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Improve Posttraumatic Stress Disorder (PTSD) Symptoms with Mindfulness Meditation

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Improve Posttraumatic Stress Disorder (PTSD) Symptoms with Mindfulness Meditation

 

By John M. de Castro, Ph.D.

 

“Regular mindfulness practice can lead to a greater present-centered awareness and nonjudgmental acceptance of potentially distressing cognitive and emotional states as well as trauma-related internal and external triggers. Awareness and acceptance of trauma-related thoughts and feelings may . . . be especially useful for individuals with PTSD, as it may help decrease experiential avoidance, reduce arousal, and foster emotion regulation.” – National Center for PTSD

 

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 meditation training has been found to be particularly effective. But meditation is actually a complex practice involving many different components. One such simple non-meditative component is relaxation and slowed breathing. In addition, there are many different meditation techniques. As a result, it is difficult to know what types of meditation are most effective. It is also difficult to specify if meditation per se or the relaxation and slow breathing that occurs with meditation may be responsible for meditation effects.

 

In today’s Research News article “Mechanistic pathways of mindfulness meditation in combat veterans with posttraumatic stress disorder.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803530/, Wahbeh and colleagues investigate different components of meditation and the route of their effectiveness, psychological or physical. They recruited combat veterans who had an established diagnosis of posttraumatic stress disorder (PTSD) and randomly allocated each to one of four conditions; body scan mindfulness meditation, slow breathing with a biofeedback device, mindful awareness of the breath with an intention to slow the breath, or 4) sitting quietly. They were trained once a week for 6 weeks and were assigned to practice 20 minutes per day between sessions. The participants were measured before and after training for mindfulness, PTSD symptoms, lifetime trauma, combat experience, perceived symptom improvement, intrusive thoughts, perceived stress, depression, positive and negative emotions, self-efficacy, sleep quality, and attentional ability. They also received physical measures with electroencephalogram (EEG), salivary cortisol, heart and respiration rates.

 

They found after training that the 2 mindfulness meditation conditions produced significantly greater mindfulness, perceived symptom improvement, the greatest improvements in PTSD symptoms, and greater reductions in respiration rates. Hence, the inclusion of meditation was critical for symptomatic improvement. But, the improvements were all psychological. In general, there were no differences in physiological measures, except for slowed breathing in meditation.

 

The study’s strength was that it separated components of meditation practice and identified the effective components. Mindfulness meditation appears to improve the psychological symptoms of posttraumatic stress disorder (PTSD). It appeared to do so, independent of relaxation and physiological changes. So, physical relaxation or physiological changes are not sufficient. The study suggests that the inclusion of meditation practice is mandatory in order to treat PTSD. Since meditation is known to improve emotion regulation and attention, reduce stress responding, and reduce worry and rumination, the study suggests that these psychological effects of meditation are crucial to symptom relief for PTSD sufferers.

 

So, improve posttraumatic stress disorder (PTSD) symptoms with mindfulness meditation.

 

“But new research has now demonstrated that mindfulness—a non-judgmental awareness of our thoughts and feelings—might be a useful tool for veterans battling PTSD. Rather than being stuck in disturbing memories and negative thoughts, they can use mindfulness to actively shift their attention out of ruminations and produce lasting changes in the brain.” – Adam Hoffman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Wahbeh, H., Goodrich, E., Goy, E., & Oken, B. S. (2016). Mechanistic pathways of mindfulness meditation in combat veterans with posttraumatic stress disorder. Journal of Clinical Psychology, 72(4), 365–383. http://doi.org/10.1002/jclp.22255

 

Abstract

Objective

This study’s objective was to evaluate the effect of two common components of meditation (mindfulness and slow breathing) on potential mechanistic pathways.

Methods

102 combat veterans with posttraumatic stress disorder (PTSD) were randomized to: 1) the body scan mindfulness meditation (MM), 2) slow breathing (SB) with a biofeedback device, 3) mindful awareness of the breath with an intention to slow the breath (MM+SB), or 4) sitting quietly (SQ). Participants had six weekly one-on-one sessions with 20 minutes of daily home practice. The mechanistic pathways and measures were: 1) Autonomic Nervous System: hyperarousal symptoms, heart-rate (HR), heart-rate variability (HRV); 2) Frontal Cortex Activity: Attentional Network Task (ANT) conflict effect and event-related negativity, and intrusive thoughts; and 3) Hypothalamic-pituitary-adrenal axis: awakening cortisol. PTSD measures were also evaluated.

Results

Meditation participants had significant but modest within-group improvement in PTSD and related symptoms although there were no between-group effects. Perceived impression of PTSD symptom improvement was greater in the meditation arms compared to controls. Resting respiration decreased in the meditation arms compared to SQ. For the mechanistic pathways 1) Subjective hyperarousal symptoms improved within-group (but not between-group) for MM, MM+SB, and SQ while HR and HRV did not; 2) Intrusive thoughts decreased in MM compared to MM+SB and SB while the ANT measures did not change; and 3) MM had lower awakening cortisol within-group but not between-group.

Conclusion

Treatment effects were mostly specific to self-report rather than physiological measures. Continued research is needed to further evaluate mindfulness meditation’s mechanism in people with PTSD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803530/

Women Benefit More than Men from Mindfulness

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Women Benefit More than Men from Mindfulness

 

By John M. de Castro, Ph.D.

 

“For people that tend to be willing to confront or expose themselves or turn toward the difficult, mindfulness is made for helping that process. For people who have been largely turning their attention away from the difficult, to suddenly bring all their attention to their difficulties can be somewhat counterproductive. While facing one’s difficulties and feeling one’s emotions may seem to be universally beneficial, it does not take into account that there may be different cultural expectations for men and women around emotionality.” – Willoughby Britton

 

Mindfulness training has been shown to be beneficial for a variety of mental health problems, including anxiety, depression, Antisocial Personality Disorder, Borderline personality disorder, impulsivity, obsessive compulsive disorder, phobias, post-traumatic stress disorder, sexual dysfunction, suicidality and even with psychosis. It also improves the psychological well-being of healthy people. Interestingly, there appears to be differences between men and women in the occurrence of various mental illnesses. Women have a much higher incidence of emotional issues than men such as anxiety and depression. On the other hand, men are more likely to have conduct disorders and substance abuse.

 

One of the ways that mindfulness appears to work to improve mental health is by improving emotion regulation. This increases the individual’s ability to fully experience emotions but react to and cope with them adaptively, in other words, not to be carried away by them. Since women are more likely to have emotional issues than men, and mindfulness is particularly effective in improving emotion regulation, it would seem reasonable to hypothesize that mindfulness would have greater psychological benefits for women than for men.

 

In today’s Research News article “Women Benefit More Than Men in Response to College-based Meditation Training.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397480/, Rojiana and colleagues recruited male and female university students and trained them for 12 weeks, 3 times per week for 1 hour, in focused and open monitoring meditation. They completed measurements before and after training of mindfulness, positive and negative emotions, and self-compassion. They then compared the effectiveness of the meditation training for men and women.

 

They found that after training both men and women improved in mindfulness and self -compassion, but women had greater improvements than men in mindfulness and the mindfulness facets of observing, describing, non-judging, and non-reacting. Women also showed greater decreases in negative emotions. For women, it was found that the greater the increase in mindfulness, the greater the decrease in negative emotions. Hence, they found that women tended to benefit more from the meditation training that the men.

 

These are interesting results that suggest that women respond to meditation training with greater improvements in emotions and mindfulness than men. This may well have occurred due to the facts that mindfulness is known to improve emotion regulation and women have greater problems with emotion regulation and thereby benefit more. The greater improvements in mindfulness in women are interesting and may be due to the fact that the women were lower in mindfulness, particularly non-reactivity, to begin with. The meditation simply increased their levels of mindfulness to those of the men. This suggests that women have a greater tendency to react emotionally and that mindfulness training by decreasing this reactivity has greater benefits for women.

 

The results might have been different had the study measured behavioral conduct and externalizing behaviors rather than emotions. In a sense, the study played right to the issues than most trouble women and didn’t measure those that are more characteristic of males. Had they measured these factors perhaps they would have seen greater improvement in men rather than women. Regardless, women appear to benefit more emotionally from mindfulness training than men.

 

“When thrown by their feelings, men tend to “externalize” their emotions by doing things like working out, playing video games or otherwise interacting with their outer worlds. Women tend to “internalize” by analyzing and ruminating over their emotional states, psychologists say. While many men go outward — and one might argue, distract themselves from their internal world — women go inward.” – Drake Baer

 

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

Rojiani, R., Santoyo, J. F., Rahrig, H., Roth, H. D., & Britton, W. B. (2017). Women Benefit More Than Men in Response to College-based Meditation Training. Frontiers in Psychology, 8, 551. http://doi.org/10.3389/fpsyg.2017.00551

 

Abstract

Objectives: While recent literature has shown that mindfulness training has positive effects on treating anxiety and depression, there has been virtually no research investigating whether effects differ across genders—despite the fact that men and women differ in clinically significant ways. The current study investigated whether college-based meditation training had different effects on negative affect for men and women.

Methods: Seventy-seven university students (36 women, age = 20.7 ± 3.0 years) participated in 12-week courses with meditation training components. They completed self-report questionnaires of affect, mindfulness, and self-compassion before and after the course.

Results: Compared to men, women showed greater decreases in negative affect and greater increases on scales measuring mindfulness and self-compassion. Women’s improvements in negative affect were correlated to improvements in measures of both mindfulness skills and self-compassion. In contrast, men showed non-significant increases in negative affect, and changes in affect were only correlated with ability to describe emotions, not any measures of experiential or self-acceptance.

Conclusion: These findings suggest that women may have more favorable responses than men to school-based mindfulness training, and that the effectiveness of mindfulness-based interventions may be maximized by gender-specific modifications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397480/

Focus in Meditation for Cognitive Effects but Open Monitor in Meditation for Physical Effects

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Focus in Meditation for Cognitive Effects but Open Monitor in Meditation for Physical Effects

 

By John M. de Castro, Ph.D.

 

“In focused attention meditation, the focus of the mind is placed only on one thing. This implies that you have to stop everything you are doing and designate time for this type of meditation. On the other hand, in open monitoring meditation, your focus is neutral and receptive to anything that becomes present to you in the moment.” – Mind Body Vortex

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, meditation training has been called the third wave of therapies. One problem with understanding meditation effects is that there are, a wide variety of meditation techniques and it is not known which work best for improving different conditions.

 

Two types of meditation are the most commonly used practices for research purposes In focused attention meditation, the individual practices paying attention to a single meditation object, frequently the breath or a mantra, and learns to filter out distracting stimuli, including thoughts, to stay focused on the present moment, filtering out thoughts centered around the past or future. On the other hand, in open monitoring meditation, the individual opens up awareness to everything that’s being experienced regardless of its origin. These include bodily sensations, external stimuli, and even thoughts. The meditator just observes these stimuli and lets them arise, and fall away without paying them any further attention.

 

These techniques have common properties of restful attention on the present moment, but there are large differences. These differences are likely to produce different effects on the practitioner. In today’s Research News article “A selective review of dharana and dhyana in healthy participants.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5192286/

Telles and colleagues review the published literature (eight studies) on the differences in the effects of focused attention meditation and open monitoring meditation.

 

They found quite interesting differences. Focused attention meditation tended to produce greater improvements in attentional ability while open monitoring meditation tended to produce larger changes in the physiology, specifically decreased activity in the sympathetic division and increased activity in the parasympathetic division of the autonomic nervous system. The sympathetic division tends to produce greater physiological arousal, including heart rate and blood pressure increases while the parasympathetic division tends to produce greater physiological relaxation, including heart rate and blood pressure reductions.

 

The published research, then, reflects considerable difference in the effects of these two meditation types. It should not be surprising that practicing focusing attention results in improved attentional ability. But, the difficulty in actually focusing attention may be somewhat stressful. Simply allowing whatever arises to come into consciousness, on the other hand may be much more relaxing. The differences in the effects of these meditation techniques suggest that focused attention meditation may be more appropriate for enhancing attention and thought for perhaps the treatment of attention deficit disorder or aging produced reductions in cognition. On the other hand open monitoring meditation may be more appropriate for the treatment of stress related disorders.

 

So, focus in meditation for cognitive effects but open monitor in meditation for physical effects.

 

“Focused attention and open monitoring — these are the two flavors meditation comes in. Mix and match as you like; add whatever extra toppings you desire; you’ll still be left with focused attention and open monitoring. Sure, people claim that it is best — maybe even essential — to concentrate on this or that in order to benefit the most from meditation. Others would have us believe that open awareness/monitoring needs to be done in a certain fashion, which obviously seems to belie the point of being open to whatever.“ – Brian Hines

 

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

Telles, S., Singh, N., Gupta, R. K., & Balkrishna, A. (2016). A selective review of dharana and dhyana in healthy participants. Journal of Ayurveda and Integrative Medicine, 7(4), 255–260. http://doi.org/10.1016/j.jaim.2016.09.004

 

Abstract

Attention is an important part of the process of meditation. Traditional Yoga texts describe two stages of meditation which follow each other in sequence. These are meditative focusing (dharana in Sanskrit) and effortless meditation (dhyana in Sanskrit). This review evaluated eight experimental studies conducted on participants in normal health, who practiced dharana and dhyana. The studies included evaluation of autonomic and respiratory variables, eLORETA and sLORETA assessments of the EEG, evoked potentials, functional magnetic resonance imaging, cancellation task performance and emotional intelligence. The studies differed in their sample size, design and the method of practicing dharana and dhyana. These factors have been detailed. The results revealed differences between dharana and dhyana, which would have been missed if the two stages of meditation had not been studied separately.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5192286/