Selected Podcast
Mindfulness Based Lifestyle Change
Life's challenges mean you need time to relieve your weary mind. Dr. Hani Chaabo, Family Medicine Doctor at Ridgecrest Regional Hospital's Rural Health Clinic, discusses mindfulness.
Featuring:
Dr. Chaabo completed a family medicine residency at West Virginia University - Charleston Area Medical Center, working with a population that has some of the highest rates of chronic disease in the US, needing more integrative and preventative approaches to care. He trained in Mindfulness based stress reduction (MBSR) and developed a mindfulness based lifestyle change program delivered in clinical and group settings. He also designed an institutional well-being curriculum to combat burnout that was presented at the American Academy of Family
Physicians Program Directors Workshop and the Integrative Medicine for Under-served conference. He was awarded “Outstanding Senior Resident” and the “Resident Wellness Recognition Award”. Currently he practices primary care and runs a stress reduction clinic at the Ridgecrest Rural Health Clinic.
Dr. Chaabo also holds certifications in Reiki and Quantum touch, and is currently specializing in Integrative Medicine through the University of Arizona. He enjoys writing, forest bathing, is an accomplished pianist, and devoted yogi. He believes in nutritional therapy, mind-body medicine, cognitive behavioral therapy and biofeedback, empowering people to invest in self development and the healing journey.
Hani Chaabo, MD
Dr. Chaabo attended medical school at the University of Balamand – Saint George Hospital during which he volunteered at a non-governmental organization providing healthcare to marginalized LGBTQ refugees in Lebanon, and steered community driven yoga activities for children in refugee camps. After graduating he worked on national public health projects with the United Nations Development Program, World Health Organization, World Bank, and Lebanese Ministry of Public Health. The largest project brought free universal healthcare to 100,000 people living below the poverty line, intending to expand to the entire population. He also helped develop the region’s first academic Integrative Health center providing services through the American University of Beirut Medical Center.Dr. Chaabo completed a family medicine residency at West Virginia University - Charleston Area Medical Center, working with a population that has some of the highest rates of chronic disease in the US, needing more integrative and preventative approaches to care. He trained in Mindfulness based stress reduction (MBSR) and developed a mindfulness based lifestyle change program delivered in clinical and group settings. He also designed an institutional well-being curriculum to combat burnout that was presented at the American Academy of Family
Physicians Program Directors Workshop and the Integrative Medicine for Under-served conference. He was awarded “Outstanding Senior Resident” and the “Resident Wellness Recognition Award”. Currently he practices primary care and runs a stress reduction clinic at the Ridgecrest Rural Health Clinic.
Dr. Chaabo also holds certifications in Reiki and Quantum touch, and is currently specializing in Integrative Medicine through the University of Arizona. He enjoys writing, forest bathing, is an accomplished pianist, and devoted yogi. He believes in nutritional therapy, mind-body medicine, cognitive behavioral therapy and biofeedback, empowering people to invest in self development and the healing journey.
Transcription:
Prakash Chandran (Host): We all face challenges in life, but did you know that the practice of mindfulness can be integrated into your life to help you better understand and manage your stress? We’re going to learn about it today with Dr. Hani Chaabo, a Family Medicine doctor at Ridgecrest Regional Hospital’s Rural Health Clinic. This is a podcast from Ridgecrest Regional Hospital. I’m Prakash Chandran. So, Dr. Chaabo, let’s start with something that I think I know what it is but what exactly is mindfulness?
Hani Chaabo, MD (Guest): So, mindfulness is really – it’s many things. But the actual definition is it’s basically a quality of attention. And it’s a way you pay attention, where you are paying complete attention on purpose to the present moment without judgement. That’s the cookie cutter definition of mindfulness.
Host: Okay and how is that different from meditation because the two definitions sound pretty similar?
Dr. Chaabo: Absolutely. Absolutely. So, mindfulness is more about a way of going about your day, a way of interacting with people, a way of observing yourself. Meditation is more the act of sitting down, closing your eyes, listening to your thoughts, doing some breathing techniques.
Host: I see, I see. So, it’s kind of like a walking, active meditation, if I were to make a comparison. I’ve heard that there are many health benefits to practicing mindfulness. So, maybe you can explain some of those for us.
Dr. Chaabo: So, there’s actually so many health benefits that really whatever you throw mindfulness onto, it has an effect. But we have about 40 years of research now on mindfulness in healthcare through a specific program called the Mindfulness Based Stress Reduction Program. And it’s been studied on mental health disorders, on chronic pain, headaches, even autoimmune disorders like psoriasis, quality of life related to chronic disease, quality of life related to cancer. So, many different conditions and it’s really shown to be helpful in all of these conditions.
Host: Yeah so, let’s talk about the science and the mechanism and the process around how mindfulness works. Talk to us a little bit about how people put it into practice.
Dr. Chaabo: It’s really actually a fascinating area of study because it marries so many different scientific practices and two places that we’re finding a lot of advancement in. The first is neuroplasticity. Have you ever heard of neuroplasticity before?
Host: I have, yes.
Dr. Chaabo: So, basically, we used to think that our brain’s architecture is static, we’re born with a certain number of brain cells and if you lose some; that’s it, they’re gone. But now we are starting to understand that there’s actually a phenomenon known as neuroplasticity where the brain changes its architecture based on your experience. So, for example, people that are depressed will have changes in their brain architecture that actually keeps them depressed. And likewise when people start to practice mindfulness and come out of depression; we’ll see the brain change its architecture towards places that are involved in more positive processing and more so in regulation and so will keep people in a good place. So, that’s the first phenomenon, neuroplasticity.
The other phenomenon is called epigenetics. So, very similarly just think how your brain changes its architecture based on your experience, your DNA is also turning itself on and off based on your experience. And when you practice mindfulness; we can actually watch the DNA turn different places on and off especially when it comes to things related to aging for example, where when you practice mindfulness, the DNA that’s supposed to conserve your DNA matter to keep it longer as you age actually starts to increase. And we can see that in multiple different ways. We can even see mindfulness; we can measure the effect on your immune system. So, like if you practice mindfulness before you took a flu shot; we can measure your immune system now in higher immune response to that flu shot than if you didn’t do mindfulness before the flu shot.
So, there’s all kinds of science showing how it works and why it works but mainly it’s grouped under the neuroplasticity and epigenetics fields.
Host: That’s truly fascinating. This is the first time that I’m learning about all this. I’m curious, you say practice mindfulness. Maybe talk a little bit about some on the different practices. Like what does it exactly mean to practice?
Dr. Chaabo: So, there’s actually what’s called formal and informal mindfulness practice. Formal mindfulness practice is what resembles meditation. So, you are sitting down, you are either doing a body scan or an awareness of breath mediation or you are doing some kind of guided imagery like a mountain meditation or loving, kindness meditation. So, there’s all kinds of different formal meditations with really different objectives they are supposed to help in your life and physiologically in your body.
And then there’s also the informal practices which resemble more like what you said, moving meditations. So, kind of how do you incorporate that mindful quality of attention as you are moving through your life. So, things like mindful eating, mindful speaking and listening, mindfulness of daily activities. The kind of turning your whole life into a meditation and not just when you are sitting down and closing your eyes.
Host: So, you mentioned the flu shot example. And I’m sure that there are a number of different applications of mindfulness but maybe talk to us about some of the most common applications that you see with mindfulness.
Dr. Chaabo: Yeah, so, mental health disorders, depression, anxiety, insomnia, all kinds of mental health disorders; it’s actually been shown to be very effective and some studies where the participants did an e-week program, the Mindfulness Based Stress Reduction Program and they just did that program one time and never did it again; we could actually measure the positive effects on their mood disorders three years down the line and counting. So, that goes to show you how changing your brain architecture during one period of time can have lifelong lasting effects.
And along the same lines, when it comes to chronic pain for example; mindfulness is starting to find its way into the National Guidelines of treating things like low back pain, chronic pain syndrome, all kinds of stuff because in studies, it’s been shown to reduce the feelings of unpleasantness by about 57% and the intensity of pain by about 40% and when you compare that to the classical ways we treat pain with narcotics and non-narcotics; it’s actually in many ways, more effective than when you treat people with medicine. So, those are two places I find it very effective.
Host: Yeah, that’s absolutely fascinating. You are truly healing the body with the mind rather than the drugs that we ingest so often that only address the symptoms rather than the root cause. I wanted to ask you a little bit about this clinic at Ridgecrest that I’m hearing about. It’s called the Mindfulness Based Lifestyle Change Program. Can you tell us a little bit about it?
Dr. Chaabo: Yes. So, our clinic incorporates two areas that are really growing right now in healthcare. So, mindfulness is one, we’ve talked about that. And lifestyle change is another one. So, you said your body has a way where it can heal itself where you can give it what it needs, where you can live your life in a way that maximizes your body’s potential to heal. And so lifestyle change is one of those big areas right now in medicine where it’s like okay how do you eat to maintain optimal health. How do you exercise to maintain optimal health. How do you sleep better. All those kinds of things.
And so our program bridges all of that and the first half of the program you go through a mindset change. So, we explore your resistances, the way you deal with your triggers, the different ways you can look at things, different areas in your life that you’d like to enhance, areas in your life that maybe bring you down. So, we kind of, the first four weeks are going through a mindset change. And then the second four weeks are all about learning about different ways you can eat, different ways you can exercise, there’s some handholding there, different areas in your life that need a little bit of tweaking like let’s say your social environment, the way you relate to other people, your purpose in life, those kinds of things.
And that’s all delivered over eight weeks.
Host: Wow, that really sounds fantastic. Just as we close here, I’d love for you to take us through a mindfulness exercise. We only have a couple of minutes, but I’m sure that we could all use a little bit more in this day. So, maybe you can walk us through something like that.
Dr. Chaabo: I would love to. It’s actually my favorite thing to do. So, let’s do it. so, I’m going to ask you to close your eyes. And start taking a couple of deep breaths. A very nice long inhale, and exhaling. Nice long inhale. And I’m going to ask you to do that a couple more times. And maybe even inhale a little bit deeper and exhaling, maybe the exhale is a little bit longer. And on your next round of inhales and exhales; start to bring your attention back to the present moment. So, noticing what you are hearing, what you are feeling, what you are smelling, tasting. Just feeling your attention ground back into your body.
And just breathe easy now. Taking a moment, appreciate the silence. Letting go of your day, of this interview. Just bringing back your attention to the present moment without judgement. I know we are on a time limit, but you can give yourself this moment. And then we a re going to do a very quick, very easy body scan. So, you are going to bring your attention on the inhale to the point between your eyebrows, and on the exhale relax your eyebrows. And on the inhale, bringing your attention to your throat and your jaw. And on the exhale, relaxing that area.
Moving your attention on the inhale to the shoulders and relaxing your shoulders. And then on the inhale to the groin, relaxing your groin on the exhale and then finally to the toes relaxing on the exhale and just moving one more time through these five points relaxing them on the exhale, the point between your eyebrows, your throat and your jaw, your shoulders, your groin and your toes. Just take a moment to appreciate your space you have created. This is mindfulness. And as you are coming back to this interview; maybe bringing that space with you and keeping that space with you for the rest of the day. That’s it.
Host: This is certainly the most peaceful and calming conversation I’ve ever had in all my time doing this. And I truly appreciate it. The fascinating thing is as I was going through it, I just, I forgot about the microphone, I forgot about the fact that we’re being recorded and the headset and everything else and I just kind of let it wash over me which is nice. I think as I mentioned before, one of my favorite parts about this is the fact that if someone listening to this might think that heh this whole like mindfulness word and this meditation word is maybe a little bit too out there for me; read the evidence that Dr. Chaabo has brought up because not only can you feel it; but there are things happening in your body with that neuroplasticity and all of the changes in your brain to make your body heal itself.
So, Dr. Chaabo, I truly appreciate this time today and I appreciate that you took us through that exercise. Thank you so much. That’s Dr. Hani Chaabo, a Family Medicine doctor at Ridgecrest Regional Hospital’s Rural Health Clinic. Thanks for checking out this episode of Ridgecrest Regional Hospital Podcast. Head to www.rrh.org/podcast for more information. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll talk next time.
Prakash Chandran (Host): We all face challenges in life, but did you know that the practice of mindfulness can be integrated into your life to help you better understand and manage your stress? We’re going to learn about it today with Dr. Hani Chaabo, a Family Medicine doctor at Ridgecrest Regional Hospital’s Rural Health Clinic. This is a podcast from Ridgecrest Regional Hospital. I’m Prakash Chandran. So, Dr. Chaabo, let’s start with something that I think I know what it is but what exactly is mindfulness?
Hani Chaabo, MD (Guest): So, mindfulness is really – it’s many things. But the actual definition is it’s basically a quality of attention. And it’s a way you pay attention, where you are paying complete attention on purpose to the present moment without judgement. That’s the cookie cutter definition of mindfulness.
Host: Okay and how is that different from meditation because the two definitions sound pretty similar?
Dr. Chaabo: Absolutely. Absolutely. So, mindfulness is more about a way of going about your day, a way of interacting with people, a way of observing yourself. Meditation is more the act of sitting down, closing your eyes, listening to your thoughts, doing some breathing techniques.
Host: I see, I see. So, it’s kind of like a walking, active meditation, if I were to make a comparison. I’ve heard that there are many health benefits to practicing mindfulness. So, maybe you can explain some of those for us.
Dr. Chaabo: So, there’s actually so many health benefits that really whatever you throw mindfulness onto, it has an effect. But we have about 40 years of research now on mindfulness in healthcare through a specific program called the Mindfulness Based Stress Reduction Program. And it’s been studied on mental health disorders, on chronic pain, headaches, even autoimmune disorders like psoriasis, quality of life related to chronic disease, quality of life related to cancer. So, many different conditions and it’s really shown to be helpful in all of these conditions.
Host: Yeah so, let’s talk about the science and the mechanism and the process around how mindfulness works. Talk to us a little bit about how people put it into practice.
Dr. Chaabo: It’s really actually a fascinating area of study because it marries so many different scientific practices and two places that we’re finding a lot of advancement in. The first is neuroplasticity. Have you ever heard of neuroplasticity before?
Host: I have, yes.
Dr. Chaabo: So, basically, we used to think that our brain’s architecture is static, we’re born with a certain number of brain cells and if you lose some; that’s it, they’re gone. But now we are starting to understand that there’s actually a phenomenon known as neuroplasticity where the brain changes its architecture based on your experience. So, for example, people that are depressed will have changes in their brain architecture that actually keeps them depressed. And likewise when people start to practice mindfulness and come out of depression; we’ll see the brain change its architecture towards places that are involved in more positive processing and more so in regulation and so will keep people in a good place. So, that’s the first phenomenon, neuroplasticity.
The other phenomenon is called epigenetics. So, very similarly just think how your brain changes its architecture based on your experience, your DNA is also turning itself on and off based on your experience. And when you practice mindfulness; we can actually watch the DNA turn different places on and off especially when it comes to things related to aging for example, where when you practice mindfulness, the DNA that’s supposed to conserve your DNA matter to keep it longer as you age actually starts to increase. And we can see that in multiple different ways. We can even see mindfulness; we can measure the effect on your immune system. So, like if you practice mindfulness before you took a flu shot; we can measure your immune system now in higher immune response to that flu shot than if you didn’t do mindfulness before the flu shot.
So, there’s all kinds of science showing how it works and why it works but mainly it’s grouped under the neuroplasticity and epigenetics fields.
Host: That’s truly fascinating. This is the first time that I’m learning about all this. I’m curious, you say practice mindfulness. Maybe talk a little bit about some on the different practices. Like what does it exactly mean to practice?
Dr. Chaabo: So, there’s actually what’s called formal and informal mindfulness practice. Formal mindfulness practice is what resembles meditation. So, you are sitting down, you are either doing a body scan or an awareness of breath mediation or you are doing some kind of guided imagery like a mountain meditation or loving, kindness meditation. So, there’s all kinds of different formal meditations with really different objectives they are supposed to help in your life and physiologically in your body.
And then there’s also the informal practices which resemble more like what you said, moving meditations. So, kind of how do you incorporate that mindful quality of attention as you are moving through your life. So, things like mindful eating, mindful speaking and listening, mindfulness of daily activities. The kind of turning your whole life into a meditation and not just when you are sitting down and closing your eyes.
Host: So, you mentioned the flu shot example. And I’m sure that there are a number of different applications of mindfulness but maybe talk to us about some of the most common applications that you see with mindfulness.
Dr. Chaabo: Yeah, so, mental health disorders, depression, anxiety, insomnia, all kinds of mental health disorders; it’s actually been shown to be very effective and some studies where the participants did an e-week program, the Mindfulness Based Stress Reduction Program and they just did that program one time and never did it again; we could actually measure the positive effects on their mood disorders three years down the line and counting. So, that goes to show you how changing your brain architecture during one period of time can have lifelong lasting effects.
And along the same lines, when it comes to chronic pain for example; mindfulness is starting to find its way into the National Guidelines of treating things like low back pain, chronic pain syndrome, all kinds of stuff because in studies, it’s been shown to reduce the feelings of unpleasantness by about 57% and the intensity of pain by about 40% and when you compare that to the classical ways we treat pain with narcotics and non-narcotics; it’s actually in many ways, more effective than when you treat people with medicine. So, those are two places I find it very effective.
Host: Yeah, that’s absolutely fascinating. You are truly healing the body with the mind rather than the drugs that we ingest so often that only address the symptoms rather than the root cause. I wanted to ask you a little bit about this clinic at Ridgecrest that I’m hearing about. It’s called the Mindfulness Based Lifestyle Change Program. Can you tell us a little bit about it?
Dr. Chaabo: Yes. So, our clinic incorporates two areas that are really growing right now in healthcare. So, mindfulness is one, we’ve talked about that. And lifestyle change is another one. So, you said your body has a way where it can heal itself where you can give it what it needs, where you can live your life in a way that maximizes your body’s potential to heal. And so lifestyle change is one of those big areas right now in medicine where it’s like okay how do you eat to maintain optimal health. How do you exercise to maintain optimal health. How do you sleep better. All those kinds of things.
And so our program bridges all of that and the first half of the program you go through a mindset change. So, we explore your resistances, the way you deal with your triggers, the different ways you can look at things, different areas in your life that you’d like to enhance, areas in your life that maybe bring you down. So, we kind of, the first four weeks are going through a mindset change. And then the second four weeks are all about learning about different ways you can eat, different ways you can exercise, there’s some handholding there, different areas in your life that need a little bit of tweaking like let’s say your social environment, the way you relate to other people, your purpose in life, those kinds of things.
And that’s all delivered over eight weeks.
Host: Wow, that really sounds fantastic. Just as we close here, I’d love for you to take us through a mindfulness exercise. We only have a couple of minutes, but I’m sure that we could all use a little bit more in this day. So, maybe you can walk us through something like that.
Dr. Chaabo: I would love to. It’s actually my favorite thing to do. So, let’s do it. so, I’m going to ask you to close your eyes. And start taking a couple of deep breaths. A very nice long inhale, and exhaling. Nice long inhale. And I’m going to ask you to do that a couple more times. And maybe even inhale a little bit deeper and exhaling, maybe the exhale is a little bit longer. And on your next round of inhales and exhales; start to bring your attention back to the present moment. So, noticing what you are hearing, what you are feeling, what you are smelling, tasting. Just feeling your attention ground back into your body.
And just breathe easy now. Taking a moment, appreciate the silence. Letting go of your day, of this interview. Just bringing back your attention to the present moment without judgement. I know we are on a time limit, but you can give yourself this moment. And then we a re going to do a very quick, very easy body scan. So, you are going to bring your attention on the inhale to the point between your eyebrows, and on the exhale relax your eyebrows. And on the inhale, bringing your attention to your throat and your jaw. And on the exhale, relaxing that area.
Moving your attention on the inhale to the shoulders and relaxing your shoulders. And then on the inhale to the groin, relaxing your groin on the exhale and then finally to the toes relaxing on the exhale and just moving one more time through these five points relaxing them on the exhale, the point between your eyebrows, your throat and your jaw, your shoulders, your groin and your toes. Just take a moment to appreciate your space you have created. This is mindfulness. And as you are coming back to this interview; maybe bringing that space with you and keeping that space with you for the rest of the day. That’s it.
Host: This is certainly the most peaceful and calming conversation I’ve ever had in all my time doing this. And I truly appreciate it. The fascinating thing is as I was going through it, I just, I forgot about the microphone, I forgot about the fact that we’re being recorded and the headset and everything else and I just kind of let it wash over me which is nice. I think as I mentioned before, one of my favorite parts about this is the fact that if someone listening to this might think that heh this whole like mindfulness word and this meditation word is maybe a little bit too out there for me; read the evidence that Dr. Chaabo has brought up because not only can you feel it; but there are things happening in your body with that neuroplasticity and all of the changes in your brain to make your body heal itself.
So, Dr. Chaabo, I truly appreciate this time today and I appreciate that you took us through that exercise. Thank you so much. That’s Dr. Hani Chaabo, a Family Medicine doctor at Ridgecrest Regional Hospital’s Rural Health Clinic. Thanks for checking out this episode of Ridgecrest Regional Hospital Podcast. Head to www.rrh.org/podcast for more information. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll talk next time.