Month: November 2017

Improve Mental Illness with Yoga

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Improve Mental Illness with Yoga

 

By John M. de Castro, Ph.D.

 

“for the general person, yoga greatly enhances mental health: mood, sense of self, motivation, sense of inner direction and purpose, as well as physical health—and physical health is so important for mental health.“– Eleanor Criswell

 

Yoga is a complex of practices including postures, movements, breathing practices and meditation. Although its benefits have been touted for centuries, it is only recently that scientific study was verified these benefits. Yoga practice has been repeatedly demonstrated in research studies to be beneficial for the psychological and physical health of the practitioners. It appears to be helpful for both healthy individuals and those suffering from physical and mental health issues.

 

In today’s Research News article “The Efficacy of Body-Oriented Yoga in Mental Disorders: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400032/ ),

Klatte and colleagues review, summarize, and perform a meta-analysis of the published research literature on effects of yoga practice on a variety of mental health problems. They focused on randomized controlled studies with adults suffering from psychiatric problems. They identified 25 published studies that met their criteria, including treatment of depression, schizophrenia, dependency, post-traumatic Stress Disorder (PTSD), and other mental illnesses.

 

They found that yoga practice produced, on the whole, large and significant improvements in the symptoms of the mental illnesses even in comparison to active control groups such as attention training and exercise. The beneficial effects of yoga practice were comparable to those produced by psychotherapy. But, the combination of yoga practice with psychotherapy produced even greater effects.

 

These are exciting and compelling findings that yoga practice is an effective treatment for mental illness on a par with individual psychotherapy. But, yoga practice has the advantage of being relatively inexpensive, can be practiced at home or in groups, and after a few weeks of instruction can be carried on without a therapist present. In addition, it can supplement traditional psychotherapy potentiating its effectiveness.

 

It would appear that the exercise component of yoga practice is not essential for its effectiveness as exercise only control groups show benefits but significantly less than the yoga practice groups. This suggests that the improvement of mindfulness that occurs in yoga practice has an additional beneficial role to play in treating mental illness. The combination of exercise with mindfulness training that occur with yoga  practice appears to be particularly effective in treating mental illnesses. These results suggest that yoga practice is safe and effective and should applied either as a stand-alone treatment or be combined with more traditional treatments.

 

So, improve mental illness with yoga.

 

“It will come as no surprise that the various forms of yoga have long been acknowledged as allies in mastering the mind and coping with stress. Science is Increasingly validating those claims, especially for depression, schizophrenia, anxiety, PTSD (post-traumatic stress disorder), and ADHD (attention deficit hyperactivity disorder).” – Mental Health America

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Klatte, R., Pabst, S., Beelmann, A., & Rosendahl, J. (2016). The Efficacy of Body-Oriented Yoga in Mental Disorders: A Systematic Review and Meta-Analysis. Deutsches Ärzteblatt International, 113(12), 195–202. http://doi.org/10.3238/arztebl.2016.0195

Abstract

Background

The efficacy of body-oriented yoga in the treatment of mental disorders has been investigated in numerous studies. This article is a systematic review and meta-analysis of the relevant publications.

Methods

All studies in which the efficacy of hatha-yoga, i.e., body-oriented yoga with asanas and pranayama, was studied in adult patients suffering from a mental disorder (as diagnosed by ICD or DSM criteria) were included in the analysis. The primary endpoint was disorder-specific symptom severity. The publications were identified by a systematic search in the PubMed, Web of Science, PsycINFO and ProQuest databases, supplemented by a search with the Google Scholar search engine and a manual search in the reference lists of meta-analyses and primary studies, as well as in specialized journals.

Results

25 studies with a total of 1339 patients were included in the analysis. A large and significant effect of yoga was seen with respect to the primary endpoint (symptom severity) (Hedges’ g = 0.91; 95% confidence interval [0.55; 1.28]; number needed to treat [NNT]: 2.03), with substantial heterogeneity (I2 = 69.8%) compared to untreated control groups. Small but significant effects of yoga were also seen in comparison with attention control (g = 0.39; [0.04; 0.73]; NNT: 4.55) and physical exercise (g = 0.30; [0.01; 0.59]; NNT: 5.75); no difference in efficacy was found between yoga and standard psychotherapy (g = 0.08; [-0.24; 0,40]; NNT: 21.89). In view of the relatively high risk of bias, these findings should be interpreted with caution.

Conclusion

Body-oriented yoga with asanas and pranayama as central components is a promising complementary treatment for mental disorders and should be investigated in further high-quality studies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400032/

It’s the Causes of Suffering, Stupid

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It’s the Causes of Suffering, Stupid

By John M. de Castro, Ph.D.

“Basically, life is suffering. And we create our suffering by thirsting or craving for what we cannot have. But are these really all the causes of suffering? Do we really create all of our suffering? I would argue that there is more to suffering than what we cause with our craving. Fighting with reality surely adds to our suffering – if I do not accept that I am sick, for example, and moan the whole time that I shouldn’t be sick, I will suffer more.” – Rachel Buddeberg

In a previous essay http://contemplative-studies.org/wp/index.php/2016/08/07/its-the-suffering-stupid/
the first Noble Truth was discussed, reflecting the patently obvious fact that there is suffering, a.k.a. unsatisfactoriness. Although I previously overlooked and ignored this important truth, an investigation of my daily life revealed that it was chock full of unsatisfactoriness. It became clear that this unsatisfactoriness must be witnessed completely to see the Buddha’s wisdom. Life is so full of unsatisfactoriness that it’s impossible to move forward on a spiritual path until it is addressed. Unsatisfactoriness is at the very core of existence and a major impediment in attaining true happiness let alone enlightenment. It became evident to me that it was the suffering, stupid.

But, once this is clearly realized and a complete inventory is taken of unsatisfactoriness, what’s the next step. This is presented in the Second Noble Truth that there are causes to suffering. My initial naive thoughts were that the causes of suffering were obvious. If I stepped on a nail and experienced pain or contracted the flu and experienced malaise, the causes were obvious. But, once I realized that unsatisfactoriness was rampant in my life, I realized that I wasn’t always sure what caused it. Why should I care if someone thinks highly of me? Why should I try to avoid boredom? Why should I be unhappy when certain forms of music are played? Why should I be afraid of heights even when I know it’s safe? The causes here are subtler and more difficult to identify. But, it’s important to do so, as unsatisfactoriness can only be eliminated if we first know what’s producing it.

To put it simply, unsatisfactoriness arises whenever we want things to be different than they are. Struggling against what is, is the primary source of unsatisfactoriness. This is a simple and absolutely true statement. But as with everything there’s more to it. There are a number of sources that are either built into us or inculcated by our society that produce a desire for things to be different. But, keep in mind that no matter what the source, ultimately it’s the refusal to accept what is that’s the source of unsatisfactoriness.

Our attraction and aversion to sensory experiences is a big driver of wanting things to be different. We want pleasurable experiences, be they beautiful sights, music, the flavors of a good wine, perfumes, sexual orgasm, ocean waves hitting our skin, etc. There is nothing wrong with these desires. Many are programmed into us by evolution. The problem arises when we are attached to these sensations and are never satisfied unless they’re present. Hence, in order to obtain them we strive to change the ways things are. When we don’t accept their absence, we suffer. There’s nothing wrong with liking pleasant sensations. We can enjoy them when they’re present. After all that’s accepting the present as it is. In fact, we can even seek them out. Problems arise when we’re not OK when we can’t get them or when we strive to hold onto these experiences even though they will inevitably fade. Not accepting that this is the nature of these experiences causes us to grasp onto them and then suffer when they dissipate. These are seemingly subtle distinctions, but they’re crucial. Grasping is the key. If we don’t grasp, then there’s no unsatisfactoriness.

We are not only wired to seek out pleasant sensation we’re also wired to avoid or eliminate unpleasant sensations, be they ugly or disgusting sights, grating sounds (the noise from lawn tools is one of my aversions), the taste of spoiled wine, the odor of rotten eggs, feeling of being chilled or overheated, pain, etc. There is nothing wrong with not liking these sensations, avoiding them, or attempting to stop them. Again evolution has programmed many of them to help protect us. The problem arises when we do not accept that these sensations arise as they inevitably will, or when we grasp at their avoidance not accepting what is. So, rather than accepting that we’re experiencing a headache, we fight against it, which amplifies the pain. Sure, lie down, close your eyes, rest, take an analgesic, but also accept that pain is present. There’s no sense in denying it or fighting it. That’s what causes the unsatisfactoriness. Just accept it, and relax knowing that like all sensations it will eventually go away. Additionally, we suffer when we become fearful of the possibility that they might occur. So we worry about the next headache or ruminate about the last one. This is a waste of time and makes us miserable. There is no headache present. Enjoy your non-headache. Aversion to certain kinds of sensory stimuli can be a major source of unsatisfactoriness, but only when we don’t accept what is.

Another major source of unsatisfactoriness is the unwillingness to accept ourselves as we are, to desire to be different than what we are. We want to be more successful, more attractive, more knowledgeable, more liked, happier, healthier, more assertive, younger, older, slimmer, stronger, less fearful, a better parent, less fidgety, etc. Just look in the self-help section of a bookstore as evidence of its pervasiveness. This is especially true in western society, where most people simply don’t like themselves. They want to be different. Once again, this is not accepting what is, rather wanting things to be different, producing intense unsatisfactoriness. This lack of acceptance of the self can generate unhealthy jealousy of others who seeming have what we wish we had. It can also cause us to judge others, making us feel better about ourselves by denigrating others. Hence, this desire to be different than we are can be a major source of unsatisfactoriness.

This is not to say that we shouldn’t want to improve ourselves. There’s no problem with working hard to advance one’s career, to lose weight, to exercise, to change hair color, to save toward purchasing a house, etc. This is normal and healthy. The problem arises when we can’t accept what we are in the present moment, when we can’t see that we’re just fine as we are even though we’re working to improve ourselves. There is much about us that we can’t change. No matter how hard I try, I won’t be able to make myself taller, smarter, or unemotional. This is what I am. To be happy, I need to accept myself as I am in the present moment. Fighting it is a waste of time and energy and a major source of unsatisfactoriness.

It is easy to say “got it”, I see the causes of suffering, so let’s move on to how I get enlightened. But, it is important to thoroughly investigate the causes of unsatisfactoriness. It drives home how we go about making ourselves unhappy. Every time you wish that things were different than they are right now, ask the question, why? What’s wrong or missing from the present moment? This doesn’t have to be done for major agonizing suffering. It’s best to look at something simple, like we’re bored. Ask why? Why are we unsatisfied with what’s going on right now? Is it that we crave more sensory stimulation? Then take a careful look at the sensations you’re currently experiencing and ask why they’re not sufficient. It can be an amazing revelation to see how we’re bored because we’re used to and are ignoring the incredible wonder of what is right around us. We’re not happy with the same old experiences, we crave something new. Why?

Don’t try to move on too quickly. Take the time to explore this thoroughly. This morning I was out for a speed walk workout in the heat and humidity, wishing it were cooler. If it was, I thought, then I’d enjoy the walk. But, I explored this a bit more deeply and realized that I was missing the extraordinary feelings of my body being hot, the sweat on my brow, the sun on my face. Then I started to appreciate the present moment and started to enjoy the situation that I was in at the time. The exploration of unsatisfactoriness can lead to greater happiness and simple enjoyment of what is. So, explore the reasons for your unsatisfactoriness and begin to understand your mind and to learn to appreciate what you have right now.

“If we can recognize when incorrect comprehension has affected our mind states, we can then make more sound judgments. We can tell when we are seeing things correctly, because we can notice peacefulness inside of us. Only when incorrect comprehension is in action do we feel tension and agitation.” – Lisa Mitchell

CMCS – Center for Mindfulness and Contemplative Studies

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

Improve Brain Systems Underlying Mental Well-Being with Gratitude Meditation

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Improve Brain Systems Underlying Mental Well-Being with Gratitude Meditation

By John M. de Castro, Ph.D.

“benefit of meditation. Or, rather, some ancient benefit that is just now being confirmed with fMRI or EEG. The practice appears to have an amazing variety of neurological benefits – from changes in grey matter volume to reduced activity in the “me” centers of the brain to enhanced connectivity between brain regions.” – Alice Walton

There has accumulated a large amount of research demonstrating that meditation has significant benefits for psychological, physical, and spiritual wellbeing. Its positive effects are so widespread that it is difficult to find any other treatment of any kind with such broad beneficial effects on everything from mood and happiness to severe mental and physical illnesses. This raises the question of how meditation could do this. One possibility is that mindfulness practice results in beneficial changes in the nervous system.

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. 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. In other words, mindfulness practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

These neuroplastic changes, however, result from the summation of individual changes occurring to the nervous system in real time produced by the immediate behavior. In order to better understand the process by which behavior affects the nervous system, it is important to look initially at the short-term changes produced by behavior. Loving-kindness meditation has been shown to produce improvement in the regulation of emotions and also changes the areas of the nervous system involved in emotion regulation. To better understand the processes involved it is important to look at the short-term effects of focusing on gratitude on the nervous system.

In today’s Research News article “Effects of gratitude meditation on neural network functional connectivity and brain-heart coupling.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506019/, Kyeong and colleagues recruited meditation-naïve adults. They were measured before testing for depression, competence, relatedness, and autonomy. The participants laid in a brain scanner and were instructed to think deeply in a gratitude condition and a resentment condition while their heart rate was recorded and functional Magnetic Resonance Imaging (f-MRI) was performed. In the gratitude condition the participants were instructed to think about and visualize their mother for 4 minutes and tell her in their mind how much they love and appreciate her. In the resentment condition the participants were instructed to think about and visualize a person who made them angry. The two conditions were presented in counterbalanced order to two randomly assigned groups.

They found that the heart rate was significantly lower during the gratefulness condition indicating the positive emotional effects of gratitude. In addition, they found that the functional connectivity of brain areas was significantly related to heart rate in the gratefulness condition but not the resentment condition. Hence, experiencing gratefulness connects central and peripheral mechanisms of emotion. They found that the functional connectivity of neural systems were altered during and after the two conditions. But, the gratitude condition altered the functional connectivity of brain areas associated with emotions and motivation.

These results suggest that the immediate focusing on gratitude produces momentary alterations of brain systems associated with the regulation of emotions and self-motivation. When carried out over a period of time this could sum to produce relatively permanent changes in these neural systems. This may be the mechanism by which loving-kindness meditation improves emotional well-being. These results are a useful start at unravelling the processes by which mental contents can produce relatively permanent alterations of the nervous system and thereby produce relatively permanent changes in the individual’s mood and regulation of that mood.

So, improve brain systems underlying mental well-being with gratitude meditation.

“Being distracted exacts a cost on our well-being, If we become more mindful of our everyday activities, we can learn well-being and become happier.” – Ritchie Davidson

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/
They are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Kyeong, S., Kim, J., Kim, D. J., Kim, H. E., & Kim, J.-J. (2017). Effects of gratitude meditation on neural network functional connectivity and brain-heart coupling. Scientific Reports, 7, 5058. http://doi.org/10.1038/s41598-017-05520-9

Abstract
A sense of gratitude is a powerful and positive experience that can promote a happier life, whereas resentment is associated with life dissatisfaction. To explore the effects of gratitude and resentment on mental well-being, we acquired functional magnetic resonance imaging and heart rate (HR) data before, during, and after the gratitude and resentment interventions. Functional connectivity (FC) analysis was conducted to identify the modulatory effects of gratitude on the default mode, emotion, and reward-motivation networks. The average HR was significantly lower during the gratitude intervention than during the resentment intervention. Temporostriatal FC showed a positive correlation with HR during the gratitude intervention, but not during the resentment intervention. Temporostriatal resting-state FC was significantly decreased after the gratitude intervention compared to the resentment intervention. After the gratitude intervention, resting-state FC of the amygdala with the right dorsomedial prefrontal cortex and left dorsal anterior cingulate cortex were positively correlated with anxiety scale and depression scale, respectively. Taken together, our findings shed light on the effect of gratitude meditation on an individual’s mental well-being, and indicate that it may be a means of improving both emotion regulation and self-motivation by modulating resting-state FC in emotion and motivation-related brain regions.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506019/

Improve Sleep with Tai Chi

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Improve Sleep with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai chi, a lifestyle intervention that targets stress that can lead to insomnia, was also found to reduce inflammation, and did so by reducing the expression of inflammation at the cellular level and by reversing activation of inflammatory signaling pathways.” – Science Daily

 

It is estimated that over half of Americans sleep too little due to stress. As a result, people today sleep 20% less than they did 100 years ago. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness. Yet over 70 million Americans suffer from disorders of sleep and about half of these have a chronic disorder. It has been estimated that about 4% of Americans revert to sleeping pills. But, these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to improve sleep. Mindfulness-based practices have been reported to improve sleep amount and quality. In addition, exercise has been shown to improve sleep.

 

Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Since Tai Chi and Qigong are both mindfulness practices and exercises, they may be effective treatments to improve sleep.

 

In today’s Research News article “Tai Chi Improves Sleep Quality in Healthy Adults and Patients with Chronic Conditions: A Systematic Review and Meta-analysis.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5570448/, Raman and colleagues review and summarize the published research literature on the ability of Tai Chi practice to improve sleep quality. They found 11 published studies, 9 of which were randomized controlled trials.

 

They reported that the research demonstrated that Tai Chi practice significantly improves both self-report and objective measures of sleep quality in a variety of people with and without illness. The improvements included decreases in the time to go to sleep and the use of sleeping pills and increases in sleep duration. No significant negative side effects were reported. Hence, Tai Chi practice appears to be a safe and effective treatment to improve sleep in both well and sickly people.

 

These are exciting and important findings that support the use of Tai Chi practice for the improvement in sleep. The mechanism by which Tai Chi practice produces sleep improvement is not known. The ability of mindfulness practices to reduce the physiological and psychological responses to stress may remove this obstacle to a good night’s sleep and thereby improve sleep. Regardless, it is clear that Tai Chi practice may be a solution to the chronic sleep problems experienced by many.

 

So, improve sleep with Tai Chi.

 

“The practice of Chi Gong can be used as a spiritual aid to help connect with a higher power, which can provide comfort and peace for those having difficulty sleeping. Even for individuals who are not spiritual, the mental, emotional and physical benefits are worth the effort in order to obtain restful sleep.” – Sifu Romain

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Raman, G., Zhang, Y., Minichiello, V. J., D’Ambrosio, C. M., & Wang, C. (2013). Tai Chi Improves Sleep Quality in Healthy Adults and Patients with Chronic Conditions: A Systematic Review and Meta-analysis. Journal of Sleep Disorders & Therapy, 2(6), 141. http://doi.org/10.4172/2167-0277.1000141

 

Abstract

Background

Physical activity and exercise appear to improve sleep quality. However, the quantitative effects of Tai Chi on sleep quality in the adult population have rarely been examined. We conducted a systematic review and meta-analysis evaluating the effects of Tai Chi on sleep quality in healthy adults and disease populations.

Methods

Medline, Cochrane Central databases, and review of references were searched through July 31, 2013. English-language studies of all designs evaluating Tai Chi’s effect on sleep outcomes in adults were examined. Data were extracted and verified by 2 reviewers. Extracted information included study setting and design, population characteristics, type and duration of interventions, outcomes, risk of bias and main results. Random effect models meta-analysis was used to assess the magnitude of treatment effect when at least 3 trials reported on the same sleep outcomes.

Results

Eleven studies (9 randomized and 2 non-randomized trials) totaling 994 subjects published between 2004 and 2012 were identified. All studies except one reported Pittsburg Sleep Quality Index. Nine randomized trials reported that 1.5 to 3 hour each week for a duration of 6 to 24 weeks of Tai Chi significantly improved sleep quality (Effect Size, 0.89; 95% confidence interval [CI], 0.28 to 1.50), in community-dwelling healthy participants and in patients with chronic conditions. Improvement in health outcomes including physical performance, pain reduction, and psychological well-being occurred in the Tai Chi group compared with various controls.

Limitations

Studies were heterogeneous and some trials were lacking in methodological rigor.

Conclusions

Tai Chi significantly improved sleep quality in both healthy adults and patients with chronic health conditions, which suggests that Tai Chi may be considered as an alternative behavioral therapy in the treatment of insomnia. High-quality, well-controlled randomized trials are needed to better inform clinical decisions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5570448/

Have a Mindful Thanksgiving

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Have a Mindful Thanksgiving

 

By John M. de Castro, Ph.D.

 

 “I am grateful for what I am and have. My thanksgiving is perpetual.” – Henry David Thoreau

 

“The greatest gift one can give is thanksgiving. In giving gifts, we give what we can spare, but in giving thanks we give ourselves.”
Br. David Steindl-Rast

 

Thanksgiving is a time for gratefulness. Most people, most of the time rue what they want and don’t have. So Thanksgiving is particularly important as a reminder of how lucky we are for all the blessings we have. It is a time to recognize that despite all our negative thoughts we have everything that we really need and probably much, much, more.

 

At this time of year the fall harvest is in and almost universally there is a celebration of the abundance provided. These crops will sustain us through the cold winter and till new crops can be planted, grow, mature, and are harvested. Hence, thanksgiving is very much a celebration of nature and all that it provides. In a modern world we lose track of all that is entailed in bringing us this food. When we are grateful for the food we need to recognize that we should be also be grateful for the seeds, the sun, the rain, the soil, the insects and birds that pollinate the crops, and even the worms and grubs that prepare the soil. Without any of these the food would not grow. In a sense, if we look carefully, we understand that our gratefulness is not just for the particular food item. It is in fact for the entire universe to which we and the food are intimately connected.

 

These interconnections extend into society and technology. The steel to build the plow, the engines that move the plow, the trains and trucks that transport the food, the farmers, drivers, and engineers, the fuel for the engine, the oil wells and refineries that produce the fuel, the engineers who designed and built the machinery and factories, the men and women who educated the scientists, engineers, and farmers. I’m sure by now that you’ve got the picture. A little reflection soon reveals the vast network of interconnections, even stretching back in time.

 

Thanksgiving is also a time to celebrate the people we are closest to, our friends and especially our family. They are our origin and our support through development. They are our connections to the past and future. They are the emotional fuel that sustains us. They give us hope and purpose. Yes, there is dysfunction. That goes with all forms of human interactions. But, should we lose any of them we will quickly realize how important they are to our flourishing and happiness.  Remember, that on the deathbed, one of the biggest regrets is not having spent more time with family and friends. Thanksgiving is a time to recognize these interconnections, to be grateful for these people and their importance to our existence.

 

Certainly one of the most taken for granted amazing blessings that we have is our own awareness. We’ve always been aware. We’ve never, not been aware. So, it is so easy for it to go unrecognized and unappreciated. But, reflect for a moment what a miracle it is. There is an essence to us that is forever present and unchanging. What we are aware of is constantly changing, but that which is aware is not. Without our awareness we are nothing but biological automatons, robots. With it we are suddenly human and spiritual. We would not be able to be grateful or enjoy Thanksgiving without it. So, do not forget on Thanksgiving to be grateful for this wonder that forms the essence of what we are.

 

There is a very subtle kind of gratefulness that we should also adopt. It’s what the great sage Thich Nhat Hahn calls our “non-toothache.” He points out that if we had a toothache we would be thinking how grateful we’d be if it ended. But once it does we take it for granted. We need to be thankful not only for what we have but also for many things that we don’t. The health of our bodies is taken for granted, but we should be intensely grateful for our non-disease. We may not be happy in our job, but if we didn’t have one we’d think how grateful we’d be to find one. We may be unhappy for the police officer who gave us a speeding ticket. But, we don’t recognize that our safety on the roads depends upon enforcement of the laws. We should be thankful for our non-accident. We are so fortunate in so many ways that we take for granted like our “non-toothache”. But, at Thanksgiving it is good to reflect upon all of these unnoticed blessings.

 

Finally, it is illuminating to reflect on whether you’re a source of thanksgiving for others. Specifically, what have you done that would make someone grateful to you. In other words, what have you given. This is important as it is not always what we have or what we get that’s important but what we share, what we do for others, and what we give. This is often the source of genuine happiness. The things that we have are never satisfying in a lasting way, but the things that we give forever bring joy. So, ask yourself on Thanksgiving, have you truly and sincerely given to others without expecting something in return?

 

It is very useful to reflect upon all of these things at Thanksgiving. The modern world, with its emphasis on self-sufficiency and individuality, produces feelings of independence and isolation. But these thanksgiving reflections soon reveal that this is an illusion. We are inextricably connected to the entire fabric of the universe, the tapestry of our physical, social, and spiritual existence. There is so much to be grateful for that upon reflection we can see that our sufferings are silly and small by comparison. We should revel in the vast interconnected blessings that make up everything about our world and ourselves. We should celebrate the miracle of life and our awareness of it.

 

So, eat, drink, and be merry on Thanksgiving, enjoy the wonderful celebration, but also invest a few moments in reflecting upon all that we have to be thankful for.

 

He who thanks but with the lips
Thanks but in part;
The full, the true Thanksgiving
Comes from the heart.
~J.A. Shedd

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

Improve the Mental and Physical Health of Breast Cancer Survivors with Yoga

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Improve the Mental and Physical Health of Breast Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

“It was very frightening. You wonder, obviously—Am I going to live through this? I’m convinced that yoga made all the difference in my treatment. The breathing was the thing that always came back for me—keeping the fear and panic down. I was in a PET scan machine for an hour. You just lie there and think terrible thoughts. I found my breathing. That was the most valuable thing.” – Debra Campagna

 

About 12.5% of women in the U.S. develop invasive breast cancer over their lifetimes and every year about 40,000 women die. Indeed, more women in the U.S. die from breast cancer than from any other cancer, besides lung cancer. Breast cancer diagnosis, however, is not always a death sentence. Death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%. The improved survival rates mean that more women are now living with cancer.

 

Surviving cancer, however, carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” (National Cancer Survivors Day). Also, breast cancer survivors can have to deal with a heightened fear of reoccurrence. This is particularly true with metastatic cancer. Additionally, cancer survivors frequently suffer from anxiety, depression, mood disturbance, Post-Traumatic Stress Disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, an alteration of their body image, and psychiatric symptoms which have been found to persist even ten years after remission. So, safe and effective treatments for the symptoms in breast cancer and the physical and psychological effects of the treatments are needed.

 

Mindfulness training has been shown to help with general cancer recovery and breast cancer recovery. Mindfulness helps to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Yoga practice has also been shown to be helpful with the residual symptoms and the psychological and physical ability to deal with cancer treatment. So, it’s reasonable to further explore the potential benefits of yoga practice for women during and after treatment.

 

In today’s Research News article “Effect of Long-term Yoga Practice on Psychological outcomes in Breast Cancer Survivors.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5545946/, Amritanshu and colleagues recruited breast cancer survivors who were at least 6 months since the completion of treatment. They separated them into groups based upon whether they practiced yoga or not during the last year. The participants were measured for perceived stress, anxiety, depression, sleep quality, general health, and quality of life, including physical, psychological, social, and functional dimensions.

 

They found that the group that practiced yoga had significantly better psychological and physical health, sleep, and quality of life on all measures compared to the group that did not practice yoga. Hence, the overall health and well-being of the breast cancer survivors were significantly superior when they practiced yoga.

 

It should be kept in mind that this was not a manipulative study, so causation cannot be determined. It is possible that only those breast cancer survivors who were generally healthy would choose to participate in yoga. Previous research, however, that actively trained breast cancer patients in yoga has demonstrated that yoga practice produced significant improvements in the health and well-being of the participants. So, there is reason to believe that yoga practice was responsible for the present findings and that yoga practice improves the mental and physical health of breast cancer survivors.

 

So, improve the mental and physical health of breast cancer survivors with yoga.

 

“Studies suggest that doing yoga while going through breast cancer treatment helps you get through it with fewer side effects. Often doctors have to stop chemo or lower doses to levels that may not be as effective because people don’t tolerate the side effects. But yoga appears to decrease all kinds of side effects.” – Timothy McCall

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Amritanshu, R. R., Rao, R. M., Nagaratna, R., Veldore, V. H., Usha Rani, M. U., Gopinath, K. S., & Ajaikumar, B. S. (2017). Effect of Long-term Yoga Practice on Psychological outcomes in Breast Cancer Survivors. Indian Journal of Palliative Care, 23(3), 231–236. http://doi.org/10.4103/IJPC.IJPC_93_17

 

Abstract

Aim:

Breast cancer has become a pandemic with an ever-increasing incidence. Although better diagnostics and treatment modalities have reduced mortality, a large number of survivors face cancer and treatment-related long-term symptoms. Many survivors are taking up yoga for improving the quality of life (QoL). The present study attempts to evaluate predictors of psychological states in breast cancer survivors with long-term yoga experience.

Materials and Methods:

A case–control study recruited early breast cancer survivors, 30–65 years, completing treatment > 6 months before recruitment, and grouped them based on prior yoga experience (BCY, n = 27) or naïve (BCN, n = 25). Demography, cancer history, diet, exercise habits, and yoga schedule were collected and tools to assess stress, anxiety, depression, general health, and QoL were administered. Multivariate linear regression was done to identify predictors of psychological variables.

Results:

BCY had significantly lower stress, anxiety, depression, better general health, and QoL (P < 0.001). Global QoL and trait anxiety were significantly predicted by Yoga practice; depression was predicted by yoga practice, annual income, and sleep quality; state anxiety was predicted by Yoga practice and income; and stress was predicted by Yoga practice and sleep quality.

Conclusion:

Results indicate that breast cancer survivors, doing yoga, have better psychological profiles and are able to deal with demanding situations better. The psycho-oncogenic model of cancer etiology suggests that a better psychological state in survival has the potential to improve prognosis and survival outcomes and Yoga may be a suitable practice for staying cancer-free for a longer time.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5545946/

Decrease Sadness with Mindfulness

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Decrease Sadness with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation can be helpful. . . We are like a plant in winter: cold, dark, dormant. If we can accept this feeling as a natural part of having a human heart—that it breaks sometimes—we can give it the attention and love it needs. It may be painful, but being with the sadness without trying to do much with it is the best way to let the winter pass of its own accord.” – Mindful

 

Sadness is labelled as a negative emotion. It is, however, a natural and normal reaction to loss, or lack, or loneliness. But, if sadness if overly intense or prolonged, it can turn into an intense misery, e.g. grief. Sadness is sometimes confused with depression. But they are quite different states. Sadness occurs normally in response to a situation, while depression occurs without an external referent. The mindfulness approach to emotion is to simply observe it, not deny or suppress it, but let it arise and then watch it dissipate. How the individual reacts to n emotion can results in an amplification of the magnitude of the emotion. Acceptance of the emotion then can eliminate the magnification of the emotion. This mindfulness approach has been shown to improve the ability to regulate most emotions. So, it would seem reasonable to hypothesize that mindfulness training would be able to reduce sadness.

 

There are other strategies to control emotions including suppression and reappraisal. Suppression is an active attempt to inhibit both the physical and psychological aspects of an emotion. On the other hand, reappraisal is an active process of reinterpreting the cause of the emotion and thereby reduce its impact. It is not known which of these three strategies would be most effective in dealing with sadness.

 

In today’s Research News article “Effects of mindfulness, reappraisal, and suppression on sad mood and cognitive resources.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5509409/, Keng and colleagues recruited college students and randomly assigned them to receive instructions for dealing with emotions with mindfulness, suppression, or reappraisal. They listened to a pre-recorded (10 minute) audio instruction. The instructions for the mindfulness condition, emphasized registering thoughts and emotions as they are without judging them. Instructions for the reappraisal condition were to reframe the meaning of an emotional event to reduce its emotional impact. Instructions for the suppression condition emphasized suppressing both the experience and expression of emotions.

 

A sad mood was induced by asking the participants to recall and spend 10 minutes writing about sad events in their lives while listening to sad music. The participants were then asked to use their assigned strategy, mindfulness, suppression, or reappraisal to deal with the sad emotion. They rated their sadness every minute during the application of the strategy. Before and after inducing the sad mood, the participants were measured for sadness, and attentional ability (Stroop task). Only participants who had a significant increase in sadness resulting from the induction were included in the final sample.

 

They found that over time sadness declined, but it declined faster with the mindfulness strategy than with either the suppression or reappraisal strategies. In addition, mindfulness resulted in better attention performance. So, although this was a somewhat artificial laboratory experiment, the results suggested that mindfulness was a superior strategy for dealing with sadness and maintaining attentional ability than either suppression or reappraisal.  So, experiencing emotions as they are without judgement appears to be better at reducing the strength of the emotion than trying to eliminate or reinterpret it.

 

So, decrease sadness with mindfulness.

 

“Despair is what happens when you fight sadness. Compassion is what happens when you don’t.” – Susan Piver

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Keng, S.-L., Tan, E. L. Y., Eisenlohr-Moul, T. A., & Smoski, M. J. (2017). Effects of mindfulness, reappraisal, and suppression on sad mood and cognitive resources. Behaviour Research and Therapy, 91, 33–42. http://doi.org/10.1016/j.brat.2017.01.006

 

Abstract

The present study investigated the relative effects of mindfulness, reappraisal and suppression in reducing sadness, and the extent to which implementation of these strategies affects cognitive resources in a laboratory context. A total of 171 Singaporean undergraduate participants were randomly assigned to receive brief training in mindfulness, reappraisal, or suppression prior to undergoing a sad mood induction. Individual adherence to Asian cultural values was assessed as a potential moderator of strategy effectiveness. Participants rated their mood and completed a Color-Word Stroop task before and after mood regulation instructions. Analyses using multi-level modelling showed that the suppression condition caused less robust declines in sadness over time compared to mindfulness. There was also a nonsignificant trend in which mindfulness was associated with greater sadness recovery compared to reappraisal. Suppression resulted in lower average sadness compared to mindfulness among those high on Asian cultural values, but not those low on Asian cultural values. Both mindfulness and reappraisal buffered against increases in Stroop interference from pre-to post-regulation compared to suppression. The findings highlight the advantage of mindfulness as a strategy effective not only in the regulation of sad mood, but also in the preservation of cognitive resources in the context of mood regulation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5509409/

Improve Dementia Patient Caregiver Mental Health and Reduce Stress with Mindfulness

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Improve Dementia Patient Caregiver Mental Health and Reduce Stress with Mindfulness

 

By John M. de Castro, Ph.D.

 

“To my mother, I owe the experience of being with her since the beginning of her dementia, and the ability to notice what a difference mindfulness practice made in our relationship. From feeling only grief, to a growing acceptance of her in the moment, even appreciating new aspects of her personality that became freed as a result of her condition.” – Marguerite Manteau-Rao

 

Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. Dementia patients require caregiving particularly in the later stages of the disease. Alzheimer’s disease is the most common type of dementia and accounts for 50 to 70 percent of dementia cases. Other types of dementia include vascular dementia, mixed dementia, dementia with Lewy bodies and frontotemporal dementia. For Alzheimer’s disease alone, there are an estimated 10 million caregivers providing 9 billion hours of care at a value of over $100 Billion dollars.

 

Caregiving for dementia patients is a daunting and all too frequent task. 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 caregivers report that they are effectively on duty 24/7. Over time dementia will lead to loss of memory, loss of reasoning and judgment, personality and behavioral changes, physical decline, and death. The memory and personality changes in the patient may take away all those characteristics that make the loved one identifiable, unique, and endearing, producing psychological stress in the caregiver.

 

The feelings of hopelessness can be overwhelming regarding the future of a patient with an irreversible terminal degenerative illness. In addition, caregivers often experience an anticipatory grief associated with a feeling of impending loss of their loved one. If this isn’t bad enough, a little appreciated consequence is that few insurance programs cover dementia care outside of the hospital. So, medical expenses can produce extra financial strain on top of the loss of income for the caregiver. It is sad that 72% of caregivers report relief when their loved one passes away.

 

Obviously, there is a need to care for the caregivers of dementia patients. They play an essential and often irreplaceable role. So, finding ways to ease the burden is extremely important. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving. In today’s Research News article “Mindfulness training for psychological stress in family caregivers of persons with dementia: a systematic review and meta-analysis of randomized controlled trials.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626236/, Liu and colleagues review and summarize the published Randomized Controlled Trials (RCTs) on the effectiveness of mindfulness training on the psychological state of caregivers for dementia patients.

 

They identified 7 published Randomized Controlled Trials (RCTs). The studies employed a variety of different mindfulness training techniques; including Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT), and meditation practice. They report that the published studies find that mindfulness training produces a significant decrease in depression and perceived stress, a trend toward decreased anxiety, and significant improvement in mental health quality of life. The importance of these findings is underscored by the fact that these were all well controlled scientific studies of high quality. Hence, mindfulness training appears to be of significant help to caregivers of dementia patients improving their mental health and quality of life.

 

It has been demonstrated that mindfulness training improves anxiety, depression, and quality of life, and reduces stress in a wide variety of populations. So, it is not surprising that it has similar effectiveness for these caregivers. The magnitude of the burden on these caregivers, however, is such that the improvements produced by mindfulness training are a blessing. Hence, mindfulness training should be incorporated into routing support and treatment programs for caregivers of dementia patients.

 

So, improve dementia patient caregiver mental health and reduce stress with mindfulness.

 

“One of the major difficulties that individuals with dementia and their family members encounter is that there is a need for new ways of communicating due to the memory loss and other changes in thinking and abilities. The practice of mindfulness places both participants in the present and focuses on positive features of the interaction, allowing for a type of connection that may substitute for the more complex ways of communicating in the past.” – Sandra Weintraub

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Liu, Z., Chen, Q., & Sun, Y. (2017). Mindfulness training for psychological stress in family caregivers of persons with dementia: a systematic review and meta-analysis of randomized controlled trials. Clinical Interventions in Aging, 12, 1521–1529. http://doi.org/10.2147/CIA.S146213

 

Abstract

Caring for a relative with dementia is extremely challenging; conventional interventions may not be highly effective or easily available on some occasions. This study aimed to explore the efficacy of mindfulness training in improving stress-related outcomes in family caregivers of people with dementia using a meta-analytic review. We searched randomized controlled trials (RCT) through April 2017 from five electronic databases, and assessed the risk of bias using the Cochrane Collaboration tool. Seven RCTs were included in our review. Mindfulness interventions showed significant effects of improvement in depression (standardized mean difference: −0.58, [95% CI: −0.79 to −0.37]), perceived stress (−0.33, [−0.57 to −0.10]), and mental health-related quality of life (0.38 [0.14 to 0.63]) at 8 weeks post-treatment. Pooled evidence did not show a significant advantage of mindfulness training compared with control conditions in the alleviation of caregiver burden or anxiety. Future large-scale and rigorously designed trials are needed to confirm our findings. Clinicians may consider the mindfulness program as a promising alternative to conventional interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626236/

It’s the Suffering, Stupid

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It’s the Suffering, Stupid

 

By John M. de Castro, Ph.D.

 

” If you want to understand suffering you must look into the situation at hand. The teachings say that wherever a problem arises it must be settled right there. Where suffering lies is right where non-suffering will arise, it ceases at the place where it arises. If suffering arises you must contemplate right there, you don’t have to run away. You should settle the issue right there. One who runs away from suffering out of fear is the most foolish person of all. He will simply increase his stupidity endlessly. We don’t meditate to see heaven, but to end suffering.” – Ajahn Chah

 

When I was first introduced to the Buddha’s Four Noble Truths I was underwhelmed, to say the least. They said first that there’s suffering. Yeah, I thought, that’s obvious, there’s lots of suffering in this world. So, what’s new. Then they said that there are causes for suffering. Again, I thought, of course, there are causes for everything. So, when do we get to the good stuff. Then they said that there’s a way to end suffering. That’s clear and obvious, I thought. Of course, if you know what causes it then there’s always ways to end it. Let’s get to the meat. Lastly, they said that there was a path to the end of suffering. Yeah, yeah, of course, let’s move on and get to how do we attain enlightenment. How do we get to nirvana and eternal bliss?

 

I don’t believe that my response was unusual as my unscientific discussions with peers has revealed similar responses. I believe that part of the reason that we missed the importance of what was being taught was the word suffering itself. It’s a translation from the Pali word “dukkha” that was the language that was likely used by the Buddha. But, it can equally well be translated as “imperfect”, “unsatisfying”, or “incapable of providing perfect happiness.” I happen to favor unsatisfactory. Using this translation, I began to see what was being taught here. Suffering implied to me an extreme and painful experience, agony, which I saw as relatively rare. But, unsatisfactoriness, now that’s a different story. Most things in life are to one degree or another unsatisfactory. So, the teaching now seems to apply to a much wider range of experiences. This was the beginning of the revelation as to just how seminal this teaching is. It’s when I realized that “It’s the suffering, stupid.”

 

I should have noted the clear and precise teaching of the Buddha. When asked about how to attain enlightenment the Buddha said “I teach one thing and one thing only: that is suffering and the end of suffering.” This should have been a clear message that the pursuit of enlightenment is actually the pursuit of the end of “dukkha”, the end of unsatisfactoriness. It should have been obvious that the key to enlightenment is unsatisfactoriness, its causes, and how to eliminate them. But somehow, I wanted to jump ahead and missed the most important teaching of all.

 

Looking carefully at existence from the perspective of unsatisfactoriness, it is clear that unsatisfactoriness is ubiquitous, it’s everywhere.

 

The alarm goes off in the morning and I think, I want to sleep longer, but I can’t. The day starts off with unsatisfactoriness. I notice a slight ache in my neck and want it to go away, and this is more unsatisfactoriness. Rising out of bed in the morning there’s a need to use the bathroom. My state is unsatisfactory. When picking out some clothes to wear I find the outfit I want to wear is out at the cleaners and I’ll have to wear something less satisfactory. I feel a bit shabby and old fashioned in the clothes. Being late, a breakfast bar is grabbed as I rush out the door, wishing I could sit down and have some scrambled eggs but have to eat an unsatisfactory breakfast. I go outside and feel the cold and wish the day to be warmer. The temperature is unsatisfactory. Driving to work I get caught at a red light and want it to be green, feeling frustrated and unsatisfactory. Traffic is moving slower than I want, so I find driving unsatisfactory. At work my co-worker looks at me with a scowl and I’m unsatisfied because I think that she doesn’t like me. etc., etc., etc. The entire day is filled from one end to the other with unsatisfactoriness.

 

The more I look at it the more I see that some of the unsatisfactoriness is due to external circumstances, the red light, the outside temperature, and the neck pain that I have little control over. But, I see that the more insidious type of unsatisfactoriness is of my own making. I make myself suffer by my interpretation of how I look in the clothes I’m wearing or how I think about events like my co-worker’s scowl. I assumed it was because she didn’t like me and I want to be liked. But, that was my interpretation. I brought that unsatisfactoriness onto myself. She may have just had a bad morning or been called on the carpet by the boss. I make so many assumptions and interpret a large number of events as suggestive of some personal failure or fault when they probably have nothing to do with me whatsoever.

 

Once we take this perspective it begins to dawn that life is replete with unsatisfactoriness. There is no end to it. Now I get what the Buddha was talking about. It’s the suffering, stupid. It’s the unsatisfactoriness. I am constantly dissatisfied with virtually everything. What a miserable way to live. Seeing the all pervasiveness of my suffering, it becomes evident that I’m rarely truly happy and even then when it’s over I feel unsatisfied. This reveals another way that unsatisfactoriness arises. One that is produced by the impermanence of all things. Everything is constantly changing and I find it unsatisfactory when good stuff goes away or when bad stuff begins. I want pleasurable experiences never to end and unpleasant ones never to begin. This is perfectly reasonable, but nevertheless a major source of the unsatisfactoriness that fills my day.

 

So, life is inherently unsatisfactory. How can one ever experience eternal bliss, if unsatisfactoriness is everywhere? I guess that’s what the Buddha was talking about. It has been said that the way to nirvana is through samsara or in plain language we must go through suffering to get to bliss. If this is true, then we must fully experience and understand our unsatisfactoriness in order to make progress on the spiritual path toward enlightenment. The first step is to carefully explore our experiences and see where and what we find unsatisfactory.

 

So, begin with the suffering, stupid.

 

“On top of the sufferings of birth, aging, sickness, and death, we encounter the pains of facing the unpleasant, separating from the pleasant, and not finding what we want. The basic problem lies with the type of mind and body that we have. Our mind-body complex serves as a basis for present sufferings in the form of aging, sickness, and death, and promotes future suffering through our usual responses to painful situations.” – Dalai Lama

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

A Pilot Study of Mindfulness Training for the Cognitive and Psychological Symptoms with Multiple Sclerosis

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A Pilot Study of Mindfulness Training for the Cognitive and Psychological Symptoms with Multiple Sclerosis

 

By John M. de Castro, Ph.D.

 

“Mindfulness practice appears to be a safe, drug-free approach to coping with stress and anxiety, which may in turn help reduce your MS symptoms.” Amit Sood

 

Multiple Sclerosis (MS) is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It affects about 2 million people worldwide and about 400,000 in the U.S. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis. There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms.

 

Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, physical impairment, depression, and poor sleep quality. In addition, there are marked deficits in cognition in around half of MS patients that include impairments in memory, information processing speed, executive functioning, attention, and verbal fluency. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life. Mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, emotion regulation, and fatigue. It has also been shown to improve the symptoms of multiple sclerosis.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Stress Reduction on Psychological Distress and Cognitive Functioning in Patients with Multiple Sclerosis: a Pilot Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605592/, Blankespoor and colleagues investigated the ability of mindfulness training to relieve the psychological symptoms, including cognitive impairments, with Multiple Sclerosis (MS). In a pilot study, they recruited patients with MS and provided them with an 8-week Mindfulness-Based Stress Reduction (MBSR) program consisting of meditation, body scan, and yoga practice. The participants met in group sessions for 2.5 hours once a week and also performed home practice. The participants were measured before and one week after training for mindfulness, depression, multiple sclerosis quality of life, fatigue, self-compassion, and cognitive ability including tests of memory, visuospatial memory, processing speed, working memory, attention, and executive function.

 

They found that in comparison to baseline measures, after MBSR training the patients showed significant improvements in their psychological states including their physical and emotional quality of life, self-compassion, and mindfulness. Unfortunately, the patients did not show cognitive impairments at baseline. So, it was not surprising that the only cognitive ability that significantly improved was visuospatial processing.

 

Unfortunately, the study was flawed in a number of ways. In particular the lack of a control comparison condition opens the way for a large number of alternative, confounding, explanations for the results. Also, there was a 30% dropout rate which raises the possibility that only those who felt better continued and were measured after treatment. Finally, the lack of baseline impairment in cognitive abilities precluded the assessment of the effectiveness of MBSR to improve these common symptoms of MS. The study needs to be repeated in a Randomized Controlled Clinical Trial (RCT) with procedures implemented to maximize patient retention and with patients who demonstrate cognitive impairment prior to treatment.

 

Patients with Multiple Sclerosis suffer in many ways and it will be important to determine if mindfulness training can reduce the suffering.

 

“Studies in multiple sclerosis, these have shown that mindfulness can improve quality of life and help people cope better with their MS. The studies also found that it decreased stress, anxiety and depression.” – MSTrust

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Blankespoor, R. J., Schellekens, M. P. J., Vos, S. H., Speckens, A. E. M., & de Jong, B. A. (2017). The Effectiveness of Mindfulness-Based Stress Reduction on Psychological Distress and Cognitive Functioning in Patients with Multiple Sclerosis: a Pilot Study. Mindfulness, 8(5), 1251–1258. http://doi.org/10.1007/s12671-017-0701-6

 

Abstract

Patients with multiple sclerosis (MS) often suffer from psychological distress and cognitive dysfunctioning. These factors negatively impact the health-related quality of life. Only recently behavioral therapeutic approaches are being used to treat psychological distress in MS. The aim of the present pilot study was not only to investigate the effectiveness of mindfulness-based stress reduction (MBSR) on psychological distress but also to explore whether it can improve cognitive functioning among patients with MS. Outpatients of the MS Center of the Radboud University Medical Center (Radboudumc) were invited to participate in an MBSR training. Psychological and cognitive measures were administered pre- and post-intervention. Twenty-five MS patients completed the MBSR training and psychological measures, of which 16 patients completed the cognitive tests. Significant improvements were found in depressive symptoms, quality of life, fatigue, mindfulness skills, and self-compassion. Of the cognitive tests, performance on a visual spatial processing test significantly improved after the intervention. Overall, this pilot study showed promising results of the effects of MBSR on reducing psychological distress, and it suggests MBSR might improve cognitive functioning in MS patients. Future randomized controlled trials should be conducted to confirm the possible effectiveness of MBSR—and its long-term effects—on psychological and cognitive functioning in MS patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605592/