By John M. de Castro, Ph.D.
“Mind-body exercise offers a low-cost approach that could be used as a complement to traditional psychotherapy or drug treatments. These self-directed practices give PTSD patients control over their own treatment and have few side effects.” – Sang H. Kim
Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. But, only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life. For military personnel it’s much more likely for PTSD to develop with about 11%-20% of those who have served in a war zone developing PTSD.
PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.
Obviously, these are troubling symptoms that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective. The nervous system is constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. For example, the brain area that controls the right index finger has been found to be larger in blind subjects who use braille than in sighted individuals. Similarly, cab drivers in London who navigate the twisting streets of the city, have a larger hippocampus, which is involved in spatial navigation, than predefined route bus drivers. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. This all suggests that mindfulness training would improve PTSD symptoms by producing changes to the brains of sufferers.
In today’s Research News article “Altered default mode network (DMN) resting state functional connectivity following a mindfulness-based exposure therapy for posttraumatic stress disorder (PTSD) in combat veterans of Afghanistan and Iraq.” See:
or below
King and colleagues perform functional Magnetic Resonance Imaging (f-MRI) before and after a 16-week mindfulness treatment program for Post-Traumatic Stress Disorder (PTSD) in veterans and compared the results to veterans treated with a present-centered group therapy for PTSD. They found that both groups showed improvement in PTSD symptoms, but only the mindfulness treatment produced significant improvement in total and intrusive, avoidant, and hyperarousal PTSD symptoms. This replicates previous results that mindfulness training is effective in treating PTSD symptoms.
King and colleagues also found that the mindfulness treatment produced changes in the nervous system. In particular, they found increased connectivity between the dorsolateral prefrontal cortex and dorsal anterior cingulate cortex. These are structures included in what has been termed the Default Mode Network (DMN) which is involved in producing mind wandering and intrusive thoughts. In addition, they found that the greater the increase in connectivity of these structures the greater the improvement in PTSD symptoms. These results suggest that mindfulness training changes the nervous system in such a way as to improve the ability of the individual to shift attention away from mind wandering and intrusive thoughts. These off-task thoughts are characteristic of PTSD sufferers and are a key symptom of the disorder. By being able to shift away from these thoughts and pay attention to the present moment, the mindfulness trained individuals are better able to keep these thoughts from tormenting them and thereby improve PTSD.
These results demonstrate the effectiveness of mindfulness training for Post-Traumatic Stress Disorder (PTSD) and suggest a mechanism by which the training produces these effects. It appears to alter the Default Mode Network (DMN) of the brain allowing the individual to better pay attention to the present moment and shift thinking away from the intrusive thoughts like flashbacks that are characteristic of PTSD.
So, change the traumatized brain with mindfulness.
“Very often, depression can be about the past, ruminating over and over about losses or other terrible things that happened in the past. Anxiety, meanwhile, very often involves ruminating about terrible things that you’re afraid are going to happen in the future. But in the present, very often, there’s actually nothing terrible going on, and the act of recognizing that can be helpful.” – Anthony King
CMCS – Center for Mindfulness and Contemplative Studies
Study Summary
King, A. P., Block, S. R., Sripada, R. K., Rauch, S., Giardino, N., Favorite, T., Angstadt, M., Kessler, D., Welsh, R. and Liberzon, I. (2016), Altered default mode network (DMN) resting state functional connectivity following a mindfulness-based exposure therapy for posttraumatic stress disorder (PTSD) in combat veterans of Afghanistan and Iraq. Depress. Anxiety, 33: 289–299. doi: 10.1002/da.22481
Abstract
Background: Recent studies suggest that mindfulness may be an effective component for posttraumatic stress disorder (PTSD) treatment. Mindfulness involves practice in volitional shifting of attention from “mind wandering” to present-moment attention to sensations, and cultivating acceptance. We examined potential neural correlates of mindfulness training using a novel group therapy (mindfulness-based exposure therapy (MBET)) in combat veterans with PTSD deployed to Afghanistan (OEF) and/or Iraq (OIF).
Methods: Twenty-three male OEF/OIF combat veterans with PTSD were treated with a mindfulness-based intervention (N = 14) or an active control group therapy (present-centered group therapy (PCGT), N = 9). Pre-post therapy functional magnetic resonance imaging (fMRI, 3 T) examined resting-state functional connectivity (rsFC) in default mode network (DMN) using posterior cingulate cortex (PCC) and ventral medial prefrontal cortex (vmPFC) seeds, and salience network (SN) with anatomical amygdala seeds. PTSD symptoms were assessed at pre- and posttherapy with Clinician Administered PTSD Scale (CAPS).
Results: Patients treated with MBET had reduced PTSD symptoms (effect size d = 0.92) but effect was not significantly different from PCGT (d = 0.46). Increased DMN rsFC (PCC seed) with dorsolateral dorsolateral prefrontal cortex (DLPFC) regions and dorsal anterior cingulate cortex (ACC) regions associated with executive control was seen following MBET. A group × time interaction found MBET showed increased connectivity with DLPFC and dorsal ACC following therapy; PCC–DLPFC connectivity was correlated with improvement in PTSD avoidant and hyperarousal symptoms.
Conclusions: Increased connectivity between DMN and executive control regions following mindfulness training could underlie increased capacity for volitional shifting of attention. The increased PCC–DLPFC rsFC following MBET was related to PTSD symptom improvement, pointing to a potential therapeutic mechanism of mindfulness-based therapies.