breastcancerwellness_mentalreadinessPreparing for Healing

by Kathi J Kemper, M.D., M.P.H


After more than thirty years, I’m finally coming out of the closet. I’ve been to medical school, completed a residency and a fellowship, taught at prestigious medical schools, received NIH grants, conducted research, held leadership positions in national medical societies, and published more than 150 papers in peer reviewed scientific journals. But now I’m coming out as a “healer.”
Although I graduated as a doctor and learned many useful skills, I really went to medical school to learn how to be a healer. I didn’t. It’s taken decades and guidance from some of the nation’s best healers, but I’ve finally learned enough to write about what I wish I’d learned when I was that young medical student who wanted to know how to heal. Authentic Healing: A Practical Guide for Caregivers was written for both professional and personal caregivers who want a basic introduction to healing from a reputable, reliable resource.
What I learned over these decades is that we can gain confidece for healing when we prepare ourselves physically, emotionally, mentally, and spiritually.
For the purpose of this article, we will briefly focus on using mental practices to prepare for healing but indepth knowledge about preparing one’s physical, emotional and spiritual well-being are available in the book and other resources as well. Mental practices or exercises share the generic name of meditation (mental training). The word meditation comes from the same root as the word medicine. Both historical experience and modern science suggest that meditation has important benefits when practiced regularly.

The two main types of meditation are:

1. Concentration or focused attention: A conscious focus on a desired intention, object, word, phrase, sound, or image; returning to the intended focus when the mind wanders
2. Mindfulness: Intentional, curious, friendly, warm-hearted nonjudgmental awareness of and insight into the ever-changing milieu of current experiences, thoughts, sensations, and emotions.
Both kinds of meditation offer a stronger sense of wellbeing and inner tranquility, less anxiety, and better concentration. I recommend to learn and practice both types. You may find that one is easier than another. Embrace the paradox of remaining centered and grounded while extending your awareness, sensitivity, and compassion to yourself and others.
Meditation directions sound simple, but the challenge lies in the actual practice. As soon as we try to meditate, we find our minds wandering or judgments arise. On average, it takes less than eight seconds for our minds to wander to something else. This is normal.
The key to successful practice is to notice when it happens and then to gently return our awareness to the original intention. There are a number of excellent books, CDs, DVDs, MP3 files, apps for smart devices, YouTube videos on meditation, and electronic courses available online (See the Ohio State University online course on Mind-Body Skills Training for Resilience, Effectiveness, and Mindfulness, which lists resources). Additional help from a teacher, coach, or counselor, or practice group can be very useful.

Concentration-Based or Focused-Attention Meditation

What are possible objects of intentional attention? Some people focus on a physical object, such as a candle, a sound, or word. Some people focus on an activity like breathing, or a part of the body, like the heart or space between the eyebrows or the tip of the nose. Find a practice that suits you, and practice regularly to develop a deep sense of its benefits for improving attention and the meta-cognitive skill of being aware of your awareness.
One common type of concentration-based meditation is focusing on a single word, such as “calm,” “relax,” “one,” or “peace.”
The most famous medical proponent of concentration meditation is Herbert Benson, M.D., the Harvard cardiologist and author of The Relaxation Response who founded the Benson-Henry Institute for Mind Body Medicine at the Massachusetts General Hospital.
Over 35 years, Dr. Benson and his colleagues have documented the profound physical, mental, and emotional benefits of simple meditation practices, such as repeating the number “one.” Concentration meditation builds attention, concentration, and confidence, as well as a sense of calm and peacefulness. It is similar to breathing meditation, but instead of counting breaths, simply repeat the number “one” or another word or phrase. When the mind wanders, gently bring it back to your chosen word.
To enhance the benefits, you can focus on a positive emotion, such as appreciation. You could also focus on a positive expectation or affirmation of hope—“I’m getting better; I can feel myself healing; help is on the way; yes, we can.” You can also focus on a prayer or a short phrase of scripture to enhance the spiritual benefits of meditation.
Long-term meditation practice actually changes brain structure and function—it increases activity in the left-sided anterior prefrontal cortex (a pattern associated with positive moods) and the putamen (a part of the brain involved in attention and learning). Just as body builders develop larger muscles with practice, long-term meditators develop thicker, more active areas in the parts of the brain devoted to attention, processing, planning, and positive moods. Regular meditation practice leads to improved ability to cope, reduced pain, reduced anxiety, and enhanced immune function.
Here are three simple steps for concentration meditation.


Concentration Meditation

1. Find a place where you will not be disturbed for the period of your meditation; sit comfortably upright or recline with your spine straight so you feel supported and stable; set a timer so you don’t have to look at a clock.
2. Pick a single object, word, phrase, emotion, or action on which to focus. Breathe in a relaxed, normal fashion. You don’t have to take especially deep breaths, but you may notice your breathing gradually slows as you practice.
3. When your mind wanders, recognize it, refrain from self-criticism, and gently return your attention to your intended focus.
You may imagine your mind like an enthusiastic puppy you are taking for a walk. The puppy sees a squirrel (a sensation, thought, memory, plan, fantasy, or emotion) and darts toward it. You gently remind it to “heel.” It does for a minute, and then it spots a leaf (another distracting thought or sensation) and darts toward that. You again remind it to “heel.” Soon, it hears another dog (another distraction, like wondering if this is a waste of time and how much longer we have to do this), and it dashes to find a new friend. Again, “heel.” Soon, the puppy mind, or as some call it, “monkey mind,” learns to attend to the chosen object of attention, and concentration becomes effortless.


Mindfulness or Insight Meditation

Mindfulness meditation is a way of bringing your attention to the present moment, freeing your mind from ruminating about the past, judging anything, or worrying about the future. In mindfulness meditation, one is simply quietly aware of what is happening in the body, emotions, or thoughts, with kind curiosity, without judging those experiences, simply noticing how quickly the mind darts from physical sensation to emotion to thoughts, back to an emotion, on to thoughts of the past or future. As you notice a deviation from the present, simply notice it and return to awareness of the constantly changing present moment.
Mindfulness meditation is about being fully engaged in the present. The best-known scientific proponent of this form of meditation is Jon Kabat-Zinn, Ph.D., who founded the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts. Dr. Kabat-Zinn and his colleagues globally have conducted numerous studies showing that mindfulness meditation improves anxiety, attention, mood, sleep, and stress.
There are three keys to mindfulness practice: intention, attitude, and attention.
1. Intention: Have a clear intention to focus on the present moment.
2. Attitude: Maintain a sense of curiosity and an open, accepting attitude about whatever emerges in one’s perceptions, sensations, thoughts, or emotions during practice.
3. Attention: Focus on the present experience; when attention wanders to another time or place, return to present awareness, gently and without self-condemnation.
Body scan and sitting meditation are two easy ways to practice mindfulness.
1. Body scan: For this practice, start with focusing on one tiny part of your body, such as your little toe. Be aware of any physical sensations in your little toe. Now move to the other toes, the rest of the foot, and so on up to the top of your head. Take your time. Just notice the sensations. You don’t need to label them or judge whether they are good or bad. The focus is on awareness.
You may notice that sensations change in unexpected ways. If you start thinking about something else, simply return your awareness to where you left off and begin again. Experienced meditators can take forty-five to sixty minutes to complete a body scan. Take your time. Do not worry if you take longer or shorter time than others. The OSU Center for Integrative Health and Wellness offers free guided practices for the body scan that you can download to your smart device from www.go.osu. edu/mindfulness. Similar recordings are available from the University of Wisconsin and the University of California at Los Angeles.
2. Sitting meditation: For this meditation, sit in a comfortable position. Become aware of your breathing, the sounds in the room, the quality of light, aromas, and other perceptions. Imagine that you are a three-month-old baby who does not yet have names for things, so you can just observe without labeling or judging. When a thought other than your current perception enters your mind, notice it, and return to observing and perceiving the current moment.
Similarly, emotions need not be rejected or avoided; just note the emotions that arise. Neither pursue nor flee them. Simply observe in a curious, neutral, detached way. When judgments or criticisms arise, similarly notice them and set them aside. Soon you will notice how quickly thoughts and judgments come and go. What remains is the awareness of awareness.
3. Movement: Dr. Kabat-Zinn, the Kripalu Center for Yoga & Health, and others include gentle hatha yoga and walking meditation as a type of mindfulness meditation practice.
Others might include tai chi or chi gong exercises. These kinds of exercises are typically done very slowly and gently and can be readily adapted or modified if discomfort is encountered. Slow, conscious movement that is not aimed specifically at achieving any goal other than awareness of the movement itself can provide the same benefits as sitting and body scan meditations. That is, it can improve memory, attention, concentration, and mood, while decreasing worry and obsessive thoughts.
Mindfulness can be incorporated into any other kind of exercise, whether it is weightlifting, swimming, or running. It can also be included in other daily activities—eating, washing dishes, brushing teeth, participating in conversations, gardening, creating art or music, answering the phone. Eventually, you may want to bring mindful awareness to every moment of your life.
Gaining experience with a range of practices will help you select those that are most helpful for you in different situations. Not everyone is a visual person. Even if you don’t visualize easily, you might want to practice these exercises a few times — you never know when they might come in handy. Practice regularly to develop your skills and deepen your sense of well-being.




Dr. Kemper is the Director of the Center for Integrative Health and Wellness and a Professor of Pediatrics at the Ohio State University. She is a graduate of the University of Chicago, UNC-Chapel Hill (for MD, MPH and Preventive Medicine residency), and the University of Wisconsin Pediatric Residency. Dr. Kemper has served on the faculty of the University of Washington, Yale, and Harvard University, and has founded three Centers for Integrative Medicine: Boston Children’s Hospital, Wake Forest University, and the Ohio State University. She has published over 160 peer-reviewed research papers and four books for the public (The Holistic Pediatrician; Mental Health Naturally; Addressing ADD Naturally, Authentic Healing: A Practical Guide for Caregivers.) She is Past President of the Academic Pediatric Association, and she founded the American Academy of Pediatrics Section on Integrative Medicine. She serves as the Editor in Chief of the international journal, Complementary Therapies in Medicine.  Dr. Kemper is recognized internationally as the founder of the field of integrative pediatrics, and is frequently consulted by media including the New York Times, Chicago Tribune, Newsweek, ABC News, the Wall Street Journal, Redbook, and USA Today.

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