>> Welcome to the Johns Hopkins Women's Health Podcast:
A Woman's Journey, Insights that Matter.
I'm Kelly Gear Ripkin and I invite you to listen to
Johns Hopkins specialists discuss
the latest topics in women's health.
Now here's your host, Lily Schakne.
>> Hi, this is Lily Schakne from a Woman's Journey at
Johns Hopkins and this is our podcast, Insights that Matter.
We hear the terms mindfulness and meditation a lot in the news.
What are the current-day roles of these ancient practices?
My guest today is Doctor Neta Gould,
a clinical psychologist and assistant Professor of
Psychiatry and Behavioral Science at Johns Hopkins.
What exactly is mindful meditation?
>> Well, you're right, it's become a very popular term,
but the concept is actually pretty simple,
it's being aware of the present moment,
but in a particular way,
with some curiosity and openness,
and without judgment,
so really noticing what's happening inside our bodies as well as
in our external environment but without judging it as good or bad.
How often should we be practicing this and how
often and for what duration
is considered to be the most effective?
>> It's a wonderful question I think I'm asked that a lot.
What I say to people is that the more you do,
the better but of course,
we're not going to spend our entire days
doing formal meditation practices.
There are a couple of answers.
One is to make the practice fit your lifestyle.
Whatever you think you can do to make it a long-term commitment,
and for some people that might mean 10 minutes a day,
for some people that might be an hour or more a day but I
suggest trying to build up to 20 minutes daily.
>> Is there a time of day that it's better to do?
>> Again, fitting it into
your schedule is the most important thing.
Many people like to do it in the morning because
it sets a framework for the day where you can
bring some of the mindfulness to
your daily activities but that just may not be feasible for
many people where the mornings are very rushed and
so you can practice during the daytime,
you can practice in the evening,
or all three and every day could look a little bit
different but I think what we want to do is try to create a habit.
>> We all feel like we're in the fast lane I think,
especially women that are juggling family
and work and children and lots of other things.
How can mindfulness potentially reduce our stress?
>> To step back and think about our stress response,
we also think about it as
it's called the fight or flight response.
This system is set in place to protect us in moments of danger.
The issue with our daily lives today is that most of the time
the stress response turns on and there is
no danger to our physical integrity.
It's often a thought that we have about what could
happen or should happen or thoughts
we've had about the past and those turn on the stress response
or situations that might be a psychological or a social threat.
Mindfulness can help by allowing
us to notice those thoughts that might trigger
the stress response or those stories
that we get caught up in and to bring us
back to the facts and to
the present moment and just to be with that.
We get some distance from some of
those stressful thoughts that might trigger the stress response.
>> That's very clever and very interesting.
What are conditions that mindful meditation can help,
such as we certainly do have
individuals that are dealing with chronic pain,
for example, obesity, smoking cessation.
How can it fit in with some of these conditions?
>> Absolutely, yes. It's become a very popular area of
research and I'm really happy about
that because I think it's a very important area of research.
Some of the most robust findings are in
the areas of psychological health.
Across clinical and non-clinical populations,
what we see is improvements in anxiety and depression and stress,
and also, as you mentioned, in pain.
There's a lot of convincing research in
literature that shows that with mindfulness practice,
there's improvement in functioning with pain,
as well as how much the pain interferes with daily life.
>> How about smoking cessation?
Does it have a role there?
>> Absolutely. There have
been some reviews and research and also some books
that some well-known mindfulness teachers have
written about these habits such as smoking.
One book was written by Judson Brewer that
specifically targets the craving
associated with these different addictions.
>> And food too.
>> Absolutely. If you think of it broadly,
what mindfulness does is creates a pause for us so we stop,
and in that pause,
we can sometimes make a different decision.
What's happening is that we break out of
those automatic habits that might
result in negative decision-making.
>> Like opening the refrigerator.
>> That's exactly right.
We can pause and in that pause,
we might be able to make a different decision sometimes.
>> Got it. How does mindfulness affect functions of our brain?
>> That's a fascinating area of
research and one of the really interesting parts,
and the part that might translate most to
what we see in terms of stress reduction is
that the part of the brain
responsible for the fight or flight response,
it's called the amygdala.
With continued mindfulness practice,
that part of the brain doesn't turn
on as frequently and when it turns on,
we have the tools to turn it off more readily.
That's a really fascinating part of the brain research.
Also what happens is we see that the wiser parts of our brain,
the parts of our brains that make us uniquely human,
the frontal lobes of our brains become
more active so we begin to make better decisions
because we're engaging those parts of the brain more than
the primitive parts of our brain that just react to situations.
>> How about for memory?
>> Absolutely. One way to think about
the memory is that we're more likely to
remember something if we pay attention to it and
mindfulness allows us to pay attention to a situation,
so it's more likely to get encoded.
But there's also some fascinating research with
continued mindfulness practice the part of
the brain that's involved in memory formation,
the hippocampus sometimes even grows
new neurons as a result of
mindfulness practices so really fascinating.
>> That's incredible. Absolutely.
>> How have you personally found mindfulness to be helpful?
>> When I turned to mindfulness about 10 years ago,
I took a course called
the mindfulness-based stress reduction course,
which is an internationally offered course and one
that I teach now myself.
It was really a life-changing concept for me to live in
the present moment and I think how it
really helped me is to, as I mentioned earlier,
notice my thoughts, but not feel
as though they were necessarily all true
or that I had to react to all of them
and to bring my attention back to
just what was in the moment was really a novel concept for
me and I really saw that it did in fact reduce my stress,
improve my sleep, and allow me that space to see
things more broadly and make better decisions as a result.
>> That's fascinating.
What are some myths about mindfulness?
>> I think the first one that's really
popular is people think they have to clear their mind of thoughts.
>> Yes, that's what I thought when
I was first learning about this too,
was empty my brain.
>> That's right. I think it's a relief for people
to realize that we're not
actually trying to empty the brain in mindfulness practice,
but we're beginning to just notice the patterns of our thinking,
notice our thoughts without
judging them or without trying to push them away or cling to them.
>> Which I think should be easier than trying to empty our brain.
I think it's very hard to say I'm not going to think about
these things anymore because that just makes you
think of them constantly and worry about them constantly.
>> That's exactly right and then people start thinking,
oh, I can't do this, it's not working.
>> Yes, you set up to fail before you even start.
>> That's exactly right.
I think are there other myths that people think
that they don't have time to practice and
that they're not going to be efficient if they practice it.
What we actually know is that if you do take that time aside,
even though it does take time out of your day,
if you do take that time aside to practice,
you're actually more productive and
you enjoy the tasks that you're doing to a greater degree.
>> That's wonderful. If people aren't doing this yet,
we really do need to get them engaged because it's
going to benefit them in pretty extraordinary ways.
How can we practice mindfulness?
For example, give us some information as to
what we should be doing in order to be mindful.
>> Absolutely. There are two ways to think about mindfulness,
and one is a formal meditation practice,
which is what might come to mind where we sit
on a chair or a cushion and we might bring
attention to our breathing
that's a formal meditation practice and then
there are informal ways we can bring mindfulness into our days.
Every moment of every day,
we could just pause and notice
what's happening in our senses for example,
our senses are always in the present moment and so we just
note in a couple of words what's happening in our senses.
In terms of the formal meditation practice
the recommendation might be to start
small and to start with some guided practices.
There are a few resources that I could
suggest at the end that people could
begin to use to start and then
if they'd like to grow the practice from there, they can do so.
>> I've heard about eating a meal mindfully.
What would that involve?
>> A lot of people ask that,
what is eating mindfully?
I suggest that people think about how they ate their last meal.
For many of us, it's being at
the computer or checking our phone simultaneously,
or even while we're driving.
Eating mindfully is to be with the food,
to notice it in its entirety
to notice the sense of smell and sight,
and sense the food going into our mouth and
really slowing down and savoring and it's of course,
best done if we can do it alone.
But you can do it at any time by
just not being on automatic pilot when you eat.
We do eat less and we enjoy the food more when we eat mindfully.
>> Which makes sense why it can help with issues of obesity?
>> That's exactly right.
>> What does the expression mean drop the story?
>> One of my favorite tools that I've picked up along the way.
When we're faced with a stressful event,
we have the event itself that's
stressful and then we have the story,
the add-on thoughts that we add to that stressful event.
For example, if you're running late,
you're already running late
and that's stressful but then you think,
oh my gosh, what if my supervisor is going to be mad at me?
What if I lose my job?
All those stories that likely don't happen.
With dropping the story is a tool that
one could use by just stating the facts,
I'm late and then noticing when
the mind likes to travel to all of the catastrophic thoughts.
>> Worst case scenario.
>> Worst case scenarios, that's right and
then returning back to the fact,
the only part that's true, I'm running late.
>> That's interesting. I will certainly begin using this then.
I worry about snow.
Back in 1984, decades ago,
I was in a serious car accident and broke my arm and leg,
and it was in snow and ice.
Since then, if I just hear the word snow,
I start worrying so I'll watch
the news and they'll say there's a chance of snow and
I've already fast-forwarded my life to the next day that I
have to drive the car
somewhere and I'm going to be in snow so of course,
I'm going to have an accident
and then I'm going to go to the hospital,
I'm going to be in plaster when if I think about it,
I don't even have anywhere to go tomorrow so it
can snow all it wants it doesn't matter.
Thank you for telling me that.
I'm going to drop that story.
>> It's a wonderful example of how our brains can torture us.
>> Absolutely. You've used the word pause
quite a few times as we've been sitting
here having this conversation.
That's a keyword, isn't it?
And something that we don't do in our daily lives.
We're just fast forward continuously,
hurry up, how much can women
multitask and being able to hit that pause button,
I think I'm going to type up a little sign for
myself and put on my desk and also in the kitchen,
on the counter that just says pause see if that helps.
What are some of the resources that people can
use if they would like to give mindfulness a try?
>> A lot of people like to use apps
and if you're an individual
who has your phone with you all the time,
which is most of us, an app can be a very useful place
to start and there are many apps out there,
but some of the most popular are the Calm app and Headspace.
>> Headspace, clever.
>> Yeah, those two are popular ones.
The nice thing about apps like that is that they have
short meditations daily that they'll unlock for
you and so they're guided and it's structured,
so it begins to help you create that habit.
>> Are they different lengths?
>> Yes, exactly. You can pick and choose.
You can create a group of
them that maybe you like the most that you're most
likely to use and they have ones that are good
for sleep and ones that might be good for anxiety and stress,
and mood so they're
very comprehensive apps and I do recommend those.
There's also a couple of websites that I recommend to individuals,
and one is the UCLA Mindful Awareness Research Center.
They have a whole list of free guided meditations.
If you Google UCLA MARC, M-A-R-C,
they have a lot of guided meditations and then also UCSD,
University of California San Diego,
they have a mindfulness-based
professional training institute and again,
they have a whole list of
mindfulness resources including free guided audio.
>> That's fabulous.
Well, those are all excellent resources for us to
share with the individuals that are listening to us today.
I'm going to hope that they become mindful.
I know that I certainly will begin some of
these practices to reduce my stress.
Thank you so much, Doctor Gould,
for sharing your expertise today and I hope
you've learned the place of
mindfulness in managing our health in today's world.
I'm Lily Schakne.
Please join us on the first Thursday of each month
when we'll be discussing insights that matter;
a monthly podcast for a Woman's Journey at Johns Hopkins.
>> Thank you for listening to a Woman's Journey podcast.
Join me, Kelly Gear Ripkin,
your host, Lily Schakne,
and a variety of Johns Hopkins experts on
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about medical advances in women's health.
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Until next time, stay well.