Transcript: The Science Behind Mindfulness

Okay. So we’ll get started. My name is Joey Remenyi and I work down in Geelong, Victoria, Australia, down by the surf coast. And I’m a vestibular audiologist and mindfulness educator. I help people with tinnitus and vertigo navigate their recovery.

So those of you who turned into yesterday’s webinar will have learnt that I have quite an interesting background in both psychology, neuroscience, vestibular audiology, and cognitive behavioral therapy, acceptance commitment therapy, yoga, and mindfulness.

I’ve had quite an interesting educational background, and I’ve really enjoyed grabbing pills of wisdom from the east and the traditions of mindfulness practice, and also learning the science behind it all and how our neurons and our brain wire together to help us do what we need to do and ultimately be the person we want to be. It’s really wonderful to be hosting this webinar series and talking tonight about the science behind mindfulness.

This is part two of a two-part webinar series. Today, what we will be looking at is a little bit of how they research mindfulness, because I’m sure some of you are thinking, “How do you really get into the science of words like ‘meditation’ and how do we look at the brain and what’s happening?” And it’s actually quite creative what some of the scientists are doing, and I will share that with you tonight in the webinar series.

There’s loads more research happening and I think there’s a lot more research we can do as a community of vertigo and tinnitus people, whether we experience those symptoms ourselves or whether we’re working with people who have vertigo and tinnitus.

We’ll try out some skills and tools tonight, ’cause I like to … Or actually, even when I work with clients one on one, every session I try and really keep them practical. So we’re practicing and we’re doing, and it’s not so much chitchat or writing or talking about it, but also incorporating some very active, mind/body type therapies.

I think that’s really key to our recovery, is the doing side of moving forwards. And that really leads us into neuroplasticity and stress. I’m gonna talk a little bit about the science behind stress, healthy stress, and chronic stress and how that impacts on our brain’s ability to rewire and reshape itself.

Then we’ll have a section with the chat box where you guys can type in any questions you may have about the online programs and resources or mindfulness training, as well as any other questions about mindfulness, vertigo or tinnitus. I won’t be checking the chat box until the end of the session, and I will go through some of the resources that are available for those who are interested in really diving in further and understanding your inner world and how mindfulness tools can help you and help your clients or your friends and family really move forwards from strength to strength.

Just to recap on yesterday, mindfulness is really defined by these three things, being purposeful, open, or another word for this is being curious, and nonjudgmental. There’s a lot of skills involved around using these concepts and a lot of the skills involve cultivating curiosity. And it’s things like stopping and going, “Oh, this is interesting. I’m noticing spinning and tilting and this is interesting, yesterday it was a bit left, and now today it’s a bit right and I’m just really curious about that.”

So there’s this very gentle and kind witness and observation, even in the middle of potentially very difficult and uncomfortable situations. Mindfulness is very relevant for everyday of our lives. It’s certainly not about sitting on a mountain top and meditating.

So within mindfulness, we really go into the feeling body, and I really love the way we go right into self-compassion and compassion for all beings and loving kindness. The science is showing that that is having really beneficial affects on our emotional brain. And it makes sense, ’cause it’s this idea that neurons that fire together, wire together. If on a daily basis, we’re going in towards feelings of self-kindness and acts of self-kindness, then those pathways in our body, in our emotional body actually become more rich and more engaged. And that is partially how we’re gonna start looking through this science behind the meditation.

Neurons that fire together, wire together. In order to practice mindfulness, there are a few things you really do need, and I would say number one is willingness, because it does take purposeful focus. If you’re distracted or waiting for somebody else to come in and fix your problems or waiting for a miracle and it’s this idea of “My solution’s out there.” Well, you’re possibly just not quite yet ripe to jump into the mindfulness stuff, because it does involve a lot of inner motivation, connection, and willingness.

And that’s where on a therapy side of things, I’m gonna help people keep remembering why we’re doing this, why are we coming back to the body, why am I coming back to my vertigo and tinnitus and offering kindness to those feelings and frustration? And the why is because we need to rewire and we’ll talk more about that.

Mindfulness can be done in every breath and it can be done in a way we observe our touch or any of our senses, whether it be sound, thoughts, emotions, anything at all. So mindfulness is something we can use every day of our lives. And I know it’s really genuinely helped me through many difficult times, including my own experiences of severe vertigo and very loud and distressing tinnitus. I personally feel really blessed that I’ve had these skills from the age of 15.

Some of you will be able to relate to this picture and it’s that feeling that we’ve got this vertigo and feeling not quite right, and tinnitus is raging in our heads or in our one ear or the other ear, and it just gets us down. It’s like, “I can’t concentrate, I can’t be the mother I want to be, I can’t work as well as I would like to. I can’t even do basic household tasks. This is wearing me down.”

And so there’s this pattern or this cycle of sometimes feeling confused, isolated, hopeless, helpless, and I suppose it can sometimes feel like we could give up or become despondent. And especially if you’ve been to multiple doctors, whether it be neurologists, ear, nose and throat surgeons, GPs, psychiatrists, and then allied health professionals like psychologists, physiotherapists, audiologists, and then you might’ve also done naturopathy and acupuncture and Chinese medicine.

I have seen patients who have literally done the rounds and they’re exhausted, they’re really exhausted. This is sometimes where we’re coming from, and this is where the mindfulness practice is going to start, in this place of going, “Wow. How did I get here? How can I still feel this way? I thought it would’ve gone by now. People said it would go.” Or “People say I need to live with it. I can’t live with it.” And the mindful comes in. “Oh, I’m noticing thoughts, I can’t live with this.” It’s okay you feel that way, you deserve to feel this way. It has been a really tough few years.

And so the voice comes in that sort of normalizes and validates that you don’t need to put on a brave face anymore, you can really be authentic with what’s happening in your inner world. And then there’s moments like this where it’s like, “Just get me out of here! I don’t want to live in my body. There’s this sound and I want to escape it and I can’t escape it.” And it’s this idea that we actually, at these moments, don’t even like our own body. So it’s like we’re in conflict with ourselves.

That is obviously not the greatest feeling and not the greatest way to approach our day-to-day life. So this frustrated feeling of the symptoms inside our body, whether they be vertigo, dizziness, tinnitus or even chronic pain, the mindfulness actually helps us to drop in and say, “Okay. I am super frustrated right now. I’m not gonna lie. I’m noticing frustration, I’m noticing it’s here. It’s in my shoulders. I’m noticing the frustration is actually tensing my shoulders and I’m noticing the frustration is making me short with my family and it’s making me distance myself. And I’m noticing all of this and I’m thinking, ‘Hang on, where do I want to be and what sort of person am I? Do I want to keep distancing myself? Do I want to start asking for support? Do I want to start reaching out for new strategies and new ways to make me feel more relief?'”

And the mindfulness helps us troubleshoot with that clear thinking space that’s beside the frustration instead of caged inside of it, like this. Let’s have a go together. Why don’t we all close our eyes and, of course, only if you feel comfortable, and certainly not if you’re driving. So close your eyes and just let the breath move absolutely freely through your body. So there’s no need to start to deepen or slow your breath, just let your breath move normally.

And see if you begin to notice that you’ll have a particular rhythm in your breath, and if you’d like to, you can put your hands on your ribs or near your belly button. And you’ll notice that there’s a little ebb and flow of your belly as you do normal breathing. And just see if you can notice the shape of your body as you breathe, and there’s no judgment. There’s no right or wrong, it just is what it is and we’re all just noticing. So see if you can bring your mind and your brain to really notice your particular rhythm and your particular shape of breath …

And you’ll notice that the longer you keep your mind focused on the shape of your body and the shape of your belly and the shape of your breath as it moves, you’ll notice the more details you get. If you want to keep your eyes closed and keep listening, you’re absolutely welcome. And if you want to bring your eyes back open and follow the PowerPoints, you’re welcome to do that, too.

But you’ll notice when we breathe, there’s all these myriad types of movements the body can do, whether it’s side to side or front to back, or even a vertical shape breath. And it’s changing all the time, so the breath itself is very intelligent and will constantly be adapting for our environment. And some of you may notice that when you stop to look at the breath, suddenly you go, “Oh, oh, oh,” and it sort of goes rugged and sharp and then you think, “Oh, how should I be breathing?” And that’s the mind coming in to sort of micromanage.

And so that’s not ideal, but it does happen when learning and getting comfortable with the breath. So mindfulness starts to bring in all this mind, body conversation, where the body sometimes has to say to the mind, “You know what, you can stay out of this, ’cause I’ve got it covered. Breathing’s my thing. So mind, you don’t need to come in and boss me around.”

And it’s those little moments and little explorations within ourself that actually help us really learn what’s really going on up in our mind, what’s going on in my body, and how can I distinguish between the two? Because sometimes that can be very limiting and confusing. With mindfulness, we can choose with purpose what we focus on. Doesn’t need to be the breath, but it’s one thing we can use as a practice.

And as you’ll see later on in an article that was done on what we call pranayama, or yoga breathing, they’re looking at the mechanisms, so the science behind how the breath modulates our stress response. When we do certain breathing, we can actually make our stress levels higher, and when we do other relaxed and restful breathing, we can bring our stress levels right down and help our body move into repair. The breath can be really useful on many levels.

This is a photo of me jumping obviously for a photographer, and I put this up because it’s like, well, we can’t always have these moments and we can’t always have these days. But when we do have them, it’s really important that we can feel them. As I was saying before, sometimes our mind space can be really going through streams of, “I can’t do this if I can’t hear anything because of my tinnitus and I can’t talk to people, and I can’t concentrate and I can’t sleep and I can’t work properly. I can’t earn enough money. I can’t bend down and pick up my kids, I’m too dizzy. I feel nauseous, I’m gonna vomit.”

The mind every minute is just got all these thoughts that it’s generating, and they’re automatic. You don’t have to feel any shame or guilt about thoughts, ’cause essentially, they’re on autopilot. And the body will be giving us completely different signals. The mindfulness strategies can help us sometimes to say, “Hey, right now, I’m actually feeling a lot of love and compassion and gratitude for my family, or for the job that I have. Or for that beautiful blue sky.” And it’s this feeling of stopping to truly savor that reality.

And not this, they call it psychological smog, actually in acceptance commitment therapy with Ross Harris. And it’s this idea that our mind can sometimes actually bog us down with these heavy thoughts that are not necessarily really related to the current moment. So that means our head space can be futuristic or catastrophizing, but our body will always be in the present. And that’s really important to practice distinguishing.

In fact, somebody asked yesterday about a client who was afraid to drive in case the dizziness got worse. And you have to get really real and safe when it comes to driving, and so that client’s going to have to really learn how to feel into his safety signs. When does he feel and know he’s genuinely road worthy? And how can he contrast that to feeling slightly, moderately dizzy, and then really dangerously dizzy.

So dropping into the body for both the good feelings as well as the safety signals and the more uncomfortable feelings. Learning to identify them and see them clearly is really key to our recovery, ’cause it can help us move forwards and thrive. So for those of you who really like reading, this is a snapshot of my website. There’s loads of articles you can check out, and I thought I’d just show you where to find them on the website. So it’s in the main menu and it looks like this.

Here’s one article, which is talking about how chronic stress, so this is this type of mind frame, “I can’t, I can’t. I should be better. I shouldn’t be like this. Why’s everybody else like this? I’m living in uncertainty and it’s eating me.” So it’s these cycles of chronic stress can actually lead to inhibition of brain plasticity. Neuroplasticity or brain plasticity is when the neurons in our brain meet together and they start to form new connections.

As we discussed in yesterday’s webinar, the brain is receiving information from our emotional centers, from our balance and our hearing, from our eyes, and from our whole body. If the brain is unable to effectively manage that information, it finds it can’t rewire and it gets chaotic. And clients will often say, “I feel like there’s a cloud in my brain.” Or, “I feel out of body. I feel like this is not my body anymore.”

And it’s this idea that they can’t quite rewire and reconnect. The mindfulness is not necessarily going to stop all of the stresses of daily life, realistically. The mindfulness will help us notice them, sit beside them, and transition them into feelings that we need at the time. So we can transition from the chaos and catastrophe into the calm and the kindness and the support. And that is a process we can repeat as many times as we need every day.

This diagram is essentially talking about the emotional system or the limbic system, and over here we’ve got the vestibular nuclei which we study a lot as vestibular audiologists, and this is the part of our brain that is filtering and using information coming from our touch senses, our vision, and our balance organs, or vestibular efferents.

When we’re healthy, that information comes in, the brain recognizes it, it uses what it needs, and it throws away what it doesn’t need. And when we’re going through a space of migraine or we’re recovering from an inner ear trauma, whether that be a labyrinthitis or Meniere’s, or even [inaudible 00:20:27], it means that the brain is actually getting extra wonky rubbish information and it can get temporarily confused, because it’s like, “Oh, this doesn’t make sense anymore.”

And that’s when we get vertigo. So it’s this situation where the brain is capturing random information and it’s trying to glue it together to make sense. We spoke about avoidance behaviors and how when we feel the dizziness, sometimes we want to isolate ourselves and not do certain things. And then by avoiding those activities, we’re not allowing the brain to gel and to rewire.

And then with tinnitus … Excuse me. We notice that … It’s almost like the brain is so clever, it has these categories and places to put things. So down here we got some of the stress reactors and these stress responses are traveling through our body. As we’re experiencing things like maybe a stressful incident of tinnitus or dizziness, the brain and body are then going into a stress reaction, which could mean we tense the muscles in even our shoulders, our stomach, our legs. And we can stop digesting food, because the body decides, “Well, this is a high threat time and I’m not sure what’s going on, but just in case I have to run away, I’m going to put all of my blood flow into my muscles. I’m gonna stop digesting. I’m gonna stop healing, repairing. I’m not going to tend to those skin cells or those arthritic joints. I’m going to focus on staying safe and getting away.”

So we have very natural protective stress mechanisms, which are designed to keep us away from danger. If they’re chronically active, then we have the problems, because our repair system is basically muted. With the tinnitus, if the tinnitus is perceived as a threat, and for some people, they may have been given a really big fright with the onset of their tinnitus. So it’s associated with a trauma. Or maybe they were given information that made them feel like it was a sign of damage or dying or who knows, but their body or their subconscious has decided that the tinnitus noise is a threat and it’s dangerous.

The brain is so clever that what it will do is actually make the tinnitus louder, so that it can always be monitoring it and on high alert to it, because if it’s a threat, it wants to know all about it. It wants to study it, analyze it, and keep it as a very high priority in the brain activity. And then if you think about other sounds, like the whirring of a fridge or even distant traffic noise or maybe somebody’s talking to you and you’re not really interested. They’re talking about accounting or something that has nothing to do with you, the brain will notice that that’s useless and not interesting and actually turn that down.

In the therapy and using the mindfulness skills, we’re actually trying to get the brain and the body to register, so it’s not necessarily conscious what you’re talking, but what you’re feeling. We need to body to recognize the tinnitus as being not a threat, because it’s not a lion chasing us, it’s not going to hurt us and it’s not even going to affect our hearing. Tinnitus itself is very safe.

So we need to get the brain to relocate it with its neuroplasticity and shift into that useless section where it goes, “Well, the tinnitus is not actually going to hurt me or give me useful information, so I’ll turn the volume down.” And that process is a neuroplastic process. And it’s very difficult to do when we’re under stress.

That was really just to remind you of how the ears, the body, the eyes, and the brain are all working together as a team, and so we really need these networks to be working efficiently to help our recovery. So to thrive within uncertainly, we spoke about this yesterday in the first webinar, is we need to really understand our boundaries and what safety feels for us. So I used the example of trying surfing again after taking, I think, 12 years off, and I was terrified and there were times when I would maybe just go in for 10 minutes and just paddle a little bit.

I wouldn’t even attempt catching a wave. It was just about easing myself in to the process, so that I could get my head around it without feeling overwhelmed. I think the other key to thriving within uncertainly, apart from understanding your own boundaries, is having someone to support you through it. So with the surfing example, I actually got my cousin who’s excellent, he’s an artist and surfer, to offer me coaching tips so that I could actually stay safe and read the water and read the currents, and feel that while I was vulnerable, I was capable of looking after myself and nurturing myself.

And this is really what we’re trying to do in our daily life, so it’s beyond the vestibular exercises, it’s really, “How do I be the person that I want to be knowing that I got these symptoms?” Whether it’s vertigo or tinnitus. How do I take them, hold them very gently and say, “You know what, it’s really important to me that I spend time in my garden, and I’ve been terrified of bending over and weeding the garden, and I think I’m gonna get support. And I’m gonna take that vulnerability of dizziness with me, and I’m gonna really gently start just sitting near the garden, and then maybe just picking the odd weed here and there. And little by little, taking that vulnerability, holding it dear, offering it kindness and just taking very little steps.”

And there is never any rush. So coming back to this wonderful picture of the brain, that was just to remind us that the limbic system, emotional shock trauma system, is right within the middle of the brain. So there have been science researchers looking at MRIs and functional MRIs, so I just wanted to explain for those of you who weren’t sure of what that meant, it’s a scan. It’s a magnetic resonance imaging scan that can look at the activity of the brain.

For example, if you’re watching … Or let’s say, reading a book, and you go into the MRI scan, then the visual part will light up really brightly, showing that that part of the brain is very active while you’re reading and doing a visual task. And then if you’re listening to music, the hearing section will activate very brightly.

They’ve done these MRI scans and they’ve done them while people are meditating and they’re learning at what’s happening in the meditation brain, and they’re doing all sorts of exciting experiments. So this part in the middle is the emotional coping, emotional resilience brain. And so they are finding changes, physical changes to the shape in this part of the brain for people who are doing mindfulness in an eight week course.

Some of the researches have shown reduced inflammation, this is after practicing mindfulness. I’m pretty sure they’re all in eight week courses, but we’ll get into the details after. But with practicing mindfulness, so bringing this compassion and kindness into life, they’re seeing reduced inflammation compared to non-meditators or non-mindfulness practitioners, reduced feelings of loneliness, better emotional regulation, improved decision making and ability to concentrate. And I notice in my clients, when they are practicing a lot of those breath exercises and body scan exercises, that they’re able to better center themselves and think clearly.

And also, I’ve seen a lot of improved sleep, body awareness. So these are people that are very afraid of where their body is in space, there’s a lot of resistance and fear in the daily body language, and that really drops away and they become more comfortable in their body.

And then, of course, we see a lot of this vestibular improvements. So improved stability, increased confidence, and improved perception of symptoms. Even some clients come in for vertigo, but then they leave saying, “Hey. My chronic pain feels better.” So actually the whole perception of the body shifts, it really softens as we stop fighting and trying to run away from those feelings. And we stop and we go, “Oh, that’s interesting. My stomach feels quite nauseous at the moment. I wonder how long that will last?” So this is real openness and possibility, this whole mind frame can change from rigid, which rigid tends to lead to more stress-like patterns, and we’re shifting on a daily basis into open minded possibility and this recovery mindset.

And so my favorite part of all of this is watching people develop the ability to self-soothe. You know that they’re going to be okay, ’cause suddenly they realize, “I can get myself through this. I don’t rely on anybody else or anything else. I know what I need and I can make sure that I’ve got that.”

Pranayama is yoga breathing and we think of yoga breathing, really, as very smooth and steady breathing. When it gets fancy and advanced, it can be quite controlled and contrived, but in the beginning, most people will practice quite natural, steady, smooth, regular breathing. There’s absolutely no forcing and there’s no real power. It’s like you’re receiving the breath.

What that does is it helps to relax these certain stretch receptors around our breathing organs, and it helps to trigger the repair system, or the parasympathetic nervous system in our body. And that is the system we were speaking about earlier that helps us repair. If we have vestibular damage or tinnitus and hearing damage, there will be an element of repair within our hearing organs and the pathways to the hearing and balance areas of the brain.

And those repair processes will require this parasympathetic nervous system. This is when we’re no longer running away from the lion and tensing and getting all the muscular blood flow or the heart pounding and the closed throat and the dry mouth, that’s all in distress mode, sympathetic. When we move into the breath and the regular, steady breath, it’s like the body realizes, “Okay, there’s no lion chasing me. I can just go back to my repair jobs and maintenance as usual.”

This was a really interesting article looking at those mechanisms behind the scenes. I’ve actually got this book on my lap here, and it’s quite a big book, and it is a good one if you’re interested in this stuff. Jon Kabat-Zinn and ‘The Mindfulness Based Stress Reduction’ is worth reading about. And he’s done a lot of research, so he’s a really good character in this mindfulness work.

So just in a nutshell to help you learn a little bit about how they’re researching. So in Harvard University and the Massachusetts General Hospital, that FMRI is the functional MRI I was talking about earlier, that showed thickening regions in the brain and these are areas associated with learning, so taking on new things; with memory, and with emotional regulation.

If you remember the picture of the brain, they were looking at changes to the brain from doing these eight week mindfulness courses. What they did in a lot of these were before and after tests. So you might have a group of mindfulness participants doing it for eight weeks and they will either assess them beforehand and then afterwards and they’ll compare them to the non-meditators.

These other ones are really funny, the University of Wisconsin collaboration is really creative. The volunteers actually had artificial blisters created somewhere on their body and then they had to do some really technical presentation to a panel of experts. So it was deliberately stressful public speaking event, and they had non-mindfulness practitioners compared to mindfulness practitioners.

And the mindfulness people had blister reductions, so their body was able to reduce the inflammation much better compared to the participants that did not have these skills. So they’re really looking here at emotional resilience and being able to calm the stress response and keep the body in that maintenance mode.

So the repair functions are more fruitful. And then the other one was looking at anxiety being handles better and that was looking at having the activity of the brain followed, so they were looking at the electrical type activity happening in the prefrontal cortex. And they also with that same study, they gave the participants a flu shot and they noticed that the mindfulness practitioners had a stronger antibody response compared to the non-mindfulness practitioners.

And that was after their eight week course. So it’s really encouraging to know that while it is a practice, and we have to do it, they’re actually being able to document and see changes really quite quickly. It’s not like you need to sit on a mountain for 10 years. And then the last one was looking at reduced loneliness, and again, looking at blood samples and inflammation markers related to immune blood samples.

This is a really great study that pricked my interest, and so psychoneuroimmunology, or PNI, is looking at our immune system, the brain, the nervous system. And it’s looking at the interaction between them all. So we’ve got the flight, fight, freeze system, which we spoke about; sympathetic nervous system. And that’s communicating with our brain and our brain’s communicating with our immune system.

So we’re very much in the fight, flight, and freeze mode. The brain, the immune system, and the nervous system are basically letting everybody know, “Now is not a good time to repair and now is not a good time to digest food.” When we’re in the chronic stress mode, we’re repairing our body and report digestion. So report uptaking nutrients. And that’s why we are seeing some irritable bowel syndrome and things like this where the body’s unable to digest sufficiently.

And then on the other side, when we’re cool, calm, and collected, the nervous system is in the parasympathetic mode, and that’s communicating with the brain and that’s communicating with the immune system and it’s letting the immune system know that now is a good time to be in repair and maintenance.

They did this little test on people with a skin disease, and similar to vestibular conditions, the skin condition was exacerbated by stress and fatigue and it was of an unknown cause and it was very vague. They didn’t have much specific treatments for it, so it was all like we’re guessing and people are just trying random things. It was a little bit of a similar situation to some of our chronic vestibular clients.

But what they did was put them in this UV light cubicles, and the mindfulness participants were listening to meditation audios and visualizing their skin healing. So they’re in the light cubicle and they’re bringing their focus, their purposefulness and their kindness into their skin. So their mind and their body are connected and focused on that job of repair.

Now those participants healed four times faster than the participants who had no mindfulness skills or training. And if you think about it, if you’ve got this skin disease and you’re naked in a UV light cubicle, I mean, I think if that was me, I would be like, “Why am I like this? I don’t want to be here. Nobody else has to be in this stupid cubicle.” And so my mind would be running away potentially, just being frustrated with it all.

I can understand how by bringing the mindfulness in and really honing in on this psychoneuroimmunology, it would improve the healing. And this is exactly what I see with my tinnitus and vestibular clients when we go through these mindfulness processes of visualizing our repair pathways.

We don’t want to feel like this too often. A little bit is natural and fine, but once we had these feelings, the key is not to deny them, ignore them, or try and distract. Like, “Oh, I don’t want to feel like that. I’ll just go eat chocolate.” I think the key is really to acknowledge it’s there. It’s like, “Wow, I am experiencing frustration. And I’m just gonna take a few breaths and I’m gonna notice how long it lasts and then I’m gonna go and do something meaningful. Something meaningful to me.” We’re really stepping back into this inner world.

And that brings us back to thriving. I spoke a little bit in the first webinar about what thriving meant for me, and I said, “I’m really interested in what thriving means for you.” Because we’re all different and all of my clients are different and that’s the beauty, I suppose, of being humans. But in order to move beyond our symptoms and move beyond that place of, “I’m a dizzy person. I live with Meniere’s,” “I live with dizziness,” “I live with migraines.” Or “I have tinnitus.” It’s like it’s really becoming almost that label that weighs us down.

I think we need to have those symptoms beside us and hold them with that tenderness that not necessarily own them, so we can have our thriving goals ahead of us and can know where we’re moving. So this is really an essential part of our therapy and of our recovery. So we’re taking our tender symptoms, whatever they are, and we’re really supporting ourselves and getting support and getting skills to be able to gently soften in, stay in the parasympathetic repair system, and really journey our way through that neuroplastic process of connecting.

I ask you all, in your life at the moment, how do you, or you and your clients, break that cycle of chronic stress and stay supported? I think it is important to stop and think about this and think, “Well, what are my strategies and what are my tools?” ‘Cause I’m sure you all have many of different strategies in place, and it’s really important that we don’t ignore, deny, or just push it aside. The chronic stress stuff, I think is quite relevant, and we need really concrete tools.

When I do rehab, it’s really about getting clients into the vestibular and tinnitus side of their treatment and rehab and combining that with the purposefulness and the curiosity and the kindness that the mindfulness skills offer us. So perhaps, why don’t we all just pause for a moment and we’ll close the eyes and we can drop back into the body and see how we’re all feeling in the moment. So let’s get a snapshot of our inner world.

So, close your eyes and just take a moment … take a moment to feel your body at the moment, and some of you might actually be feeling a little bit of the chronic stress cycle at the moment and there could be very good reason for that. ‘Cause there are times in our lives when the chronic stress is a little bit higher than others, and the first step to addressing it is just to pause, stop, and feel into it and have that honest reflection of, “Oh, actually, I am feeling a little bit disjointed and tense at the moment and I’m not necessarily sure why, but I can feel it’s there.” And that’s okay, you’re allowed to have stress.

It’s the process of going in and feeling whatever’s real for you, that is part of the healing and recovery. So see if you can notice what you’re feeling and let your brain travel all the way back down to the feet like we did last webinar, and see if your brain can really just focus in on maybe the tops of the feet today. If you’re wearing socks or shoes, see if you can feel that top part of the foot contacting something, whether it be socks, shoes or the couch or the floor, depending on how you’re sitting.

And just notice that the longer you spend focusing feeling the body, often the more information you’ll get. And if it’s really tricky for you to feel anything on the top of your feet tonight because you’re new to this, try the bottom of your feet. See if you can press the feet into the floor and feel that instead.

And as we travel into the body and become very purposeful, we’re still creating that curiosity of maybe I can’t feel my feet at all. Well, that’s interesting, and that’s okay too. As you spend a little bit of time right now in your inner world, see if you can just take a few breaths and bring your mind now back into how you’re feeling. So the feeling and emotional body and part of yourself. And be quite purposeful and see if you can really hone in on what you’re feeling at the moment.

And whatever’s real for you is perfect. Doesn’t need to be a good, neutral, bad, doesn’t matter. Whatever you feel is just how it is for you right now and that’s okay. And see if you can think of a way to show yourselves some self-kindness, and that’ll be really different to each and every one of us tuned into this webinar. So just see how you’re feeling at the moment. You might be feeling calm, you might be feeling intrigued, you might be feeling absolute despair and desperation, frustration. Just see if you can offer some kindness to whatever emotion you’re feeling at the moment, in your own ways. So it’s this self-dialogue. What would I say to myself to be kind right now?

And once you’ve done that, enjoy that feeling. Notice sometimes we want to run away from ourselves, but really stay there and go, “Yeah, it’s okay you feel this way.” And just let yourself linger in that space of self-support. So when you’re ready, you can bring your eyes back to the webinar, if you choose.

The mindfulness really covers all of us, because it’s enabling us to feel into the body, it’s enabling us to learn more about our symptoms, it’s enabling us to feel our breath, our thoughts, our emotional feelings, and it’s really getting us to reflect and be insightful about our deeper values and what actions we can take to keep us in that maintenance and repair mode where we’re feeling very connected. Instead of maybe actions that actually might keep us in a stress mode.

That in itself can be a whole therapeutic journey of trial and error. So what actions keep me in this stress and not repairing mode, and what actions are helping me navigate my repair and maintenance, to be efficient and connected? So proprioception is something that we use for our balance system, but also we use it a lot in mindfulness practice, especially if any of you have done [inaudible 00:46:51] meditation where we body scan 10 days straight, about I think it’s 10 or 11 hours a day.

So you do 110 hours in 10 or 11 days. And that’s with no eye contact and no talking. You’re really just training your brain to feel into your sensory system over and over again. And that is actually very useful. It’s a beautiful practice and I personally really enjoy it. But from a practical point of view, if we can stop and feel where we are, and stop and feel our feet, and notice what am I touching? It grounds us into the present moment. So this purposeful openness, curiosity, here and now. Not 10 years from now and not 10 minutes ahead of now, but right now.

And that in itself can be very informative and can help us making good decisions, to think clearly, and to take those actions that let us be the person we are ready to be. And self-support, I just wanted to reiterate this again. I mentioned it yesterday, but I feel that coming into this space of knowing, “I’m prepared for my symptoms. They’re not gonna drag me down. I can support myself through a severe day. I’m planned and prepared.” And learning these skills step-by-step with guidance can certainly get us there.

I think being realistic that if we’ve had chronic symptoms and for some of you listening, you may know either yourself or somebody who’s had these symptoms ongoing for an exhaustive amount of time. To bring self-support into that situation can be a little bit challenging at first, because sometimes we’ve formed this relationship with ourself that’s sort of like, “Well body, you’ve let me down and you’re still giving me all this pain and I can’t sleep properly and I’m exhausted and frustrated, and I actually don’t like you.” So there can be quite this conflicted relationship happening between our mind and body, within ourselves.

I’m really a big fan of stepping into self-compassion and self-kindness with step-by-step guidance, and I find the audio recordings really useful for that, which I use with my one-on-one clients. Oh, which brings us to the online programs. If you’ve got questions, now’s a good time to start typing them into the chat box and I haven’t looked at them yet, but I can see there’s been a little bit of action there. So I’ll jump on and have a look at those.

Great. Cool. So just to let you know, I have a 12-week online vertigo recovery program, which I designed for my rural and remote clients. And actually, I have to thank all of my clients past, present and future, because you guys are the ones who inspired me to build this program and asked me to build this program. It really is a very gentle and step-by-step option and alternative for people who are feeling lost, confused, or isolated. Or just feeling a little frustrated and wanting to get the best out of their recovery, instead of just feeling like they’ve got to live with the symptom. Nothing will change.

It’s about being open minded and willing to practice. There’s recommend about 15 minutes of exercise a day and roughly one hour per module. So if you get one learning module a week, that would be about one hour of online learning. And then if you get it each two weeks, it would be an hour each two weeks. But there’s loads of audios on self-compassion, self-kindness, sleep skills, and also understanding panic and anxiety.

And these are things clients can use, or you can use, if you’re having a day when you’re just feeling really burnt out and alone, and you can just hit play. So the interesting thing is, is I’ve made all these videos and audios and my local clients are using them, and they’re really loving using them, even though they can come in and see me in person. So it’s been really nice getting this use of technology.

Let’s have a look at some of these questions. “How do you explain three PD, persistent postural perceptual dizziness to your clients when they ask ‘What’s causing my dizziness?'” I am very big at not using too many labels, but I’ll often use pictures and I’ll draw the brain and I’ll draw the ears and the eyes and the body, and I’ll say things like, “Our brain is extremely clever and it has a filter system and it’s designed to capture all the information that is very meaningful and necessary. If we’re on a boat, we’re capturing all the signals we need to walk on the deck and to keep our vision stable and it’s different to the information we need when we’re walking normally on concrete. So the brain is adapting very cleverly.”

And with these clients I’ll often say, “It seems to me that something in the filter system in your balance brain is making errors, which means it’s not quite capturing the right or the effective information. So you’re actually feeling like this wobbly dobby loose feelings all the time.” And I really let them know that with time and practice and this self-compassion work, the brain will actually reset, in the same way as when you have to restart a computer or restart an iPhone, and it will actually become good again.

It takes willingness, it takes trust in the body, and I think neuro education helps a lot. So I hope that answered your question. “When the vertigo starts, there is no way I could sit in the garden as the world is spinning. I feel like I’m in a vortex.” Great question. When vertigo comes and goes, it tends to be intermittent, which means it’s not like a spin, spin … and I’m just explaining this for those who haven’t experienced vertigo.

So it tends to be spin, spin, spin for a period of time and most commonly, that’s less than minute. So we’re talking seconds, and in some conditions, it can be longer than 20 minutes or even up to a few hours. But then there’ll be moments when it stops, the spin, spin, spin, and it eases off and either you have a day of feeling very drunken and hungover and you’re in full on repair mode, or it stops and you go back to relatively normal.

These vulnerable feelings, we have to really listen to them because it would be ridiculous and not safe when you’re in the middle of a spinning active episode to do anything that’s a challenge, whether that be driving a car or walking to the garden or surfing. When I have vertigo, when I’ve experienced it, I’m not gonna go surfing. So you pick your moments and there’s always a start and a stop.

So the spinning sensations will have an on and an off, and when you’re actively spinning, it’s best that you stay very still and that’s when some of my clients would listen to supportive audios, so they’re actually supported and they’re listening in to that healing and repair process. And then once that’s finished, you just gently go back to your life.

I would choose your moments to challenge yourself, and that’s where having support and having a sounding board I think is really important, because you can aggravate your symptoms, absolutely. So I hope that answered your question. Great. And does anybody else have another message on the chat box? Otherwise I’ll move to some email questions.

Great. One of the other email questions I had was, “Who is the online program suitable for?” And I think it’s a good question, and I think if you are wanting to learn more about your body and you are wanting to learn more about self-compassion and mindfulness in a very practical context, this program is for you. It’s to help people feel community, feel belonging, feel supported and feel proactive.

I’ve got a few people over the age of 60 who have used it and I’ve got younger people who are in their 20s using it. So I don’t think age is much of an issue. But you would need access to streaming videos, audios, and email content. [inaudible 00:55:59]. Yeah, that’s a really good question, Paul. I probably will build one eventually. So the question is, “Are there specific modules for tinnitus sufferers without vertigo?”

My tinnitus clients, I do tend to do some one-on-one work with, because tinnitus is a very personal experience, but all of the modules in the 12 week program go through techniques and strategies that will benefit people with tinnitus. Because it’s all about the focus and the purposefulness and the values. You’ll get the benefits, and I would probably consider doing some one-on-one work if you feel you wanted extra guidance specifically for the tinnitus. So I hope that answered your question. Great.

I’m just gonna jump through. I really want you to … I’m very glad you’ve all been on the webinar and it’s been so lovely to connect with different people from different continents, and I’m very passionate about mindfulness for vertigo and tinnitus, because in my career I have seen thousands of people who are so confused and so lost and they’ve been ping pong balling around various professionals, and they still feel so unsafe in their bodies.

I’m quite passionate about helping patients really thrive and really feel at home in their bodies, because I’ve seen it time and time again. I’ve seen clients with 30 years of symptoms and on strong medication with migraines on a 10 day cycle. I’ve seen them completely off medication and back into a relatively … Well, very normal sensory system. So their whole body, once they started doing this work, completely rewired.

And I must say, I was shocked. That was not our intention. So mindfulness is never about, “Let’s get rid of symptoms. Let’s be perfect.” It’s about, “Let’s use what we can to very gently nurture and hold these sensations, and as I’m ready, move forwards.” And in the process, often the symptoms vastly reduce or disappear altogether.