Mindfulness in Clinical Care

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Description

A Three Webinar Short Course.

We all understand that stress has deep and wide influences on all of our patients, so what do you do about it?

Dr Paul Epstein is a naturopath with extensive expertise in mindfulness, which he has been using for over 30 years. Mindfulness is a hugely valuable addition to the care plans of every single one of your patients. It is a remarkable skill that dissolves the burden of stress by viewing it peacefully and accepting the circumstances as they are. This has profound effects on people where no other method seems to be effective. Not only does stress disappear, Paul routinely sees it resolve pain, insomnia, depression, anxiety, inflammation, immune suppression, infertility… and more.

In this 3-part, practical course Dr Epstein gives you clear direction on how to use mindfulness clinically. He will firstly show us how to be mindful in practice – to become mindful as a practitioner. This has surprising effects on you and your patients. It dramatically changes the way you are with clients and evokes a strong therapeutic effect just by your mindful nature. Paul is also teaching us how use mindfulness as therapy.

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Session 1 – Becoming a Mindful Practitioner


  • Personal and professional clinical therapeutic benefits
  • Neuroplasticity and epigenetics, the cell and the self
  • What is mindfulness, how to practice, mindfulness and stress, Buddhist psychology, reflection, relationship, resilience, intentions for meditation, healing and listening

Session 2 – Mindfulness and the Healing Process


  • The healing therapeutic relationship
  • Cultivating unconditional presence, compassion and interpersonal neurobiology
  • Preventing burnout, the wounded healer

Session 3 – Clinical Application and Integration


  • Facing and acceptance, heal and cure
  • Cellular resilience and epigenetics
  • Evidence based research, anti-inflammatory effects
  • Working with and engaging patients
  • Working with stress, pain and difficult emotions
  • Post-traumatic stress disorder, anxiety, depression, psychocardiology, psycho-oncology

Listen to Dr Epstein


About Dr Epstein


paul-epstein

Dr. Paul Epstein is a naturopathic physician, mind body therapist, mindfulness meditation teacher, speaker, workshop leader and author. He graduated from the National College of Naturopathic Medicine in 1984, where he did a residency in holistic medicine, stress and lifestyle counseling and directed the clinical lifestyle change program “Healthstyles”. He has successfully advocated the clinical application and integration of mind-body-spirit therapies in health care for 30 years exploring the mind-body connection, how biography becomes biology, narrative medicine, neuroplasticity, epigenetic, and the role of stress and childhood trauma in health and disease. He specializes in treating people with stress related disorders and mentoring health professionals to integrate mindfulness and mind-body therapies.

Paul was co-founder of the Israel Center for Mind-Body Medicine. He graduated from the Academy for Guided Imagery, completed the three-year training program for Community Dharma Meditation Teachers at the Spirit Rock Meditation Center, and has trained in the “Internal Family System model of psychotherapy. Paul travels extensively and teaches mindfulness and mind-body therapy intensive training workshops and webinars, mentors health care professionals to integrate mindfulness and mind-body therapy. He maintains a private practice in Westport CT where he was the founder and guiding teacher of the Insight Meditation Community of Fairfield County. He is author of ‘Happiness Through Meditation.”

Among the venues he has taught classes and programs and been a keynote speaker include;

  • Omega Institute for Holistic Studies
  • Kripalu Center for Yoga and Health
  • New York Insight Meditation Center
  • New York Open Center
  • Institute for Integrative Nutrition
  • The Graduate Institute
  • Yoga Retreat on Paradise Island, Bahamas
  • National Institute for the Clinical Advancement of Behavioral Medicine
  • The Wainwright House
  • Sivananda Yoga Center and Retreat, Nassau, Bahamas

He has also presented at the annual professional conferences of the;

  • Ontario Association of Naturopathic Doctors
  • California Naturopathic Doctors Association
  • American Association of Naturopathic Physicians
  • British Columbia Naturopathic Association
  • New York Association of Naturopathic Physicians
  • Association for the Advancement of Restorative Medicine
  • Institute for Self Leadership (Internal Family Systems conference)
  • American Society of Group Psychotherapy and Psychodrama
  • Israeli Naturopathic Medical Association

Paul has also presented at the following universities;

  • Canadian College of Naturopathic Medicine
  • National College of Naturopathic Medicine
  • University of Bridgeport School of Naturopathic Medicine
  • Southwest College of Naturopathic Medicine
  • Boucher College
  • Bastyr University
  • Tel Aviv University School of Social Work
  • University of Virginia Medical School
  • Lesley University

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Studies have shown that practicing mindfulness, even for just a few weeks, can bring a variety of physical, psychological, and social benefits. Here are some of these benefits, which extend across many different settings.

  • Mindfulness is good for our bodies. A seminal study found that, after just eight weeks of training, practicing mindfulness meditation boosts our immune system’s ability to fight off illness.
  • Mindfulness is good for our minds. Several studies have found that mindfulness increases positive emotions while reducing negative emotions and stress. Indeed, at least one study suggests it may be as good as antidepressants in fighting depression and preventing relapse.
  • Mindfulness changes our brains. Research has found that it increases density of gray matter in brain regions linked to learning, memory, emotion regulation, and empathy.
  • Mindfulness helps us focus. Studies suggest that mindfulness helps us tune out distractions and improves our memory and attention skills.
  • Mindfulness fosters compassion and altruism. Research suggests mindfulness training makes us more likely to help someone in need and increases activity in neural networks involved in understanding the suffering of others and regulating emotions. Evidence suggests it might boost self-compassion as well.
  • Mindfulness enhances relationships. Research suggests mindfulness training makes couples more satisfied with their relationship, makes each partner feel more optimistic and relaxed, and makes them feel more accepting of and closer to one another.
  • Mindfulness is good for parents and parents-to-be. Studies suggest it may reduce pregnancy-related anxiety, stress, and depression in expectant parents. Parents who practice mindfulness report being happier with their parenting skills and their relationship with their kids, and their kids were found to have better social skills.
  • Mindfulness helps schools. There’s scientific evidence that teaching mindfulness in the classroom reduces behaviour problems and aggression among students, and improves their happiness levels and ability to pay attention. Teachers trained in mindfulness also show lower blood pressure, less negative emotion and symptoms of depression, and greater compassion and empathy.
  • Mindfulness helps health care professionals cope with stress, connect with their patients, and improve their general quality of life. It also helps mental health professionals by reducing negative emotions and anxiety, and increasing their positive emotions and feelings of self-compassion.
  • Mindfulness helps prisons. Evidence suggests mindfulness reduces anger, hostility, and mood disturbances among prisoners by increasing their awareness of their thoughts and emotions, helping with their rehabilitation and reintegration.
  • Mindfulness helps veterans. Studies suggest it can reduce the symptoms of Post Traumatic Stress Disorder (PTSD) in the aftermath of war.
  • Mindfulness fights obesity. Practicing “mindful eating” encourages healthier eating habits, helps people lose weight, and helps them savour the food they do eat.

Full Text Research Papers on Clinical Mindfulness


Changes Seen in Neuroimaging Studies

Functional neuroimaging studies reveal compelling evidence that mindfulness impacts the function of the medial cortex and associated default mode network as well as insula and amygdala. Additionally, mindfulness practice appears to affect lateral frontal regions and basal ganglia, at least in some cases. Structural imaging studies are consistent with these findings and also indicate changes in the hippocampus.

Marchand WR. Neural mechanisms of mindfulness and meditation: Evidence from neuroimaging studies. World J Radiol. 2014 Jul 28;6(7):471-9


Improves Psychological Well Being and Grey Matter Activity

Individuals can improve their levels of psychological well being through utilization of psychological interventions, including the practice of mindfulness meditation.

Results showed that scores on five psychological well being subscales as well as the psychological well being total score increased significantly over the mindfulness based stress reduction course. The change was positively correlated with gray matter concentration increases in two symmetrically bilateral clusters in the brainstem. Those clusters appeared to contain the area of the pontine tegmentum, locus coeruleus, nucleus raphe pontis, and the sensory trigeminal nucleus.

The identified brain areas include the sites of synthesis and release of the neurotransmitters, norepinephrine and serotonin, which are involved in the modulation of arousal and mood, and have been related to a variety of affective functions as well as associated clinical dysfunctions.

Singleton O, Hölzel BK, Vangel M, Brach N, Carmody J, Lazar SW.Change in Brainstem Gray Matter Concentration Following a Mindfulness-Based Intervention is Correlated with Improvement in Psychological Well-Being. Front Hum Neurosci. 2014 Feb 18;8:33


The Opposite of Mindlessness

In medicine, a common example of mindless attitude is defining a person by the diagnosis, ignoring or not accounting for the individual as a non-diagnosed person. A mindful clinical practice could help find different ways to see the patient’s situation and self that would have a positive effect of the patient’s psychological well-being.

Pagnini F, Phillips D, Langer E. A mindful approach with end-of-life thoughts. Front Psychol. 2014 Feb 21;5:138


Improves Positive Perspective

The main finding of this study is that individuals with no previous experience of meditation reported less positive affect and showed less joy expression when asked to adopt a mindful perspective.

The significant results are noteworthy given that we have been able to directly and empirically compare mindfulness, reappraisal and expression suppression, which to our knowledge, has never been done.

We could show that mindfulness allowed an improvement in positive affect – a phenomenon that very few studies have investigated. This is a step forward in understanding the relationship between mindfulness practice and emotion regulation.

Lalot F, Delplanque S, Sander D. Mindful regulation of positive emotions: a comparison with reappraisal and expressive suppression. Front Psychol. 2014 Mar 24;5:243


Similar to, and Enhances Exercise Training

Mindfulness based interventions seem to share similar mechanisms with physical fitness by which they may influence cardiovascular responses to stress.

A “mindful” exercise may provide benefits that are not available in “non-mindful” regular exercise or in opposition to situations where exercise is performed in a multitasking context. If so, a mixture of aerobic or resistance physical training with mindfulness would have the potential to improve cardiovascular response to stress in a more effective direction.

Demarzo MM, Montero-Marin J, Stein PK, Cebolla A, Provinciale JG, García-Campayo J. Mindfulness may both moderate and mediate the effect of physical fitness on cardiovascular responses to stress: a speculative hypothesis. Front Physiol. 2014 Mar 25;5:105


Multiple Benefits Last for 4 Years

Mindfulness based stress reduction reduces rumination and interoception of distressing physical signals and increases mindful awareness and acceptance of pain. It has demonstrated efficacy in addressing severity of medical symptoms and psychological symptoms, pain intensity, and coping with stress and pain; these treatment gains may last up to 4 years after intervention in many domains.

Mindfulness based stress reduction has been effective in diverse pain samples,and in individuals with irritable bowel syndrome, neck pain, migraine, fibromyalgia and chronic musculoskeletal pain. Additionally, it addresses co-occurring symptoms of depression in individuals with some chronic pain conditions like fibromyalgia and enhances the effects of multidisciplinary treatment on disability, anxiety, depression and catastrophizing.

Meta-analytic studies in chronic pain have shown small to moderate effects of on anxiety, depression, and psychological distress in patients with chronic illnesses including pain and these benefits tend to be robust across studies.

Sturgeon JA. Psychological therapies for the management of chronic pain. Psychol Res Behav Manag. 2014 Apr 10;7:115-24


Protects Against Depression and Anxiety

Mindfulness, involving an attitudinal orientation of curiosity, openness, and acceptance, has been linked to emotional intelligence in its shared focus on perceptual clarity to one’s emotional state.

A number of studies have in fact attributed the efficacy of mindfulness in reducing symptoms of stress and negative affect to its capacity to modify emotion regulation abilities, with evidence suggesting that emotion regulation is directly engaged during the active performance of mindful exercises.

By enhancing behavioural self-regulation, increasing emotional differentiation, and reducing the routine tendency to emotionally react to transitory thoughts and physical sensations, mindfulness practice is thought to decrease negative affect, stress and mood disturbance, and protect against symptoms of anxiety and depression, including ruminative thinking.

Prakash RS, De Leon AA, Patterson B, Schirda BL, Janssen AL. Mindfulness and the aging brain: a proposed paradigm shift. Front Aging Neurosci. 2014 Jun 24;6:120


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