Dr. Greco HealthBeat Podcast

Can mindfulness and meditation help you live a less stressful, happier, healthier life? Carol Greco, PhD, Professor of Psychiatry at the University of Pittsburgh School of Medicine discusses the benefits of mindfulness and meditation and ways to get started.

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– This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgments when advising their patients. Patients in need of medical care should consult their personal care provider.

– Mindfulness and meditation: Chances are you’re hearing a lot about them these days. Are they really the secret to a less stressful, happier, healthier life? Hi, I’m Tonia Caruso. Welcome to this UPMC HealthBeat podcast, and joining us right now is Dr. Carol Greco. She is an associate professor of psychiatry at the University of Pittsburgh School of Medicine and a certified trainer in the Mindfulness-Based Stress Reduction program. Thank you so much for joining us.

– Thank you for having me here.

– I have so many questions. Everyone on our crew has questions. We’ve been talking about this a lot. So I guess, first, when we think about health, we normally think about physical health, but mental health and our mindset can be just as important. What do you want to say about the power of the mind?

– Oh, so much. And, actually, I don’t feel that we can really separate the mind from the body, either. And so, our mind is really powerful. Our mind can actually influence our physical health in a negative direction or a positive direction. So, when you’re really stressed and worried about something, even if it’s not dangerous, that can have an effect on your blood pressure, et cetera, getting you into that fight or flight. And so, conversely, mindfulness and meditation help to move us in a healthier, positive direction where we let go of some of the kind of worry and flurry that is so often part of our daily life these days and just be fully present with the mindset of “It’s OK, and let me move forward with what’s the best I can do.” So that would be a mindful mind if that makes any sense.

– So tell me about your journey. How did you begin in mindfulness and meditation, and how long have you practiced these?

– So, it’s been, I think around … wow, it’s been about 26, 27 years now, but I got started because I was a researcher at Pitt and I was doing research studies on how people can help take care of their pain better without medicines. And so I went to a conference, a scientific conference, and I met the developer of the Mindfulness-Based Stress Reduction program, and I was so excited cause I thought, “Oh, this is going to help my patients that would have pain, and have stress, and chronic illness. And so he told me how to learn, how to meditate, who I could learn from here in Pittsburgh. And so when I came back, I met those folks, and I started meditating. They helped me. What I found out first was how helpful it was for me. So, this was back in, like, 1994, and I began to practice meditation, work with different teachers, and it was actually about 10 years of my own practice before I felt like I had it inside me enough that I could really offer to patients and to the community to teach them how to meditate.

– So let’s talk first about mindfulness, and then we’ll move to meditation. Mindfulness is a form of meditation?

– Well, it’s a little tricky. Definitions are always tricky, but I consider that mindfulness meditation is a kind of meditation. There are many, many kinds, but mindfulness is actually a capacity that we all already have. It’s a kind of awareness that is here. When we pay attention on purpose to what’s actually happening in this moment, to what’s happening physically, in our emotions, in the context, et cetera, without as much judgment, so being open to what’s here, this is mindfulness, and we all have that capacity. So, meditation can actually cultivate that capacity and let it grow in the person. And so meditation is a more of a method that is very helpful, can be very helpful for health, and also can cultivate this mindfulness, mindful awareness.

– So, let’s give an example to someone of mindfulness. And what would we say is the purpose of mindfulness? Is it just a grounding of someone, or is it just something that happens?

– I’m going to answer it in two or three different ways. So, on the one hand, it can just happen. So, you open your door on a beautiful, sunny morning, and you’re just there, and you appreciate that. You’re just, wow. You’re just right there. You’re not, like, thinking about your meeting. So, that’s a moment of mindfulness. So we all drop into maybe more times than we think. So, that’s one aspect, and you said, “What’s the purpose?” My second answer is that on a large scale, there isn’t really any purpose other than to be fully present and be with what’s here, and this can lead to greater enjoyment, less stress. It really can. And so that’s a second answer to you. My third answer, it comes more from when I teach these courses in Mindfulness-Based Stress Reduction, what people often learn over this eight-week class is they learn through these practices and through growing that mindfulness capacity that the things that used to stress them out, they’re a little less reactive to them. It’s like if you had buttons all over your body for alarm, and you have fewer buttons. It’s like, “Eh.” So, they’re more responsive to what’s happening as opposed to reacting to the stressors and the things that come.

– So, sitting here, if not all these cameras were here, and I’m in front of you, and we have things in front of you, what would a moment of mindfulness be like? Do you need silence?

– Oh, that’s a great question. And what I’d like to say about that is that especially for the beginner, silence is helpful. It’s very helpful because there’s so much going, and mindfulness and meditation is really like coming inward. So, silence can be helpful. And, on the other hand, it’s not needed. So, you could meditate in the midst of the emergency room waiting room. You could just be present with the sounds, maybe even sensing the emotions that you’re having and those of others, and that’s meditation, too.

– So, let’s move to meditation because it seems like it could be daunting. So, what would you say is the most basic definition of meditation?

– I’ll just have to start off by saying this is just me as a person, not as an expert in Buddhism, or religions, or anything like that. So, to me, the purpose is really coming home to kind of who we are at a basic level, and developing the ability to concentrate also is part of it. So we meditate in order to bring the wandering mind back gently and without judgment or blame as best we can and really feel what it is to be human, to have this body, to be living right now.

– In general, what do you want to say to people about expectations when they start to meditate, and how you get started as a beginner?

– What I’d like to say first is the most important “rule,” which there aren’t any rules, really, is to be kind to yourself and watch out for self-judgment because often people will say when they’re beginning, “I think I must be doing this wrong because ‘X, Y, and Z,’ because I don’t always feel relaxed, or because my mind wanders.” So, the first thing is, of course your mind’s going to wander. So be kind to yourself. For beginners, I would say there’s a lot of really good apps but you could also work with a teacher. You could take a class if you wanted to. Just be sure that your teacher is experienced and that you fit well with that person. What is also helpful for most beginners is to choose some kind of an anchor for their attention. And you were telling me that for you, sound is a wonderful anchor. It’s like, you just hear that sound, and when you’re filled with that sound and that’s filling your brain in a sense, then there’s not a whole lot of room. There’s not a lot of geography for worrying and thinking about the next thing that you have to do. You’re just there. So, many people that I work with like to anchor their attention to breath sensations in the body. So, they’re always changing. So, they’re kind of interesting. They can also focus on some body part or just the sensations in the body. Like, the palms of the hands are usually a nice one because they’re warm.

– We’ve already said there are definitely health benefits, and your mind is important, and that’s important to overall health. But what if I’m stressed out because I think I’m not doing this right?

– What’s the ideal?

– So, I’m not sure there really is an ideal, but it’s interesting you ask that question because I’m a researcher, and some of the research that I do is about meditation, and in our studies, we’re starting to measure, using an app or whatever, how long are the people meditating, and do the folks that actually do their home practice more, do they have more benefits? So, what we’re finding in that is that the folks that actually do practice and maybe meditate for a little longer have more health benefits in terms of whatever we’re measuring in our research. However, very few of them actually meditate as long as we are asking them to. So, I think there’s good evidence that a little longer is good. However, what’s most important is what you’re able to do. So, I think what I would like to say is 20 minutes is really great because at least for me, it lets the little wild animals of the mind have a chance to, like, they run around for a bit and then they’re like, “OK.” Then, there’s a little bit of settledness that happens. However, if what you have is 10 minutes, you’re still building your capacity to meditate, and for mindfulness, and whatever you can do.

– And so, really, is it something accumulative like the more you do it, the better you get at it?

– Well, it’s really more how useful is it to bring the mind to where we want it to be and to be present in our life so that we are actually can be happy, even if maybe circumstances aren’t what we would choose.

– I’ve read mornings are best, but you say, what?

– I personally like mornings because it’s a nice way to set my day. It’s like, “OK, yeah, this is real.” However, any time of the day is fine. A person new to meditation, they might try different times of day. See what suits them. You try in the afternoon, that’s great. If you do it before bed, that’s great. But see what works best for you in terms of fitting it into your schedule.

– Show us and tell me about what you brought.

– So, a bell or a chime is not really necessary for meditation at all, but it’s kind of nice. It makes a nice sound, and it’s often a way to start and end a meditation session. So what I’ll do is I’ll ring the bells, and then I’ll give just a little bit of guidance in a very brief meditation. Is that OK?

– Yes.

– OK, sure. And then we’ll close with the bells again, and usually when I’m teaching a class, our meditations might last 20, 30 minutes, sometimes 45, but today, we don’t have that time.

– It’s a 30-second meditation.

– So, settling into your posture with a fairly straight back, and if you’d like, you can allow your eyes to close, but it’s OK to leave them open. And beginning to gather your attention to some aspect of this moment’s experience. It might be the breath sensations that you can feel in your body. Breathing in, breathing out, not trying to manage or control your breathing in any way, but simply noticing how different areas feel as the air comes in and touches and as the air leaves. And the mind will wander as best you can without judgment or blame, just gently escorting the mind back to the body and to breath sensations or some other aspect of this moment. Taking a moment now, a breath or two, to just sense into how your body is feeling and maybe a moment or two to check in with your mental state, however that might be.

– OK, that was amazing. Your soft voice, can I bring you home to help me meditate every day? You mentioned before, there are teachers, there are lots of apps out there as well. Are we each setting our own goal for meditation? How do you know that you’ve had a successful meditation? Given your research, is there any collective definition that you all have come by as successful?

– Good meditation is one that you do. So, almost like letting go of judgment of yourself or even of the meditations. So, sometimes I’ll meditate and at the end I’m like, “OK, I think my mind was wandering about 80% of the time, and I wasn’t even aware of it.” So, I might not feel as relaxed, but I still had what I would consider a fine meditation because I was able to notice that this was a time of a lot of maybe more agitation or the mind wandering. So, when we actually notice those things, then we have a chance to make a choice about our behavior in our life. So what we learn in a meditation is always useful. And, of course, some meditation sessions are going to feel pleasant, feel useful, feel beneficial. And others, maybe not so.

– We’ve mentioned it a few times, but let’s tell folks about the Mindfulness-Based Stress Reduction program. And, I know you’re a certified trainer in that. What is it, and how does it work?

– So, it’s an eight-weeks-long curriculum. It’s based upon, of course, ancient meditation practices, but it’s taught very, very secular. So, there’s no mention of the Buddha or anything like that. It’s very much practical in our daily lives. It’s a group course. Now, we’re doing it online, and we used to do it in person. We meditate together, they get guided just like I guided you, then we debrief. We have various topics like awareness of pleasant events, awareness of unpleasant, mindfulness and communication. So, various topics. And, also, a big part of it is that we’re asking folks to practice at home. We give them recordings that are in line with the curriculum. As I mentioned, I am a researcher. And one of the beauties of that curriculum is that it’s fairly standardized, yet every teacher and every class is different. So, there’s flexibility within it, but it can be studied because it is at least fairly standardized. So, in many of the research programs, mindfulness is actually showing lots of, as we mentioned, health benefits, as well as benefits for anxiety and distress. And the only way we can know that is by having a fairly standard class or course.

– There is so much more attention to mindfulness and meditation these days. Do you feel like this will become a larger part of medical treatment in general? Where do you think most of your colleagues in the medical field are with this these days?

– Yeah, well, I don’t know about most, but I know significantly greater numbers of physicians and others in health care are paying attention and are interested, and they’re often suggesting mindfulness and meditation to patients. And the American Heart Association has recommended the MBSR and other meditation programs for those patients who are interested, so that’s great. And, also, chronic pain, it’s very useful for chronic pain. So there’s been a statement, a scientific statement, about the usefulness of Mindfulness-Based Stress Reduction for chronic pain. And that’s one of the greatest causes of disability, both of those twp, heart disease and pain. So, scientifically, there’s more recognition of that, but I do want to say that not every person is going to be interested because as you know, setting aside the time to meditate and doing that kind of self-exploration, it may not be for everybody. Some people might just be like, “Just give me a pill, doc.” My hope is that everybody becomes interested and more and more people feel the benefits of mindfulness and meditation in their lives.

– What else has research shown recently that you’re most excited about when it comes to mindfulness and meditation?

– Well, I’m excited about all of it, but my one colleague has just published a paper on a study that we did with Pitt and CMU, and the focus was really on does the immune system change, or the cells of the immune system change when a person is engaged in meditation? So, we did a study of older adults with loneliness, and it was a very nice study, controlled with an active control group if you know anything about what that means, but the people that were in the meditation group, their cells had greater responsiveness in terms of the immune system. So, that paper just came out. So, that’s pretty amazing, especially in this day where we’re all concerned with immunity and our ability to fight off diseases.

– Wow, this is a fascinating topic. What do you want to say to folks, real quick, your elevator pitch about what we should all be thinking about if we’re going to try meditation?

– I would say, go for it with an attitude of openness and kindness to yourself. You can try various apps, but just be careful not to get too caught up in, like, “Am I doing this right?” Be patient with yourself, too, and just enjoy. Just enjoy, and maybe consider taking a class if that would be OK for you.

– Well, some great information. Doctor, thank you so much for coming in and spending time with us today. We appreciate it.

– Thank you.

– I’m Tonia Caruso. Thank you for joining us. This is UPMC HealthBeat.

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