by Malia Kirby

In my last post, So You Think You're Present, Part One, I discussed being present and centered in the context of Chinese medicine and introduced an exercise to help us determine how mindful we may or may not be. Today's posting, part two of this series, will include some basic mindfulness exercises that we can offer to empower our patients (and ourselves) to help combat the stressors of everyday life and further aid our treatments.

Starting a daily practice
Yeah, I know. It's difficult to cultivate and maintain a daily practice long-term. At first, everything is new and interesting...or it can seem pointless and a waste of time, depending on each individual starting out in meditation. Pulling your butt out of bed earlier than you're used to can be irritating and I can guarantee that there will be days where you'd much rather sleep in, particularly during the holiday seasons or if you have neighbors who are notorious for throwing all-night parties that could wake the dead. You will have days where your first instinct is to throw your alarm clock out the window and cover your head with the pillow. You will have days where you'll want to quit and tell yourself that it is impossible for you to be mindful every single day and that only enlightened yogis on the mountain with nothing but time on their hands could possibly accomplish what I'm suggesting we all attempt. Here's a secret, though: everyone feels that way, even the "enlightened" yogis on the mountain. The point is to make the commitment to yourself; that your health, emotional outlook, spirituality, or whatever is driving you to begin a daily practice is more important than your current difficulty that will only last for a moment. It is worth it, but it's up to you to prove it to yourself. No one else can do that for you.

...

Baby steps: Starting with our Senses
Tactile
So, where do we begin? We start with the very first activity each and every one of us has done at birth: we breathe. We focus only on our breath. Some of us may feel more comfortable lying down with our knees bent and our feet flat on the floor (particularly those who have tight psoas muscles) while others may feel more comfortable sitting upright. Once we find a position that we can comfortably hold for a few minutes, we draw our focus to our breathing, closing our eyes if we need to. Notice the sensations you feel inside your nostrils as air enters and leaves your body. Don't try to alter the natural rhythm of your breath at first, just watch and take note of what you experience. Initially, you may notice that you are breathing shallowly and quickly and as you become more relaxed, you may find that your breath slows and deepens. If you find your mind wandering, acknowledge the distraction and bring your focus back to inhalation and exhalation. You may want to begin with five minutes at first and gradually add more time to your breathing meditation as your focus improves.

Once you feel comfortable with breathing meditation, you can adjust your focus to sensations in the body. Start off by getting into a comfortable position and begin with breathing meditation. Once you are ready, start by noticing any sensations you may be feeling in your body. Don't try to determine whether or not anything is comfortable or uncomfortable, simply notice what you feel and take note of it. Start with your big toe on either foot, taking note of the sensations you feel, moving on to each individual toe. Once you've accomplished that (it will be difficult at first), move on to the toes on the other foot. Work your way up the body to your head. It will take a seemingly inordinate amount of time to get through every sensation you feel in every portion of your body, so be prepared to set aside plenty of time, thirty minutes minimum.

Sight
Sometimes it can be difficult for us to relax with our eyes open, so start with breathing meditation to relax your body. Once you have relaxed, open your eyes and choose a singular object such as a plant, a candle flame, maybe even a favorite piece of sculpture. Focus your entire awareness on your chosen object, letting your eyes soften and relax, as well as the muscles in your face, neck, and shoulders. Let your eyes wander over the object, looking for details that may not be immediately obvious. Notice any textures and where light might be reflecting or creating shadows. If your mind wanders, take note of it and bring your awareness back to your object. Start with five minutes of sight meditation in the beginning and gradually increase your time as your ability to remain with your chosen focus object increases.

To make sight meditation more complex, you can utilize favorite works of art and new photos. Even the Where's Waldo children's books from the 90s can be used. Notice what sort of color scheme the artist used and if any colors are missing. What seems to be going on in the composition? If people (or animals) are involved, what interactions do you see? What do you think they might be experiencing and thinking? If you need any suggestions of photographers' websites, here's a few of my favorites:

Adam Barker Photography
Corey Rich Photography
Dawn Sparks
Jeremy Turner
John Daido Loori, Roshi
Mike Tittel Photography
Neil Corman Photography
Trystan Photography

Sound
While you can certainly go out and buy CDs or MP3s of music produced specifically for sound meditation purposes, there really is no need to do so when you have all the sounds you need around you, regardless of your location, indoors or out. Very rarely will you hear complete silence. Start with breathing meditation to relax you and focus on the sounds you hear in your environment. Focus first on the sounds closest to you, working your way outward, and note the direction from which it comes from and the quality. If you can identify the source of the sound, feel free to do so and then move on to the next sound you hear. Gradually work your way back to the sounds you hear closest to you and then note any sounds you may be making yourself.

Smell & Taste
Considering that the majority of what we taste comes from our sense of smell, one of the best ways to work with our senses of smell and taste is through eating. Start with breathing meditation to relax the body and then focus on an orange. Slowly begin peeling the orange and notice the instant you smell it. Take a deep breath inward, savoring the smell of the fruit, and exhale. Once the orange has been completely peeled, remove one section of the orange and take a bite, but don't chew, holding the bite of fruit in your mouth. Take another deep breath through your nose and note if the smell has changed any or if it has intensified. Release your breath and slowly begin to chew your bite of the orange. Note the flavors of the orange and the different textures in your mouth, as well as the feel of the fruit in your hands. Feel the acidity of the juice on your tongue and in your mouth. Swallow the bite you have taken and continue with the rest of the orange, noting any change with smell and/or flavor. Note any differences in your experience with eating in this manner with how you may normally eat.

Once you have become more comfortable with mindful eating, move on to other foods that may have more complex flavors such as an entree or a full meal. Notice the differences in smell, taste, and texture, and see if you can identify each individual flavor involved. Think about where each part of your meal may have come from and the people who may have been involved in getting your food to your plate, from the chef who prepared it all the way back to the farmer who harvested the plants (if vegetarian) or the rancher who cared for the animal (if omnivorous).

After Baby Steps: Building in Complexity
Movement
Yes, even walking can be a form of meditation if we bring our awareness into what we're doing and remembering that the act of walking is our purpose, not to arrive at a destination. You are walking to be somewhere, not to go somewhere. Initially, it can be helpful to begin by walking a little more quickly than normal and gradually slow your pace down until it may feel a little awkward. Adjust your stride to smaller steps, possibly adjusting your speed until it is comfortable until your balance improves. Make every step deliberate. Imagine that every time you take a step, your foot kisses the earth beneath it. Be conscious that you may be placing your entire weight on living beings beneath you. Walk in silence, letting your cares and troubles fall behind you. Note your breathing in relation to your footsteps, but don't try to alter your natural rhythm at first. You may see that with every respiratory cycle (one inhalation and one exhalation) that you are taking two or three steps, possibly more. With time and practice, try to add another step or two per cycle, visualizing flowers springing up behind you in your footsteps. You may also want to try smiling while doing walking meditation and smiling with every cell of your being. Note any changes in your experience.

If you are lucky enough to live near a labyrinth or two, walking them can add another dimension to your meditation. Supposedly, walking a labyrinth (and for that matter, walking meditation in general) temporarily suspends left-brained activity such as logical thought, planning, and analysis, allowing right-brain processes to come to the forefront reducing effects of stress and anxiety and restoring mental clarity after trauma (1) and a lowering of blood pressure (2). To find a labyrinth near you, simply enter in your location at Veriditas, Inc and The Labyrinth Society's combined online project, the World-Wide Labyrinth Locator.

Mindful Exercise
WARNING: Please do not take up any of the following sports without proper instruction and guidance to avoid injuries and unnecessary accidents!

I'm going to show my Republic of Boulder tendencies here, but to further increase your health, you might consider taking up exercise that requires you to be mindful in your activity such as yoga or rock climbing rather than running on a treadmill listening to music on your Ipod and thinking about your day. Trail running, skiing and snowboarding, mountain climbing, and other typical Colorado outdoor sports all require you to be focused on what you are doing right here, right now, and to be aware of your abilities in order to prevent injuries and accidents. Activities that would require mindfulness in other climates might include surfing, snorkeling and/or scuba diving, and swimming. If mushing with a dog sled team is your bag, then go for it.

That's not to say that other sports and exercise can't be mindful in nature because, as we've experienced through the above meditations and techniques, anything and everything can be experienced in a more mindful manner. You will need to be aware, however, that repetitive motions can easily induce trance-like states, leading you to be focused on anything...well...other than what you may be doing. I know that if I run on a treadmill rather than outside, the lack of outside stimulation combined with repetition with few changes will have me tuned out entirely from what my body is doing and thinking only on my grocery list, what I need to accomplish for the week, etc, never mind what I personally feel about indoor exercise. Weightlifting on machines usually has the same effect, particularly if I go into the gym in a foul mood. I find myself thinking about what's bothering me, rather than what I'm doing, and next thing I know, I'm whining to my hubby about how "I've injured myself again and you'd think I'd have learned not to go to the gym when I'm angry by now."

Instead of doing what I do with most indoor exercise, know yourself and change your behavior accordingly. If you know that, like me, you have a more difficult time staying focused with repetitive activity, think about changing it up a bit. Instead of lifting weights at the gym, you might consider taking a kettlebell class. Instead of running indoors on a treadmill, you might consider running outside or on a track, or at the very least, make sure you program the treadmill to change elevation and speeds periodically to help keep you focused.

Tying it all together
Now that we've discussed some techniques in mindfulness to engage all of our senses, you may be wondering where you may see a benefit from it. In my patients' experiences, some have seen reductions in their pain levels while others have realized exactly where their pain levels come from. One patient notices that his blood pressure is lower when he keeps a daily practice but creeps up on him if he starts skipping days. Another patient who suffered from multiple paralyzing panic attacks every day has learned ways to talk herself down from them and is now at the point where she only has one per month. While I'd like to be able to point at those results and claim they're all due to my mad skills in the treatment room, that's not how I roll. Credit must be given when it is due, and I cannot take it all. My patients who work on living more mindful lives have all responded better to treatment in shorter periods of time than those who don't.

From my own experience, I've also noticed quite a few changes. In the past five years, I've only been sick twice. Once was food poisoning from contaminated hamburger and the other was when that horrible flu that went around two years ago and every single patient walking into my office had it. On top of that, my ability to deal with stressful situations gracefully has increased ten-fold, I don't have the problems with insomnia that I've had in the past, and my thyroid (which is hyperactive due to genetics) has mellowed out and my MD is no longer threatening radioactive therapy. I used to have a really short fuse--what can I say, I come from German stock--but now, it takes a lot of aggravation to get under my skin in comparison to where I was in younger days. My memory has improved and I can easily say that I'm happier now than I've ever been before. Last, but certainly not least, my ability to effectively treat my patients has increased. My needle technique has improved, I'm more secure in my pulse diagnosis, and my ability to effectively communicate with my patients and understand what they are experiencing has made questioning diagnosis much easier.

For now, try incorporating some of the techniques discussed here and see what happens. You may not see results immediately, but give it time and be patient. I think you'll like what you see if you give it the old college try. Try it out before we move on to part three of this series, where I'll discuss where problems can arise in the treatment room when practitioners aren't present and centered and how we can fix those problems when they pop up. Until next time, be present.

1. http://www.qclabyrinth.org/Benefits.asp
2. http://www.ncbi.nlm.nih.gov/pubmed/16740899