Meditation

Meditation Can Reduce the Age-Associated Degeneration of the Brain

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Meditation Can Reduce the Age-Associated Degeneration of the Brain

 

By John M. de Castro, Ph.D.

 

“The brain begins to decline in the 20s, and continues to decrease in volume and weight through old age. Meditation, in addition to boosting emotional and physical well-being at any time in life, may be an effective way to prevent neurodegenerative diseases like dementia, Alzheimer’s and Parkinson’s, as well as help stave off some of the normal cognitive decline that comes with aging. The strategy is free, and it comes with no side effects.” – Carolyn Gregoire

 

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decreases during aging. The aging process involves a systematic progressive decline in every system in the body, the brain included. Starting in the 20s there is a progressive decrease in the volume and activity of the brain as the years go by.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity.  Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread area. and have found that meditation practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits. In addition, they have been able to investigate various techniques that might slow the process of neurodegeneration that accompanies normal aging. They’ve found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners.

 

In today’s Research News article “Reduced age-associated brain changes in expert meditators: a multimodal neuroimaging pilot study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578985/, Chételat and colleagues recruited expert meditators with at least 10 years of experience and a total of at least 15,000 hours of meditation practice and age matched meditation naïve controls. They also included non-meditators at a wide range of ages, 20-87 years. They all underwent scanning of the brain with either Positron Emission Tomography (PET) or Magnetic Resonance Imaging (MRI). They were measured for verbal fluency, episodic memory, short-term memory, and working memory, processing speed and executive functions, frequency of participation in leisure activities before 30 and from 30 to 65 years, and the highest level of occupation reached, adherence to Mediterranean diet, sleep quality and sleep disturbance.

 

They found that the older the meditation naïve participants the lower the volume of the brain gray matter and the lower the brain metabolism. Hence, they demonstrated, as have many others, age related degeneration of the brain. On the other hand, the expert meditators had significantly greater brain gray matter volume and metabolic activity than the age matched controls in the bilateral ventromedial prefrontal and anterior cingulate cortex, insula, temporo-parietal junction, and posterior cingulate cortex /precuneus. All of the expert meditators were over 60 yet their brain volumes were in the range of meditation naïve controls in their 30s and 40s.

 

These are remarkable results that suggest that large amounts of meditation practice can help to preserve the brain countering age related decline. The amount of meditation performed by these expert meditators is so high as to be unrealistic for use with the general population. Fortunately, other research suggests that the elderly brain changes positively in response to much lower amounts of mindfulness practice. So, mindfulness training may well be a feasible practice to protect the brains of seniors from further deterioration.

 

So, use meditation to reduce the age-associated degeneration of the brain

 

“A growing body of research supports the immediate benefits of meditation, such as reduced stress and anxiety levels, lower blood pressure, and enhanced happiness. Studies on mindfulness interventions show these effects are common in as few as eight weeks. While these initial perks may be reason enough for us to practice, meditation’s positive impact appears to be even more far-reaching, potentially adding years to our lives and improving cognitive function well into old age.” – Rina Deshpande

 

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

 

Chételat, G., Mézenge, F., Tomadesso, C., Landeau, B., Arenaza-Urquijo, E., Rauchs, G., … Lutz, A. (2017). Reduced age-associated brain changes in expert meditators: a multimodal neuroimaging pilot study. Scientific Reports, 7, 10160. http://doi.org/10.1038/s41598-017-07764-x

 

Abstract

Aging is associated with progressive cerebral volume and glucose metabolism decreases. Conditions such as stress and sleep difficulties exacerbate these changes and are risk factors for Alzheimer’s disease. Meditation practice, aiming towards stress reduction and emotion regulation, can downregulate these adverse factors. In this pilot study, we explored the possibility that lifelong meditation practice might reduce age-related brain changes by comparing structural MRI and FDG-PET data in 6 elderly expert meditators versus 67 elderly controls. We found increased gray matter volume and/or FDG metabolism in elderly expert meditators compared to controls in the bilateral ventromedial prefrontal and anterior cingulate cortex, insula, temporo-parietal junction, and posterior cingulate cortex /precuneus. Most of these regions were also those exhibiting the strongest effects of age when assessed in a cohort of 186 controls aged 20 to 87 years. Moreover, complementary analyses showed that these changes were still observed when adjusting for lifestyle factors or using a smaller group of controls matched for education. Pending replication in a larger cohort of elderly expert meditators and longitudinal studies, these findings suggest that meditation practice could reduce age-associated structural and functional brain changes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578985/

Relieve Medical Professional Burnout with Mindfulness

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Relieve Medical Professional Burnout with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness programs in the workplace may help employees better deal with stress, and develop the ability to observe negative emotions and automatic thought patterns and behaviors, and remain calm, present, self-aware and alert, rather than succumbing to the slippery slope of negative emotions.” – Grace Bullock

 

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. 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. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout it is a threat to the healthcare providers and their patients. 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. But, 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.

 

In today’s Research News article “Effect of heartfulness meditation on burnout, emotional wellness, and telomere length in health care professionals.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463663/, Thimmapuram and colleagues recruited hospital medical residents, staff physicians and nurses and allowed them to choose to participate in a no-treatment control condition or receive once a week for 12 weeks of meditation training consisting of one weekly 30-minute training session and morning and evening home practice. They were measured before and after training for burnout and emotional wellness. They also supplied salivary samples that were assayed for the molecular genetic aging marker of telomere length.

 

Following the 12-week intervention the meditation group had significant improvements in burnout including decreases in emotional exhaustion and depersonalization and a significant increase in feelings of personal accomplishment. The meditation group also had significant increases in measures of emotional wellness. In addition, the younger meditation participants (< 35 years of age) had a significant increase in telomere length.

 

The results are interesting but the study has a number of methodological shortcomings that prevent clear conclusions. These include self-selection for conditions and a no-treatment control producing potential confounding from participant bias, placebo effects, attention effects, experimenter bias, etc. There is evidence, however, from a number of better controlled prior studies that indicate that meditation practice can significantly relieve the symptoms of burnout and increase telomere length.

 

So, relieve medical professional burnout with mindfulness.

 

“Dealing with sick, scared, suffering and dying patients is draining all by itself. Throw in distraction by negative emotions like worry, anger, frustration, righteous indignation … and you can easily double the energy drain. Mindfulness is incredibly valuable, because it brings the energy drain of non-supportive thoughts and feelings to a screeching halt.” – Dike Drummond

 

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

 

Thimmapuram, J., Pargament, R., Sibliss, K., Grim, R., Risques, R., & Toorens, E. (2017). Effect of heartfulness meditation on burnout, emotional wellness, and telomere length in health care professionals. Journal of Community Hospital Internal Medicine Perspectives, 7(1), 21–27. http://doi.org/10.1080/20009666.2016.1270806

 

ABSTRACT

Background: Burnout poses significant challenges during training years in residency and later in the career. Meditation is a tool to treat stress-related conditions and promote wellness. Telomere length may be affected by burnout and stress. However, the benefits of meditation have not been fully demonstrated in health care professionals.

Objective: We assessed the effects of a 12-week ‘Heartfulness Meditation’ program on burnout, emotional wellness, and telomere length in residents, faculty members, and nurses at a large community teaching hospital during the 2015–16 academic year.

Methods: All subjects completed a baseline Maslach Burnout Inventory (MBI) and Emotional Wellness Assessment (EWA) at the beginning of the study. Meditators received instructions in Heartfulness Meditation. At week 12, subjects completed a follow up MBI and EWA scores. Salivary telomere length was measured at baseline and week 12.

Results: Twenty-seven out of a total 155 residents (17.4%) along with eight faculty physicians and 12 nurses participated in the study. Thirty-five enrolled as meditators and 12 as controls. At 12 weeks, the meditators had statistically significant improvement in all measures of burnout and in nearly all attributes of EWA. Controls showed no statistically significant changes in either burnout or emotional wellness scores. Relative telomere length increased with statistical significance in a younger subset of meditators.

Conclusion: Our results indicate that meditation offers an accessible and efficient method by which physician and nurse burnout can be ameliorated and wellness can be enhanced. The increased telomere length is an interesting finding but needs to be confirmed with further research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463663/

Increase Spirituality and Positive Emotions in Meditation with Oxytocin

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Increase Spirituality and Positive Emotions in Meditation with Oxytocin

 

By John M. de Castro, Ph.D.

 

“A meditation practice gives you the benefit of turning inward to your spirituality for answers, instead of looking to others. Meditation can drastically improve the loneliness, or longing you have in your life. Reach a state of interconnectedness with others and with your higher self, improve the joy you feel daily and become a compassionate person, free of fear and anxiety.” – EOC Institute

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred.” Spirituality has been promulgated as a solution to the challenges of life both in a transcendent sense and in a practical sense. The transcendent claims are untestable with the scientific method. But, the practical claims are amenable to scientific analysis. There have been a number of studies of the influence of spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health.

 

Oxytocin is a hormone and a neuromodulator that affects both the peripheral physiology and the brain. High levels of Oxytocin have been associated with high levels of social bonding and spirituality. But, the fact that the Oxytocin and spirituality are related does not demonstrate that there’s a causal connection. To determine if Oxytocin actually produces increased spirituality there is a need to manipulate its levels and observe its effects on spirituality. In today’s Research News article “Effects of oxytocin administration on spirituality and emotional responses to meditation.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040919/, Van Cappellen and colleagues examine the relationship of Oxytocin with spirituality by actively manipulating its levels and observing its effects on spirituality and well-being.

 

Van Cappellen and colleagues recruited meditation naïve males between the ages of 35 and 65 years and randomly assigned them to either receive Oxytocin or a placebo administered via a nasal spray in a double-blind fashion. Before administration the participants were genotyped for the oxytocin receptor gene. After administration the participants were administered a 20-minute guided meditation and measured for emotions afterward. Both before and after administration and 1 week later the participants completed two measures of spirituality, a measure of positive and negative emotions, and involvement in religious organizations.

 

They found that after oxytocin administration in comparison to placebo there was a significant, 33%, increase in spirituality, including interconnectedness and meaning and purpose, that were maintained one week later. They also had significantly greater positive emotions during and after meditation that were significantly mediated by the increases in spirituality. That is, oxytocin increased spirituality that, in turn, increased positive emotions associated with meditation. Finally, they found that these effects were modulated by variants of oxytocin receptor genes.

 

This was an interesting, tightly controlled study that demonstrated that elevated levels of oxytocin cause a lasting increase in spirituality and positive emotions during and after meditation. The fact that these effects are modulated by different variant of receptor genes suggests that different individuals are biologically predisposed to spirituality. So, spirituality is at least in part influenced by the biology and has the effect of improving the individuals’ mood.

 

So, increase spirituality and positive emotions in meditation with oxytocin.

 

“Awe involves that assimilation — giving up your cognitive structures in order to accommodate [the object of awe]. And mindfulness is a little bit about that too, because you’re paying attention and exercising non-conceptual awareness, so you should be more open to the immensity that’s there. You step out of the small frame that you have and this small idea of what the world is… You’re not stuck in your own story.” – Brian Ostafin

 

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

 

Van Cappellen, P., Way, B. M., Isgett, S. F., & Fredrickson, B. L. (2016). Effects of oxytocin administration on spirituality and emotional responses to meditation. Social Cognitive and Affective Neuroscience, 11(10), 1579–1587. http://doi.org/10.1093/scan/nsw078

 

Abstract

The oxytocin (OT) system, critically involved in social bonding, may also impinge on spirituality, which is the belief in a meaningful life imbued with a sense of connection to a Higher Power and/or the world. Midlife male participants (N = 83) were randomly assigned to receive intranasal OT or placebo. In exploratory analyses, participants were also genotyped for polymorphisms in two genes critical for OT signaling, the oxytocin receptor gene (OXTR rs53576) and CD38 (rs6449182 and rs3796863). Results showed that intranasal OT increased self-reported spirituality on two separate measures and this effect remained significant a week later. It also boosted participants’ experience of specific positive emotions during meditation, at both explicit and implicit levels. Furthermore, the effect of OT on spirituality was moderated by OT-related genotypes. These results provide the first experimental evidence that spirituality, endorsed by millions worldwide, appears to be supported by OT.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040919/

Protect the Aging Brain with Meditation

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Protect the Aging Brain with Meditation

 

By John M. de Castro, Ph.D.

 

“long-term engagement in mindfulness meditation may enhance cognitive performance in older adults, and that with persistent practice, these benefits may be sustained. That’s great news for the millions of aging adults working to combat the negative effects of aging on the brain.” B. Grace Bullock

 

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decreases during aging. The aging process involves a systematic progressive decline in every system in the body, the brain included. Starting in the 20s there is a progressive decrease in the volume of the brain as we age.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity.  Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread area. and have found that meditation practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits. In addition, they have been able to investigate various techniques that might slow the process of neurodegeneration that accompanies normal aging. They’ve found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners.

 

In today’s Research News article “Promising Links between Meditation and Reduced (Brain) Aging: An Attempt to Bridge Some Gaps between the Alleged Fountain of Youth and the Youth of the Field.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447722/, Kurth and colleagues review and summarize the published research literature on the neuroprotective effects of meditation in the elderly. They discuss the ideas that the aging based deterioration of the brain is due to a number of processes, including changes in the DNA telomeres, inflammation, stress, and neuroplasticity and that meditation appears to effect all of these processes.

 

There has accumulated evidence that meditation protects against age related decline at the molecular genetic level. As we age the length of a DNA structures called the telomeres progressively shorten. It is thought that the shorter the telomeres get the more difficult it becomes for cells to replicate properly and thus leads to decline. Mindfulness training in general and meditation specifically, has been shown to reduce the shortening of the telomeres with aging. Kurth and colleagues speculate that this is one mechanism by which meditation protects the brain from age related decline.

 

As we age the natural inflammatory response that normally occurs to protect against infection begins to increase in general and lose its specificity to fighting particular diseases, pathogens, and injuries. It becomes more widespread damaging normal tissues. Mindfulness training in general and meditation specifically has been shown to reduce inflammatory responses. It seems reasonable that this is another mechanism by which meditation protects the body from age related decline.

 

Stress is present throughout life. But if it is too intense or prolonged the biological responses to stress begin to damage the body. These stress induced changes are similar to age related deterioration. Stress effects may accumulate over time. Hence, the older we get the greater the total stress induced damage. Mindfulness training in general and meditation specifically has been shown to improve emotion regulation and to reduce the physiological and psychological responses to stress. This is hypothesized to be another mechanism by which meditation protects the brain from deterioration with aging.

 

Neuroplasticity is a change in the size and connectivity of brain structures as they are exercised over a prolonged period of time. Mindfulness training in general and meditation specifically has been shown to produce neuroplastic changes in the brain, increasing the size and connectivity of brain structures. This process would tend to counteract brain degeneration with aging and may be another mechanism by which meditation protects the brain during aging.

 

Hence there has accumulated evidence that meditation reduces the deterioration of the brain with aging. It appears to do so by altering a number of different mechanisms including changes in the DNA telomeres, inflammation, stress, and neuroplasticity. This protection of the brain may be responsible to the ability of meditation to reduce the decline in mental abilities that occur with aging. This would tend to make aging a more benign process.

 

So, protect the aging brain with meditation.

 

We expected rather small and distinct effects located in some of the regions that had previously been associated with meditating. Instead, what we actually observed was a widespread effect of meditation that encompassed regions throughout the entire brain.” – Florian Kurth

 

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

 

Kurth, F., Cherbuin, N., & Luders, E. (2017). Promising Links between Meditation and Reduced (Brain) Aging: An Attempt to Bridge Some Gaps between the Alleged Fountain of Youth and the Youth of the Field. Frontiers in Psychology, 8, 860. http://doi.org/10.3389/fpsyg.2017.00860

 

Abstract

Over the last decade, an increasing number of studies has reported a positive impact of meditation on cerebral aging. However, the underlying mechanisms for these seemingly brain-protecting effects are not well-understood. This may be due to the fact, at least partly, that systematic empirical meditation research has emerged only recently as a field of scientific scrutiny. Thus, on the one hand, critical questions remain largely unanswered; and on the other hand, outcomes of existing research require better integration to build a more comprehensive and holistic picture. In this article, we first review theories and mechanisms pertaining to normal (brain) aging, specifically focusing on telomeres, inflammation, stress regulation, and macroscopic brain anatomy. Then, we summarize existing research integrating the developing evidence suggesting that meditation exerts positive effects on (brain) aging, while carefully discussing possible mechanisms through which these effects may be mediated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447722/

Improve Opiate Relief of Low Back Pain with Mindfulness

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Improve Opiate Relief of Low Back Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“I’ve been doing research on back pain for 30 years. The biggest revolution has been the understanding that it’s not just a physical problem with physical solutions. It’s a biopsychosocial problem.” – Daniel Cherkin

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. The pain interferes with daily living and with work, interfering with productivity and creating absences. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years.

 

Pain involves both physical and psychological issues. Physically, exercise can be helpful in strengthening the back to prevent or relieve pain. Psychologically, the stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain.

 

There have been few attempts to study the combination of opiate treatment with mindfulness training for the treatment of chronic low back pain. In today’s Research News article “Mindfulness Meditation-Based Intervention Is Feasible, Acceptable, and Safe for Chronic Low Back Pain Requiring Long-Term Daily Opioid Therapy.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991566/, Zgierska and colleagues examine their combination. They recruited patients with chronic low back pain who have been taking daily opiates for at least 3 months and randomly assigned them to either continue opiate treatment or to continue it in combination with mindfulness training. Mindfulness training consisted of once a week for 8 weeks, 2-hour sessions with training in breath meditation, walking meditation, loving kindness meditation, and body scan. Participants were also required to practice at home. Before and after treatment and 18 weeks later the patients were measured for pain severity, physical function (disability), and opioid intake and side effects. After treatment, they also completed measures of adherence to the treatment protocol and satisfaction with the treatment.

 

They found that there were significant decreases in pain severity and pain sensitivity in the mindfulness treatment group at the 18-week follow-up. No adverse events were reported and opioid use declined slightly albeit not significantly. None of the participants withdrew from the study and there was a 91% adherence to treatment protocol rate. Additionally, participants were satisfied with the intervention and generally planned to continue practice.

 

These results are very exciting and suggest that mindfulness training is an acceptable, safe, and effective supplement to opioid treatment for pain relief in chronic back pain patients. Given that the patients were already on pain killers, this was a remarkable effect of mindfulness training. It is thought that mindfulness training reduces pain by interrupting the patients’ psychological reactions to pain. Mindfulness is known to improve emotion regulation, and reduce stress effects, fear, worry, and anxiety all of which can amplify pain. By eliminating these factors that magnify the pain, mindfulness practice reduces the patients’ overall pain level.

 

So, improve opiate relief of low back pain with mindfulness.

 

“We are accumulating evidence that meditation’s effects on pain can be realized with very short training. A fast-acting, non-pharmacological, inexpensive treatment for chronic pain? That might be a pill everyone can swallow.” – Stephani Sutherland

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Zgierska, A. E., Burzinski, C. A., Cox, J., Kloke, J., Singles, J., Mirgain, S., … Bačkonja, M. (2016). Mindfulness Meditation-Based Intervention Is Feasible, Acceptable, and Safe for Chronic Low Back Pain Requiring Long-Term Daily Opioid Therapy. Journal of Alternative and Complementary Medicine, 22(8), 610–620. http://doi.org/10.1089/acm.2015.0314

 

Abstract

Objective: Although mindfulness meditation (MM) is increasingly used for chronic pain treatment, limited evidence supports its clinical application for opioid-treated chronic low back pain (CLBP). The goal of this study was to determine feasibility, acceptability, and safety of an MM-based intervention in patients with CLBP requiring daily opioid therapy.

Design: 26-week pilot randomized controlled trial comparing MM-based intervention, combined with usual care, to usual care alone.

Setting: Outpatient.

Patients: Adults with CLBP treated with ≥30 mg of morphine-equivalent dose (MED) per day for 3 months or longer.

Interventions: Targeted MM-based intervention consisted of eight weekly 2-hour group sessions and home practice (30 minutes/d, 6 days/wk) during the study. “Usual care” for opioid-treated CLBP was provided to participants by their regular clinicians.

Outcome measures: Feasibility and acceptability of the MM intervention were assessed by adherence to intervention protocol and treatment satisfaction among experimental participants. Safety was evaluated by inquiry about side effects/adverse events and opioid dose among all study participants.

Results: Thirty-five participants enrolled during the 10-week recruitment period. The mean age (±standard deviation) was 51.8 ± 9.7 years; the patients were predominantly female, with substantial CLBP-related pain and disability, and treated with 148.3 ± 129.2 mg of MED per day. All participants completed baseline assessments; none missed both follow-up assessments or withdrew. Among experimental participants (n = 21), 19 attended 1 or more intervention sessions and 14 attended 4 or more. They reported, on average, 164.0 ± 122.1 minutes of formal practice per week during the 26-week study and 103.5 ± 111.5 minutes of brief, informal practice per week. Seventeen patients evaluated the intervention, indicating satisfaction; their qualitative responses described the course as useful for pain management (n = 10) and for improving pain coping skills (n = 8). No serious adverse events or safety concerns occurred among the study participants.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991566/

Let the Dharma Do You!

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Let the Dharma Do You!

 

By John M. de Castro, Ph.D.

 

“To truly be in the moment, to not be defined by expectation, requires mindful clarity; a heart conditioned by love, compassion, and empathetic joy for others; and equanimity that allows you to receive life however it unfolds. This can inspire and orient you in how to live in the moment. You simply lay aside your expectations as best as you are able. You may be surprised when you discover how much choice you have in letting go of expectations. When you do this, you are showing up for what you value and discovering a sense of joy and ease that is independent of the conditions in your life.” – Phillip Moffitt

 

In mindfulness meditation, we are instructed to let go of trying to control our experience and instead let things be as they are. This seems like a simple instruction until it begins to dawn on us that the act of letting go is itself an attempt to control experience. We, in essence, try to control not controlling! But, if we let go of this control, then experience is taken over by our naturally controlling mind. It would appear that there is no solution, we are caught in a trap. This seemingly makes it impossible to comply with the instruction to let go of trying to control our experience. How can we possibly follow the teaching (Dharma)?

 

When we enter into meditation our first task is to focus our attention. The focus can be on the breath, a mantra, the body, etc., regardless we attempt to hold this single thing in our attention. This is obviously not letting go as we’re consciously exerting control on our attention. But it’s a step in the right direction, as we’re attempting to occupy our minds so that thoughts, memories, and plans are less likely than usual to enter consciousness. It will be readily recognized by all who have attempted meditation that this is devilishly difficult to do. Inevitably and frequently the mind wanders away and thoughts, memories, and plans flood into consciousness. What we discover is that the harder we try to control this and prevent our minds from wandering, the more and more they tend to. As Adyashanti likes to say, “if you go to war with your mind, you’ll be at war forever.”

 

So, what are we to do? The answer is ridiculously simple. We need to patiently let the Dharma do us. The key is not to try to control the mind, but to simply relax and let the mind settle. As we practice meditation, we can notice that over time, our concentration gets better and better and mind wandering occurs less and less. This is a slow process and may take months or years to be at the level that’s noticeable. But, if we simply relax and try to focus our attention, it will occur. One of the keys is to not get upset when we fail and the mind wanders. We need to just patiently relax and recognize that the mind is simply doing what it was designed to do. Be OK with that. Rather we should congratulate ourselves when we return to the focus of the meditation. Recognize what a miracle it is that we’ve let go of the mind wandering. Take note that letting go occurred spontaneously. We actually didn’t have to do anything. If we just relax, letting go will spontaneously happen. This is allowing the teachings (Dharma) do us.

 

Now, in the course of meditation, every once in a while, our mind settles, and we become simply an observer of the sensations occurring in the present moment. This may only occur for a very short time, perhaps seconds, but occasionally it will spontaneously occur. Once again, we should congratulate ourselves that we truly let go. Don’t let judgement and recriminations creep in that it couldn’t be maintained. Simply revel in the fact that letting go spontaneously occurred. Simply, meditate without attempting to produce it, control it, or hold onto it. Just simply note when it spontaneously happens, recognize it, and enjoy it. There’s nothing more to it. We’re just letting the process do us.

 

The peace and serenity we feel during the periods of letting go, even brief ones, will reinforce the process and make it more likely to occur again in the future. It simply feels good to experience such silence and peace. Our natural hedonic instincts to seek pleasure will take over. Slowly, perhaps taking months or years, the periods of letting go will become longer and more frequent. As long as we don’t try to control them but simply let them happen and then don’t try to hold onto them, the normal natural process will happen. As we let this occur, peace, silence, and serenity become stronger and stronger and the minds attempts to control it becomes weaker and weaker. We begin to spend more and more time in our meditation in just being, in a state of relaxed joyful awareness.

 

This is not a linear process. We can do this well one week and terribly the next. Don’t get discouraged, the process will unfold and the good weeks will become more and more frequent and have more and longer periods of serenity and the bad weeks will have less and less and shorter periods of mind wandering. Think of the process as being like a roller coaster that is positioned on a gradual upward slope. Understanding this will help to prevent discouragement. Just know that you are moving up the slope.

 

It has to be reiterated, that you don’t have to do anything for this to occur. In fact, the more you try to do, the less success you will have. Simply set up the conditions for success, regular meditation, and it will happen on its own as the Dharma does us.

 

“Letting go isn’t an immediate phenomenon. It is a process. Craving to let go and attaching to the idea that we will be happy once we let go of this one thing is harmful. We have to let it happen. Bring your awareness to the experience of aversion and impermanence. Bring your awareness to the craving to be rid of it. Letting go is a practice in allowing space for our experience.” – Elizabeth Key-Comis

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

Improve 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/

No Escape

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No Escape

 

By John M. de Castro, Ph.D.

 

Contemplative practice is, for the most part, a wonderful, relaxing, and peaceful endeavor. Engaging in it makes us feel refreshed and rested. This is wonderful, but can be a trap. We can use it as another in our arsenal of tactics to escape from a reality. This is a mistake and a lost opportunity.

 

Our lives are generally full of problems, from work, to family, to relationships, to health, to the challenges of getting it all done in a 24-hour day. In addition, we bring baggage from the past in the form of unresolved issues from childhood, or traumatic experiences, or deep emotional hurts. We also are confronted with fears and anxieties about an uncertain future. The totality of all of these problems can be overwhelming.

 

A frequent response is to try to escape them through various distractions such as the media, the internet, sports, alcohol and drugs, etc. It is useful to give ourselves a break once in a while and relieve some of the stress. But, if this is all we do, then it prevents us from addressing the problems and these distractions become an additional problem.

 

Our contemplative practice should not be added to the list of escape tactics. Indeed, contemplative practice is not an escape. Many people believe that spiritual awakening, aka enlightenment, will be an escape from their human problems. That is simply not the case. After awakening, all our problems are still there.

 

Contemplative practice should be employed to quiet the mind and allow for space for the emotions to be fully and honestly experienced. This sets the stage for being able to confront our problems, contemplate resolutions, and work through unresolved issues with a calm clarity. With the mind’s incessant chatter at least slightly muted and the emotions reduced to manageable intensity, we have to opportunity to honestly address our problems.

 

Contemplative practice is not the time to try to address the problems. It is the time to set the stage for addressing the problems. So, do not enter contemplative practice with the intent of thinking about the issues. Enter it as a time to allow the mind and physiology to settle and to enter into a present moment mindset. Regardless, the mind will inevitably wander and our deepest issues will emerge.

 

This can be seen in the amplified context of a silent meditation retreat. Here we cannot escape from our problems. They frequently emerge with full force and we are forced to confront them. Retreat can be an emotionally wrenching experience. Most can deal with it and benefit greatly by bringing them into the light of day and confronting them. But others can be overwhelmed. Retreat must be entered into with caution and with the presence of an understanding and experienced staff, to help us when the emotions become too strong to handle.

 

Hence, contemplative practice is not another escape but a means to get us prepared to fully address our deepest issues.

 

So, engage in contemplative practice and engage in dealing with the problems of life. The two endeavors complement each other.

 

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

Reduce Mild Aging Cognitive Decline with Yogic Meditation

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Reduce Mild Aging Cognitive Decline with Yogic Meditation

 

By John M. de Castro, Ph.D.

 

“The healthier and more active one’s lifestyle, the more likely he or she will maintain cognitive performance over time. And meditation may be a key ingredient for ensuring brain health and maintaining good mental performance.” – Grace Bullock

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our mental abilities which decline with age including impairments in memory, attention, and problem solving ability. It is inevitable and cannot be avoided. But, there is some hope for age related cognitive decline, as there is evidence that it can be slowed. There are some indications that physical and mental exercise can reduce the rate of cognitive decline and lower the chances of dementia. For example, contemplative practices such as meditation, yoga, and Tai Chi and Qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging. Mindfulness practices have been shown to improve cognitive processes.

 

Yoga is a mindfulness practice that is safe and applicable to the elderly. So, it could potentially be an ideal practice for the slowing of age related cognitive decline. In today’s Research News article “A randomized controlled trial of Kundalini yoga in mild cognitive impairment.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540331/, Eyre and colleagues recruited elderly (older than 55 years of age, average 68) with a mild degree of cognitive impairment and randomly assigned them to a 12 week, 60 minutes once a week, standard memory enhancement treatment or to yogic meditation practice, Kundalini Yoga. Daily homework was assigned. Kundalini Yoga includes meditation, breathing exercises, and mantra practice. The participants were measured before and after training and 12 weeks later for memory ability, executive function, resilience, physical and cognitive symptoms, neuropsychiatric symptoms, illness, apathy, and mood including depression.

 

They found that following training both the yoga and memory enhancement groups had significant improvements in memory and apathy and these improvements were still present 12 weeks after the end of training. In contrast, only the Kundalini Yoga group had significant improvements in depression, resilience, and executive function, including cognitive flexibility, response inhibition, and semantic fluency. Hence, both groups improved in memory and apathy, but only the Kundalini Yoga group also improved in mood, resilience, and higher-level thinking (cognitive function).

 

These are exciting findings suggesting the Kundalini Yoga is a safe and effective treatment that for age related declines in cognitive function, depression, apathy, and memory and improves stress resilience. It has been demonstrated that mindfulness training produces a wide variety of benefits for the elderly including mood, memory and cognitive improvements. So, Kundalini Yoga can be added to the list of effective mindfulness trainings for the elderly.

 

This was an excellent study as the comparison condition was the current “gold standard” of treatment for mild cognitive impairment in the elderly, memory enhancement training. Yet, Kundalini Yoga was significantly more beneficial. The improvement in stress resilience is important and may underlie some of the other benefits of the Kundalini Yoga training. Aging can produce considerable economic, physical, psychological, and social stresses. Improvement in the ability to withstand the effects of these stresses should be highly beneficial by decreasing the impact of these stresses on other aspects of physical and psychological functioning in the elderly.

 

So, reduce mild aging cognitive decline with yoga.

 

“Meditation could be a promising intervention in contrasting the negative effects of aging. Indeed, it has been shown to enhance cognitive efficiency in several domains, such as attention and executive functions.” Marco Sperduti

 

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

 

Eyre, H. A., Siddarth, P., Acevedo, B., Van Dyk, K., Paholpak, P., Ercoli, L., … Lavretsky, H. (2017). A randomized controlled trial of Kundalini yoga in mild cognitive impairment. International Psychogeriatrics, 29(4), 557–567. http://doi.org/10.1017/S1041610216002155

 

Abstract

Background

Global population aging will result in increasing rates of cognitive decline and dementia. Thus, effective, low-cost, and low side-effect interventions for the treatment and prevention of cognitive decline are urgently needed. Our study is the first to investigate the effects of Kundalini yoga (KY) training on mild cognitive impairment (MCI).

Methods

Older participants (≥55 years of age) with MCI were randomized to either a 12-week KY intervention or memory enhancement training (MET; gold-standard, active control). Cognitive (i.e. memory and executive functioning) and mood (i.e. depression, apathy, and resilience) assessments were administered at baseline, 12 weeks and 24 weeks.

Results

At baseline, 81 participants had no significant baseline group differences in clinical or demographic characteristics. At 12 weeks and 24 weeks, both KY and MET groups showed significant improvement in memory; however, only KY showed significant improvement in executive functioning. Only the KY group showed significant improvement in depressive symptoms and resilience at week 12.

Conclusion

KY group showed short- and long-term improvements in executive functioning as compared to MET, and broader effects on depressed mood and resilience. This observation should be confirmed in future clinical trials of yoga intervention for treatment and prevention of cognitive decline

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540331/

Improve Workaholism with Meditation

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Improve Workaholism with Meditation

 

By John M. de Castro, Ph.D.

 

“mindfulness is most impactful when it is a way of being that is seamlessly interwoven into daily life, rather than simply a standalone practice. Although it may seem difficult to abandon our attachment to electronic devices and ditch the urge to work nonstop, the space that we create for living, loving, and interacting with the world is by far worth the effort.” – Grace Bullock

 

In western culture working hard is encouraged. But, it should not become an addiction. Work, like many good things can be overdone and become damaging to productivity and the individual’s psychological and physical health and well-being. We refer to work addiction as workaholism. It has been estimated that over 10 million Americans work in excess of 60 hours per week and even though the average American receives 13 paid vacation days per year over a third do not take a single day of vacation and when they do, 30% report feeling constantly worried about work while on vacation. Most bring laptops and cell phones with them to work while on vacation. Workaholics say that they have to rush through their day to accomplish all that they want to and at the end of the day they feel that they didn’t accomplish all that they could. This overwork spills over into family life where workaholic marriages are much more likely than average to fail, with a 55% divorce rate.

 

The treatments for workaholism generally resemble treatments for other addictions. Mindfulness training has been shown to be helpful in treating addition and preventing relapse. Mindfulness has also been shown to be effective for treating and preventing burnout at work. But, to my knowledge there have not been published research studies on the application of mindfulness training for the treatment of workaholism. This was, however, addressed in today’s Research News article “Meditation awareness training for the treatment of workaholism: A controlled trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520118/, Van Gordon and colleagues recruited full-time male and female workers (mean age of 39 years) who scored high on a workaholism scale and created meditation training and wait-list control groups matched on sex, age, education level, salary, and employment type. The meditation training consisted of 2-hour meditation workshops once a week for 8 weeks and guided meditation CDs to continue practice at home. They were measured before and after training for workaholism, job satisfaction, work performance, anxiety, depression, stress, and hours of work per week both at work and at home.

 

They found that the meditation group, compared to baseline and to the wait-list control group, showed significant reductions in workaholism, hours worked per week, anxiety, depression, and stress and increases in job satisfaction. Hence, the meditation practice produced significant relief of workaholism. In addition, job performance was unchanged even though they worked fewer hours. These results suggest that a randomized controlled clinical trial is warranted with an active control group and perhaps a comparison of different therapies. They also

suggest that meditation practice is an effective treatment for workaholism.

 

So, improve workaholism with meditation.

 

“It is possible to move through the drama of our lives without believing so earnestly in the character that we play. That we take ourselves so seriously, that we are so absurdly important in our own minds, is a problem for us. We feel justified in being annoyed with everything. We feel justified in denigrating ourselves or in feeling that we are more clever than other people. Self-importance hurts us, limiting us to the narrow world of our likes and dislikes. We end up bored to death with ourselves and our world. We end up never satisfied.”
― Pema Chödrön

 

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

 

William Van Gordon, Edo Shonin, Thomas J. Dunn, Javier Garcia-Campayo, Marcelo M. P. Demarzo, Mark D. Griffiths. Meditation awareness training for the treatment of workaholism: A controlled trial. J Behav Addict. 2017 Jun; 6(2): 212–220. Published online 2017 Apr 19. doi: 10.1556/2006.6.2017.021

 

Abstract

Background and aims

Workaholism is a form of behavioral addiction that can lead to reduced life and job satisfaction, anxiety, depression, burnout, work–family conflict, and impaired productivity. Given the number of people affected, there is a need for more targeted workaholism treatments. Findings from previous case studies successfully utilizing second-generation mindfulness-based interventions (SG-MBIs) for treating behavioral addiction suggest that SG-MBIs may be suitable for treating workaholism. This study conducted a controlled trial to investigate the effects of an SG-MBI known as meditation awareness training (MAT) on workaholism.

Methods

Male and female adults suffering from workaholism (n = 73) were allocated to MAT or a waiting-list control group. Assessments were performed at pre-, post-, and 3-month follow-up phases.

Results

MAT participants demonstrated significant and sustained improvements over control-group participants in workaholism symptomatology, job satisfaction, work engagement, work duration, and psychological distress. Furthermore, compared to the control group, MAT participants demonstrated a significant reduction in hours spent working but without a decline in job performance.

Discussion and conclusions

MAT may be a suitable intervention for treating workaholism. Further controlled intervention studies investigating the effects of SG-MBIs on workaholism are warranted.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520118/