Cancer and other health conditions not only affect the body physically; they can also carry a major emotional impact. While the main focus for many patients is treating the cancer itself and its accompanying side effects, it’s also crucial to address your mental health. While there are many ways to do this, meditation and mindfulness can be effective tools.
But how exactly does meditation work? And where should you start if you’ve never tried it before?
To learn more about a technique that’s practiced by millions of people worldwide, we talk with Patricia Arcari, PhD, RN, program manager for meditation and mindfulness at Dana-Farber’s Leonard P. Zakim Center for Integrative Therapies and Healthy Living, in this podcast. We cover topics including:
- What is meditation?
- How can I start meditating?
- What is the difference between meditation and mindfulness?
- How do you combine meditation and mindfulness?
- What are some tips or exercises for people who are completely new to this practice?
- What are some of the benefits of meditating every day?
This transcript has been edited for length and clarity.
AUSTIN FONTANELLA (DANA-FARBER COMMUNICATIONS): What exactly is meditation?
ARCARI: Meditation is actually referred to as a mental discipline. At the Zakim Center, we use it as a mind-body therapy. It’s an intervention that allows you to begin to get a sense for the effects of the mind on the rest of the body, so it’s a basic two-step process that has many different applications.
The basic steps for any meditation practice are:
- You develop a focus. You identify a focus. Most people are familiar with using the breath as the first step in how you meditate. The breath becomes that place where you are literally asking your mind to rest in, to focus on. It becomes the place where you anchor your attention. In this practice of meditation, we continue to keep the focus on the breath to avoid the mind wandering off.
- When you notice that the mind is doing its thing, that it has wandered off that place of focus, then you gently, without giving yourself a hard time, just escort your attention back to that place of focus.
Now, meditation as a discipline was originally brought to this country from the Buddhists in the east. The Buddhists actually identify many different points of potential focus, many different places that we could anchor our attention, and they say that anything that’s based in the senses is a great place to be paying attention. That can mean your breath. That can mean how the body feels as you’re breathing.
You can also use the sense of hearing as a place to anchor your attention. So many people use sound — either music or bowls or mantras — so that sound becomes the place where you’re simply paying attention, and when you notice that the mind wanders away from hearing the sound, you say, “Oh, there I am, thinking,” and you bring it back to the focus on sound.
You can also use awareness of the body as a whole. That’s why yoga and tai chi and qigong are considered forms of meditation, because you’re taking your focus, you’re paying attention to the body as it’s moving in the practices, and when you notice that you’re not paying attention to the body, if you feel like you fall out of the position, you say, “Oh, my mind wandered away! It took me away from this focus on the posture. I need to bring the focus back.”
Another point of focus can be sight, that sense of sight, visually. Many people choose to use a candle or a piece of artwork or a religious statue, where they simply fix their attention on seeing what’s in front of them, and when they notice that the mind has wandered away, they come back to that sense of seeing.
So, anything that we are paying attention to, other than thinking, can be a place of meditation, and when we pull our attention away from thinking, that’s what actually creates the physiologic relaxation that is the main benefit of meditation for beginning practitioners.
FONTANELLA: You mentioned that there are many places of focus, but every time I’ve ever thought or heard about meditation, it’s all about the breathing. Is that just because that’s an easier place to start?
ARCARI: Absolutely. Everybody breathes, right? Everybody carries breath with them. It’s a very concrete anchor for attention. You can absolutely tell the difference between feeling your breath versus thinking about what’s on your desk when you go back to work, right?
That distinction between feeling breath but being caught in thought is very stark and concrete, and it allows people to notice when they are paying attention versus lost in thought.
FONTANELLA: What is the difference between meditation and mindfulness?
ARCARI: That’s such a great question because it’s something that people wonder about all the time, and we actually do have to spend a little time distinguishing. One of my first teachers was a physiologist down at the University of Massachusetts. His name was Jon Kabat-Zinn, and he actually was responsible for bringing mindfulness into healthcare as an intervention to help people manage their stress, feel a sense of relaxation, and really develop clarity and insight and experiences of positive emotions.
Anyway, Kabat-Zinn distinguishes mindfulness into two categories. Informally, mindfulness means that you are taking this sense of attention, and you are moving it into all the activities of your daily life. Remember when we were talking about meditation, and we said that we need to focus on something sense-based?
Well, mindfulness is about focusing, too, but it’s about focusing on all of those moment-to-moment, day-to-day activities that we’re involved in. It’s paying attention to everything that’s happening in your life as you’re moving forward.
So, let me ask you, Austin — this morning, what did you notice when you woke up?
FONTANELLA: That it was cold!
ARCARI: That it was cold — right. So, you were bringing mindfulness into your life by noticing that experience of feeling cold. You could also notice the appearance of sun much earlier now, right? The sun is coming up at 6:15, so we’re able to see sunrise. You might be able to notice — what did you have for breakfast?
ARCARI: Did you taste it?
FONTANELLA: I did.
ARCARI: You did! So, you were bringing mindfulness into your breakfast. It’s about paying attention in the moment to what you’re doing versus letting your thoughts go into things that are not happening in the moment.
Did you notice, maybe as you were eating your oatmeal, were you wondering about what your commute might be like on your way to work?
FONTANELLA: I did.
ARCARI: You did?
FONTANELLA: I did.
ARCARI: Yeah, so if you’re thinking about the commute, then you probably weren’t tasting the oatmeal, right?
ARCARI: So, mindfulness is this quality that allows us to really experience the fullness of life, the joys, the everyday pleasures that are always part of our lives, but we’re just not paying attention to them because we’re caught up in our thoughts. Mindfulness is sort of this application of meditation but in a moment-to-moment, day-to-day way with all of our activities, not just that sitting down or spending twenty minutes in an activity that’s structured like meditation.
Unfortunately, if you ever stop and look at where your mind is at, most of the time, it’s not in the present moment. Most of the time, we’re either anticipating what’s next, we’re in the future, thinking about what your commute is or what’s on your laptop or what you have to do when you get to work, or you’re caught in thinking about the past, that conversation that I had with my mother yesterday or that great shirt that I saw in the store window. Your mind is usually not in this moment but spends most of its time thinking about what’s next or what happened before, so mindfulness is a skill that needs to be cultivated because of the mind’s natural tendency to want to go other places.
FONTANELLA: Is it important to then mix meditation with mindfulness? How do you start from there? How do you work those two together?
ARCARI: The daily practice of meditation gives you the experience of what it means to be paying attention. It gives you the relaxation. It gives you the ability to really notice if your mind has wandered and come back. It gives you that opportunity to experience a sense of calm when you’re just anchored on that focus.
So, I like to think of it as the thing that reminds me every morning that I need to be paying attention, not just while I’m sitting in my meditation practice, but to take that sense of attention into everything that I’m doing, because when I’m paying attention and in the moment, no matter what I’m doing, I do get those same benefits of relaxation and calm and joy.
There’s another teacher by the name of Thich Nhat Hanh who says that everything that happens in our lives has the ability to bring joy. Everything is a miracle when we stop and pay attention to it, but the thing is, we don’t pay attention, so we’re not experiencing those benefits. Meditation is the daily practice that reminds you to pay attention throughout all of your day so that, instead of living in a stress response, feeling anxious, we can come to rest in this place of calm and positivity that the present moment has to give us.
FONTANELLA: It doesn’t sound like meditation has to be spiritual or completely structured for you to get benefits from it.
ARCARI: Right. No, there are many different kinds of meditation that can elicit this mind-body phenomenon of relaxation. It’s just a matter of finding a strategy that resonates with you. So, if you are an exerciser, let’s say, maybe you want to choose a meditation that’s body-based. Maybe you want to use yoga or tai chi as your meditation. If you are someone who has a deeply spiritual root, maybe you want to use a religious word or phrase to ground your meditation practice. If you are someone who really loves the arts, you can use music as that door into meditation. There are lots of different ways to cultivate this practice in your life.
And if I can, in our mind-body programs at Dana-Farber, we do introduce patients to many different ways to meditate because it’s not about doing it the way that someone tells you that you need to do it. It’s about finding the way that feels best for you, because ultimately, you’re only going to do this practice if it feels comfortable for you, right?
And meditation only works if you use it regularly, so anything that’s going to allow you to create the discipline of daily practice is what you want to find so that you make sure that the practice stays grounded in your life in a regular way, and that’s when you see the benefits. Meditation only works to the degree that you use it regularly.
FONTANELLA: Is there one tip or one exercise you give people who are completely new to this practice that just want to try it and go from there?
ARCARI: The breath is usually the go-to first place where we introduce people who are new to the practice to meditation.
FONTANELLA: How long should each meditation session be? Are there rules or restrictions that you should be following with this?
ARCARI: Unfortunately, we don’t have research yet that sort of quantifies in a dose-dependent relationship how much meditation will produce a certain outcome, but a general guideline that we use is twenty minutes. Twenty minutes can feel like an eternity, or twenty minutes can feel like something that passes really quickly. The point of it is just to be with whatever you’re experiencing in those twenty minutes and allowing it to unfold and know that, whatever happens during those twenty minutes, you’re doing it right just by setting the intention to pay attention.
So, twenty minutes as a general guideline… The second, again, important guideline is to attempt to create a daily practice. How do you introduce this new behavior of meditation into your life in a daily way? That’s a challenge. Sometimes we say that it can be stressful to take a stress management class because they’re going to ask you to create this new behavior, to find twenty minutes in the course of a life that’s already really busy to fit meditation in.
A good way to begin to create this new behavior is to experiment in the course of your day when it most easily fits and then anchor it to that time and place. For me, when I first started meditating, I would anchor my meditation to my shower. I would get up, get in the shower, and then, after my shower, I would sit and meditate. That worked for a really long time until I had kids and didn’t necessarily have the chance to get a shower, so then I had to shift my practice to a time that did work in the context of my life.
Again, step number two, most important — figure out a way that meditation is going to fit into the context of your day-to-day life, so it becomes something that you do every day, just like taking a shower or brushing your teeth.
FONTANELLA: What are some of the benefits that people can get from practicing this every day?
ARCARI: I think the benefits break down into three categories.
The first is that sense of relaxation, or literally the physiology of relaxation. Many people start to meditate in response to the stressors in their lives. Especially here at Dana-Farber, this meditation strategy is something that people rely on to cope with the stressors of their illness. Meditation as a discipline actually works physiologically to induce a state of relaxation in the body. When we’re stressed, the body goes into fight-or-flight. When we meditate, the body moves into relaxation response, which literally creates a calming of the body. That’s the first benefit.
The second benefit of meditation that accrues over time is you begin to develop insight into how your mind works. Our minds are constantly thinking, but that thought is occurring just below the level of conscious awareness. That can create real damage for us emotionally and physically because the brain is the place where we create stress. The brain perceives some sort of a threat — again, with our cancer patients, a threat to our physical wellbeing, to our emotional wellbeing, and those thoughts of threat create that physiology of fight-or-flight that can cause physical damage. Over time, with continuing practice, we come to sort of make friends with that mind, to notice when the mind is taking us to those places that are creating the feeling of threat, and when we can see the thoughts as they’re coming up, we’re in a position to say, “No, that’s not real. That’s not true. I’m not going to experience something really horrible. It’s just my mind worrying about it.” So, the second benefit of the meditation practice is to give you a little window into the thinking mind that allows you to let go of those thoughts that are irrational and distorted, and move into thoughts that are more positive and reflective of reality.
And then the third benefit of the practice over time is that we really can choose to be in this place inside that is the source of peace and wellbeing and joy and love and all of those positive emotions that we want to be experiencing. They’re all inside. Meditation helps us find that way in.
FONTANELLA: What if you’ve tried it before, and you’re like, “I just don’t get it – I can’t do it?” What do you tell those people?
ARCARI: Kabat-Zinn used to say all the time, “It’s simple. It’s a simple practice, but it’s not easy,” because you’re coming face to face with the thinking mind. If you’re new to meditation, that’s just been used to doing what it wants to do. The mind was designed to think, so what you’re trying to do is not necessarily to stop it from thinking but to choose the place where you’re focusing. When you’ve noticed that you’ve moved into thinking, you acknowledge the thoughts, but then, from this place of insight and ability to control what happens in our heads, we bring the focus back.
So, that’s why, again, we introduce so many different ways to meditate, because inevitably, you’ll find a way that works for you. And if you notice that you’ve tried one way — you’ve tried the breath — but your mind is just out of control, you can deal with it in one of two ways. You can say, “I’m finally coming to understand what’s happening in my mind. I’m going to not give myself a hard time. I’m just going to look at this, learn from it, and keep coming back to my breath focus.” Or, “The breath is just not working for me. Let me see if I can try yoga and use my body as a focus. Maybe sound meditation is most helpful. Maybe I can use Tibetan singing bowls as my point of focus.” Maybe it’s nature, focusing visually on what you’re experiencing, that can anchor your attention.
There are many different ways to meditate. The most important ingredient is your intention, your desire to do so. The more you practice, the easier it becomes, but you need to make that commitment.
FONTANELLA: Would you mind taking us through a quick meditation session, just to give people an idea of what they should be looking for?
As we begin this meditation practice, I’m going to ask you to just let your feet connect to the floor so that your feet are firmly anchored on the floor, and just take your sense of attention, your focus, and move it down into the bottoms of your feet.
So, what you’re focusing on now is just those feelings that are here, in the bottoms of your feet, as you begin to notice this connection with possibly your shoes or the feeling of the floor beneath you, that support that the floor is providing to your body as it’s sitting now.
Shift your attention up, from the bottoms of your feet, and just begin to notice the feelings that are present in your thighs now. Take your hands and place them, palms down, on your thighs. As you’re focusing on your thighs now, you might begin to notice sensations of warmth. You might feel a sense of tingling. Just allow those sensations that are here now in your thighs to be the place where you’re paying attention. So, you’re not thinking about your thighs, but you’re simply being with the feelings that are here, right now, in your thighs.
Now, if you haven’t already, allow your eyes to gently close and take that sense of attention and move it even more deeply into your body so that you’re just beginning to notice your breathing, becoming aware of your in-breath and feeling your out-breath. If you notice that your mind jumps in — it happens for us all — if you notice that you’re caught in thinking, it’s OK. Just gently, without giving yourself a hard time, label that thinking, and then escort your attention back to feeling this breath.
Breathing in now, I calm my body.
Breathing out now, I smile.
Dwelling in this present moment, with this breath, just as I am… This is a wonderful moment.
And as we come to the end of this breath-focused meditation, just begin to bring yourself back to a sense, once again, of sitting here in your chair, feeling your body as a whole, maybe wiggling your toes and shaking out your fingers a bit. And when you feel ready, gently open your eyes.