Episode 81: Practicing Mindfulness Techniques Part 2

Dan Keller 0:08

Welcome to this episode of Substantial Matters: Life and Science of Parkinson's. I'm your host, Dan Keller. At the Parkinson's Foundation, we want all people with Parkinson's and their families to get the care and support they need. Better care starts with better research and leads to better lives. In this podcast series, we highlight the fruits of that research—the treatments and techniques that can help you live a better life now, as well as research that can bring a better tomorrow.

Mindfulness has been developed as a therapeutic technique, but it can also be a part of daily life to cope with stress, pain, anxiety, or depression. It is really a practice of conscious awareness of experiences, sensations, feelings, and emotions at each moment, all in a relaxed and non-judgmental way, accepting them but not being influenced by them. Through this awareness and acceptance in the moment, one hopes to achieve calm and promote a clearer path in one's daily life. While there is no universally accepted definition of mindfulness, Dr. Angela Johnson, like many practitioners, turns to one put forth by one of the pioneers in the field.

Dr. Angela Johnson 1:32

The most commonly used working definition of mindfulness comes by way of Dr. Jon Kabat-Zinn, who's kind of known as the father of mindfulness here in the United States, and he's at the University of Massachusetts. And so the definition of mindfulness is really the awareness that emerges through paying attention on purpose, in the present moment. And so it suggests that the mind actually is fully attending to what's happening. So, for example, you're more present and aware of what you're doing when you're doing it, and as well as having an awareness of the space that you're moving through.

Dan Keller 2:10

Can you give me some examples of it, or how one would begin to become more mindful?

Dr. Angela Johnson 2:17

Yeah, so there are actually two primary ways of practicing mindfulness, and they kind of fall into two categories. So, most of us, you know, when we think about mindfulness, kind of conjure up perhaps an image of someone sitting, right, with their eyes closed and meditating, and this kind of falls into the category of formal mindfulness practice. In this example, it's a practice where someone would intentionally, you know, set aside time to focus on the breath and paying attention to the sensations of breathing with each breath in and each breath out. So, in an instance of mindful breathing, someone would notice the sensations of the coolness of the air as it enters the nose and the warmth as it exits.

Other forms of mindfulness meditation practices include, like, mindful eating where, when you are eating, you're just eating instead of multitasking, and you're noticing, you know, the colors of food on your plate, you're noticing the senses, right—how the food smells and how it tastes—and you're really kind of eating nice and slow. Mindful walking: an example of mindful walking is when you're walking outside, you know, you're really aware of yourself in movement one step at a time, feeling your feet connecting with the ground, noticing the sights and sounds around you when you're in the moment. Those are examples of formal mindfulness practices.

So alternatively, when we practice mindfulness, there's another category called informal mindfulness practices, and this is kind of where we bring our attention to our experiences on a moment-to-moment basis, kind of during the day. For example, we can practice informal mindfulness—I mean, every day, hopefully, we're all washing our hands, and so you can, as you are washing your hands, instead of allowing your mind to kind of be wandering off and carried away by, you know, the thoughts and worries that you have in your mind, you are instead engaged with the process of washing your hands. You're feeling the warmth of the water on your hands, you're noticing the softness of the soap, and so that's kind of an example of an informal mindfulness practice.

Dan Keller 4:29

Can exercise be a form of mindfulness, or can the reverse—mindfulness—enter into your exercise routines or practices?

Dr. Angela Johnson 4:40

Yeah, that's a great question. So, it absolutely can fit into exercise, and so one of my most favorite practices—and I kind of referred to this earlier in the formal mindfulness definition—is kind of along the lines of mindful walking. And so again, the idea with this practice is to be present with the sensations of movement, again, noticing your feet connecting with the ground, noticing your clothes against your skin as you move, noticing sensations in your body without being in judgment of what you're noticing. It's a way of training your attention in the present moment.

And to the other part of the question is, let's say that someone—maybe their exercise routine is doing whatever, like running, or maybe it is sitting and doing some gentle yoga stretching—and so the idea with mindfulness is to fully bring your attention to whatever movement or exercise you're doing, and to notice your body in movement, to feel your skin against your clothes, if you're outside feeling the sensation of the air against any areas of exposed skin. And the moment that you notice your mind wandering off of that exercise or those moments of movement—which the mind will wander, we know from neuroscience that the mind automatically wanders nearly 48% of our waking hours is when the mind wanders—when we notice that our mind has wandered off of whatever it is that we're doing in that moment, you know, exercise, the yoga, the walking, we gently bring our attention back to what we're trying to do. This is how we train our mind to be present to what we're doing in the moment—that's mindfulness.

Dan Keller 6:25

Can mindfulness help deal with stress, either by being mindful and doing mindfulness practices all along, or even in a particular situation where someone is feeling stress, then going back to their mindfulness practices and what they know about it?

Dr. Angela Johnson 6:43

Absolutely. You know, mindfulness practices can be especially beneficial during times of high stress. There's actually a growing body of research to indicate that when we practice mindfulness, we are actually changing our physiology because the nervous system begins to calm down, which may help us feel less stressed and less anxious.

So what research is finding is that when we practice mindfulness, what's happening, or partly what's happening, is that the amygdala—which is the size and shape of an almond, located kind of just behind the temples—is the part of the brain that fires up when we are in a place of, like, when we're feeling kind of stressed and anxious and fearful. And when that is fired up, it often carries us off into the fight-or-flight response, the stress response. And being in a kind of chronic state of fight-or-flight is certainly not good for any of us, including people with Parkinson's. Chronic stress increases inflammation, which can make any condition worse.

So, when we practice mindfulness, there's evidence to suggest that the firing inside the amygdala actually begins to quiet down, and instead, the prefrontal cortex, which is known as our executive functioning area, helps us feel more grounded, more focused. It allows us to respond to what's happening inside more skillfully, and that is the beauty of mindfulness and how it helps us during times of stress.

Dan Keller 8:14

Right now, a lot of people may be feeling stress—we're in the middle of a coronavirus pandemic—but sometime we're going to get back to a normal routine and people are going to have more to do in their day. How can you fit in mindfulness into your daily life in those conditions?

Dr. Angela Johnson 8:32

You know, the wonderful thing about mindfulness is that you don't have to go anywhere special to practice it. It does not cost a dime; it can be incorporated really into all aspects of your life. It's all about finding a mindfulness practice that resonates with you and figuring out a way to get into the habit of practicing, and then doing it and see how it works for you.

For example, mindful breathing: we as human beings breathe 17-plus thousand times a day, and so we have 17-plus thousand opportunities to practice mindful breathing, even if it's just for one breath cycle, where you are following the breath from the beginning of the inhalation through the middle to the end, and then the beginning of the exhalation through the middle to the end. There you go. There's your practice—one breath. So it's really about finding what works for you and getting into the habit and doing it.

Dan Keller 9:35

You focused up till now mostly on physical sensations—attending to your breath or feeling the air when you're outside walking or something like that—but how about more internal stuff, attending to your emotions in the moment, and things like that?

Dr. Angela Johnson 9:51

I really appreciate you asking me this question about using mindfulness to help deal with emotions. So, you know, as human beings, we experience emotions; it's a natural and normal part of life. Oftentimes, without any sort of mindfulness practice, when we experience emotions—and especially if they're difficult—we are kind of hardwired to react automatically to our emotions, and it's sometimes unhealthy, right? When we're feeling stressed or anxious or irritable, we can often lash out at other people, lash out at ourselves, be in judgment of ourselves, be in judgment of other people, and that just increases kind of the heaviness of our emotional experience.

So being mindful of emotions, getting into the habit of that really means like just tapping into, taking a moment and pausing on purpose to identify, "How am I feeling in this moment? You know, what is the most present thought in my mind? What is the present emotion that I have in my heart?" And the idea with mindfulness, in terms of emotions and thoughts, is to label—label what you are noticing in the moment. And instead of saying, for example, if you are experiencing some anxiety, instead of saying, "I'm anxious," you can stop and pause and say, "In this moment, I notice anxiety." And again, research is finding that when we label our emotions, the neural networking inside the amygdala begins to quiet down, which then quiets down the stress response, and it re-engages and strengthens the neural networking inside the prefrontal cortex. And so it's such a beautiful practice to get into the habit of doing.

Dan Keller 11:44

Does mindfulness training and mindfulness itself have physical health benefits, or anything measurable in the physical realm, especially for Parkinson's?

Dr. Angela Johnson 11:55

Trials that have been done have found evidence to suggest that mindfulness can lower anxiety and depression, improve motor functions, help people experience greater verbal fluency, as well as reduce pain.

Dan Keller 12:10

Where can people find mindfulness training? Is it only at medical centers, or is it available in the community, or online?

Dr. Angela Johnson 12:20

You know, many large academic medical centers offer some form of mindfulness training, so certainly, if you are interested in attending, like, a six or eight-week mindfulness series, you could certainly do a search. And if you live in a big city, you know, I would suggest that you do a search of your local medical centers and see what's being offered. But alternatively, for people who are interested in doing an online program—which, you know, certainly now would be an incredible time to do that—there are many, many places across the United States that are offering online programs. And so some of the places that your listeners might want to look into is mindfulness training through places like University of Massachusetts, University of California at San Diego, and University of California at Berkeley. Those are some great places to begin, and there's certainly many, many, many more out there. It's important that people kind of do their own research, maybe ask around to family and friends, and see if they have any suggestions, but really find something that works best for you.

Dan Keller 13:25

And finally, is there anything to add, or anything important we've missed?

Dr. Angela Johnson 13:31

If your listeners are finding this information interesting and they've never tried mindfulness out, I would just suggest that they try it out for themselves and kind of use themselves as their own lab and see how these practices feel for them. While there certainly are suggested guidelines and nuances for each type of mindfulness practice, your listeners should remember that these are certainly just suggestions, and really, it's all about getting into the habit of doing some sort of self-care, whatever feels best for them, and adjusting these practices to make it work for them personally.

Dan Keller 14:10

Great, thank you. That's a lot of information. I'm sure it'll be helpful. Mindfulness exercises have been widely adopted in the United States in schools, businesses, the entertainment industry, and the military. One desired outcome is to help people better control their thoughts rather than be controlled by them. In these uncertain times, you may want to try an online mindfulness course to relieve some of the stress.

We additionally invite you to join the Parkinson's Foundation's Mindfulness Mondays, when each Monday an expert speaker will give tips on staying mindful, and where you'll have a chance to interact with other people with Parkinson's as part of our PD Health @ Home virtual educational and wellness programs. Mindfulness Mondays will provide guided relaxation techniques to help you ease into your week with calmness. You can register for upcoming Mindfulness Mondays at parkinson.org/pdhealth. Past Mindfulness Mondays are archived on our website as well.

You can also check out our podcast episode 78, "Benefits of Self-Awareness with PD," for more on the benefits of cultivating self-awareness and how it relates to health confidence, and episode 80, part one of this mindfulness series, explains how mindfulness techniques affect the nervous system. If you enjoyed this episode, we encourage you to learn more from Angela Johnson through our archived Care Partner Summit videos, which went live this past weekend, featuring Angela Johnson as she walked participants through mindfulness tips and techniques. You can view this video by visiting parkinson.org/summit.

As always, our PD Information Specialists can answer questions and provide information in English or Spanish about today's topics or anything else having to do with Parkinson's. You can reach them at 1-800-4PD-INFO. To receive news and updates about future events and resources, you can opt into our email list at the bottom of our website's homepage. If you have questions or want to leave feedback on this podcast or any other subject, you can do it at parkinson.org/feedback, or if you prefer, email us at podcast@parkinson.org.

If you enjoyed this podcast, be sure to subscribe and rate and review the series on Apple Podcasts, or wherever you get your podcasts. At the Parkinson's Foundation, our mission is to help every person diagnosed with Parkinson's live the best possible life today. To that end, we'll be bringing you a new episode in this podcast series every other week. Until then, for more information and resources, visit parkinson.org or call our toll-free helpline at 1-800-4PD-INFO, that's 1-800-473-4636. This episode is supported by a grant from Genentech, a member of the Roche Group. Thank you for listening.

Angela Johnson is a Doctor of Acupuncture in the Cancer Center at Rush University Medical Center. She also holds a faculty appointment as an Assistant Professor in the Department of Psychiatry & Behavioral Sciences, Rush Medical College.

As the acupuncturist in the Rush Cancer Center, Dr. Johnson provides personalized treatments for patients who are interested in achieving optimal health in the face of chronic illness. In her faculty role, she collaborates in research, serves as a preceptor for students interested in integrative medicine rotations, and teaches mindfulness meditation in clinical, academic, corporate, and retreat settings.

Angela Johnson holds a Doctorate in Acupuncture and Chinese Medicine, Master of Public Health, Master of Science Traditional Oriental Medicine, and Bachelor of Art. Additionally, she has completed mindfulness training with Mindfulness Without Borders; University of California San Diego Center for Mindfulness; University of California Los Angeles Mindful Awareness Research Center; Rush University Medical Center’s MBSR program; The Center for MindBody Medicine; and The Center for Mindful Self-Compassion.