Nicholas V. Karayannis, MPT, PhD
Title: Mindfulness Based Physical Therapy: Approaching Our Practice with Humility and Curiosity
Synopsis: The intention of this talk is to introduce clinicians to experiential skills that will cultivate elements of compassion within themselves, to make them accessible while engaging with their patients, and to learn tools to guide their patients through training in mindfulness and self-compassion. The content of this talk will draw upon the contemplative and pain science literature, as well as meditation training practices derived from The University of Massachusetts Medical School Center for Mindfulness in Medicine, Health Care, and Society - Mindfulness Based Stress Reduction (MBSR) program, The Stanford Medicine Center for Compassion and Altruism Research and Education - Compassion Cultivation Training program, the Mind and Life Summer Research Institute, and the Insight Meditation Center.
Paying attention in a particular way: on purpose, in the present moment, and non-judgmentally (mindfulness) can be cultivated with formal participatory, resting-state and movement-based meditation practices. Similar to therapeutic exercise interventions, there are many approaches to choose from, which can range from attention and interoceptive focused practice (e.g., breathing/awareness of the breath meditation, body scanning, walking, yoga, Tai Chi), to compassion/gratitude, prosocial and emotion regulation practice (e.g., loving-kindness meditation and affect dyads), to metacognition, perspective taking on self and others practice (e.g., observing-thoughts and perspective dyads). MBSR is an effective therapy for people living with chronic pain.
Our understanding of the primary processes of the positive health behavior changes and outcomes that occur through MBSR and other forms of meditation training is through the enhancement of self-report measures of mindfulness, self-efficacy, pain acceptance, and social connectedness, and improvement in physiological/interoceptive measures like heart beat perception accuracy.
We also know that the communication skills of the clinician has an impact on patient health outcomes. While there are many sub-types of communication styles that can range in focus from motivational interviewing, shared decision making, patient-centered care, empathic care, to cultural competency, all approaches hold a foundational aspect of empathy- a cognitive attribute that can be learned, and cultivated with compassion training.
Compassion at its core contains both the effective feeling of caring for one who is suffering, and the motivation to relieve that suffering. Compassion is the capacity to attend to the experience of others, to feel concern for others, and to sense what will serve others. Compassion training included components of mindfullness, self-compassion, and a sense of common humanity. Some of the benefits of compassion cultivation include reduced defensiveness, improved listening skills, and improved ability to decode facial expressions and body language.
All of these attributes can serve a role in establishing a stronger therapeutic alliance, enhancing patient autonomy and treatment adherence, and reducing the inherent vulnerability of clinicians to stress overload and 'empathy fatigue'.
Dr. Nicholas Karayannis bio
My research aims to improve the health status, beliefs and behaviors of people suffering from persistent spinal pain through innovative refinement of clinical decision-making, and participatory rehabilitation. My work is clinically motivated and focuses on developing a better understanding of which person will respond to one type of mind-heart-body therapy over another—in addition to understanding and refining the content and delivery of these meditative and movement-based forms of care.
Dr. Nicholas Karayannis (Pronounced KA-ruh-YAH-nees) is a lead Physical Therapist within the Division of Pain Medicine and a Researcher within the Systems Neuroscience and Pain Laboratory at Stanford. Before receiving his Ph.D. in Physiotherapy from the University of Queensland, Australia, in 2013, he trained as a fellow in orthopedic manual therapy in the USA and Canada (North American Institute of Orthopedic Manual Physical Therapy).
He graduated with a Master's in Physical Therapy degree in 2000 from Ohio University, and a Bachelor of Science degree in Biological Sciences from the same institution. Nicholas is a Fellow of the American Academy of Orthopedic Manual Physical Therapists, board certified as an Orthopedic Clinical Specialist, a Certified Yoga and Tai Chi Teacher, A Center for Mindfulness Qualified Mindfulness Based Stress Reduction (MBSR) Teacher, and a Stanford Chronic Pain Self-Management Program (CPSMP) Leader.