Listen — there is a tendency when wanting to help someone to jump into “doing” mode and trying to help them fix the situation. This has been called the “righting reflex” where we want to make it “right” for another person. However, when the righting reflex pops up, we stop listening to another person. When another person is suffering, whether with anxiety or depression, often what they are longing for is connection, and this begins by really listening.
As a part of my series about “How To Develop Mindfulness And Serenity During Stressful Or Uncertain Times”, I had the pleasure of interviewingDr. Lichtenstein.
Dr. Brad Lichtenstein received his BA in communication disorders and psychology from University of Pittsburgh in 1989, his ND from Bastyr University in 1995 and is currently a core faculty member of Bastyr University’s School of Naturopathic Medicine. Dr. Lichtenstein’s work examines psycho-emotional-spiritual health in the midst of living with a chronic, life-challenging illness. He has been involved in HIV care for 15 years. For three years, Dr. Lichtenstein was involved in research on the impact of meditation on end-of-life care, including guiding hospice patients in biweekly guided meditation sessions.
Thank you so much for doing this with us! Our readers would love to “get to know you” a bit better. Can you share with us the backstory about what brought you to your specific career path?
As I have been fond of saying lately, my mother took me to my first yoga class in the basement of our synagogue in Pittsburgh, PA, when I was 7, back in the early 70s. This sparked my interest in yoga, meditation, mindfulness, and breathing. In other words, I was always interested in ways we could heal without needing to take any medication — including supplements. When I was 13, I became a vegetarian, which was both challenging and unheard of in Pittsburgh at that time. I was a vegetarian for 22 years (no longer a vegetarian, now focusing on sustainable and organic food choices). In college, I ended up in the ER several times after having severe GI distress, which I had experienced my entire life growing up. At no time did anyone say I could have had a food allergy. After those college ER visits, I found a cookbook, Healing with Whole Foods, and in it, the author spoke about dairy being a major culprit to GI distress. It took me six months to give up dairy, and once I had, within a week, almost all my symptoms abated. This was amazing. Again, this helped me realize the importance of basic lifestyle factors. After being accepted to a conventional MD/Ph.D. program, I was told of Bastyr University, then John Bastyr College of Naturopathic Medicine, here in Seattle, WA. I was intrigued by their holistic approach, so I enrolled and moved out to Seattle without knowing too much about it.
During my training, I focused on HIV care, becoming a member of the scientific review committee at Seattle Treatment Education Project (STEP), where we reviewed the literature and research for all things HIV treatment-related. Upon graduation, I specialized in HIV care. While naturopathic treatment was vital to mitigating side effects of medications and provided some quality of life, after those biochemical discussions, the conversation always turned to how you are living life. Over the years, this became my sole focus. Rather than exploring treatments to eradicate disease, which is helpful, but only goes so far, I became passionate about helping people live their lives as fully as possible at this moment. One of the most profound experiences that helped shape my work is my participation at the end of life, hospice study, where I went to the bedside of hospice patients twice a week until they died, leading them through guided meditation. I saw first head the power not only of meditation but also of being present with someone, without trying to fix anything — just being with them as fully as possible.
All of these (and other) experiences have shaped my work — which I describe as helping people explore how they want to live in this moment. How do they want to breathe and move through their lives regardless of what is happening? Think of it this way, many of my patients with intense medical diagnoses, such as stage 4 cancer, often get scans and tests to tell them about their disease progression. Often it takes a few days to a week to get results. I will ask them, how do they want to live and breathe during that week of waiting? Most of us, myself included, tend to hold our breath, which is a whole mind-body experience. If I am holding my breath, then I am tightening and bracing my muscles. My thoughts tend to be rigid and tight as well — thinking and ruminating about one thing. All of this prevents me from being as present as possible in this moment. Sure this is understandable, yet there is another way. That is how I describe my work.
What advice would you give to other leaders about how to create a fantastic work culture?
Take the time to cultivate relationships with others. Many leaders focus on productivity, yet mistakenly emphasis output without addressing the person who is doing the work. We are not machines, yet, people wouldn’t treat their vehicles this way. If you want your car to work optimally, run more smoothly, and for a longer period of time, you need to attend to what you put into it and maintain it. We need to maintain and cultivate positive relationships with the people with whom we work. This cannot be mere lip service. The number one reason for burnout in all industries is feeling disconnected from the values of the organization. Without taking the time to cultivate relationships, people do not feel valued. This may take time, and training since many leaders have not had positive relationships modeled to them.
What we are talking about here is creating a culture where everyone feels safe. When we feel safe, this regulates our parasympathetic nervous system. When we do not feel safe at work, for whatever reason, then our sympathetic nervous system may become activated and be in the dominant state. If that happens, then we do not have access to all the areas of the brain — so we become less creative, less clear focused, less articulate. This is not about relaxation; a word often anathema to leaders and managers. I am not speaking about relaxation but connection. If the leaders feel “uncomfortable” with connecting and engaging with others, my question to them is what is unsafe for them about it? If they worry that their employees will be less productive, I might suggest data that shows the opposite.
Is there a particular book that made a significant impact on you? Can you share a story or explain why it resonated with you so much?
So many. But probably the one that has had the most significant impact was Rachel Naomi Remen’s book Kitchen Table Wisdom. In this book, Dr. Remen imparts amazing wisdom by sharing a collection of stories from her personal life and the lives of people with life-threatening illnesses with whom she has worked. All of us on the planet know loss, pain, hurt, rejection, and pain. What really heals on a truly deep, unconscious level is connection. Many times, practitioners hide behind their remedies — the pills, procedures, lab tests, white coats, and expertise — failing to see the whole person sitting before them. This book reminded me to sit with others in their suffering, and that no matter the situation, I always have something to offer to be of service — my compassion and humanity. Dr. Remen’s stories are little gems that help you look at life in new ways.
Ok, thank you for all that. Now let’s move to the main focus of our interview. From your experience or research, how would you define and describe the state of being mindful?
What most of us know as mindfulness is based on the contemporary approaches of mindfulness that has been extensively researched over the past 40 years. Mindfulness can be defined as attention and focus on the present moment without elaboration or judgment. The present moment focus can be anything, our breath, our body sensations, a thought, etc. These objects of mindfulness are called the “anchor.” One of the most profound outcomes of mindfulness training is that we learn to be less reactive and defensive. We learn to engage with others, ourselves, and our very own thoughts in a way that allows for greater creativity and engagement. We can hear others in a way that is supportive and collaborative. Furthermore, mindfulness training will enable us to notice the true nature of what is happening without layering it with more judgment.
This might be intuitive to you, but it will be instructive to spell this out. Can you share with our readers a few of the physical, mental, and emotional benefits of becoming mindful?
Much of the health-related research on mindfulness training comes from the work of Jon Kabat-Zinn and his Mindfulness-Based Stress Reduction Program. One study published in JAMA showed the following potential benefits of mindfulness training:
- Decreases perception of pain severity
- Increases ability to tolerate pain or disability
- Reduces stress, anxiety, or depression
- Diminishes usage of, and thereby reduced adverse effects from analgesic, anxiolytic, or antidepressant medication
- Enhances the ability to reflect on choices regarding medical treatments
- Improves adherence to medical treatments
- Increases motivation for lifestyle changes involving diet, physical activity, smoking cessation, or other behaviors
- Enriches interpersonal relationships and social connectedness
- Alterations in biological pathways affecting health, such as the autonomic nervous system, neuroendocrine function, and the immune system.
JAMA, September 17, 2008 — Vol 300, №11
Ok. Here is the main question of our discussion. The past 5 years have been filled with upheaval and political uncertainty. Many people have become anxious from the dramatic jolts of the news cycle. The fears related to the coronavirus pandemic have only heightened a sense of uncertainty, anxiety, fear, and loneliness. From your experience or research what are five steps that each of us can take to develop mindfulness and serenity during such uncertain times? Can you please share a story or example for each.
- I believe the very first step in this process is for every one of us to set our intention. This requires us to pause and step out of our habitual, automatic response pattern, to consciously and honestly ask ourselves, how do I want to experience/feel in this moment? Too often, we are quick to blame and shame. We do this when we say to others, “When you did x, y, or z, YOU MADE ME FEEL….” Unfortunately, that isn’t exactly true. If another reaction is possible; for instance, if another person might respond differently, it is not a fact that someone made you feel a certain way. This means our reactions are not set in stone. With practice, you can learn to respond and react differently. The question is, do you want to? And then, how willing are you to do the work? Many of us will eagerly put in the time to learn a new skill, like learning a new sport, play an instrument, or even knit. It isn’t easy at first, but we prevail when we tell ourselves that I can do this. That mantra, if you will, is a practice in and of itself. Yes, I can. We do not give the same respect and attention to our mental and emotional states. We think they are set in stone and spend no time cultivating them. So, do you want to feel differently, and are you ready to “practice” something different?
- Pause — this becomes challenging in our go, go, go culture. The nervous system was not designed for constant mobilization, no matter what any employer, teacher, or coach says. We grow, develop, and heal through periods of rest and renewal. Throughout the day, each of us needs to schedule pause periods. It can be as simple as setting your alarm to remind you to take these necessary pauses.
- Change posture/move — based on current studies, many practitioners have become fond of saying, “Sitting is the new smoking.” Not exactly true, but the point remains. We have to move. We were not designed to sit and be stationary for very long. Furthermore, research on embodied emotions suggests that our moods might have more to do with the posture we inhabit throughout the day than we would like to think. Somatic practitioners suggest that if you want to feel differently, then you must move differently. What postures do you adopt and remain in all day? How often do you stand, walk around, squat, stretch? Most physical therapists and physical medicine doctors recommend changing positions every 20 minutes! It doesn’t have to be long, 1–2 minutes might be enough, especially if you are doing this consistently. Not only does it improve your circulation, but it also improves your postural muscles, so you are not tight, constricted, and miserable at the end of the day.
- Breathe — The first three suggestions I made are the foundation before you can breathe. Pause and move your body, THEN take five slow, diaphragmatic breaths, in and out through the nose, for a count of 5–6 seconds in, and 5–6 seconds out. Whether seated or standing, place your hands over your belly button or slightly lower. Relax your jaw, lips, and tongue. Soften your abdomen. Allow the breath to come into your body slowly, and exhale slowly. If you are finding you take in the breath too rapidly, imagine breathing in honey or molasses and exhaling through pursed lips. This slow diaphragmatic breathing regulates the nervous system and cultivates a calm, relaxed state. Many times when we are so mobilized, rushing about, we tighten our abdomen, breathe into the chest, and take in large amounts of air and hold it. However, our parasympathetic nervous system relaxes on the exhale. Learning to slow down the breath, strengthens our parasympathetic system, making us able to focus and be more present.
- Gratitude — it is an evolutionary adaptive response to always be looking for the problem. Even when a lot of things are going well, our mind is scanning the environment to make sure we are safe. If there is a problem, we want to make sure we address it. However, practicing gratitude can also strengthen our parasympathetic system. This doesn’t need to be a complicated practice. Simple list 2–3 things you are grateful for in this moment. It could be as simple as being able to take a breath or that you are sleeping in a bed. Some research suggests that people who identify 3–5 things for which they are grateful every morning and every evening experience less anxiety and depression and are more confident in their daily lives.
From your experience or research what are five steps that each of us can take to effectively offer support to those around us who are feeling anxious? Can you explain?
- Listen — there is a tendency when wanting to help someone to jump into “doing” mode and trying to help them fix the situation. This has been called the “righting reflex” where we want to make it “right” for another person. However, when the righting reflex pops up, we stop listening to another person. When another person is suffering, whether with anxiety or depression, often what they are longing for is connection, and this begins by really listening.
- Don’t pathologize — Anxiety is a broad term. Typically, anxiety involves “future tripping,” where we are thinking about consequences later in time. Yet, at the core, we all wish to feel safe. We experience anxiety when we believe our future safety will be compromised. Safety might not be as specific as our very existence being called into question. Safety might mean we believe our respect, value, worth will be called into question. Extending that further into the future, if my respect or worth is called into question, it might mean “I might lose my job or be alone.” Again, all of these, on a very foundational level, are unsafe. Being concerned about our future safety is a normal reaction. While some people do need professional help to manage their moods, we are prone to be concerned about our safety. Reminding ourselves and those who are anxious that this is understandable and common can help remove some of the stigma and judgment we all place on ourselves, only creating more anxiety
- Recognize the individual manifestation of anxiety — Each of us manifests this worry in different ways. For some, they mobilize, feeling compelled to stay busy and active, whether physical or mental, while others mentally and physically freeze, unable to process or focus on anything. And within these two broad categories, there are variations. Try and identify how others respond to anxiety.
- Ask — rather than taking over (righting reflex) or telling the person what they need to do, first ask what they might need in this moment to feel safer? If there is something very tangible, like being removed from an unsafe situation, ask how you can help remedy that situation. If, on the other hand, they comment on how they need to learn not to let something bother them or to let it go, ask them how they have done that in the past. Truth be told, every one of us has had experience and success with something go. We fail to remember or recognize that. Another question might be, what would you like to focus on instead of this train of thought?
- Breathe — people learn to regulate their states by observing others. If we engage in conversation with someone who is anxious, yet we ourselves are breathing rapidly or holding our breath, if we are speaking rapidly, then the anxious individual will often remain anxious. Take time to breathe yourself
What are the best resources you would suggest for someone to learn how to be more mindful and serene in their everyday life?
There are so many excellent meditation apps, websites, and programs available. Calm and Insight Timer are excellent resources. For people who prefer more physical practices could benefit from online yoga classes. Many meditation studios are now offering online sessions.
I offer free guided meditations on my website (below) and on Insight Timer. I also offer live meditations on Tuesdays and Thursdays on my Instagram Live channel at 8 AM.
Also, connect with a friend or colleague who is also interested in cultivating mindfulness. Set check-ins and chats (phone or video) — actual chats, no texts — to inspire and encourage each other, and practice.
You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
My dream is that we become a society and culture that values awareness — of self and of others. Our current world seems to pray to the god of productivity, yet we fail to realize that we can increase our optimal performance through awareness. In my vision, this would begin in childhood, where we would teach children how to be present with themselves — their thoughts, physical sensations, and emotions. Most of the time, we try to get rid of any thought, feeling, or sensation that is remotely uncomfortable. This practice not only makes those experiences an “enemy” that we must do battle with, but it prevents us from learning how to address the root cause in the first place as we focus on the symptoms.
What is the best way our readers can follow you online?
My website — www.thebreathspace.com
My YouTube channel — https://www.youtube.com/channel/UCxa0ZIJE8ODPByVFVHWyzCg?view_as=subscriber
Thank you for these fantastic insights. We wish you only continued success in your great work!