Month: May 2016

Reduce Maladaptive Ideas in Substance Abuse with Mindfulness

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Reduce Maladaptive Ideas in Substance Abuse with Mindfulness

 

By John M. de Castro, Ph.D.

 

“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.” – James Davis

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 deaths annually and including all causes alcohol abuse accounts for around 90,000 deaths each year, making it the third leading preventable cause of death in the United States.

 

Obviously there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to prevent these relapses. Mindfulness training has been shown to be a safe and effective treatment for reducing addiction relapse.

 

The fact that mindfulness training works in reducing relapse implies that there are alterations in mental contents and thought processes that may be making relapse more likely. It has been found that addicts frequently have maladaptive conceptualizations of themselves and the environment called maladaptive schemas. These have been defined as a “broad, pervasive theme or pattern comprised of memories, emotions, cognitions, and bodily sensations regarding oneself and one’s relationships with others … [that] are dysfunctional to a certain degree.” Eighteen different schemas have been identified; emotional deprivation, abandonment, mistrust/abuse, social isolation, defectiveness, failure, dependence, vulnerability, enmeshment, subjugation, self-sacrifice, emotional inhibition, unrelenting standards, entitlement, insufficient self-control, approval-seeking, negativity/pessimism, and punitiveness.

 

In today’s Research News article “The Relation between Trait Mindfulness and Early Maladaptive Schemas in Men Seeking Substance Use Treatment.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1233666469990610/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465817/

Shorey and colleagues investigate the degree to which mindfulness is related to these maladaptive schemas in men seeking substance abuse treatment. They found that the higher the level of mindfulness the lower the levels of maladaptive schemas. This was true in general but only 15 of the 18 schemas reached statistical significance. They also found that addicts who endorsed more than one maladaptive schema were significantly lower in mindfulness than those who endorsed one or less.

 

These results are interesting, but, it should be kept in mind that the study was correlational and mindfulness was not manipulated. So, a causal connection cannot be demonstrated. It is equally likely that mindfulness causes lower schemas, that lower schemas cause mindfulness, or that some third variable, e.g. the intensity of addiction, causes both. It remains for future research to determine if mindfulness training can produce changes in these maladaptive schemas.

 

Keeping this in mind, the results suggest that maladaptive ways of thinking are associated with addiction and that mindfulness training may be a solution, reducing the schemas and thereby assisting in relapse prevention.

 

So, reduce maladaptive ideas in substance abuse with mindfulness.

 

“Teaching clients “awareness in the moment” can help them develop healthy responses to stress and cravings. This attitude of curiosity and openness to inner life can also enrich their entire sobriety.” – Jenifer Talley

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Shorey, R. C., Brasfield, H., Anderson, S., & Stuart, G. L. (2015). The Relation between Trait Mindfulness and Early Maladaptive Schemas in Men Seeking Substance Use Treatment. Mindfulness, 6(2), 348–355. http://doi.org/10.1007/s12671-013-0268-9

 

Abstract

Recent research has examined the relation between mindfulness and substance use, demonstrating that lower trait mindfulness is associated with increased substance use, and that mindfulness-based interventions help to reduce substance use. Research has also demonstrated that early maladaptive schemas are prevalent among individuals seeking substance use treatment and that targeting early maladaptive schemas in treatment may improve outcomes. However, no known research has examined the relation between mindfulness and early maladaptive schemas despite theoretical and empirical reasons to suspect their association. Therefore, the current study examined the relation between trait mindfulness and early maladaptive schemas among adult men seeking residential substance abuse treatment (N = 82). Findings demonstrated strong negative associations between trait mindfulness and 15 of the 18 early maladaptive schemas. Moreover, men endorsing multiple early maladaptive schemas reported lower trait mindfulness than men with fewer early maladaptive schemas. The implications of these findings for future research and treatment are discussed.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465817/

Relieve Uncertainty and Panic Disorder with Mindfulness

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By John M. de Castro, Ph.D.

 

“Panic gains momentum from the energy we put into fighting it, and the fact is, we don’t always need to fight it. Life happens to you and me as it happens to all people, whether we are ready for it or not, and all we really need to do is be open to experiencing it one moment at a time.” – Krista Lester

 

Anxiety and fear happen in everyone and under normal conditions are coped with adaptively and effectively and do not continue beyond the eliciting conditions. But, in a large number of people the anxiety is non-specific and overwhelming. Anxiety Disorders are the most common psychological problem. In the U.S., they affect over 40 million adults, 18% of the population, with women accounting for 60% of sufferers They typically include feelings of panic, fear, and uneasiness, problems sleeping, cold or sweaty hands and/or feet, shortness of breath, heart palpitations, an inability to be still and calm, dry mouth, and numbness or tingling in the hands or feet.

 

A subset of people with anxiety disorders are diagnosed with Panic Disorder. These are sudden attacks of fear and nervousness, as well as physical symptoms such as difficulty breathing, pounding heart or chest pain, intense feeling of dread, shortness of breath, sensation of choking or smothering, dizziness or feeling faint, trembling or shaking, sweating, nausea or stomachache, tingling or numbness in the fingers and toes, chills or hot flashes, and a fear that they are losing control or are about to die. A common additional symptom of panic disorder is the persistent fear of having future panic attacks. The fear of these attacks can cause the person to avoid places and situations where an attack has occurred or where they believe an attack may occur. Needless to say patients are miserable, their quality of life is low, and their ability to carry on a normal life disrupted.

 

There are a number of treatments for Panic Disorder including psychotherapy, relaxation training, and medication. Recently it’s been demonstrated that panic disorder can be treated with mindfulness practice. In particular, Mindfulness Based Cognitive Therapy (MBCT) has been shown to be particularly effective. It is not known, however, the exact mechanism of action of MBCT effects on Panic Disorder. In today’s Research News article “Impact of Mindfulness-Based Cognitive Therapy on Intolerance of Uncertainty in Patients with Panic Disorder.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1232976826726241/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823195/

Kim and colleagues investigate whether an intolerance of uncertainty may be a key factor in Panic Disorder and the response to MBCT. Intolerance of uncertainty is defined as a “dispositional characteristic that results from a set of negative beliefs about uncertainty and its implications, and involves the tendency to react negatively on an emotional, cognitive, and behavioral level to uncertain situations and events.”

 

Kim and colleagues recruited patients suffering with Panic Disorder and treated them with an 8-week program of Mindfulness Based Cognitive Therapy (MBCT). They measured Panic Disorder intensity, depression, and intolerance of uncertainty both before and after treatment. They found that MBCT produced significant decreases in all measures, with patients having significantly lower levels of Panic Disorder intensity, depression, and intolerance of uncertainty after treatment. They also found that before treatment, the higher the level of intolerance of uncertainty, the greater the intensity of Panic Disorder and the higher the level of depression. In addition, the greater the reduction in intolerance of uncertainty produced by MBCT, the greater the reduction in Panic Disorder intensity. The significant association between intolerance of uncertainty and Panic Disorder intensity was present even after the pre-treatment level of Panic Disorder intensity and Depression were accounted for.

 

These results suggest that Mindfulness Based Cognitive Therapy (MBCT) is an effective treatment for Panic Disorder. They further suggest that the effectiveness of MBCT is at least in part due to it reducing the intolerance of uncertainty that is characteristic of Panic Disorder patients. Mindfulness training in general and MBCT in particular increase attention to what is transpiring in the present moment and decrease thinking about the future. Since intolerance of uncertainty is a worry about future events, it would seem reasonable that MBCT would reduce it. Since intolerance of uncertainty is clearly related to Panic Disorder, its reduction should reduce Panic Disorder.

 

It should be noted that the study did not contain a control (comparison) condition. So, it cannot be concluded that MBCT was responsible for the improvements. It is possible that a placebo effect or spontaneous remissions were responsible. Regardless, the results are suggestive that MBCT is a safe and effective intervention for the relief of Panic Disorder, depression, and intolerance of uncertainty. So, relieve uncertainty and panic disorder with mindfulness.

 

“mindfulness takes ‘thinker’ out of thought, and teaches us to step back and observe our minds and our thoughts. Mindfulness is learning to see exactly what is happening. It ‘disengages’ our ‘automatic pilot’ and gives us the necessary space to see cause and effect as it happens in ‘real’ time. Cause: thought. Effect: panic and/or anxiety.” – Bronwyn Fox

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

Kim, M. K., Lee, K. S., Kim, B., Choi, T. K., & Lee, S.-H. (2016). Impact of Mindfulness-Based Cognitive Therapy on Intolerance of Uncertainty in Patients with Panic Disorder. Psychiatry Investigation, 13(2), 196–202. http://doi.org/10.4306/pi.2016.13.2.196

 

Abstract

Objective: Intolerance of uncertainty (IU) is a transdiagnostic construct in various anxiety and depressive disorders. However, the relationship between IU and panic symptom severity is not yet fully understood. We examined the relationship between IU, panic, and depressive symptoms during mindfulness-based cognitive therapy (MBCT) in patients with panic disorder.

Methods: We screened 83 patients with panic disorder and subsequently enrolled 69 of them in the present study. Patients participating in MBCT for panic disorder were evaluated at baseline and at 8 weeks using the Intolerance of Uncertainty Scale (IUS), Panic Disorder Severity Scale-Self Report (PDSS-SR), and Beck Depression Inventory (BDI).

Results: There was a significant decrease in scores on the IUS (p<0.001), PDSS (p<0.001), and BDI (p<0.001) following MBCT for panic disorder. Pre-treatment IUS scores significantly correlated with pre-treatment PDSS (p=0.003) and BDI (p=0.003) scores. We also found a significant association between the reduction in IU and PDSS after controlling for the reduction in the BDI score (p<0.001).

Conclusion: IU may play a critical role in the diagnosis and treatment of panic disorder. MBCT is effective in lowering IU in patients with panic disorder.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823195/

 

Relieve Depression with Mindful Meditation

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By John M. de Castro, Ph.D.

 

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. It is generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression. Major depression can be quite debilitating. It is distinguishable from everyday sadness or grief by the depth, intensity, and range of symptoms. These can include feelings of sadness, tearfulness, emptiness or hopelessness, angry outbursts, irritability or frustration, even over small matters, loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports, sleep disturbances, including insomnia or sleeping too much, tiredness and lack of energy, so even small tasks take extra effort, changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people, anxiety, agitation or restlessness, slowed thinking, speaking or body movements, feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility, trouble thinking, concentrating, making decisions and remembering things, frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide, unexplained physical problems, such as back pain or headaches. Needless to say individuals with depression are miserable.

 

Depression appears to be the result of a change in the nervous system that can generally only be reached with drugs that alter the affected neurochemical systems. But, depression can be difficult to treat. Of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. In, addition, drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. So, it is important to investigate alternative treatments for depression.

 

Mindful meditation training is a viable alternative treatment for depression. It has been shown to be an effective treatment for active depression and for the prevention of its recurrence. It can even be effective in cases where drugs fail. In today’s Research News article “Critical Analysis of the Efficacy of Meditation Therapies for Acute and Subacute Phase Treatment of Depressive Disorders: A Systematic Review.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1232267610130496/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383597/

Jain and colleagues investigated the state of knowledge regarding mindful meditation effectiveness for depression. They reviewed the published research literature on the application of mindful meditation training to the relief of depression and/or the prevention of relapse. Meditation occurred in a variety of different techniques, meditation, yoga, mindful movement (i.e. Tai Chi), and mantra meditation. The most frequent technique (57% of studies) was Mindfulness Based Cognitive Therapy (MBCT). This was not a surprise as MBCT was developed specifically to treat depression.

 

They reported that the research results made a clear case that meditation therapies are effective for depression. They were effective in relieving depression when the patient was experiencing an active episode and also when the patient had recovered from major depression but was experiencing residual depressive symptoms. Thus, the published research is clear that mindful meditation is an effective treatment for depression. They caution, however, that more research is needed to unequivocally demonstrate its effectiveness under more highly controlled conditions.

 

It is not known exactly how meditation relieves depression. It can be speculated that mindful meditation by shifting attention away from the past or future to the present moment interrupts the kinds of thinking that are characteristic of and support depression. These include rumination about past events, worry about future events, and catastrophizing about potential future events. Mindfulness meditation has been shown to interrupt rumination, worry, and catastrophizing and focus the individual on what is transpiring in the present. By interrupting these forms of thinking that support depression, shifting attention to the present moment where situations are actually manageable, mindful meditation may disrupt depression.

 

Regardless of the speculations, it is clear that mindfulness meditation is a safe and effective treatment for depression.

 

“It’s been more than two years since I started that experiment. I have not missed a single day. And I’m going to tell you right now, still in half-disbelief myself: meditation worked. I don’t mean I feel a little better. I mean the Depression is gone. Completely. I still have very hard days, yes. But when issues come up, real or imagined (or a combination of both), meditation provides an awareness that helps me sort through it all, stay steady on, and understand deeply what is going on. “ – Spike Gillespie

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

Jain, F. A., Walsh, R. N., Eisendrath, S. J., Christensen, S., & Cahn, B. R. (2015). Critical Analysis of the Efficacy of Meditation Therapies for Acute and Subacute Phase Treatment of Depressive Disorders: A Systematic Review. Psychosomatics, 56(2), 140–152. http://doi.org/10.1016/j.psym.2014.10.007

 

Abstract

Background: Recently, the application of meditative practices to the treatment of depressive disorders has met with increasing clinical and scientific interest, due to a lower side-effect burden, potential reduction of polypharmacy, as well as theoretical considerations that such interventions may target some of the cognitive roots of depression. We aimed to determine the state of the evidence supporting this application.

Methods Randomized, controlled trials of techniques meeting the Agency for Healthcare Research and Quality (AHRQ) definition of meditation, for participants suffering from clinically diagnosed depressive disorders, not currently in remission, were selected. Meditation therapies were separated into praxis (i.e. how they were applied) components, and trial outcomes were reviewed.

Results: Eighteen studies meeting inclusionary criteria were identified, encompassing seven distinct techniques and 1173 patients, with Mindfulness-Based Cognitive Therapy comprising the largest proportion. Studies including patients suffering from acute major depressive episodes (N = 10 studies), and those with residual subacute clinical symptoms despite initial treatment (N = 8), demonstrated moderate to large reductions in depression symptoms within group, and relative to control groups. There was significant heterogeneity of techniques and trial designs.

Conclusions: A substantial body of evidence indicates that meditation therapies may have salutary effects on patients suffering from clinical depressive disorders during the acute and subacute phases of treatment. Due to methodological deficiences and trial heterogeneity, large-scale, randomized controlled trials with well-described comparator interventions and measures of expectation are needed to clarify the role of meditation in the depression treatment armamentarium.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383597/

Help School-Aged Children with Yoga

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By John M. de Castro, Ph.D.

 

“Students all around the world now stretch in downward dog in a more mindful classroom, one that sheds away the hectic bell schedule frenzy that behavior psychologists say leads to anxiety.” – Mark W. Guay

 

We, as adults, often have and idealized concept of childhood, remembering all the fun, exploration, learning, and joy of childhood. We forget that childhood can in fact be quite difficult, particularly in modern times. Children in school face stresses with parental pressure and high stakes testing. Children are frequently kept so busy with academic and extracurricular activities that little time is left to just be a kid, be playful and creative, and imaginative. Social pressures can be troubling during childhood which can affect the individual’s developing self-concept. In addition, children are frequently teased and bullied by peers.

 

Children, when they do have free time, are distracted by media, electronic games, and social media, leaving little time for physical activity. Children have immense energy and modern life doesn’t allow any outlets for that energy. This can be particularly problematic during times, like in school, when they are required to sit quietly. In addition, the lack of physical activity produced by the sedentary lifestyle, can have major impacts on children’s health. Obesity and even adult-onset diabetes, previously unheard of in children, are becoming major health problems.

 

Yoga training may be helpful. It has been shown to helpful for the physical and mental health of children. Recently, a number of schools have implemented yoga programs during school hours which have produced significant benefits for the children. It makes sense that yoga could be helpful for children as it is a gentle and safe exercise that can help overcome the problems produced by a sedentary lifestyle, it can be an outlet for excess energy and thereby allow for better attention in school, it can help improve cognitive abilities, and it can help develop a more positive physical self-concept. So, it would see appropriate to continue studying whether yoga training in school can help the children.

 

In today’s Research News article “Yoga Training in Junior Primary School-Aged Children Has an Impact on Physical Self-Perceptions and Problem-Related Behavior.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1231540190203238/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763067/

Richter and colleagues implemented a pilot study of either a yoga program or a physical skills training program during a break from school for groups of 6 to 11-year old children. Yoga or physical skills were taught and performed for 45 minutes twice a week for 6 weeks. The children were extensively tested for physical and cognitive abilities, emotional state, and physical self-concept both before and after training.

 

Both groups showed improvements in executive functions of attention and response inhibition. The two different types of training had different effects on the children’s perceived abilities with yoga improving perceived flexibility while physical skills training improved perceived speed. In addition, the yoga group showed a greater diversity of coping methods for difficult, anxiety provoking, conditions.

 

This was a pilot study with only a small number of children in each group (~12), a relatively wide range of ages, and generally high scores on all assessments. As a result, there was little room for differences and there was insufficient statistical power to detect differences. So, the task of evaluating these kinds of programs was left unfinished. But the study does demonstrate that these programs can be implemented. It remains for larger and better controlled trials to demonstrate their relative effectiveness.

 

The potential benefits of yoga programs for children demand that research on their effects be continued and expanded. Yoga is potentially helpful for many of the difficulties encountered by school-aged children. It could, thus be a great help in making childhood more like our idealized concept.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“Yoga is one path to a classroom where teachers and students can relax in the face of stress, and love themselves, each other, and their work a little more. As one teacher put it, “I’m glad the yoga class is on Wednesday. By then, I don’t like the children very much anymore. After yoga class, I like them again.”” –  Jane Rosen

 

Study Summary

Richter, S., Tietjens, M., Ziereis, S., Querfurth, S., & Jansen, P. (2016). Yoga Training in Junior Primary School-Aged Children Has an Impact on Physical Self-Perceptions and Problem-Related Behavior. Frontiers in Psychology, 7, 203. http://doi.org/10.3389/fpsyg.2016.00203

 

Abstract

The present pilot study investigated the effects of yoga training, as compared to physical skill training, on motor and executive function, physical self-concept, and anxiety-related behavior in junior primary school-aged children. Twenty-four participants with a mean age of 8.4 (±1.4) years completed either yoga or physical skill training twice a week for 6 weeks outside of regular school class time. Both forms of training were delivered in an individualized and child-oriented manner. The type of training did not result in any significant differences in movement and executive function outcomes. In terms of physical self-concept, significant group differences were revealed only for perceived movement speed such that yoga training resulted in perceptions of being slower while physical skill training resulted in perceptions of moving faster. Analysis of anxiety related outcomes revealed significant group effects only for avoidance behavior and coping strategies. Avoidance behavior increased following yoga training, but decreased following physical skill training. In addition, following yoga training, children showed an increased use of divergent coping strategies when facing problematic situations while after physical skill training children demonstrated a decrease in use of divergent coping strategies. Changes in overall physical self-concept scores were not significantly correlated with changes in avoidance behavior following yoga training. In contrast, following physical skill training increased physical self-concept was significantly correlated with decreases in avoidance behavior. In sum, exposure to yoga or physical skill training appears to result in distinct effects for specific domains of physical self-concept and anxiety-related behavior. Further studies with larger samples and more rigorous methodologies are required to further investigate the effects reported here. With respect to future studies, we address potential research questions and specific features associated with the investigation of the effects of yoga in a sample of school-aged children.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763067/

 

Increase Health Behaviors with Mindfulness

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By John M. de Castro, Ph.D.

 

“Even though the academic research on mindfulness meditation isn’t as robust as, say, nutrition or exercise, there is a reason why it’s been around for literally thousands of years. And we’re starting to get a better understanding of why it seems to be beneficial for so many aspects of life, from disease and pain management, to sleep, to control of emotions.” – Amanda Chan

 

We tend to think that illness is produced by physical causes, disease, injury, viruses, bacteria, etc. But, many health problems are behavioral problems or have their origins in maladaptive behavior. This is evident in car accident injuries that are frequently due to behaviors, such as texting while driving, driving too fast or aggressively, or driving drunk. Other problematic behaviors are cigarette smoking, alcoholism, drug use, or unprotected sex. Problems can also be produced by lack of appropriate behavior such as sedentary lifestyle, not eating a healthy diet, not getting sufficient sleep or rest, or failing to take medications according to the physician’s orders. Additionally, behavioral issues can be subtle contributors to disease such as denying a problem and failing to see a physician timely or not washing hands. In fact, many modern health issues, costing the individual or society billions of dollars each year, and reducing longevity, are largely preventable. Hence, promoting healthy behaviors and eliminating unhealthy ones has the potential to markedly improve health.

 

Mindfulness training has been shown to promote health and improve illness. It appears to be associated with a number of factors that also promote health including emotion regulation, stress management, and immune function. Many of the improvements occur by changing health behaviors. This suggests that mindfulness may affect health indirectly through intermediaries, with mindfulness affecting an intermediary which in turn affects health behaviors which in turn affects health.

 

In today’s Research News article “Mindfulness facets, trait emotional intelligence, emotional distress, and multiple health behaviors: A serial two-mediator model.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1230914793599111/?type=3&theater

or see below

Jacobs and colleagues explore the role of emotional intelligence and stress management as intermediaries between mindfulness and health behaviors. They had a large group of occupational therapists complete a series of tests on-line and conducted sophisticated statistical analyses to determine mediation effects of emotional intelligence and stress management between four different facets of mindfulness, observing, describing, acting with awareness and accepting without judging, and health behaviors.

 

They found that all of the mindfulness facets were significantly associated with positive health behaviors. The observing facet was primarily associated directly with health behaviors while the mindfulness facets of acting with awareness and accepting without judging affected health behaviors indirectly by affecting emotional intelligence and stress management which in turn, improved health behavior. Hence, the effects of mindfulness on health behaviors is partially direct with observing and indirect through emotional intelligence and stress management for the acting with awareness and accepting without judging facets.

 

These results suggest that observing, being able to notice and pay attention to internal and external occurrences, allow the individual to be better able to change their health behavior. Perhaps, being more aware of the effects of behavior on the body, the condition of the body, and the links to external conditions is helpful in motivating behavioral change. In other words, improved awareness of what the individual is doing and its consequences produces positive change in what the individual does.

 

Emotional intelligence involves being able to experience emotions fully without judging them. The mindfulness facet of accepting involves “being nonjudgmental and allowing the experienced

phenomena to be as they are without attempting to avoid, change or eliminate them.” Hence, mindfully accepting emotions is itself a component of emotional intelligence. In addition, emotional intelligence involves acting appropriately and adaptively in response to the emotions. This includes acting with awareness. Hence, the mindfulness facet of acting with awareness would be directly linked to emotional intelligence. In turn, emotional intelligence would allow for a more rational and adaptive response to our situation which would include promoting health behavior. So, the ability of mindfulness to produce positive health behaviors occurs in part directly and in part through its relationship with emotional intelligence.

 

The most important message here is that mindfulness can contribute greatly to your health. It improves your behavior to take better care of your health and it also improves the way you deal with your emotions making you better able to cope with the stresses of everyday life, improving your health. So, increase health behaviors with mindfulness.

 

“people who have battled with health problems for years find relief through accepting and working with their condition in a new way, dropping the desperate struggle to make things different from how they are. Mindfulness training makes it possible for a different kind of healing to take place, creating an open space of awareness from which people can start choosing to live well, as best they can, even with a serious illness.” – Line Goguen-Hughes

 

CMCS – Center for Mindfulness and Contemplative Studies

 

 

Study Summary

Jacobs, I., Wollny, A., Sim, C.-W. & Horsch, A. (2016). Mindfulness facets, trait emotional intelligence, emotional distress, and multiple health behaviors: A serial two-mediator model. Scandinavian Journal of Psychology

 

Abstract

In the present study, we tested a serial mindfulness facets-trait emotional intelligence (TEI)-emotional distress-multiple health behaviors mediation model in a sample of N = 427 German-speaking occupational therapists. The mindfulness facets-TEI-emotional distress section of the mediation model revealed partial mediation for the mindfulness facets Act with awareness (Act/Aware) and Accept without judgment (Accept); inconsistent mediation was found for the Describe facet. The serial two-mediator model included three mediational pathways that may link each of the four mindfulness facets with multiple health behaviors. Eight out of 12 indirect effects reached significance and fully mediated the links between Act/Aware and Describe to multiple health behaviors; partial mediation was found for Accept. The mindfulness facet Observe was most relevant for multiple health behaviors, but its relation was not amenable to mediation. Implications of the findings will be discussed.

 

Promote Adaptive Emotions with Mindfulness

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Promote Adaptive Emotions with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness allows us to watch our thoughts, see how one thought leads to the next, decide if we’re heading toward an unhealthy path, and if so, let go and change directions. It allows us to see that who we are is much more than a fearful or envious or angry thought. We can rest in the awareness of the thought, in the compassion we extend to ourselves if the thought makes us uncomfortable, and in the balance and good sense we summon as we decide whether and how to act on the thought.” – Upaya Zen Center

 

Mindfulness is associated with the health and well-being of the individual. It affects a strikingly wide variety of physical and mental capacities and conditions, from cognitive process, to emotions, to stress, to disease states, to mental health, etc. Its effects are so widespread and diverse that it would seem unlikely that mindfulness would directly affect each individual process or state. It is more likely that mindfulness works through intermediaries. That is, it has direct effects on a few processes that in turn have influences on even more processes. This would suggest that many of the effects of mindfulness are indirect.

 

One possibility for an intermediary is coping style. Mindfulness has been shown to heighten adaptive coping. This is a form of coping with stresses in which the individual does not personalize it but looks directly at its environmental causes and addresses them directly. Mindfulness has also been shown to reduce maladaptive coping such as avoidant coping, where the individual does not directly confront the stress but rather turns away from, ignore, or escape from stress. This form of coping does not adequately address the stress which can reemerge in the future.

 

Mindfulness has also been shown to improve emotion regulation, such that the individual fully experiences emotions but reacts appropriately and adaptively to them. Emotion regulation, then, involves coping with the emotion adaptively. It would seem logical then that the improved emotion regulation that occurs with mindfulness may be a secondary effect of the effect of mindfulness on adaptive and maladaptive coping. So, improved emotion regulation may be the result of the improved adaptive coping or less maladaptive coping produced by mindfulness.

 

Emotions are quite complex and dynamic. They can be considered as reasonably stable traits that characterize and individual. But, emotions also vary from moment to moment and different individuals have different patterns of emotional variation over the course of the day. Some people have highly variable emotions that show frequent changes over the day, while some people tend to have more stable emotions that don’t change much, called emotional inertia, while some people have great instability in their emotions, changing wildly from moment to moment, and some people switch back and forth between positive and negative emotional states frequently over the day. To date the effect of mindfulness on these aspects of dynamic daily emotions has not been investigated, nor their relationships to coping styles.

 

In today’s Research News article “Riding the Tide of Emotions with Mindfulness: Mindfulness, Affect Dynamics, and the Mediating Role of Coping.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1230334476990476/?type=3&theater

or see below

Keng and Tong address these questions. They measured trait mindfulness, coping styles, positive and negative affect, self-esteem, depression, openness, and habitual reappraisal and suppression. They also acquired reports of the emotional states of participants at 19 different points a day for 2 days from which they calculated the individual’s emotional variability, inertia, instability, and switching.

 

Keng and Tong found the higher the levels of trait mindfulness, the lower the levels of emotional variability, instability, and inertia. High mindfulness people were also more likely to switch from feeling negatively in the morning to feeling positively in the afternoon. These relationships with mindfulness were not due to positive and negative affect, self-esteem, depression, openness, and habitual reappraisal and suppression. So highly mindful people tend to have less variability in their emotions, but also less inertia being able to change emotions when appropriate. They were also less likely to have unstable, wildly varying emotions and be more likely to switch from a negative to a positive emotional state. Hence mindfulness appears to produce less variable and unstable emotions that are better attuned to the events of the day and more likely to become positive.

 

Keng and Tong also found that maladaptive coping meditated these effects. Highly mindful people were less likely to use maladaptive coping strategies in their emotional reactivity to daily stressors. Interestingly adaptive coping styles did not mediate these effects. These results suggest that mindfulness does not affect emotional well-being by producing adaptive coping styles, but rather by interfering with maladaptive styles. Thus mindfulness makes it less likely that the individual will use ineffective maladaptive coping with stress and thereby have higher emotional wellbeing.

 

The most important message here is that mindfulness improves your emotional life and makes you less likely to cope with your emotions in such a way as to make matters worse. It doesn’t change your life, just how you experience and deal with your emotions and this make life better. So, promote adaptive emotions with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“The next time you sense a strong emotion, take some time to put a finger on exactly what you’re feeling. Get quiet, turn inward, and just listen.” – Lisa Nichols

 

Study Summary

 

Keng, S., & Tong, E. W. (2016). Riding the Tide of Emotions with Mindfulness: Mindfulness, Affect Dynamics, and the Mediating Role of Coping. Emotion, doi:10.1037/emo0000165

 

Abstract:

Little research has examined ways in which mindfulness is associated with affect dynamics, referring to patterns of affect fluctuations in daily life. Using ecological momentary assessment (EMA), the present study examined the associations between trait mindfulness and several types of affect dynamics, namely affect variability, affect inertia, affect switch, and affect instability. Three hundred ninety undergraduate students from Singapore reported their current emotions and coping styles up to 19 times per day across 2 days. Results showed that trait mindfulness correlated negatively with variability, instability, and inertia of negative affect and positively with negative-to-positive affect switch. These relationships were independent of openness, habitual reappraisal, habitual suppression, depression, and self-esteem. Importantly, lower maladaptive coping was found to mediate these relationships. The study suggests that trait mindfulness independently promotes adaptive patterns of affective experiences in daily life by inhibiting maladaptive coping styles.

 

The Noble Eightfold Path: Right Livelihood

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By John M. de Castro, Ph.D/

 

“Given that almost everyone’s life includes an economic dimension, work and career need to be integrated into life as a Buddhist. Most of us spend the majority of their waking lives at work, so it’s important to assess how our work affects our mind and heart. How can work become meaningful? How can it be a support not a hindrance to spiritual practice — a place to deepen our awareness and kindness?” – Sangharakshita

 

Most people need work to earn a living to support themselves and a family. For most, this is not a choice, it is a necessity for survival. But, what we do to make that living can be a choice and the nature of the occupation chosen can have a major impact on the psychological and spiritual development of the individual. The Buddha’s notion of “Right Livelihood” emphasizes the nature and importance of this choice.

 

Unless you’re a hermit, making a living is a social endeavor. It involves an array of people and it impacts on many others. A manager of a grocery store has to hire and coordinate the activities of many employees, has to work with upper management, suppliers, government regulators including the health department, and has to interact with customers. The manager’s activity impacts a wide array of people. This will also be true for most of us in our work. So, again the choice of occupation can have far reaching effects, not only on the individual, but on a wide network of interconnected people. Positive and/or negative effects of our occupation can thereby have many direct and indirect effects on our happiness and well-being as the effects on others feedback and affect ourselves.

 

“Right Livelihood” is the fifth component of the Buddha’s Noble Eightfold Path, Right View, Right Intentions, Right Speech, Right Actions, Right Livelihood, Right Effort, Right Mindfulness and Right Concentration.” “Right Livelihood” is actually a subcategory of “Right Action”, but is so important that it like speech is singled out for its own step on the path. It’s particularly important because of its cascading impact on others. What we do and how we do it can make important contributions to the well-being of many or it may produce widespread harm. Having an occupation that produces good and doesn’t produce harm is as important to our own spiritual development as can be to the well-being of others.

 

The notion of “Right Livelihood” mandates that we should engage in an occupation that not only earns us a living but also creates greater happiness, wisdom, and well-being, and relieves suffering in ourselves and others. Conversely, we should avoid occupations that produce harm. The notion of “Right Livelihood” doesn’t discourage earning profits and accumulating wealth. It simply indicates that it must be done in the right way. It indicates that we should acquire wealth only by legal means, peacefully, without coercion or violence; we should acquire it honestly, not by trickery or deceit; and we should acquire it in ways which do not entail harm and suffering for others. This means that in performing our work we should fulfil our duties diligently and conscientiously, not wasting or misrepresenting the hours worked, or stealing, we should pay due respect and consideration to employers, employees, colleagues, and customers, and we should engage in business transactions truthfully without deceptive advertising, misrepresentations, or dishonesty.

 

In the choice of occupations to pursue there are some obvious jobs to aspire to. These are occupations that on their face create good and promote well-being. They include professions such as physician, social worker, peace negotiator, relief worker, therapist, etc. Of course, even these occupations can cause harm, as mistakes can and do happen, but the intent is to relieve suffering, and that’s what counts. Similarly, there are occupations that rather obviously create harm and should be avoided, such as drug dealer, arms merchant, professional criminal, etc.

 

Most occupations, unfortunately, are not so obviously good or harmful. Many can have harmful effects, not by immediate actions, but indirectly. For example, working as an accountant for a cigarette manufacture. Accounting is not itself harmful, but in this case would contribute to the distribution of a product that has been demonstrated to be harmful to people’s health. But, most occupations are even trickier to evaluate. Working on an oil rig in the Gulf of Mexico produces a product, energy, that is needed for the well-being of virtually everyone. Without affordable energy, every aspect of the economy would collapse. So, working on the oil rig could be seen as promoting well-being and relieving suffering. On the other hand, there is potential for great environmental harm, including oil spills that directly pollute sensitive environments, or contributing to carbon dioxide emissions that can indirectly create great harm by contributing to global warming.

 

So should someone on the eightfold path accept or reject a job working on an oil rig? The answer cannot be given by anyone other than the individual themselves. It is imperative that the individual look deeply and objectively at what they’re doing and determine for themselves if they are doing more harm than good. On the eightfold path, the primary spiritual impact of “Right Livelihood” is on the individual engaging in the occupation. So, the decision has to be theirs. That is not to say that experts or friends can’t or shouldn’t be consulted, but that ultimately the individual must decide for themselves and be willing to accept the potential consequences.

 

Is it “Right Livelihood” to raise cattle, or chickens for consumption, to be a butcher, or sell animal products? At the surface this might seem simple as it involves the destruction of sentient beings which should be avoided. But, like everything, it’s sometimes not so simple. Firstly, killing out in self-defense is regrettable and should be avoided however possible, but if necessary is not a problem. In fact, there is a long history of lethal self-defense techniques being taught and practiced at some Buddhist monasteries. Killing and eating meat might be seen as self-defense and when other foods are not available for sustenance it’s defensible. In fact, the Buddha and his followers occasionally ate meat and taught that once killed animal products should not be wasted. But, in general, for most people in affluent situations, being involved in the raising, slaughtering, and distribution of animals would not be considered “Right Livelihood.” It may well have negative consequences on the individual and others.

 

In my own career, before I started on the eightfold path, I engaged in research projects using animals. At the time, it seemed to be a noble endeavor, increasing scientific knowledge for the good. But, I believe that I was harmed by this. I now look back with deep regret and guilt that I was responsible for the deaths of literally hundreds of animals. It doesn’t matter that they were lab rats. They were beings who should not have been used and harmed for my own selfish reasons to advance my scientific career. I remember those days long ago vividly and feel terrible that I could have created so much harm. It is something that will haunt me for the rest of my life. I paid and am paying the consequences on violating “Right Livelihood.”

 

We spend so much of our lives at work, that the choice of the wrong occupation can be a major impediment to our spiritual growth. Conversely, the choice of the right occupation can be a major asset. It can create greater happiness, wisdom, and well-being, and relieve suffering in ourselves and others. This is a major step on our spiritual path. So, engage in “Right Livelihood” and move forward toward enlightenment.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“A lay follower should not engage in five types of business. Which five? Business in weapons, business in human beings, business in meat, business in intoxicants, and business in poison.” – Buddha

Reduce Pain by Accepting it Mindfully

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By John M. de Castro, Ph.D.

 

“They were able to have a sense of personal control over their migraines. It really makes us wonder if an intervention like meditation can change the way people interpret their pain.” – Rebecca Erwin Wells

 

Headaches are the most common disorders of the nervous system. It has been estimated that 47% of the adult population have a headache at least once during the last year. The most common type of headache is the tension headache with 80 to 90 percent of the population suffering from tension headaches at least some time in their lives. The second most common type of headache is the migraine headache. Around 16 to 17 percent of the population complains of migraines. It is the 8th most disabling illness in the world with more than 90% of sufferers unable to work or function normally during their migraine. American employers lose more than $13 billion each year as a result of 113 million lost work days due to migraine.

 

There are a wide variety of drugs that are prescribed for chronic headache pain with varying success. Most tension headaches can be helped by taking pain relievers such as aspirin, naproxen, acetaminophen, or ibuprofen. A number of medications can help treat and prevent migraines and tension headaches, including ergotamine, blood pressure drugs such as propranolol, verapamil, antidepressants, antiseizure drugs, and muscle relaxants. Drugs, however, can have some problematic side effects particularly when used regularly and are ineffective for many sufferers. So, almost all practitioners consider lifestyle changes that help control stress and promote regular exercise to be an important part of headache treatment and prevention. Avoiding situations that trigger headaches is also vital.

 

Mindfulness training has been shown to be an effective treatment for headache pain. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, reducing worry and catastrophizing can reduce headache pain. In addition, mindfulness improves self-efficacy, the belief that the individual can adapt to and handle headache pain. In addition, mindfulness training also has been shown to alter not only what is thought, but also how thoughts are processed. Central to this cognitive change is mindfulness and acceptance. By mindfully viewing pain as a present moment experience it can be experienced just as it is and by accepting it, the individual stops fighting against the pain which can amplify the pain.

 

It is not known whether it is the changes in the what or how, or both, of thoughts that is responsible for mindfulness training’s efficacy in treating headache pain. In today’s Research News article “The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1229081490449108/?type=3&theater

or see below

Day and Thorn investigate this question. They randomly assigned headache patients to receive either 8-weeks of Mindfulness Based Cognitive Therapy (MBCT) or treatment as usual as a wait-list control condition. Before and again after treatment measurements were obtained of pain, pain acceptance, pain catastrophizing, and pain self-efficacy.

 

They found, as has previously been shown, that the MBCT training significantly reduced the level of pain and pain catastrophizing, and increased the levels of pain self-efficacy and pain acceptance. Day and Thorn then went on to use a sophisticated statistical technique to assess whether the change in pain produced by mindfulness training was due to the changes in the what or how about thinking. They found that only the how aspect of thought, pain acceptance, significantly mediated the effect. Neither of the what aspects of thought, pain catastrophizing nor pain self-efficacy, were significantly related to the mindfulness training effects on pain.

 

These results are very interesting and potentially important. They suggest that mindfulness training reduces headache pain by altering how pain is thought about, increasing acceptance of the pain. Acceptance is defined as the “conscious willingness to stay in direct contact with experience.” This may operate by reducing the individual’s attempts to counteract the pain. Since, fighting against the pain can actually increase the level of pain, accepting the pain interferes with this amplifying process, thus lowering the pain level experienced. It is interesting that neither the pain catastrophizing nor pain self-efficacy were significant mediators as they have long been thought to be important mechanisms of mindfulness’ effectiveness for pain management. But, it is clear that how pain is thought about, in particular, the acceptance of pain, is the key.

 

So, reduce pain by accepting it mindfully.

 

“Awareness transforms emotional pain just as it transforms the pain that we attribute more to the domain of body sensations. When we are immersed in emotional pain, if we pay close attention, we will notice that there is always an overlay of thoughts and a plethora of different feelings about the pain we are in, so here too the entire constellation of what we think of as emotional pain can be welcomed in and held in awareness.” – Jon Kabat-Zinn

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

 

Day MA, Thorn BE. The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache. Complement Ther Med. 2016 Apr;25:51-4. doi: 10.1016/j.ctim.2016.01.002. Epub 2016 Jan 13.

 

Highlights

  • Pain acceptance was a significant mediator of the MBCT-pain interference relation.
  • Specifically, activity engagement emerged as the critical component of acceptance.
  • Pain catastrophizing and self-efficacy did not meet criteria for mediation.
  • This is the first study to show acceptance is a key mediator of MBCT for headache.

Abstract

Objectives: This study aimed to determine if mindfulness-based cognitive therapy (MBCT) engenders improvement in headache outcomes via the mechanisms specified by theory: (1) change in psychological process, (i.e., pain acceptance); and concurrently (2) change in cognitive content, (i.e., pain catastrophizing; headache management self-efficacy).

Design: A secondary analysis of a randomized controlled trial comparing MBCT to a medical treatment as usual, delayed treatment (DT) control was conducted. Participants were individuals with headache pain who completed MBCT or DT (N = 24) at the Kilgo Headache Clinic or psychology clinic. Standardized measures of the primary outcome (pain interference) and proposed mediators were administered at pre- and post-treatment; change scores were calculated. Bootstrap mediation models were conducted.

Results: Pain acceptance emerged as a significant mediator of the group-interference relation (p < .05). Mediation models examining acceptance subscales showed nuances in this effect, with activity engagement emerging as a significant mediator (p < .05), but pain willingness not meeting criteria for mediation due to a non-significant pathway from the mediator to outcome. Criteria for mediation was also not met for the catastrophizing or self-efficacy models as neither of these variables significantly predicted pain interference.

Conclusions: Pain acceptance, and specifically engagement in valued activities despite pain, may be a key mechanism underlying improvement in pain outcome during a MBCT for headache pain intervention. The theorized mediating role of cognitive content factors was not supported in this preliminary study. A large, definitive trial is warranted to replicate and extend the findings in order to streamline and optimize MBCT for headache.

 

Biomarkers Predict Mindfulness’ Effectiveness for Caregivers

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By John M. de Castro, Ph.D.

 

“mindfulness isn’t just a technique to cope with the stress; it’s a way to fully embrace one’s role as a caretaker, living in the present moment with joy and appreciation, no matter what that moment may bring.” – Elisabeth Dykens

 

There are many characteristics that all human being have in common, but there are also huge individual differences. Virtually everything about us is to some extent unique, including experiences, and physical and psychological characteristics. There is no other face exactly like ours. There is no other brain exactly like ours. There is no other mind exactly like ours. There is no other mind exactly like ours. There is no other personality exactly like ours. These differences are wonderful and define our individuality and uniqueness. There has never been nor will there ever be anyone exactly like you.

 

This uniqueness extends to our reactions to environmental and physical events and even extends to our responses to treatments. One of the most exciting trends in modern medicine is individualized medicine. It has been realized that people respond differently to treatments. The same drug, procedure, or therapy that cures one person will have negligible effects on another, and may harm yet another. So, tailoring the treatment to the individual can maximize effectiveness. In order to do this predictors, biomarkers, are needed. These are measurable characteristic that predict that a certain treatment will be effective for that person. So cancer treatment now includes genetic analysis looking for particular genes that predict that an individual will respond to one treatment rather than another.

 

Mindfulness training has been shown to be an effective treatment for a myriad of psychological and physical conditions, including the psychological and physical problems that develop while providing care for an Alzheimer’s patient. But, this effectiveness is “on average.” While many people are helped, some are not, and some even get worse. In order to improve the effectiveness of mindfulness training it would be helpful to identify who is likely to respond positively and who is not. To do this, predictors, markers, of responsiveness are needed. To date, there have been few studies that attempt to identify predictors, markers, of responsivity to mindfulness training.

 

In today’s Research News article “Biomarkers of Resilience in Stress Reduction for Caregivers of Alzheimer’s Patients.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1228448170512440/?type=3&theater

or below

Ho and colleagues took blood samples from non-professional adult caregivers for Alzheimer’s patients prior to and after an 8-week Mindfulness Based Stress Reduction (MBSR) training. They found, confirming the majority of findings in the research literature, that the MBSR course produce significant increases in the mindfulness and the psychological health of the caregivers. In addition, they found that the greater then increase in mindfulness, the greater the improvements in psychological health.

 

Ho and colleagues also found considerable individual differences in the degree of improvement. They then separated the caregivers in three groups based upon the amount of benefit in psychological health obtained from the MBSR training; poor, moderate, and good responders. They used measures of gene expressions in these three groups to investigate potential predictors of responsiveness to MBSR training. They found that genes associated with the modulation of the inflammatory response, stress responses, and depression were highly expresses in caregivers who responded to MBSR training.

 

These results are not surprising as mindfulness training has been previously shown to improve the inflammatory response, stress responses, and depression. Unfortunately, these results do not demonstrate cause and effect. It is equally likely that the improved psychological health produced the changes in gene expression as it is that the changes in gene expression produced the improvements in psychological health, or that some third factor might be responsible for both.

 

To look for possible causal factors, they then looked at gene expressions present before the MBSR training in the various groups. They found that expressions of genes prior to treatment that modulate the immune system and the insulin system were predictive of positive responses to treatment. It has previously been shown that mindfulness training produces improvements in the immune system. But, it has not been previously demonstrated that the state of the immune system prior to mindfulness training would be associated with positive outcomes.

 

These are fascinating results and again demonstrate the effectiveness of Mindfulness Based Stress Reduction (MBSR) training for caregivers. But, importantly, the study identifies biomarkers, gene expressions, that predict the individual’s likelihood of having positive improvements in psychological health produced by MBSR training. Caregivers who showed heightened expressions in genes that improve the immune system were those that obtained the greatest benefit. It will require future research to identify how heightened immune system activity might be responsible for MBSR effectiveness.

 

Regardless, the study demonstrates that biomarkers predict mindfulness’ effectiveness for caregivers. This suggests that it may be possible in the future to tailor mindfulness training based upon individual differences in gene expression, maximizing the effectiveness of the therapy.

 

So,

 

“I have discovered that it isn’t so much about what I did or did not say or do that was key to pass on to professionals and family members — it was more about the way in which I was being with the persons who have dementia that seemed important to communicate. […] Each person with dementia has taught me the importance of relaxing into being in the present moment. That moment may be perceived by her to be in a different place or time, but it is her very real and present moment.” –  Nancy Pearce

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

 

Ho L, Bloom PA, Vega JG, Yemul S, Zhao W, Ward L, Savage E, Rooney R, Patel DH, Pasinetti GM. Biomarkers of Resilience in Stress Reduction for Caregivers of Alzheimer’s Patients. Neuromolecular Med. 2016 Mar 17. [Epub ahead of print] PMID: 26984114

 

Abstract

Caregiving for a dementia patient is associated with increased risk of psychological and physical health problems. We investigated whether a mindfulness-based stress reduction (MBSR) training course for caregivers that closely models the MBSR curriculum originally established by the Center of Mindfulness at the University of Massachusetts may improve the psychological resilience of non-professional caregivers of Alzheimer’s disease patients. Twenty adult non-professional caregivers of dementia patients participated in an 8-week MBSR training course. Caregiver stress, depression, burden, grief, and gene expression profiles of blood mononuclear cells were assessed at baseline and following MBSR. MBSR training significantly improved the psychological resilience of some of the caregivers. We identified predictive biomarkers whose expression is associated with the likelihood of caregivers to benefit from MBSR, and biomarkers whose expression is associated with MBSR psychological benefits. Our biomarker studies provide insight into the mechanisms of health benefits of MBSR and a basis for developing a personalized medicine approach for applying MBSR for promoting psychological and cognitive resilience in caregivers of dementia patients.

 

Cope with Violence Trauma with Mindfulness

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By John M. de Castro, Ph.D.

 

“People with PTSD ruminate, and rumination is all about not being present. It’s all about focusing on something terrible that happened in the past or something frightening that will happen in the future, so these patients are stuck in a rut. My personal bias is that mindfulness-based therapy has a big effect on rumination, and decreasing rumination allows people to experience the present moment, which expands their awareness of different possibilities and increases their ability to pay attention to things they have avoided in the past,” – Anthony King

 

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. Many, 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.

 

PTSD can be produced by traumatic events occurring to anyone in a variety of different contexts. These include interpersonal violence (IPV). It is defined “as the intentional use of physical or sexual violence against another person within the context of a relationship. This includes physical or sexual violence committed by a family member, intimate partner, friend, or acquaintance.” A frequent form of IPV is intimate partner violence. Indeed, 27% of women and 11% of men have reported that they had been harmed by sexual or physical violence at some time during their lives.

 

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 serious and 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. In today’s Research News article “Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results from a Stage I RCT.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1227840437239880/?type=3&theater

or below

Kelly and Garland randomly assigned adult female survivors of interpersonal violence (IPV) to either an 8-week mindfulness training or wait-list control condition. The intervention was a form of Mindfulness Based Stress Reduction (MBSR) that was modified for treatment with trauma survivors.

 

They found that the treatment produced a clinically significant decrease in PTSD symptoms to the point where a significant number of participants could no longer be classified as PTSD sufferers. The more the participant practiced the mindfulness training the greater the reduction in PTSD symptoms. There were also significant decreases in the mindfulness group in depression and anxious attachment. Anxious attachment is a symptom of PTSD that involves “vacillating between attempts to draw in significant others with endearing attention-seeking behaviors and attempts to attract attention through emotional outbursts of crying or anger.” Reducing anxious attachment allows the sufferer to conduct much healthier interpersonal relationships.

 

These are very promising results that suggest that the modified form of Mindfulness Based Stress Reduction (MBSR) is a safe and effective treatment for PTSD caused by interpersonal violence (IPV). It is not known how mindfulness training could be so effective for PTSD. It can be speculated that the improvement in present moment awareness might have helped by focusing on the individual on the present rather than the past when the trauma occurred and by reducing rumination about the past. In addition, mindfulness training is known to improve emotion regulation and this may allow the PTSD sufferers to not avoid but fully experience the emotions and then respond to them in a constructive fashion. Finally, mindfulness training is known to reduce the physiological and psychological responses to stress. This lowered stress levels may reduce the intensity of their response to memories of the trauma, allowing the individual to be able to internally address the events directly.

 

Regardless of the mechanism, it is clear that mindfulness training is an effective treatment for PTSD symptoms caused by interpersonal violence (IPV). So, cope with violence trauma with mindfulness.

 

“Mindfulness-based stress reduction teaches individuals to attend to the present moment, to attend to what they are experiencing — their thoughts, their feelings — in a nonjudgmental, accepting manner. We think that teaching people these mindfulness skills helps them to have a different relationship with their PTSD symptoms — a willingness to let thoughts be there without trying to push them away,” -Melissa Polusny

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

Kelly, A. and Garland, E. L. (2016), Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results From a Stage I RCT. J. Clin. Psychol., 72: 311–328. doi:10.1002/jclp.22273

 

Abstract

OBJECTIVE: This pilot randomized controlled trial evaluated a novel trauma-informed model of mindfulness-based stress reduction (TI-MBSR) as a phase I trauma intervention for female survivors of interpersonal violence (IPV).

METHOD: A community-based sample of women (mean age = 41.5, standard deviation = 14.6) with a history of IPV was randomly assigned to an 8-week TI-MBSR intervention (n = 23) or a waitlist control group (n = 22). Symptoms of posttraumatic stress disorder (PTSD) and depression as well as anxious and avoidant attachment were assessed pre- and postintervention.

RESULTS: Relative to the control group, participation in TI-MBSR was associated with statistically and clinically significant decreases in PTSD and depressive symptoms and significant reductions in anxious attachment. Retention in the intervention was high, with most participants completing at least 5 of the 8 sessions for the intervention. Minutes of mindfulness practice per week significantly predicted reductions in PTSD symptoms.

CONCLUSION: TI-MBSR appears to be a promising and feasible phase I intervention for female survivors of interpersonal trauma.