
Weekly therapeutic groups
Healing services and Community programs
! Considerations in tailoring treatment
Spiritual
Spiritual
assessment to action
assessment to action
! ! Written tool developed in partnership with The Written tool developed in partnership with The
Healthcare Chaplaincy Healthcare Chaplaincy
" " What keeps you going? ( What keeps you going? ( hope hope ) )
" " What What s important in your life? ( s important in your life? ( purpose purpose ) )
! ! Connect questions with breath cycle Connect questions with breath cycle
" " Breathing in, what keeps me going? Breathing in, what keeps me going?
" " Breathing out, what Breathing out, what s important? s important?
! ! Broadly-framed contemplative practice Broadly-framed contemplative practice
" " Clients disconnected from/not identified with religion Clients disconnected from/not identified with religion
and prayer and prayer
" " Clients with insight but no behavioral shift Clients with insight but no behavioral shift
E.g., those in recovery from addictive substances/behaviors E.g., those in recovery from addictive substances/behaviors
VII.
VII.
Commentary
Commentary
! ! How can the benefits of ABC be measured? How can the benefits of ABC be measured?
Measurable outcome
Measurable outcome
evaluation
evaluation
! ! Concrete practice invites concrete evaluation Concrete practice invites concrete evaluation
" " How many times do you practice ABC per week? How many times do you practice ABC per week?
" " How often are you experiencing symptoms of How often are you experiencing symptoms of
Clinical depression Clinical depression
Anxiety Anxiety
Pain (define type) Pain (define type)
" " How often/much are you taking meds for? How often/much are you taking meds for?
Clinical depression Clinical depression
Anxiety Anxiety
Pain (define type) Pain (define type)
" " How often/much are you self-medicating? How often/much are you self-medicating?
Recovery (addictive substances and behaviors) Recovery (addictive substances and behaviors)
VII.
VII.
Commentary (cont.)
Commentary (cont.)
! ! How can the benefits of ABC be measured? How can the benefits of ABC be measured?
! ! How is this How is this transdisciplinary transdisciplinary care? care?
" " Cross-training Cross-training
" " Integration as adaptive clinical treatment Integration as adaptive clinical treatment
" " Patient-centered CARE planning Patient-centered CARE planning
Charting <==> Connecting Charting <==> Connecting
Assessing <==> Appreciating Assessing <==> Appreciating
Referring <==> Relating Referring <==> Relating
Educating <==> Empathizing Educating <==> Empathizing
VII.
VII.
Commentary (cont.)
Commentary (cont.)
! ! How can the benefits of ABC be measured? How can the benefits of ABC be measured?
! ! How is this How is this transdisciplinary transdisciplinary care? care?
! ! Adaptability to other settings Adaptability to other settings
Treatment in Acute Care Setting
Treatment in Acute Care Setting
! ! Memorial Sloan-Kettering Cancer Center Memorial Sloan-Kettering Cancer Center
" " ABC as adaptive treatment ABC as adaptive treatment bridge bridge for for
outpatient=inpatient outpatient=inpatient
repeat customers repeat customers
! ! NYU NYU Langone Langone Medical Center Medical Center
" " Palliative Care considerations Palliative Care considerations
Considerations for other settings
Considerations for other settings
! ! Healthcare Healthcare
" " Adult Day Treatment Adult Day Treatment
" " Acute care / VA Acute care / VA
" " Rehab Rehab
" " Long-term residential Long-term residential
" " Hospice Hospice
! ! Non-Healthcare Non-Healthcare
" " Military Military
" " Prison Prison
" " Schools Schools
" " Corporate and other workplaces Corporate and other workplaces
Mindful + hopeful + purposeful = Mindful + hopeful + purposeful =
Healing oneself, Healing community Healing oneself, Healing community
VIII.
VIII.
Resources
Resources
! ! www. www.trustingtransitions trustingtransitions.com/resources.html .com/resources.html
! Marshall B. Rosenberg, Ph.D., Nonviolent
Communication: A Language of Life, 2nd. Edition, 2003,
Puddledancer Press, http://www. http://www.cnvc cnvc.org .org
! Hal Stone, Ph.D., and Sidra Stone, Ph.D., Embracing
Our Selves, The Voice Dialogue Training Manual, 1989,
Nataraj Publishing, http://www. http://www.voicedialogue voicedialogue.org .org
! Steven C. Hayes, Act in Action: Cognitive Defusion,
2008, New Harbinger Publications, U.S
! ! http://en. http://en.wikipedia wikipedia.org/ .org/wiki wiki/Acceptance_and_commitment_therapy /Acceptance_and_commitment_therapy
! Fleischman, J., Healing Community: Transforming
Trauma in Relationship, 2008, PlainViews, Volume 5, No.
11, http://www. http://www.plainviews plainviews.org/v5n11/ .org/v5n11/lv lv.html .html
IX. Contact Info
IX. Contact Info
! ! Chaplain Judy Chaplain Judy Seicho Seicho Fleischman Fleischman
" " Info@ Info@trustingtransitions trustingtransitions.com .com
" " T 212-696-7238 T 212-696-7238
Thanks to
Thanks to
! ! My Zen teacher, My Zen teacher, Roshi Roshi Pat Pat Enkyo Enkyo O O Hara Hara
! ! Chaplain George Chaplain George Handzo Handzo
! ! Chaplain Jane Chaplain Jane Mather Mather
! ! Clients and staff of Housing Works, Inc. Clients and staff of Housing Works, Inc.
! ! Patients and staff of Memorial Sloan-Kettering CC Patients and staff of Memorial Sloan-Kettering CC
! ! Patients and staff of NYU- Patients and staff of NYU-Langone Langone Medical Center Medical Center
Thank you
Thank you
! ! My Zen teacher, My Zen teacher, Roshi Roshi Pat Pat Enkyo Enkyo O O Hara Hara
" " Village Zendo Village Zendo
! ! Chaplain George Chaplain George Handzo Handzo
" " The Healthcare Chaplaincy The Healthcare Chaplaincy
! ! Chaplain Jane Chaplain Jane Mather Mather
" " HCC and Memorial Sloan-Kettering Cancer Center HCC and Memorial Sloan-Kettering Cancer Center
! ! Clients and staff of Housing Works, Inc. Clients and staff of Housing Works, Inc.
! ! Patients and staff of Memorial Sloan-Kettering CC Patients and staff of Memorial Sloan-Kettering CC