Month: March 2018

Improve Post-Traumatic Stress Disorder (PTSD) with Mindfulness

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Improve Post-Traumatic Stress Disorder (PTSD) with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Overall, there is a lot of evidence supporting mindfulness as a treatment approach for adults with PTSD, and a recent burgeoning literature corroborating positive neurological changes is following suit.” – 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 negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

 

Obviously, these are troubling symptoms that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective. Mindfulness Based Stress Reduction (MBSR) has been found to improve PTSD symptoms. It has been shown that mindfulness practices can alter the brain structures and connectivity and this may underlie the beneficial effects of mindfulness on PTSD.

 

In today’s Research News article “Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5747539/ ), Boyd and colleagues review and summarize the published research literature on the effects of mindfulness training on the brain and its relationship to improvements in PTSD symptoms. They report that there is substantial evidence that a variety of mindfulness-based treatments including Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and Loving Kindness Meditation are effective for relieving the symptoms of PTSD.

 

In regards to brain function, they report that mindfulness practices result in greater activity in the prefrontal cortex, structures that are involved in higher level thought processes and attention and lower activity in the amygdala region that is associated with emotional arousal. In addition, there is increased connectivity between these two regions. This could explain the ability of mindfulness practices to reduce hyperarousal and emotionality with more rational thought and improvement in emotional regulation. In addition, they report that a series of midline cortical structures labelled the default mode network (DMN) have increased connectivity, suggesting an improvement in self-referential thinking.

 

There is increased activity in a series of cortical structures that connect to lower centers in the brain labelled the salience network (SN) that appears to be involved in detecting particularly important stimuli and regulating emotional responses to them. This may result in the PTSD sufferer having a greater ability to respond appropriately to things in the environment that may have previously produced flashbacks and hyperarousal. Finally, mindfulness training appears to improve the activity and connectivity of the brain’s Central Executive Network (CEN), including dorsolateral prefrontal cortex and the posterior parietal cortex, that is associated with high level thinking.

 

These findings suggest that mindfulness training alters brain function to increase thinking and reasoning in contrast to emotional arousal. This is exactly what the PTSD patient needs as PTSD tends to produce the opposite pattern with decreased reasoning and increased emotional responding. Hence these findings suggest that mindfulness training acts on the nervous system to counter the abnormal brain responses that occur with PTSD and thereby relieve the symptoms of PTSD. Obviously much more research is needed. But a coherent picture is emerging of the alterations in the nervous system produced by mindfulness training that are responsible for its beneficial effects on the symptoms of PTSD.

 

So, improve post-traumatic stress disorder (PTSD) with mindfulness.

 

“This type of attention training may help patients notice when they are stuck in a negative pattern of thought or rumination and make it a little easier to shift their attention to other things. And if you think about what mindfulness meditation is, that makes perfect sense. The ‘muscle’ that you are training is the ability to catch yourself when you are not thinking about your breath and move it to something else.” – Tony 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 and on Twitter @MindfulResearch

 

Study Summary

 

Jenna E. Boyd, Ruth A. Lanius, Margaret C. McKinnon. Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence. J Psychiatry Neurosci. 2018 Jan; 43(1): 7–25. Published online 2017 Oct 3. doi: 10.1503/jpn.170021

 

Abstract

Mindfulness-based treatments for posttraumatic stress disorder (PTSD) have emerged as promising adjunctive or alternative intervention approaches. A scoping review of the literature on PTSD treatment studies, including approaches such as mindfulness-based stress reduction, mindfulness-based cognitive therapy and metta mindfulness, reveals low attrition with medium to large effect sizes. We review the convergence between neurobiological models of PTSD and neuroimaging findings in the mindfulness literature, where mindfulness interventions may target emotional under- and overmodulation, both of which are critical features of PTSD symptomatology. Recent emerging work indicates that mindfulness-based treatments may also be effective in restoring connectivity between large-scale brain networks among individuals with PTSD, including connectivity between the default mode network and the central executive and salience networks. Future directions, including further identification of the neurobiological mechanisms of mindfulness interventions in patients with PTSD and direct comparison of these interventions to first-line treatments for PTSD are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5747539/

The Variety of Transcendent States During Meditation

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The Variety of Transcendent States During Meditation

 

By John M. de Castro, Ph.D.

 

“Ancient masters described intense transcendent states that result from meditation. A true awakening, transformation of consciousness, oneness with the ALL. Many esoterics have glimpsed these levels of consciousness, and for a few it became a persistent state – enlightenment.” – Future Thinkers

 

Millions of people worldwide seek out transcendent experiences by engaging in practices, such as meditation, yoga, and prayer. Others use drugs such as peyote, mescaline, LSD, ayahuasca and psilocybin to induce these experiences. Transcendent experiences have many characteristics which are unique to the experiencer, their religious context, and their present situation. But, the common, central feature of transcendence is a sense of oneness, that all things are contained in a single thing, a sense of union with the universe and/or God and everything in existence. This includes a loss of the personal self. What they used to refer to as the self is experienced as just a part of an integrated whole. People who have had these experiences report feeling interconnected with everything else in a sense of oneness with all things. Although transcendent experiences can vary widely, they all contain this experience of oneness.

 

I published a summary and review of these characteristics in a paper entitles “A Model of Enlightened/Mystical/Awakened Experience. It can be found on Research Gate at https://www.researchgate.net/publication/281807307_A_Model_of_EnlightenedMysticalAwakened_Experience.

 

Because of their relatively rare, ineffable, and completely subjective characteristics, transcendent experiences have received only a small amount of scientific attention. This, however, flies in the face of their importance to humans of spirituality. They are central to the human search for the nature and meaning of existence. Hence, there is a need for greater scientific attention to transcendent experiences.

 

In today’s Research News article “A Systematic Review of Transcendent States Across Meditation and Contemplative Traditions.” Wahbeh and colleagues summarize the published peer-reviewed scientific literature on transcendent experiences occurring during meditation. They identified 25 studies involving a total of 672 participants that measured a variety of physiological, psychological, and experiential variables during or after the experience of transcendence during meditation.

 

They found that “as meditation progresses, a person’s sense of agency, location and boundaries in time and space become weaker and the sense of self dissolves”. This was associated with relaxed wakefulness which included decreased respiration, skin conductivity, and muscle relaxation, increase in the brain’s alpha rhythm power, alpha blocking, and changes in brain area interconnectedness and activity. The meditators report experiencing “a sense of timelessness, spacelessness, unconditional love, peace, profound joy, and loss of boundaries of the self. In Christian contemplative traditions, there is a “transformative presence of God” and religious ecstasy.” The meditators report changes in perception that are reflected in changes in brain activity in the sensory cortices. Phenomenologically these changes are reported to not alter the present sensory environment but transcends it producing a sense on oneness of all things.

 

The studies reported were very heterogenous with different methodologies, measurements, and focus and with great differences in scientific quality and bias. This is unfortunate, as this is such an important area of study. There is a need for more work under similar conditions with standardized measurements and tighter experimental controls. Rather than considering the published research as definitive, it should be viewed as a first step in the investigation of transcendent experiences during meditation. But, the published studies to date produce a tantalizing glimpse into these states, reflecting an altered interpretation of reality and perhaps insight into the nature of being.

 

“during transcendent states, we slip into an altered state of consciousness different from our ordinary waking or rational consciousness. “No account of the universe in its totality can be final which leaves these other forms of consciousness quite disregarded.” – William James

 

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

 

Wahbeh H, Sagher A, Back W, Pundhir P, Travis F. A Systematic Review of Transcendent States Across Meditation and Contemplative Traditions. Explore (NY). 2018 Jan – Feb;14(1):19-35. doi: 10.1016/j.explore.2017.07.007. Epub 2017 Oct 23.

 

Background

Across cultures and throughout history, transcendent states achieved through meditative practices have been reported. The practices to attain transcendent states vary from transcendental meditation to yoga to contemplative prayer, to other various forms of sitting meditation. While these transcendent states are ascribed many different terms, those who experience them describe a similar unitive, ineffable state of consciousness. Despite the common description, few studies have systematically examined transcendent states during meditation.

Objectives

The objectives of this systematic review were to: 1) characterize studies evaluating transcendent states associated with meditation in any tradition; 2) qualitatively describe physiological and phenomenological outcomes collected during transcendent states and; 3) evaluate the quality of these studies using the Quality Assessment Tool.

Methods

Medline, PsycINFO, CINAHL, AltHealthWatch, AMED, and the Institute of Noetic Science Meditation Library were searched for relevant papers in any language. Included studies required adult participants and the collection of outcomes before, during, or after a reported transcendent state associated with meditation.

Results

Twenty-five studies with a total of 672 combined participants were included in the final review. Participants were mostly male (61%; average age 39 ± 11 years) with 12.7 ± 6.6 (median 12.6; range 2–40) average years of meditation practice. A variety of meditation traditions were represented: (Buddhist; Christian; Mixed (practitioners from multiple traditions); Vedic: Transcendental Meditation and Yoga). The mean quality score was 67 ± 13 (100 highest score possible). Subjective phenomenology and the objective outcomes of electroencephalography (EEG), electrocardiography, electromyography, electrooculogram, event-related potentials, functional magnetic resonance imaging, magnetoencephalography, respiration, and skin conductance and response were measured. Transcendent states were most consistently associated with slowed breathing, respiratory suspension, reduced muscle activity and EEG alpha blocking with external stimuli, and increased EEG alpha power, EEG coherence, and functional neural connectivity. The transcendent state is described as being in a state of relaxed wakefulness in a phenomenologically different space-time. Heterogeneity between studies precluded any formal meta-analysis and thus, conclusions about outcomes are qualitative and preliminary.

Conclusions

Future research is warranted into transcendent states during meditation using more refined phenomenological tools and consistent methods and outcome evaluation.

https://www-sciencedirect-com.ezproxy.shsu.edu/science/article/pii/S1550830717300460

Improve Heart Disease with Mindfulness

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Improve Heart Disease with Mindfulness

 

By John M. de Castro, Ph.D.

 

“it is not the stress in our life, but the reaction to stress that is so potentially harmful to our health, including cardiovascular health. Hence, being in a potentially very stressful profession, meditation and relaxation techniques are extremely important and useful to minimize these unhealthy reactions to stress.” – Joon Sup Lee

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” (Centers for Disease Control). A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. But the safest effective treatments are lifestyle changes. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Cardiac rehabilitation programs for patients recovering from a heart attack, emphasize these lifestyle changes. Unfortunately, for a variety of reasons, 60% of cardiac patients decline participation, making these patients at high risk for another attack.

 

Other safe and effective treatments for cardiovascular disease are contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to be helpful for producing the kinds of lifestyle changes needed to prevent heart disease such as smoking cessation, weight reduction, and stress reduction. Although death from heart disease is decreasing in men it is actually increasing in women. So, there is a need to study the effectiveness of mindfulness practice for the treatment of cardiovascular disease in women.

 

In today’s Research News article “Impact of Mindfulness Based Stress Reduction Therapy on Myocardial Function and Endothelial Dysfunction in Female Patients with Microvascular Angina.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5762694/ ), Kim and colleagues recruited women who were diagnosed with microvascular angina which is “heart disease that affects the heart’s smallest coronary artery blood vessels. Causes of microvascular angina: Spasms within the walls of these very small arterial blood vessels causes reduced blood flow to the heart muscle leading to a type of chest pain referred to as microvascular angina.” (American Heart Association). The women were provided with an 8-week, 2.5 hour once-a-week program of Mindfulness-Based Stress Reduction (MBSR) which includes of meditation, yoga, and body scan practices and on hour per day of home practice. Participants were measured for heart function and stress parameters before and after the 8-week practice.

 

Kim and colleagues found that following the 8-week MBSR program there was a marked and significant decrease in most stress parameters including somatization, compulsivity, interpersonal sensitivity, depression, anxiety, phobic anxiety, paranoid ideation, and psychoticism. Importantly there were improvements in cardiovascular functions including a decrease in systolic blood pressure and improvements in heart left ventricular function and heart arterial blood vessel function. Additionally, they found that the greater the reduction in the stress parameters the greater the improvements in heart function.

 

Conclusions from this study must be tempered as there wasn’t a comparison group included in the study, only females were examined, and no short- or long-term follow-up was included. But previous research has clearly established that mindfulness training, including MBSR, produces significant reductions in the psychological and physiological responses to stress and improves cardiovascular function. These prior findings combined with the present findings makes the case that MBSR reduces stress response which in turn improves cardiovascular function. This is very important for the promotion of longevity and well being in everyone but particularly for patients with cardiovascular disease.

 

So, improve heart disease with mindfulness,

 

“an analysis of 23 controlled trials into heart disease determined that psychosocial interventions (such as meditation, breathing exercises, and physical relaxation techniques) improved the outcomes when they were added to cardiac rehabilitation programmes for patients with CHD.” – British Heart Foundation

 

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

 

Bong Joon Kim, In Suk Cho, Kyoung Im Cho. Impact of Mindfulness Based Stress Reduction Therapy on Myocardial Function and Endothelial Dysfunction in Female Patients with Microvascular Angina. J Cardiovasc Ultrasound. 2017 Dec; 25(4): 118–123. Published online 2017 Dec 29. doi: 10.4250/jcu.2017.25.4.118

 

Abstract

Background

Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders. In this study, we investigate the impact of MBSR on left ventricular (LV) and endothelial function in female patients with microvascular angina.

Methods

A total of 34 female patients (mean age 52.2 ± 13.8 years) diagnosed with microvascular angina underwent a MBSR program with anti-anginal medication for 8 weeks. The global longitudinal strain (GLS) of the LV was used as a parameter to assess myocardial function and reactive brachial flow-mediated dilatation (FMD) was used to assess endothelial function. Symptoms were analyzed by the Symptom Checklist 90 Revised to determine emotional stress. Changes in GLS and FMD between baseline and post-MBSR were analyzed.

Results

After 8 weeks of programmed MBSR treatment, stress parameters were significantly decreased. In addition, GLS (−19.5 ± 2.1% vs. −16.6 ± 2.5%, p < 0.001) and reactive FMD significantly improved (8.9 ± 3.0% vs. 6.9 ± 2.6%, p = 0.005) after MBSR compared to baseline. The changes in GLS correlated to changes in FMD (r = 0.120, p = 0.340) and with the changes in most stress parameters.

Conclusion

MBSR has beneficial impacts on myocardial and endothelial function in female patients with microvascular angina.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5762694/

 

The Noble Eightfold Path: Right Effort

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The Noble Eightfold Path: Right Effort

 

By John M. de Castro, Ph.D.

 

“The Fourfold Right Diligence is nourished by joy and interest. If your practice does not bring you joy, you are not practicing correctly.” – Thich Nhat Hahn

 

In order to progress on the Buddha’s Noble Eightfold Path, effort must be exerted. One cannot simply sit back and wait for something to happen, one has to practice, one has to work at it. To some people that means working very, very, hard, perhaps meditating for hours on end, day after day. This comes from the Western work ethic that teaches that the harder you work, the more likely it is that you’ll achieve your goals. This is also the case in some Zen schools. A meditation teacher once described a Zen retreat as “Buddha boot camp,” requiring extreme endurance and perseverance. For many people this simply does not work and may lead to them abandoning practice and the path completely.

 

“Right Effort” sometimes called right diligence is the sixth 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.” The idea of “Right Effort” is that the effort exerted in practice and in life needs to be “Right.” It needs to be finely tuned, neither too lax, nor too effortful. The Buddha taught that practice should be like a well-tuned string instrument. If the strings are too loose, they won’t play a sound. If they are too tight, they will break. Practice should be nourishing, not draining. So, “Right Effort” actually points precisely to the Buddha’s “Middle Way.”

 

The notion of “Right Effort” is not just for meditation practice but for how we conduct our lives. It calls for us to develop and encourage good qualities, ones that will lead forward on the path, and reduce or discourage bad qualities, ones that interfere or block progress. There are many good qualities to be cultivated but the ones that the Buddha particularly targeted were mindfulness, investigation of phenomena, energy, joy, tranquility, concentration, and equanimity.

 

This suggests that we should work to develop mindfulness, paying attention, on purpose, without judgment, to what is occurring in the present moment. After all, how are we going to progress on a spiritual path if our minds are lost in thought, memories of the past or projections of the future? Only by being attentive to what is happening right now, do we have any hope of seeing things as the truly are. Mindfulness can be developed by engaging in contemplative practices such as meditation, yoga, contemplative prayer, mindful movement practices, etc. So, “Right Effort” mandates that we practice to cultivate our mindfulness, but do so with energy and striving, but not too much or too little. We need to practice on the “Middle Way.”

Investigation of phenomena needs to also be cultivated. Whereas mindfulness is observing what is, investigation is probing into the nature of what is. Investigation involves exerting concentration and energy to search out the characteristics, conditions, and consequences of the phenomena we observe with mindfulness. So, we look carefully as to what exactly composes a feeling, what leads up to the feeling arising, and what is produced by the feeling. So as anger arises, we look with mindfulness as to how exactly it feels in the body and mind, we look at what produced the anger, and we look at what consequence it might have for our actions and thoughts. If we can truly see these aspects of anger, we can better recognize it when it begins to arise, control it, and manage its consequences to lead away from harm and toward greater wisdom and happiness.

 

Fundamental to the entire process is energy. It must be cultivated and distributed carefully as there is only a limited amount available. We must first develop the energy to initiate mindfulness and investigation. It is impossible in real life to be constantly in the present moment and probing its nature. But, we must have the energy to return to these healthy processes whenever we have the opportunity to come back. Once mindfully engaged it is important to cultivate the energy to persevere and remain mindful as long as possible. Finally, we have to learn how to hold some energy in reserve so that when we reach a significant juncture in our practice we can focus our energy to break through and make a leap forward.

 

All of this energy can be built and cultivated by making our efforts joyful. Joy will replenish and charge our batteries for use when we need it. So, practice with joy, allow yourself to experience the beauty and awe available in every moment, and refrain from pushing too hard and losing the joy and happiness of practice. If we are careful and follow this joy, it will build and build and reach crescendos of bliss. This fuels our progress on the path. But, it is impossible to remain in a state of continuous bliss. Eventually the practice leads to tranquility, a peacefulness that comes from knowing the joyfulness of existence and practice. This tranquility now can allow the practice to proceed with knowing serenity. This peacefulness is the foundation for ceasing seeking and quieting the mind. Maintaining this stillness requires concentration. Once stabilized equanimity develops, an inward poise, free from the extremes of inertia and excitement. A state is reached like when driving a car with the cruise control on, neither having to press the gas peddle harder nor letting up on the peddle, just rolling along enjoying the scenery, without effort or striving, just observing things as they are. Just moving along the “Middle Way.”

 

It is wonderful to be cultivating positive qualities but at the same time it is necessary to prevent bad qualities from hindering progression on the path. There are also many bad qualities to be discouraged or removed but the ones that the Buddha particularly targeted were sensual desire, ill will, dullness and drowsiness, restlessness and worry, and doubt. As part of pursuing “Right Effort” on the path effort should be exerted to prevent these bad qualities from arising and if they do to refrain from pursuing or reinforcing them so that they can diminish or extinguish on their own.

 

Sensual desires is actually a broad category that includes cravings for all those objects or states that are pleasing, sights, sounds, emotions, feelings, tastes etc. The actual experiences are fine and need not be avoided. It’s the pursuit of them and the attempt to hold onto them that produces hindrance. “Right Effort” involves not seeking them out, but if they arise letting them come and go without striving to hold onto them. Just letting them pass by like a sunrise or a sunset, looking, seeing, appreciating, and letting go. Trying to hold on only produces unsatisfactoriness and frustration.

 

At times negative feeling arise toward objects or people. These can be a hindrance also if they are focused on, held onto, or pursued. Feelings such as hatred, anger, resentment, repulsion, jealousy, etc. arise at times in the normal course of life and in our practice. This is normal and need not be actively pushed aside. This will only tend to strengthen them. They should simply be let go, allowed to dissipate on their own, noticing, taking note, sensing the feelings and releasing them. Situations and people who tend to evoke these feeling should be avoided as much as possible. It is easier to handle them if they never arise. So, if someone should cause you harm and anger and resentment begin to arise, let them. Just observe them with mindfulness. Feel the feelings and the mental anguish. Don’t avoid it, but don’t pursue or react to it. This can be difficult, but the more it is practiced the easier and easier it becomes. This is how to exert “Right Effort” toward these ill feelings.

 

Dullness and drowsiness are often indicators of too little rest and sleep or too much exertion.  “Right Effort” involves staying on the “Middle Way” and getting sufficient rest and sleep and not overdoing anything. These states of dullness and drowsiness are actually very good indicators and guides to return to the “Middle Way.” So, when tired, rest, when sleepy, sleep, and when dull, relax and recharge. Similarly, restlessness and worry are indicators of straying from attention to the present moment and wanting things to be different than they are, ruminating about the past, or fantasizing about the future. These states can also be useful as signposts and guides leading back to the present moment. “Right Effort” is to use these states to assist in maintaining energy, staying with mindfulness, and concentrating. The more they are used in this way the easier it gets to sense straying from the path and the sooner the return can happen.

 

The path can be difficult and progress is haphazard, improving one day, falling back another. It can sometimes be difficult to tell that progress is actually being made. This can lead to doubt that the “Eightfold Path” is the right way toward spiritual development. When doubt arises don’t fret. This is normal. It signals that questions should be asked of others, particularly those who have navigated the path. This can help to elucidate that the up and down course of practice is normal and if energy is invested in persistence, progress will be made. Doubt also signals that studying the teachings, reading, and contemplation may be needed to strengthen resolve and provide direction. This is truly “Right Effort.”

 

Obviously, there’s a lot to “Right Effort.” But the keys are joyful practice and the “Middle Way.” Look carefully at discursions from the path of unhealthy desires, bad feelings toward others, sleepiness or restlessness, worry, or doubt. There’s no need to feel bad about them. They are part of being human and everyone from time to time experiences them. Rather than regretting them, let them be pointers to returning to the path. Slowly, improvement will occur and falling off the path will happen less and less often, the good qualities will be present more and more often for longer and longer periods, and forward movement will occur on the path toward awakening and enlightenment.

 

“Enlightenment is not your birthright.
Those who succeed do so only through proper effort.” – Ramana Maharshi

 

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

Reduce Blood Pressure and Improve Vigilance with Yogic Alternative Nostril Breathing

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Reduce Blood Pressure and Improve Vigilance with Yogic Alternative Nostril Breathing

 

By John M. de Castro, Ph.D.

 

“Alternate Nostril Breathing helps calm the mind, reduce anxiety, and bring a feeling of relaxation to the entire body.” – Art of Living

 

Yoga practice is becoming increasingly popular in the west, for good reason. It has documented benefits for the individual’s psychological and physical health and well-being. It has also been shown to have cognitive benefits, improving memory. Yoga, however, consists of a number of components including, poses, breathing exercises, meditation, concentration, and philosophy/ethics.  So, it is difficult to determine which facet or combination of facets of yoga are responsible for which benefit. Hence, it is important to begin to test each component in isolation to determine its effects.

 

Alternate nostril yoga breathing is a regulated breathing alternating between the left and right nostril. Breathing through each nostril is thought to affect its respective hemisphere in the brain producing differential effects. In today’s Research News article “Alternate-Nostril Yoga Breathing Reduced Blood Pressure While Increasing Performance in a Vigilance Test.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5755948/ ), Telles and colleagues recruited male college students and had them practice either Alternate-Nostril Yoga Breathing, Breath Awareness, or quiet rest for 18 minutes on three separate days in random order. The participants were measured before and after each practice for blood pressure and vigilance. To measure vigilance, they had the participants perform a digit vigilance test in which they were asked to cancel the numbers 6 and 9 from a page of 1500 random digits and recorded the time to complete the task and the number of errors made.

 

They found that compared to baseline and the control conditions of breath awareness and quiet sitting there was a significant reduction in systolic and arterial blood pressure following alternate nostril breathing. They also found that after alternate nostril breathing there was a significant reduction in the time to complete the vigilance task. But, this was also true for the quiet sitting condition. Hence, alternate nostril breathing appears to reduce the level of activation and improve vigilance. But, the improvement in vigilance may be simply due to the rest provided by the task. This suggests that yoga practice has its beneficial effects, in part, by the ability of the breathing practices to reduce physiological activation.

 

So, reduce blood pressure and improve vigilance with yogic alternative nostril breathing.

 

“Alternate Nostril Breathing: This simple yet most powerful technique is a pranayama that is easy to do, and it creates a deep sense of well-being and harmony on the physical, mental, and emotional levels. It is integrating and grounding, and balances the right and left hemispheres of the brain.” – Yogi Bhajan

 

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

 

Shirley Telles, Sadhana Verma, Sachin Kumar Sharma, Ram Kumar Gupta, Acharya Balkrishna. Alternate-Nostril Yoga Breathing Reduced Blood Pressure While Increasing Performance in a Vigilance Test. Med Sci Monit Basic Res. 2017; 23: 392–398. Published online 2017 Dec 29. doi: 10.12659/MSMBR.906502

 

Abstract

Background

Reports suggest that vigilance or sustained attention increases sympathetic activity. A persistent increase in sympathetic activity can lead to an increase in blood pressure. Alternate-nostril yoga breathing has been shown to be useful to (i) improve attention and (ii) decrease the systolic and diastolic blood pressure. Earlier studies did not report simultaneous recordings of the blood pressure and performance in vigilance tests after alternate-nostril yoga breathing. With this background, the present study was planned to determine if 15 minutes of alternate nostril yoga breathing could improve the performance in a vigilance test without an increase in blood pressure.

Material/Methods

Fifteen healthy male volunteers participated in the study (group mean age ±SD, 22.4±2.4 years). Participants were assessed on 3 separate days in 3 different sessions. These were (i) alternate nostril yoga breathing, (ii) breath awareness, and (iii) sitting quietly as a control. Blood pressure and the digit vigilance test were simultaneously assessed before and after each session.

Results

Systolic blood pressure (p<0.01), mean arterial blood pressure (p<0.05), and the time taken to complete the digit vigilance test (p<0.05) significantly decreased following alternate-nostril yoga breathing. The time taken to complete the digit vigilance test differed significantly between sessions (p<0.05). The time taken to complete the digit vigilance test was also significantly decreased after sitting quietly (p<0.01).

Conclusions

Alternate-nostril yoga breathing appears to improve performance in the digit vigilance test, along with a reduction in systolic blood pressure. This is suggestive of better vigilance without sympathetic activation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5755948/

Reduce Low Back Pain with Yoga

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Reduce Low Back Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“For most of our lives, we take our backs for granted. But at some point in just about everyone’s life, our backs revolt and remind us that they need love and attention too. Thankfully, for many of us, the pain is only temporary. But for others, it can be much more debilitating—and much more frustrating. In severe cases, medical attention may be necessary, but if your pain is less severe, yoga may be able to help by strengthening the back, stretching it and improving circulation to the spine and nerves.” – Liz Rosenblum

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses. Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects.

 

Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Yoga practice has been shown to have a myriad of health benefits. These include relief of chronic pain. Yoga practice has also been shown to be effective for the relief of chronic low-back pain.  Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of back and neck pain for many individuals. So, it makes sense to further explore the effectiveness of yoga therapy for chronic low back pain.

 

In today’s Research News article “Yoga treatment for chronic non-specific low back pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294833/ ), Wieland and colleagues review and summarize the published research studies that examined the effectiveness of yoga practice for the treatment of chronic low back pain. They discovered only 12 published research studies on the subject. They reported that the studies found that yoga practice in comparison to no-exercise control conditions produced small but significant improvements in pain and back function that were maintained for 6 months. This demonstrates that yoga practice is effective for back pain but does not allow for a determination of whether exercise in general or yoga specifically was effective. So, they looked at studies of yoga practice in comparison to other forms of exercise and found that yoga practice produced small but significantly better improvements than other exercises in pain but equivalent improvements in back function. When yoga practice was combined with other exercises it did not produce significantly greater benefits than exercise alone.

 

The summary suggests that yoga practice and other exercises are safe and effective treatments for chronic low back pain that can produce lasting improvements in pain and back function. They found evidence that yoga practice may be slightly better than other exercises in reducing pain, but there is no additional benefit of combining yoga with other exercises. Hence, yoga practice is an acceptable, safe, and effective alternative to drug and surgical treatments that has small but significant benefits for the relief to the suffering of people with chronic low back pain.

 

So, reduce low back pain with Yoga.

 

“a structured yoga program may be an alternative to physical therapy for people with chronic low-back pain, depending on individual preferences, availability, and cost.” – NCCIH

 

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

 

Wieland, L. S., Skoetz, N., Pilkington, K., Vempati, R., D’Adamo, C. R., & Berman, B. M. (2017). Yoga treatment for chronic non-specific low back pain. The Cochrane Database of Systematic Reviews, 1, CD010671. http://doi.org/10.1002/14651858.CD010671.pub2

 

Abstract

Background

Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines state that exercise therapy may be beneficial. Yoga is a mind-body exercise sometimes used for non-specific low back pain.

Objectives

To assess the effects of yoga for treating chronic non-specific low back pain, compared to no specific treatment, a minimal intervention (e.g. education), or another active treatment, with a focus on pain, function, and adverse events.

Search methods

We searched CENTRAL, MEDLINE, Embase, five other databases and four trials registers to 11 March 2016 without restriction of language or publication status. We screened reference lists and contacted experts in the field to identify additional studies.

Selection criteria

We included randomized controlled trials of yoga treatment in people with chronic non-specific low back pain. We included studies comparing yoga to any other intervention or to no intervention. We also included studies comparing yoga as an adjunct to other therapies, versus those other therapies alone.

Data collection and analysis

Two authors independently screened and selected studies, extracted outcome data, and assessed risk of bias. We contacted study authors to obtain missing or unclear information. We evaluated the overall certainty of evidence using the GRADE approach.

Main results

We included 12 trials (1080 participants) carried out in the USA (seven trials), India (three trials), and the UK (two trials). Studies were unfunded (one trial), funded by a yoga institution (one trial), funded by non-profit or government sources (seven trials), or did not report on funding (three trials). Most trials used Iyengar, Hatha, or Viniyoga forms of yoga. The trials compared yoga to no intervention or a non-exercise intervention such as education (seven trials), an exercise intervention (three trials), or both exercise and non-exercise interventions (two trials). All trials were at high risk of performance and detection bias because participants and providers were not blinded to treatment assignment, and outcomes were self-assessed. Therefore, we downgraded all outcomes to ‘moderate’ certainty evidence because of risk of bias, and when there was additional serious risk of bias, unexplained heterogeneity between studies, or the analyses were imprecise, we downgraded the certainty of the evidence further.

For yoga compared to non-exercise controls (9 trials; 810 participants), there was low-certainty evidence that yoga produced small to moderate improvements in back-related function at three to four months (standardized mean difference (SMD) −0.40, 95% confidence interval (CI) −0.66 to −0.14; corresponding to a change in the Roland-Morris Disability Questionnaire of mean difference (MD) −2.18, 95% −3.60 to −0.76), moderate-certainty evidence for small to moderate improvements at six months (SMD −0.44, 95% CI −0.66 to −0.22; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −2.15, 95% −3.23 to −1.08), and low-certainty evidence for small improvements at 12 months (SMD −0.26, 95% CI −0.46 to −0.05; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −1.36, 95% −2.41 to −0.26). On a 0–100 scale there was very low- to moderate-certainty evidence that yoga was slightly better for pain at three to four months (MD −4.55, 95% CI −7.04 to −2.06), six months (MD −7.81, 95% CI −13.37 to −2.25), and 12 months (MD −5.40, 95% CI −14.50 to −3.70), however we pre-defined clinically significant changes in pain as 15 points or greater and this threshold was not met. Based on information from six trials, there was moderate-certainty evidence that the risk of adverse events, primarily increased back pain, was higher in yoga than in non-exercise controls (risk difference (RD) 5%, 95% CI 2% to 8%).

For yoga compared to non-yoga exercise controls (4 trials; 394 participants), there was very-low-certainty evidence for little or no difference in back-related function at three months (SMD −0.22, 95% CI −0.65 to 0.20; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −0.99, 95% −2.87 to 0.90) and six months (SMD −0.20, 95% CI −0.59 to 0.19; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −0.90, 95% −2.61 to 0.81), and no information on back-related function after six months. There was very low-certainty evidence for lower pain on a 0–100 scale at seven months (MD −20.40, 95% CI −25.48 to −15.32), and no information on pain at three months or after seven months. Based on information from three trials, there was low-certainty evidence for no difference in the risk of adverse events between yoga and non-yoga exercise controls (RD 1%, 95% CI −4% to 6%).

For yoga added to exercise compared to exercise alone (1 trial; 24 participants), there was very-low-certainty evidence for little or no difference at 10 weeks in back-related function (SMD −0.60, 95% CI −1.42 to 0.22; corresponding to a change in the Oswestry Disability Index of MD −17.05, 95% −22.96 to 11.14) or pain on a 0–100 scale (MD −3.20, 95% CI −13.76 to 7.36). There was no information on outcomes at other time points. There was no information on adverse events.

Studies provided limited evidence on risk of clinical improvement, measures of quality of life, and depression. There was no evidence on work-related disability.

Authors’ conclusions

There is low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at three and six months. Yoga may also be slightly more effective for pain at three and six months, however the effect size did not meet predefined levels of minimum clinical importance. It is uncertain whether there is any difference between yoga and other exercise for back-related function or pain, or whether yoga added to exercise is more effective than exercise alone. Yoga is associated with more adverse events than non-exercise controls, but may have the same risk of adverse events as other back-focused exercise. Yoga is not associated with serious adverse events. There is a need for additional high-quality research to improve confidence in estimates of effect, to evaluate long-term outcomes, and to provide additional information on comparisons between yoga and other exercise for chronic non-specific low back pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294833/

Slow Mental Decline in the Elderly with Tai Chi

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Slow Mental Decline in the Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“improvement of heart function combined with increased muscular power meant that the martial art should be considered the preferred technique for elderly people to maintain good health.” – The Telegraph

 

We celebrate the increasing longevity of the population. But, aging is a mixed blessing. The aging process involves a systematic progressive decline of the body and the brain. Every system in the body deteriorates including cognitive function (thinking ability) and motor function with a decline in strength, flexibility, and balance. It is inevitable. In addition, many elderly experience withdrawal and isolation from social interactions. There is some hope as there is evidence that these declines can be slowed. For example, a healthy diet and a regular program of exercise can slow the physical and cognitive decline of the body with aging. Also, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline.

 

Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Only recently though have the effects of Tai Chi practice been scrutinized with empirical research and found to be effective for an array of physical and psychological issues. Tai Chi has been shown to help the elderly improve attention, balance, reducing falls, arthritis, cognitive function, memory, and reduce age related deterioration of the brain. Because Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion.

 

In today’s Research News article “Tai Chi Improves Cognition and Plasma BDNF in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial.”  Sungkarat and colleagues recruited elderly participants with mild cognitive impairments and randomly assigned them to either receive educational instruction related to cognitive impairment and fall prevention or practice Tai Chi at home guided by a 50-minute video, 3 times per week, for 6 months. They were measured at the beginning and end of training for cognitive performance, including memory, visuospatial ability, and executive function, and plasma markers for inflammation and neuroprotection, including plasma BDNF, TNF-α, and IL-10 levels.

 

They found that compared to baseline and control participants, the elderly who practiced Tai Chi had significantly improved levels of cognitive function, including improvements in memory and thinking ability (executive function). In addition, Tai Chi practice was found to significantly increase the levels of brain-derived neurotrophic factor (BDNF). BDNF is a neurotrophic factor that works to protect the brain from deterioration and promote the growth of brain cells. Hence, they found that Tai Chi practice reduces cognitive decline with aging and increases neuroprotection.

 

The cognitive decline with aging has been associated with degeneration of neural tissues. On the other hand, mindfulness practices have been found to change the brain and protect it against age related decline. The present results add further evidence that mindfulness practices, Tai Chi  in particular, improves memory and cognitive performance and promotes neuroprotection in the elderly. The attractiveness of the low intensity, low cost, convenient, and socially fun nature of Tai Chi practice makes it a great treatment for the prevention of age related decline.

 

So, slow mental decline in the elderly with Tai Chi.

 

“Scientists . . . found increases in brain volume and improvements on tests of memory and thinking in Chinese seniors who practiced Tai Chi three times a week.” – Science Daily

 

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

 

Somporn Sungkarat, PhD, SirinunBoripuntakul, PhD, Sirinart Kumfu, PhD, Stephen R. Lord, PhD, Nipon Chattipakorn, MD, PhD. Tai Chi Improves Cognition and Plasma BDNF in Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial. Neurorehabilitation and Neural Repair. First Published January 20, 2018, https://doi-org.ezproxy.shsu.edu/10.1177/15459683177536

 

Abstract

Background. Effects of Tai Chi (TC) on specific cognitive function and mechanisms by which TC may improve cognition in older adults with amnestic mild cognitive impairment (a-MCI) remain unknown. Objective. To examine the effects of TC on cognitive functions and plasma biomarkers (brain-derived neurotrophic factor [BDNF], tumor necrosis factor-α [TNF-α], and interleukin-10 [IL-10]) in a-MCI. Methods. A total of 66 older adults with a-MCI (mean age = 67.9 years) were randomized to either a TC (n = 33) or a control group (n = 33). Participants in the TC group learned TC with a certified instructor and then practiced at home for 50 min/session, 3 times/wk for 6 months. The control group received educational material that covered information related to cognition. The primary outcome was cognitive performance, including Logical Memory (LM) delayed recall, Block Design, Digit Span, and Trail Making Test B minus A (TMT B-A). The secondary outcomes were plasma biomarkers, including BDNF, TNF-α, and IL-10. Results. At the end of the trial, performance on the LM and TMT B-A was significantly better in the TC group compared with the control group after adjusting for age, gender, and education (P < .05). Plasma BDNF level was significantly increased for the TC group, whereas the other outcome measures were similar between the 2 groups after adjusting for age and gender (P < .05). Conclusions. TC training significantly improved memory and the mental switching component of executive function in older adults with a-MCI, possibly via an upregulation of BDNF.

http://journals.sagepub.com.ezproxy.shsu.edu/doi/full/10.1177/1545968317753682