By John M. de Castro, Ph.D.
“Mindfulness can help people train themselves to get unstuck from a vicious cycle of negative thinking, often a cornerstone of trauma.” – Jennifer Wolkin
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 emotional numbing 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.
It is clear that a key problem with PTSD sufferers is a difficulty with regulating emotions. So, a technique, like mindfulness training, that improves emotion regulation may be beneficial. Indeed, mindfulness training has been found to be particularly effective for PTSD. Hence, it is important to further investigate mindfulness relationships to emotion regulation in PTSD sufferers in order to optimize treatment. In today’s Research News article “A Pilot Study of Mindfulness-Based Exposure Therapy in OEF/OIF Combat Veterans with PTSD: Altered Medial Frontal Cortex and Amygdala Responses in Social–Emotional Processing.” See:
or see summary below or view the full text of the study at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028840/
King and colleagues recruited combat veterans with PTSD and examined the effects of mindfulness training on the brain’s processing of emotional stimuli in veterans with PTSD. The veterans were randomly assigned to receive either 16-weeks of, 2-hour sessions, once a week, of group psychotherapy or Mindfulness-Based Exposure Therapy (MBET). MBET involved mindfulness training, self-compassion training, psycho-education, and mindfulness prolonged exposure therapy. Their brains were scanned with functional Magnetic Imaging (f-MRI) 2-weeks before and 2-weeks after training while they were presented with faces expressing either neutral, angry, or fearful emotions.
They found that Mindfulness-Based Exposure Therapy (MBET) produced a marked significant reduction in PTSD symptom severity that was greater than that produced by group therapy. They found that regardless of therapy type that relief of PTSD symptoms was associated with increased activation of the dorsal prefrontal cortex which is usually under active in PTSD sufferers. They also found increased activation in brain areas associated with emotion regulation, the medial prefrontal cortex and the rostral anterior cingulate cortex. In addition, the MBET trained veterans showed greater increases in amygdala and fusiform gyrus responses to angry faces, as well as increased response in medial prefrontal cortex to fearful faces. These responses suggest that the mindfulness training resulted in the veterans’ brains being more engaged in processing threatening stimuli.
These findings suggest that mindfulness training improves PTSD symptoms by improving the brain’s ability to process emotional stimuli. By paying greater attention to these stimuli they become better at regulating their emotional responses to them. Since, PTSD involves problems with emotions, the improved emotion regulation would be particularly beneficial to the veterans allowing them to better cope with the emotions produced in response to their memories or environmental stimuli.
So, improve the brain’s regulation of emotions in PTSD with mindfulness.
“Mindfulness can help people cope with and manage their trauma memories, explore their patterns of avoidance when confronting reminders of their trauma, and better understand their reactions to their symptoms. It helps them feel more grounded, and to notice that even very painful memories have a beginning, a middle and an end — that they can become manageable and feel safer. It’s hard work, but it can pay off.” – Anthony King
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
King, A. P., Block, S. R., Sripada, R. K., Rauch, S. A. M., Porter, K. E., Favorite, T. K., … Liberzon, I. (2016). A Pilot Study of Mindfulness-Based Exposure Therapy in OEF/OIF Combat Veterans with PTSD: Altered Medial Frontal Cortex and Amygdala Responses in Social–Emotional Processing. Frontiers in Psychiatry, 7, 154. http://doi.org/10.3389/fpsyt.2016.00154
Abstract
Combat-related posttraumatic stress disorder (PTSD) is common among returning veterans, and is a serious and debilitating disorder. While highly effective treatments involving trauma exposure exist, difficulties with engagement and early drop may lead to sub-optimal outcomes. Mindfulness training may provide a method for increasing emotional regulation skills that may improve engagement in trauma-focused therapy. Here, we examine potential neural correlates of mindfulness training and in vivo exposure (non-trauma focused) using a novel group therapy [mindfulness-based exposure therapy (MBET)] in Afghanistan (OEF) or Iraq (OIF) combat veterans with PTSD. OEF/OIF combat veterans with PTSD (N = 23) were treated with MBET (N = 14) or a comparison group therapy [Present-centered group therapy (PCGT), N = 9]. PTSD symptoms were assessed at pre- and post-therapy with Clinician Administered PTSD scale. Functional neuroimaging (3-T fMRI) before and after therapy examined responses to emotional faces (angry, fearful, and neutral faces). Patients treated with MBET had reduced PTSD symptoms (effect size d = 0.92) but effect was not significantly different from PCGT (d = 0.43). Improvement in PTSD symptoms from pre- to post-treatment in both treatment groups was correlated with increased activity in rostral anterior cingulate cortex, dorsal medial prefrontal cortex (mPFC), and left amygdala. The MBET group showed greater increases in amygdala and fusiform gyrus responses to Angry faces, as well as increased response in left mPFC to Fearful faces. These preliminary findings provide intriguing evidence that MBET group therapy for PTSD may lead to changes in neural processing of social–emotional threat related to symptom reduction.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028840/