contemplative practice

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

 

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Improve Stress, Sleep, and Memory with Mindfulness

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Improve Stress, Sleep, and Memory with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation trains you to be mindful of your incoming thoughts, weakening both the physiological link and strength that each thought has on you, as well as decreasing the frequency of incoming sleep-preventing thoughts. Meditation forces the worrywart, insomnia causing mind to shift into the present moment, while realizing that the day is now over, and tomorrow is not yet here.” – EOC Institute

 

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. 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. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness and can even lead to memory problems. So, there is a need to find better methods to improve sleep. Mindfulness-based practices have been reported to improve sleep amount and quality, reduce stress and improve memory. It is not known, however, how these effects of mindfulness are related.

 

In today’s Research News article “Dispositional Mindfulness and Memory Problems: The Role of Perceived Stress and Sleep Quality.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363402/ ), Brisbon and Lachman measured adult participants in the Boston Longitudinal Study for mindfulness, perceived stress, sleep quality, memory problems, physical health, openness, and neuroticism. The relationships between these measured were then explored with a regression analysis.

 

They found that stress was a key, with higher levels of perceived stress associated with poorer sleep quality and greater memory problems and neuroticism. Mindfulness was only slightly associated with lower perceived stress and neuroticism and greater openness and no significant relationship with sleep quality. A mediation analysis revealed that mindfulness was associated with lower memory problems indirectly by being associated with lower perceived stress which was associated with memory problems. Hence, high mindfulness was related to lower perceived stress which was, in turn, related to memory problems.

 

It should be kept in mind that the preset study was correlational and no conclusions about causation can be reached. But, these results suggest that stress is a key factor in sleep and memory problems and that mindfulness, by being associated with lower stress, is related to improved memory. It remains for future research to manipulate mindfulness and thereby determine if there are causal connections. But, given the increased memory problems associated with aging, it would be important to establish whether mindfulness may be helpful in delaying or reversing the deterioration of memory.

 

So, improve stress, sleep, and memory with mindfulness.

 

“We were surprised to find that the effect of mindfulness meditation on sleep quality was large and above and beyond the effect of the sleep hygiene education program, Not only did the researchers find that mindfulness could help reduce sleep problems in older adults, but that “this effect on sleep appears to carry over into reducing daytime fatigue and depression symptoms.” – David S. Black

 

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

 

Brisbon, N. M., & Lachman, M. E. (2017). Dispositional Mindfulness and Memory Problems: The Role of Perceived Stress and Sleep Quality. Mindfulness, 8(2), 379–386. http://doi.org/10.1007/s12671-016-0607-8

 

Abstract

There is a growing body of evidence exploring the beneficial effects of mindfulness on stress, sleep quality, and memory, though the mechanisms involved are less certain. The present study explored the roles of perceived stress and sleep quality as potential mediators between dispositional mindfulness and subjective memory problems. Data were from a Boston area subsample of the Midlife in the United States study (MIDUS-II) assessed in 2004–2006, and again approximately one year later (N=299). As expected, higher dispositional mindfulness was associated with lower perceived stress and better sleep quality. There was no direct association found between mindfulness and subjective memory problems, however, there was a significant indirect effect through perceived stress, although not with sleep quality. The present findings suggest that perceived stress may play a mediating role between dispositional mindfulness and subjective memory problems, in that those with higher mindfulness generally report experiencing less stress than those with lower mindfulness, which may be protective of memory problems in everyday life.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363402/

 

Reduce the Symptoms of PTSD with Yoga

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Reduce the Symptoms of PTSD with Yoga

 

By John M. de Castro, Ph.D.

 

“It can be very difficult to stay in your own body when you’re getting flashbacks. The lighting changes, and you feel like you’re not even in the room. . . . [Yoga] reminds me that if I just keep plodding along, I can get there,” she says. “I can face it in little chunks and say, “I can work with this piece.'” – Denise Wills

 

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. In addition, yoga has been shown to help relieve the symptoms of PTSD. In today’s Research News article “Yoga for posttraumatic stress disorder – 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/PMC5863799/ ), Cramer and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the application of yoga practice for the treatment of the symptoms of Post-Traumatic Stress Disorder (PTSD).

 

They found 7 randomized controlled trials on 284 patients. They found that most of the research was of low quality. But, these studies found that yoga practice produced significant improvements in PTSD symptoms. There was good retention of participants in the yoga practice groups. In addition, there were no significant adverse events reported. Hence, they found that the published literature suggests that yoga practice is helpful for the relief of the symptoms of PTSD but the evidence was rather weak. This strongly suggests that better controlled, larger randomized controlled trials are needed.

 

Yoga is a complex practice, usually involving multiple components of postures, breathing exercises and meditation. It is not known which of these components or which combinations are necessary for effectiveness. The sole piece of evidence found was that the trial that did not contain the postures component did not find significant relief of symptoms. This suggests that the practice of yoga postures is the critical component.

 

So, reduce the symptoms of Post-Traumatic Stress Disorder (PTSD) with yoga.

 

“The first step in yoga practice is to link the mind and body through the breath, bringing awareness to what is happening in the moment. Intense feelings and thoughts can be experienced and reduced in intensity as the mind becomes more still and calm and the body allows the sensations to pass. An experience of a deeper level of existence is possible allowing the body mind complex to feel peace and generate positive emotions and enter a transformative period. With repeated practice and guidance, a yoga practice can bring long term relief and a fresh perspective on life for PTSD sufferers.” – The Art of Living

 

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

 

Cramer, H., Anheyer, D., Saha, F. J., & Dobos, G. (2018). Yoga for posttraumatic stress disorder – a systematic review and meta-analysis. BMC Psychiatry, 18, 72. http://doi.org/10.1186/s12888-018-1650-x

 

Abstract

Background

Yoga is increasingly used as a therapeutic treatment and seems to improve psychiatric conditions such as anxiety disorders and depression. The aim of this systematic review was to assess the evidence of yoga for reducing symptoms of posttraumatic stress disorder (PTSD).

Methods

The Cochrane Library, Medline/PubMed, PsycINFO, Scopus, and IndMED were searched through July 2017 for randomized controlled trials (RCTs) assessing the effects of yoga on symptoms of PTSD. Mean differences (MD) and standardized mean differences (SMD) with 95% confidence intervals (CI) were computed. The quality of evidence and the strength of recommendation were graded according to the GRADE recommendations.

Results

Seven RCTs (N = 284) were included. Meta-analysis revealed low quality evidence for clinically relevant effects of yoga on PTSD symptoms compared to no treatment (SMD = − 1.10, 95% CI [− 1.72, − 0.47], p < .001, I2 = 72%; MD = − 13.11, 95% CI [− 17.95, − 8.27]); and very low evidence for comparable effects of yoga and attention control interventions (SMD = − 0.31, 95%CI = [− 0.84, 0.22], p = .25; I2 = 43%). Very low evidence was found for comparable retention of patients in the trial for yoga and no treatment (OR = 0.68, 95%CI [0.06, 7.72]) or attention control interventions (OR = 0.66, 95%CI [0.10, 4.46]). No serious adverse events were reported.

Limitations

Few RCTs with only limited sample size were available.

Conclusions

Only a weak recommendation for yoga as an adjunctive intervention for PTSD can be made. More high quality research is needed to confirm or disconfirm these findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5863799/

 

Improve Sleep with Mindfulness

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Improve Sleep with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When we lose awareness of the present moment, our minds get stuck in maladaptive ways of thinking. For example, you might be trying to go to sleep but your mind gets lost thinking about all the groceries you need to buy. Deep, relaxed breathing is forgotten. And once you realize sleep isn’t happening, your muscles tense and your thought process quickly shifts to “I’m not falling asleep! I have XYZ to do this week and I won’t be able to function tomorrow.” The body seizes up, breathing and heart rate can both quicken, and falling sleep becomes more difficult.” – Shelby Freedman Harris

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant psychological distress can impair sleep. Indeed, 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. So, non-drug methods to improve sleep are needed. Contemplative practices have been reported to improve mindfulness and, in turn, improve sleep amount and quality and help with insomnia. But, how mindfulness improves sleep has not been explored.

 

In today’s Research News article “Potential Mechanisms of Mindfulness in Improving Sleep and Distress.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866834/ ), Lau and colleagues examine possible intermediaries that are effected by mindfulness and which, in turn, influence sleep. They recruited a large sample of meditation naïve, Chinese, adults and measured them over the internet for mindfulness, sleep quality, depression, anxiety, and stress. They then performed regression analysis of the associations among these variables.

 

Replicating previous findings, they found that the higher the levels mindfulness, especially acceptance (non-react facet of mindfulness), the greater the sleep quality and the lower the levels of anxiety, depression, and stress. They also found that the higher the levels of psychological distress, the higher the levels of anxiety, depression, and stress and the lower the levels of mindfulness and sleep quality. So, mindfulness, especially acceptance, was associated with better psychological health and sleep, while psychological distress acted in the opposite direction.

 

They then tested models that asserted various pathways whereby mindfulness affected sleep quality. They found that the higher the level of acceptance (non-react facet of mindfulness), the greater the impact of awareness (observe facet of mindfulness) on lower general psychological distress and higher the sleep quality. This suggests that acceptance associations with higher sleep quality may be in part mediated by the association of acceptance with lower levels of psychological distress and in turn improved sleep quality.

 

These findings begin the unravel the mechanisms by which mindfulness improves sleep. It suggests that acceptance (non-react facet of mindfulness) is a very important component of the associations with better sleep and that it, in part, works through associations with lower levels of psychological distress.

 

So, improve sleep 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. . . . worrying about sleep works against the process of falling asleep. All of those concerns about your insomnia just might be making it harder to let go at the end of the day, to relax and let your body rest.” – 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

Lau, W. K. W., Leung, M.-K., Wing, Y.-K., & Lee, T. M. C. (2018). Potential Mechanisms of Mindfulness in Improving Sleep and Distress. Mindfulness, 9(2), 547–555. http://doi.org/10.1007/s12671-017-0796-9

 

Abstract

The mechanisms of mindfulness-improved sleep quality are not extensively studied. Recently, attention monitoring/awareness and acceptance in mindfulness have been proposed to be the underlying mechanisms that tackle distress and related disorders. The current study tested if acceptance moderated the relationship of awareness with psychological distress and sleep quality, and verified that psychological distress mediated the relationship between mindfulness and sleep quality in a group of community-dwelling healthy adults. Three hundred and sixty-four healthy Chinese non-meditators (age 18–65, 59% female) completed a set of online self-reported questionnaires in Chinese via SurveyMonkey. Awareness and acceptance were measured by Observe and Nonreact facets in the Five Facet Mindfulness Questionnaire (FFMQ), respectively. General psychological distress levels and sleep quality were reflected in the global score of the Depression Anxiety and Stress Scales (DASS) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Model 1 and model 8 in the PROCESS macro for SPSS were used to assess the moderation and moderated mediation effects. Increased level of acceptance (Nonreact) weakened the positive relationship between awareness (Observe) and poor sleep quality (β = −0.0154, p = 0.0123), which was partially mediated through perceived psychological distress (β = −0.0065, 95% bias-corrected bootstrap CI = −0.0128, −0.0004) in a group of community-dwelling healthy adults. Our findings suggested that awareness and acceptance could be the mechanisms of mindfulness interventions in improving sleep quality, partly via reducing psychological stress.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866834/

 

The Middle Way in Mindfulness Practice

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The Middle Way in Mindfulness Practice

 

By John M. de Castro, Ph.D.

 

“Monks, these two extremes ought not to be practiced by one who has gone forth from the household life. (What are the two?) There is addiction to indulgence of sense-pleasures, which is low, coarse, the way of ordinary people, unworthy, and unprofitable; and there is addiction to self-mortification, which is painful, unworthy, and unprofitable. Avoiding both these extremes, the Tathagata (the Perfect One) has realized the Middle Path; it gives vision, gives knowledge, and leads to calm, to insight, to enlightenment and to Nibbana.”  – Siddhārtha  Gautama

 

I have a life-long habit of trying too hard. In American culture, that is not considered a fault, but in the contemplative life it often is. The Buddha taught the middle way as the proper approach. He tried the extremes from the excess in the life of a prince to the opposite excess in the life of an ascetic. He found after years of futile effort that neither worked in ending suffering. But, when he rejected both and compromised, exerting effort but not too much, he found success and attained enlightenment. So, he taught his followers the middle way.

 

The Buddha likened the spiritual path to a stringed musical instrument. If no effort is exerted the string is slack and does not produce music. If too much effort is exerted, the string is tightened too much and breaks. Only when the string is tightened moderately does it produce beautiful music. He taught this middle way of moderation in all things to achieve success in all phases of life but particularly in spiritual endeavors.

 

The modern sage Thich Nhat Hahn visited the San Francisco Zen Center; a center noted for its rigor. After his visit, he was asked by the leader how the Center could improve. He stated that first he would sleep later, and that they shouldn’t be so grim and dour, and should smile much more. What he was pointing to is the middle way; being less strict and rigorous and practicing with greater joy; keeping the body and spirit at a moderate level that allows for the practice to be relaxed and joyful.

 

I learned this lesson during this most recent retreat. It was a personal retreat with no one but myself setting the schedule of activities. The first couple of days it was raining hard, so I took the opportunity to meditate frequently and for extended periods; as it turns out too frequently and too long. After two days, I was physically and mentally exhausted. Meditation became painful and unproductive. I decided to take the afternoon and evening of the third day off. I simply rested, maintaining silence, but read a novel. Many teachers would reprimand me from breaking from the focus on silent meditation. But, as it turned out, it worked wonderfully. The next day I was refreshed, the pain was gone and my level of concentration was wonderful.

 

I scaled back on the frequency and duration of the meditation and rested more often and for longer times. There was no more novel reading or time off. I had learned the middle way as the way to practice in retreat. Previously on a formal retreat with scheduled meditations, I would scoff at participants who would skip a scheduled meditation or a dharma talk and believed that they were wasting a valuable opportunity. Now I see that I was being unfairly judgmental. I now realize that they were being wise, tailoring the retreat to their own level of energy and physical endurance. They were keeping the practice within the middle way.

 

Psychological research has demonstrated that there is an optimum level of motivation for any task and it is not at the extremes, but in the middle. The research has also demonstrated that what the optimum level is varies from person to person. For some, a low level works best, while for others only very high levels produce optimum results. For most, somewhere in the middle is best. It is up to each of us to find our own optimum level and practice accordingly. I found mine on this personal retreat and once I practiced at this level, the results were good. The Buddha taught to judge an activity, not by its nature, but by the results it produces. Clearly, following my own middle way had positive results for me.

 

Happiness is more likely to be found on the middle way. Studies of happiness have shown that people with very low incomes are generally unhappy. Surprising, those who are quite rich tend to be generally unhappy. It’s the people in the middle, with sufficient, but not excessive income, are generally the happiest. A surprising fact in this regard is that people who have one large amounts of money in the lottery afterward are much less happy than before. It is clear that the middle way with wealth leads to the greatest happiness.

 

Athletes have learned the benefits of the middle way. Trying too hard results in poorer performance and often times injury. Not working hard enough, being too lax, similarly leads to poor performance. Exerting the right amount of effort and relaxing, the middle way, leads to excellence in athletic achievement. Every yoga student knows that to improve flexibility muscles and tendons can’t be stretched too hard. The muscles will resist the stretch or could get injured. Similarly, too little stretch produces no benefits. On the other hand, moderate, middle way, stretching produces the best results.

 

Even something as simple as eating is best practiced on the middle way. We all know that we have to eat. Eating too little is damaging to health and eating too much leads to obesity and disease. During the evolutionary development of humans, the problem was a lack of consistency in the supply of food. Food was plentiful at times, but scarce at others. It was adaptive for humans to overeat during times of plenty in order to store the energy needed to withstand the times of scarcity. In modern times, though, where food can be plentiful at all times, the tendency to overeat doesn’t solve a problem, it creates one, obesity. Here, also, the middle way is best; eating sufficiently for health but not more than is needed. This is promoted by mindful eating. Eat carefully on the middle way.

 

Driving a car is a clear example of the need for a middle way. Driving too fast can lead to loss of control or inability to stop quickly in an emergency, which can be fatal. On the other hand, driving too slowly can also be dangerous as it can lead to being rear ended, prompt overly aggressive passing by other cars, or major back-ups in traffic. Driving too aggressively van be dangerous, while driving too passively can also be. It is best to be driving the middle way, not meaning down the center of the road, but with moderation with speed and assertiveness.

 

I spent many years as a teacher and observed students who were very highly motivated getting exhausted cramming and then were so nervous during exams that they performed poorly. It has been established that too high a level of motivation interferes with learning and memory. Similarly, students who were lackadaisical and don’t apply themselves also performed poorly. But those students who were moderately motivated so that they studied but who could relax, performed the best. Hence, in academics as in meditation, athletics, and work, the middle way is best.

 

In our live in general, overly stressing one aspect of life almost always leads to unhappiness. Balance, the middle way, is needed. Many people, particularly Americans, work excessively at their jobs, working long hours and rarely taking vacations. They may have successful careers, but be miserable. On the deathbed, people virtually never wish that they had spent more time or effort on developing their resumes, on working harder or being more successful. Rather, they most often decry the fact that they didn’t spend enough time and energy on family and friends. A palliative care nurse once recorded the top five regrets of the dying. They were

  1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
  2. I wish I hadn’t worked so hard.
  3. I wish I’d had the courage to express my feelings.
  4. I wish I had stayed in touch with my friends.
  5. I wish that I had let myself be happier.

 

When I was younger and went to a new interesting place, I was determined to see all the sights. I got up early and ran from sight to sight till closing time. By evening, I and any companions were exhausted. I had seen many great things; what the place had to offer. But, upon reflection, I realized that I really didn’t enjoy or truly appreciate any of them. I’ve learned to take the middle way, to slow down, to relax, to see less, but enjoy and learn from it more. Spending the day ticking off as many items as possible from the to-do list is a recipe for unhappiness. Take the middle way in everything you do.

 

Raising children is best guided by the middle way. Young children must learn boundaries to their behavior in order to function at home and in society. They can’t have everything they want and they can’t do everything they want. If parenting is too lax the child will grow unruly and difficult and will have problems integrating into school and social groups. On the other hand, if parenting is too severe and intrusive the child will be fearful, the child will have a damaged self-concept, creativity will be stifled, and the child will avoid authority. At extreme levels the child may experience abuse and trauma that may haunt them for the rest of their lives. Mindful parenting takes the middle road, maintaining boundaries but doing so with love and understanding, valuing the child, and guiding development with unconditional positive regard. With this middle way, children grow and are socialized while maintaining creativity and a positive self-regard. They grow into psychologically health adults.

 

So, practice the middle way in mindfulness practice and in life in general, finding the level of effort what works for you. Don’t string yourself too loosely or too tightly, enjoy the symphony of life, and play beautiful spiritual music.

 

“Your hand opens and closes, opens and closes. If it were always a fist or always stretched open, you would be paralyzed. Your deepest presence is in every small contracting and expanding, the two as beautifully balanced and coordinated as birds’ wings.” ― Jalaluddin Rumi

 

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