Ask an Expert: Judy Zhu Discusses Mindfulness and Meditation for Parkinson’s Disease

Dr. Judy Zhu, RCC, Dr. TCM, is a clinical counsellor at Parkinson Society BC (PSBC). For over a decade, she has used a holistic approach to help her clients with anxiety, depression, stress disorders, past trauma, and chronic health issues get on a path of physical and emotional wellbeing. As a counsellor, Judy uses mindfulness-based therapies, along with Buddhist philosophy.

What is mindfulness, and how is it practiced?

The word “mindfulness” is the translation of the term “Sati” from an ancient language, Pali. It refers to awareness of the present moment, experienced with the attitude of acceptance and kindness.

Mindfulness practice has been an important part of Buddhist meditation. However, because it benefits many aspects of wellbeing, it has been widely used not only in the field of medicine and psychotherapy, but also in the workplace, in schools, in athlete training, and even in parenting. To put it simply, mindfulness means paying attention to what is happening in the moment, without judging or identifying with the experience. It can be practiced informally in your daily life, like when you eat, drink, fold laundry, wash dishes, or listen to music. You can also have a formal practice, which involves devoting 30-60 minutes a day to mindfulness. Those who have practiced mindfulness for a while, and want to deepen their experience, can look into participating in a meditation retreat that lasts from a weekend to two weeks or more.

How can mindfulness help people with Parkinson’s?

There are many benefits to practicing mindfulness. Research has shown that it can activate brain circuits associated with feeling happy, and lead one to engage in life with greater enthusiasm. It can also improve one’s attention span. The long-term practice of mindfulness can increase grey matter density (GMD) to prevent aging and illness in the brain.

Some may find mindfulness practice helps regulate emotions, and reduce anxiety and the effects of stress on the body. Ongoing practice helps to cultivate empathy, love, and kindness; therefore, it can improve our sense of emotional wellbeing, as well as the quality of intimate relationships and connectedness in the community. The acceptance aspect of mindfulness allows one to better cope with aging and illness. In short, the practice enables us to live a life with more ease and fulfillment.

Mindfulness practice can have positive effects on cognitive and motor function in people living with Parkinson’s disease (PD). The loss of grey matter density is associated with motor and cognitive symptoms in PD. A study by Pickut et al. (2013) showed that increased GMD was found in a mindfulness-based Intervention group, in the neural networks that play an important role in PD. Another study by Dissanayaka et al. (2016) indicated that mindfulness intervention tailored for PD was associated with reduced anxiety and depression, as well as improved cognitive and motor function. Further, another study by Pickut et al. (2015) also indicated that mindfulness training may help to restore some degree of self-determination in the experience of living with PD.

How can people with PD and their caregivers incorporate mindfulness in their everyday lives?

There are many different mindfulness techniques that one can incorporate in their everyday lives, such as breathing practice, body scans, listening practice, mindful walking, mindful eating, and loving-kindness practice. I would suggest people start with the breath practice which is basic, but very helpful.

As long as we are alive, our breath is always with us. It is a wonderful reminder of the present moment because we all have to inhale and exhale. No matter what kind of rush we are in, we have to take one breath in and one breath out. Any moment we notice ourselves getting caught in worrying thoughts, or feeling stressed, we can simply take a breath and bring our attention to following the process of breathing in and breathing out. As you are doing this, remind yourself that no matter what distress you feel, in this moment, you have this breath with you and you have this life with you. Please bring a sense of gratitude towards this breath that we often take for granted.

How do you prescribe mindfulness to your counselling clients?

In order to be an effective therapist, I strive to be present for my clients. To do this, I practice being mindful and having an attitude of acceptance and kindness.

Through mindfulness, I hope to create an environment that is conducive for clients to be accepting of their experience during the session. I use the principle with every client, which can manifest in many different ways. For example, if I notice that a client seems distressed when talking about their frustrations and struggles, and they seem caught in the stress of daily life, I may simply ask them to take a deep breath, to bring them back to the present moment. For some clients, I may also guide them to do one or two short, 3-5 minute mindfulness practices during our sessions together. I decide when and how much mindfulness to use depending on the issues each client struggles with, and how receptive they are to this type of therapy.

How does mindfulness differ from cognitive behavioural therapy?

Cognitive behavioural therapy (CBT) is a very popular therapeutic approach. The biggest difference between mindfulness-based intervention and CBT is the relationship we have with our internal experiences. CBT emphasizes becoming aware of negative thoughts, and changing those unhelpful thoughts into helpful ones. On the other hand, mindfulnessbased intervention involves clients acknowledging their thoughts without identifying or engaging with them, as a way to create more ease. It can increase clients’ awareness of their internal processes, and facilitate acceptance and self-compassion, which is the foundation of any successful therapy.

For therapists who practice different modalities, to start adopting mindfulness, it is crucial that they first practice it themselves in order to be more present for their clients and conduct more effective therapy.

Do you have any advice or recommendations for those looking to try practicing mindfulness?

I would say that mindfulness is good for everybody who is willing to practice it. To start, I recommend that you join a class or a meditation group. You can look into a mindfulness-based stress reduction course, or check out local Buddhist meditation groups. The former is more focused on using mindfulness to handle stress and other chronic health issues, while the latter is more spiritually focused.

Many places offer mindfulness or meditation groups. I recommend trying these out to see which one is more suitable for you, and then commit for a few months. The benefit you get from practicing mindfulness is directly proportional to how much you practice.

Start small — even 5 minutes a day is useful, and you can start to build on that over time. The most important thing is practice, practice, and practice. When you begin, remember to be kind to yourself as you are trying something new, so it will take some time to learn. Your mind may wander, and that is normal. If this happens, look to bring your mind back to your breath with gentleness and kindness.

Another important thing about mindfulness is that it is not just about the mind — it is also about the body. When you practice mindfulness, you will start to feel your body more, including your Parkinson’s symptoms. You may feel some sensations that you probably want to avoid, reject, or resist. You may feel uncomfortable when they arise. This is normal. The practice of mindfulness is about allowing them to be there, and to reconnect with your body. If you feel too overwhelmed about feeling these sensations and need more guidance and support, please consider reaching out to a counsellor.

Mindfulness is to be practiced with a loving kindness toward yourself. It is not only useful for coping with life’s many challenges, but also a way of living that welcomes ease and joy.

Additional Resources

Center for Mindfulness Canada | www.mindfulnessstudies.com

Mountain Rain Zen Community, Vancouver | www.mountainrainzen.org | 604-462-0604

Vancouver Shambhala Center, Vancouver | www.vancouver.shambhala.org

Turning Point Bodymind Wellness | www.turningpointacupuncture.ca | 604-738-5288

Sources

Dissanayaka, N.N. (2016). “Mindfulness for Motor and Nonmotor Dysfunctions in Parkinson’s Disease.” Parkinson’s Disease Journal. https://doi.org/10.1155/2016/7109052 

Pickut, B.A. et al. (2013). “Mindfulness based intervention in Parkinson’s disease leads to structural brain changes on MRI” Journal of Clinical Neurology and Neurosurgery, 115(12). https://doi.org/10.1016/j.clineuro.2013.10.002 

Pickut, B.A. et al. (2015). “Mindfulness Training among Individuals with Parkinson’s Disease: Neurobehavioral Effects.” Parkinson’s Disease Journal. https://dx.doi.org/10.1155/2015/816404 

This content was published in the Spring 2020 edition of our quarterly magazine, Viewpoints. The content was accurate as of this publication date.