University of Wisconsin–Madison

Mindfulness Program

Mindfulness Training Program

The Mindfulness Training Program offered by the UW Department of Psychiatry was developed to teach participants how to systematically and intentionally cultivate mindfulness. Mindfulness is the awareness of what is happening now without judgment, commentary or decision. This is the power of being present to the present moment with acceptance. Studies show that people who utilize mindfulness may experience a lasting decrease in physical and psychological stress related symptoms, an increased ability to relax, an enhanced ability to cope with chronic pain, a greater energy and enthusiasm for life, improved self esteem, and the ability to cope more effectively with short and long-term stressful situations.

Individuals experiencing workplace, family and financial stress, anxiety and panic, depression, insomnia, chronic fatigue, headaches, or substance abuse may benefit from participating in Mindfulness Training.

What is Mindfulness?

Mindfulness is paying attention intentionally to the present moment with acceptance in a non-judgmental fashion.

Why is this useful?

Mindfulness has been shown to be helpful with a number of anxiety disorders and decrease relapse of depression in individuals with three or more depressive episodes. There are preliminary studies suggesting that it may help partially responding patients reach remission. There is also preliminary research suggesting that patients with treatment resistant depression may benefit from mindfulness based cognitive therapy.

What do we do?

We will use a combination of experiential exercises and group discussion to facilitate the development of mindfulness and its use in relationship to depression, anxiety and well being. These exercises will include work with loving-kindness, self- compassion, body scan, mindful yoga, and mindful meditation. We will also work with a number of other exercises aimed at understanding and managing anxiety and avoidant behaviors.

Goals

  • To understand what mindfulness is and how to cultivate it.
  • To develop both a formal and informal mindfulness practice.
  • To cultivate mindfulness of body sensations, thoughts, emotions and behaviors.
  • To use mindfulness to identify unskillful thought patterns, beliefs and behaviors.
  • To develop a skillful relationship with thoughts, emotions, and behaviors.
  • To learn to work skillfully and compassionately with difficult emotions and mind states in order to prevent the escalation of anxiety.
  • We will explore avoidance behaviors and use mindful acceptance, values, intentions, and goals to foster moving toward a life worth living.
  • To learn how to cultivate loving-kindness, compassion and self compassion.
  • For each participant to discover for themselves what tends to bring more ease, happiness and a sense of well being and what tends to bring more dis-ease and dissatisfaction.
  • We will review resources for continuing mindfulness practice after the group.

The “Pause Exercise”* is a brief exercise that can be used anytime and anywhere. It helps us shift gears from begin wrapped up in our thinking about future or past and come to settle in the present. This is one of the mindfulness practices which many people find useful when they take a mindfulness group and will continue after the group is finished. At first you can try it in the quiet of your home to get a feeling for the exercise. Then as you gain confidence you can use it to pause in the middle of your day or in the face of a stressful experience. After you finish you simply make the next best choice for you and move back into your activities.

 

Below are some formal written instructions.

  1. Pause – Awareness: Stop what you are doing. If sitting, sit upright in a dignified but not stiff posture. If standing, stand upright but not rigid. Be aware of what is happening in your experience. Take a moment to take note of seeing, hearing, body sensations, thoughts, emotions. Notice liking, disliking or spacing out. Simply observe, acknowledge and register your experience, even if it is unwanted. Come home to this moment as it is right now. The essence of the pause is being aware of your present moment’s experience, however it is.
  2. Relax- Dropping into the Body: Relax the body and gently redirect full attention to the body. Feel the support of the contact places of the body, the feet, the buttocks, the back of the thighs, the hands, the lips, the eyelids. Feel the direct experience of the sensations, touch, pressure, softness, firmness, warmth or coolness. Open to the sensations and your physical experience throughout the whole body.
  3. Breathe: Direct your attention to your breath. Feel each in and out breath. Let it be in its own natural rhythm. Your breath and body can function as an anchor to bring you into the present and help you tune into a state of awareness and stillness.
  4. Open – Expanding: Expand the field of your awareness around your breathing, so that it includes a sense of the body as a whole, your posture, and facial expression. Open up to the breath and body and sounds. Open up to the breath and body and sounds and sights. Open up to all senses as you move into your life.

“The breathing space provides a way to step out of automatic pilot mode, out of rumination or reactivity to strong emotion, to reconnect and open to the present moment.” The Mindful Way Through Depression

* In Mindfulness-based Cognitive Therapy this is called the “Breathing Space”. The “Pause Exercise” is used in Mindfulness-based Stress Reduction and is a variant of the Breathing Space exercise.

There are four major areas that will be covered during the class. loving-kindness (self compassion and compassion), mindfulness, cognitive therapy, acceptance and commitment therapy.

Loving-kindness Meditation

Loving-kindness meditation is a form of meditation to cultivate a sense of well wishing toward oneself and others. In traditional mindfulness practice this type of practice serves a number of functions. It is a relatively easy form of meditation to cultivate concentration and attention. It counteracts aversive and negative mind states and negative self judgments. It helps develop a sense of common humanity and counteracts isolation. Barbara Fredrickson’s work has shown that in nonclinical populations it increases the frequency of positive emotion and decreases the frequency of anxiety and depression. Her study also showed support for her broaden and build theory of positive emotion, whereby our attention, problem solving and sense of connectedness is increased under its influence.

Self compassion/compassion

Compassion dove tails with mindfulness for when the aware relaxed mind turns to face suffering or dis-ease the natural response is compassion. Much of anxious mind states involve a great deal of self hatred in response to this suffering. This part of the class will be developing a healthy attitude toward one’s own suffering and understanding it in the broader context of universal suffering. Attachment based studies have shown that when people prime their mind with exercises which contemplate kindness and nurturance (even those with a problematic attachment history) they are more likely to respond in a compassionate fashion. We will take advantage of this in the pursuit of self compassion. We will use the practices which cultivate the mind state of compassion. Traditionally compassion is a mind state that tends to compete with the aversive mind states of fear and hatred. When compassion is directly cultivated, compassion can become a more frequent experience thus protecting the mind from aversive mind states which precipitate depression.

Mindfulness

Mindfulness is the awareness of what is happening now without judgment, commentary or decision. This is the power of being present to the present moment with acceptance. This cultivates beginners mind which opens possibility. Fixed beliefs on the other hand tend to close down options and create passivity and hopelessness. We will work to gradually cultivate mindfulness in its different arenas, awareness of the body, thought, emotion, and behavior. After we have cultivated some basic mindfulness we will spend time working with how to use mindfulness with difficult mind states which tend to lead to downward spirals in mood. Mindfulness is a very healthy and skillful mind state because its tendency is to bring balance, openness and ease to the mind and body.

Cognitive behavioral therapy/Acceptance and commitment therapy

We will cover cognitive distortions, hidden beliefs which lead to anxiety and worsening of anxiety. We will cover working toward acceptance of anxieties and fears, particularly with mindfulness tools. We will work with understanding and confronting avoidance behaviors. We will identify values and goals to help confront avoidance behaviors.

headshot Jones

Stuart Jones, MD

Dr. Stuart Jones is a Psychiatrist with the University of Wisconsin Department of Psychiatry. Stuart received his medical degree from Rosalind Franklin University of Medicine and Science and completed his residency at the UW Department of Psychiatry Residency Program. Dr. Jones is interested in mindfulness and meditation practice as it relates to psychotherapy and the promotion of psychological health and well-being.


Jane Gogan, PhD

Dr.  Jane Gogan is a clinical psychologist who sees adults with a wide range of mental health concerns. She is particularly interested in helping patients with depression and anxiety, difficult life challenges and relationship concerns. It is important to Dr. Gogan that she understands the unique needs of each patient before working collaboratively to establish a treatment focus and approach. She draws on a number of therapeutic modalities, and has advanced training in interpersonal and brief psychodynamic psychotherapies. Dr. Gogan also has an interest in mindfulness practice and co-facilitates the Mindfulness-Based Cognitive Therapy group for patients with anxiety and depression.


headshot NitschkeJack Nitschke

Dr. Jack Nitschke is a clinical psychologist, neuroscientist, and associate professor in the Department of Psychiatry. His NIH-funded research used brain imaging to answer questions about anxiety, depression, and emotion. His clinical work using psychotherapy spans 25 years and brings the advances in our understanding of the brain and neuroplasticity directly into his psychotherapy utilizing various evidence-based treatments with adolescent and adult patients suffering from a broad range of mental disorders. In addition, Dr. Nitschke has been an instructor of traditional martial arts in Tae Kwon Do for 27 years and a meditation practitioner for 26 years.

 

Start Dates:

Groups typically start the first week of February, first week of June and end of September or Early October.

Where:

All groups will be held at Wisconsin Psychiatric Institute and Clinics at 6001 Research Park Blvd, Madison. We will meet in the “Commons Room”. Please check in 10-15 minutes ahead of time at the front desk.

Groups:

Groups will be closed with a maximum of 10 participants in each group. They are filled on a first-come, first-served basis.

Commitment:

Participants will be expected to commit to 8 of 10 classes for the depression group and 10 of 12 classes for the anxiety group. Participants will be asked to do homework 6 of 7 days per week with a goal of 45-60 min per day. Home work consists of mindfulness exercises which are guided with either CD’s or MP3 files.

Cost:

Please contact your insurance carrier regarding any questions on your coverage. Insurance may cover this as group therapy depending on the policy and prior authorization requirements. For this purpose, there is a billing code of 90792 for the initial assessment with Dr. Kane or Dr. Jones and the billing code for the group visits is 90853. If this is completely out-of-pocket for you, you may check with the group leader. There will be a $50 – $75 cost for materials that is out-of-pocket.

Contact:

For either information or to set up an appointment to become part of the group, contact Megan Kasdorf at 608/263-6090 or mkasdorf@wisc.edu.

Who Might Benefit:

Research shows patients who have had three or more major depressive episodes who are in remission will benefit. There is some preliminary research to suggest it to be helpful for patients with depression with partial responses to treatment and treatment resistant depression. In my clinical experience I have found it to be helpful chronic stress induced depression, dysthymia, and people who suffer with low self-esteem or high self criticism. It has been shown to be helpful for people with fibromyalgia and depression. People with active depression can benefit if there is not a continuous state of depression that impairs the ability to have modest levels of concentration, function and periodic breaks from the negative mind states.

People with generalized anxiety disorder, panic disorder, obsessive compulsive disorder, adjustment disorders with anxiety, anxiety related to life stresses.

Exclusions:

Those who have active severe symptoms of depression such as impaired thinking, constant negative rumination, psychotic thoughts or hallucinations, high risk of self harm or such severe motivational problems that they will be unable to do homework assignments. People with a history of severe post traumatic stress disorder who have flooding, dissociation or psychosis when they are exposed to relaxation or lack of structure for short periods of time. These people may benefit from mindfulness under the careful instruction of their therapist but are likely inappropriate for this group. Severe agoraphobia where the person is likely to miss more than two classes.

Requirements:

Each person will have an individual interview to review their diagnosis, suitability, and timing in their life. We are asking people for a major life commitment for 10-12 weeks. This class is about the possibility of change in the context of acceptance. This will only happen with regular effort and practice. We are willing to modify the homework assignments on an individual basis. We will need to discuss whether this level of commitment makes sense at this time in their lives. If the patient needs medication management or safety management they must have another mental health provider other than the group leader to manage their medications and any acute safety issues. Participants are asked not to come to class intoxicated and would be asked to leave if under the influence of nonprescription drugs or alcohol.

What to wear:

Please wear loose fitting or clothes appropriate for sitting cross legged, lying on the floor and doing gentle mindful yoga. If you have your own yoga mat or meditation cushions which you prefer, you may bring them to use. We will have these available for participants as well.

For information or to set up an appointment to become part of the group contact Megan Kasdorf at 608-263-6090 or mkasdorf@wisc.edu