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Fo r t h e C o m m u n i t y a n d Fr i e n d s o f W i n d h o r s e I n t e g r a t i v e M e n t a l H e a l t h
Winter 2010 | Vol. 10, No. 1

An Interview with Mindsight author Dan Siegel

As we move into 2010 with our new name and the initial funding to begin building a presence in California, we have developed a relationship with Dan Siegel from the UCLA Medical Centers Mindful Awareness Research Center. Clinical director Marilyn Marks along with clinicians Nick Luchetti, Mary Tibbetts, and Kermit Cole compiled the following questions to inform our readers of Dans important work.

Please consider a contribution to Windhorse Integrative Mental Health today in support of our scholarship fund.
WInDhorse stAff (Fall 2009) Eva Claire albion-Wright, Administrative intern Jeff Bliss, MSW, director, Admissions & Marketing nick Boutros, Ma, team Leader Guangye Cao, Administrative intern Sarah Carr, Ma, team Leader, Admissions Kermit Cole, Ma, team Leader anne Collins, Fiscal Manager Gineen Cooper, Ma, Housemate Susan Dorfman, respite Eric Friedland-Kays, Ma, Admissions Manager /senior clinician Robert Gardiner, MD, Psychiatrist Bruce Goderez, MD, Psychiatrist Elizabeth Johnson, Housemate Patty Kruglack, smith college MsW intern Gary Kuntz, MSW, respite Michael Levy, Ba, Housemate / team counselor
Frank Liebman, Housemate nick Luchetti, MS, Housemate / senior clinician Marilyn Marks, LICSW, clinical director Renee Mendez, Rn, Ma senior clinician, nurse Timothy ness, Housemate Suzanne Rataj, Ba, respite Harold Raush, PhD, elder Kate Richardson, BFa, Office Manager Jack Rockefeller, JD, MPH, executive director Ben Ross, Ba, respite Sparky Shooting Star, spiritual counselor David Stark, Ba, Peer coordinator Cheryl Stevens, MD, respite Jennifer Stuart, respite Mary Tibbetts, LICSW, senior clinician, Family coordinator Phoebe Walker Murray, Ma, senior clinician Sara Watters, Ma, LMHC, director, clinical Operations Lindsay Weremay, Ba, team counselor Stephanie Westphal, BS, Rn, Wellness nurse Stuart Wetherbe, Foster Family caregiver Elise White, Ba, Peer counselor, Admin. Asst. Tess anais Zinnes, Administrative intern

BoArD of DIreCtors
John Copen Sera Davidow, clerk Peter Dulchinos, JD, vice-President Reuven Goldstein, MEd, President nan Grand-Jean David Stark, Ba Mike Stein, treasurer Lisa Teague CreDIts Editor: Jeff Bliss; Designer: LaC Design

Windhorse: In your book Mindsight, you define mindsight as a process that enables us to monitor and modify the flow of energy and information... sensing this flow within ourselves and within others through our relationships. Also as a very special lens that gives us the capacity to perceive the mind with greater clarity than ever before. Is mindsight another word for mindfulness, and if not, what is the distinction between the two?
Dan: Mindfulness has been defined in many ways: As a form of being conscientious (as be mindful of what you eat), as an approach to learning that promotes creativity by avoiding premature closure of categories (in the work in mindful education of Ellen Langer), and in the ancient contemplative practicessuch as yoga, tai chi, quiqong, and mindfulness meditation in the Buddhist traditionthat promote what Jon Kabat-Zinn has described as paying attention, on purpose and non-judgmentally, to moment-to-moment experience. Mindsight is a term I created

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art by: nick Luchetti

WInDhorse IntegrAtIve mentAl heAlth, a non-profit therapeutic and educational organization, is pioneering a whole-person approach to recovery from psychiatric disorders. We offer comprehensive, individually designed therapeutic programs in the community. Care is based in the clients home or in a therapeutic household shared with a staff housemate in the Northampton area. Mindfulness, attention to the whole person, restoration of personal and social connections, and belief in recovery are basic principles under-lying our approach. Windhorse also offers education and training in recovery skills and consultation to individuals and families. For more information, to request a brochure describing our programs, or to make a referral or inquire about admission, contact Admissions by phone (ext. 303), mail, or e-mail.

to approach the ways we see the internal world because my own professors in medical school seemed to focus only on the physical aspect of human realitybodies, symptoms, diseases rather than on the internal subjective, mental side of life. Over time, I found the drive to integrate a wide range of sciences into one framework to understand human development, lead to a view of a triangle of wellbeing that could sense energy and information flow within our brain (the extended nervous system), share in our relationships, and regulated by the mind. Mindsight is the ability to sense and shape this flow across each of these three aspects of human experiencebrain, relationships, and mindand move our lives toward integration. Integration is the linkage of differentiated aspects of a system whether that is a person, a couple, a family, a community, a society, or the planet itself. Integration creates harmony; lack of integration leads to chaos and/or rigidity. In these ways, mindsight embraces the power of mindfulness to promote what is called integration

of consciousness in which we differentiate awareness from that which we are aware of. But mindsight moves us into new domains of integration beyond mindfulness, weaving a deep understanding of the brain and relationships into an approach to see our mental lives with more clarity and depth and move them more effectively toward health and well-being.

I have found the formal practices of mindfulness training in meditation and yoga, tai chi and quiqong, to be helpful for my patients. And personally, I have not only found groups of like-minded people and made new friends in the world of mindfulness that have greatly enriched my life, but coming out of the closet as a mind-focused person in a profession that often has lost its mind has been of great value to me in this journey. Windhorse: It seems that you discuss the self in ways that are similar to post-modern philosophers such as Derrida, Levinas, or Michel Henry, who have much to say that is relevant to psychology and psychotherapy. Can you tell us how they might have influenced you in your work? I would also wonder if Martin Bubers influence on the interpersonal approach to psychotherapy has impacted you?
Dan: I am not trained in philosophy, though I love to think about issues of how we know what we know. So I can say that, unfortunately, I have no familiarity with any of these authors but am interested in learning about their perspectives. Trained as both a scientist and a clinician, working at the boundaries between the objective and the subjective, I have tried my best to stick very closely to carefully amassed research data and actual, lived experience. Ideas that emerge from these two very grounded but distinct ways of knowing have served as our source of conceptual framework building. That effort to bridge these two worlds of the objective and subjective and to keep up with the explosion of research in the various fields has kept me quite busy and quite full in terms of finding the consilience across their perspectives. Consilience, the effort to find parallel findings across independent ways of knowing, is the fundamental approach to creating the field of interpersonal neurobiology in which I work.

Mindsight is the ability to sense and shape this flow across each of these three aspects of human experiencebrain, relationships, and mindand move our lives toward integration.

Windhorse: How has learning about mindfulness practice changed your relationship to your life and work?
Dan: Learning about mindfulness has been an important

source of connection for me across the personal, clinical, and academic aspects of my life. Academically, it has been wonderful to weave the contemporary research on this ancient contemplative practice into our interpersonal neurobiology perspective that embraces all ways of seeking truth into a common synthesis of knowledge. Mindfulness researchers have worked hard with ingenious studies that support the notion that integration is at the heart of health and that intentional mental practice can transform the brains function and structure toward wellbeing. Clinically,

Dan: At the beginning of the Decade of the Brain, the 1990s, I was seeking ways to understand the link between mind and brain and I invited forty scientists to address this topic. We met for four years, exploring the insight from their various disciplines that ranged from anthropology to neurobiology, sociology to linguistics. In the course of that effort, it became clear that while the brain could be easily defined as a collection of neurons, embedded in the skull but a part of an extended nervous system distributed throughout the entire body, no one had a common description of the mind. And while people might say things like the mind is just the activity of the brain or the mind is the what links people together in groups across generations, there was no consensus on what mind is. And so, in an effort to keep the group going, as its facilitator I felt the need to come up with some working definition of the mind that could enable us to communicate respectfully and effectively with one another. The definition that ultimately I offered to the groupof which there was one hundred percent agreementis this: The mind can be defined as an embodied and relational process that regulates the flow of energy and information. This was essentially the beginning of the field of Interpersonal Neurobiologythe effort to find the consilient view across a wide range of sciences, and now all ways of knowing from contemplative practices and the arts to clinical experience and religionthat now has its own professional library, training programs, and organizations.

Windhorse: While reading Mindsight, I was impressed with the balanced interweaving of accessible scientific information, case histories, user-friendly tools for enhancing mindsight, and vignettes from your own personal experience. I have begun incorporating some of the concepts and tools in my work with clients, and find them appreciative of the hand model of the brain, the notion of implicit and explicit memory, the wheel of awareness, and the mindfulness exercises. Do you believe that these body-oriented components of healing are essential elements to integrate into traditional talk therapy, and why?
Dan: Thanks for your thoughtful reflections on the book, Mindsight. My wife reminds me that while the book has been in development for five years, it is really a lifetimes work and so it is deeply moving to hear you say the ideas, stories, and practices are helpful. That makes all the energy and vulnerability of putting something new down on paper worthwhile. As I discuss in the book, the flow of energy and information is what we use to shape our lives. And words are only one top-down aspect of that flow, helpful yes, but limiting if we believe words have the final say on what is real! And so the stories in the book attempt to illustrate, with real life example from my own life or from clinical experiences as a therapist, how we can use integration of energy and information flow beneath, before, and beyond words to create health in our lives. Being body-oriented is one aspect of this non-worded approach, but this is just one part of the ways we can free the mind itself by focusing our attention on energy and information flow patterns. This is why the book is organized around mindsightthe learnable skill that can help people literally transform their lives by changing the very structure of their brains and the patterns of communication in their relationships. I will be very grateful if the stories make these empowering and scientifically grounded ideas accessible to the reader.

Windhorse: You also write about interpersonal neurobiology. Can you describe it briefly and its implications for your work?

The essence of Interpersonal Neurobiology is that we use mindsight to promote integration that we view as the heart of health and well-being. Chaos and rigidity are present when integration is impaired; promoting the linkage of differentiated elements of a system leads to integration and the movement toward harmony. Being flexible, adaptive, coherent, energized, and stable are the fundamental features of an integrated state. While Interpersonal Neurobiology is not a form of therapy, it does inform how to understand our lives and human development and therefore is used to organize an approach to psychotherapy, education, family functioning, and organizational processes.

Dan siegel, m.D.

Dan Siegel is the author of the internationally acclaimed text, The Developing Mind: Toward a Neurobiology of Interpersonal Experience (1999). He serves as the Founding Editor for the Norton Series on Interpersonal Neurobiology. His book with Mary Hartzell, M.Ed., Parenting from the Inside Out: How a Deeper Self-Understanding Can Help You Raise Children Who Thrive (2003) explores the application of this newly emerging view of the mind, the brain, and human relationships. His professional book is The Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being (2007). His first book for a general readership, Mindsight: The New Science of Personal Transformation, is due out on January 12, 2010.

Windhorse: In your book you tell the story of Jonathon, a young man diagnosed with bipolar disorder, who experienced swings from depression and suicidal thoughts to manic symptoms and emotional dysregulation. Could you tell us how the combination of psychotherapy, mindfulness, healthy diet, and aerobic exercise alleviated his symptoms and precluded the need for psychotropic medications?
Dan: Offering stories of real clinical cases is a powerful way of illustrating ideas. Naturally, many people with serious psychiatric conditions may need a combination of approaches, including various psychotherapeutic interventions that can harness the power of the mind to change the brain as well as psychiatric medications. But the crucial point in Jonathons story is that, while traditional psychiatric treatment might

windhorse newsletter winter 2010

windhorse newsletter winter 2010

only move to medications for someone diagnosed (by three board certified psychiatrists, including me) with bipolar disorder, we should also consider the science of neuroplasticity in creating our treatment strategies. Neuroplasticity is how the brains structure changes in response to experience. We now know that the focus of attentionthe mindcan change the specific activity in the brain and therefore ultimately change the structure of the brain in those activated regions: Neurons that fire together, wire together. Knowing this, I wanted to offer this young adolescent patient, relatively new with his symptoms of dysregulation, the opportunity to see if we could use his mind to change his brain. I knew from writing the book, The Mindful Brain, that studies suggested that mindfulness practice might promote the growth of integrative fibers of the prefrontal cortexones that might be crucial in changing Jonathons brain from dysregulated to regulated. These prefrontal fibers send inhibitory axons down to the lower limbic areassuch as the amygdalacan calm those regions down when they become excessively irritated. Subsequent studies from Yale have actually shown that these prefrontal to amygdala inhibitory fibers are actually too few in number in those with bipolar disorder. So the idea was to use mindfulness practice to create a state of mindful awareness that would then, with repetition, become a trait of regulation and equanimity in Jonathons life. The harnessing of neuroplasticity was our goal, so I also offered Jonathon the

strategies of aerobic exercise, sleep hygiene, good diet, and the close, careful focus of attention during mindfulness practice and journal writing reflections. This does not always work people need to be up for this intense practice and diligent in their focusbut in Jonathons case it seems we could inspire him to rewire his brain. Years later now, he is still symptom free and doing great! Windhorse: As I read Mindsight, I felt moved by the compassion that emanates from the pages of the book, and also by your statement that Curiosity, openness, and acceptance are in many ways the fundamental ingredients of love. Moment by moment, albeit imperfectly, clients and staff attempt to cultivate these states of being at Windhorse, and to return to them when we stray. As a scientist, physician, and board-certified psychiatrist, are you, in essence, offering us the psychoneurobiological basis for the healing potential of love?
Dan: Beautifully said. I hope so, and I hope by trying to carefully articulate the science of our inner life in this work, well illuminate the mind, the brain, and our relationships so that we can have more love, kindness and compassion toward ourselves and toward others in this fragile and wonderful world in which we live.

The Transformation: Changing the name and logo of our organization

By Jeff Bliss

with this newsletter we are shifting to our new name and logo design. Both of these honor and recommit us to the approaches our founders established, while more precisely describing the focus of our integrative methods of support. By using the term Mental Health in our name we are joining a movement that challenges the stigma often associated with this term while continuing to honor and protect the anonymity of our clients. During ten months of discussion and consideration of a new symbol, we realized that the previous logo constrained our broader affiliation with the contemplative traditions which inform our clinical approach. For some the new logo design suggests the delicate balance in the aspects of mind, body, speech, and environment, which can represent the way we each find wholeness in our lives. For others the stones are a marker suggesting Youre on the right path. This interpretation is found among some native cultures in their use of stone cairns. a ubiquitous design that invites insight and personal interpretation is what we wanted, as a representation of how we serve each member of our community. We welcome hearing your interpretation as we move forward, committed to the deliberate, daily work of attending to healing our lives and the lives of those whom we serve.

Community news
We are making the move into our new name over these next few months which requires changing many aspects of our printed identity, both here in Northampton and on the web, where so many people are now learning about us. We welcome any phone calls or letters about the change and want everyone who is part of our community to be informed about the new logo and name. In the early fall a family of a past Windhorse client made a large gift of $100,000 to the lowincome financial aid endowment fund that they had earlier established. This brings that fund to a total of $200,000 which now allows us to begin spending a small portion of the investment proceeds for supporting individuals in need with scholarship funds. This is the beginning of a long term strategy to build this into a fund that can wholly support one or more individuals during their time at Windhorse. Senior Clinician Mary Tibbetts recently chaired a panel at the National ISPS Conference held outside Washington D.C. and presented a paper that she authored with senior clinician Nick Luchetti titled The Between: Antidote to Psychotic Loneliness. Sara Watters, Director of Clinical Services, recently conducted a Natural Teams training for Thrive, a mental health agency in Columbia, Maryland. Thrive has been learning how to adapt our basic attendance practices for use with adolescents with ADHD or ADD diagnoses. Due to a convergence of a generous gift from a grateful family of a past client and a increased volume of calls from the west coast, we are developing another location for the Windhorse approach to flourish in. San Luis Obispo, California is the town that the Windhorse Integrative Mental Health-West will be located in. Look for more information in our next newsletter.

art by: Daniel Ovadia

windhorse newsletter winter 2010

windhorse newsletter winter 2010

A Notice to the Parent

By Tim Ness (Windhorse Housemate) From Windhover School: Your daughter returned to school today. We let her sit with the nurse for the first hour. She was confident all was well, but knew this needed to go slowly. Your daughter was worried about removing the bandages. The wounds had all disappeared, but scars would now be revealed. They went outside together and found a spot in the grass. The bandages came off easily and perhaps could have been removed some time ago. Her hands had been in bad shape, but her strength and her belief have turned her skin golden. Her patience worked all through her body and transformed her hair into a tapestry. Because she endured so much, her heart now has an extra chamber and her blood is richer than before Later in the day, in music class, she sang and her harmony made everyone laugh happily.

photo by: Mike Levy

Comings We are delighted with the addition of two new board members recently. Nan Grand-Jean from San Francisco and Lisa Teague from Portland, Oregon have each taken their seats. We welcome Robert Gardiner, M.D. as a Psychiatrist for Windhorse clients. Robert joins our founding Psychiatrist, Bruce Goderez, M.D., in this important role. Board elections occurred this past fall and leadership roles are now filled by: Reuven Goldstein as President, Peter Dulchinos as Vice-President, Mike Stein as Treasurer, and Sera Davidow as Clerk. We welcome Tim Ness and Elizabeth Johnson as housemates on Windhorse household teams here. This past fall we benefited from the able internship work of Guangye Cao, Eva Claire Albion-Wright and Tess Anais Zinnes, all students from Smith College who helped us with Marketing and Development projects. Beginning this past fall, Patty Kruglack, a Masters candidate in Social Work at Smith College, joined us for a year as a clinical intern. She has brought a vibrant empathy and strong clinical skills to her position here.

Goings We are grateful to Victoria Yoshen and Carol Douglass, who have completed their service as our board members. Victoria brought her depth of past Windhorse leadership to her service and Carol brought to the board her concise analysis and questioning to her role on the board. We have said goodbye to Gabrielle Vitiello, a senior clinician here at Windhorse. She provided insightful clinical care to each client she worked with. We wish her well in all her future pursuits. Ilina Singh has moved on from her position as Wellness Nurse. Keep your eyes open for her beautiful poetry. It has graced the pages of this publication in the past and she graced us with her nursing skills. Sarah Carr, a Team Leader has headed out to Thailand for a long-term professional training. She brought insight and clarity to her clinical work and to her work as a member of the Admissions team. We have a feeling that we will be working with Sarah yet again in the future. We thank Jamila Gore for her administrative assistance over the past year. She brought wit and ease to everything she was involved in at Windhorse. We also thank Jordan Stout and Jenny Woodward for the caring and consistent support they provided as housemates with Windhorse clients.

windhorse newsletter winter 2010

windhorse newsletter winter 2010