Contents of the MBSR for RLS Program
Contents of the MBSR for RLS program
Week / Session / Content1 / Introduction to mindfulness
Participants were introduced to the group. The program aims and outlines were discussed. Each participant received a CD with guided meditation tracks:
Mindful sitting meditation-expanding awareness (15min); body scan (25 min); mindful walking meditation (7 min); mindful yoga (60 min [ 30 min laying postures and 30 min standing postures]);mindfulness of emotions and physical pain (15 min); mindfulness of the breath ( 8 min); 3 minute breathing exercise (3 min). Participants were introduced to mindfulness, the foundations of mindfulness practice and Kabat-Zinn’s seven attitudinal principles were discussed.
The raisin meditation was practiced as the first exercise to introduce participants to the practice following by a discussion of their experiences, relating them back to the attitudinal principles. A five minute breathing exercise (sitting with the breath) was also practiced. Participants were instructed to practice eating at least one snack mindfully or to mindfully complete another routine activity. They were also instructed to practice either a 3 or an 8 minute mindfulness sitting meditation (using the audio tracks as guidance) and to read chapters 1-3 of KabatZinn’s ‘Full Catastrophe Living (FCL)’.
2 / Mindful sitting meditation / expanding awareness
The session began with a review of the readings and homework tasks (mindfulness practice), and time to trouble-shoot any issues/questions.
An extension of the mindful breathing exercise and sitting with the breath (10-15 mins) was practiced. Discussion of “responding vs reacting” or “choosing to move vs compulsion to move” was explored with reference to extended sitting meditations as a way to cope with RLS symptom onset. Mindfully bringing awareness and choice into movements/urges. A second mindfulness exercise was practiced. Participant were guided through sitting with the breath and expanding awareness to the body as a whole, sitting with sound, sitting with thoughts and feelings and choiceless awareness (20 mins) following by a discussion of their experiences. As homework, participants were instructed to practice breathing meditation for 10-15 minutes daily at least 6 times during the week, using the ‘expanding awareness (15 min)’ audio track as guidance. Participants were advised that mornings may easiest to practice longer sitting meditations due to the nature of RLS symptom onset in the evenings. Reading chapters were assigned from FCL.
3 / Body scan / Walking meditation
Readings and homework task mindful practice were reviewed discussed with the group.
This session involved an introduction and practice of an inactive meditation: the body scan technique. Participants were guided through a 20 min body scan followed by a discussion of their experience. As RLS symptoms can often be brought on by long periods of inactivity, the walking meditation (20 mins) was also introduced and practiced following the body scan.
Alternate practice of the body scan, and the walking meditation (20-30 mins each) were assigned as homework (using the audio tracks) alternating between an active and inactive practice each day. Readings from FCL were also assigned.
4 / Mindful Yoga
Readings and homework task of mindful practice were reviewed. The aim of this session was to introduce mindful yoga. This included laying and standing yoga postures (45 mins). This was followed by a discussion of their experience and discussion of the benefits of cultivating strength, balance and flexibility. Participants were instructed to include mindful yoga into their mindful practice at least once (30-60 mins) per week (using the audio track as guidance). It was suggested to alternate between passive (breathing meditation / body scan) and active (yoga / walking) meditations. Chapters from FCL were also assigned.
5 / Mindfulness of emotions and physical pain / mindfulness in everyday life
Readings and home mindfulness practice was reviewed. The focus of this session was in the identification and recognition of strong emotions, and the acceptance and acknowledgement their presence. This included the physical sensations of RLS as well as the accompanying negative affectivity, cognitive and physiological arousal such as anxiety and stress. Mindfulness was discussed a stress reduction strategy and mindfulness of emotions and physical pain (10-15 mins) guided meditation was performed.
The second half of this session focused on the effects of ‘autopilot’, and mindfulness in everyday life. Formal and informal practice was discussed and a discussion of how to incorporate these into everyday routines.
Participants were instructed to incorporate informal practice into their routines as much as possible, and to continue with their choice of formal meditation (30-45 mins) for at least 6 days that week without the use of audio guidance. Chapters from FCL were assigned.
6 / Self reflection / Self management
The final session was used primarily for self-reflection and to generatean summary of the program. Participants discussed their experiences and sdhared their understanding of how mindfulness can be used to self-manage RLS and related symptoms. Participants were invited to re-experience the raisin meditation and to share their experiences, and compare this with their first experience in week 1. An action plan or relapse prevention plan was also discussed in this session where participants were encouraged to think about and write down some of their learnt coping skills and strategies to manage their RLS symptoms, and prompted to consider barriers and solutions to implementing mindfulness in their everyday lives.