Enhancing Counseling with Aromatherapy, Imagery & Meditation

Welcome, everybody. Today we're going to go over aromatherapy, meditation and guided imagery. Over the next little bit, we're going to review the concepts of mindfulness and how to incorporate it into daily life. I know we talked about mindfulness last session, but it's important to bring back again because a lot of what we're going to talk about when we get down to meditation and guided imagery pertains to guess what? Mindfulness. We'll also learn about the history, benefits, cautions and methods of incorporation into practice of aromatherapy, meditation and guided imagery. So there are some cautions that we want to talk about and we'll hit those as we go. Mindfulness means being aware of your current state emotionally, mentally, physically and spiritually. So that's being in the moment. A lot of times we talk to our clients about not living in the past or not living in the future and trying to appreciate the present moment. But so many of our clients don't even really know what that is. They're not connected to that. They're too worried about what's going to happen or still too busy beating themselves up for the past. Encouraging them to focus on mindfulness and the present state of being will help them not only identify relapse warning signs and relapse triggers, but it'll also just help them be happier and incorporate things that will make them happy. And I harped on that before and I'll harp on it again. It's important not only to eliminate the negative, but to enhance the positive in our lives and in our clients lives. Mindlessness allows people to ignore minor stress until it adds up to a meltdown. And all of us have been there at one time or another, most likely where little things have happened, maybe throughout the day or throughout the week, and all of a sudden something happens that should be relatively inconsequential and we kind of lose our stuffing. And that is one of the effects of mindlessness. Another example would be driving home from work. If you've had a long day or you've got a lot on your mind, you can leave the office and get home and get home safely. But you may not remember that drive at all. And that's mindlessness, not being aware of the present moment. And in the present moment, it's important to remember that we can put discriminative stimuli or things in their environment to remind us to do a mindfulness scan so we stay mindful. Most of us are not used to practicing that. Y' all know that. I encourage my clients to do it at mealtimes because those are anchor points throughout the day, we all eat. And if they incorporate breakfast, lunch, and dinner, mindfulness scans to see where they're at emotionally, mentally, physically, and spiritually. That's three times a day more than they were doing before. And that's awesome. Eventually, they'll start to learn to check in with themselves when they start feeling wonky. That's my clinical term for the day. And figure out what's out of kilter. So mindfulness activities can be just doing a body scan, going from head to toe or toe to head, finding if there's muscle tension, if you feel like your respiration's up, if the heart rate's up, anything that might signal an impending anxiety or panic attack, anything that might be contributing irritability, do one of those. Check in. We can also check in when we do our body scan for posture. And that's one thing I'm really guilty of is sitting slumped over at my desk, and I need to remind myself to sit up and sit straight. Mindful breathing, focusing on breathing in and breathing out and keeping control of our breathing. Most Americans, and I would say a lot of people, don't breathe efficiently. We breathe through our chest. We breathe shallowly and rapidly as opposed to through our abdomen. So taking a few minutes to just take some mindful breaths will help you stop your mind and slow down a little bit. Mindful observation. We've talked about focusing on just what's in the room. You know, just observing what's in the room without judgment or doing the four and four. Four senses. Four things what do I. Four things I see, four things I hear, four things I smell, four things I feel. Mindful awareness means stop and think before you act. So stop, think and then act, and then mindful appreciation. I changed it in this presentation to reflect random acts of kindness. A lot of times we don't take into account or appreciate the person who holds the door for us or the mail carrier who actually brings the packages to your door and puts them in a plastic bag when it's rainy outside. So focusing and finding four or five things during a day that you're like, hey, you know, that was really nice that somebody else did, or something happened. So now that we've reviewed our mindfulness, we're going to move on to one of my favorite topics, and that's aromatherapy. A little bit about the history. It didn't just drop out of the sky suddenly in 2016. As long as 2,500 years ago, Hippocrates identified that the key to Good health rests on having daily aromatic baths and scented massages. I'm thinking I'll go live there if I can have a daily aromatic bath and a massage. Cool. We don't do that today. So the question is, if that's the key to good health, what are we doing instead? And oftentimes the answer is nothing. That's a problem. Some of the plant materials that have been written about include many of the herbs and essential oils we use today, including cardamom, cinnamon, myrrh, basil, fennel, frankincense, juniper, pine, rose, rosemary and thyme. I have a chart that's coming up for you, so don't get all caught up in worrying about specific essential oils or specific techniques. If you've taken these classes before, you know that I'm not going to harp on the minutia. I really just want you to get the broad scope and then you can look up and Google whatever else that you want to look at more in depth. Scented ointments and oils were recognized as having a great benefit on both the physical and psychological level. One of the principal aspects of medicine is massage with aromatic oils. So it's important to remember that certain, like Eastern medicine really focuses a lot on the mind, body connection and the energies. Massage helps with the aromatic oils. It helps to move energies around, relieve blockages and all that kind of stuff. We'll get there in a little while. Distillation of essential oils is credited to the Persians back in the 10th century. So again, we didn't just all of a sudden come up with essential oils and go, hmm, this would be a great thing to sell and make money. It's been around for a while. In 1887, French physicians first recorded laboratory tests on the antibacterial properties of essential oils. So there are some essential oils that can be used antibacterially and have a lot of effects for skin care and wound care and all that sort of stuff. We're not going to go into a lot of those because we're focused more here on the psychological effects, psychological benefits of aromatherapy. But in some of the readings that I have included in your class, you can do some more research on all of the benefits of aromatherapy. In 1910, Rene Guetifoss discovered the healing properties of lavender after severely burning his hands in a lab explosion. He later used the wound healing, antiseptic properties of essential oils and the care of soldiers in military hospitals during World War I. He actually is credited with coining the term aromatherapy and published a book by the same name. It was translated into English in 1993. Another French army surgeon used essential oils in the treatment of war wounds during the French Indochina War and wrote the book Practice of Aromatherapy, which again was translated into English in 1964. And finally, a French biochemist and nurse lectured and gave seminars in the early 30s throughout Europe on the rejuvenating properties of essential oils, resulting in the overall sense of well being they provided. Now, before we really get into the nitty gritty of essential oils, it's important to point out that while certain essential oils are, if you will, known for having certain properties, like lavender is supposed to help relieve anxiety and help people sleep. If someone doesn't like lavender or they have a negative experience with lavender, it's not going to have that same effect because the brain recognizes that stimulus and goes, oh, that's not good, that's noxious. So we don't want to necessarily force people and say, well, lavender is the only thing that does it. There's an array of different essential oils that can produce similar effects, if you will. The inhalation of aromatic molecules affects us on a variety of levels, physical, emotional, and spiritual. When we inhale it, it crosses into our system, triggers our olfactory receptors, which triggers our brain, which stimulates memories. You know, when our brain's triggered, it decides it has to do something. And so it figures out whether this is a pleasurable scent that is supposed to induce calming or it's a stressful scent that's supposed to kind of wake us up and get us to do something. The olfactory receptor sites are responsible for things like triggering things in the nervous system, endocrine and immune systems, in fact, impacting pleasure, pain, emotions, memory, sleep, appetite, and sex. So there's a lot of different things going on there. And we've talked in the past about the impact of thoughts and. And the effects of different neurochemicals on all of these things. So basically, we're saying that it's likely. Now, we haven't done human studies with brain tissue and stuff because that would not be good, but it's likely that the aromas that people are inhaling are stimulating the release of certain neurochemicals, which are linked to emotions and memory and all that other stuff. A 2009 study found that preoperative patients who received aromatherapy with Lavendan, which is a form of lavender essential oil, were significantly less anxious about their surgery than controls. A 2007 study in the Journal of Alternative and Complementary Medicine suggests that women who used aromatherapy during labor reported less Pain overall and were able to use fewer pain medications. There's, again, a bunch of research that revolves around people with chronic pain, people with cancer, people who are aged and have dementia, and people who are in labor. So those are the main kind of captive audiences, I guess they have that. They're using a lot of the. As a lot of the test subjects. But a lot of this information is generalizable to some of our patients. The benefits of aromatherapy, assisting with diffusing anger, anxiety control, ADHD and concentration. Assisting people with depression and grief, fatigue and energizing. Assisting people who are irritable and that can be physiologically irritable or just grumpy, irritable. Pain management, peace and contentment and relaxation and sleep. And you might be saying, why are some of those bolded? Well, if you look at the ones who are bolded, what are their common denominator? They are all symptoms of depression. Go figure. So there are a lot of things or a lot of symptoms of depression that can be addressed potentially with aromatherapy. And we know that our patients will present with different profiles, if you will, or different symptoms of depression, which is why they don't have a checklist that you have to have all of the symptoms. Some will present with concentration issues, some will present without them, some will have sleep issues, some won't. So it's important to look at what our patients are experiencing and identify ways we might be able to address those specific symptoms instead of just addressing depression as a whole. We want to know, what is it about the depression? What symptom are we really trying to target? One interesting one in the Journal of Dentistry for Pain Management, they found that clove oil and benzocaine, when they were put side by side, were equal in their ability to numb skin tissue. So before a needle prick, both benzocaine and clove oil were found to be excellent topical anesthetics. Interesting. I promised you a chart. Now, it's not pretty, I know, but it gets the point across. Essential oils are really cool. And one of the things that I do when I'm working with people, as well as when I'm working with animals, and I do it a lot more with animals, is I let them kind of choose. I find a array of different scents that apply to what I'm looking at. So if somebody has anxiety issues, then I'm going to have a whole bunch of different things for them to kind of sniff and go, does that smell good or not? If it doesn't smell good, then likely it's not triggering the right Places in the brain. For example, two of our donkeys, they're rescue donkeys, and they didn't like to be haltered. They'd never been haltered. They hadn't had their hoofs picked hardly at all. So there was a lot of anxiety about interacting with humans. And when I first got them, I tried using lavender essential oil on their halters to see if it would help calm them down. And it did nothing. Less than nothing, actually. But valerian essential oil does the trick. You know, you put that on there and they'll just sit for the farrier like nobody's business. Can I explain it? No. But I can tell you that I've seen it and I expected the lavender to work better than the valerian. So it's not my expectation sort of effect. That being said, with some of these essential oils, there is a certain amount of expectation. If someone says, yes, this is going to work for me, then likely it will. Some studies that are in your class have been. Have looked at the fact that some people will say, well, that's not going to work, that's just quackery. But it has still shown something of an effect on people who had an element of disbelief. They were willing to try, willing enough to try it, but they didn't really think it was going to work. They were kind of skeptical. Most of these essential oils you want to get therapeutic grade, you're not going to want to prescribe these. That should be done by a naturopath or someone that is really skilled with and certified in working with aromatherapy. However, I think it's good to educate our clients about the options that are out there so they can educate themselves and seek out a professional. Professional. That being said, for anger issues, you have things like bergamot, Roman, chamomile, frankincense, lavender, myrrh, neroli, palo santo, patchouli, rose, sandalwood, vet vier and ylang ylang. You can see a lot of the same essential oils that work for anger, work for anxiety, depression, grief and relaxation. If you're going to look at essential oils, and I encourage my clients to do the same thing, if they're going to look at them, identify as many of the symptoms that they have and try to find oils that appeal to multiple symptoms so they don't end up needing to buy 15 oils, a lot of times you can go with something as simple as bergamot, which, just as an aside, makes you sensitive to light. So if you put it on your skin, you want to cover it up before you go Outside Roman chamomile is another one that's really good across the board. Frankincense is good across the board. They all have different odors and the aromas. Aromatherapy essential oils can be used in lotions, massage oils. You want to dilute them. You know, clients never want to put them directly on themselves. It's actually found to be faster to get into the brain and where we need it to increase mood and improve how we feel through inhalation. So that doesn't involve any topical application at all. You'll find some places online they talk about oral administration of essential oils. There's a lot of debate about this, and it's a really, really dangerous practice, especially if it's not monitored by a physician. So I would suggest just steering clear of any oral applications. If clients want to use them topically, encourage them to educate themselves about any interactions and seek consult with someone who is well versed in the essential oils that they are particularly looking at. Some things that we need to be careful of with aromatherapy is sensitivities and allergies. If you're putting something on your skin, it could irritate your skin. Some of your spices, your cinnamon, your cloves, your gingers can be warming, but they can be really irritating on somebody who has sensitive skin, they can trigger some allergies. So obviously, if you know you've got an allergy to something, you don't want to use an essential oil that is derived from that plant family I mentioned earlier. Photosensitivity. Any of your citrus, bergamot, lemon, lime, or bitter orange can make you sensitive to light. So if you do put it in lotion and put, put it on your skin, you want to watch your exposure to sun. But, you know, especially bergamot has a lot of really positive calming qualities. So, you know, I'd say use it as an inhalation if your clients are wanting to use that. That way you get the benefit without having to worry about the sensitivity. Don't use them during pregnancy unless you're under the guidance of a physician, because if you put it on your skin, it gets absorbed through the skin and into the bloodstream. Anything that's in the bloodstream goes to the fetus. Yes, it may be one drop and it's like mega, mega diluted by the time it gets down to the fetus. But do you really want to take that chance? Like I said earlier, prior learning may impact experiences. So if you happen to work, maybe in a hospital that used lavender in the emergency room to help calm people down, but you didn't have a pleasant experience working there. Then when you smell lavender, you may have memories of that hospital which make it a negative association. Likewise, we have positive associations. And not all aromatherapy has to be essential oils. Now, when we're talking about the benefits on altering brain chemistry and those sorts of things, obviously we're talking about essential oils. But some smells just naturally produce a little bit of a dopamine rush the fall, the smell of crisp air. As soon as I smell that, I'm just like, oh, I'm in the best mood ever. I bake bread in the fall, so the smell of baking bread puts me in a really good mood. It's different for different people. Pine Sol is another one for me because my grandmother always used to clean with it. Encourage people, even if they don't want to use essential oils, to remember that smell is one of our strongest triggers of memory. So we want to trigger good memories with our smells. Because of the dermal absorption, it's important to understand that some essential oils may interact with medications. If you've got patients that are on buspirone, for example, they're not supposed to drink grapefruit juice or eat grapefruit while they're on it because it greatly increases the plasma concentration of the buspirone. So we would follow, they wouldn't want to use grapefruit essential oil either. Some essential oils that have been thought to increase estrogen, as evidenced by some studies that have seemed to indicate the development of gynecomastia or development of breast tissue in boys, are lavender tea tree oil and fennel oil. The jury's still kind of out on that, but, you know, it's worth being aware of. And again, that is through topical application, not inhalation. So how do we use aromatherapy topically? Essential oils have a chemical weight of less than 1000 molecules and can be absorbed by the skin and enter the bloodstream. So that's cool to an extent, because that also means if you have too much, it can be toxic. In a facial steam, you only want to use one to three drops in a bowl of hot water. Use skin friendly essential oils and keep your eyes closed. Compresses hot and cold or alternating compresses can be used with essential oils. One of the things I like to do, believe it or not, dry rice, who would have thought? But dry rice, if you put it in a sock and I try to use a cotton sock, because nylon gets a little bit hot. But dry rice can be heated or it can be put in the freezer and it actually holds the temperature better than most hot and cold pads. And most of us have rice in the house. But you can also sprinkle some essential oils on the hot or cold pad before you put it on so you're smelling it, relaxing while you're trying to get your muscles to relax. Clay masks. Again, use it very sparingly. One drop, maybe two drops in a clay mask and a massage oil. One to 3% dilution in a carrier oil like coconut, argan or apricot. You can find recipes for this online pretty much everywhere. Doterra, Eden's Garden. And there's one other that I came across. It'll come to me in a minute. The three of those are young living essential oils. Are known for having purer essential oils. Now, you know, I haven't tested them myself, but they seem to have good reputations. I use Eden's Garden myself, but that's just me. Methods of incorporation, inhalation, electro mist diffusers. You know, those electronic mists that go off either when you walk by them or every 20 minutes. Heat generated diffusers like tarts, the little wax things that you can plug into the plug into the wall. Put the little wax drops in. They also have bulb rings. If you're using the old incandescent bulbs that get hot, there are these little rings that stick. Sit right on top of the incandescent bulb and you can put an aromatherapy oil on it. The heat from the bulb disperses it, spritzing it just in the air or on your clothes. Be careful. A lot of essential oils can discolor clothing. Steaming it, just sniffing it, opening the bottle and going. It works, you know, gives you kind of throwbacks to the movie airplane from the 1970s. But digress and aromatic bass, you don't want to use more than six to eight drops total. So if you're using three different oils, you're going to use, you know, like two drops of each. It sounds like it won't do much because, you know, big bathtub, little tiny drops. But they are very, very potent. Do avoid things like any of your mints, Peppermint, spearmint. Just imagine putting Icy Hot on places that you wouldn't want to put Icy Hot. Yeah, this is kind of the sensation that you would get. So avoid putting mints in baths and a lot of your spices. Anything that tastes spicy if you eat it in the kitchen, not as an essential oil like cinnamon or ginger will also likely be irritating to your skin. Note that water and heat will increase absorption of the essential oils. So that is your brief little overview of essential oils. I know I covered those really quickly because we've got a lot to go over today. I really encourage you to look at the different benefits. Dr. Axe. Dr. Period, A, X, E. If you go to his website, he's got a lot of really good information about essential oils that's written in, you know, layman's terms. So it's really easy to print out for your clients if you want to give them information, or easy for them to look up. I also have it on my Pinterest board, so you can go there and look if that's where you'd prefer to do it. Okay. Meditation. So aromatherapy is great, and you can do aromatherapy on the run if you need to. But if you combine aromatherapy with meditation or guided imagery, then you get an exponential beneficial effect. The structured practice of meditation is believed to have been developed approximately 5,000 years ago in India, initially developed by the Hindus to understand and get closer to the true nature of their higher power. The first articles on the health benefits of meditation, because that's what we're concerned about, appeared in the Journal of Transpersonal Psychology in 1970. In 1979, I didn't realize MBSR was that old, but in 1979, Mindfulness Based Stress Reduction was founded in the United States. It used meditative techniques in the treatment plans for patients with chronic diseases. A lot of what we teach patients now when we talk about mindfulness, is Mindfulness Based stress Reduction. Just kind of an interesting little point. It's something that has persevered through the decades. According to meditation, fluctuations of mood arise because we're too closely involved in the external situation. We're like a child making a sandcastle who's excited when it's first made. But if it's destroyed, we get really upset right away. Instead of appreciating the fact that we made a great sandcastle, we get to start again. It came and it went, just like everything else in life. You know, we see a corollary here. We get upset by training and meditation. We create an inner space and clarity that enables us to control our mind regardless of the external circumstances. So you can see the sandcastle. You can be proud of the sandcastle. You can love the sandcastle. And when the sand castle goes away, that doesn't mean your pride for what you made has to go away or your love for it has to go away, but the visual representation of it has gone away. Gradually, we develop mental equilibrium and balance instead of oscillating between the extremes of excitement and despondency. So we learn to hold on to that appreciation. And when something goes away, it went away, we can't change that, it's gone. So we need to figure out how to appreciate what is there and be a little bit more middle of the road and appreciating maybe the tide that came in of how cool that is, that it comes in and it restarts everything. Psychological benefits of meditation Reduced stress, anxiety, depression, and possibly ADHD symptoms. Reduced irritability and moodiness. Increased creativity and intelligence. Increased learning ability, memory and concentration. Feelings of vitality and rejuvenation. Increased emotional control, Increased self esteem, increased alertness and improved relationships. So I sounded like the side effects bit on the end of a drug commercial. What I want you to see is that meditation has a lot of benefits. There's research supporting all of these claims in your class. So if you want to go look at the different research that's out there, great. You know, I really encourage people to look at independent research. What I want you to think about is why does meditation have these benefits? Well, if we're not going between yay and crying all the time, we're not expending near as much energy. So we have some more energy in reserve to deal with life on life's terms. As we may have said before, basically we're eliminating or moderating a vulnerability. We're keeping some energy available. So that's really awesome. Meditation allows us to learn how to silence our mind and not be attending to the 16 different things that are going on and focus on just one thing. Think how awesome it would be if you could come to work. And especially if you work in community mental health, you can sort of identify with me here. If you could come to work, go to your office and focus on just one thing for even an hour without having the telephone ringing, the email coming in, the clients knocking on your door, fire drills going off. So another one of the benefits of meditation is being able to help people increase their focus. If you can focus on that one task for 15 minutes and get it done, it expends a lot less energy than trying to get it done. And juggle six other things where it takes, you know, two hours to get the task done and think about writing progress notes. You know, that's. At least that was my experience in community mental health. Writing progress notes used to take forever because there was always something else, somebody coming in. And yes, I didn't want to do them. I hated documentation. But it was necessary so we could get reimbursed. So there was an element of not wanting to. The nice thing about meditation is, again, being in the moment, acknowledging that I don't want to do this, however it needs to be done, and just moving on with it. Irritability and moodiness often comes from going from that activating event to the consequence. Something happens, we get upset without just stopping to appreciate the totality of the moment and appreciate what was increased creativity and intelligence. If you silence all the noise, how many more really cool ideas will pop out? And not that you have to attend to them. Remember, in meditation, we let things come, we let them go. You're not going to get hung up on anything that comes out. But if you can silence some of that extra noise and start learning how to filter out the extraneous variables, it helps a lot. I had a colleague when I was in graduate school who had adhd, and she did a presentation on it one time, and it really hit home with me. She had us all sitting in the room, and she was talking, and then somebody else got up and started flicking the lights on and off. And somebody else got up and turned on a radio, and somebody else got up and started knocking on the door. And they kept doing that while she was talking. And all of us were sitting in there going, I can't focus. And she was like, all right, cut it. She's like, that's how I feel all the time. I can't decipher as easily the extraneous noise from what I need to pay attention to. When people start practicing meditation and it doesn't happen overnight, they start being able to filter out some of that background noise. Why is this helpful for people with anxiety, depression, ptsd, adhd? Because it helps them focus on what's important, reduces that irritability, improves their ability to concentrate. If I'm not distracted by people walking down the hall, if I don't even notice it, then I'm kind of in my zone. And I think most of us have been in the zone before. You just get in there and you don't even realize. You look up and six hours have passed. That's a great zone to be in. But it's hard for a lot of people to get there. It gives you a sense of increased emotional control, because if you're able to choose which reactions that you attend to, you know, something happens and you're like, okay, it happened. I'm feeling angry. What else am I feeling? You know, let the emotions come. You don't have to latch onto that anger and go, I'm feeling angry. So I'm going to get really, really ticked off. You're angry, okay, let it go. There's nothing you can do about it. Easier said than done. Increased self esteem a lot of times comes from as a side effect, if you will, of meditation. You're feeling more in control of your emotions, you're feeling more rejuvenated and you know, you're more awake, you have more energy, you're able to get focused, you're less irritable. You know, that tends to make everybody feel better about themselves if they tend, if they're happier and healthier and more energetic. So increased self esteem says, I got this. Which also benefits relationships. Nobody wants to. Well, let me go with the positive. People want to be around other people who are happy, not moody, who are creative, who are enthusiastic, who are curious. And meditation really encourages that to develop in people. Physiological benefits, just real quick, because we know there's a connection between the mind and the body, may help lower blood pressure. We know that when this fight or flight reaction is activated, the body dumps cortisol, the body dumps adrenaline in order to prepare us to fight or flee. This raises blood pressure. Understanding this is important because we know if the blood pressure is going to go down, then those stress chemicals are going down, which likely means what we label as the emotional reaction going down prevented, slowed or controlled pain as people learn to meditate. And there are certain techniques that are specifically designed to help people deal with chronic pain or even post operative acute pain. As that pain goes down, their sense of happiness goes up. Most of us are cranky when we're in pain. Most of us feel helpless if we can't get up and do stuff for a long period of time. I can sit still, I can be sick, I can do whatever for two days, maybe three if I'm really, really in pain. But after that, I start getting a little bit testy that I don't feel well still, just like I don't feel well. The same thing is true for a lot of our clients. If they have chronic pain, it can feel very overwhelming and hopeless. So if they find a type of meditation that helps them deal with that pain, then they're going to feel more in control and they're also going to feel less pain, which, you know, bonus. So they will be able to do more things. Boosted immune system if you're not using a whole bunch of energy on extraneous stuff, your body can focus that energy on immunity. Lowered cholesterol levels. When cortisol goes up, cholesterol goes up. We know that cortisol is our fight or flight chemical or one of them. So if we are stressed out, if we are up here, if we are anxious, angry, any of those wound up dysphoric emotions, cortisol is going to be high. So if cortisol is high, cholesterol goes up. So if we can help people reduce their dysphoria, then cholesterol levels may decrease concurrently. Additionally, a lot of the foods that we eat for comfort eating may increase cholesterol levels. So, you know, there's a double benefit to reducing stress and dysphoria, not only in just lowering cholesterol, but lowering or improving nutrition, improved airflow, especially in those with asthma. Meditation, breathing. Focusing on your breath as it comes in and goes out can help people breathe better, breathe more efficiently, and calm their breath. In a panic attack, people start to hyperventilate. One of the first things people start to notice is their heart rate increasing. Then they start breathing more rapidly. If they can focus on their breathing and slow it down, likely that will have cascade effects and help calm the body down. It helps manage the heart and respiratory rate, like I just said, and it improves sleep. How many times have you gone to bed and you've just had a million and one things going through your head and you couldn't turn it off? It was just, you know, it was. It was like a whole concert going on in your head. So you didn't sleep well. But on the days that you can turn it off, you sleep better. Meditation, regardless of what kind you use, helps your body relax. And it can help you focus on one thing, ideally that's not stressful, which will help you get to sleep and help you relax. So to avoid getting too particularly complicated, there are two basic types of meditation. Concentration and mindfulness. Concentration meditation focuses attention on internal or external objects, like a sound, a word, or a bodily sensation, while minimizing distractions and bringing the wandering mind back to attention on the chosen object. This is one type of meditation that can be used in pain management, but the key is you don't focus on the pain. If the pain is in your back, then you want to focus on your big toe, or you want to focus on your knee or something that doesn't hurt. Focus on what it feels like. Focus on anything that basically changes your mind's attention to something that's not hurting you. Mindfulness meditation, on the other hand, is an outgrowth of a Buddhist tradition called Vespana. Well, whatever, I can't pronounce anything today, which focuses on the present moment, focusing attention alertly but non judgmentally on all processes passing through the mind. This is the key. Non judgmentally, not I shouldn't have thought that or I can't focus today. Just letting it come and letting it go. One of the main influences of mindfulness in the west is Jon Gobet Zinn. His mindfulness based stress reduction program, remember the one that was formed back in the 1970s, has really brought meditation to the forefront of American treatment and culture and that kind of stuff. Open monitoring meditation instead of focusing on the attention of any one object can help us in our focused when we keep our mind open, monitoring all aspects of our experience without judgment or attachment. So this goes more with the mindfulness meditation, just being aware, being in the present. Focused attention. Meditation focuses attention on a single object during the whole meditation session. Like I said earlier, this can be the breath, a mantra, visualization or a part of the body. Qigong means life energy cultivation. It's a body mind exercise for health and meditation. It involves slow body movements, inner focus and regulated breathing to increase and remove blockages of qi or the life force throughout the eight extraordinary meridians. Extraordinary meridians are considered in traditional Chinese medicine or tcm, to be storage vessels or reservoirs of energy. So qigong is something that you'll see in hospitals, you'll see in assisted living facilities. There's a lot of research of the benefits of qigong on its restorative properties. There are literally hundreds of different ways to do qigong. There are hundreds of different applications. So I've given you links that you can click on. Go research them a little bit more. Not everybody is comfortable with sitting in a chair and meditating. So qigong does give them more of an active option if they want to, with the slow movements so they don't feel like they are just sitting still and doing nothing. Tai Gi is a martial arts form of qigong. A lot of people practice Tai Chi in fitness centers, in wellness centers. It is geared more towards the martial arts than the healing and wellness. Either way, it's focusing on management of that energy and being aware of your body in space and in time. So it's increasing your self awareness and your mindfulness whether whatever form you choose to use. So what are some cautions with meditation? People with PTSD may feel vulnerable during a meditation session. It's been shown to be helpful for PTSD and helpful for managing flashbacks. But not everybody's going to be comfortable with it. People who have been victims of or survivors of ritualistic abuse will sometimes not be comfortable with certain Types of meditation or any type of meditation, especially if it involves closing their eyes. Anything where they feel like they're dissociating may be anxiety provoking for people. Likewise, if one of your clients has a difficulty not dissociating, you may want to look at how to incorporate meditation safely. So you're not encouraging dissociation, but you're actually encouraging the person to be aware of their, their body, their mind, and their spirit in the present moment. Victims of violent crimes, again, may not want to close their eyes, may not want to feel that vulnerable. Practicing for periods, short periods, like a minute or two or three minutes at a time, can be helpful for them if they want to try it out. People with depression. Now, why would meditation be bad for depression? You would ask. Well, when you're depressed or when you're meditating and you're sitting there and you're letting the thoughts come through your mind and go out. People with depression often have a lot of negative thoughts that come through their mind. Now, even if they're trying to let them go, the preponderance of thoughts that are going through their mind are negative and may increase their depression. Some research has found that they tend to seize those thoughts that are more negative, more self fulfilling, if you will. So until they've gotten a hold of some of their unhelpful cognitions and guilt and resentment and that kind of stuff, meditation may make it worse. Now, that doesn't mean mindfulness is out of the question. We still want people to be aware of where they are, but meditation as a practice may need to come later. And people with anxiety, a lot of times people with anxiety are kind of revved up. And if they are told that they have to sit still or they have to be quiet, or they have to try to quiet their mind, just even thinking about doing that is overwhelming. They're like, if I knew how to do that, I wouldn't be here. Okay. People with anxiety should be encouraged to take it slowly. Remember, there's not a right way to do it. The mind is going to wander. It doesn't want to stay focused on one thing because that's not what we've trained it to do. We've trained our mind to be aware. Think about a little kid, my son, when he was a toddler. We would go places and he would notice the most obscure things. And then we would go back, you know, a week later, and he'd point out that whatever it was was gone. My mother came to visit once, and she visits like once every six months. To a year. And she pulled out her hairdryer, and he's like, is that a new hair dryer? He was like 4, but he noticed what her old hair dryer looked like, and he took note of it and noticed it again. Children are like sponges. A lot of times we're still like sponges, noticing a lot of stuff. We just filter through it better or worse. So it's important to help people remember that it's going to take time to be able to quiet your mind. When I work with clients, if they're willing to try meditation, I generally suggest we just start with breathing. And it's not closing their eyes and taking deep breaths necessarily. You know, I just encourage them to sit there for a second and notice their breathing. You know, notice where it's coming from, what it feels like, how quickly it's going in and going out, simple things. As they get used to that and start to be able to quiet their mind for even 15 seconds, then they can extend it for a little while longer. But the key is not to increase their anxiety by having them think that they're failing or they're not doing it right. How do we incorporate it before getting out of bed? Mindfulness meditation. Before you get out of bed, just be aware, do a body scan, look around, be focused on the present moment, how you feel, what you're thinking, how you feel physically, and, you know, to kind of get ready to know where you're at for the day. At the beginning and ending of each counseling session, mindfulness meditation can be helpful. How are you feeling? You know, get a sense for how your clients are feeling emotionally, mentally, physically, when they come into into your session, whether it's individual or group. And then after session, so you can identify maybe any relapse, warning signs or things that you still need to tie up before they leave. Before eating. A focused attention meditation can help people calm down so they're more aware of what they're eating and they taste it instead of just shoving it in. I've always eaten fast, but when my son was little, he had really bad gastric reflux. And so I would like inhale my food in order to be able to, you know, pick him up and walk him around so everybody else could eat. He's 16 now, and I still have a bad habit of inhaling my food if I don't really make a cognitive choice to focus on it. So focused attention meditation, just sitting at the table and focusing on three or four breaths. Three or four, that's all. It doesn't have to be a long thing helps people get kind of in the mind space that they're getting ready to eat. They can also do meditation, if you will, or attentiveness while they're eating, focusing on how the food tastes when they're eating it, what it reminds them of, you know, what they're feeling prior to going to sleep. Focused attention meditation can help people get sleepy. If you focus on the ceiling fan or you focus on something on your wall, if you have a picture that you can focus on, or you close your eyes and you focus on a mental image, focusing on that and the thoughts from the day will come through, but you just let them come through go by. And at the first sign of an anger or anxiety trigger, if somebody feels themselves starting to get a little revved up, encouraging them to step back and do a body scan at the very least, and then try to attend to whatever's going on. If they step back and they notice that their heart rate is up, then taking a few slow breaths can help slow their heart rate down. So they. And then once they've gotten away from that or calmed down that body response that has been their timeout, their adrenaline has gone away and they can think a little more clearly. Guided imagery is actually kind of an outshoot, if you will, of meditation. Various forms of guided imagery have been used for centuries. As far back as ancient Greek. Jacob Moreno's technique of psychodrama has been linked to guided imagery as the enactment of someone's own imagery. So if you've studied psychodrama, you may be going, oh, yeah, that kind of makes sense. In the 1970s, Dr. David Bressler and Dr. Martin Rossman established support for guided imagery as an effective approach to the treatment of chronic illness and founded the Academy for guided imagery in 1989. So how does it work? The body does not have to be actively experiencing something for the mind to respond to it. Think about lemons. Just think for a second about the last time you had a lemon, what it tasted like and the sourness. And think about drinking a really sour lemonade that somebody forgot to put sugar in. You know, your salivary glands start going. It's just one of those natural reactions. The lemon is nowhere around when you're watching a tennis match. I played tennis all through high school, and we would watch game tapes and we would watch professional athletes. And I could see in my mind's eye myself reproducing what Bjorn Borg or somebody else did childbirth in Lamaze classes, envisioning what the childbirth experience is going to be. Like, and practicing the breathing before you get to the point where you're going, went epidural, please. Really helpful. Another way to use guided imagery is to go to a happy place. And you know, that's not meant to sound condescending, but everybody's happy place is different. But when the person goes there, have them notice with all their senses, not just what they see, because not everybody's visual, but what they smell, what they hear, what they feel. If they're in the middle of the woods, is there a breeze? Is there not a breeze? Where's the sun coming from? There are a lot of details that can help people really immerse themselves in this happy place, if you will. And if the person's been there before, then it brings up all of those memories, those positive memories from the past, and helps them experience it. A diver, you know, a diver is though, well, I should have chosen another verb that I could conjugate better. But a diver can see himself and feel himself going through a dive. So then the diver can also see himself or herself going through the perfect dive and what it would feel like because we've all hit that sweet spot occasionally and gone. That was it. Research has shown guided imagery to be helpful in the treatment of a whole bunch of mental health issues, substance abuse, post traumatic stress issues, relationship issues, and family and parenting issues. Even because you can mentally rehearse what's going on. The biggest caution with guided imagery is that it has been linked in some cases that to false memories. Now, whether you can blame the guided imagery or there are personality factors, there's probably a whole bunch of stuff, stuff that goes in there. But do be aware that guided imagery, if you start involving all those senses and get the brain to really believe it's there, then it can create sort of a false memory. How do we incorporate it? Going to your happy place. If you've had a stressful day, maybe just laying back and relaxing in your favorite easy chair and imagining what it's like to be in whatever that place is. Mental rehearsal of coping or refusal skills. If you are going to have to have a stressful, excuse me, a stressful confrontation with someone, maybe mentally rehearsing it ahead of time so you see what you're going to say, you anticipate how you're going to react, they're going to react, then you anticipate how you're going to react. We can do active rehearsal in group, but it's also really effective for people to practice mentally rehearsing new coping skills that they learn in Counseling or even in self help books, you know, they want, they need to incorporate it into their brain so those memory pathways are activated when they're needed. And visualization, if you've got muscle tension, you can envision the muscles relaxing. You can envision angels rubbing the knots out of your muscles. You can envision whatever you want to that helps you get rid of the muscle tension. People with cancer and HIV have used guided imagery to imagine the body actually attacking the tumor or the helper cells growing in force so the person becomes healthier. And they've shown it does have an effect. Anxiety. What are you going to envision with anxiety? Well, people envision the anxiety provoking situations and their reactions to it and how they can react. So it's not so anxiety provoking. Depression, you can use guided imagery to envision what it'll be like when you're not depressed anymore. That's your end goal. So what is it going to be like when you get there? Public speaking or social anxiety? If somebody envisions going out on stage and making that speech, it will help them and doing it successfully, managing their anxiety, it can help them prepare for the event. It's also with guided imagery you can use it as a form of systematic desensitization. As they're imagining the situation, their anxiety goes up. You can help them learn how to bring that anxiety back down. Same thing with test anxiety. People who have test anxiety imagine going in there and just, you know, scoring an A on, on the exam, not getting stressed out, accepting the fact that they are going to find run into questions that they don't know the answers to. But that's okay. Mindfulness involves increasing awareness of our emotional, mental and physical selves. Aromatherapy has many uses for emotion, hormone and pain regulation. And we know as estrogen goes up, the availability of serotonin also goes up. And as estrogen goes down, serotonin availability can go down too. So hormone regulation is just as important as the other neurotransmitters and everything else. Meditation is a practice designed to quiet the mind and help people develop non judgmental acceptance of the experience. It just is. Guided imagery can facilitate skill acquisition and relaxation in some people. Now again, one of the biggest keys with meditation and guided imagery is to not beat yourself up over it. Your mind is not really used to, to focusing on something or going quite that deep into an image. So it'll take some time and rehearsal. And not everything works for everybody. So if a client tries guided imagery and says no, that's not working, you know, okay, it doesn't work for you. Let's see if there's anything else that does. What we want is to help the person achieve the ability to separate the experience from the emotional reaction so they can just be in the moment. If you enjoy this podcast, please like and subscribe either in your podcast player or on YouTube. You can attend and participate in our live webinars with Dr. Snipes by subscribing at allceus.com counselortoolbox this episode has been brought to you in part by allce.com providing 24.7 multimedia continuing education and pre certification training to counselors, therapists and nurses since 2006. Use coupon code counselortoolbox to get a 20% discount off your order this month.