Reduce Stress in Kids with Yoga

“Yoga is about exploring and learning in a fun, safe and playful way. Yoga and kids are a perfect match.” – PBS Parents

 

Childhood can be a wonderful time of life. But, it is often fraught with problems that can stress the child. Grammar school aged children are exposed to many stressors including problems at home. These can vary from simple disciplinary problems to physical and sexual abuse to familial economic stresses. At school they can be discriminated against, teased, bullied, or laughed at. In addition, modern testing programs insure that these children are constantly exposed to high stakes testing. All of these stresses can occur while the child has yet developed adequate strategies and mechanisms to cope with the stress. So, there is a need to develop methods to assist young children, perhaps even more so than adults, to cope with stress.

 

Yoga practice has many positive physical and psychological benefits including reducing the physical and psychological responses to stress in adults (see http://contemplative-studies.org/wp/index.php/category/contemplative-practice/yoga-contemplative-practice/). It has even been shown to benefit high school students (see http://contemplative-studies.org/wp/index.php/2015/10/24/keep-grades-up-with-downward-dog/). It is known that mindfulness training has positive effects on 4th and 5th grade children (see http://contemplative-studies.org/wp/index.php/2015/08/08/building-a-better-adult-with-elementary-school-mindfulness-training/) and even with preschool children (see http://contemplative-studies.org/wp/index.php/2015/07/17/building-a-better-adult-preschool-mindfulness-training/).  This suggests that there it is reasonable to further explore the effects of yoga practice on stress at earlier ages.

 

In today’s Research News article “Effects of a Classroom-Based Yoga Intervention on Cortisol and Behavior in Second- and Third-Grade Students: A Pilot Study”

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410873/

Butzer and colleagues conduct an uncontrolled trial of 10 weeks of yoga training for 2nd and 3rd grade students and measured salivary cortisol levels, a marker of stress, and obtained teacher behavioral ratings. The children received instruction in the classroom in all components of yoga practice, including breathing exercises, physical exercises and postures, meditation techniques, and relaxation. They practiced twice a week for 30-minutes for the 10 weeks. Measures were taken before and after the 10-week yoga practice period.

 

They found that the 2nd graders showed a significant decrease in salivary cortisol levels from the beginning of the 10-week training period to the end. This suggests that there was a decrease in stress levels in these children. The teacher rating again revealed significant improvement in the 2nd grade children in social interactions with classmates, attention span, ability to concentrate on work, ability to stay on task, academic performance, ability to deal with stress/anxiety, confidence/self-esteem, and overall mood. This suggests that there was an increase in academic, social, and emotional abilities in the 2nd grade children over the testing period. Unfortunately, they did not observe similar benefits in the 3rd grade children.

 

These are encouraging results. But, it must be kept in mind that this was an uncontrolled pilot trial. Without a control group there is no way to tell if the children simply improved due to their maturing, growing more accustomed to their environment, or learning from the normal instruction over the 10-week period. There is also the possibility of a bias effect as the teachers who taught the yoga were the same ones doing the ratings. In addition, the fact that the 3rd grade students did not show similar responses as the 2nd graders, limits the generalizability of the results and questions their validity. It is possible, though that the differences between the 2nd and 3rd grade were due to differences in the teachers or the classroom environments rather than the yoga training.

 

Regardless, these pilot results provide support for implementing a larger randomized control trial of the application of yoga to grammar school children and, perhaps, demonstrate a safe and effective method to reduce stress in kids.

 

“We can learn so much from how children respond to uncertainty with a sense of curiosity and adventure. Rather than fearing that we’ll fail to meet an expectation, we can adopt a child’s practice of letting go, and so much more becomes possible. We can create more magic, inspiration, happiness, love, joy, and laughter both on and off the mat.” –  Kali Love

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Religiosity Protects against Alcohol and Drug Abuse

“Research investigating the relationship between religious commitment and drug use consistently indicates that those young people who are seriously involved in religion are more likely to abstain from drug use than those who are not; moreover, among users, religious youth are less likely than non-religious youth to use drugs heavily” – Gerald Bachman

 

Alcohol intake is a ubiquitous fact of life. In the United States 87% of adults reported that they drank alcohol at some point in their lifetime; 71% reported that they drank in the past year; 56% reported that they drank in the past month. If alcohol intake is tempered by moderation and caution it can be enjoyed and may be potentially beneficial. But as alcohol intake gets out of control it can lead to binge drinking and alcoholism. It is reported that 25% of U.S. adults reported that they engaged in binge drinking in the last month and 7% have what is termed an alcohol use disorder.

 

This is troubling as it can be very dangerous and potentially fatal. Nearly 88,000 people in the US and 3.3 million globally die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States. Drunk driving accounted for over 10,000 deaths; 31% of all driving fatalities. Excessive alcohol intake has been shown to contribute to over 200 diseases including alcohol dependence, liver cirrhosis, cancers, and injuries. It is estimated that over 5% of the burden of disease and injury worldwide is attributable to alcohol consumption. So, clearly, it is important to control excessive alcohol intake.

 

Spirituality and religiosity have been shown to be associated with successful treatment and relapse prevention with substance abuse in general including alcoholism. Alcohol intake and binge drinking rates are higher in sexual minorities than in heterosexuals, especially women. So, it makes sense to further investigate the relationship of spirituality and religiosity with alcohol intake in sexual minority women. In today’s Research News article “Religiosity as a protective factor for hazardous drinking and drug use among sexual minority and heterosexual women: Findings from the National Alcohol Survey”

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Drabble and colleagues revisit a major national survey of alcohol intake patterns and investigate participation in religion and alcohol intake in sexual minority women.

 

They found that sexual minority women had significantly higher rates of drug use in general including alcohol intake, higher rates of hazardous drinking and lower rates of being lifetime abstainers from alcohol. Sexual minority women had significantly lower rates of high religiosity and participation in religions that had norms unfavorable to alcohol intake. This was particularly true with lesbian women. So, sexual minority women are more likely to drink and misuse alcohol and are less religious than heterosexual women. They also found that religiosity was associated with higher rates of lifetime abstinence of alcohol regardless of sexual orientation. But, religiosity and participation in religions that had norms unfavorable to alcohol intake were associated with lower rates of hazardous alcohol or illicit drug use in heterosexual women but not in sexual minority women. So, religiosity appears to have less of an impact on alcohol intake in sexual minority women than heterosexual women.

 

Why is religiosity associated with lower overall and hazardous use of alcohol? One possible reason is that religions in general have negative teachings about alcohol. Buddhism teaches that intoxication is an impediment to spiritual development. Other religions completely prohibit alcohol while many decry the behaviors that occur during alcoholic stupor.  This provides a cognitive incompatibility between drinking and religiosity. The recognition that drinking is not an OK thing to do might provide the extra motivation to help withstand the cravings. In addition, religious groups tend to be populated with non-alcoholics. So, increased religiosity also tends to shift the individual’s social network away from drinking buddies to people less inclined to provide temptation. It is very difficult to not drink when those around you are not only drinking themselves but encouraging you to drink. So shifting social groups to people who either abstain or demonstrate controlled drinking can help tremendously.

 

But, why does religiosity appear to have a smaller effect on sexual minority women than heterosexual women? One possibility is that many religions are associated with negative teachings regarding homosexuality. For sexual minority women, their rejection of these teachings may generalize to affect their adherence to the other teaching of the religion including alcohol intake. As a result, being religious has less of an impact on alcohol and drug use for these women. It would be interesting to investigate the relationship of religiosity and alcohol intake in sexual minority women who belong to religions that are very tolerant to homosexuality versus religions who are intolerant.

 

Regardless, protects against alcohol and drug abuse with religiosity.

 

“Religious involvement can protect against substance use by providing opportunities for prosocial activities, which themselves may promote antidrug conduct norms, and for interaction with nondeviant peers. Youth who are involved in religious activities tend to form peer groups with youth who are involved in similar activities, and they are less likely to form friendships with deviant peers.” – Flavio Marsiglia

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Meditate Naked!

That all is as thinking makes it so, and you control your thinking. So remove your judgments whenever you wish and then there is calm.” – Marcus Aurelius

 

There are a number of meditation practitioners who literally meditate naked, without clothes. They report that the openness and the sensations from the air moving over the skin are both pleasant and helpful to being open to experience in meditation. We have been taught that being naked is something we should be ashamed about, and that we should hide our imperfections. By meditating naked, we can accept what we truly are.

 

For most people meditating without clothes is not acceptable or appropriate and would certainly be problematic in group meditation settings. But, unclothed meditation is not essential to the true meaning of meditating naked. What we’re referring to is meditation that involves an unclothed mind, one where the mental process with which we cloak our experiences have been stripped away and they are appreciated simply as they are unvarnished by thinking.

 

We tend to live in our thoughts far away from what is actually happening around us. I find when teaching meditation that it is a complete shock to the beginning student to discover that they are unable to control their minds and thoughts simply arise regardless of their efforts to stop them. They have always believed that they were in control, that they were the rulers of their internal mental state and to discover that they are not is a revelation. Meditation is wonderful when we can strip off our thoughts, when we can be mentally naked and completely open to our immediate experience.

 

At first the student tries to stop the thoughts, thinking that this is what it means to be mentally naked in meditation. But, this is a misunderstanding. To be aware in the present moment is to be aware of all of our experiences and that thoughts are simply a part of that experience. What we need to do is strip away our attachments to our thoughts, to our beliefs that our thoughts represent reality and what we truly are and simply let them be part of our experience. We simply watch the thoughts, naked of attachments, and not hold onto them but allow them to simply and spontaneously arise and fall away.

 

We need to meditate naked of goals and aspirations. Meditators make the mistake of trying to accomplish something. A goal or an aspiration engages the mind in seeking and attempting to control experience in order to attain the goal. This is also a mistake as there is no goal to meditation. There’s just relaxing, letting go, and letting experience rise up and fall away, stripped of effort, of accomplishment, and of control. We need to strip away all notions that there is a goal that must be pursued.

 

We need to meditate naked of judgments. Meditators often classify their meditations as either good or bad depending upon how close to their expectations they came during the meditation. This is a mistake. Meditation is about letting go and just letting things be as they are. So, however they are is fine, not good, not bad, just what is at the moment. The human mind is constantly weighing and judging everything. This is useful in everyday life but in meditation it is a refusal to recognize that what occurs is simply what occurs neither right nor wrong. Strip off judgements and see things just as they are.

 

We need to meditate naked of interpretations. Meditators tend to interpret whatever is happening during the meditation. Hearing a sound the mind automatically interprets it as footsteps. Feeling a tactual sensation the mind interprets it as an itch. Seeing the light dim, the mind interprets it as a cloud moving to cover the sun, etc. This is a mistake. Strip away these interpretations. Just interpret the sound simply as an experienced sound, the tactual sensation as a just a sensation, the light dimming as just light falling away. Just be, watching, feeling, hearing stripping away any attempt to interpret the experience

 

Finally we need to meditate naked of expectations that we can actually maintain a meditation naked of thoughts, goals, aspirations, judgments, and interpretations. We need to strip away any belief that complete naked meditation can actually be accomplished. We’re human beings with minds that we can’t control. We need to strip away any notion that we can. It’s OK when we interpret, when a thought arises, when we judge, when we try to accomplish something. It will happen and will happen frequently. These things happen, even to the most experienced and adept meditators. Strip away any notion of a perfect meditation. Every meditation is perfect in its own way but not in the way that our minds think it should be. The thoughts, goals, aspirations, judgments, and interpretations are just as much part of our experience as the sounds of birds chirping, as the sight of a sunset. Strip away any regret that you are not the naked meditator that you want to be. Just be what you are, experience what it, and be exposed to your true nature.

 

So, strip the mind and meditate naked.

 

We could say that meditation doesn’t have a reason or doesn’t have a purpose. In this respect it’s unlike almost all other things we do except perhaps making music and dancing. When we make music we don’t do it in order to reach a certain point, such as the end of the composition. If that were the purpose of music then obviously the fastest players would be the best. Also, when we are dancing we are not aiming to arrive at a particular place on the floor as in a journey. When we dance, the journey itself is the point, as when we play music the playing itself is the point. And exactly the same thing is true in meditation. Meditation is the discovery that the point of life is always arrived at in the immediate moment.” – Alan Watts

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Better Control Drinking with Mindfulness

“mindfulness gives us the strength psychologically and neurologically to sit in discomfort, to lean into the void, as opposed to avoid it and jump to our addiction.” – Mindful Muscle

 

Inappropriate use of alcohol is a major societal problem. In fact, about 25% of US adults have engaged in binge drinking in the last month and 7% have what is termed an alcohol use disorder. Alcohol abuse is very dangerous and frequently fatal. Nearly 88,000 people in the US and 3.3 million globally die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States. Drunk driving accounted for over 10,000 deaths; 31% of all driving fatalities. Excessive alcohol intake has been shown to contribute to over 200 diseases including alcohol dependence, liver cirrhosis, cancers, and injuries. It is estimated that over 5% of the burden of disease and injury worldwide is attributable to alcohol consumption.

 

Alcohol abuse often develops during adolescence and it on display with college students where about four out of five college students drink alcohol and about half of those consume alcohol through binge drinking. About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall. More than 150,000 students develop an alcohol-related health problem.

 

Alcohol abuse can have dire consequences as 1,825 college students die each year from alcohol-related unintentional injuries and between 1.2 and 1.5 percent of students indicate that they tried to commit suicide within the past year due to drinking or drug use. But, drinking has widespread consequence to not only the students but also the college communities, and families. More than 690,000 students are assaulted by another student who has been drinking. More than 97,000 students are victims of alcohol-related sexual assault or date rape. 599,000 students receive unintentional injuries while under the influence of alcohol.

 

These facts clearly highlight the need to explore methods to control excessive alcohol intake. One potential method is mindfulness as it has been shown to assist in the control of alcohol intake (see http://contemplative-studies.org/wp/index.php/category/research-news/alcoholism/) and in recovery from alcohol addiction (see http://contemplative-studies.org/wp/index.php/category/research-news/addiction/). So it would make sense to further explore the effects of mindfulness on alcohol intake in college students.

 

In today’s Research News article “How to think about your drink: Action-identification and the relation between mindfulness and dyscontrolled drinking”

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Schellhas and colleagues do exactly that, examining the relationships between mindfulness, alcohol intake, difficulty in controlling alcohol intake, and their identification with alcohol intake in college students. Interestingly, they did not find a relationship between mindfulness and weekly use of alcohol. But there was a relationship between mindfulness and the ability to control alcohol intake. In other words, mindful individuals drink as much as those with low mindfulness but they are better able to control their intake.

 

They also found that mindfulness also had an indirect effect on alcohol consumption. Mindfulness was negatively related to the use of alcohol to escape emotional problems. This escape use of alcohol intake was strongly related to the inability to control alcohol intake. In other words, students high in mindfulness were less likely to use alcohol to deal with their emotional problems and this in turn allowed the students to better control, their intake.

 

The results suggest that mindfulness may help students control alcohol intake. The study, however, did not actively change levels of mindfulness, but simply measured existing levels and their relations to alcohol consumption. As a result, it cannot be concluded that mindfulness was responsible for the better control of intake. It could be that individuals who are better at controlling behavior are more mindful or that some third factor such as emotional maturity was related to both. Future research is needed where mindfulness training is implemented to increase students’ mindfulness and observe its subsequent effect on intake and ability to control intake.

 

Regardless it is clear the mindfulness and control of alcohol intake are positively related. So, better control drinking with mindfulness.

 

“mindfulness is likely an effective tool in helping people with addiction because it’s a single, simple skill that a person can practice multiple times throughout their day, every day, regardless of the life challenges that arise. With so much opportunity for practice—rather than, say, only practicing when someone offers them a cigarette—people can learn that skill deeply.” – Sarah Bowen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Help Kids Emotionally and Cognitively with Mindfulness

“Mindfulness within schools makes a lot of sense. There is a growing body of evidence that supports the claims that mindfulness improves working memory, attention, academic skills, social skills, emotional balance and self-esteem.” – Joseph Pound

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This occurs almost without any intervention from the adults as the child appears to be programmed to learn. It is here that behaviors, knowledge, skills, and attitudes are developed that shape the individual. But, what is absorbed depends on the environment. If it is replete with speech, the child will learn speech, if it is replete with trauma, the child will learn fear, if it is replete with academic skills the child will learn these, and if it is replete with interactions with others the child will learn social skills. It is up to adults to structure the environment to be conducive to learning what is most important.

 

Elementary school is a wonderful time to structure the environment to develop knowledge, attitudes, and skills. This has been known for centuries. But, which ones are most important to the development of a high functioning adult? Elementary school environments stress academic skills. This is appropriate and necessary. But at times, particularly in the United States, the emphasis on academic skills, especially factual learning, is so great that other important learning is neglected. There is often little effort to develop the so called softer skills; emotional, mindfulness, creative, meta-cognitive, psychological, and social skills. This is unfortunate as these skills are important unto themselves’ and also turn out to be very important in developing academic skills. In addition, it’s been shown that these softer skills in childhood predict health, financial stability, and educational attainment into adulthood.

 

One method that has recently been employed to help develop these softer skills in school children is mindfulness training. This has occurred for good reason as mindfulness training has been shown to improve academic performance, social skills, emotions, and meta-cognitive skills in grammar school children (see http://contemplative-studies.org/wp/index.php/2015/08/08/building-a-better-adult-with-elementary-school-mindfulness-training/) and even in preschool children (see http://contemplative-studies.org/wp/index.php/2015/07/17/building-a-better-adult-preschool-mindfulness-training/). This is a potentially very important development and as such deserves far greater research scrutiny.

 

In today’s Research News article “Mindfulness Training in Primary Schools Decreases Negative Affect and Increases Meta-Cognition in Children”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1172028366154421/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709470/

Vickery and Dorjee delivered twelve ½-hour mindfulness lessons over approximately 3-weeks to 7-9-year old primary school children in the classroom in addition to the typical curriculum. A second group of children were provided the typical curriculum without the additional mindfulness training. Children were measured with objective and observational measures before and after training and 3-months later. They found that positive changes in mindfulness were associated with positive increases in emotional awareness in the mindfulness trained children. They also found that at follow-up the mindfulness training produced a significant increase in teacher rated meta-cognitive skills and also a significant decrease in negative emotions.

 

These are potentially important findings. Meta-cognitive skills include working memory, planning/organizing, organization of materials, initiating and monitoring activities. These are important skills that are generally predictive of academic performance and success later in life. Mindfulness, paying attention to the content of the present moment, may be a prerequisite for meta-cognition. One cannot initiate, plan, organize, remember, or monitor activities without paying attention to them as they are occurring. So, mindfulness skills may be seen as foundational for cognitive skills. It is exciting that this appears to be effective in young 7-9-year old children and makes a strong argument for the implementation of mindfulness programs in grammar schools.

 

The decrease in negative emotions is also important. They can lead to anxiety and depression. It has been shown that mindfulness training in adults and adolescents is effective for the reduction of anxiety and depression. It is exciting to observe that mindfulness training may have similar effects in 7-9-year old children. This suggests that the mindfulness training may develop resilience and psychological well-being in the children. It is possible that mindfulness training may be an effective early intervention for the prevention of later psychological problems and act to promote the development of psychological health.

 

It should be noted that Vickery and Dorjee did not find significant changes in measures of mindfulness, positive emotions, emotional awareness and expressive reluctance, and positive well-being. It is possible that a the total of 6-hurs of training is simply insufficient to impact these domains. Further research is needed to clarify this issue. Regardless, the positive findings that were reported are exciting and potentially important and support the further development and research on the use of mindfulness training in grammar school curricula.

 

So, help kids emotionally and cognitively with mindfulness.

 

“People are stepping back on that full focus on reading and math scores and are looking more holistically at all the skills that really matter. Social-emotional learning is not only crucial to academic success, but also career success and lifelong being.” – Sara Bartolino Krachman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Be Less Impulsive with Mindfulness

“The antithetical nature of mindfulness and automatic or impulsive behaviors provides theoretical promise for the efficacy of mindfulness skills in the treatment of impulse control disorders.” – Kelcey J. Stratton

 

Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. In addition, 30 to 90 % of BPD cases are associated with high rates of early traumatic experiences including sexual, physical and emotional abuse. BPD is associated with high rates of co-occurring depression, anxiety disorders, substance abuse, eating disorders, self-harm, suicidal behaviors, and completed suicides. Needless to say it is widespread and debilitating.

 

Many of these symptoms occur in other mental illnesses. Impulsivity, however, distinguishes BPD from other disorders. In addition, it is the reason that the disorder is dangerous to the individuals as it can propel them, on the spur of the moment, to overreact to anger, take drugs, harm themselves, and even terminate their lives. BPD has not responded well to a variety of therapies with the exception of Dialectical Behavior Therapy (DPT). It is significant that a difference between DBT and other therapies is that it emphasizes mindfulness. This suggests that mindfulness training may be essential in treating Borderline Personality Disorder and impulsivity. Indeed, BPD sufferers who are high in mindfulness tend to be low in impulsivity. It would make sense, then, that the mindfulness training occurring in Dialectical Behavior Therapy (DPT) may be an effective treatment for the dangerous symptom of impulsivity.

 

In today’s Research News article “Effects of mindfulness training on different components of impulsivity in borderline personality disorder: results from a pilot randomized study”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1171437569546834/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709962/

Soler and colleagues randomly assigned Borderline Personality Disorder (BPD) patients to receive 10-weeks of Dialectical Behavior Therapy (DPT) which was modified to include only Mindfulness Training (MT) or Interpersonal Effectiveness Training (IE). IE is designed to teach patients how to act more effectively in interpersonal interactions. They found that only the Mindfulness Training group showed a significant improvement in three self-reported aspects of impulsivity, motor impulsiveness (acting without forethought); attentional impulsiveness (the tendency to make quick, non-reflexive decisions), and non-planning impulsiveness (failure to prepare for future events). They also measured impulsivity with a series of laboratory tests designed to measure various aspects of impulsivity. They found that the Mindfulness Training group showed improvements in delaying gratification and in time perception.

 

These results are interesting. They suggest that the Mindfulness Training component of Dialectical Behavior Therapy (DPT) may be effective in treating the impulsivity characteristic of Borderline Personality Disorder (BPD) by improving the patients’ ability to delay gratification. Improved time perception may be responsible for better ability to delay gratification. It is important to note that impulsivity usually involves an inability to wait to get what is wanted. So, improved ability to delay gratification would be antithetical to impulsiveness. This may be the underlying mechanism by which mindfulness reduces impulsivity.

 

As mentioned BPD is a difficult disorder to treat and potentially dangerous to the self and others. It appears that the distinctive feature of BPD, impulsivity, is improved by DBT and that it is the mindfulness training that is responsible. This is particularly important as impulsivity is primarily responsible for the dangerous behaviors of BPD sufferers. It also appears that the mindfulness training acts to reduce impulsivity by improving time perception and the ability to delay gratification.

 

Impulsivity produces actions reflexively without awareness. Mindfulness training by improving the individual’s awareness of the immediate situation would tend to counteract impulsive action. So, mindfulness training may be essential to DBT’s ability to reduce impulsiveness by making the individual more aware of what they are doing. One cannot be mindful and impulsive at the same time.

 

So, be less impulsive with mindfulness.

 

“Decreased impulsivity has significant and wide implications for those suffering from it. This includes less general psychiatric morbidity, improved substance use outcomes, and general improvement in decision making skills, affecting every area of a person’s life in meaningful ways.” – Gisli Kristofersson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Reduce Healthcare Costs with Mindfulness

“If we want to lower the costs of healthcare, we need to reduce the demand for healthcare services – not increase supply.” – Charles A. Francis

 

“Mindfulness is now more relevant than ever as an effective and dependable counterbalance to strengthen our health and well-being, and perhaps our very sanity.”  ― Jon Kabat-Zinn

 

In the United States the costs of healthcare are out of control. We pay more per capita by far than any other country in the world and yet our healthcare outcomes are mediocre at best. Healthcare spending per person in the U.S. is over $10,000 per year, 17% of the Gross Domestic Product, over $3 Trillion. Increasingly, Americans are having problems paying for care — 26 percent report they or a family member had problems paying medical bills in the past year. Fifty-eight percent of Americans reported foregoing or delaying medical care in the past year. Many patients stop taking medications or never fill prescriptions due to unaffordability.

 

Costs are putting a strain on the finances of individuals and the entire country. Obviously there is a need to somehow control costs while improving the quality of healthcare services. One strategy is to attempt to reduce the costs of providing care. This, however, has proved to be extremely challenging. Another tactic is to work toward reducing the need for services. This can include methods to prevent illness and shorten or dampen illnesses when they do occur. Mindfulness practices have been shown to do just that, preventing illness, decreasing symptoms, and improving recovery as a stand-alone treatment or as an adjunct to conventional treatments (see http://contemplative-studies.org/wp/index.php/category/research-news/health/ and http://contemplative-studies.org/wp/index.php/category/research-news/well-being/).

 

In today’s Research News article “The low risk and high return of integrative health services”

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Russo and colleagues review the studies of the effects of alternative treatments including mindfulness practices on costs for healthcare services. They found that the use of mindfulness techniques reduced overall hospital costs. This occurred due to reduced length of stay in the hospital prior to and immediately following surgery, decreased use of prescription drugs which in turn further reduced length of stay, post-operative co-morbidities, and drug dependence, while increasing patient self-care. The use of mindfulness practices also decreased anxiety, pain, and narcotic use and improve patient satisfaction.

 

The exact amount of money saved depends upon many complex factors such as the interventions used, the practices used, the structure of the program, and facilities used. But, some examples can highlight the magnitude of the savings. The application of yoga training to cancer treatment resulted in cost savings of $156 per day, nearly $300,000 annually. Application of mindfulness techniques to diabetes care resulted in estimated savings of $31,000 per person per year. These savings were calculated after all of the costs associated with running the programs were subtracted. Obviously, considerable savings can be obtained by hospitals with the use of mindfulness techniques.

 

To my knowledge, there have not been any estimates of the savings produced by mindfulness practices with outpatient and non-hospital healthcare cost reductions and by disease prevention. So, the actual impact of the use of mindfulness techniques on healthcare costs is unknown but logic suggests that the savings are huge.

 

These are important findings and underscore the economic consequences of the application of mindfulness techniques to healthcare. Unfortunately, in the American healthcare system there is no incentives to reduce the number of treatments employed as the providers are paid according to the number of services provided rather than value and effectiveness of the services. The move toward outcomes-based payments may help in this regard. But, clearly there is a need to change the incentives in the system to promote wellness and reduced costs. Mindfulness practices have been proven to do just that.

 

Regardless, it is clear that we can reduce healthcare costs with mindfulness.

 

“People don’t actually want to think about their own health and don’t take action until they are sick. Yet employers are very motivated to get their employees healthy, since they bear most of the burden of their health care costs.” – Clayton Christensen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Improve Caregiver Quality of Life with Yoga

“Caring for someone with dementia is made up of an infinite number of small moments where we can go either way, adding more stress or bringing more ease. The problem when we are not mindful is our words come out and our actions unfold too quickly for us to have a chance to choose the wisest, most beneficial route. Mindfulness practice slows us down and takes some of the edge off our reactive tendencies.” – Marguerite Manteau-Rao

 

Caregiving for dementia patients is a daunting and all too frequent task. It is estimated that over 15 million Americans are dementia caregivers. It is an intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. In the last year, 59% of the caregivers report that they are effectively on duty 24/7. It is sad that 72% report relief when their loved one passes away.

 

This long and difficult process can take a major toll on the caregiver. On a practical level they frequently experience financial problems from lost income and have their careers interrupted. But, the greatest problems occur due to the intense levels of stress experienced by the caregivers. Around 2/3rd of caregivers report high emotional stress and over 1/3rd report high physical stress. This stress, in turn can have emotional consequences with over 1/3rd of caregivers reporting depression and many report family problems. In addition, dementia caregivers are more likely to have physical issues such as high levels of stress hormones, reduced immune function, increased hypertension, and coronary heart disease. Needless to say caregivers need care for themselves.

 

Reducing stress is very important for dementia caregivers. Stress not only jeopardizes their own health but also the quality of care they provide for their loved ones. Since mindfulness training has been shown to be effective in reducing both the psychological and physical responses to stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/), it would seem be potentially useful for the relief of caregiver stress. Indeed, mindfulness training has been shown to reduce stress and depression, improve the quality of caregiving, and improve the quality of life for the caregiver (see http://contemplative-studies.org/wp/index.php/category/research-news/caregiving/). Hence, it would seem reasonable to further explore mindfulness practices to care for the caregiver.

 

In today’s Research News article “Yoga and compassion meditation program improve quality of life and self-compassion in family caregivers of Alzheimer’s disease patients: A randomized controlled trial”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1170247206332537/?type=3&theater

Danucalov and colleagues applied an 8-week program of yoga and compassion meditation to a group of female Alzheimer’s caregivers and compared their response to those of a wait-list control group. At the end of yoga and compassion meditation training in comparison to before training and to the control group, the yoga group reported significant improvements in their quality of life including physical, psychological, environmental, and social domains. They showed increased mindfulness, improved vitality both immediately and in general, and increased self-compassion and self-kindness.

 

These findings are remarkable and potentially important. Yoga and compassion meditation training markedly improved the psychological and physical conditions for the caregivers producing a major improvement in quality of life. Training also increased their vitality which is critical given the intense fatigue that the caregiving can produce. How this practice might produce these benefits was not explored. But, the documented ability of yoga practice in reducing stress responses would seem a likely explanation. In addition, the compassion meditation may be a useful component as Loving Kindness Meditation has been shown to improve self-compassion and kindness toward others (see http://contemplative-studies.org/wp/index.php/category/contemplative-practice/loving-kindness/).

 

Regardless of the explanation, it appears clear that mindfulness training is effective in improving the physical and psychological problems experienced by dementia caregivers.

 

So, improve caregiver quality of life with yoga.

 

“Many of us follow the commandment ‘Love One Another.’ When it relates to caregiving, we must love one another with boundaries. We must acknowledge that we are included in the ‘Love One Another.” ― Peggi Speers

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Decreased Suicidality in Veterans with Spirituality

“there are certain moral reactions to war and the experience of combat training that indicate a violation of moral conscience in war can have devastating inner consequences in soldiers.” – Rita Nakashima Brock

 

It has been widely reported that there are extremely high levels of suicides among veterans. But these reports are based upon the entire veteran population which includes large numbers of elderly veterans. Looking only at veterans discharged since 2001, the rates suicide rates observed were much lower consisting of about one suicide per day. The actual annual suicide rate these veterans was 29.5 per 100,000 veterans. This is roughly 50% higher than the rate among similar civilians. Interestingly, the rates of suicide are lower in veterans who were deployed to combat than those who were not. Deployed Veterans had a 41% higher suicide risk compared to the general U.S. population while Non-Deployed Veterans had a 61% higher suicide risk.

 

These figures are still alarming, although less so than common reports of veteran suicides. It also suggests that the transition back to civilian life may be as difficult as dealing with combat produced Post Traumatic Stress Disorder (PTSD). Regardless, it is important to investigate the causes of these suicides and discover methods that might prevent them. Mindfulness training is one important potentially helpful method to lower suicidal thoughts and prevent suicide. Mindfulness has been shown to has been shown to reduce suicidality (see http://contemplative-studies.org/wp/index.php/category/research-news/suicidality/) and to reduce the impact of trauma on the individual (see http://contemplative-studies.org/wp/index.php/category/research-news/trauma/). Another potentially important factor is spirituality. Indeed, spirituality has been shown to reduce suicide tendencies in the elderly (see http://contemplative-studies.org/wp/index.php/2015/07/17/spirituality-improves-end-of-life/). Unfortunately, there has been very little systematic research on spirituality relationships to suicide in either the general population or in veterans.

 

In today’s Research News article “Suicidal behavior and spiritual functioning in a sample of Veterans diagnosed with PTSD”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1169673129723278/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729329/

Kopacz and colleagues studied the relationships between spirituality and suicidality in a veteran sample undergoing residential treatment for PTSD. They compared three groups, a no suicide group who had not even thought about suicide, an Ideation group who had contemplated suicide, and an Attempt group who had attempted suicide. They found that the Ideation and Attempt group had greater amounts of spiritual struggle and lower level of forgiveness. They also found that low levels of thoughts about suicide (ideations) were associated with involvement in a spiritual community and high levels of spiritual experiences.

 

It should be noted that these results were correlative and thereby do not demonstrated a causal connection between spirituality and lower levels of suicidality. In fact, less suicidal ideation may prompt veterans to seek out spiritual experiences of some third factor such as religious upbringing is associated with both. In order to demonstrate causation, it will be necessary to actively increase spirituality and observe its effects on suicidality.

 

With these caveats in mind, the results may signal that being spiritual protects the individual from suicidal thoughts. It may do so by providing other higher ideas about the meaning of life and its sacredness. Higher levels of spirituality may also provide a community that is supportive of the individual and thus helps them cope with difficult thoughts and experiences. It is also possible that a key factor may be spiritual struggles, where the inability to find higher meaning makes suicide more likely. It is also possible that inability to forgive is the key, where the individual cannot forgive, particularly themselves, making destroying the self are seemingly reasonable solution.

 

Regardless, it is clear that spirituality is an important factor influencing suicidality in veterans. This clearly suggests that further research is warranted and that spirituality may be an important factor in suicide prevention in veterans.

 

“The Army’s “spiritual fitness” encourages soldiers to see events in a neutral light, rather than labeling them as good or bad, and to create a nightly list of positive things that happened that day. The lack of awareness is startling regarding what it might mean to ask someone to think of killing a child, losing a close friend or torturing detainees as neutral or positive.”Rita Nakashima Brock

 

CMCS – Center for Mindfulness and Contemplative Studies

 

What’s Missing from the Present Moment

 

The mind is never satisfied with the objects immediately before it, but is always breaking away from the present moment, and losing itself in schemes of future felicity… The natural flights of the human mind are not from pleasure to pleasure, but from hope to hope. – Samuel Johnson

 

One of the central tenets of Buddhism is that life is characterized by dukkha, which is usually translated as suffering. But, I prefer the less colorful translation as unsatisfactoriness. We in general constantly find ourselves and our lives to be unsatisfactory. It would appear to be a human characteristic to be constantly striving for something better. This can be a good thing as it’s been a driving force behind the development of agriculture, science, medicine, and engineering which has allowed us to improve our physical well-being. But, it has left us with intense feelings of unsatisfactoriness, dukkha.

 

This constant striving for something better results in seeing whatever is currently happening as flawed and needing improvement. Hence, we critically evaluate the present and find it unsatisfactory, not quite up to what it could be. As a result we impatiently wait for whatever is going on now to end so we can move on to the next thing. Unfortunately, when we get there, that too is seen as flawed and unsatisfactory and we again look forward to the next thing. But, that too is unsatisfactory. So we eagerly anticipate the next thing which of course is also found to be unsatisfactory, etc. etc. etc.

 

So we never enjoy anything for simply what it is. We are constantly looking for something better in the future, which of course it never is. So we move through life never happy, never appreciating all the beauty, wonder, and happiness that is present right now. What a sad treadmill! Constantly striving but never attaining the elusive perfect experience. A bit of thought quickly leads to the conclusion that the problem is that we never simply immerse ourselves in what is present. We’re always looking forward to something better resulting in us never truly enjoying what is.

 

When you’re on this treadmill and looking forward to a better future that never comes, break out of it by thinking “what exactly is missing from this very moment?” Examine what is actually present right here, right now, not in relation to the past or the future, but simply as it is right now. Is there anything that is actually missing? If you look deeply you’ll begin to see that nothing is missing. The present moment is complete and wonderful. Everything is perfect just as it is.

 

This takes some practice as our minds constantly want to find flaws and find ways to improve things. Don’t think about what might make it better. That involves memories of the past and expectations for the future. Simply, focus on what is. Look at what you’re experiencing. Listen deeply to the sounds that are present. The gnawing sound of the motorized lawn tools that is breaking up your peace is actually quite fascinating if you listen carefully. What a miracle it is that you experience it. Somehow you can sense which direction it’s coming from and how far away it is. How do you do that? What a wonder. Look carefully at what it is about it that makes you cringe and want it to go away. Realize that this unique sound will never be present again exactly as it is right now. How amazing is that? Here’s a one of a kind completely unique experience right here in your present moment.

 

Look at the intricacies and beauty available in the simplest things around you. Appreciate the incredible ability of the fly to soar through the air. Slowly you’ll begin to appreciate its completeness and its perfection. Look what is right in front of you. It may not be picturesque, perhaps a parking lot. But revel in the colors and forms that are witnessed. Appreciate the miracle of seeing. We take it so for granted. So, look at it deeply. What a wonder it is. What a delight!

 

Now let the greatest wonder of the present moment come front and center. Look at what is looking. Observe not just what’s being seen, but observe what’s seeing, what’s listening, what’s feeling, what’s knowing. What you’re observing is completely incomprehensible to science. It is one of the greatest mysteries in the universe, human consciousness, and you can view it right now within yourself. It’s only available in the present moment, but it’s truly one of the greatest wonders of all.

 

What could possibly be missing from this incredible moment? If you simply look at it deeply, honestly, without recourse to the past and future, you’ll find that it is absolutely complete and perfect as it is. You need not look to something else for happiness it’s right here, right now, in the miracle of existence, that’s always there in every moment.

 

Always say ‘yes’ to the present moment… Surrender to what is. Say ‘yes’ to life – and see how life starts suddenly to start working for you rather than against you”Eckhart Tolle

 

The power for creating a better future is contained in the present moment: You create a good future by creating a good present.” – Eckhart Tolle

 

CMCS – Center for Mindfulness and Contemplative Studies