Elisha Goldstein's, Ph.D. Psych Central, Mindfulness & Psychotherapy blog interview with Bridging the Hearts and Minds of Youth conference workshop leader Amy Saltzman,MD about her work and research with children and teens.

The theory and practice of mindfulness as a way for children to calm their busy minds, self regulate, become more hopeful and happy has been an area of increasing interest. The potential impact on our culture is great as it affects future generations.

It’s my pleasure to bring you this interview with Amy Saltzman, MD a holistic physician in Northern California who has been integrating mindfulness with children and teens for many years. Her current research has found significant impacts on children in the areas of attention, anxiety and compassion. I’ll be watching Amy speak at Bridging the Hearts and Minds of Youth Conference in San Diego on February 4 -5.

Today Amy talks to us about what the still quiet place is for children and teenagers, the impact of her research with children, and a little practice and advice to help us parents, caregivers and teachers along the way.

Elisha: What is the “Still Quiet Place” within for children and teenagers?

Amy: The Still Quiet Place is a way for children and teens to experience pure awareness.

Awareness is a concept that may not make sense to young children. However, with guidance most children can discover that stillness and quietness (aka awareness) is alive inside of them.

When I introduce mindfulness to children I begin by inviting them to attend to the breath– the feeling of the expansion of the in-breath, the stillness between the in-breath and the out-breath, the release of the out-breath, and the stillness between the out-breath and the in-breath.

They are encouraged to rest in the stillness, and to realize that this stillness and quietness is always with them—when they are breathing in, when the breath is still, when they are breathing out, when the breath is still, when they are frustrated with a math problem, or angry with someone, when they are doing sports, playing an instrument, or hanging out with friends. This stillness and quietness is always with them. They can rest in this stillness and quietness whenever they want. And when they rest in their Still Quiet Place they can observe their thoughts and feelings and then choose their behavior.

Elisha: Give us an overview of your research that originally started with Philippe Goldin, PhD at Stanford and now with renowned neuroscientist Amishi Jha PhD in working with young children and mindfulness.

Amy: This research, which will be published soon, looked at the benefits of offering mindfulness to children in 4th-6th grade and their parents. The children and parents participated in the Still Quiet Place course, an 8-week age-adapted mindfulness training. After becoming familiar with the Still Quiet Place they are supported in learning to rest in the stillness and quietness and observe their thoughts, feelings, physical sensations, and impulses. Through home practice and group discussion we explore how these observations allow us to choose our behavior, especially in difficult circumstances.

For example, say a student is really struggling with math. When he becomes aware of his struggle he could take a few deep breaths, settle into his Still Quiet Place, and observe his experience- a feeling of frustration, showing up in his body as a headache, and tight shoulders, and showing up in his thinking as what I call Unkind Mind- “I am stupid. I can’t do this. I am never going to get this….” Resting in his Still Quiet Place he can remember that “thoughts are just thoughts, and I don’t have believe them or take them personally” and then he can choose what he wants to do next. Take a quick break and get a snack, go for a run, call a classmate, check-in with his teacher in the morning, etc…

As for the results of our research, we showed that after 8 weeks of learning these skills the children had documented decreases in anxiety, and improvements in attention on an objective, computerized attention assessment called the Attention Network Task (ANT).

In their own words the students reported decreased emotional reactivity, and increased ability to deal with day- to-day life challenges.

Interestingly, the parents demonstrated similar improvements even though the “dose” of mindfulness was lower than that of a typical adult course. And most importantly for parents they experienced increased parenting self-efficacy; this means they felt they were more effective parents.

Elisha: What is an example you have that can show us how mindfulness has helped a child you’ve worked with to handle unhealthy stress?

Amy: This story demonstrates that mindfulness is a practice lived moment by moment. When we met, Malia was a lovely, very bright 4th grader and a competitive gymnast. She felt pressure, mostly self-induced, to perform well both in school, and in the gym. Her stress was so severe that she was suffering from migraines. After 4-6 sessions of learning to rest in her Still Quiet Place, attend to her breath, her thoughts, her feelings and her physical sensations she was able to happily participate in both school and gymnastics for about a year.

A year later, as she approached the state meet, her stress and headaches returned; she wanted to quit gymnastics. She let her family know and they called me. As we explored this it became clear that she was afraid of letting herself, her parents, and her coach down. She thought they would be angry if she didn’t perform well. Interestingly, given her level of distress, I initially considered that her assessment of her parents’ and her coach’s expectations was correct, and my basis was that if she were simply competing to fulfill others expectations, it would be healthier for her to quit.

However in discussing it with her parents they felt strongly that they wanted her to see the season through, not to perform at a certain level, rather to learn that she could move forward in the face of fear and distress. With my support her parents were able to hear her distress, minimize mixed messages, clarify why they wanted her to finish the season, and most importantly clearly express that that they loved her no matter what.

That reassurance, along with a funny tailored ritual, allowed to her compete in the state meet with both joy and success. The ritual developed out my asking what pre-meet routine would help her remember that her parents loved her regardless of her performance. She said she wanted her dad to make her bacon before the meet. So their code word was “bacon”. As she approached each event she would look at her parents and they would mouth “bacon” to her. This of course made her smile and relax, and reminded her that they did love her not matter what.

When I wrote Malia to ask if I could use her story she wrote back

Dr. Amy,

Yes, you can use my Bacon Story and you can also use my name or I like the name Molly instead of Lilly.

By the way, I have quit gymnastics. I think I might like to try ‘excel’ gymnastics which is less hours a week and a more fun and relaxed competitive program. But right now I’m not doing anything so I can rest my foot and do physical therapy. I miss gymnastics but I don’t miss the practices. I miss bouncing on the trampoline and doing cartwheels.

Malia

This is a beautiful example of family mindfulness.

Malia was aware of and expressed her feelings. Her parents heard her, and expressed their values, and their love.

They created a joyful, humorous mindfulness ritual which will serve them well for a long time to come. Together they are practicing choosing freshly in each new moment.

Elisha: What is the message you give to parents who seem to be struggling with managing the children and stress?

Amy: As parents we need to recognize that our children’s lives are stressful, and that we contribute significantly to that stress. In fact research from Dr. Georgia Witkin at Mt. Sinai hospital in New York showed that the greatest source of childhood and adolescent stress is not school work, extracurricular activities, or peer pressure, but parental stress. So as parents one of the best things we can do to decrease our children’s stress is to decrease our stress. And of course one the best ways to do that is to take a mindfulness based stress reduction course, or perhaps use the excellent Mindfulness-Based Stress Reduction Workbook you co-wrote with Bob Stahl.

When we as adults learn mindfulness—paying attention here and now with kindness and curiosity and then choosing our behavior, we can support our children and teenagers in bringing these skills into their lives. If we are in the present, we aren’t worrying about our third grader getting into college and we aren’t passing this stress onto them in our day-to-day interactions. If we learn to witness our anger, fear and sadness with kindness and compassion we show our children that this way of working with intense emotion is possible.

If we slow down and choose how to respond to a difficult situation in daily life, and especially if we do it during challenges with our children and “out loud,” “Honey I am really frustrated, that you did X again, I am going to take a few minutes and then we can discuss this.” Then they see that they can do the same with various difficulties.

Children learn what they live; the best way to support them in practicing mindfulness is to practice ourselves.

Thank you so much Amy for your important work and what a wonderful message.

To learn more about Dr. Amy’s work visit her at The Still Quiet Place.