Mindfulness-BasedStressReduction(MBSR)
AuthorizedCurriculumGuide©
2017
VersionRevisedandEdited
by:
SakiF.Santorelli,EdD,MA
FlorenceMeleo-Meyer,MS,MA
LynnKoerbel,MPH
JonKabat-Zinn,PhD
MBSRprogramfounderandcreatoroftheMBSRcurriculum
TheMindfulness-BasedStressReductionauthorizedcurriculumguideisthepropertyofthe
UniversityofMassachusettsMedicalSchool,CenterforMindfulnessinMedicine,HealthCare,and
Society™andmaynotbecopied,distributed,ortransferredtoanyindividualoranyorganization
withoutwrittenpermission.
CenterforMindfulnessinMedicine,HealthCare,andSociety(CFM)
UniversityofMassachusettsMedicalSchool
Mindfulness-BasedStressReduction(MBSR)
AuthorizedCurriculumGuide©
2017
ACKNOWLEDGEMENTS
Weofferadeepbowofgratitudetoourcolleagueswhohaveshepherded,withgreat
careandattention,theMBSRprogramcurriculumintomainstreammedicineandhealth
caresince1979…
JonKabat-Zinn,PhD
MBSRprogramfounderandoriginalcurriculumwriter
MelissaBlacker,MA
Majoreditorialcontributionstomultiple
revisionsoftheMBSRcurriculum
Contributorstothis2017versioninclude:
GwénolaHerbette,PhD
CarlFulwiler,MD,PhD
PleasedirectallcorrespondenceregardingtheAuthorizedCurriculumGuide©to
LynnKoerbel,MPH:[email protected]
CenterforMindfulnessinMedicine,HealthCare,andSociety(CFM)
UniversityofMassachusettsMedicalSchool
Mindfulness-BasedStressReduction(MBSR)
AuthorizedCurriculumGuide©
2017
TableofContents
Prologue………………..…………………………………………………………
1
MBSRCourseOverview …………………………………………………………
4
OrientationSessionOverview ………………………………………………….
6
OrientationSessionLogisticalDetails…………………………………………...
8
ClassOne ……………………………………………………………………….
12
ClassTwo ……………………………………………………………………….
15
ClassThree ……………………………………………………………………….
18
ClassFour ……………………………………………………………………….
21
ClassFive
……………………………………………………………………….
24
ClassSix
……………………………………………………………………….
28
All-DayClass………………………………………………………………………
32
ClassSeven ……………………………………………………………………….
36
ClassEight ……………………………………………………………………….
39
NotesontheCurriculum…………………………………………………………. 42
Appendix:ConductingOrientationSessionsattheUMassCenterforMindfulness44
Prologue
By
SakiF.Santorelli
Eightcenturiesago,duringthelasttwelveyearsofhislife,thegreatteacherandpoet,Jelaluddin
Rumi,recitedandwrotetheMasnavi–sixvolumescomprising64,000linesofpoetry.Inthisgreat
work,oneofthetopicsRumispeaksaboutiswhathecallsthe“varietyofintelligences”and,as
well,about“UniversalIntelligence”-whathereferstoas“TheMindoftheWhole.”Likeallgood
teachers,heurgesusto“figureouthowtobedeliveredfromourownfiguring.”1
Inanotherinstancehecommentson“personalintelligence”:
Personalintelligenceisnotcapableofdoing
work.Itcanlearn,butitcannotcreate.
Thatmustcomefromnon-time,non-space.
Realworkbeginsthere.”2
Hespeaks,too,aboutwhathecalls“twokindsofintelligence”:
Onethatisacquired…onealreadycompleted
andpreservedinsideyou.3
InthecontextofthisMindfulness-BasedStressReduction(MBSR)CurriculumGuidethese“two
kindsofintelligence”maybewellworthexploring.
AcquiredIntelligence:TheInstrumentalDimensionofMBSR
OftenenoughpeoplelearningtoteachMBSRaskmethequestion,“HastheMBSRcurriculum
changedmuchin38years?”Iamkeenlyattentivetothesilencethatusuallyensuesbetweenus
whenthisquestionarises.
Whatistheanswer?Yes?No?YesandNo?Neitheryesnornoseemstometobeaboutascloseto
realityasIcanland.
Atheart,theMBSRcurriculumhasremainedabsolutelytruetotheformandformlessnessthatit
enteredtheworldwithin1979.
Fornow,thebasicstructureoftheprogram,thesequencingofmeditationpractices,theunderlying
classthemesandthememespermeatingtheprogramremainrobustandintact.
1
Moyne,J.,Barks,C.(1984).OpenSecret.Putney,VT:ThresholdBooks.
Moyne,J.,Barks,C.(1994).SayIAmYou.Athens,GA:MAYPOP.
3
Moyne,J.,Barks,C.(1988).ThisLonging.Putney,VT:ThresholdBooks.
2
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
1
Inaggregate,thesecurricularcomponentsconstitutethe“instrumental”domainoftheMBSR
curriculum.ThisinstrumentaldomainiswhatRumiisreferringtoas“acquired”intelligence.
Acquiredintelligencecomesthroughpractice,throughrepetition,attainmentandthedevelopment
ofskillsandcompetencieslearned,understood,andexperientiallyrefinedovertime.Surely,the
instrumentalisofgreatvalue,comprisingonedomainoflearning.
Seenthroughtheperspectiveoftheinstrumental,thiscurriculumguideisakintoanoperating
manual-aclass-by-classhandbook.Understandablyso,whensomeoneisfirstlearningtobecome
anMBSRteacher,thecurriculumisoftenapproachedinthisway.
Whenviewedthroughthelensoftheinstrumental–theworldofdoingandbecoming-thenthe
answertothequestionofwhetherthecurriculumhaschangedleanstowards“no”;thecurriculum
hasnotchangedmuchatallsince1979.
Ofcourse,hereinliesoneoftheinherentdangersofpublishingan“authorizedcurriculumguide.”
Soonenough,itwillbemistakenfora“manualizedprotocol.”Soonenough,peoplewillbecome
fastenedtotheform–boundtightlytotheinstrumental-becauseitprovidesastructure,a
trajectory,andamapthatiseasilymistakenfortheterritory.Whilevaluableandoftentimes
comforting,thisisalsoproblematicbecauseitislimiting.
Muchofthetime,wewantthemaptobetheterritorybecausewedesperatelywantconstancy.
Surelyitissoofteneasierforustoholdfirmlytoandbecomfortedbytheinstrumental-bythe
form.
Havingestablishedsomesenseoftheinstrumentaldimensionofintelligence,let’snowturnour
attentiontoawhollyotherdomainofintelligence.
“AlreadyCompleted”Intelligence:TheNon-InstrumentalDimensionofMBSR
Atthemostbasiclevel,youneedaroomtoteachMBSR,agatheringplaceforpeople.
Ofcourse,youalreadyinhabitaroomthatisalwayswithyou.Thisistheroomofyourheart.Rumi
callsthisplacelessplace:
“Thefreshnessinthecenterofyourchest”…“Thecityinsideyourchest.”
Thisfreshnessisoutsideofspaceandtime,outsideofneedingtogetanything,outsideof
transformingyourselforanyoneoranything-noattaining,nonon-attaining,nocompletenessor
incompleteness…simplybeing.
Thisisthenon-instrumentalactualityofMBSR,theintelligencethatisalreadycompletewithinyou–
andwithinthosewithwhomyouwork.Thisintelligencedoesnotneedtobeacquiredbutrather,
remembered.
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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Thisistherealcurriculum…therealguide…thedeepspringfromwhichMBSRflowsoutofyouand
makesitswayintotheworld.
Youmightconsiderreturningtothiswaterwheneveryouneedareminderofwhoandwhatyouare
behindallthewordsandformsdescribedinthisCurriculumGuide.This“freshness”availabletoyou
wheneveryoubecomelostortired,overextendedordiscouragedorsimplyinneedofrestandease
andtherefreshmentofnotneedingtopursueanyaimatall.
Isuspectthatifyouallowyourselftheroom,you’lldiscoverforyourselfthatholdingtoofirmlyto
theinstrumentalinevitablyblindsyoutothenon-instrumental-towhatismostessentialabout
MBSR-becauseitismostessentialaboutyouandallhumanbeings.
LikeRussianMatryoshkadolls,theinstrumentalisnestedwithinthenon-instrumental.Ifthiswere
notthecase,howcouldyoulearnanything?Howcouldyouloveanyone,iflovewerenotaninnate
attributeofyourbeing?Howcouldyouacheandfeeltendernessintheorbitofanother’spain,if
empathywasn’tinherent?Surely,wecanlearntobecomeincreasinglyfamiliarwiththese
attributesthroughdeliberatenessandpractice.However,iftheywerenotalreadypartandparcel
ofwhoandwhatyouare,youwouldhavenoreferencepointforloving,compassionating(asWalt
Whitmansays)orassumingyourownmeasureofuniversalresponsibility.
IfMBSRisworthanything,itsworthliesinitsaliveness.Itsalivenessrestsinthebasic
ungraspabilityofthecurriculumasMBSR.Seenfromthisvantagepoint–thevantagepointofthe
non-instrumental-thentheanswertothequestion,“hasthecurriculumchanged”isyes.The
curriculumhaschanged-because,likeeverythingelse,itisconstantlychanging.Likewise,whoand
whateveryouthinkofas“you”isalsocontinuallychanging.Thisdynamicfluxisnoneotherthan
thecreativenatureofRumi’s“UniversalIntelligence”reflectedthroughyouandembodiedasyou.
And,ofcourse,asyougrowanddeepen,thecurriculumischanged,deepeningandexpandinginto
newexpressionsofitself,endlessly.
Ultimately,andinaverypalpableway,the“curriculum”ofMBSRisnoneotherthanyourlifeand
thelivesofthepeopleyou’llshareinandengagewithweekbyweekintheclassroom.The
suffering,theinconstancy,thelackofasolid,concrete“self”-thewishforreliefofsufferingand
thelongingforwellbeingthatyoucarrywithinyou,andallthepeopleyou’lleverworkwithcarry
withinthem-isthecurriculum,thevitallifeofMBSR.
Now,asyouturnthepageandenterthisMBSRCurriculumGuide,nowandagain,andoverand
overagain,myinvitationtoyouistorealizethattherealguidetotheMBSRcurriculumisalways
availableinsideofyou,alwaysawaitingyourattention,alwaysrestinginyourcompletenessoutside
ofanynotionsofhereandnow,pastandfuture,timeandspace.
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CenterforMindfulnessinMedicine,HealthCare,andSociety(CFM)
UniversityofMassachusettsMedicalSchool
Mindfulness-BasedStressReduction(MBSR)
AuthorizedCurriculumGuide©
2017
Overview
AstheplaceoforiginofMindfulness-BasedStressReduction(MBSR),theUniversityofMassachusetts
CenterforMindfulnesshas,since1979,conceptualized,developed,implementedandresearchedMBSR
intheformofan8-week,10-sessioncoursecomprisedof31hoursofdirectinstruction.
This2017versionofMBSRCurriculumGuideisbaseduponourcumulativeexperiencetotalingmore
thanonemillionhoursofclinicalcare,morethan24,000MBSRprogramcompleters,referredbymore
than7,000physicians,hundredsofotherhealthcareprofessionals,andthroughself-referral.Inour
view,maintainingthefidelityandintegrityofMBSRasdetailedinthisCurriculumGuidewillhelpinsure
theclinicalefficacy,scientificvalidity,andeducationalrigorofthisapproach.
AdherencetothetheoreticalconstructsandcoreelementsofMBSRasdescribedinthisCurriculum
Guidearebaseduponclinicalexperienceandscientificinvestigations.Astheseinvestigationsproceed
andnewdiscoveriesaremade,wewelcomeandarepreparedtoaltertheMBSRcurriculum.
Currently,thereareawide-rangeofmindfulness-basedprogramsthathavedevelopedoutofthebasic
structureandformatofMBSR.Weapplaudtheseadaptationsandexperimentswhilestronglyurging
ourcolleaguestocallwhattheydoMBSRonlyiftheyadheretothestructureandstandardsdescribed
herein.Withoutsuchadherence,theveracityofMBSRwillbediminishedandthescientificresults
increasinglysuspect.
Atitscore,MBSRisbasedonsystematicandintensivetraininginmindfulnessmeditationandmindful
hathayoga.Thecurriculum,originallydevelopedbyJonKabat-Zinn,Ph.D.,isanexpressionand
reflectionofthiscoreprinciple.Therefore,itistermed“mindfulness-based.”Incontinual
developmentintheMindfulness-BasedStressReductionClinicatUniversityofMassachusettsMedical
School,thecurriculumisdesignedtoguideMBSRprogramparticipantsinthe“how”oflearningto
practice,integrate,andapplymindfulnessintheireverydaylives.TheprimaryintentionoftheMBSR
curriculumistocreateastructuredpathwaytorelievesufferingandincreasewellbeingforpeople
facingahostofchallengesarisingfromawiderangeofmedicalandpsychologicalconditionsandthe
demandsandstressorsinherentintheeverdaylivesofhumanbeings.
EmbeddedwithinthecontextofMind-BodyandParticipatoryMedicine,theMBSRcurriculumfocuses
ontheexperientialcultivationofboth“formal”and“informal”mindfulnesspracticeasameansof
familiarizingoneselfwithawarenessitself(mindfulness).Therecognitionofaninnate,ever-present
awarenessisthefoundationforthedevelopmentofpositivehealthbehaviors,psychologicaland
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emotionalresilience,andanoverarchingsenseofwellbeingthatcanbeeffectivelycultivatedand
relieduponacrosstheadultlifespan.
MBSRclinicalandbasicscienceresearchandourexperienceattheCenterforMindfulnessatthe
UniversityofMassachusettsMedicalSchoolstronglysupportstheefficacyofMBSRasaneffective
clinicalapproachthatcanbeutilizedbyparticipantsfarbeyondcompletionoftheprogram.
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OrientationSession:Overview
(Foranin-depthdescriptionoftheOrientationSessionasfollowedatUMassMedicalSchoolseeAppendixA)
Overview
ThemainintentionsoftheOrientationinclude:
v FamiliarizingpotentialparticipantswithwhatMBSRisandisnot
v Providingparticipantswithanexperienceofmindfulnessinan
atmosphereoftrustandnon-judgmentalawarenessandexchange
v Educatingparticipantsaboutprogramprocedures
v Assessinghowparticipantsinteractinthegroupsettingtodetermine
whethertheprogramisagoodmatch
v Meetingwitheachparticipantindividuallyforabriefscreeninginterview
v Elicitingacommitmentfromparticipantstoengageinactive
participationintheprogram,whichincludesweeklyclassattendance
andaminimumof45minutestoonehourofformalhomepracticeas
wellasinformalpracticethroughouttheday
Recommended
Time
Allocations
Formal
Practice
Informal
Practice
TypicalClass
Sequence
1:00-1:25hourstocoverallcomponentsinlargegroup
ShortYogasequence
SittingMeditation–AwarenessofBreath
FollowingtheGroupOrientationSession,ifparticipantsarewaitingtheirturnfor
anindividualinterview,aninvitationcanbeofferedtoconsiderbecoming
aware—forbriefmoments—oftheenvironment,bodilysensations,feelingsof
impatienceorboredom,excitementetc.
v Overviewoforientation
v BriefhistoryofMBSRandtheStressReductionClinic(SRC)(adaptfor
localvenueasneeded)
v IntroduceMindfulness
v Briefpractice(yoga,shortAOB)(Practiceisofferedherejustasitisdone
intheMBSRclass,includingguidancefortakingcare,self-assessingbefore
takingpartinanymovement,andexploringone’scurrentlimitswithout
pushingoneselfbeyondthem)
v Briefsharingoftheimmediatemindfulnesspracticeexperiencewith
OrientationSessionparticipants
v ClassLogistics:Times,dates(includingtheAll-Dayclass),theimportance
ofattendingeachclassandthecommitmenttodailypractice
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TypicalClass
Sequence
(cont)
v ClassContent:Experientiallearningofformalandinformalpractices;
recordingsandhomepractice;classtopics:Perception,stress
physiology,stressreactivityandresponding,communication
v GuidelinesforParticipation:Commitment,engagementwithpractice,
noneedto“believe”anythingasapre-requisiteforparticipation,
attentivenesstoone’sexperienceastheprimary“data.”Notethatwhile
participantsarenotrequiredtospeakinclass,classdialogueinsmall
groupsandthelargergroupisameaningfulpartofclasstime.
v Risks&Benefits:
Risks–Physical,emotional,time,social;alsonotepossible
exclusionsorareastotalkmorewithinstructorduringinterview:
Addiction,earlyrecovery,untreatedpsychosis,acutedepression,
suicidality,PTSD,SocialAnxiety,recentloss.Thesecircumstancesor
conditionsdonotruleoutthepossibilityofbeingintheclass,butitis
essentialtosharewiththeteacherduringtheinterviewtheseor
anythingthatfeelsimportanttoshare.Duringtheinterviewthe
teachercanoffersuggestionsforsupportandmakerecommend-
dationsforthemostsuccessfuloutcomesforparticipationinthe
MBSRclass(PleaserefertoAppendixAfordetailedinformationand
proceduresregardingcandidatereferralstoappropriatemedicaland
psychologicalprofessionalsandhealthemergencyintervention.)
Benefits–Bettercoping,evidence-based,dependentonconsistent
practice,capacitytobettercareforself,noguarantees
v Inviteadditionalquestions
v IndividualInterview
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MBSROrientationSessionLogisticalDetails
LogisticsoftheMBSRCourse:
BelowaredetailedlogisticsthatareincludedintheCFMOrientationSessions.Somelogisticsare
adaptabledependingonthevenueandwhetherthereisoneclassorseveralbeingofferedinagiven
timeframe;optionsareindicatedbelow.PleaseseeStandardsofPracticeformoreinformationon
programmaticelementsrequiredtobeconsidered“MBSR.”
v Thecoursemeetseveryweekfor8weeks,eitherinthemorningorevening,for2.5to3.5
hours(adapttimesforlocalvenue).
v Thereisan“All-day”class(asilentretreatday)betweenthe6thand7thweekonaweekend
day,from8:45a.m.–4:30p.m.(ItisalsopossibletoholdtheAll-dayclassbetweenthe5thand
6thweekifschedulesdemand).
v Formalandinformalpractices:Ineachclassparticipantswilllearnaboutandpractice
differentformsofmindfulnessincludingformalpracticesofyoga,sittingmeditation,body
scan,andwalkingmeditationaswellasinformalpracticessuchasmindfuleating,speaking
andlistening,andmindfulnessofdailyactivities.
v Topicscoveredinclass:Participantswilllearnaboutstress,andexplorethehabitual,
automaticbehavioral,physical,emotionalandcognitivepatternsaswellasinvestigate,in
detail,moreeffectiveandskillfulresponsestothechallengesanddemandsofeverydaylife.
Inparallel,we’llalsobeexploringwhatitmeanstotakecareofourselvesandflourish,how
torelatetoourselvesandothersmoreeffectivelyandwhatitmightbeliketonourish
behaviorsandactivitiesthatexpressourinnatecapacityforwellbeing.
v Ineachclasstherewillbeperiodsofformalmindfulnesspractice,smallandlargegroup
discussionsandtalks,aswellaspracticesandexercisesrelatedtothatweek’stopics.
v RecordingsforHomePractice:ParticipantswillreceiveCDsorMp3downloadswithguided
meditationandyogapracticesandahomepracticemanual,weeklyhandoutsoremail/online
informationwitheachweek’sformalandinformalpracticeassignments.
v Classsize:Therewillbeapproximately_______peopleineachclass.(Classsizesmayvary
fromasfewas15andasmanyas40dependingonthevenue,community,etc.SeeStandardsof
Practiceforsuggestedclasssize.)
v Whattowear/bring:Comfortableclothing,looseatthewaistthatallowsforunconstructed
breathing,supportspractice.Therearenoscheduledbreaksduringclass;takecareof
personalneedsasrequired(thisincludesbathroom,food,water,medications).Encourage
eatinglightlybeforeclassandavoidhavingfoodintheclassroom,althoughiffoodisneeded
formedicalreasons,individualsshouldbeaccommodated.Requestrefrainingfromuseof
scentedpersonalcareproducts(thismayincludedetergents)duetoothers’sensitivity.
v Dailyhomepracticeconsistsof40-45minutesofrecordedformalpracticeinadditionto
otherexercises,activities,orpracticenotrequiringarecording.Totaldailypracticetimeis
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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60minutesormore.Encourageparticipantstoconsiderhowtheywillsetasidetimefordaily
practicesincethisisanessentialcomponenttotheprogram.
v AcknowledgestressfulnessofparticipationinMBSR.Thisincludestimecommitmentand
otherpossiblechallenges.
v Attendance:Attendanceatall9classes,includingtheall-dayclassisemphasized.Ifa
participantmissesaclass,theremaybepossibilitiesformakinguptheclassthatweekon
anotherdayifmultipleclassesareheldatthesite(dependentonvenue).Ifsomeoneknows
theywillmiss2ormoreclasses,encourageparticipationinadifferentcycle.If,duringthe
course,aparticipantmisses3ormoreclasses,theyareencouragedtodropoutandtakethe
entireprogramagaininanothercyclewhentheyareabletomakethetimecommitment.
Emphasizetheimportanceofarrivingontime.Remindparticipantstocalltheteacherifthey
areunabletoattendclass,needtomakeupinanotherclass,orknowyouwillbelatefor
class.
v Weatherpolicies:Explainanyinclementweatherpolicy.
v Informedconsent-Classaudioandvideorecordingsforteacherdevelopment(if
applicable;dependentonvenue):Explainthenatureanduseofvideoandaudiorecordingof
eachclass.Informparticipantsrecordingsareusedsolelytosupportongoingteacher
developmentandcompetencyassessment.HaveparticipantssignInformedConsent
documentbeforeOrientationorthefirstclass.
Explaintherisksandbenefitsoftheprogram.(Note:itisonlyafterthesehavebeenexplainedthat
theparticipantcansigntheinformedconsentagreement.)
Physicalrisks(Ifabriefyoga/movementpracticeisofferedduringtheOrientationSession,asis
suggested,theseintroductorypointsofguidanceshouldbeincludedduringthatmovement
experienceandthenreviewedinmoredepthhere):
v Theprimaryphysicalriskisconnectedtopracticingmindfulyoga.
v Knowingoneselfandtakingcareofoneselfisatthecoreofmindfulness.
v Ifaparticipanthearsguidancethattheyknowisnotappropriatefortheirbodyorcondition,
orifanythingcausespain,thecorrectactionistodisregardtheteacherandeithermodify
thepose/movement,restandimaginedoingthepose/movement,ornoticeand
acknowledgeanythoughtsoremotionsthatmaybearisingintheexperienceofnotdoing
thepose/movement.
v Focusisonexploringone’sphysicallimits,bygoingtotheedgeofthoselimits,butnot
beyond.Thisexplorationisdoneslowlyandwithsensitivity,guidedbytheteacher.
v Beingawareofthebodyfrommomenttomomentandineverydaysituationsisanessential
aspectofMBSR.Theformalyogasequencesareastructuredwayofdevelopinggreater
bodyawareness,andassuch,areawarenesspracticesratherthanpracticestodevelopa
specificformoralignmentthatisoftenemphasizedinothertypesofyoga.
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v Theteacheroffersmodificationsoradaptationstoposes/movementstomeetthevarietyof
capacitiesintheclass(aswasdemonstratedinthebriefpracticeguidedduringOrientation
session).
v Participantswithphysicalconditionsorlimitationsshouldasktheirhealthcareproviderto
reviewtheposturesinthepracticemanual,andtosuggestonlythoseposturesthatare
suitable.
Emotionalrisks:
v Feelingsofsadness,anger,orfear,couldseemorbecomestrongeraspracticedevelops,
sincepayingattentioninaconsciousway—perhapsforthefirsttime—canhighlight
emotions.
v Ahistoryoftrauma,abuse,significantrecentlossormajorlifechanges,oraddictionto
substancesmayheightenemotionalreactions.Pleasespeakwiththeteacherifthisoccurs,
andtogetheryoucandeterminethebestcourseofaction(i.e.,modifyingpractice,dropping
thecourse,waitingforanothertimewhenacutesymptomsmaybeless).
v Participantsmaymakediscoveriesaboutthemselvesthattheymaynotlike.
v Participantsmaybechallengedandfindthemselvesfacingtheunknown.
v Experientiallearningisoftennon-linear;participants’symptomscansometimesworsen,
particularlyintheearlyweeksoftheprogram.Evenwithregularpractice,participantsmay
feellike“nothingishappening.”Thisisnormalandatypicalaspectofanylearningprocess.
Participantsareencouragedtospeaktotheirteacherwithanyconcerns.
Otherpeopleinyourlife:
v Itmaybeachallengetosetasidethespaceandtimetodothispractice;requesting
assistancefromfromfamily,friendsand/orco-workersmaybesupportive.
v Participantsmayexperiencechangesinreactivity,behaviorandcommunication,andfamily,
friendsand/orco-workersmaybeuncomfortablewiththesenewbehaviorsorattitudes.
v Participantsmayfindthattheirrelationshipschangeasattentiondeepensandnew
behaviorsevolve.
Time:
v Findingtimetomakeanewhabitofmindfulnesspracticecanbechallenging:it’snormalto
havetheideathatthereisnotenoughtimeforpractice.Participantsoftenfind,counterintuitively,thatsettingasidetimeforpracticeincreasesthesenseofspaciousnessintherest
oftheday.
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Benefits:
v Increasedawarenessandconcentration
v Discoveringnewwaystocopemoreeffectivelywithexistingconditionsdifficulties,painor
suffering
v Learningtotakebettercareofoneself
v Manyphysical,psychologicalandemotionalhealthbenefitsofMBSRhavebeenreportedin
scientificliterature
v WecannotguaranteeorpromiseanyparticularresultsfromparticipationintheMBSR
course.Rather,emphasisisplacedontheparticipant’sactiveengagementintheprogram.
Weencourageparticipantstoassumethestanceofascientistinvestigatingtheirareaof
interest:withopennessandcuriosity,suspensionofjudgementandasenseofhealthy
questioning.Itismoreimportantforaparticipanttoexperienceforthemselveswhateveris
happening,ratherthanfortheteachertotellthemwhatmayormaynothappenasaresult
oftheirparticipationinthecourse.
Inviteadditionalquestions
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ClassOne
Overview
Theme
This3-hoursessionincludesareviewoftheapproachandthe
establishmentofalearningcontractwiththeparticipant/patient.The
theoreticalunderpinningsofmindfulnesswithinthecontextofMindBodyandParticipatoryMedicineandtheapplicationofself-regulatory
skillsrelatedtotheindividual’sconditionorreferringdiagnosisarealso
established.Theparticipant/patientisexperientiallyintroducedtomindful
eating,somestandingyogastretches,mindfulnessofbreathingandthe
bodyscanmeditation.Homepracticeisassignedusingthefirstguided
recording(bodyscanmeditation)asameansofbeginningtolearnto
becomefamiliarwithmindfulawarenessofthebody.
Fromourpointofview,aslongasyouarebreathing,thereismoreright
withyouthanwrongwithyou,nomatterwhatchallengesyouarefacing.
Challengesanddifficultiesareworkable.Mindfulawareness,definedas
theawarenessthatarisesfrompayingattention,onpurpose,inthe
presentmoment,non-judgmentally,(Kabat-Zinn,J,FullCatastrophe
Living,1990,2013)isfundamentaltothisapproachsincethepresent
momentistheonlytimeanyoneeverhasforperceiving,learning,
growingandtransforming.
Buildingtrustwithinthegroupandbeginningtosenseacommunity;
definingandapplyingmindfulnesstoourlifeexperientially;openingand
startingtoexplore;acknowledgingalternativeperspectives;trustingthe
possibilitytoseeoneselfwithfresheyes.
Recommended FormalPractice–Approximately1hour(muchdependsonthesizeofthe
Time
groupandhowmuchtimeisallottedforthebodyscan).
Allocations
InformalPractice–Approximately20-30minutes(eatingmeditation)
GroupDiscussion–1hour+(dependingonsizeofgroupandneedsfor
groupintroductions
Logistics(attendance,announcements,homepractice)–30minutes
FormalPractice OpeningPractice(brief,arriving)
BodyScan
StandingYoga(ItisrecommendedthatafewposesfromtheStanding
Yogasequencebeintroducedinclasses1,2,4and5,sothatbyClass5,
whenparticipants/patientsreceivetheStandingYogarecording,all
StandingYogapostureswillhavehavebeenintroduced,eliminatingthe
needtodothesequenceinitsentiretyinclass5)
Informal
Practice
EatingMeditation
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TypicalClass
Sequence
(continued)
Welcomeandbriefintroductionofprogrambytheinstructor
Openingmeditation:becomingattentivetoandawareofthoughts,
emotions,andsensationsinthepresentmoment(mayalsoincludewhat
isseen,heard,othersenses)
Classresponsestoopeningmeditation(canbejustafewresponsesifitis
alargeclass)
Reviewdefinitionofmindfulness,includingentiretimeinclassasan
opportunitytopracticemoment-to-momentseamlessawareness(not
justinthemeditations)
Reviewofguidelinesforparticipationi.e.:Confidentiality,self-care,
communicationwithinstructor,noadvice-giving,nofixingorrescuing
others,avoidanceofscentiedproducts,etc.
Guidedindividualinternalreflection:Whathasbroughtyouhere?What
isyourintention?Whatdoyoureallywant?(Option:smallgroupordyad
sharingaboutguidedreflectionbeforegoingintolargegroup.)
Groupgo-around:Provideparticipantswiththeopportunitytointroduce
themselves,whattheyareherefor,andtheirgoalsandexpectationsfor
theprogram.Theinstructormaymakeinstructivecomments,
observations,andwelcomingremarksfromtimetotimeinresponseto
individuals.Thisisnotadiscussion;avoidcross-talkbetweenparticipants,
andteachermayinformthegroupthats/hemayneedtointerruptto
keepontimeandmaintainguidelines.Mindfullisteningandspeakingmay
beintroducedhere.Encourageeveryonetospeak—evenifonlytosay
theirname.Alsoencouragethosewhomaybeattendingforprofessional
trainingpurposes(e.g.asthebeginningofMBSRteachertraining,for
instance,orinordertointroducemindfulnesstotheirpatientsorclients)
todropbeneaththeprofessionalroletothepersonalaspectsoftheir
lives,tobeauthenticandwillingtoexplorewhatisavailableforthem,
withoutpre-conceptionsofthisprogramsolelyasatraining,butratherto
seetheirfullpartipationasanessentialpartoftraining.
Yoga:IntroductiontostandingMountainPoseandafewotherstanding
poses(Seerecommendationunder“FormalPractice”onpreviouspage).
Raisin-eatingexercise:introductiontomindfulnessmeditationusingthe
ordinaryactofeating,followedbyadialogueabouttheexperience.Focus
ondirectsensoryobservation–whatcanbeseen,felt,heard,smelled,
tasted.Observingandthenslowlyeatingoneraisin,withguidancefrom
instructor,stoppingforobservationsfromparticipants.Bringingfriendly
curiositytothisinvestigation,theneatingasecondraisininsilence.
Instructorisattentivetoobservationsthataredeductions,opinionsand
theoriesremovedfromtheparticipant’simmediateexperience.Group
dialoguecanbeaninquiryintowhatisdirectlyexperiencedthroughthis
practice.Theinstructorstaysawakeandalivetotherecognitionofpast
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
13
TypicalClass
Sequence
(continued)
experienceinfluencingthepresent;theinterconnectionoftheraisinto-
sun,soil,rain,energyofplanting,harvesting,deliveringthefood,and
thenbecomingtheenergyofthebody;relationshipbetweenhunger,
satisfaction,emptiness,andfullness;andwhatshowsupwhenpresent
forthefullactofeating.Notneedingtonecessarilybringthesetopics
forward,butallowingthemtoariseinthegroup.
Abdominalbreathing:Tiethemoment-to-momentawarenessofeating
exercisetoexperiencingthebreathinthesameway.Introducevarious
comfortableposturesforlyingdown:corpsepose,astronautpose,or
sittinginchairsifnecessary.Focusonthefeelingoftheabdomenrising
andfallingwiththein-breathandtheout-breath,mindfully“tasting”the
breathinthesamewaythatthegrouptastedtheraisin.Non-judgmentally
observingone’sownbreathingfrommomenttomoment;andbringing
one’sattentionbacktothebreathandthepresentmomentwhenthe
mindwanders.
BodyScan:Frommindfulnessofbreathing,moveintoguidedbodyscan
withpeoplecontinuingtolieonfloororsittingincomfortableposition.
Finishwithdiscussionofpeople’sexperienceswiththebodyscanand
assigndailyhomepractice.Giveinstructionsforuseofthe45-minute
BodyScanrecordingforhomepracticeduringWeekOne.
Reviewhomepractice.EndwithshortAwarenessofBreath(AOB)
meditation.
HomePractice • BodyScanrecording≥6daysthisweek
•
HomePracticeManual:The9DotsPuzzle.Giveinstructionstowork
withthepuzzleandalsobeattentivetohowyouapproachthepuzzle.
•
Eatonemealthisweekmindfullyoratleastafewbitesduringone
meal
•
Optionalinformalpractice(“smalldoses,manytimes”):Informally
andintentionallynoticeorcultivatemomentsofawarenessduring
theday—tuningbrieflyintothebreath,body,sounds,whatcanbe
seen,andthoughtsandemotions—whateverispresent,noticing
withoutjudgment;recognizingdirectlythatyoucandeliberately
cultivateacontinuityofawarenessthroughoutyourdayasawayof
beginningtoaccessyourinnateresourcesforcopingandmeeting
liveinwaysthatarelessconditionedandmoreappropriateto
situationsyouarefacing
•
Optionalinformalpractice:Informallypracticesomeofthemindful
stretchesyoulearnedinclassasawaytoreconnectwiththebody
andthepresentmoment
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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ClassTwo
Overview
Theme
This2.5hoursessionincludesonehourofexperientialmindfulness
trainingandskilldevelopment,andonehourormoreoffocuseddialogue
andreflectiononhomepracticeand,thematically,ontheroleof
perceptionandconditioningintheappraisalandassessmentofstress.
Thepivotalroleofself-responsibilityinthepositivedevelopmentofshort
andlong-termchangesinhealthandhealth-enhancingbehaviorsis
introduced.Homepracticeisassignedwithanemphasisontheregular
dailypracticeofthebodyscanforasecondweek,plusintroductionof
shortperiodsofsittingmeditation,andtheapplicationandintegrationof
mindfulnessintotheparticipant’severydaylife.
Perceptionandcreativeresponding:Howyouseethings(ordon’tsee
them)willdetermineinlargemeasurehowyouwillreactorrespondto
them.Thistiesinwithhowpeopleseetheirparticipationintheprogram;
howtheyseetheirpain,theirillness;thestressandpressuresintheirlives;
thelevelofcommitmenttheywillbringtotheprogramandtothe
personaldisciplineitrequires.Maketheconnectiontoautomatichabitual
stressreactivityandrecoveryfromacutestressors,andtheprinciplethat
“It’snotthestressorsperse,buthowyouhandlethem”thatinfluences
theshortandlong-termhealtheffectstheymayhaveonyourmind,body
andoverallsenseofhealthandwellbeing.
Recommended FormalPractice–1hour
Time
GroupDiscussion–40minutes
Allocations
DidacticPresentation(ninedots)–30minincludinggroupdiscussion
Logistics(attendance,announcements,homepractice)–20minutes
FormalPractice Openingmeditation
SittingMeditation
StandingYoga-afewpostures(optional)
BodyScan(45minutes)
AOBsittingmeditation(introductionwithposturalguidance)
Informal
Practice
Forhomepractice:Mindfulnessofroutineactivities:Brushingteeth,
washingdishes,takingashower,takingoutgarbage,shopping,reading
tokids,eating(participantchoosesone).
Continueincludingsomeoftheyogaposesintoyourday.Becomeaware
ofrepetitivemovementsinordinaryactivities,i.e.gettingintoandoutof
thecar,preparingmeals,bathingchildren,takingawalk,etc.
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
15
TypicalClass
Sequence
Standingyoga
Guidedbodyscan
Smalland/orlargegroupwork:Discussionofthebodyscanexperience
bothinthesessionaswellashomepracticewithparticularattentionto
howsuccessfultheywereatmakingthetimeforit,problemsand
obstaclesencountered(sleepiness,boredom,other),howtheyworked
withthemornot,andwhatparticipantsmaybelearningand/orseeing
aboutthemselvesfrompracticingthebodyscan.
Establishtheuniversalityofthewanderingmindandthenotionof
workingwiththisrecognitionwithcuriosity,acceptance/
acknowledgmentanddeliberate,repeated,re-focusingofattention;
explicitlylettingparticipantsknowthatthisdeliberatere-directingof
mindand“comingback”isasmuchapartofthemeditationpracticeas
stayingontheobjectofattention;noting(withoutanalysis)wherethe
mindgoesandwhatisonone’smind.Emphasizetheimportanceof
desistingfromrepressingandsuppressingthoughtsorfeelingsor
forcingthingstobeacertainway.Bestwaytogetsomewhereisnotto
trytogetanywhere,noteven“relaxed.”Theoptionisto“letbe”or
“letgo.”Thisisanewwayoflearning.Thebodyhasitsownlanguage
anditsownintelligence.Non-conceptual.
Discusseatingonemindfulmealand/ortheexperienceoftheir
relationshipwithfoodthisweek.
9-DotsPuzzle:Examinetheexperienceofworkingwiththe9-DotPuzzle
andthethemeofexpandingthefieldofawarenesswhenfacingfamiliar
ornewchallengesorcircumstances.Severalsubthemesmayemergeout
ofthisexperience.Thesemayinclude:wayssomeoneproblemsolves,
recognizingconditionedbehavioral,cognitiveandemotionalpatterns
thatarisewhenworkingwithdifficultiesandchallenges(including
“solving”the9-DotsPuzzle);beginningtorecognizepatternsthatare
self-defeatingornon-productiveaswellaswaysthatthepastinfluences
thepresent(labels,beliefs,identities);alongwiththebreakthrough
“aha!”experience.(Mayconnectany/allofthesethemestopracticingthe
bodyscan.)
Option:Usetheoldwoman/youngwomanorothertrompeL’oeilor
otherperception-challengingvisualaidstoinvestigatedifferentwaysof
seeingornotseeing.
SittingMeditation:Introducesittingmeditationwithawarenessof
breathing(AOB)asprimaryobjectofattention.Beginbyintroducingand
exploringposturaloptions.Doabriefguidedmeditation.
DiscussionabouttheAOBmeditation.
Gooverhomepractice.EndwithshortAOBmeditation.
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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HomePractice • BodyScanrecording≥6timesperweek
•
AOBsittingmeditation:10-15minutesperday–Norecordingforhome
practice.Participants/patientsareinstructedtopracticeontheirown.
Thisisnotaboutcontrollingorchangingthebreath,butratherbeing
withthebreathandthebodilysensationsofbreathing,noticingwhen
attentionwanders,anddeliberatelyreturningattentiontothebreath
•
FilloutPleasantEventsCalendarfortheweek–oneentryperday.
Note:Ifnopleasanteventisperceivedonagivenday,thereisnoneed
tofilloutthecalendarforthatday
•
Chooseonedailyactivitytobringfullawarenesstofortheweek:
Brushingteeth,takingoutthegarbage,takingashower,feedinga
pet,etc.
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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ClassThree
Overview
Theme
Inthis2.5hoursession,participantspracticeseveraldistinctyet
interrelatedformalmindfulnesspractices--mindfulhathayoga(ending
withabriefbodyscan),sittingmeditationandoptionalwalking
meditation--foraminimumof90minutes.Thisextendedformalpractice
periodisfollowedbyinquiryintoandexplorationofparticipants’
experienceswithin-classandassignedhomepractices.Typicaltopics
includechallengesandinsightsencounteredinformalpracticeandin
integratingmindfulnessintoeverydaylife.
Thereispleasureandpowerinbeingpresent.Attendingtoand
investigatingthewaythingsareinthebodyandmindinthepresent
momentthroughthepracticesofyogaandmeditation.
Recommended FormalPractice–70-90minutes
Time
GroupDiscussion–1hour
Allocations
Logistics(attendance,announcements,homepractice)–20minutes
FormalPractice Openingmeditation,whichcanflowintolongersittingpracticeofAOB
withattentiontoposture
MindfulLyingDownYoga
WalkingPractice(Iftime):Thispracticecanbeintroducedatanytime
fromweekthreeforward–Itisstronglyrecommendedthatmindful
walkingbeintroducedatleastonetimepriortotheallday-class.
Closingmeditation
Informal
Practice
TypicalClass
Sequence
Reminderduringclassdiscussions(bothsmallandlargegroup)ofmindful
listeningandspeaking
Classthreeoptionsforincreasingseamlesscontinuityofpracticeinclude
thepossibilityofmovingdirectlyfromsittingtolyingdownyogaorfrom
sittingtowalkingtolyingdownyoga,offeringalongerperiodofformal
practice.Inthiscase,thegroupdialoguewouldincludewhatwas
experiencedinallthepractices.
Sittingmeditationwithawarenessofbreathing.Specificguidance
relatedtoestablishingastable,uprightandbalancedsittingposture.
Groupdiscussiononsitting,bodyscan,andmindfulnessinroutine
activities.Discusstheimportanceofbeingembodiedthroughthesharing
ofparticipants’directexperienceoffeelingembodied(establishedintheir
somatic/bodilyexperience)orungroundedanddisconnectedfromthe
body.
Optional:Introducewalkingmeditation.
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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TypicalClass
Sequence
(continued)
LyingDownYoga:Slowlymovethroughthesequenceofposturesonthe
Lying-downYogarecording,withguidanceandcommentsinterspersedas
required.Emphasisisonmindfulnessandapproachingone’scurrentlimits
withgentleness—learningtodwellattheboundarywithoutoverstepping
andinvestigatingwhatissensitiveandwise,moment-to-momentfor
eachparticipant.Participantsareencouragedtoavoidanyposturesthey
feelwouldcauseinjuryorasetbackand,toexperimentwithcautionand
carewhenindoubt.Particularattentionispaidtopeoplewithchronic
musculoskeletalproblemsi.e.lowerback,neck,jointsandchronicpainin
general.Verbalguidanceisexplicitandaccurate(i.e.iflyingonthefloor:
“…drawingtherightkneeuptothechestandwrappingyourarmsunder
thethigh…”)sothatpeopleknowwhattodowithouthavingtolookat
theteacher.WeexpectallMBSRteacherstoactivelydemonstratethe
yogaposturesalongwithprogramparticipants.Thismayincludeoffering
chairoptionsorotheradaptationsforpeoplewithphysicallimitations.
Teachersareencouragedtorespondtospecificparticipantneedsand
tailortheposturesaccordingly.Theteacherisencouragedtoaskif
anyoneneedsadditionalguidanceregardingaposture,andifneeded,the
teachercanassisttheparticipant,askingpermissionfirstbeforemaking
physicalcontact.
Itisskillfulandsupportivetoofferchairyogaadaptationsforthosewho
areunabletoliedownonthefloor.Thismaynecessitatemovingbackand
forthbetweenthefloorandachairasyouguideparticipantsintheyoga.
Groupdiscussionabouttheexperienceofpracticingtheyogapostures.
GooverPleasantEventsCalendar,beingparticularlyattentiveto
exploringtheordinarinessofexperiencingamomentaspleasant.
(Optional:beforeaformalgroupdiscussionwiththeparticipantsaboutthe
PleasantEventsCalendarconsiderleadingashortguidedreflectionthatasks
participantstoselectonepleasantevent,focusingonphysicalsensations,
emotions,andthoughtsastheyariseasmemory,andthenastheyarisein
thepresentmoment.)
Particularemphasisonmind/bodyconnections,patterns,whatpeople
observed/learnedaboutthemselvesineverydaycircumstances.Also,
wonderingtogetheriftherewereanypleasantmomentsexperienced
duringthebodyscaninthepastweek(orsittingpractice).Investigating
whatqualitiesinallofthesepleasantmomentsoreventscausedthemto
belabeledaspleasantbytheparticipant?Whatqualitiesdothesedistinct
pleasantmomentsoreventshaveincommonfortheparticipant?(Thisis
anopeningtoacknowledgehowhabitsareconditionedandourdesireto
wantthingstobeacertainwaythatresultsinattachment,aversionetc.
Note:thisisnotanopportunityfora‘lecture’butaweavingtogetherof
someofthewaysourbehaviorsarepatternedbasedupontheactualityof
participants’responses).Relatetoobservationsthatwemissmanyofour
pleasantmoments,perhapsfocusingonlyontheunpleasantones.
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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TypicalClass
Sequence
(continued)
Possiblethemesofconnection,belonging,andcontactbeingan
importantelementofpleasantmoments.Also,theremayalsobethe
perspectiveofnotwantinganything,justappreciatingwhatwealready
haveandthepossibilityofhavingpleasantmomentsinspiteofbeingina
crisisorinphysicaloremotionalpain.(Option:PleasantEventscanbe
“unpacked”inClass4,alongwiththeUnpleasantEventsCalendar,
dependingontimeandinclinationoftheinstructor.)
Assignhomepractice,alternatingyogawiththebodyscan.Emphasize
theimportanceofgettingdownonthefloorandworkingmindfullywith
yourbodyeveryday,ifonlyforafewminutes.
Finishclasswithashortsittingmeditation,AOB,expandingattentionto
thewholebody.
HomePractice • AlternateBodyScanrecordingwithLying-downYogarecording,every
otherday≥6daysperweek
•
SittingmeditationwithAOB-15-20minperday
•
FilloutanUnpleasantEventsCalendarfortheweek,oneentryperday
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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ClassFour
Overview
Theme
Duringthis2.5hoursession,participantsengageinacombinationofthe
threemajorformalmindfulnesspracticesthattheyhavealsobeen
practicingathomeduringtheprecedingthreeweeks.Theseinclude:
mindfulhathayoga,sittingmeditationandthebodyscan.Inthisclass,a
briefguidedbodyscancanbepracticedbeforethestartofthesitting
practice(thisisoptionalandlyingdownisnotnecessary).Instruction
emphasizesthedevelopmentofconcentration,embodiment,the
capacitytotrainandre-directattention,andthesystematicexpansionof
thefieldofawareness.
Howconditioningandperceptionshapeourexperience.Bypracticing
mindfulness,wecultivatecuriosityandopennesstothefullrangeof
experienceandthroughthisprocesscultivateamoreflexibleattentional
capacity.Welearnnewwaysofrelatingtostressfulmomentsandevents,
whetherexternalorinternal.Explorationofmindfulnessasameansof
recognizingandreducingthenegativeeffectsofautomatic,habitual
stressreactivityaswellasthedevelopmentofmoreeffectivewaysof
respondingpositivelyandpro-activelytostressfulsituationsand
experiencesisaddressedwithincreasingdepthanddimensionality.The
physiologicalandpsychologicalbasesofstressreactivityarereviewed
andin-depthdiscussionisdirectedtowardusingmindfulnessasawayof
workingwith,reducing,andrecoveringmorequicklyfromstressful
situationsandexperiences.Dailypracticeaimedatrecognizingand
experientiallyinquiringintoautomatichabitualreactivepatternsis
assignedforhomepractice.
Recommended FormalPractice–1hourand10minutes
Time
GroupDiscussion–1hour
Allocations
Logistics(attendance,announcements,homepractice)–20minutes
FormalPractice Openingmeditation
StandingYoga
Sittingmeditation
Closingmeditation
Informal
Practice
TypicalClass
Sequence
Reminderduringclassdiscussions(bothsmallandlargegroup)of
mindfullylisteningandspeaking
StandingYogapostures(buildingfromthosedonelastweek)
Sittingmeditationwithfocusonbreath,bodysensations(introducedvia
briefbodyscanwhilesitting),andthewholebody.Particularemphasison
workingwithpainfulphysicalsensations.Introducingwaysofworking
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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TypicalClass
Sequence
(continued)
withdiscomfort/pain:shiftingpostureifpainisposture-related;using
uncomfortablesensationsasobjectofawarenessbyinvestigatingquality,
duration,andnatureofsensations—highlightingthecontinuallychanging
aspectofbodilysensations,andshiftingattentiontothebreathif
sensationsareoverwhelming.Inaddition,explorationofthepossibilityof
bringingawarenesstoemotionsorthoughtsthatmightalsobepresent
withphysicalpainorothersensations(forinstance,tighteningor
constrictingwhenexperiencingpain).Thiscanalsobeexpandedto
emotionalpainordiscomfort.Thesameapproachescanbeofferedwith
emotionalpain:Knowingexperiencedirectly,usinguncomfortable
emotionsasobjectsofawareness,andalsoshiftingattentiontothe
breathifemotionsbecometoodifficultorofprolongedintensity.To
developgreaterflexibilityofattention,emphasisisplacedonmodulating
attentiontoworkmoreeffectivelywithstrongbodilysensationsand
emotionsasameansofself-regulationandcopingmoreeffectively.
Groupdiscussionexploringthesittingmeditationpracticedatthe
beginningofthissession.Inquireintotheexperienceofworkingwith
physicalsensations,thedailysittingpractice,andyoga.Fine-tuneyoga
instructionsasrequired.Inviteexplorationabouttherelationship
betweenpracticingyogaandthebodyscan.Connecttodailylife
experience.
Optional:Beforeagroupdiscussionwiththeparticipantsaboutthe
UnpleasantEventsCalendar,considerleadingashortguidedreflection
thatasksparticipantstoselectoneunpleasantevent,focusingonphysical
sensations,emotions,andthoughtsastheyariseasmemory,andthenas
theyariseinthepresentmoment(thisallowseventhosewhomaynot
havecompletedthehomepracticetoparticipatefully).
ReviewUnpleasantEventsCalendar,beingparticularlyattentiveto
exploringthefamiliarityofunpleasantmoments.Emphasisonmind/body
connections,patterns,whatpeopleobserved/learnedaboutthemselves.,
andwonderingtogetheriftherewereanyunpleasantmoments
experiencedduringanyoftheformalorinformalhomepracticesinthe
pastweek.Investigatinganycommonattributesinalloftheseunpleasant
momentsoreventsthatcausedthemtobelabeledasunpleasant.What
qualitiesdothesedistinctunpleasantmomentsoreventshavein
common?
(Note:ifPleasantEventswerenotinvestigatedinclassthree,both
PleasantandUnpleasantEventsmaybeexploredinthissession.)
Groupdiscussion:Continueexploringphysicalsensations,emotions,and
thoughtsassociatedwithunpleasantevents.Connecttoexperienceof
stress--Howdoweactuallyexperienceitphysically,cognitivelyand
affectively?Askparticipantstonamestressors--whatisparticularly
stressfulforyouandwhatareyoudiscoveringaboutstressandstress
reactivitythroughthepracticeofmindfulness?Explorewiththeclasstheir
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
22
TypicalClass
Sequence
(continue)
experienceofAutomatic,HabitualStressReactivity(See:Kabat-Zinn,Full
CatastropheLiving,2013,pgs306-334).Howdoesitinfluencemind,body,
health,andtheirpatternsofbehavior?Associationwithexpectations,not
gettingone’sownway(whatismyway,anyway?…wouldIknowitifI
gotit?andhowlongwoulditlast?)Definitionsofstressandstressors
(see,forexample,evolvingtheoriesandstudiesaboutstressfrom
Cannon,Selye,Lazarus,Sapolosky,McEwen.)Besttoexplorethisthrough
dialogueandreflectionratherpresentingdidacticallyasalecture.
Assignhomepractice
Concludeclasswithbriefsittingmeditation
HomePractice • AlternateBodyScanrecordingwithLying-downYogarecording,every
otherday≥6daysperweek
•
Sittingmeditation20minutesperdaywithattentiontobreathing,
otherphysicalsensations,andawarenessofthewholebody
•
Beawareofautomatichabitualstressreactionsandbehaviorsduring
theweek,withouttryingtochangethem
•
Beawareoffeelingstuck,blocking,numbing,andshuttingofftothe
momentwhenithappensthisweek
•
Reviewinformationaboutstressinpracticemanualorhandout
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
23
ClassFive
Overview
Theme
Duringthis2.5hoursession,participantsengageinacombinationofthe
threemajorformalmindfulnesspracticesthathavealsobeenpracticedat
homeduringtheprecedingthreeweeks:Thebodyscan,mindfulhatha
yogaandsittingmeditation.Thissessionmarksthehalfwaypointinthe
course.Itemphasizesthecapacityofparticipantstoadaptmorerapidly
andeffectivelytoeverydaychallengesandstressors.Experientialpractice
ofmindfulnesscontinueswithanemphasisonresponding(vs.reacting)to
stressorsandthevalueandutilityofmindfulnessinlearningtostop,step
backandseemoreclearly/objectivelyandtothenbeinabetterposition
tomakeinformedchoices(responding)inmeetingvarioussituations.To
furtherthecapacitytorespond,problem-,emotion-,andmeaningfocusedcopingstrategiesmaybedelineated(SeeLazarusandFolkman,
andFolkman.)Acentralelementofthesessionisorientedaroundthe
participant’scapacitytorecovermorerapidlyfromstressfulencounters
whentheyoccur.Strategiescontinuetobedevelopedwithemphasison
thegrowingcapacitytoattendmorepreciselytoavarietyofphysicaland
mentalperceptionsandtousethisawarenessasawayofdeliberately
interruptingandinterveninginpreviouslyconditioned,habitualbehaviors
andchoosingmoreeffectivemindfulness-mediatedstressresponses.
(See:Kabat-Zinn,FullCatastropheLiving,2013,pgs335-349).Neuroscience
researchmaybeappropriatelyincludedhere,andisbestintroducedin
relationtowhatisbeingreportedbyparticipantsregardingtheiractual
experience.Dailymindfulnesspracticeisassigned,withanemphasison
theobservationandapplicationofmindfulawarenessindailylife.
ThemeOne
Awarenessofbeingstuckinone’slifeorinparticularsituationsinone’s
life,highlightingtheconditionedpatternsoftenencounteredinhighly
demandingsituationsinwhichonefindsoneself(i.e.fight,flight,and
freeze–stressreactivity/automaticity/mindlessness.)Investigationofthe
wayspeopleoftencopeincluding:numbing,denial,passiveaggressiveness,suppressionoffeelings,substancedependency,thoughts
ofsuicideetc.Recognizingandhonoringthefactthatthesecoping
methodsmayhavebeenprotectiveandsupportedsurvival,andthatthey
maynowbecounter-evolutionaryandlimiting,ifnotself-destructive.
Note:Thesetopicsmayhaveariseninclassfourasautomatichabitual
stressreactivityandthebiologyoffight,flightandfreezewereunpacked.
Thisthememaycontinueasparticipantsexploreanddescribewhatitwas
liketobringacloseandcaringattentiontotheirautomatichabitualstress
reactionswithouttryingtochangethem.
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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Theme
(continued)
ThemeTwo
Connectmindfulnesswithperception/appraisalinthecriticalmoment
(themomentofconsciouscontact),andwiththearisingofreactive
physicalsensations,emotions,cognitionsandbehaviors.Emphasison
attentivenesstothecapacitytorespondratherthantoreacttostressful
situations.Exploretheeffectofemotionalreactivityinhealthandillness.
Acknowledgethefullrangeofemotionsand,whencalledfor,toexpress
themwithclarityandrespectforselfandother.Exploreaswellthe
capacitytorecovermorequicklyasameansofreducingthe“wearand
tear”onthebody-mindthatoccurswhenareactivecycleofarousal
persists.
Recommended FormalPractice–1hourand20minutes
Time
GroupDiscussion–1hour
Allocations
Logistics(attendance,announcements,homepractice)–10minutes
FormalPractice Openingmeditation
StandingYoga(afewposes)
Sittingmeditation(thelonger,fullsitisoffered,includingallfiveobjects
ofawarenessandmoresilence)
Closingmeditation
Informal
Practice
TypicalClass
Sequence
Reminderduringclassdiscussions(bothsmallandlargegroup)of
mindfullylisteningandspeaking
Standingyoga
45minuteSittingMeditationattendingtobreath,body,sounds,and
thoughtsandemotionsas“events”inconsciousness,distinguishingthe
eventfromthecontent,andthenopeningtochoicelessawareness/open
presence,andreturningtobreathattheend,groundinginthebody.
Longerspansofsilenceduringformalmindfulnesspracticeare
emphasized.
Frommeditationmoveintoguidedreflection:Theprogramishalf-over
today.Howhasitbeengoingsofar?Pauseandtakestock:WhatamI
learning,ifanything?Howdoesitshowupinmylife,ifatall?HowamI
engagingwiththisprogramintermsofcommitmenttoweeklyclasses
anddailypractice?IfIhavebeenfindingitdifficulttopracticeathome
and/orattendweeklyclasses,amIwillingtorecommitforthesecondhalf
ofthecourse?Notethatgrowthisnon-linear.Lettinggoofexpectations
forthesecondhalfbasedonexperienceofthefirsthalfofcourse.
Invitationtopracticeandtakeeachmomentasanewbeginning,afresh
opportunitytobefullyengaged,fullyalive.
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
25
TypicalClass
Sequence
(continued)
Exploringthesequestions,MidwayAssessmentformsarehandedout,as
assessmentsarecompleted,participantsmoveintodyadstodiscusstheir
experienceoftheprogramsofar.(Ifnowrittenmidwayassessmentis
used,dyadsandalargegroupdiscussioncanbesubstituted.However,
whenpossible,werecommendtheuseofwrittenself-assessmentsasit
providesmanyparticipantswithausefulformofself-reflectionwhile
providingtheinstructorconfidentialandcandidresponsesfromindividual
participantsthatcanbefollowedupasanothermeansoftailoringthe
coursetoeachperson.)
Inquireintoexperiencespracticingthemeditation,bodyscanandyoga
homepractice,aswellasthenewmeditationintroducedatthebeginning
ofclass.
Exploreobservationsofreactingtostressfuleventsduringtheweek.
Notehabitualbehavioralpatterns,thoughtsandemotionsassociated
withthefeelingofbeingstuckintheseconditionedreactions.Include
patternsthatariseduringmeditationpractice.
Introduceandaskifpeoplearealsoexperiencing–eveninsmallways–
agreaterpossibilityofrespondingwithawarenessinthesemoments,
ratherthanreactingautomatically.Inmakingthedistinctionbetween
reactingandresponding,emphasizethatinmanysituations,reactingis
skillful.It’snotthestressbuthowyouperceiveandrelatetoitthat
dictatesitseffectsonthemindandthebody(withinlimits).
Option:Reviewreactingvs.respondingdiagrams(fromFullCatastrophe
Living2ndedition,2013.)Mentionevolvingtheoriesandstudiesabout
stresshardiness,coping,resilience(see,forexampleKobasa,Antonovsky,
SchwartzandShapiro,Garmezy,Werner,Bonanno),andalso
neuroscienceregardingneuroplasticityanddefaultmodenetwork
(Hölzel,Farb,Brewer,andothers).Asinclassfour,itisbesttoexplorethis
throughdialogueandreflectionratherpresentingdidacticallyasalecture.
Gooverhomepracticeassignment--EmphasizethatthenewSitting
recordinghasmoresilenceonittoallowparticipantstopracticemore
deeplyontheirowninbetweentheguidedinstructions.
Briefsittingmeditation
HomePractice • Provideparticipantsnewguidedmeditationpractices(CDsorinstruct
onMP3dowloadifused)–SittingMeditationandStandingYoga
Sequence.AlternateSittingMeditationwithStandingYogaandeither
BodyScanorLyingDownYoga(forexample:Onedaypracticesitting
meditation,thenext,practicestandingyoga,thethirddaypractice
sittingmeditation,thefourthday,practicethebodyscan,etc.).
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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HomePractice • FilloutDifficultCommunicationsCalendar
(continued)
•
Bringawarenesstomomentsofreactingandexploreoptionsfor
respondingwithgreatermindfulness,spaciousness,andcreativityin
formalmeditationpracticeandineverydaylife.Rememberthatthe
breathisananchor,awaytoheightenawarenessofreactive
tendencies,toslowdownandmakemoreconsciouschoices.
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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ClassSix
Overview
Theme
Inthis2.5hoursession,experientialtraininginMBSRcontinueswithan
emphasisonthegrowingcapacitytoself-regualteandcopemore
effectivelywithstress.Discussionisorientedaroundthecontinued
developmentof"transformationalcopingstrategies":Awareness,
attitudesandbehaviorsthatenhancethepsychologicalcharacteristic
knownas“stresshardiness"orresilience.Theoryislinkeddirectlytothe
MBSRmethodsandskillsbeingpracticedandgroundedintheactuallife
experiencesoftheparticipants.Theemphasiscontinuestobeonthe
broadeningofparticipants’innerresourcesfordevelopinghealthenhancingattitudesandbehaviorsandthepracticalapplicationofsuch
competenciesintoparticipants’particularlifesituationsandhealthstatus.
Dailymindfulnesspracticescontinuetobeassignedforhomepractice
withanemphasisontheobservationandapplicationoftheseskillsin
everydaylife.Participantsengageinanin-depthexplorationofstressasit
presentswithinthedomainofcommunications–particularly,difficultand
challenginginterpersonalexchanges.Thefocusofthisstrategy-building
sessionrevolvesaroundtheapplicationofpreviouslylearned
mindfulness/MBSRskillsandmethodsintheareaofcommunications.A
varietyofcommunicationstylesareexaminedbothdidacticallyand
experientially,andstrategiesformoreeffectiveandcreative
interpersonalcommunicationaredeveloped.
Stressfulcommunications;knowingyourfeelings;expressingyour
feelingsaccurately;developingagreaterawarenessofinterpersonal
communicationpatterns,andbarrierstodoingsoareallexplored.
Interpersonalmindfulness:remainingawareandbalancedin
relationships,especiallyunderconditionsofacuteorchronicstress,the
strongexpectationsofothers,pasthabitsofemotional
expression/suppressionandthepresentationofselfineverydaylifeare
investigatedusingawiderangeof“embodied”methods.Basedonthe
skillsthatwehavebeendevelopingthroughtheentireprogram,all
instructionalprocessesemphasizecultivatingthecapacitytobemore
flexibleandtorecovermorerapidlyduringchallenginginterpersonal
situations.
Recommended FormalPractice–1hourand10minutes
Time
GroupDiscussion–1hourand10minutes
Allocations
Logistics(attendance,announcements,homepractice)–10minutes
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FormalPractice StandingYoga
Sittingmeditation
Closingmeditation
Informal
Practice
TypicalClass
Sequence
Reminderduringclassdiscussions(bothsmallandlargegroup)of
mindfullylisteningandspeaking
Standingyoga
Sittingmeditationwithlessinstruction/moresilence:breath,body,
sounds,thoughtsandemotions,choicelessawareness/openpresence,
withoptiontoreturntobreathattheend.
Optional:returnmidwayevaluationswithcomments.Possibilityofusing
anonymousquotesfromparticipants’evaluationstoidentifyandshare
theexperiencesandlearningdiscoveriesofthisparticulargroup.
Discussthehomepractice,especiallyexperienceswiththerecorded
45-minutesittingmeditation.Explore:Whatdidyounoticeabout
respondingmorecreativelyinlifeandinthemeditationpracticeitself?
Weretherenewresponses?Whatsurprisedyou?Whereareyoufinding
theintegrationofmindfulnessinyoureverydaylifeparticularly
challengingordifficult?
Discusstheupcoming“AllDay”session.Explaintheintentionsunderlying
thissessionanddescribeindetailthestructureandformatoftheday,
includingoptionsforself-careandteacheravailability.Discusshowto
workwithextendedperiodsofsilenceandpractice.Providesuggestions
forpreparingfortheday,includingwhattobring:Lunch,loosefitting
clothes(layers),matorblanketetc.
Optional:guidedreflection–recallasituationfromtheDifficult
CommunicationsCalendar.Examinehabitualrelationalpatternsandhow
theyareexperiencedinthemindandbodyandhowtheymanifestas
behavior.
Optional:Discussinsmallgroupsordyads
Activitiesandgroupdiscussionaboutdifficultcommunications.
Thereareanumberofexercisesthatcanbeusedtoexplorethistopic.
Emphasisofmostofthecommunicationsexercisesusedinclassis
“embodiment”-engagingthebodyinitsusualposturalpatterns
includinggestureandvoicetoneetc.whenindifficultinterpersonal
situationsasameansofexploringbothfamiliarandmorenovel
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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TypicalClass
Sequence
(continued)
approachestomomentsofdifficultcommunication.Thisembodying
processtendstocatalyzeawareness,therebymakingbothhabitualand
newresponsesmorereadilyavailableforself-reflectionandinquiry.The
dialogueandinquiryduringtheseexercisesallowsaheightened
awarenessofhabitualpatternsandbehaviors,notonlyintherealmof
interpersonalcommunication,butalsoinone’sintra-personallife.Itis
essentialtopauseandreflecttogetherontheseexperiencesandto
noticehowrelationalpatternsareexternalizationsofinternalmindand
bodystates.Participantsmakeconnectionsbetweentheirpresentmomentexperienceofwitnessingand/orparticipatingintheseexercises
andthepersonalcognitive,emotionalandbehavioralpatternswithwhich
theyhavebecomefamiliarduringtheMBSRcourse.Theseexercisesalso
provideanopportunityforparticipantstoexperimentwithnewbehaviors
andnewwaysofengaginginterpersonally.
Theintentionbehindengaginginanyofthefollowing(oranyother)
communicationexercisesisthecultivationofawarenessinintra-and
interpersonalsituations.Theparticularformtheseexercisestakeisless
importantthantheessenceofthisintentionandthepotentialof
integratingmoreeffectivepatternsofcommunicationintoeverydaylife
(See:Meleo-Meyer,F,inD.McCown,D.Reibel,andM.Micozzi(Eds),
ResourcesforTeachingMindfulness:ACross-culturalandInternational
Handbook,2017).
Someoftheoptionsforcommunicationsexercisesmayinclude,butare
notlimitedto:
Speakingandlisteninginterpersonalpractice:Indyads,participantsare
givenatopicbasedonclassdiscussionsandcontent.Onespeaks,one
listens,thenreverseroles.Thepowerofactivelisteningishighlightedas
thelistenerreflectsbackwhatthespeakershared.Rolesarethen
reversed.
Experiencingandexploringpatternsofcommunicationbyphysically
enactingandexpressingdifferentpatternsandoptions(i.e.passive,
aggressive,assertive,etc.),thenhavingclassparticipantsadaptpostures
thatexpressthesecommunicationoptions,possiblyinteractinginpairs,
smallgroupsortheentireclass.
Aikido-based“pushingexercises”:Twopeopledemonstratingviaroleplaythefollowing:
• theinitialcontactwhenexperiencinginterpersonalconflict(taking
thehit)
• avoidingconflict/steppingaside/passive-aggressive
• beingsubmissive
• beingaggressive
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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TypicalClass
Sequence
(continued)
•
•
engagedinanequalstruggle
assertive,“blendingandentering,”meetingaggression,staying
engagedandwitheyeandwristcontact,whilesteppingoutofthe
pathofpotentialharmfulemotionalaggression
Demonstratewithaco-teacherorvolunteer(choosecarefully,itmay
bebeneficialtopracticewiththevolunteerbeforeclass).
• Theteacherinvitesclassparticipantstosharewhatisdirectly
experiencedastheywatcheachphaseofthe“pushingexercises.”
Theteacherhighlightseachoptionasawayofmeetingchallenges
(notonlyinterpersonalcommunication):Takingthehit,avoiding,
aggressive—engagedinthestruggle,and“blendingand
entering.”Asparticipantsafetyisparamount,classparticipants
arenotinvitedtoengagewitheachothertophysicallypracticethe
Aikido.Emphasisontheimportanceofcenteringinthemoment,
takingafirmstand,notrunningawaybutnothavingtobeintotal
control,theimportanceof“enteringandblending”while
simultaneouslymovingoutofthedirectpath,makingcontact
(handtowrist),turning,acknowledgingtheotherperson’spoint
ofview,showingone’sownpointofview,stayingintheprocess
withoutknowingwhereitisgoingorbeingfullyincontrol,
maintainingmindfulness,openness,stayinggroundedand
centered.
• Theteacherinvitesclassparticipatestosharewhatisdirectly
experiencedastheywatcheachphaseoftheAikido“pushing
exercises.”Theteacherhighlightseach.
• Verbalaikidoroleplay–similartoabove,butdonewithdialogue
withvolunteer.
Explorationofassumptions:Guidedbyinstructor,participantsfaceeach
otherinsilence,andareledintonoticingdifferencesbetween
observationandassumingorinterpreting/mindreading.Thismaybe
followedbystructureddialoguebetweenparticipants
Assignhomepractice
EndwithshortAOB/sittingmeditation
HomePractice • AlternateSittingMeditationrecordingwithBodyScanand/or
StandingorLyingdownYogarecordings
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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The“AllDay”Class:ASilentRetreat
Overview
Theintensivenatureofthis7.5hoursessionisintendedtoassist
participantsinfirmlyandeffectivelyestablishingtheuseofmindfulness
acrossmultiplesituationsintheirlives,whilesimultaneouslypreparing
themtoutilizethesemethodsfarbeyondtheconclusionoftheprogram.
Cultivatingasenseofpresencefrommomenttomoment,andbeingopen
Theme
toanyexperience,whetherevaluatedaspleasant,unpleasantorneutral,
asanopportunitytopracticemindfulattention.
Yoga
FormalPractice SittingMeditation
BodyScan
WalkingMeditation
MountainorLakeMeditation
EatingMeditation(informal,atlunch)
Optional:Fast/SlowWalking*
Loving-KindnessMeditation
Visualmeditationfollowedbymindfulwalking,possiblyoutdoors,
stoppingandnoticingonething.
ClosingMeditation
Informal
Practice
Seamlesscontinuityofmoment-to-momentawareness,whetherinformal
practiceortransitioning
TypicalClass
Sequence
TypicalClassSequence(Note:Timesaresuggestions.Sizeofclassand
otherfactorsmayincreaseordecreasethetimeslisted.However,theseare
goodapproximationstokeepinmindtobothsettledeeplyintopractice,
andalsotoofferbothstillnessandmovementpracticetocareforthebody.)
Morningsessionoptions:
Briefsittingmeditationinsilence
Welcome,introductionofteacher(s),andguidelinesfortheday,including
silence,avoidingeyecontact,self-care,availabilityofteachers,etc.
Sittingmeditation:focusonawarenessofbreathing(20’)
GuidedYoga,withtheoptionofendingwithshortbodyscan(45’-55’)
Slowwalkingmeditation:withintroductoryguidance(15’-30’)
Sittingmeditation:lessguidance,moresilence(30’-40’)
Slowwalkingmeditation:lessguidance(20’)
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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TypicalClass
Sequence
(continued)
MountainorLakemeditation--Theseimagesareusedtoassistpartici-
pantsintheirunderstandingabouthowtocreativelyworkwith
themselvesandusetheirinnatecapacitytocultivateparticularhuman
qualities.The“mountain”and“lake”aremetaphors(ratherthan
visualizations)usedtoconnecttoaspectsofthemselves–theirinnate,
innerreservoirsofstability,sovereignity,flexibilityandfluidity.The
imagesarenotintendedtotakeparticipantsoutofthepresentmoment
tosomeotherplaceortime.(25’-30’)
Talk–anopportunitytogiveencouragementorinspiration,withthe
optionoftellingateachingstoryorrecitingapoemanddrawingoutone
ormoreofthecoreteachingelementsofthecurriculum.(10’-15’)
Lunchinstructions(5’)
Silentlunch(45’-60’)
Afternoonsessionoptions:
StandingYoga(30’)or
Fast/slowwalkingexercise.TheuseoftheFast/Slowwalkingexercise
maybeeliminatedentirelyinfavorofmoresilenceandsolitarypractice
(replacedwithStandingYoga),orusedpartiallydependingonthevenue
andpopulation.Weincludeithereforthosewhomayhaveexperiencedit
orbeenwell-trainedinguidingit.Participant/patientsafetyistheprimary
concern.Inaworkenvironment,itmaybeskillfultousethefastwalking
portions(firstmoremindlesslyandautomatically,then,moving—even
veryquickly—withawarenessandintention)asanimportantpointof
learningandpractice.ThisportionoftheexercisecanalsobeusedinClass
7,whentheapplicationofmindfulnessindailylifeishighlighted.
Thisexerciserequiresspecific,well-pacedverbalguidancebytheteach-
er.Dependingonthesizeofthegroup,assistantsmayalsobeneededto
ensuresafety.Includerepeatedinstructionsfornoticing,inmovement
andstillness,variousmind-bodyexperiences.Emphasizeoptionsfor
meetingneedsastheyarise,andthepossibilityformovinginandoutof
theexercise.(Note:Ifpeoplechoosetositoutforpartorallofthe
exercise,theteacher’sguidanceincludessuggestionsforactive
participationbynotingmind-bodyexperienceswhilesittingand
continuousconnectionbytheteacher(s)withpeoplesittingdown,
assuringandinvitingthembackintotheexercisewhenitbecomesslower
ifthespeedofmovementhaskeptthemfromactiveparticipation.)(30’)
Beginwithslowwalking,graduallymovetoeachperson’susualwalking
pace,pause…Inthepauses,invitepeopletobeattentivetobody,
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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TypicalClass
Sequence
(continued)
thoughtsandemotions…beginwalkingatacomfortablepace,
incrementallyincreasingspeed,withinstructionstoincreasebodytension
(i.e.clenchfistsandtightenjaw)andmovingtowardsdeliberate
(imaginary)objectives(forexample,beinglateandneedingto
rush…continueincreasingpace,changingdirections,thenstoppingand
invitingparticipantstobeattentivetotheirentireexperience.Then,
beginwalkingagainataregularpacewithinstructionsforstayingpresent
andopen…increasingthepace,unclenchinghandsandjaws,callingto
mindthesamedeliberate(andimaginary)objectivesbutthistime,with
presenceandawareness,whilecontinuingtowalkfaster,changing
directions,andagainstopping.Teacherasksparticipantstoreflecton
currentmind-bodyexperienceandnoteifthereareanydifferences
betweenthepreviousroundofwalking.(Mayendhereorcontinuewith
nextportion).
Teachergivesinstructionsforveryslowlywalkingforwardwitheyes
closed,keepingarmsandhandsatsides,gentlyleaninginwhen
participantsmakecontactwithothers,pausingandexperiencingthe
contactbeforemovinginanotherdirection.Doingthisforseveral
minutes,thenstopping.Theentireprocesscanberepeatedwith
participantswalkingbackwardsandveryslowly.Afteroneorboth
phases,teacherencouragesparticipantstoreflectontheirmind-body
experience.Teachergivesfurtherinstructionstoorienttocenterofroom
(openeyes,noticewherecenteroftheroomis,and“aim”thebody
towardsthatpoint,thenreturntoeyesclosed),andcontinuesthe
invitationtowalkslowlybackwards,makingcontactwithothersand
remaininginphysicalcontactwhilemovingtowardsthecenterofthe
room.(Note:intheinterestofinclusion,provideoptionsforsteppinginto
contactoroutofcontact,aspersonalneedsdictate.)
Loving-Kindnessmeditation:guidanceusingminimaltalking,emphasison
spaciousness,endinginsilence.(Thismeditationisusedtohelppeople
recognizequalitiesofLoving-Kindness,friendliness,warmthand
compassion,towardsselfandothers,thatarealreadypresentand
capableofbeingcultivated.
Careistakentorecognizeandaffirmanyresistancetothepossibility
thatthesequalitiesalreadyexistwithinoneselforwishedforothers.Itis
notessentialtoofferclassicalphrasesofLoving-Kindnesspracticeasthe
feelingtoneandsenseofwell-wishingcanbeconveyedmoreimmediatelyandalsomoreinformallywithoutspecificphrasing.Andsimple
phrasescanalsobeintroduced.(25’30’)
Optionalendingpractices:
“NoticingOneThing”visualmeditationfocusingonone’shand,and
seeing,asifforthefirsttime.Thisisfollowedbymindfulwalking,possibly
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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TypicalClass
Sequence
(continued)
outdoors,withintentionplacedonmovingslowly,noticingwhatdraws
one’sattention,stoppingandfocusingonthatobject,lingeringthere,
exploringtheobjectwithopennesstoseewhatunfoldsasonestayswith
thisobject,thenaftersometime,movingtoanotherobjectthatdraws
one’sattention.Teacherringsbellstobringparticipantsbacktoroomand
guidesacontemplationonthememoryofwhatwasseen,followedbyan
openawarenessmeditation.(25’-30’)
OR:Walkingpractice—invitingparticipantstomoveoutside,awareof
thewholebody,meetingtheworld,continuingtheopenreceptivityof
loving-Kindnessintowalkingpractice.
OR:Briefsittingsalternatedwithbriefperiodsofwalkingandsittingin
otherplacesintheroomnormallyavoidedordesired(highlightingthe
possibilityorinvitationtofeelgroundedandintheir“seat”evenwhen
changeoccursandespeciallyifthatchangeisundesirable,or,ifthe
changeisdesirablebutnotusuallyactedupon).Thispracticeisakintothe
“ChangingSeats”exerciseinclass7.SeemoreinstructioninClass7
“TypicalClassSequence.”
Whateverendingpracticeischosenandbeforesilenceisdissolved,aimto
have10-15’ofsilentsitting.
Dissolvethesilencebywhisperinginpairs,theningroupsof4(optional),
discussingwhatwaslearnedandexperiencedduringthedayandhowthe
participantsworkedwithchallenges.(10’-15’)
Groupdiscussionanddialogue--Emphasizethatthedayisnotmeant
tobepleasantorunpleasant,buthowonemeetsandworkswithwhat-
everappears.Inviteparticipantswhohaddifficultiestospeakaboutthem
andfeelsupported,andassureeveryonethattherewillbemoretimeto
speakabouttheirexperienceinthenextclass.Endwithbrief“going
hometalk”abouttransitioningtotherestoftheday,evening,activities,
etc.(20’-25’)
Sittingmeditation(5’)
Closingcircle-Standingincircle,makingeyecontactwithothers,tuning
intofeelingwholeandembeddedinthecontextofthelargergroup.
Optiontoreflectandfindonewordtodescribetheexperienceofthe
moment.Encouragehonestresponses,acknowledgingthatthis,too,will
change.
Good-byes
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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ClassSeven
Overview
Theme
Inthis2.5hoursession,experientialtraininginmindfulnesscontinues.The
AllDayClass(silentretreat)isreviewedanddiscussed.Theremaybea
continuationofthediscussionofcommunicationthatbeganinclass6.
Participantsareaskedtoexercisegreaterpersonallatitudeinthechoice
offormalmindfulnesspracticesdoneashomepracticeduringtheweek
leadinguptoclasseight.Emphasisisonmaintaining45minutesofdaily
practice,withoutrecordedinstructions.Participantsareencouragedto
createtheirownblendofthevariouspractices.(Forexample,20minutes
ofsitting,15minutesofyoga,10minutesofbodyscan.)Theintentionis
tofurthermaintainthedisciplineandflexibilityofapersonaldaily
mindfulnesspracticebyencouragingpeopletobecomeattunedtothe
changingconditionsintheirlivesandtoaskthemselvesquestionslike:
“Whatiscalledfornow/today?“WhatdoIneedtotakecareofmyself
now?”
Integratingmindfulnesspracticemorefullyandpersonallyintodailylife.
Participantsareaskedtopurposefullyreflectonlife-stylechoicesthatare
adaptiveandself-nourishingaswellasthosethataremaladaptiveand
self-limiting.
Recommended FormalPractice–1hourand35minutes
Time
GroupDiscussion–45minutes
Allocations
Logistics(attendance,announcements,homepractice)–10minutes
Sittingmeditationoptions:Mountain,LakeorLoving-Kindness
FormalPractice
Otheroptions:Yoga(classchoices),window,walking
Informal
Practice
TypicalClass
Sequence
Reminderduringclassdiscussions(bothsmallandlargegroup)of
mindfullylisteningandspeaking
Optionsincludeoneorbothofthefollowingexercises:
1) YogaChoicesexercise:eachparticipantdoesastandingbodyscan
andidentifiesanareathatneedsattention.Individuallyandwiththe
group,exploreyogaposesthataddressthatareaofthebody,or
favoriteyogapostureslearnedintheprogram.Eachparticipant,with
helpfromtheteacher,ifnecessary,guidesparticipantsintheirchosen
pose.Emphasisisonusingyogainordinarydailyexperience,notasa
special,rarifiedactivity.
2) Exploringthefamiliarandtheunfamiliar-ChangingSeats:After
participantstaketheirseatsintheroom,invitethemtoclosetheireyes
andnoticehowitfeelstobesittingwherethey’resitting.Askthemto:
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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TypicalClass
Sequence
(continued)
Payattentiontowhat’sfamiliar—ifthisisaseattheychooseoften,
orwhat’sdifferentifit’sanewseat.
Noticephysicalsensations,thoughts,and/oremotionsthatmaybe
presentastheysitinthisfamiliarornewplace.
Theninvitethemtoopentheireyes,andgetasenseofwhatthe
roomlookslikefromthisperspective.Isitthesameroom?Whydid
theychoosetositwheretheydidwhentheycamein?Scantheroom
foraseatinwhichthey’veneversatorwheretheythinktheywon’t
liketosit.Askparticipantstomovetothatseat,insilence,andto
closetheireyesandnoticehowitfeelstobeinthenewplace,witha
newperspective,perhapssittingnearnewpeople.Askthemto
considerwhethertheytendtostayinthesameplacesortoexplore
newplaces,makingsuretoemphasizethatthesearesimply
patterns,andthatonepatternisn’tbetterthantheother.Canwebe
athomewhereverweare?Mentionawarenessofchoicesof
positioningoneselfinaroom,theideaoftakingone’sseatinthe
meditation(takingastandwhensitting,nomatterwhereyouare.)
Inviteawarenessofattachmenttoplace.WhereamIinmylife–in
thismoment?WhereamIgoing?Possiblynotknowingandknowing
that!
Thischangingofseatsmayberepeatedagainorevenseveraltimes.
Finally,inviteparticipantstofindaseatandestablishthemselvesina
postureforsittingmeditation,consciouslychoosingtoreturnto
“their”familiarseatortoexplorebeinginadifferentplace.
Sittingmeditation:Choicelessawareness,usingthebreathasananchor
iflost;alsopossibletoincludeaspectsofMountain,LakeorLovingKindnesspractice.Allowmoresilence.
Discussthehomepracticeandtheall-dayretreatinrelationtoautomatic
habitualstressreactionsandmindfulness-mediatedstressresponsesin
meetingwhateverwasencounteredincludinglikesanddislikes.Whatdid
yousee?Whatdidyoulearnaboutyourself?Inviteresponsesto
differentaspectsoftheall-daysession,andwhatparticipantsexperienced
afterwards.Connectthediscussiontotheexperienceofengaginginboth
theformalandinformalmeditationpracticesthisweek.Emphasison
importanceofmakingthepracticeone’sown.Thisweek,norecordings
forhomepractice.Encouragepeopletomaintainthefrequencyand
durationofpractice(45minutesperday)whilechoosingforthemselves
howbesttopracticeontheirown.
Option:Questionsandobservationsaboutcommunicationstemming
fromlastweek’ssession.Ifnecessary,thereistheoptionofcontinuingto
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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TypicalClass
Sequence
(continued)
explorecommunicationthroughtheexercisesthatarerelatedtothis
week’sclassdiscussion.
Option:IntroduceFast/SlowWalking(seeAll-DayInstructions),using
variationsasappropriateforvenueandpopulation.
Option:Discussthemeofwhatwetakein,notonlyfoodbutanykindof
sensoryexperience,andpatternsthatareself-destructiveandselfnourishing.Thismayincludeinvestigatingchoicesarounduseof
electronicsandtechnology,cellphones,internet,andallmedia.May
choosetolookatchoicesaroundtime,prioritiesandvalues,continually
encouragingparticipantsintheireverydaylivestofrequentlyexperiment
withaskingthemselvesthequestion:“What’scalledfornow?”Exploreif
andhowmindfulnessmayimpactseeminglyneutralareasandhabitsof
ourlives,bringingaboutunanticipatedchangesandemotions.
Assignhomepractice
EndwithshortAOB
HomePractice • Norecordingsthisweek.Practiceformalsitting,yoga,walkingand/or
thebodyscanonyourown,everydayfor45minutes.(Note:ifthisis
toodifficult,suggestalternatingbetweentherecordingsandselfguidanceeveryotherday.)
•
Practiceinformallywhenyouarenotdoingtheaboveformalpractices
bybeingasawareandawakeaspossiblethroughouttheday.
Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School
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ClassEight
Overview
Inthis3-3.5hoursession,experientialmindfulnesspracticecontinuesand
participantsaregivenampleopportunitytoinquireintoandclarifyany
lingeringquestionsaboutthevariouspracticesandtheirapplicationsin
everydaylife.Areviewoftheprogramisincludedwithanemphasison
dailystrategiesformaintaininganddeepeningtheskillsdevelopedduring
thecourseoftheprogram.Timeisalsoallottedforasatisfyingclosureby
honoringboththeendofthisprogramandthebeginningoflivingone’s
lifeinformedwithmindfulness.Participantshaveanopportunitytospeak
tothegroupmuchastheydidinthefirstclass,butthistime,to
acknowledgewhathasbeenmostsalient,whattheyaretakingaway,or
whathasbeendiscovered.Itisimportantforallparticipantstoknowthat
alltheircommentsarewelcomedinthissegmentofclass8.Byexample,
nothingmayhavebeen“salient.”Perhapstheywerecompletely
disappointedbythecourse…orfoundtheinstructordefensiveor
unavailabletothem.Thisisnotmeanttobeatimefortestamonialsbut
instead,foropen,honestappraisaloftheirexperienceofMBSR.
Noteonlengthoflastclass:Evenwithsmallergroups,athree-hourclass
offersampletimeandopportunityforpractice,discussionofhomepractice
andhowparticipantswillcontinueafterthecourseisover,aswellastime
foreachpersontospeaktothewholegroup(GroupGoAround)abouttheir
learninganddiscoveries(astheydidinthefirstclassabouttheirintentions
forattending).Ifclasssizeexceeds18,itmaybemoreadvantageousto
lengthenthelastclassafullhourlongerthanusual,to3.5hours.
Theme
Keepingupthemomentumanddisciplinedevelopedoverthepast7
weeksinthemeditationpractice,bothformalandinformal.Reviewof
supportstohelpintheprocessofintegratingthelearningfromthis
programovertime:Localdrop-inoptions,books,recordings,graduate
programs,freeall-daysessionsforgraduates;localretreatandyoga
centers,andotherpertinentresourcesavailabletosupportpractice.
Recommended FormalPractice–60minutesormore
Time
GroupDiscussion–2hoursand20minutes
Allocations
Logistics(attendance,announcements,homepractice)–10minutes
BodyScan
FormalPractice Yoga
SittingMeditation
Informal
Practice
Reminderduringclassdiscussions(bothsmallandlargegroup)of
mindfullylisteningandspeaking
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TypicalClass
Sequence
Bodyscan(comingfullcircle,sincethisishowclassonebegins.)
Yogastretching,eitherguidedorself-guided.
SittingMeditation,mostlysilent.
Optional-LettertoSelf:
a. Guidedreflection–Attheendoftheformalmeditationtherecanbea
briefreflectioninvitedaboutparticipationintheclass.“What
happened?Whatdoyouwanttorememberaboutyourlearning
experience—intheclass,withthepractices,andinyourlifeasa
whole?Whatisessential,thatyoudon’twanttoforget?
b. Optionofsettingthreeshort-term(3months)andthreelong-term(3
yearsormore)goalsthatcomeoutofyourdirectexperienceinthe
programandwiththemeditationpractice.Includepotentialobstacles
toreachingthesegoalsandyourstrategiesforworkingwiththem.
Participantswritelettersthatincludeoneorbothofthesethemesand
thensealtheminenvelopeswhichtheyself-address.Instructorcollects
envelopesandwillmailthemsometimeinthefuture.
Guidedreflectionthatincorporatessomeorallofthequestionsbelow.As
eachparticipantcompletestheirlettertheyareplacedinpairsbythe
instructortodiscusshowthecoursehasbeenforthem.Examplesof
questions:(1)Thinkbacktowhyyouoriginallychosetoparticipateinthis
program.Whatexpectationsdiyouhave?Whydidyouchooseto
completethecourse?(2)Whatdidyouwant/hopefor?(3)Whatdidyou
getoutoftheprogram,ifanything?Whatdidyoulearn,ifanything?(4)
Whatsacrificesdidyoumake?Whatwerethecoststoyou?What
obstaclesdidyouencounter,ifany,andwhatdidyoulearnaboutyourself
inworkingwiththeseobstacles?(5)Ifyouaremotivatedtocontinueto
practicemindfulnesshowwillyoucontinuetopracticewhenthisprogram
isover?
Groupdialogueanddiscussion:Discusstheexperienceofpracticing
withoutrecordingsthisweek.Reviewtheentirecourseandfocusbriefly
onsalientfeatures.
Activitiesbelowcanbeofferedintheorderbestsuitedtotheclass.Thereis
meritinendingwithcommunityengagement(theGroupGo-Round),having
coveredthemoredidacticand/orconceptualandinformationalsections
beforehand,butthisisuptothediscretionoftheteacher.
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TypicalClass
Sequence
(continued)
Homepractice,HintsandReminders:Reviewoffinalhomepracticesheet
(“therestofyourlife”),directionsforaccessingongoingresources
(online,handouts,community,regional,internet,etc.)
MBSR“Checklist”:Discussthevalueofputtinglearningtoimmediateuse
forcontinuedpractice.Usingindexcardsorprintedsheets,have
paricipantsreflectonwhatcriticalitemsarenecessaryforcontinued
practice,i.e.,dedicatedspace;cushion,benchorchair;yogamat,timer;
etc.Individualtimetowrite,followedbybriefopportunityforgroup
shareofintentionstocontinuepractice.
GroupGoAround:Eachparticipantsharestheirexperienceofthecourse
withthewholegroup,howtheyfeelaboutthecourseending,whatthey
havelearned,howtheywillkeepthemomentumoftheirpracticemoving
andgrowing.
Finalmeditationandacknowledgementoftheendingofthisparticular
group.
HomePractice • Gobacktotherecordingsifyouwish.Keepupthepracticeandmake
ityourown
•
Continuetoworkwithbringingseamlessattentiontoallyour
momentsinordertobemorepresentinyourlife
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NotesonTheCurriculum
CentralityofPractice
Startingeachclasswithasubstantiveperiodofformalpracticecanbeveryusefulandexpresses
severalintentions:Ithelpsparticipantsandtheteachertoarriveandsettleintoclass,andfamiliarizes
participantswiththefeelingofbeingpresent,awake,attentiveandattunedtothemselvesandtheir
surroundings.Inaddition,ifaparticipanthasnotpracticedathome,thisformalpracticeperiod
providesastrongandcommonlysharedexperiencefromwhichparticipantscanthenspeakand
participateasfullyasthosewho’veengagedinthehomepracticemoreregularly.
Thisrecommendationisnotmeanttoberigidordogmatic.Rather,wearesharingwithyouarepeated
observationinourMBSRclassesatUMass.Afteralongerpracticeperiod,wehaveoftennoticedthat
theclassroomdialogueisquintessentiallydifferent.Itseemstousthatthelongerpracticeperiod
providespeopletheopportunitytosettle,i.e.,1)becomegroundedinthebody,2)listenmoreclosely
tobody,mindandheartand3)cometorestinone’sownpresence.Thisoffersprogramparticipants
morepossibilityofrespondinginwaysthatdiffermarkedlyfromtheusual“reporting”modes.People
seemtomoreeasily movefromthedoingmodetothebeingmode.Thissharedsenseofbeingis
enlivening;ittendstoconnectpeopletotheactualityoftheirexperience,enhancesthesenseof
peoplerecognizingourcommonhumanityandassistsMBSRparticipantstomoveoutoftheirusual
modesofspeechtospeechthatsupportsandexpressestransparency,insightandclarity.
UsingtheCurriculum
WhilethecurriculumismeanttoenhanceandsupportMBSRteachersintheirteachingofthe8-week
MBSRprogram,itisessentialnottomistakethiswrittendocumentasaformulaicoroperational
manualinanysense.
InMBSRteachereducationandtrainingprograms,weoftenlikenthecurriculumtothebanksofa
river:Providingaformandcontainerfortheflowingwater.Withoutbanks,ariverwouldbe
somethingelseentirely.Tobeariver,thereneedstobebanks.Andwithdeep,firmbanks,thewater
hasaplacetocollectandflowandfinditsowndepth.Thus,thecurriculumcontainsthe“essence”of
theprogram—inthisanalogy,thewater—which,atitsmostfundamental,servesasaconveyancefor
non-conceptual,non-dualawarenessandwakefulness.Thisshowsupinparticipants’discoveryof
deepinnerresourcesthatinclude:agrowingrecognitionthattheyarefarbiggerthantheirideasand
opinionsaboutthemselves.Thisleadstoasenseofdisidentificationwithconditionedhabitsand
patternsusuallyinternalizedas“me”;agreatertoleranceforthesepatternsastheyariseanda
buddingsensethattheyarecapableofrespondinginfreshandnovelwaystobothfamiliarand
unforeseencircumstancesandsituations.
Whileitmaybetemptingtoconsidertheadditionofvariations,options,andotherwiseworthwhile
andevenevidence-basedinterventionalelementsormodalities,itishighlyrecommendedthat
teachersstaythecourse,asoutlinedhere.First,fidelitytothewrittencurriculumformhasenormous
implicationsfortherigorofMBSRresearch.Secondly,andperhapsmoreimportantly,therobustness
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anddepthoftheprogramismostcertainlynotdependentonnoveltyorvariation.Rather,itishere
thatthedepthandrobustnessoftheteacherandhisorherownmeditationpracticeandhowthe
teacherhasappliedthatpracticeoverthecourseofone’slife,vividlyshowsitself.
Inexperiencedhands,thecomponentsofthe8-weekMBSRcurriculumcomealivethroughtheperson
oftheteacher.Whatshowsupintheclassroomistheauthenticityandimmediacyoftheteachers’
owncontemplationand“encountering”oftheexplicitandimplicitcurriculumcontent.Itisthe
teachers’livedexperienceofmindfulnessaswellasthecontentthemesasthey’vemadeormake
themselvesknownpersonallyanduniquely,thatfostersthedirectandintimateconnectionwith
participants.Thisconnectionandinteraction—throughtheconduitoftheteachers’practiceand
exploration—iswhatmakesthecurriculumcomealive,andwherethe"water"—toreturntoourriver
analogy,flows,evernew.
Whiletheremaybeanoccasiontointroduceavariationonapractice,coursetheme,oractivitythat
mayrepresentoramplifythecurriculum,beforedoingso,werecommendyoureflectforatime,
consideringyourintentionforsuchchangesoradditionswhilesimultaneouslyreflectingonand
testingyourunderstandingofeachelementofthecurriculumasitcurrentlystands.Inourexperience,
thistakesyearsofteaching,yearsofpractice,andyearsofworkingcloselywithawidearrayof
programparticipants.Soweurgeyoutogoslowly,takingtimeforreflectionanddialogueinternally
and,aswell,withotherteachersandsupervisors,beforeaddingnewelementstothecurriculum.
TheteachingofMBSRtakesnothinglessthanourwillingnesstomeetourselvesandourlivesdirectly,
surrendering to not knowing—over and over again—and of being willing to listen and learn,
shoulder-to-shoulder,withthosewhoentertheclassroomwithus,inaspiritofhumbleenthusiasm
andwonder.
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AppendixA:ConductingOrientationSessions
attheCenterforMindfulnessinMedicine,HealthCareandSociety
UniversityofMassachusettsMedicalSchool
BelowisadetaileddescriptionoftheOrientationSessionasdevelopedanddeliveredattheUMass
CFM.Thismaybeausefulguide.Itismeanttoprovideoffera“taste”ofhowweconductthe
OrientationSessionratherthanasastricttemplatetobefollowedmechanically..Certainelements
suchasTeacherfilming,theuseoftheOrientationQuestionnaireand,participantinterview
proceduresareuniquetotheCenter’sgoalsandsettingandmaynotneccesarilyapplytoyouinyour
situationorsetting.TheOverviewatthebeginningofthisdocumenthighlightstheareasthatshould
beaddressed,andthesectionlabeled:DetailedLogistics,focusesonthespecificsthatparticipants
needtoknowinordertomakeaninformeddecisionabouttheirpotentialparticipationintheMBSR
program.Differentvenuesandconstraintswillnecessitatemodifications,andsomeofthosehavebeen
notedinthetextbelow.
Greetparticipantsastheyarriveintheroom,andbeavailabletoanswerquestions.
v RemindpeopletostopfillingoutthepaperworkattheSTOPpageontheOrientation
Questionnaire(SeepageAppendixB)
v Afteraround15minutes,orwhenafewpeoplehavereachedtheSTOPpageofthe
paperwork,youcanbegintheorientation
v Reassurepeoplewhohavenotfinishedthepaperworkthattherewillbetimeafterthe
orientationtocompleteit,andthatyouwillgiveextrainstructionsforthepagesafterthe
STOPpage v Remindpeoplewherethebathroomsare,andtoturnofftheircellphones
Introduceyourselfagain,andwelcomeeveryone.
Giveanoverviewofthewholeorientation,includingthefollowinginformation:
v Therewillbetimeattheendtocompletethepaperwork
v Everyonewillmeetbrieflywithyouorwithanotherteacheraftertheorientation(afollowupphonecallatafuturedatemaysubstituteforaninpersonmeeting)
v Everyonemusthaveabriefinterviewbeforeenrollingintheprogram
v Theremaybesomewaitingbeforetheirinterview
v Encouragepeopletousethistimetomeetotherpeopleintheirclass--theexperienceof
waitingcanbeapracticeofmindfulness
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GiveabriefhistoryoftheStressReductionProgramandtheCenterforMindfulnessinMedicine,
healthCare,andSociety,includingthefollowingpoints:
v Firstprinciple:EstablishsafetyandconfidentialityatthebeginningoftheOrientation
Session
v Theprogramhasalwaysbeenconsideredacomplementtomedicaltreatment.Itisnot
“alternativemedicine.”
v Itwasfoundedin1979byJonKabat-Zinn
v SakiSantorelliisthecurrentexecutivedirector
v Therehavebeenjustover24,000graduatesfromtheUMassclinic(asof2017)
v UMassMedicalSchoolisaforwardthinkinglearningcommunityandteachinginstitution.
FurtheringtheeducationalmissionofUMASS,theCFMhasaprofessionalMBSRteacher
educationprogramunderthebannerofOasisInstitute.Therefore,theremaybesome
“teachers-in-training”inyourclasses.Likeyou,theywillbetakingtheprogramas
participants.Theywillalsobemeetinginasmallgroupseminartolearnmoreabout
teachingMBSR.
v Similarly,UMassisaresearchinstitution.Thisiswhyweaskparticipantstocompletepre,
postandfollow-upassessmentsoftheMBSRprogram.Manystudiesconductedhereandat
otheracademicmedicalcentershavedemonstratedthebenefitsofmindfulnessandMBSR
forpeopleexpereincingawiderangeofconditionsandlifechallengesandweremainkeenly
interestedinimprovingourprogramcontentandprocesses. Introducemindfulnessandmentionsomeorallofthefollowingpoints:
v Mindfulnessisinnate;itarisesandisknownaswepayattention,onpurpose,inthepresent
moment,nonjudgmentally.
v Inthispractice,wecultivateasenseofcuriosity,exploration,kindnessandbasicfriendliness
towhateverweexperience
v Mindfulnesshelpsustowakeuptoourlivesratherthanbeingdrivenonauto-pilot
v Inthispractice,wenoticehowthemindmovestothepastorfuture;assoonasthisis
noticed,webringitbackwithgentlenessandfirmness,toanexperienceinthepresent
moment,suchasthefeelingofthebreathinthebody.Themovementofthemindinvolved
inpastandfuturethinkingsometimescreatesunnecessarysuffering,unproductivestriving,
andawastingenergythatcouldbeemployedinhealing,problemsolving,andagreater
enjoymentoflife
v Offerashort(afewminutes)guidedmeditation,toallowpeopletohavea“taste”of
mindfulness.Youcanbeginwithsomemovementpractice,offeringthesamecautionsas
onewouldwithanyyogasequenceofferencedinclass.Canalsoguideparticipantstobe
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awareofsensationsinthebody,thebreath,othersenseperceptions,emotionsand
thoughts
Groupintroductions
v Explainthatwewillbegoingaroundtheroomandthateveryonecantakeamomentto
introducethemselves
v Mentionthestrongemphasisonconfidentialityandsafety,bothinthisOrientationsession
andduringtheentireMBSRcourse
v Encouragepeopletobebrief,tosaytheirnames,wherethey’refrom,howtheyheardabout
theprogram,and/ortocommentonthebriefmeditation
v Youcaninteractwithpeopleastheyintroducethemselves,usingthisformatasawayof
connectingwithprogramcandidatesanddeliveringmoreinformationabouttheprogram
v Note:It’shelpfultoavoidaskingpeople“why”theyhavecome,sincethatwillbeexploredin
thefirstclassoftheprogram,andthiswillkeeptheorientationabitlighterintone.However,
youmaydecidethatyouwanttodeepentheexperienceoftheOrientationSessionbymakingit
morepersonalandaskingpeopletobemoreself-revealing.Therearepositivesandnegativesto
bothapproaches.Thedeeperquestioningcanleadtoastrongbondingexperienceforthe
group.Ontheotherhand,someparticipantsmayfindastronglyemotionalOrientationSession
tobesomewhatdisorienting—expectingamoreneutralorlessemotionalexperience.
LogisticsoftheMBSRCourse:
v Thecoursemeetseveryweekfor8weeks,eitherinthemorningorevening,for2.5to3.5
hours
v Thereisan“All-Day”class(asilentretreatday)betweenthe6thand7thweekonaweekend
day,from8:45a.m.–4:30p.m.(Note:Theall-dayclassbeginsat9:00AM,butgiventhatour
all-dayclassintegratesasmanyas150participantsandteachersfrommultipleMBSRcourses,as
wellaspastMBSRprogram“graduates”—weinviteparticipantstoarrive15minutesearlyto
findaplacetocomfortablysettleinfortheday).ItisalsopossiblefortheAll-Dayclasstobe
conductedafterClass5,toaccommodateschedulingconflicts.
v Ineachclasswewilllearnandpracticedifferentformsofmindfulnesspractice:yoga,sitting,
bodyscan,walkingmeditationandmindfuleating
v Wewilllearnaboutstress,andexploreourownbehavioral,physical,emotionaland
cognitivestresspatternsandmoreskillfulresponsestothesereactivestresspatterns,as
wellasmoremindfulwaystocommunicateandchoosenourishingbehaviorsandactivities
v Ineachclasstherewillbeperiodsofmindfulnesspractice,groupdiscussionsandtalks,small
groupdiscussions,andpracticesandexercisesrelatedtothatweek’stopics
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v YouwillreceiveCD’sorMP3swithmeditationandyogapractices,andapracticemanual,
alongwithweeklyhomepracticesheetswithdetailsofyourhomepractice
v Therewillbearound25–35peopleineachclass.(Classsizesmayvarytoasfewas15andas
manyas40)
v Wearcomfortableclothing,andavoidperfumedtoiletries
v Therearenoscheduledbreaks,butyoucanbringwater,foodormedicineasneeded.We
encourageyoutohaveamealbeforeyourclass
v Expectyourdailyhomepracticetobeatleast1hourperday,orlonger.Makesurethatyou
cansetasidethistimefordailypractice
v Highlightthecommitmentrequired,andthattheprogramischallenging
v Encourageattendanceatall9classes,includingtheAllDay.Ifsomeonehastomissaclass,
therearepossibilitiesformakinguptheclassthatweekonanotherday.Ifsomeonemisses
oranticipatesmissing3ormoreclasses,weencouragethemtodropoutandtaketheentire
programagaininanothercyclewhentheyareabletomakethetimecommitment
v Emphasizetheimportanceofarrivingontime,notinganyconstraintsaroundenteringthe
building(e.g.,atUMassCFM,thedoortothebuildingislockedintheeveningafter6:30PM)
v Callyourownteacherifyouareunabletoattendclass,needtomakeupinanotherclass,or
knowyouwillbelateforclass.Yourteacherwillnotifytheteacherinthemake-upclassthat
youwillbeattendingthatclass
v Explaintheinclementweatherpolicy,andencouragepeopletosetasidetwomoreweeks
forclass,especiallyinthewintercycle
v ExplainaboutclassrecordingsofteachersforongoinglearningandMBSRteacher
competencydevelopment.Beexplicitthatthisisonlyforteacherdevelopmentand
assessmentandthatonlyotherMBSRteachersandteacher-trainerswillbeviewing.Let
peopleknowwhichclassesthatcyclewillberecorded,andalsothatparticipants/patients
willneedtosignanInformedConsentdocumentbeforethefirstclass.
Explaintherisksandbenefitsoftheprogram.(Note:itisonlyafterthesehavebeenexplainedthat
theparticipantcansigntheinformedconsentagreement).
Physicalrisks:
v Theprimaryphysicalriskisconnectedtopracticingmindfulyoga
v Takingcareofoneselfisatthecoreofpracticingmindfulness
v Ifyouhearguidancethatyouknowisnothealthyforyourbodyorcondition,orifyouare
feelingpain,pleasedisregardtheteacherandeithermodifytheposeorrestandimagine
doingthepose
v Exploreyourlimits;gotoyourownedge,butnotbeyond
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v BecauseweareembodiedandYogaisatangibleanddirectmeansofteachingparticipants
aboutmindfulnessofthebody,beingawareofthebodyfrommomenttomomentis
emphasizedmorethanproperform
a. Theteachercanhelpyouwithmakingmodifications
b. It’salsoagoodideatoaskyourdoctororphysicaltherapisttoreviewtheposturesin
thepracticemanual,andtomakean“x”throughposturesthatarenotsuitablefor
you
Emotionalrisks:
v Feelingsofsadness,anger,fear,couldseemstrongeratthebeginningbecauseyoumaybe
payingattentioninaconsciouswayforthefirsttime
v Ahistoryoftrauma,abuse,significantrecentlossormajorlifechanges,oraddictionto
substancesmayheightenthesereactions.Pleasetellyourinterviewerifthisistrueforyou,
andwecandeterminetogetherwhetherornotitmakessenseforyoutotakethisclass
v Youmayfindthatyoumakediscoveriesaboutyourselfthatyoumaynotlike
v Youmaybechallenged,andfindyourselffacingtheunknown
v Ifatanytimeduringthecourseyounoticestrongemotionsorheightenedawareness
thatfeelsdistressingorisaconcern,contactyourteacher.Heorshemaysuggest
adaptationstopracticetosupportyou.Itmayalsobehelpfulforyourteacherto
speakwithyourtherapistifyouareseeingone,withyourpermission.Thiscanassist
yourteacherinbettersupportingyou.
Otherpeopleinyourlife:
v Itmaybeachallengetosetasidethespaceandtimetodothispractice,soit’simportantto
requestsupportfromyourfamily,friendsand/orco-workers
v Youmayfindthatyouchangepatternsofreactivity,behaviorandcommunication,andyour
family,friendsand/orco-workersmaybeuncomfortablewiththesenewbehaviorsor
attitudes
v Youmayfindthatyourrelationshipschange
Time:
v Findingtimetopracticemindfulnesscanbechallenging:itisnormaltohavethethoughtor
ideathat“Idon’thavethetimetopractice.”Indeed,noonehasthetime;tofollowthrough
onyourcommitmenttoyourselfinthecontextoftheiscourse,you’llhaveto“makethe
time”topractice.TThiswillrequireanimmediatechangeinlifestyle(i.e.lessTV,lessreading
etc.)Interestingly,andcounter-intuitively,peoplesometimesreportthatsettingasidetime
forpracticeincreasestheirsenseofspaciousnessduringtherestoftheirday
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Benefits:
v IncreasedawarenessandconcentrationNewwaystocopemoreeffectivelywithyourown
condition,difficulty,painorsuffering
v Learningtotakebettercareofyourself
v Somepeoplereportaquietermind,asenseofbalanceandenhancedwellbeing
v Manyphysicalhealthbenefitshavebeensuggestedinscientificresearch,althoughthereis
noguaranteedhealthoutcome
Inviteadditionalquestions.
Finishingthepre-evaluationforms(OrientationQuestionnaire,AppendixB):
v Explainthelastfewpagesofthepre-evaluationform(pasttheSTOPpage,listingtheir
coursegoals)
v Askthateveryonecompletealloftheirpaperwork,includingtheirregistrationform
v Encourageparticipantstotakeafewmomentstopauseandcontemplatewhattheywould
havelikedtoaccomplishattheendofthe8weeks.Makesurethatthe3goalsare
manageableanddoable
v Invitetheinterviewingteacher(s)intotheroomandintroducehimorhertothegroup
v Explainthateveryonewillmeetwithoneoftheinterviewingteacherstoreviewtheirforms
andhaveabrief,privateconversation
v Oncetheyhavecompletedtheirinterview,supportstaffwillassisttheminenrollinginthe
classtimeoftheirchoice.
v Askifthereisanyonewhoisdefinitelynotenrollingorisundecided,andsuggestthatthey
comeinforabriefinterviewanywaytodiscusstheirdecision
Thankeveryonefortheirpresenceandparticipation.
IndividualMeetingsandReviewofPaperwork
Themainintentionsoftheindividualmeetingsandreviewofpaperworkare:
v Todeterminewhethertheprogramisagoodmatchfortheparticipant/patientatthistime
v ToscreentheparticipantforsuitabilityfortheMBSRprogram
v Toallowtheparticipanttoaskquestionsthatmaynothavebeensuitableorcomfortablefor
themtoaskaboutinthelargegroup
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v Toensurethattheparticipanthasallthenecessaryinformationtomakeaninformed
decisionaboutenrollinginanMBSRcourse
v ToreviewOrientationQuestionnaireforpertinentinformationregardingconcernsorissues
relatedtotheexclusionarycriteria
v IftheMBSRprogramisnotappropriateforthecandidateatthistime,toprovidetherapy
referralsandotherresourcesthatfitthecandidatescurrentneeds
Conductingthebriefindividualinterview
Introduceyourselfagain.Thanktheparticipantforwaiting,ifnecessary.
Explainthat:
v YouwillbetakingafewmomentstoreviewtheirOrientationQuestionnairetomakesure
thatitiscomplete
v YoumayaskthecandidatequestionsbasedonanyresponsestotheOrientation
Questionnairethatraiseconcernsabouttheirparticipationintheprogram
v Theparticipantmayaskanyquestionsthattheydidnotwanttoaskinthelargegroup
v Iftheconversationneedstobelongerthanafewminutes,becauseofconcernsregarding
theexclusionarycriteria,askiftheparticipantcanwaituntilafterotherpeoplehavebeen
seen,tocandidlyspeakwiththemabouttheseconcerns.
v Reviewthepaperworkforcompletion
v Makesurethattheclassdayandtimeisfilledinonthefrontpage
v IftheOrientationQuestionnaireiscomplete,placeyourinitialsonthefrontpage.Ifitisnot
complete,asktheparticipanttocompletethequestionnaire.Ifthereareseveralincomplete
answerspleasehavethecandidatecompletethequestionnairebeforecommencingthe
interview
v Especiallyregardingsuicidality:Ifsomeoneissuicidal,askifthepersoniscurrentlyhaving
thoughtsofsuicideorhashadtheminthepastdayortwo.Iftheyaresuicidal,askifthey
haveaplan(indicativeof“activesuicidality”).Iftheinterviewingteacherdoesuncover
activesuicidalideationwithintentorplan,immediateactionisrequiredtohavetheperson
evaluatedbyalicensedmentalhealthprofessionalimmediately.Ifoneisnotavailable,the
interviewerisrequiredtodial911tohavethepersontransportedtoanemergencyroomfor
immediateevaluation,andhaveateachersitwiththepersonuntilemergencypersonnel
arrive.Theinterviewingteachershouldaskiftheyareintherapyandifareleasehasbeen
signed,notifythetherapist.Explaintheexclusionarycriterionrelatedtosuicidality,and
documenttheconversation.
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v Youmayalsodiscussanysenseyouhaveoftheperson’sbehaviorintheOrientation
SessionwhichmayaffecttheirfullparticipationintheMBSRprogram.Observedbehaviors
suchasagitation,interrupting,dominatingthegroup,inappropriatebehavior,extreme
shynessornervousnessareimportanttofollowupaboutwiththepersoninquestion.
v Discussanyotherconcern(s)relatedtoinformationontheOrientationQuestionnaire,your
senseoftheparticipant,clinicaljudgment,andpotentialoftheexclusionarycriteria.
Foranoutlineandexplanationoftheexclusionarycriteria,seethelistattheendofthissection.If
thereisaconcernoraspecialneed,dothefollowing:
1. Iftheparticipantwillbeinyourownclass,askthemtowaituntiltheendoftheinterviewing
periodsothatyoucantakeextratimetoexplainanyconcerns.Iftheparticipantunderstands
theseconcerns,andseemsstronglymotivatedandmeetstheexceptionstotheexclusionary
criteria,youmayaccepttheparticipantintoyourclass.Iftheexclusionarycriteriais
psychologicalinnatureandtheparticipantisintherapy,havetheparticipantsignthereleaseof
informationformsothatyoucanspeakwiththeparticipant’stherapist.Attachthereleaseof
informationformtotheOrientationQuestionnaire.
2. Documentyourconcernsandconclusionsontheinformationform(“SRPinterviewnotes”)and
attachittothepre-evaluationform.Forexample,ifsomeonehaschecked“suicidality”andyou
checkforsuicidalityandfindthatthereisnoactivesuicidalideationandnointentionto
commitsuicide,makeanoteofthisconversation,andsignyourinitials.(Note:Intheinterestof
transparency,uselanguagethatisacceptabletotheparticipant.)AttachtheSRPinterview
notestothepre-evaluationform
3. Iftheparticipantwillbeinanotherteacher’sclass,dothesameprocedureasin#1and#2
aboveandalsoexplaintotheparticipantthattheywillneedtohaveasecondinterviewwith
theMBSRteacherwhosecoursetheywillbeattending.
a. Calltheparticipant’steacherandgivethemtheinformationabouttheparticipanton
thephoneorinperson.Forreasonsofconfidentiality,donotputthisinformationinan
email,forreasonsofconfidentiality.
b. Informthesupportstafftoawaitenrollingtheparticipantuntilafterthesecond
interview.
c. Theparticipant’steacherwillnotifythesupportstaffafterthesecondinterviewifthey
decidethattheparticipantcansafelyenrollinthecourse.
v ThanktheparticipantfortakingthetimetocometotheOrientationSessionandinterview
v Expressyourappreciationtothemfortheirdecisiontoassumegreaterresponsibilityfor
theirownhealthandwellbeing
v Aftertheinterview,thesupportstaffwillregisterappropriateparticipants,collecttuition
and,ifnecessary,makeadjustmentstothefinancialagreement
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ScreeningCriteriaforExclusionfromtheStressReductionProgram
LifestyleIssues:
v Addictiontosubstances
v Addictsnewtorecovery(lessthanoneyear)
v Inadequatecomprehensionoflanguageinwhichcourseistaught
Exceptions:Intermsofaddiction,ifsomeoneisinrecoverylessthanoneyearandseemshighly
motivated,orisinasupportivetreatmentenvironment,theymayattendclass.
Ifthereisaproblemwithlanguagecomprehension,provisionscanbemadeforinterpretationservices.
Thesameholdstrueforhearingimpairment.
Psychologicalissues:
Baseduponpsychologicalissuesandpresentation,ifateacherisNOTconfidentaboutacceptinga
participant,refertheseconcernsdirectlytotheCFMMedicalDirector.
v Suicidality
v Psychosis(nottreatablewithmedication)
v PTSD
v Depressionorothermajorpsychiatricdiagnosis(ifitinterfereswithparticipationincourse)
v Socialanxiety(difficultywithbeinginaclassroomsituation)
Exceptions:Anyonewhoishighlymotivatedandreceivingtherapyand/ormedicationforthese
diagnosesmaybepermittedtosignupfortheclass.However,inthesecases,itisessentialthatthe
teacherstateclearlythattheywillestablish,remainin,andhaveactiveandongoingcollaborationwith
theparticipant’scurrentmentalhealthcareprovider.Areleaseofinformationmustbeacquired.
AttitudinalIssues:
v Inabilitytocomprehendthenatureandlimitationsofprogram(wantinga“quickfix”without
investingtimeandenergy)
v Inabilitytocommittoattendingclasses(ifsomeoneisgoingtomissthreeormoreclasses
theyarereferredtoanothercycle)
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PhysicalIssues:
v Inabilitytophysicallyattendclasses(thisdoesnotrefertophysicalimpairment,whichisnot
anexclusioncriterion,buttothesimpleinabilitytoactuallygettoclass,becauseofbeing
bedriddenorhomebound)
Note:Finaldecisionsregardingtheseexclusioncriteriaaresubjecttotheclinicaljudgmentofthe
instructor.
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AppendixB:OrientationQuestionnaire
DATE_______________________
Class Chosen: _________
Orientation Questionnaire (OQ)
Center for Mindfulness in Medicine, Health Care, & Society™
Mindfulness-Based Stress Reduction Program (MBSR)
University of Massachusetts Medical School
Division of Preventive & Behavioral Medicine
Thank you, for filling out these forms.
We realize the personal nature of these questions.
Please be assured that the completed forms are kept
in strict confidence.
Name: _______________________________________________________
E-Mail:_______________________________________________
Telephone#
Home (
) __________________________
Work (
) __________________________
Cell
) _________________________
(
(Please indicate best tel. # to leave you a message)
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Office use only
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1. What is your main reason for participating in the MBSR Program?
___________________________________________________________________
___________________________________________________________________
2. Occupation: ______________________________________________________
3. Date of Birth: (MM/DD/YEAR) ___/___/_____
4. Family Information: (please circle)
Single Married Not Married Living with Partner Separated Divorced Widowed
5. Do you have children?
(Yes/No)
___________
5a. If so, how many?_______ 5b. Ages?______________
6. Do you have close friends? (Yes/No) _____________
7. Sleep quality: __________________________________________
8. Do you smoke? _____ 9 . Caffeinated drinks per day: _____
10. Do you exercise? _____
11. Do you use drugs or alcohol? ________
How much? ____________
12. Do you have a history of substance abuse? ______________________________
___________________________________________________________________
13. Do you take prescription medications? (Please list):_______________________
___________________________________________________________________
___________________________________________________________________
14. Are you currently engaged in psychotherapy?
___________________________________________________________________
15. If no, have you been in therapy during the last three years?
___________________________________________________________________
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16. Previous overnight hospitalizations? (Year)
Medical/Surgical
_____________________________________________________________
Psychological
_____________________________________________________________
During the last MONTH have you:
a. Considered suicide?
YES
NO
b. Sought psychiatric help?
YES
NO
c. Had thoughts of death or dying?
YES
NO
d. Had urges to beat, injure or harm someone?
YES
NO
e. Had urges to smash or break things?
YES
NO
f. Had spells of terror or panic?
YES
NO
Please take a moment as you respond to the following three questions.
17. What do you care about most?
____________________________________________________________________
18. What gives you the most pleasure in your life?
____________________________________________________________________
19. What are your greatest worries?
____________________________________________________________________
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Date: ______________
How did you learn about this program?
We are interested in knowing how you learned about our program. Would you help us by
checking off any and all of the ways you first learned about the Mindfulness-Based Stress
Reduction Program?
_____
Primary Care Physician
Physician’s first and Last Name___________________________
_____
Other Health Care Provider
_____
Specialty Physician
_____
Psychologist/Social worker/Psychotherapist
_____
Primary Care Nurse Practitioner
Other Health Care Provider’s First and Last Name ___________________
______
Harvard Pilgrim Health Care
_____
Tufts Health Plan
_____
I received an appointment reminder with information
regarding the Mindfulness-Based Stress Reduction Program
_____
Jon Kabat-Zinn’s Book
_____
Saki Santorelli’s Book
_____
Friend/Relative that took the class
_____
Television
_____
Article from _______________________________
_____
Google Ad
_____
Other (please describe):______________________________________
Center for Mindfulness in Medicine, Health Care, and Society
University of Massachusetts Medical School
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This is a good time to
STOP…
and await further directions from your
Orientation Session Instructor.
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Please list three personal goals you have for taking the Mindfulness-Based Stress
Reduction Program:
1)
________________________________________________________________________
________________________________________________________________________
_______________________________________
2)
________________________________________________________________________
________________________________________________________________________
_______________________________________
3)
________________________________________________________________________
________________________________________________________________________
_______________________________________
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Mindfulness-Based Stress Reduction Program
UMass Medical School
Informed Consent Agreement
The risks, benefits and possible side effects of the Mindfulness-Based Stress Reduction Program were
explained to me. This includes skill training in meditation methods as well as gentle stretching (yoga)
exercises. I understand that if for any reason I am unable to, or think it unwise to engage in these
techniques and exercises either during the weekly sessions at UMMS or at home, I am under no
obligation to engage in these techniques nor will I hold the above named facility liable for any injury
incurred from these exercises.
Furthermore, I understand that I am expected to attend each of the eight (8) weekly sessions, the daylong
session and to practice the home assignments for 40-60 minutes per day during the duration of the
training program.
__________________
Date
____________________________________________
Please Print Name
____________________________________________
Participant’s Signature
_____________________________________________
Parent or Legal Guardian
(If a Minor)
EMAIL COMMUNICATION CONSENT
As a participant in the Mindfulness-Based Stress Reduction Program, you may wish to
communicate with your instructor via email on occasion. In order to ensure your privacy, we request
that you give written permission for this form of correspondence.
Please complete the form below and check one of the following options:
___I give my permission to communicate via email with my program instructor about any aspect of my
Mindfulness-Based Stress Reduction Program experience.
___I DO NOT give permission to communicate via email.
Signature: ______________________________ Date: ____________
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