Agenda

Interoception, the representation of the body's internal state, is increasingly recognized for informing subjective wellbeing and promoting adaptive regulatory behavior. Clinically-efficacious mindfulness interventions improve mental health outcomes in part by cultivating interoceptive awareness through therapist facilitation, affording trainees with tools for self-care that can be integrated into daily life. Mindful Awareness in Body-oriented Therapy (MABT) is particularly oriented towards teaching fundamental skills for interoceptive awareness, with a focus on sustaining mindful attention towards the body; the stabilization of interoceptive attention promotes reappraisal of somatic information, greater well-being, and a more integrated sense of self. Multiple studies of MABT as an adjunct to substance use disorder treatment show it to be efficacious in increasing interoceptive awareness, as well as showing increased emotion regulation and reduced symptoms of mental and physical distress. This symposium highlights the MABT approach, and new results from a cross-disciplinary collaboration between MABT developer Dr. Price and cognitive neuroscientist Dr. Farb. Dr. Price will describe the primary elements of MABT, and lead an experiential exercise involving sustained interoceptive awareness. Following this experiential grounding, Drs. Price and Farb will describe a randomized clinical trial, which explored changes in interoceptive networks in participants completing 8 weeks of MABT compared to a waitlist control group. Participants (N=22) with elevated stress were recruited to this study and completed both a baseline and post-intervention assessment. The assessment included self-reported symptoms of distress and interoceptive awareness (MAIA), followed by fMRI neuroimaging to characterize changes to interoception while participants performed a sustained interoceptive attention task, similar to what was taught in MABT. Dr. Farb will describe the study results, which are the first to show that mindfulness training promotes within-participant plasticity in interoceptive networks. Functional connectivity analyses demonstrated training-related changes in interoceptive networks, such that MABT enhanced communication between interoceptive regions and the prefrontal cortex. Connectivity changes were also correlated with subjective reports of enhanced interoceptive awareness. Mindfulness training therefore appears to re-configure neural networks to increase the availability of interoceptive signals to conscious reflection and control. These findings address critical questions regarding the potential role of interoceptive awareness and sustained attention in the body to support and enhance resilience and well-being in mindfulness and mind-body therapies.

COVID-19and increased tele-health are challenging our bodies, mind and spirit. Sitting hunched over a computer for long periods of time are taking a toll on clinician health and well-being. A short (10-15 minute) yoga spinal series combined with breath work and mantra repetition can help us attain a parasympathetic dominant state of relaxation and improved focus. It has worked for thousands of years. Clinicians need practices that can be done in a chair, are practical, give immediate benefit and are brief yet powerful. In this workshop, participants will be introduced to a short yoga set based on Kundalini yoga, with modifications, that can easily be taught to others including patients in a chair or bed. The benefits of breath work, yoga, and mindfulness are well researched. Participants will gain a simple set of skills that are powerful in this time of COVID-19 and for their future well-being.

Clinician’s word choices matter. They are in a constant state of communication with patients and families, have to think on their feet, frequently perform painful or frightening procedures, and often need to deliver bad news. Ideally, in every interaction they would convey a sense of hope, encouragement, and expectation that the patient can meet the challenges ahead. But this is a tall order, and despite the clinician’s best efforts, often misses the mark. Good communication does not mean avoidance of the truth, but finding words that fill the patient with realistic reassurance and a sense of support. This can be of significant benefit to those in our care, and may also have potential to reduce clinician’s stress and burnout risk. Similarly, skillful language use in mind-body medicine can help patients tap into inner resources such as optimism, hope, determination, and courage. The tone and pace of the voice can be also modulated to encourage calm confidence in the patient. People perceive pain and stress in many different ways, therefore skillful use of language can leave the door open for the patient to have a successful experience and avoid preconceived expectations of pain or distress. It is especially important to avoid inadvertently planting seeds of doubt, fear, or medical hexing.