Month: May 2018

Improve Mental Health with Mindfulness

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Improve Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“While mindfulness will not solve all of our problems, it is a powerful tool with great potential to help us all transform our relationship with our problems when it is not possible, or desirable, to eliminate them.” – Elana Miller

 

Mindfulness training has been shown to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness Training, Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be effective. This has led to an increasing adoption of these mindfulness techniques for the physical and psychological health and well-being of both healthy and ill individuals.

 

In today’s Research News article “Mindfulness-Based Interventions in Psychiatry.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870875/ ), Shapero and colleagues review and summarize the published research literature on the application of mindfulness techniques to the treatment of mental illnesses.

 

They report that the most commonly used mindfulness technique for the treatment of mental illness is Mindfulness-Based Cognitive Therapy (MBCT) particularly for the treatment of major depressive disorder. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs.

 

Mindfulness-based interventions (MBIs) have also been found to improve mood and relieve anxiety in patients suffering from anxiety and mood disorders and treat the symptoms of Bipolar Disorder, Obsessive Compulsive Disorder, Generalized Anxiety Disorder, and eating disorders. They have also been found to reduce drug cravings and use as well as reduce substance abuse relapse after treatment.

 

They further report that the research suggests that Mindfulness-based interventions (MBIs) produce these benefits by focusing on the present moment in a non-reactive and non-judgmental way and improving emotion regulation and thereby decreasing negative thought patterns, emotional reactivity, rumination, and worry, and increasing self-compassion. In the cognitive realm, MBIs appear to produce a different relationship with the thoughts of the individuals by noticing them and developing different ways of relating and reacting to them.

 

One way that MBIs appear to have their effects is by altering the nervous system in a process known as neuroplasticity. These include changes to eight brain regions, including areas associated with meta-awareness (frontopolar cortex), exteroceptive and interoceptive body awareness (sensory cortices and insula), memory consolidation and reconsolidation (hippocampus), self and emotion regulation (anterior and mid cingulate; orbitofrontal cortex), and intra- and interhemispheric communication (superior longitudinal fasciculus; corpus callosum).

 

These are striking findings that strongly suggest that Mindfulness-based interventions (MBIs) are safe and very effective treatments for a wide array of psychiatric disorders. They appear to work by altering thought processes, emotion regulation, and focus on the present moment. They appear to alter the brain to produce these benefits. This suggests that MBIs should be widely prescribed to relieve the symptoms and suffering produced by mental illness.

 

So, improve mental health with Mindfulness.

 

“Mindfulness and the traditional way psychiatry is practiced are really more divergent than anything else. Psychiatry is about removing emotional pain, whereas mindfulness teaches us the value of being present with our pain. It was through the practice of mindfulness that I started to learn this new perspective and started to relate to my own pain differently. Instead of running away from it, I was taught to welcome it; to befriend it and thus convert it into a source for my own emotional and spiritual growth.” – Russel Razzaque

 

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

 

Shapero, B. G., Greenberg, J., Pedrelli, P., de Jong, M., & Desbordes, G. (2018). Mindfulness-Based Interventions in Psychiatry. Focus (American Psychiatric Publishing), 16(1), 32–39. http://doi.org/10.1176/appi.focus.20170039

 

Abstract

Mindfulness meditation has a longstanding history in eastern practices that has received considerable public interest in recent decades. Indeed, the science, practice, and implementation of Mindfulness Based Interventions (MBIs) have dramatically increased in recent years. At its base, mindfulness is a natural human state in which an individual experiences and attends to the present moment. Interventions have been developed to train individuals how to incorporate this practice into daily life. The current article will discuss the concept of mindfulness and describe its implementation in the treatment of psychiatric disorders. We further identify for whom MBIs have been shown to be efficacious and provide an up-to-date summary of how these interventions work. This includes research support for the cognitive, psychological, and neural mechanisms that lead to psychiatric improvements. This review provides a basis for incorporating these interventions into treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870875/

 

Improve Psychological and Physical Health in End Stage Renal Disease with Mindfulness

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Improve Psychological and Physical Health in End Stage Renal Disease with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation could be a valuable, low-cost, nonpharmacologic intervention for reducing blood pressure and adrenaline levels in patients with chronic kidney disease” –  Kurtis Pivert

 

End-stage renal disease (ESRD) is a serious and all too common medical problem that results from a total and permanent failure of the kidneys. As a result, the body retains fluid and harmful wastes build up. Treatment, usually dialysis, is required to replace the work of the failed kidneys. Kidney dialysis uses a machine to filter harmful wastes, salt, and excess fluid from your blood. This restores the blood to a normal, healthy balance. Without dialysis or a kidney transplant the ESRD patient cannot survive It is estimated that ESRD occurs in more than 650,000 patients per year in the United States and is increasing by 5% per year. Those who live with ESRD are 1% of the U.S. Medicare population but account for 7% of the Medicare budget. Worldwide there are an estimated 2 million ESRD patients.

 

End-stage renal disease (ESRD) is frequently accompanied by a number of other serious diseases, such as cardiovascular disease and diabetes. Making matters worse is the fact that ESRD patients often experience psychological distress including depression. It is possible that mindfulness training may be helpful as it has been found be helpful for patients with kidney disease and help relieve depression.

 

In today’s Research News article “Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875579/ ), Sohn and colleagues conducted and uncontrolled pilot study to investigate the effectiveness of group based Cognitive Behavioral Therapy that includes mindfulness training for improving the psychological health or 7 patients with End-Stage Renal Disease (ESRD) undergoing dialysis and suffering from depression.

 

The therapy included muscle relaxation, meditation, and cognitive therapy to uncover automatic thinking regarding their emotions and was conducted once a week for 12 weeks. The participants were measured before, at 8 weeks and after treatment for the biochemical variables of albumin, serum creatinine, calcium/phosphorus, and interdialytic weight gain and for the psychological variables of quality of life, anxiety, depression, perceived stress. They found that compared to baseline the participants had significant increases in quality of life, and significant decreases in albumin, serum creatinine, anxiety, depression, perceived stress.

 

Hence, after Cognitive Behavioral Therapy with mindfulness training the patients psychological and physical states were greatly improved. These are intriguing results that must be interpreted cautiously as this was an uncontrolled pilot study with just 7 patients. But, the findings clearly justify conducting a large randomized controlled trial with an active control condition. These patients suffer greatly and identifying a safe and effective therapy to relieve their psychological distress and improve their physical well-being is sorely needed.

 

So, improve psychological and physical health in end stage renal disease with mindfulness.

 

“Not only did mindfulness meditation decrease the anxiety related to dialysis, many patients also used this technique to assist relaxation and improve sleep at home.” – Raymond Chang

 

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

 

Sohn, B. K., Oh, Y. K., Choi, J.-S., Song, J., Lim, A., Lee, J. P., … Lim, C. S. (2018). Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients. Kidney Research and Clinical Practice, 37(1), 77–84. http://doi.org/10.23876/j.krcp.2018.37.1.77

 

Abstract

Background

Many patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) experience depression. Depression influences patient quality of life (QOL), dialysis compliance, and medical comorbidity. We developed and applied a group cognitive behavioral therapy (CBT) program including mindfulness meditation for ESRD patients undergoing HD, and measured changes in QOL, mood, anxiety, perceived stress, and biochemical markers.

Methods

We conducted group CBT over a 12-week period with seven ESRD patients undergoing HD and suffering from depression. QOL, mood, anxiety, and perceived stress were measured at baseline and at weeks 8 and 12 using the World Health Organization Quality of Life scale, abbreviated version (WHOQOL-BREF), the Beck Depression Inventory II (BDI-II), the Hamilton Rating Scale for Depression (HAM-D), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS). Biochemical markers were measured at baseline and after 12 weeks. The Temperament and Character Inventory was performed to assess patient characteristics before starting group CBT.

Results

The seven patients showed significant improvement in QOL, mood, anxiety, and perceived stress after 12 weeks of group CBT. WHOQOL-BREF and the self-rating scales, BDI-II and BAI, showed continuous improvement across the 12-week period. HAM-D scores showed significant improvement by week 8; PSS showed significant improvement after week 8. Serum creatinine levels also improved significantly following the 12 week period.

Conclusion

In this pilot study, a CBT program which included mindfulness meditation enhanced overall mental health and biochemical marker levels in ESRD patients undergoing HD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875579/

 

Make Self-Views More Positive and Relieve Social Anxiety Disorder with Mindfulness

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Make Self-Views More Positive and Relieve Social Anxiety Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“I call this type of mindfulness practice while we are interacting with others—or even while we are simply around others—curiosity training. We are learning to get out of our heads and into the moment. Instead of focusing our attention on ourselves—criticizing our performance or appearance, trying to guess what others are thinking of us, struggling to script out what to say—we learn to treat all those thoughts as background noise—something we’re aware of but not paying attention to—and instead return our attention to taking interest in the situation, the person, and the conversation.” – Larry Cohen

 

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.

 

SAD is the most common form of anxiety disorder and it is widespread, occurring in about 7% of the U.S. population and is particularly widespread among young adults. Anxiety disorders have generally been treated with drugs. But, there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for SAD. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD). Mindfulness-Based Stress Reduction (MBSR) contains three mindfulness trainings, meditation, body scan, and yoga, and has been shown to be effective in treating anxiety disorders. It is not known, however, how these treatments produce their effects.

 

In today’s Research News article “Self-Views in Social Anxiety Disorder: The Impact of CBT versus MBSR.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376221/ ), Thurston and colleagues recruited unmedicated patients with Social Anxiety Disorder (SAD) and randomly assigned them to receive 12 weekly sessions of 2.5 hours of either Mindfulness-Based Stress Reduction (MBSR), Cognitive Behavioral Group Therapy (CBGT) or a wait-list control condition. They also recruited a group of healthy control participants. They were measured before and after training for social anxiety and positive and negative self-views.

 

They found that in comparison to healthy controls, participants with SAD had significantly lower positive self-views and significantly higher negative self-views. Both Mindfulness-Based Stress Reduction (MBSR), Cognitive Behavioral Group Therapy (CBGT) produced significant reductions in social anxiety and significant improvements in self-views, reducing negative and increasing positive self-views. Importantly, they found that changes in positive, but not negative self-views were the intermediary between MBSR and CBGT treatments and improvement in social anxiety. That is, the treatments improved the patients’ positive views of themselves and this in turn produced reduced social anxiety.

 

These results are interesting and potentially important. By demonstrating that changing the patients’ views concerning themselves was a key to improving social anxiety, the findings suggest that tailoring treatment to improving positive self-views might produce more effective therapies for Social Anxiety Disorder (SAD).

 

So, make self-views more positive and relieve social anxiety disorder with mindfulness.

 

“Our nervous system is like the soundtrack for every scene in life that we encounter. It is all but impossible to experience a scene as safe and happy when the music tells us otherwise. With a mindful, body-based approach, clients can learn to change their music.” – Jeena Cho

 

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

 

Thurston, M. D., Goldin, P., Heimberg, R., & Gross, J. J. (2017). Self-Views in Social Anxiety Disorder: The Impact of CBT versus MBSR. Journal of Anxiety Disorders, 47, 83–90. http://doi.org/10.1016/j.janxdis.2017.01.001

 

Go to:

Abstract

This study examines the impact of Cognitive-Behavioral Group Therapy (CBGT) versus Mindfulness-Based Stress Reduction (MBSR) versus Waitlist (WL) on self-views in patients with social anxiety disorder (SAD). One hundred eight unmedicated patients with SAD were randomly assigned to 12 weeks of CBGT, MBSR, or WL, and completed a self-referential encoding task (SRET) that assessed self-endorsement of positive and negative self-views pre- and post-treatment. At baseline, 40 healthy controls (HCs) also completed the SRET. At baseline, patients with SAD endorsed greater negative and lesser positive self-views than HCs. Compared to baseline, patients in both CBGT and MBSR decreased negative self-views and increased positive self-views. Improvement in self-views, specifically increases in positive (but not decreases in negative) self-views, predicted CBGT- and MBSR-related decreases in social anxiety symptoms. Enhancement of positive self-views may be a shared therapeutic process for both CBGT and MBSR for SAD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376221/

Mindful Memorial Day

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Mindful Memorial Day

 

By John M. de Castro, Ph.D.

 

“We who are left how shall we look again
Happily on the sun or feel the rain
Without remembering how they who went
Ungrudgingly and spent
Their lives for us loved, too, the sun and rain?”
~Wilfred Wilson Gibson

 

Memorial Day is the unofficial start of the Summer holiday season. But, it’s primary purpose is to remember and honor those men and women who have died in wars. As such it’s a somber occasion and a reminder of the human cost of warfare. This is usually a day celebrating patriotism and the righteousness of the country’s cause. Some may think that I’m being a little discourteous to the honored dead. But, I believe that the greatest honor we can provide is to work tirelessly to insure that no one else has to die for their country in warfare.

 

Some wars are regrettably necessary. At times, pacifism and nonviolence just can’t work. It requires a minimally just society. For example, in 1938 Adolph Hitler advised the British government on how to protect their empire from the threat posed in India of Mahatma Gandhi: “kill Gandhi, if that isn’t enough then kill the other leaders too, if that isn’t enough then two hundred more activists, and so on until the Indian people will give up the hope of independence.” Fortunately, the British did not follow this advice and Gandhi’s nonviolence triumphed. But, if this had been Hitler’s empire, pacifism, no matter how well led or intentioned, would have failed miserably.

 

Even the Buddha who taught love, compassion, and nonviolence, also taught that we should defend ourselves. There are sects of Buddhist monks who practice martial arts and are celebrated for their skills. When under attack, we have a right and perhaps an obligation to stand up and resist violent assault. If non-violent means aren’t successful, then violence and aggression may be necessary. This is never a good thing, but at times necessary. There have been far too many wars, most unnecessary. We should honor the courage, valor, and commitment of those who died in war by doing our best to make sure that unnecessary wars are never fought again.

 

It is right that we honor those who died in warfare, not just soldiers, but also civilians and merchant marine who often perish in massive numbers. They too should be remembered. We should always remember that what we have and enjoy, including peace, was paid for dearly. But, we should honor all who perished. This doesn’t mean just those who belonged to our side. We should remember that the vast majority of combatants entered into battle with the finest of intentions, believing that their cause was right and just, and that they were fighting for their families and their countries. Regardless of whether they were misled by unscrupulous, evil, or incompetent leaders, they entered into battle honorably and deserve our respect.

 

It is sometimes difficult to see, but their sacrifices have paid off for the rest of us. Since World War II, European countries and similarly, the Asian countries of China, Korea, and Japan, who had been at virtually constant war among themselves for thousands of years, are now peaceful and there has not been an armed conflict between them in over 70 years. So, even with all of the conflict in the world, there is less warfare now than at any time in recorded history. We have the honored dead from the terrible conflict of World War II to thank for the peace and prosperity that has been enjoyed since. We don’t need this reason to honor them, but it is reassuring to know that their sacrifices were not in vain.

 

To prevent these horrors in the future and honor our dead by abolishing warfare completely, there are a number of strategies that may be helpful. We should view our past, present, and future enemies, as the great sage Thich Nhat Hahn did during the Vietnam War, as people whose lives, backgrounds, training, and beliefs put them into the roles they are playing. If we lived in their shoes, we would likely make the same choice they did. No matter how despicable we may think they are, or how horrible their deeds, we need to understand that what they experienced in life, led them there. If we truly place ourselves in the shoes of our enemy, do we honestly believe that we would make different decisions. The terrorist, so despised in the west, may have been brought up in poverty, with little education save for religious indoctrination, that taught him that his god demands that he kill the infidel and that he will be rewarded in the next life for doing so. If we were raised similarly, would we act differently. This kind of understanding can lead to actions that may help to prevent future violence. Seeing the enemy as intrinsically evil can only lead to more warfare. Seeing them as human beings whose situation dictated their behavior can lead to peace.

 

A key strategy for preventing future wars is forgiveness. Violence begets violence. Retribution demands that the people who killed your family members must themselves be killed. But, this is a never ending cycle as the families of those you killed now seek to kill you. The only way to break the cycle is forgiveness. This can be very difficult.  But it is the only way. Nelson Mandela, when he took over leadership of South Africa from those who oppressed and imprisoned him and his people for decades, didn’t enact retribution. Instead he launched a massive campaign of forgiveness and reconciliation. He understood that this was the only way to heal his country. He was amazingly successful and South Africa, although far from perfect, has become peaceful and prosperous working for the betterment of all of its citizens.

 

Most people look at creating peace and preventing war as a massively difficult task that is beyond their capabilities to resolve. As a result, they do nothing waiting for a Ghandi, Mandela, or King to lead them. But, this is a grave mistake. We can all honor our fallen by contributing to world peace. We can do this if we stop looking for grand solutions and instead, contribute in the ways that we can during every day of our lives. By leading peaceful, nonviolent lives we contribute. We create ripples on the pond of life spreading out to the far horizons. “If in our daily life we can smile, if we can be peaceful and happy, not only we, but everyone will profit from it. This is the most basic kind of peace work.” ― Thich Nhat Hanh

 

Communications is a key to peace. By engaging in non-violent communications, what the Buddha calls “Right Speech,” we not only produce peace in ourselves but in the people we’re communicating with. Their peacefulness then affects others, who affect others, etc. interpersonal ripples of peace. We also become role models for our children who then become role models for their children, etc., producing intergenerational ripples of peace. If many of us practice non-violence the ripples will become build and sum into tidal waves of peace washing over the earth. “If we are peaceful, if we are happy, we can smile and blossom like a flower, and everyone in our family, our entire society, will benefit from our peace.” ― Thich Nhat Hahn

 

Practicing mindfulness can similarly promote peace and create ripples. By being focused on the present moment non-judgmentally, we are fully present for those around us. This produces the deepest kinds of human communications based upon understanding and compassion. In human communications there is great power in non-judgmental listening. It has a tremendously calming effect on people, particularly when they are highly agitated. In a leadership position I once held, I would quite often have people come into my office and just rail on about the injustices they’ve experienced and the horrible people around them. I would just listen and occasionally acknowledge their emotions. At the end, they would almost inevitably thank me and tell me how much that helped. I had done nothing other than deeply listen and this by itself had dramatic effects. Over time, I could see how the ripples moved outward and affected the entire organization. Listening is a powerful tool of peace.

 

Another key method for promoting individual, societal, and planetal peace is practicing compassion. This is simply looking deeply at ourselves and others to understand their suffering. First we must have compassion for ourselves. Unless we do, we cannot have true compassion for others. We have to acknowledge that we are flawed human beings and not scold ourselves for it, but compassionately understand and forgive ourselves. We are essentially good. But, sometimes our background, indoctrination, humanness, and circumstances conspire to produce harmful acts. Rather than looking at the actions as good or bad, think of them as skillful or unskillful; bringing greater or less harmony and happiness. We need to understand this about ourselves, forgive ourselves with the intentions to do better, to be more skillful, and look upon ourselves with eyes of kindness and caring.

 

It is important to also recognize and congratulate ourselves for all of the good we do. Celebrate our goodness while having compassion for our faults. Once, we can do this. We can then move on to others. Being compassionate to our enemies involves looking deeply into their suffering, looking deeply into their background, indoctrination, humanness, and circumstances that conspire to produce harmful acts, and then being forgiving, kind, and caring about them. This is essential to healing wounds and developing world peace.

 

So, on this Memorial Day, let us resolve to honor the fallen for what they have done. But let us truly honor them by working to make their sacrifices not in vain, to do what we can to develop peacefulness in ourselves and others, and to let their deaths be the foundation not of more war but of lasting peace.

 

 “On Memorial Day, I don’t want to only remember the combatants. There were also those who came out of the trenches as writers and poets, who started preaching peace, men and women who have made this world a kinder place to live.” – Eric Burdon

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Improve Sleep Quality in Older Adults with Mindfulness

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Improve Sleep Quality in Older Adults with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Studies have shown that sleeping habits improve dramatically when participants where taught to respond to sleep disturbance with mindfulness skills- rather than reacting automatically by increasing effort to rest. After meditating regularly, the average time it took participants to fall asleep dropped from an hour and a half to only 15 minutes.” – IPNOS

 

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.

 

Unfortunately. as we age it becomes more and more difficult to get that good night’s sleep. Although the need for sleep doesn’t change with age sleep patterns change.  Older people have a more difficult time falling asleep and staying asleep, waking up several times during the night, and waking early in the morning. In addition, there is less deep sleep, so we don’t feel as rested. Insomnia is much higher in older adults affecting as many as 44%. A safe and effective means for improving sleep in the elderly is important for the health and wellbeing of this vulnerable population. Mindfulness-based practices have been reported to improve sleep amount and quality. There is a need, however, to further study the impact of mindfulness training on sleep in older individuals.

 

In today’s Research News article “A Secondary Analysis of Sleep Quality Changes in Older Adults From a Randomized Trial of an MBSR Program.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874181/ ), Gallegos and colleagues recruited older adults over 65 years of age and randomly assigned them to receive either an 8-week, once a week, 2 hour session of Mindfulness-Based Stress Reduction (MBSR) or be assigned to a wait-list control condition. MBSR consists of a combination of meditation, yoga, and body scan practice in combination with discussion and home practice. The participants were measured before and after training and 6-months later for sleep quality.

 

They found that compared to baseline and the wait-list controls, the MBSR participants had significantly improved sleep quality that was maintained for 6 months following completion of training. The effectiveness of MBSR was amplified in participants who had sleep disturbance and was even greater in participants who had insomnia. Hence, the MBSR program improved sleep in the elderly, with the greater the sleep problem the greater the improvement. These are interesting and important results. Sleep disturbance in the elderly is common and is associated with health problems. So, improving sleep quality in this group may well lead to improvements in overall health and longevity.

 

So, improve sleep quality in older adults with mindfulness.

 

“When I first started using mindfulness to get sleep, I believed I needed to be meditating at bedtime if I wanted to cure my insomnia. I was completely wrong! I learned that my worries about sleep were happening all day long. I started using mindfulness during the day to notice those worries and learn to accept that I may not get as much sleep as I hope for each night.” – Mary Sauer

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

 

Gallegos, A. M., Moynihan, J., & Pigeon, W. R. (2016). A Secondary Analysis of Sleep Quality Changes in Older Adults From a Randomized Trial of an MBSR Program. Journal of Applied Gerontology : The Official Journal of the Southern Gerontological Society, 733464816663553. Advance online publication. http://doi.org/10.1177/0733464816663553

 

Abstract

This secondary analysis examined changes in sleep quality associated with participation in a Mindfulness-Based Stress Reduction (MBSR) program among healthy older adults. Data were collected at baseline, 8-weeks post-treatment, and a 6-month follow-up from adults aged ≥ 65 (N = 200), randomly assigned to MBSR or a waitlist control. Group differences were examined using mixed analysis of covariance with repeated measures on the total Pittsburgh Sleep Quality Index (PSQI) score. A small-sized, significant effect was found on overall sleep among MBSR participants with baseline PSQI scores > 5, indicative of a sleep disturbance, F(2, 80) = 4.32, p = .02, η2P=.05. A medium-sized, significant effect was found for MBSR participants with baseline PSQI scores ≥ 10, F(2, 28) = 3.13, p = .04, η2P=.10. These findings indicate that improved sleep quality for older adults who have higher levels of sleep disturbance may be associated with participation in MBSR.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874181/

Improve Mental Health in Medical Residents with Mindfulness

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Improve Mental Health in Medical Residents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“increasing physician resilience, or the ability to “bounce back” from experiences such as burnout, has been shown to have a significant positive impact on patient care and physician wellbeing. . . benefits include improved quality of care, reduced errors and minimized attrition . . . mindfulness-influenced wellness programs for residents can improve self-compassion, empathy, burnout and stress reactions. Mindfulness meditation introduces a way of cultivating awareness of one’s relationship with the present moment. With practice, it may lead to healthier ways of working with stressful life experiences, including those inherent to residency training.” – Vincent Minichiello

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. It would be best to provide techniques to combat burnout early in a medical career. Medical residency is an extremely stressful period and many express burnout symptoms. This would seem to be an ideal time to intervene.

 

In today’s Research News article “Mindfulness-Based Stress Reduction for Residents: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5880763/ ), Verweij and colleagues examined the ability of a Mindfulness-Based Stress Reduction (MBSR) program to treat the symptoms of burnout in medical residents. They recruited medical residents and randomly assigned them to either receive an 8-week, once a week, 2,5 hour session of Mindfulness-Based Stress Reduction (MBSR) or be assigned to a wait-list control condition. MBSR consists of a combination of meditation, yoga, and body scan practice in combination with discussion and home practice. The residents were measured before the program and 3 weeks later for emotional exhaustion, worry, home-work interference, mindfulness, self-compassion, positive mental health, physician empathy, and medical errors.

 

They found that in comparison to baseline and to the wait-list control condition, the residents who received MBSR training had significantly higher mindfulness, self-compassion, personal accomplishment, and perspective taking empathy, and significantly lower worry. These outcomes were all of moderate effect sizes. There were no significant effects on the primary measure of burnout, emotional exhaustion. But, the residents who had the highest levels of emotional exhaustion did show a significant improvements in emotional exhaustion after treatment.

 

These results suggest that Mindfulness-Based Stress Reduction (MBSR) maybe an effective treatment to improve the mental health of medical residents and perhaps reduce the tendency toward burnout. It should be noted, however, that medical residents are very restricted for time and MBSR training requires a considerable investment of time both in the training sessions and in home practice, making participation difficult. Future research should include an active control condition such as aerobic exercise to help control for potential sources of confounding and bias.

 

So, improve mental health in medical residents with mindfulness.

 

“I experienced burnout as a resident, and meditation was a key aspect to my recovery. My mother advised me to meditate, and afterwards, I felt like my brain had been rebooted.” – Louise Wen

 

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

 

Verweij, H., van Ravesteijn, H., van Hooff, M. L. M., Lagro-Janssen, A. L. M., & Speckens, A. E. M. (2018). Mindfulness-Based Stress Reduction for Residents: A Randomized Controlled Trial. Journal of General Internal Medicine, 33(4), 429–436. http://doi.org/10.1007/s11606-017-4249-x

 

Abstract

Background

Burnout is highly prevalent in residents. No randomized controlled trials have been conducted measuring the effects of Mindfulness-Based Stress Reduction (MBSR) on burnout in residents.

Objective

To determine the effectiveness of MBSR in reducing burnout in residents.

Design

A randomized controlled trial comparing MBSR with a waitlist control group.

Participants

Residents from all medical, surgical and primary care disciplines were eligible to participate. Participants were self-referred.

Intervention

The MBSR consisted of eight weekly 2.5-h sessions and one 6-h silent day.

Main Measures

The primary outcome was the emotional exhaustion subscale of the Dutch version of the Maslach Burnout Inventory–Human Service Survey. Secondary outcomes included the depersonalization and reduced personal accomplishment subscales of burnout, worry, work–home interference, mindfulness skills, self-compassion, positive mental health, empathy and medical errors. Assessment took place at baseline and post-intervention approximately 3 months later.

Key Results

Of the 148 residents participating, 138 (93%) completed the post-intervention assessment. No significant difference in emotional exhaustion was found between the two groups. However, the MBSR group reported significantly greater improvements than the control group in personal accomplishment (p = 0.028, d = 0.24), worry (p = 0.036, d = 0.23), mindfulness skills (p = 0.010, d = 0.33), self-compassion (p = 0.010, d = 0.35) and perspective-taking (empathy) (p = 0.025, d = 0.33). No effects were found for the other measures. Exploratory moderation analysis showed that the intervention outcome was moderated by baseline severity of emotional exhaustion; those with greater emotional exhaustion did seem to benefit.

Conclusions

The results of our primary outcome analysis did not support the effectiveness of MBSR for reducing emotional exhaustion in residents. However, residents with high baseline levels of emotional exhaustion did appear to benefit from MBSR. Furthermore, they demonstrated modest improvements in personal accomplishment, worry, mindfulness skills, self-compassion and perspective-taking. More research is needed to confirm these results.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5880763/

 

Improve Symptoms of Pelvic Organ Prolapse with Yoga

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Improve Symptoms of Pelvic Organ Prolapse with Yoga

 

By John M. de Castro, Ph.D.

 

“the only way to completely repair a pelvic prolapse is via surgery. Appropriate exercise can however alleviate and in some cases eliminate prolapse symptoms in women with mild to moderate prolapse.” – Michelle Kenway

 

Childbirth and some surgeries, particularly hysterectomies can weaken the muscles that hold the pelvic organs in place. This can lead to Pelvic Organ Prolapse where the pelvic organs such as the bladder drop from the lower belly and push against the walls of the vagina. The most common symptom of pelvic organ prolapse is feeling very full in the lower belly. Symptoms also include feeling as if something is falling out of the vagina, feeling a pull or stretch in the groin area or pain in your lower back, incontinence or needing to urinate a lot, having vaginal pain during sex, and constipation.

 

It is estimated that Pelvic Organ Prolapse affects about a third of women sometime during their lifetime. When mild to moderate in intensity Pelvic Organ Prolapse is usually left untreated and the patient learns to cope with the symptoms. But in sever cases surgery is called for. Exercises to strengthen the muscles holding the organs in place can be helpful in relieving symptoms. Although Yoga training has been shown to be beneficial for a large array of physical and mental disorders it has not been systematically tested for Pelvic Organ Prolapse.

 

In today’s Research News article “Effect of mula bandha yoga in mild grade pelvic organ prolapse: A randomized controlled trial.” (See summary below or view the full text of the study at: http://www.ijoy.org.in/article.asp?issn=0973-6131;year=2018;volume=11;issue=2;spage=116;epage=121;aulast=Sweta ), Sweta and colleagues recruited women with mild Pelvic Organ Prolapse who were not on any medication and randomly assigned them to either a yoga practice or control condition. Both groups received their usual treatments. Yoga practice consisted of poses while tightening and relaxing the lower pelvic muscles for 5 to 7 minutes, twice a day, for 12 weeks. They were measured before, during, and after the 12-week practice period for pelvic floor dysfunction, pelvic floor muscle function, and symptoms of Pelvic Organ Prolapse.

 

They report that the yoga, but not the control group following treatment had a significant progressive decrease in pelvic floor distress, urinary distress, pelvic pain, vaginal discharge, and feelings that something is falling out of the vagina, and significant improvement in perineal muscle function and quality of life. Hence, the yoga practice produced a significant improvement in the symptoms of Pelvic Organ Prolapse.

 

These are interesting and potentially important results that suggest that practicing selected yoga poses along with exercising pelvic muscles in addition to usual therapy is safe and significantly improves Pelvic Organ Prolapse symptoms. This would markedly reduce the discomfort and suffering of these women and improve their quality of life.

 

So, improve symptoms of pelvic organ prolapse with yoga.

 

“There is certainly a role that yoga can play in the management of reproductive organ prolapse, but there are also some poses, movements and breathing methods that could potentially exacerbate the condition.” – Shelly Prosko

 

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

 

Sweta K M, Godbole A, Awasthi H H, Pandey U. Effect of mula bandha yoga in mild grade pelvic organ prolapse: A randomized controlled trial. Int J Yoga 2018;11:116-21

 

Abstract
Background: Pelvic organ prolapse is the growing health issue related to women of the reproductive and postmenopausal age group in India and across the globe. Treatment option for pelvic organ prolapse includes both surgical and non-surgical intervention. The development of pelvic organ prolapse is an indication for major surgery among 20% of all women. Nevertheless, the recurrence of pelvic organ prolapse is detected among 58% of the patient after surgery. This highlights the need for preventive measures for reducing the impact of pelvic organ prolapse. Aims and Objective: To study the effect of 3 months yoga therapy in female patients suffering from mild pelvic organ prolapse. Material and Methods: 50 Participants were allocated into two groups (25 in each group) by generating Random allocation sequence. Women aged 20-60 with symptomatic mild pelvic organ prolapse in the yoga group were offered Mulabandha yoga therapy along with other conventional treatment modalities, while the control group was only on conventional treatment. All participants gave written informed consent. An assessment was done by improvement in chief complaints and Pelvic Floor Distress Inventory-20 (PFDI-20) & Pelvic floor impact Questionnaire-7 (PFIQ-7) at baseline and at the end of 4, 8 & 12 weeks. Results At the end of 12 weeks, Post-study comparison between the two groups showed a significant improvement in chief complaints like perennial pain, P/V discharge, Perineal muscle laxity and Feeling of something coming out P/V (P < 0.001). Participants in the yoga group improved by (on average) 5.7 (95% confidence interval 3.1 to 14.7) points more on the PFDI-20 than did participants in the control group (P = 0.1) and a mean score of PFIQ-7 was also improved significantly. Conclusions: Although Mulabandha (Root Lock) yoga therapy led to a significantly greater improvement in PFDI-20 & PFIQ-7 scores the difference between the groups was below the presumed level of clinical relevance (15 points). More studies are needed to identify factors related to the success of Mulabandha (Root Lock) yoga therapy and to investigate long-term effects.

http://www.ijoy.org.in/article.asp?issn=0973-6131;year=2018;volume=11;issue=2;spage=116;epage=121;aulast=Sweta

 

Reduce Anxiety and Depression in Patients with Mental and Physical Illness with Mindfulness

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Reduce Anxiety and Depression in Patients with Mental and Physical Illness with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When you become aware of the present moment, you gain access to resources you may not have had before. You may not be able to change a situation, but you can mindfully change your response to it. You can choose a more constructive and productive way of dealing with stress rather than a counterproductive or even destructive way of dealing with it.” – Mindful

 

There are vast numbers of people worldwide who suffer with mental or physical illnesses. These illnesses often include or are accompanied by anxiety and depression which exacerbate the suffering. Mindfulness practices have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. In addition, mindfulness practices have been found to relieve anxiety and depression. The mindfulness practices include mindfulness training, meditation, body scan, yoga, and a variety of mindful movement practices such as Tai Chi, Qigong, and Baduanjin. Baduanjin is a mind-body training that is very similar to Tai Chi and consists of 8 movements for limbs, body-trunk, and eye movements.

 

In today’s Research News article “Mindfulness-Based Baduanjin Exercise for Depression and Anxiety in People with Physical or Mental Illnesses: 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/PMC5858390/ ), Zou and colleagues review, summarize and perform a meta-analysis of the effectiveness of Baduanjin practice for the relief of the anxiety and depression that often accompany mental and physical illnesses. They discovered 26 published randomized controlled studies.

 

They found that the published studies showed large significant improvements in both anxiety and depression produced by Baduanjin practice; the amount of practice appeared to matter. The greater the number of hours of practice the lower the levels of anxiety and the greater the number of Baduanjin practice sessions the lower the levels of depression. Hence Baduanjin practice appears to significantly improve the psychological health of patients with mental and/or physical ailments in a dose response manner.

 

Baduanjin practice, like all mindful movement practices, is gentle and 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, 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 be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Baduanjin practice would appear to be an almost ideal, safe and effective treatment for the anxiety and depression that often accompany other mental and physical illness.

 

So, reduce anxiety and depression in patients with mental and physical illness with mindfulness.

 

“Mindfulness keeps us focused on the present, and helps us meet challenges head on while we appreciate all our senses absorb. On the contrary, focus on the future contributes to anxiety, while perseveration on the past feeds depression. Far too often when we look to the future, we ask ourselves, “What if,” and the answer we give ourselves is often a prediction of a negative result.” – Vincent Fitzgerald

 

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

 

Zou, L., Yeung, A., Quan, X., Hui, S. S.-C., Hu, X., Chan, J. S. M., … Wang, H. (2018). Mindfulness-Based Baduanjin Exercise for Depression and Anxiety in People with Physical or Mental Illnesses: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 15(2), 321. http://doi.org/10.3390/ijerph15020321

 

Abstract

Objectives: we used a quantitative method to systematically synthesize the emerging literature and critically evaluate the effects of Baduanjin on depression and anxiety in people with physical or mental illnesses. Additionally, we determined if the number of total Baduanjin training sessions is associated with decreased anxiety and depression levels. Methods: both English and Chinese databases were searched for potential studies published between January 1982 and October 2017. The eligible randomized controlled trials were considered for meta-analysis. Effect size (Hedge’s g) was computed for the pooled effects while the random-effect model was set. For moderator analysis; Subgroup meta-analysis for categorical variables and meta-regression for continuous variables were performed. Results: the aggregated result has shown a significant benefit in favour of Baduanjin on anxiety (Hedge’s g = −0.99; CI −1.63 to −0.74) and depression (Hedge’s g = −1.07; CI −1.3 to −0.83). For continuous potential moderators; meta-regression indicated a significant effect for total hours in Baduanjin practice (β = −0.0053; 95% CI −0.009 to −0.0014; p = 0.008). With regard to depression; meta-regression indicated a significant effect for total sessions of Baduanjin practice (β = −0.0023; 95% CI −0.006 to −0.0004; p = 0.028). Conclusions: the encouraging findings indicate the efficacy of Baduanjin exercise in reducing depression and anxiety symptoms in people with physical or mental illnesses. However; the results should be interpreted with caution because of existing methodological limitations (e.g., high risk of bias; Baduanjin combined with other behavioral interventions; and heterogeneity of control groups).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858390/

 

Improve Health Behaviors in Adolescents with Mindfulness

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Improve Health Behaviors in Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Your teenager may react with skepticism at first when you suggest meditation. But, with all the noise in the world and on the internet these days, teens can definitely benefit from taking time to quiet the noise and meditate. It’s a handy practice that can help them through all kinds of confusing and stressful situations in life.” – Cleveland Clinic

 

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

 

Mindfulness training has been shown to promote health and improve illness. It is well established that if patterns and habits of healthy behaviors can be established early in life, long-term health can be promoted and ill health can be prevented. In today’s Research News article “Integrating mindfulness training in school health education to promote healthy behaviors in adolescents: Feasibility and preliminary effects on exercise and dietary habits.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840835/ ), Salmoirago-Blotcher and colleagues explore the relationship of mindfulness to health behaviors in adolescents.

 

They recruited 9th grade classes in two high schools and assigned one to receive either 6-months of the usual health education class for 45 minutes 4 days per week combined with mindfulness training for 45 minutes one day per week or to receive the 4 days health education plus 1-day attention control. Students were measured before and after the 6-month training period for physical activity and dietary intake. Over the 6-month training period class attendance was high at 96%.

 

They did not find differences between groups before and after training for students who had low physical activity at baseline and did not find differences in dietary intakes. But, for students, particularly males, who were physically active at baseline participation in the health education plus mindfulness class produced significant increases in activity levels at the end of training. This was not true for the health education plus attention control condition.

 

These findings suggest that incorporating mindfulness training into the health education curriculum may increase health behaviors in adolescents. It is unfortunate that this intervention did not appear to work with the students who needed it the most, the sedentary students and did not work for dietary intake, with overweight and obesity a major problem. Perhaps a more refined and targeted program my work with this group. Unfortunately, the research did not explore other known benefits of mindfulness training for adolescents such as psychological health. This should be explored with future research. Regardless, the results suggest that mindfulness training should be further explored to increase health behaviors in adolescents. Strengthening these behaviors at a relatively early age may have positive health consequences throughout their lives.

 

So, improve health behaviors in adolescents with mindfulness.

 

“Qualitative data collection reveals that adolescents are less anxious and sleep better after doing yoga; in addition, their self-awareness and ease in their body increase, and their worldview begins to shift toward a more positive alignment.” – Sat Bir S. Khalsa

 

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

 

Salmoirago-Blotcher, E., Druker, S., Frisard, C., Dunsiger, S. I., Crawford, S., Meleo-Meyer, F., … Pbert, L. (2018). Integrating mindfulness training in school health education to promote healthy behaviors in adolescents: Feasibility and preliminary effects on exercise and dietary habits. Preventive Medicine Reports, 9, 92–95. http://doi.org/10.1016/j.pmedr.2018.01.009

 

Abstract

Whether mindfulness training (MT) could improve healthy behaviors is unknown. This study sought to determine feasibility and acceptability of integrating MT into school-based health education (primary outcomes) and to explore its possible effects on healthy behaviors (exploratory outcomes). Two high schools in Massachusetts (2014–2015) were randomized to health education plus MT (HE-MT) (one session/week for 8 weeks) or to health education plus attention control (HE-AC). Dietary habits (24-h dietary recalls) and moderate-to-vigorous physical activity (MVPA/7-day recalls) were assessed at baseline, end of treatment (EOT), and 6 months thereafter. Quantile regression and linear mixed models were used, respectively, to estimate effects on MVPA and dietary outcomes adjusting for confounders. We recruited 53 9th graders (30 HEM, 23 HEAC; average age 14.5, 60% white, 59% female). Retention was 100% (EOT) and 96% (6 months); attendance was 96% (both conditions), with moderate-to-high satisfaction ratings. Among students with higher MVPA at baseline, MVPA was higher in HE-MT vs. HE-AC at both EOT (median difference = 81 min/week, p = 0.005) and at 6 months (p = 0.004). Among males, median MVPA was higher (median difference = 99 min/week) in HE-MT vs. HEAC at both EOT (p = 0.056) and at 6 months (p = 0.04). No differences were noted in dietary habits. In sum, integrating school-based MT into health education was feasible and acceptable and had promising effects on MVPA among male and more active adolescents. These findings suggest that MT may improve healthy behaviors in adolescents and deserve to be reproduced in larger, rigorous studies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840835/

 

MindFULLness

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MindFULLness

 

By John M. de Castro, Ph.D.

 

“You have power over your mind – not outside events. Realize this, and you will find strength.” -Marcus Aurelius
It is a basic instruction of contemplative practices such as meditation, to work to empty the mind and thereby quiet it. It doesn’t take long for the practitioner to realize that this seemingly simple and easy instruction is very, very difficult to do. The practice feels like a “whack-a-mole” process where as soon as a mental content is eliminated, another rushes in to fill the vacuum, and the process has to begin again, and again, and again. This seems like a never-ending process. The practitioner is taught to seek emptiness, but is cautioned that that doesn’t really mean empty! In fact, it is very, very full; full of everything. As has been pointed out, a glass that has no fluid in it is not empty, it contains air. It is empty only of fluid. Many novices become so frustrated with these paradoxes that they give up and quit contemplative practice.

 

Another instruction is to “let go” of thoughts and desires. But, the mind, like nature, abhors a vacuum. As soon as one thing is let go of, another arises to take its place; another “whack-a-mole” process. “Letting go” as it turns out is as difficult as emptying the mind. In fact, the desire to let go is itself a desire that has to be let go of. This sort of conundrum is typical of what confronts the practitioner who when in frustration asks “tell me what to do,” is told do nothing. As if the mind is ever capable of doing nothing.

 

The term mindfulness is a synonym of attention. But, attention is ambiguous as there is always attention to something. The word mindfulness by itself, does not indicate attention to what. Trying to attend is not “letting go” and attending to something is not emptying the mind. These are such conundrums that they can bring the uninitiated to the point of complete frustration and abandonment of practice.

 

A helpful way to look at the issues of practice is to realize that the mind is always going to be full. It’s not a question of emptying it, but rather of what that content should be. It’s not a question of letting go, but rather what should remain. It’s not a question of emptiness, but rather what actually is there. It’s not a question of mindfulness, but rather what we should be mindful of. It’s not a question of attention, but rather what should be attended to. In other words, realize that the mind is always full, the issue for the practitioner is to fill it with things that will lead to insight and greater happiness.

 

The mind always contains something. What exactly the mind contains is studied using a technique called time sampling. The individual is provided a signal at random times during the day and is simply asked to report on exactly what was in the mind when the signal occurred. Studies using this technique revealed the nearly half of the time, regardless of what the person is actually doing, the mind is wandering. The individual is thinking about something other than what is presently in front of them. When wandering, 42.5% of the time, people’s minds were on pleasant topics, 26.5% on unpleasant topics, and 31% on neutral topic. When asked how happy they were at the moment, they reported that they were no happier when thinking about pleasant topics than about their current activity, but, were considerably unhappier when thinking about neutral topics or unpleasant topics. So, the mind is always full of something, the question is of what. The thought sampling studies suggest that we’re happiest when the mind is focused on the present moment. So, the notion that the mind should be full of the present moment makes sense. It will increase happiness and lower suffering.

 

It is a trap to get carried away with present moment awareness. Don’t think that to gain insight and happiness one must be constantly focused solely on the present moment. In fact, the mind should not be perpetually paying attention only to the present moment. Thinking, planning, remembering are not bad things. In fact, they are very adaptive human qualities that allow us to better control our environment, learn from the past, and be prepared for the future. It is the case that sometimes, it is best if the mind is full of things other than the present moment. The instructions to empty the mind and let go of thinking are not absolute. So, practitioners shouldn’t feel bad when the mind is not full of the present moment. Rather it’s a matter of how often our mind is full of the present and how often of other thoughts.

 

The complexity of modern life demands more thinking and planning than was needed in the past. But, in addition to the needed attention to thinking, the modern world has developed a vast array of distractions from the present moment. Television, movies, social media, email, cell phones, video games, etc. are ever present and take up a substantial proportion of our time. It might be argued that when paying attention to social media we are paying attention to the present moment. In fact, no matter what we’re involved in, is the present moment. But, what is really being alluded to with present moment awareness is attention to the stimuli immediately present in the environment at the expense of thinking.

 

When we’re told to empty the mind, we’re not being literally told to get rid of all mental content, rather we’re being instructed to empty the mind of thoughts. What’s left then, what the mind should be full of, are the physical stimuli around and in us. In part, filling the mind with present moment sights, smells, tastes, sounds, feelings forces thoughts out. So, one way to empty the mind is actually to fill it up, fill it up with sensations. This replacement of thoughts with sensations makes us happier and begins to truly quiet the mind. The instruction to follow the breath is an attempt to do just that, fill the mind with internal stimuli, the sensations of the lungs filling and emptying, and the consequent changes to the abdomen, chest and head.

 

So, quieting the mind is not about emptying it out, rather it’s about filling it up completely. Filling it with awareness of sensations and emptying it of thoughts. This by itself will bring greater peace and happiness. But that’s not all that’s possible. When the mind is full of sensory experience the practitioner slowly begins to recognize that, underneath these experiences is a ground on which the experiences are perceived. This is the next great insight of the practice and is the first glimpse at the practitioner’s true nature.

 

As the process continues, sometimes very slowly and sometimes with flashes of insight the practitioner comes to see that ground on which the experiences are perceived is pure awareness. One reason for quieting the mind of thoughts is that thoughts block the perception of this ground. That’s why the instruction to empty the mind of thoughts exists. Not because there’s anything fundamentally wrong with thoughts, but because they prevent the individual from seeing their true nature.

 

The more time spent in present moment sensation awareness the more the ground of our being becomes apparent and becomes an object of awareness itself; awareness becoming aware of itself. Slowly or suddenly, it reveals that this pure consciousness is a completely empty state of nothingness, that is pure awareness. This is sometimes referred to as a void. But actually, it is not. It is a space of infinite potential. A space where anything can appear and/or disappear at any moment. It is an emptiness that is alive, bubbling over with potential. But, it is empty of thoughts and sensations. This is our true nature. This is what is called Buddha Nature. This is what is called the spirit. This is what is called the soul. It is all there to be witnessed if the individual is willing to patiently invest the time and effort it takes to first empty the mind of thoughts and fill it up with present moment sensations, allowing the ground of being to emerge into consciousness.

 

So, practice MindFULLness.

“You must live in the present, launch yourself on every wave, find your eternity in each moment. Fools stand on their island of opportunities and look toward another land. There is no other land; there is no other life but this.” ― Henry David Thoreau

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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