现在该如何开展心理健康训练
《心理韧性》现在该如何开展心理健康训练,页面无弹窗的全文阅读!
MMFT的首次练习可以培养我们产生对身体和周围环境之间的接触意识。
请找一个舒适的地方坐下，最好坐在椅子上，让你的背部朝向坚实的墙壁，而非门、窗或开放的空间。你也可以闭上眼睛，如果你觉得这么做舒服的话。如果这样让你感觉不适，那么你也可以看着前方的地面。让你的脊椎保持挺直而放松。要想做到这个姿势，有时最简单的方法就是让臀部紧贴椅子，耸肩，把肩关节向上靠近耳朵，然后放下肩膀，将手放在膝盖上。
让自己体会被椅子和地面支撑的感觉。你的目标是感受身体中的支持感，而不是对这种支持感进行思考或分析。请留意大腿背侧和臀部与椅子的接触，以及脚底与地面的接触。如果你无法感觉自己的脚，你可以轻轻活动自己的脚趾或是用脚踩一踩地面。
当你注意到这种来自周围环境的支持时，请快速扫描自己的身体，看看是否有什么地方保持着紧张的状态。特别留意你的眉毛、下巴、颈项和肩膀等部位。不要试图专门做些什么，请看看将注意力转移到这些部位是否可以改变紧张感，无论可不可以，这都没什么问题。
这时，请让注意力回到身体与周围物体的接触感上。你可能会注意到诸如挤压、冷热、软硬、刺痛、麻木、出汗或潮湿的感觉。请留意以下3种不同部位的感觉：腿部、臀部及下半身与椅子的接触；脚底与地面的接触；以及双手与腿部的接触或双手之间的接触。
当你体察到每一处接触点的感觉后，请选出你所注意到的接触感最为强烈的部位。现在，这个接触点就是你的关注目标。如果你发现自己并没有注意到任何感觉，那么请试着脱下鞋袜并坐在坚硬的地方，或者用双手摩挲自己的大腿。这些改变或许可以帮助你更清晰地注意到自己的感觉。
当你选择了接触点之后，请将自己的注意力转移到此处，并且保持在这里。接着细致地考察接触点的感受。例如，如果你关注的是臀部和椅子之间的接触，那么左右两侧臀部的感觉到底是相同还是不同呢？请不要过多思考，你只需要用不带评判的好奇心去注意和探寻身体上的感觉。
如果发现自己走神，那么你只需注意到这个问题，然后以温和且不加评判的态度将注意力重新转移到接触感上。你可能会经常走神，但这也没什么。只要重新开始即可。每当你将注意力重新转移到接触感上的时候，你就是在打破自己旧有的思维“峡谷”，控制自己的注意力。请将其当作你神经可塑性的一种表现。
开始时，请给自己设定一个每天至少练习5分钟的目标。随着时间的推移，在你培养自己注意力控制力的过程中，你便可以进行每天10~20分钟的接触点练习。你还可以将这个练习当作每天不同阶段之间的过渡，比如在起床、下班回家及上床睡觉时这么做。
在结束这项练习时，你可以将注意力扩展到坐在椅子上的整个身体上。请留意自己的身心系统是否在这项练习之后发生了任何变化。请带着不加评判的好奇心去思考这个问题：我的身体是更放松了还是更易激了？肌肉的紧张程度是提升了还是降低了？能量水平是高了还是低了？你变得更困了还是更清醒了？更专注了还是更容易分心了？是变得更加平静了、更加焦虑了，还是更加易怒了？你可能会发现练习后身心系统有所变化，也可能没有。无论结果如何都没关系。你的目标仅仅是注意你的身心系统当下的状态。
在前几周，我建议你坐在椅子上进行这项练习。不过你也可以站着或躺着练习。站着练习时，你可以留意脚底和地面的接触感。躺下时，你可以注意身体整个背部和你躺着的表面的接触感。你也可以躺在地板上，双脚抵墙；这个姿势对神经系统来说有很好的镇静效果，有助于静脉和淋巴引流。然而，如果你有高血压，那么这个姿势可能就不太适合你。
接触点练习之所以可以成为MMFT训练的第一项练习，原因有三。
■ 通过培养自己感受身体和周围环境（比如你所坐的椅子或你脚下的地板）之间接触的能力，你就有了可以在任何情况下聚焦注意力的对象。而我们的身体总是会接触到什么的！
■ 在注意到自己走神的时候不加评判地选择将注意力移回接触感之上，这种做法可以让你加强对注意力的控制。
■ 在将注意力转移到接触感上的时候，你会把注意力都集中在中性的刺激上，而这会向生存脑和神经系统传达一种你现在是踏实的、稳定的且很安全的信息。反过来，这也创造了一种最有利于你的生存脑感知安全，继而减缓应激唤醒反应的条件。如果你已经超出了自己的应激临界点，那么这种练习可以帮助你的身心系统回归耐受窗，同时也为它的全面恢复奠定了基础。
综上所述，我们持续关注身体接触感的能力是心理健康训练的一项基本技能，我们将在后续章节继续学习。
当你的身心系统习惯了对接触点的关注时，你也可以将自己的接触点当作一块试金石，即一种以具体的方式让自己完全身处当下的途径。当你经历压力激活，陷入思维循环或发生人际交往上的冲突时，你的接触点将变得尤其有用。它们还可以帮助你终止冲动或反应性行为。
最重要的是，持续练习几周之后，你的接触点便可以成为你的生存脑的避风港。在第13章，你将需要借助这个避风港来进行下一阶段的心理健康训练。
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[3]特别是背侧前扣带皮层和前岛叶。Matthew D. Lieberman, Social: Why Our Brains Are Wired to Connect (New York: Crown, 2013), chap. 3。
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[6]Porges, The Polyagal Theory, chap. 5.
[7]M. B. Stein et al., “Increased Amygdala and Insula Activation during Emotion Processing in Anxiety-Prone Subjects,” American Journal of Psychiatry 164,no. 2 (2007): 318-327; M. P. Paulus and J. L. Stewart, “Interoception ano Drug Addiction,” Neuropharmacology 76 (2014): 342-350; K. Domschke et al.,“Interoceptive Sensitivity in Anxiety and Anxiety Disorders: An Overview and Integration of Neuro biological Findings,” Clinical Psychology Review 30, no. 1(2010): 1-11; J. A. Avery et al., “Major Depressive Disorder Is Associated with Abnormal Interoceptive Activity and Functional Connectivity in the Insula,”Biological Psychiatry 76, no. 3 (2014): 258-266; M. E Paulus and M. B. Stein,“An Insular View of Anxiety,” Biological Psychiatry 60, no. 4 (2006) 383-387;M. P. Paulus and M. B. Stein, “Interoception in Anxiety and Depression,” Brain Structure and Function 214, no. 5-6 (2010): 451-463; Davidson and Begley,The Emotional Life of Your Brain, 81; van der Kolk, “Clinical Implications of Neuroscience Research in PTSD” ; Pat Ogden, Kekuni Minton, and Clare Pain,Trauma and the Body: A Sensorimotor Approach Psychotherapy (New York:Norton, 2006), 7; Robert C. Scaer, The Trauma Spectrum: Hidden Wounds and Human Resiliency (New York: Norton, 2005), 62-64.
[8]Johnson et al., “Modifying Resilience Mechanisms in At-Risk Individuals”; L.Haase et al., “Mindfulness-Based Training Attenuates Insula Response to an Aversive Interoceptive Challenge,” Social Cognitive and Affective Neuroscience 11, no. 1 (2016): 182-190.
[9]David Gelles, “How to Meditate,” New York Times, December 25, 2016.
[10]C. Johnson et al., “Effectiveness of a School-Based Mindfulness Program for Transdiagnostic Prevention in Young Adolescents,” Behaviour Research and Therapy 81 (2016): 1-11.
[11]J. R. Lindahl et al.,“The Varieties of Contemplative Experience: A MixedMethods Study of Meditation-Related Challenges in Western Buddhists,”PLOS One 12, no. 5 (2017): e0176239; W. B. Britton, Current Opinion in Psychology 28 (2019): 159-165; P. L. Dobkin, J. A. Irving, and S. Amar,“For Whom May Participation in a Mindfulness Based Stress Reduction Program Be Contraindicated?” Mindfulness 3, no. 1 (2011): 44-50; V.Follette, K. Palm, and A. Pearson, “Mindfulness and Trauma: Implications for Treatment,” Journal of Rational-Emotive and Cognitive-Behavior Therapy 24(2006) 45-61; C. Strauss et al., “Mindfulness-Based Interventions for People Diagnosed with a Current Episode of an Anxiety or Depressive Disorder: A Meta-Analysis of Randomised Controlled Trials,” PLOS One 9, no. 4 (2014):e96110; L. C. Waelde, “Dissociation and Meditation,” Journal of Trauma and Dissociation 5, no. 2 (2004): 147-162; E. Shonin. W. van Gordon, and M. D. Griffiths, “Are There Risks Associated with Using Mindfulness in the Treatment of Psychopathology?,” Clinical Practice 11, no. 4 (2014): 398392; A. W. Hanley et al., “Mind the Gaps: Are Conclusions about Mindfulness Entirely Conclusive?,” Journal of Counseling and Development 94, no. 1(2016): 103-113；S. F. Santorelli, “Mindfulness-Based Stress Reduction(MBSR): Standards of Practice”, (Worcester, MA: UMass Medical School Center for Mindfulness in Medicine, Health Care, and Society, 2014).
[12]UMass Medical School Center for Mindfulness in Medicine Health Care, and Society, “FAQ-Stress Reduction,” umassmed.edu/cfm/stress-reduction/faqs; Santorelli, “Mindfulness-Based Stress Reduction (MBSR).”
[13]E. A. Stanley et al., “Mindfulness-Based Mind Fitness Training: A Case Study of a High-Stress Predeployment Military Cohort,” Cognitive and Behavioral Practice 18, no. 4 (2011): 566-576.
[14]Bessel A. van der Kolk, The Body Keeps the Score: Brain, Mind and Body in tbe Healing of Trauma (New York: Viking, 2014); Pat Ogden and Janina Fisher, Sensorimotor Psychotherapy: Interventions for Trauma and Attachment (New York: Norton, 2015); Payne et al., “Somatic Experiencing”;Ogden et al., Trauma and the Body.
[15]J. D. Teasdale and M. Chaskalson (Kulananda), “How Does Mindfulness:Transform Suffering? II: The Transformation of Dukkha,” Contemporary Buddhism 12, no.1 (2011): 103-112.
[16]Ogden and Fisher, Sensorimotor Psychotherapy; Peter A. Levine, Waking the Tiger: Healing Trauma (Berkeley, CA: North Atlantic, 1997); M. L. Leitch,“Somatic Experiencing Treatment with Tsunami Survivors in Thailand:Broadening the Scope of Early Intervention,” Traumatology 13, no. 3 (2007):11-20; Ogden et al., Trauma and the Body; M. L. Leitch, J. Vanslyke, and M. Allen, “Somatic Experiencing Treatment with Social Service Workers Following Hurricanes Katrina and Rita,” Social Work 54, no.1 (2009):9-18;Payne et al., “Somatic Experiencing.”
[17]你可以通过这个网站找到体感疗愈治疗师：sepractitioner.membergrove。你还可以通过这个网站找到感觉运动心理治疗师：sensorimotorpsychotherapy.org/referral.html。
[18]我们已经在针对预部署部队的研究中对MMFT八周课程的五种不同变化形式进行了测试：它们包括24小时版本、20小时版本、16小时版本，以及两个8小时版本，它们有的强调（1）课堂练习与讨论，也有的强调（2）有关压力与心理韧性的神经生物学知识。从实证结果来看，20小时版本是最佳的。
[19]A. P. Jha et al., “Examining the Protective Effects of Mindfulness Training on Working Memory Capacity and Affective Experience,” Emotion 10, no. 1(2010): 54-64; Stanley et al., “Mindfulness-Based Mind Fitness Training”;A. P. Jha et al., “Minds ‘at Attention: Mindfulness Training Curbs Attentional Lapses in Military Cohorts,” PLOS One 10, no. 2 (2015): e0116889; A. P.Jha, A. B. Morrison, S. C. Parker, and E. A. Stanley, “Practice Is Protective:Mindfulness Training Promotes Cognitive Resilience in High-Stress Cohorts,”Mindfulness 8, no. 1 (2017): 46-58; A. P. Jha et al., “Short-Form Mindfulness Training Protects against Working-Memory Degradation over High-Demand Intervals,” Journal of Cognitive Enhancement 1, no. 2 (2017): 154-171.
[20]Johnson et al., “Modifying Resilience Mechanisms in At-Risk Individuals.”事实上，参加MMFT训练的海军陆战队队员的应激反应模式与其他针对人类和哺乳动物的实证研究发现的模式相似，在这些研究中，心理韧性与应激反应的快速激活及其有效终止有关。Feder et al., “Psychobiology and Molecular Genetics of Resilience”; E. R. De Kloet, M. Joels, and F.Holsboer, “Stress and the Brain: From Adaptation to Disease,” Nature Reviews Neuroscience 6 (2005): 463-475。
[21]Johnson et al,. “Modifying Resilience Mechanisms in At-Risk Individuals.”我们可以从两个角度用神经肽浓度来衡量心理韧性水平。首先，在静息状态下，血液中较高的神经肽浓度与心理韧性有关。此外，正如参加MMFT训练的海军陆战队队员表现出的那样，这种在应激时分泌额外的神经肽，继而迅速释放它的能力正是适应性应激反应和有效恢复的标志，是心理韧性的另一个方面。有关神经肽作为心理韧性指标的更多内容，可参考J. Pernow et al. “Plasma Neuropeptide Y-Like Immunoreactivity and Catecholamines during Various Degrees of Sympathetic Activation in Man,” Clinical Psychology 6 (1986): 561-578;R. Yehuda, S. Brand, and R. Yang, “Plasma Neuropeptide-Y Concentrations in Combat Exposed Veterans; Relationship to Trauma Exposure, Recovery from PTSD, and Coping,” Biological Psychiatry 59 (2006): 660-663; C. A.Morgan et al.,“Plasma Neuropeptide-Y Concentrations in Humans Exposed to Military Survival Training,” Biological Psychiatry 47 (2000): 902-909;C. A. Morgan et al., “Relationship among Plasma Cortisol, Catecholamines,Neuropeptide-Y, and Human Performance during Exposure to Uncontrollable Stress,” Psychosomatic Medicine 63, no. 3 (2001): 412-422; C. A. Morgan et al., “Neuropeptide-Y, Cortisol, and Subjective Distress in Humans Exposed to Acute Stress: Replication and Extension of Previous Report,” Biological Psychiatry 52, no. 2 (2002): 136-142; Feder et al., “Psychobiology andMolecular Genetics of Resilience”; Z. Zhou et al., “Genetic Variation in Human NPY Expression Affects Stress Response and Emotion,” Nature 452, no. 7190 (2008): 997-1001; T. J. Sajdyk, A. Shekhar, and D. R.Gehlert, “Interactions between NPY and CRF in the Amygdala to Regulate Emotionality,” Neuropeptides 38 (2004): 225-234。
[22]S. R. Sterlace et al., “Hormone Regulation under Stress: Recent Evidence from Warfighters on the Effectiveness of Mindfulness Based Mind Fitness Training in Building Stress Resilience,” poster presentation at the Society for Neuroscience Annual Meeting, New Orleans, LA (October 2012).
[23]Elizabeth A. Stanley and John M. Schaldach, Mindfulness-Based Mind Fitness Training (MMFT) Course Manual, 2nd ed. (Alexandria, VA: Mind Fitness Training Institute, 2011), 199-209.
[24]R. Meeusen et al., “Prevention, Diagnosis and Treatment of the Overtraining Syndrome,” European Journal of Sports Science 6 (2006): 1-14.