Syllabus for Mindfulness-Based Stress Reduction Course
Theme: “There is more right with you, than wrong with you.”
Learning focus: Problems can be worked with, and the MBSR program offers the opportunity to do this in a supportive environment. Present-moment awareness of body sensations, thoughts, and emotions is the foundation of this work, because it is only in the present that one can learn, grow, and change. This includes formal a refection on “What is mindfulness?” and “What do I really want?”
- Awareness of the Breath
- Body Scan
- Physical Pain
- Emotional Pain
Theme: “Perception and creative responding.”
Learning focus: How you see things, or don’t see them, will determine how you will respond to them. It is not the events themselves but rather how you handle them that influences the effects on your body and mind.
Practice Introduced: Sitting meditation (focus on awareness of breath).
Practice Reinforced: Body scan.
Theme: “The pleasure and power of being present.”
Learning focus: We miss many of our pleasant moments, perhaps by focusing only on the unpleasant ones, such as crisis or pain. Yet it is possible to have pleasant moments even when you are experiencing crisis or pain. Developing deeper understanding and present moment contact with the triangle of awareness: body sensation, thought, and emotion.
Practices Introduced: Mindful yoga (floor yoga).
Practices Reinforced: Body scan, sitting (breath awareness).
Theme: “The shadow of stress.”
Learning focus: Cultivating mindfulness can reduce the negative physiological and psychological effects of stress reactivity, as well as help develop more effective ways of responding positively and proactively to stressful situations and experiences. Includes formal didactic presentation on stress physiology.
Practices Introduced: Mindful yoga (standing postures), sitting meditation (expanding focus from awareness of breath to body sensations and sound).
Practices Reinforced: Body scan, sitting (breath awareness).
Theme: “Finding the space for making choices.”
Learning focus: Connect mindfulness with perception, appraisal, and choice in the critical moment. Particular attention is paid to observing thoughts as events, and distinguishing events from content — “You are not your thoughts.”
Practice Introduced: Sitting meditation (expanding awareness to whatever arises in the present moment — “choiceless awareness”).
Practices Reinforced: Yoga.
Theme: “Working with difficult situations.”
Learning focus: How to maintain your center, recognize habitual patterns of relating, and discern skillful options in stressful interpersonal exchanges. Includes formal didactic presentation and experiential activities to demonstrate communication possibilities in both the verbal and nonverbal realms.
Practice Introduced: Walking meditation.
Practice Reinforced: Sitting (choiceless awareness).
Day of Silence:
Theme: “Dive in!”
Learning focus: Deepen mindful awareness of experience by formally cultivating mindfulness over an extended period of time, fostering the possibility of greater self-knowledge and insight into the impermanence of pleasant and unpleasant body–mind states. M
Practices: The full range of practices from prior sessions are reinforced, and two new practices are introduced — mountain meditation and loving kindness meditation
Theme: “Cultivating kindness towards self and others.”
Learning focus: Attitudes and practices to help develop a disposition of generosity in formal meditation so that it may arise more readily in our day-to-day life. Continued work with interpersonal communication.
Practices Reinforced: Sitting (choiceless awareness), loving kindness.
Theme: “The eighth week is the rest of your life.”
Learning focus: How do you keep up the momentum and discipline you’ve developed over the past seven weeks of mindfulness practice? Presents a range of resources, such as books, recordings, advanced programs, and other opportunities for practice in the community, to support continued practice. Meditation practice and opportunities for sharing with the group close the session and the course.
Practices Reinforced: Body scan, mountain meditation, sitting (choiceless awareness), loving kindness.
The Eight Week MBSR Program:
“The most important thing is just to get started.”
Hopefully once you start, you will keep it up and proceed through the entire eight weeks. Remember, we tell our patients, “You don’t have to like it, you just have to do it.” By the time you have been practicing for eight weeks, you will have enough momentum and direct personal experience with the practice to keep going with it for years if you choose to.
The place to start, of course, is with your breathing.
If you haven’t done the three-minute experiment on paying attention to your breathing (see Chapter 1) and watching what your mind does, then you might want to do that now, just to make sure you know what we mean about keeping the mind on the breath and bringing it back when it wanders. We recommend that, at the very least, you do this every day for five or ten minutes, either sitting or lying down, at a time that is convenient for you. Review the chapter on breathing (Chapter 3) and start getting comfortable with feeling your belly expand and deflate (rise and fall) as you breathe, then follow the instructions in exercises 1 and 2 at the end of that chapter.
The most important thing to remember is to practice every day. Even if you can make only five minutes to practice during your day, five minutes of mindfulness can be very restorative and healing.
MBSR Syllabus, Lessons 1 – 2
For the first two weeks of your formal practice, we recommend that you do the body scan as described in Chapter 5 (tape 1, side 1). Do it every day, whether you feel like it or not, for approximately forty-five minutes. As we have seen, you will have to experiment with what the best time of day is for you to practice, but remember, the idea is to “fall awake,” not to fall asleep. If you have a lot of trouble with sleepiness, do it with your eyes open. In addition to the body scan, practice mindfulness of breathing while sitting for ten minutes at some other time during the day.
To cultivate mindfulness in your daily life—what we have been calling “informal practice”—you might try bringing moment-to-moment awareness to routine activities such as waking up in the morning, brushing your teeth, showering, drying your body, getting dressed, eating, driving, taking out the garbage, shopping. The list is endless, but the point is simply to zero in on knowing what you are doing as you are actually doing it and on what you are thinking and feeling from moment to moment as well. If this seems too overwhelming, just pick out one routine activity each week, such as taking a shower, and see if you can remember to just be fully there when you take your shower, every time. And you might try to eat at least one meal a week mindfully as well.
MBSR Syllabus, Lessons 3 – 4
After practicing in this way for two weeks, start alternating the body scan one day with the first sequence of hatha yoga postures (guide audio instructions) the next, and keep this up during weeks 3 and 4. Follow the recommendations for the yoga as described in chapter 6. Remember only to do what you feel your body is capable of and always to err on the side of being conservative, listening carefully to your body’s messages as you practice. Remember also to check with your doctor or physical therapist if you have chronic pain or some kind of musculoskeletal problem, or lung or heart disease. Continue to practice mindfulness of breathing in the sitting posture, now for fifteen to twenty minutes per day.
For informal practice in week 3, try to be aware of one pleasant event per day in your life as it is happening. Keep a calendar for the week, jotting down what the experience was, whether you were actually aware of it at the time it was happening (that’s the assignment but it doesn’t always work out that way), how your body felt at the time, what thoughts and feelings were present, and what it means to you at the time you write it down. A sample calendar is provided in the appendix. In week 4, do the same thing for one unpleasant or stressful event per day, again bringing awareness to it as it is happening.
MBSR Syllabus, Lessons 5 – 6
In weeks 5 and 6 we recommend that you stop doing the body scan for a while and replace it with longer sittings (up to forty-five minutes at a time) (tape 2, side 1). Practice the sitting meditation as described in the exercises at the end of Chapter 4. You can sit the whole time just focusing on your breathing (exercise 1) or you can gradually expand the field of your awareness to include other objects such as bodily sensations (exercise 2), sounds (exercise 3), thoughts and feelings (exercise 4) or no particular object (exercise 5). Remember to let your breathing serve as the anchor for your attention in all of these practices.
In the long run you might benefit most from the sitting meditation, especially if you are not using the sitting tape for guidance, if you stay with the breath as the primary object of attention for weeks, even months. In the early stages of the sitting practice it is possible to be uncertain as to where to focus your attention when, and to worry inordinately about whether you are doing it “right.” For the record, if your energy is continually going into patient self-observation from moment to moment, whether your attention is on the breathing or on other objects, and you are bringing it back each time it wanders without giving yourself a hard time, then you are doing it right. If you are looking for a special feeling to occur, whether it be relaxation or calmness or concentration, or insight, then you are trying to get somewhere else other than where you already are and you need to remind yourself to just be with the breath in the present. Paradoxically, as we have seen, this is the most effective way to “get somewhere” and to nurture relaxation, calmness, concentration, and insight. They will come by themselves in time if you keep up the daily discipline and practice according to these guidelines.
In weeks 5 and 6 the people in the stress clinic alternate a forty‑ five-minute sitting one day with the yoga practice the next. If you aren’t doing the yoga, then you might like to alternate the sitting with the body scan during these weeks or to just sit every day. This is also a good time to start practicing some walking meditation as described in Chapter 7.
By this time you will probably want to be making the decisions about when and what to practice and for how long for yourself. After four or five weeks many people feel ready to start crafting and personalizing their own meditation practice more and more, using our guidelines merely as suggestions. By the end of the eight weeks our goal is for you to have made the practice your own by adapting it to suit your schedule, your body’s needs and capabilities, and your personality in terms of which combination of formal and informal techniques you find most effective.
MBSR Syllabus, Lesson 7
To encourage self-directed practice, week 7 in the stress clinic is dedicated to practicing without the tapes if at all possible. People devote a total of forty-five minutes per day to a combination of sitting, yoga, and body scanning, but they have to decide on the mix themselves. They are encouraged to experiment, perhaps by using two or even three of the techniques together on the same day, say thirty minutes of yoga followed by fifteen minutes of sitting, or twenty minutes of sitting followed by yoga either right after it or at another time of day entirely.
Some people find they do not feel ready for practicing in this way at this point. They prefer to continue using the tapes. They find the guidance comforting and reassuring and don’t get the same degree of relaxation on their own when it is up to them to decide what to do next, particularly in the body scan and the yoga. From our point of view this is not a problem. Our hope is that, with time, people will internalize the practice and be comfortable practicing on their own, without tapes or books for guidance. However, the development of this kind of confidence and faith in your own capacity to guide the meditation does take time, and it varies from one individual to another. Many of our patients can meditate quite well on their own but still prefer to use their tapes even years after they complete the program.
MBSR Syllabus, Lesson 8
In week 8 in the stress clinic we come back to the tapes. Leaving them and coming back to them in this way can be quite revealing. You are likely to hear things on the tape you never heard before and to perceive the deeper structure of the meditation practice in a new way. In this week you are encouraged to practice with the tapes even if you prefer doing it without them. By this point you are deciding what technique or techniques you wish to use. You may just be practicing the sitting meditation or the yoga or the body scan, depending on your situation, or you may be combining two or three in various ways.
Whether you realize it or not, it is important that you now have some familiarity with all three formal techniques. You are likely to find this knowledge beneficial in very practical ways. For instance, you may find yourself drawn from time to time to practice yoga or the body scan even if your daily practice is mainly sitting. The body scan can be particularly useful when you are sick in bed, or in acute pain, or unable to sleep, even if it is not your regular practice. Likewise, a little yoga can be particularly helpful at certain times, such as when you are very tired and need to revitalize yourself, or when there is stiffness in particular regions of your body.
The eighth week, being the end of our formal recommendations for practice, is also the first week of practicing on your own. We tell our patients that the eighth week lasts the rest of their lives. We see it as a beginning much more than an ending. The practice doesn’t end just because we have stopped telling you what to do. By this point you will be firmly in the driver’s seat yourself and, one would hope, if you have been practicing in a regular, disciplined way, you will have enough skill and experience to keep up the momentum you have developed to guide your own mindfulness practice. At the end of the book you will find more suggestions for how to keep up the momentum of mindfulness practice and deepen it over the years. This includes not only a review of the formal practice but more suggestions for bringing mindfulness into daily life and using it to help you to cope with the situations you might be facing. But in all likelihood, by the time you get there, you will probably have invented better ones for yourself.
Note: As we proceed, we recommend that you keep to the practice schedule outlined above, so that as you read more about the process and its ramifications, it is actually unfolding simultaneously in your own life and in your own heart.
Source- Full Catastrophr Living, by Jon Kabit-Zinn, pages 140-146
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