Improve Well-Being in Nurses with Mindfulness

Improve Well-Being in Nurses with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For nurses, many of them went into the field because of their ability to connect with people and make a difference in their lives. Mindfulness is a path to help us reconnect with what brings meaning to the profession. It brings humanity back to healthcare.” – Susan Bauer-Wu

 

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. 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. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout 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 and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. Hence, mindfulness may be a means to reduce burnout and improve well-being in nurses.

 

In today’s Research News article “Mindfulness to promote nurses’ well-being.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716566/), Penque recruited Registered Nurses (RNs). They participated in a Mindfulness-Based Stress Reduction (MBSR) program. The MBSR program consists of 8 weekly 1-hour group sessions involving meditation, yoga, body scan, and discussion. The participants were also encouraged to perform daily practice at home. They were measured before and after training and 3 months later for mindfulness, self-compassion, serenity, interpersonal reactivity, work satisfaction, and burnout.

 

She found that following the Mindfulness-Based Stress Reduction (MBSR) program there were significant increases in mindfulness, self-compassion including  self-kindness, common humanity, mindfulness, serenity, and interpersonal reactivity including perspective taking, and empathetic concern. There were also significant decreases in burnout, isolation, overidentification, self-judgment, and personal distress. She also found that the higher the levels of mindfulness, the higher the levels of self-compassion and serenity.

 

The results must be interpreted with caution as there wasn’t a control, comparison, group. So, potential confounds such as placebo effects, experimenter bias, Hawthorne effects, etc. were present. Other, better controlled studies, however, have demonstrated that mindfulness training increases self-compassion and reduces burnout. So, it is likely that these same benefits of mindfulness training occurred here irrespective of confounding conditions.

 

The Mindfulness-Based Stress Reduction (MBSR) program is a complex of meditation, yoga, and body scan practices. It is not possible to determine which components or combination of components were responsible for the benefits. Regardless, the results suggest that MBSR training is a safe and effective program to improve the well-being of nurses and reduce burnout. This can not only improve the psychological health of the nurses but also improve the retention of these valuable and important healthcare workers.

 

So, improve well-being in nurses with mindfulness.

 

Mindfulness can positively affect how nurses feel and cope with the pressures of their work, thereby resulting in better self-care and improved patient outcomes.” – Nursing Times

 

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

 

Penque S. (2019). Mindfulness to promote nurses’ well-being. Nursing management, 50(5), 38–44. doi:10.1097/01.NUMA.0000557621.42684.c4

 

This article examines the effects of MBSR on job-relevant factors, including mindfulness, self-compassion, empathy, serenity, work satisfaction, incidental overtime, and job burnout. Nursing is a high-stress profession that may be taking a toll on our nurses. Mindfulness-based programs can help nurses develop skills to manage clinical stress and improve their health; increase overall attention, empathy, and presence with patients and families; and experience work satisfaction, serenity, decreased incidental overtime, and reduced job burnout.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716566/

 

Happy New Year with Mindfulness

Happy New Year with Mindfulness

 

By John M. de Castro, Ph.D.

 

The object of a new year is not that we should have a new year. It is that we should have a new soul.”  ~G.K. Chesterton

 

At the stroke of midnight on December 31st all over the world revelers ring in the new calendar year with a hearty celebration. It’s a celebration of a relatively arbitrary day that has been designated as the first day of a new calendar year. The celebration of the solstice, 10 days before, at least has astrological meaning as the shortest day of the year. But, January 1 has no such physical meaning. January 1 was designated as the start of the year by Julius Caesar in 45 BC. That date was chosen to honor the Roman God Janus, the god of beginnings, whose two faces allowed him to look back into the past and forward into the future. That symbolism has stuck as the new year’s celebration involves a reflection about the year past and hope for the year to come.

 

Don’t Look Back

 

To some extent this looking back into the past and forward into the future is the antithesis of mindfulness which emphasizes the present moment. Our recollection of the past is, in fact, an illusion. When we look at the past we view it with the distorted lens of memory and the delusions that we have about the self. The memories of what happened during the last year bare only a fleeting resemblance to what actually happened. Recollections tend to be dominated by hazy and distorted memories of emotionally charged events and neglects everyday times of calm and contentment. When we look back we primarily remember the highs and the lows and believe that if we could simply keep repeating the highs and eliminate the lows then we’d be truly happy. This is the trap sometimes known as the hedonic treadmill. We keep seeking the highs and are unhappy when we can’t reproduce them or if we are successful are unhappy to find that we can’t maintain them. Unfortunately, our New Year’s celebration and our resolutions reinforce and amplify these ideas propelling us to even greater unhappiness in the new year.

 

Our view of the past is additionally distorted by the beliefs that we have about ourselves. These self-concepts are mainly incorrect and terribly distorted. Western culture, by its adoration of extraordinary and unrealistic models of perfection, produces and reinforces rampant self-dislike. We can never really attain the societal norm of perfection and this makes us feel horribly deficient. As a result, most westerners don’t like what they are and want to be different. As a consequence, people look back on the events of the year and interpret them through the lens of self-dislike.

 

We remember primarily those events that conform to our beliefs about what we should be, but cannot achieve. This creates a vicious cycle where the low self-esteem and self-worth causes us to remember events that exemplify this self-concept, creating even greater self-dislike. Those rare events that reveal us to be adequate are quickly forgotten. The events of the past year, then, are perceived as evidence to support our harsh view of ourselves. Rather than accurately remembering what actually happened during the year, our recollections are dominated by this distorted reality. So, don’t look back at the past year, rather look carefully and mindfully at yourself. You need to develop self-acceptance, before you can ever hope to have an honest idea of what the past contained.

 

Don’t Look to the Future

 

These distortions also color our thoughts about the upcoming year. We resolve to change ourselves to better conform to our unrealistic beliefs about what we should be. The New year’s resolutions that are such a common part of our new year’s celebration are a direct outgrowth of our self-dislike. The problem with these new year’s resolutions is that they are a declaration that we’re not happy with ourselves or the way things are. We want to be different. That’s not bad unto itself. Striving to better oneself is a good thing. The problem is that what we desire for ourselves is usually totally unrealistic as it’s based on a distorted reality. But, we strongly believe that this is what we need to be happy. It’s all a delusion that’s doomed to failure. In fact, research has suggested that only 8% of these resolutions are ever achieved.

 

Better New Year’s Resolutions

 

We need to craft a new set of resolutions, based upon self-acceptance, and a realistic view about what needs to be and can be achieved. The resolutions should be to better see things, including ourselves as they really are. To look at the world and ourselves mindfully without judgment, just as we are. These are the kinds of resolutions that can really work towards, not making us happy, but letting us be happy in the coming year; to simply experience the happiness that has been within us all along.

 

There are some rules of thumb about these resolutions. Don’t be too grandiose. Don’t set goals of perfection. Small steps with a recognition that you won’t always be successful are recommended. Make a resolution to practice mindfulness. Pick a practice that you not only can do, but that you can comfortably sustain. The only one perfect right practice is the one that you’ll do and keep doing. It may be meditation, yoga, body scan, tai chi or qigong, contemplative prayer, or another of the many available practices or some combination of practices. The only thing that matters is that you’re drawn to it, comfortable doing it, and you’ll stick with it. Once you start, don’t try too hard. Remember the Buddha recommended the middle way, with right effort, not too much and not too little. Practice nonjudgmentally. Don’t judge whether you’re doing it right or wrong, whether the particular practice was good or bad, or whether you’re making progress or not. Just practice. Just relax and let the practice do you. You don’t need to do it.

 

Focus on Now

 

All of these various practices promote nonjudgmental attention to what is occurring in the present moment, the now. Slowly you come to realize that the now is the only time available where you can be satisfied and happy. The past are only nows that are gone and the future are only nows that have yet to happen. So, focus on the present moment. It’s where life happens. If you can learn to be happy right now, then you’ll be able to happy in the future when it becomes now. As you look calmly, nonjudgmentally, and deeply at what is happening right now you begin to see the beauty and wonder that is there all of the time. You just need to stop ruminating about the past and worrying about the future. Learn to enjoy the moment.

 

Focusing on the present moment the impermanence of all things becomes evident. In the present we can observe things rising up and then falling away. Change is constant. If things are bad at the moment, you can be sure that it’ll change. So, be patient. On the other hand, if things are good, know also that this will change too. Don’t try to hang onto what is present. Learn to enjoy the moment as it is. These observations reveal that every moment is new. It has never happened before and it will never happen again. Every moment is a new opportunity. Don’t worry about it passing. The next moment will again provide a new opportunity. Make the most of it. If you can learn to do this, you’ll enjoy life to its fullest, as the dynamically changing perpetual now.

 

Renewal

 

In the new year, we need to not think about a “happy new year.” Rather think about a “happy new day.” In fact, it’s best to think about each “happy new moment.” Focus on the present moment and wish yourself and everyone else a “happy new moment.” Every moment is a unique opportunity to experience life as it is, appreciate its wonder, and enjoy it while it’s here, in the present moment. Each moment is an opportunity for renewal. If we’re not happy in the moment, we can be in the next. We have a new opportunity every new moment. If we pay attention to them, we can use the opportunity to create happiness.

 

So, have a “happy new moment” with mindfulness.

 

“Empty your glass and feel your way through this New Year. If it feeds your soul, do it. If it makes you want to get out of bed in the morning with a smile, carry on. Be present and let your energy synchronise with the earth and give you the clarity to move forward and be comfortable and contented with who you are. Let your intuition guide you through a wonderful year and attract an abundance of positive opportunity.” – Alfred James

 

“Many of us are thinking about new year’s resolutions and taking stock at this time, but how many of those typical resolutions are just ‘self’ improvement projects (which means we’re trying to get more, be more or have more) rather than ways to actually embrace the life we already have right here and now?” – Mrs. Mindfulness

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Mindfulness is Associated with Lower Perpetrator Levels of Physical and Sexual Dating Violence

Mindfulness is Associated with Lower Perpetrator Levels of Physical and Sexual Dating Violence

 

By John M. de Castro, Ph.D.

 

perceived partner infidelity and dating violence perpetration were positively related for women with low and mean dispositional mindfulness, but not for women with high dispositional mindfulness.” – Megan Brem

 

Dating should be a time for young people to get together, get to know one another and have fun. But all too often, dating involves violence or aggression. Nearly 1.5 million high school students in the U.S. experience physical abuse from a dating partner each year, 33% are victims of physical, sexual, emotional or verbal abuse from a dating partner, and 10% have been purposefully hit, slapped or physically hurt. Dating violence doesn’t just occur in High School as 43% of college women experience violent or abusive dating behaviors. Sadly, only about a third of the victims ever tell anyone about the abuse. Hence it is important to find ways to prevent dating violence. Mindfulness has potential to reduce dating violence.

 

In today’s Research News article “Understanding the Role of Alcohol, Anxiety, and Trait Mindfulness in the Perpetration of Physical and Sexual Dating Violence in Emerging Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579748/), Ngo and colleagues recruited emerging adults (aged 18-25) who were seeking treatment at an emergency department for any reason. They completed measures of alcohol use, mindfulness, anxiety, and perpetration of dating violence including sexual dating violence and physical dating violence.

 

They found that in both males and females alcohol consumption and high levels of anxiety were related to higher perpetrator levels of both physical and sexual dating violence. On the other hand, they report that high levels of mindfulness, particularly the acting with awareness and non-judgement facets, was related to lower perpetrator levels of both physical and sexual dating violence.

 

It needs to be kept in mind that this study is correlational and as such no definitive conclusions regarding causation can be reached. But the results suggest that dating violence, both the physical and sexual forms, are lower when mindfulness is present and when anxiety and alcohol are absent. These may be useful leads for potential interventions to reduce dating violence perpetration in emerging adults by training in mindfulness, dealing with anxiety, and reducing alcohol consumption.

 

Dating is very important to emerging adults. But dating violence is a serious problem. Discovering means to reduce the likelihood of engaging in dating violence would be highly desirable. The present results suggest that mindfulness training may be an important tool to reduce these troubling occurrences.

 

Hence, mindfulness is associated with lower perpetrator levels of physical and sexual dating violence.

 

mindfulness interventions have led to improvements across a range of mental health problems, including domains known to be associated with dating violence.” – Ryan Shorey

 

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

 

Ngo, Q. M., Ramirez, J. I., Stein, S. F., Cunningham, R. M., Chermack, S. T., Singh, V., & Walton, M. A. (2018). Understanding the Role of Alcohol, Anxiety, and Trait Mindfulness in the Perpetration of Physical and Sexual Dating Violence in Emerging Adults. Violence against women, 24(10), 1166–1186. doi:10.1177/1077801218781886

 

Abstract

This study examines alcohol consumption, anxiety, trait mindfulness, and physical and sexual dating violence aggression (PDV and SDV) among 735 emerging adults (18–25 years) in an urban emergency department. Of the total sample, 27.2% perpetrated PDV and 16.5% perpetrated SDV. Alcohol was positively associated with PDV/SDV. Anxiety was positively associated with PDV. Mindfulness was negatively associated with PDV/SDV. Interaction analyses revealed women had lower PDV with higher nonjudgment facet of mindfulness. Higher act aware was associated with lower PDV regardless of high versus low alcohol. Findings indicate different contributing factors among perpetrators of PDV/SDV; some factors may be attenuated by mindfulness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579748/

 

Reduce Suicide Risk in Young Adults with Mindfulness

Reduce Suicide Risk in Young Adults with Mindfulness

 

By John M. de Castro, Ph.D.

 

The pain of depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne. The prevention of many suicides will continue to be hindered until there is a general awareness of the nature of this pain.”– William Styron

 

After cancer and heart disease, suicide accounts for more years of life lost than any other cause. Around 43,000 people take their own lives each year in the US. Someone dies from suicide every 12.3 minutes. Worldwide over 800,000 people die by suicide every year. (Suicide Awareness Voices of Education). It is much more prevalent with males who account for 79% of suicides. The problem is far worse than these statistics suggest as it has been estimated that for every completed suicide there were 12 unsuccessful attempts. In other words, about a half a million people in the U.S. attempt suicide each year.

 

Yet compared with other life-threatening conditions there has been scant research on how to identify potential suicide attempters, intervene, and reduce suicidality. A risk factor for suicide has been found to be an inability to describe and identify emotions, alexithymia. On the other hand, mindfulness training has been shown to reduce suicidality.  Hence, there is a need to further study the relationship of alexithymia and mindfulness in affecting the risk of suicide.

 

In today’s Research News article “Mindfulness and Suicide Risk in Undergraduates: Exploring the Mediating Effect of Alexithymia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753216/), Fang and colleagues recruited undergraduate students and measured them for mindfulness, suicide risk, difficulty in identifying feelings, difficulty in describing feelings and alexithymia. They then performed regression and mediation analysis of the data.

 

They found, pretty much as expected, that the higher the levels of mindfulness the lower the levels of suicide risk, difficulty in identifying feelings, difficulty in describing feelings and alexithymia, while the higher the levels of alexithymia the higher the levels of suicide risk, difficulty in identifying feelings, difficulty in describing feelings. In addition, they found that the negative relationship between mindfulness was in part direct but also strongly mediated by alexithymia, such that the higher the levels of mindfulness the lower the levels of alexithymia which, in turn, was associated with lower suicide risk. The mindfulness – suicide risk relationship also was mediated by the alexithymia components of difficulty in identifying feelings and difficulty in describing feelings.

 

It should be noted that the present study was correlational and as such causation cannot be determined. Hopefully future research with investigate the effects of mindfulness training on suicide risk and alexithymia. Nevertheless, the present study verified that being high in mindfulness is associated with being low in the risk of committing suicide. It also verified the that being high in alexithymia is a risk factor for suicide. The new finding here is that mindfulness is associated with reduced suicide risk, in large part, by its association with lower levels of alexithymia.

 

Ignoring the problems with determining causation it can be speculated that mindfulness makes an individual more sensitive to their internal state and emotions. This is the opposite to the lower sensitivity with alexithymia. This greater sensitivity to the individual’s emotional state produced by mindfulness reduces the likelihood that negative emotions can lead to suicide. Hence, mindfulness may be a protective factor for suicide.

 

So, reduce suicide risk in young adults with mindfulness.

 

Mindful curiosity treats suicidal thoughts for what they are: a symptom, not a truth. They are a symptom that something in you needs healing. . . Mindfulness enables you to recognize just how transitory thoughts are. They come and they go, like clouds before the sun.” – Stacey Freedenthal

 

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

 

Fang, Y., Zeng, B., Chen, P., Mai, Y., Teng, S., Zhang, M., … Zhao, J. (2019). Mindfulness and Suicide Risk in Undergraduates: Exploring the Mediating Effect of Alexithymia. Frontiers in psychology, 10, 2106. doi:10.3389/fpsyg.2019.02106

 

Abstract

The present study was designed to examine the relationship between dispositional mindfulness and suicide risk in undergraduates, and it further explored the potential mediating role of alexithymia in this relationship. A total of 2,633 undergraduates completed the Mindful Attention Awareness Scale (MAAS), the Suicidal Behaviors Questionnaire – Revised (SBQ-R), and the 20-item Toronto Alexithymia Scale (TAS-20). The results indicate that mindfulness and suicide risk were negatively correlated, and alexithymia partially mediated the relationship between mindfulness and suicide risk only in the female undergraduates. Moreover, only the difficulty in identifying feelings (DIF) factor of alexithymia mediated the relationship between mindfulness and suicide risk in the female undergraduates. These findings contribute to the potential mechanism that explains the relationship between mindfulness and suicide risk. Furthermore, it is possible to implement mindfulness in the suicide intervention of alexithymic individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753216/

Indications That the Mental Health of Relatives of Long-Missing Persons Can be Improves with Mindfulness

Indications That the Mental Health of Relatives of Long-Missing Persons Can be Improves with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness for grief is not about whitewashing your pain, or “getting over” your loss. It is about learning how to stay present, cultivate compassion, and make wise choices that will help you cope with this new normal known as life after loss.” – Mindfulness and Grief Institute

 

Grief is a normal, albeit complex, process that follows a loss of a significant person or situation in one’s life. This can involve the death of a loved one, a traumatic experience, termination of a relationship, relationship to a long-missing person, etc. Exactly what transpires depends upon the individual and the nature of the loss. It involves physical, emotional, psychological and cognitive processes. In about 15% of people grief can be overly intense or long and therapeutic intervention may become necessary.

 

Mindfulness practices have been found to help with coping with loss and its consequent grief.  Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. This would seem to be an ideal treatment protocol to treat the intense emotions that occur when a loved one goes missing.

 

In today’s Research News article “Cognitive behavioural therapy and mindfulness for relatives of missing persons: a pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642737/), Lenferink and colleagues recruited “adults who experienced the disappearance of a spouse, family member, or friend more than 3 months.” They were randomly assigned to a wait-list or to receive 8 weekly sessions of an adapted form of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training for grief, Post-Traumatic Stress Disorder (PTSD) symptoms, depressive symptoms, mindfulness, and presumed causes for disappearance.

 

This was a small pilot trial and as such there were insufficient participants to assess statistical reliability of the results. But the study proved that employing Mindfulness-Based Cognitive Therapy (MBCT) for people with long-missing relatives was feasible and acceptable. They found that on average following MBCT there were increases in mindfulness and decreases in grief, PTSD symptoms, and depressive symptoms.

 

These findings are encouraging although far from definitive. They demonstrate that providing Mindfulness-Based Cognitive Therapy (MBCT) treatment for relatives of missing persons is possible and appears to help relieve the suffering of these relatives. This suggests that a larger randomized controlled clinical trial should be attempted. These relatives of missing persons are suffering from grief, depression, and PTSD symptoms and MBCT may help ease this suffering.

 

So, there are indications that the mental health of relatives of long-missing persons can be improves with mindfulness.

 

The pure practice of mindfulness is to bring your attention to exactly what is — whether that is pain or bliss, peace or torment — each moment, as it arises. At its core, mindfulness does not try to talk you out of anything, nor does it judge what you feel. It’s not a prescription for happiness. Mindfulness is meant to help you acknowledge the truth of the moment you’re in, even, or especially, when that moment hurts.” – Megan Devine

 

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

 

Lenferink, L., de Keijser, J., Wessel, I., & Boelen, P. A. (2019). Cognitive behavioural therapy and mindfulness for relatives of missing persons: a pilot study. Pilot and feasibility studies, 5, 93. doi:10.1186/s40814-019-0472-z

 

Abstract

Objectives

Relatives of long-term missing persons need to deal with uncertainties related to the disappearance. These uncertainties may give rise to ruminative thinking about the causes and consequences of the loss. Focusing on tolerating uncertainties in treatment of relatives of missing persons might foster recovery. Adding mindfulness to cognitive behavioural therapy might serve this aim. The feasibility and potential effectiveness of cognitive behavioural therapy with mindfulness were evaluated in a pilot study. We aimed to detect changes in symptom levels and mindfulness from pre-treatment to 1 week, 12 weeks, and 24 weeks post-treatment.

Method

Dutch adults who experienced the disappearance of a significant other more than 3 months earlier and scored above clinical thresholds for psychological distress were eligible to participate. Participants were recruited from January 2015 to July 2016. Participants in the immediate treatment group started treatment after 1 week after randomization, whereas waiting list controls started the treatment after 12 weeks of waiting. Data from self-report measures as well as clinical diagnostic interviews (tapping persistent complex bereavement disorder, major depressive disorder, and posttraumatic stress disorder) were gathered among 17 relatives of missing persons with elevated symptom levels.

Results

The response rate (31.7%) was low, and dropout rate (47.1%) high. Cognitive behavioural therapy with mindfulness coincided with changes in psychopathology levels (Hedges’ g 0.35–1.09) and mindfulness (Hedges’ g − 0.10–0.41). Participants completing the treatment were satisfied with treatment quality and reported high treatment compliance.

Conclusions

Because of the limited research about effective treatments for relatives of missing persons and promising results of small and/or uncontrolled trials examining the effect of mindfulness-based treatment to target grief-related complaints, it seems valuable to continue investigating the effects of cognitive behavioural therapy with mindfulness on reducing post-loss psychopathology in future research. However, in order to increase the feasibility of future trials among relatives of missing persons, we recommend collaborating internationally and/or extending duration of recruitment phase, to maximize the sample size.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642737/

 

Improve Brain Processing of Awareness and Emotions with Mindfulness

Improve Brain Processing of Awareness and Emotions with Mindfulness

By John M. de Castro, Ph.D.

 

Evidence suggests that particular areas of the brain may either shrink or grow in response to regular mindfulness practice.” – Meera Joshi

 

There has accumulated a large amount of research demonstrating that meditation practice has significant benefits for psychological, physical, and spiritual wellbeing. One way that meditation practices may produce these benefits is by altering the brain. 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.

 

Neuroscience has established that contemplative practices produce neuroplastic changes in widespread areas of the nervous system. In other words, mindfulness practices appears to mold and change the brain, producing psychological, physical, and spiritual benefits. One mindfulness therapeutic technique, Mindfulness-Based Stress Reduction (MBSR), has been commonly applied to the treatment of multiple physical and psychological conditions. The MBSR practice consists of discussion, meditation, yoga, and body scan practices. It is important to understand what are the exact changes in the brain that are produced by the MBSR training.

 

In today’s Research News article “Alterations of Regional Homogeneity and Functional Connectivity Following Short-Term Mindfulness Meditation in Healthy Volunteers.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813410/), Xiao and colleagues recruited meditation naive healthy adults who were participating in an MBSR training and a matched group of no-treatment control participants. The MBSR program met for 2 hours once a week for 8 weeks along with daily home practice. They were measured before and after training for mindfulness and positive and negative emotions. In addition, the participants’ brains were scanned with a functional magnetic resonance imaging (fMRI) technique.

 

They found that in comparison to baseline and the no-treatment controls, the participants in the Mindfulness-Based Stress Reduction (MBSR) training had significant increases in mindfulness and significant decreases in negative emotions. They also found that following MBSR training there were significant increases in the synchronization of activities in the parietal lobe and significant decreases in the synchronization of activities in the posterior cingulate cortex, precuneus, and cuneus, and increased functional connectivity in the superior parietal lobule and postcentral gyrus and the median cingulate cortex, insula and precentral gyrus.

 

The findings that Mindfulness-Based Stress Reduction (MBSR) training increases mindfulness and decreases negative emotions and affects brain structures and connectivity are well established by other studies. The parietal lobe is known to be involved in attentional and executive control brain networks. So, the findings that its’ activities synchronizations were increased by MBSR training are also not surprising, suggesting that the training improves attention. Likewise, and the posterior cingulate cortex is associated with what’s called the default mode network which is associated with mind wandering and discursive and internalized thinking. So, the findings that its’ activity synchronizations were decreased by MBSR training are also not surprising, suggesting that the training reduces mind wandering.

 

In addition, the findings that Mindfulness-Based Stress Reduction (MBSR) training increases functional connectivity of the median cingulate cortex and insula would be expected as these structures are involved in interoceptive awareness, suggesting that MBSR training heightens the awareness of the practitioner’s internal state. Finally, the findings that MBSR training increases functional connectivity of the precentral and postcentral gyrus would be expected as these structures are involved in coordination of tactile and motor information, suggesting that MBSR training heightens the bodily awareness, another component of mindfulness.

 

The findings, then, of the present study are compatible with prior findings of the effects of Mindfulness-Based Stress Reduction (MBSR) training on the practitioners’ psychological states and the brain systems underlying these states. This helps to present a clearer picture of the impact of mindfulness training on the individuals psychological processes and their underlying neural substrates. MBSR training is a combination of meditation, yoga, body scan, and experience sharing. It remains for future research to delineate which components or combinations of components may or may not be responsible for each of these effects.

 

So, improve brain processing of awareness and emotions with mindfulness.

 

“The impact that mindfulness exerts on our brain is borne from routine: a slow, steady, and consistent reckoning of our realities, and the ability to take a step back, become more aware, more accepting, less judgmental, and less reactive. . . mindfulness over time can make the brain, and thus, us, more efficient regulators, with a penchant for pausing to respond to our worlds instead of mindlessly reacting.” – Jennifer Wolkin

 

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

 

Xiao, Q., Zhao, X., Bi, G., Wu, L., Zhang, H., Liu, R., … Chen, Z. (2019). Alterations of Regional Homogeneity and Functional Connectivity Following Short-Term Mindfulness Meditation in Healthy Volunteers. Frontiers in human neuroscience, 13, 376. doi:10.3389/fnhum.2019.00376

 

Abstract

Mindfulness is described as the non-judgmental awareness of experiences in the present moment. The sustained practice of mindfulness may also have beneficial effects on an individual’s well-being. For instance, mindfulness meditation is an effective approach for improving emotion regulation. Specifically, the early stage of mindfulness meditation training enhances emotional monitoring systems related to attention regulation and executive function. Reduced activity in the default mode network (DMN) would probably be observed corresponding to the attenuated mind wandering. In the present study, we hypothesized that alterations in functional activity in the frontal-parietal cortex and DMN may be induced by short-term mindfulness meditation. In this study, before and after 8 weeks of weekly Mindfulness-Based Stress Reduction (MBSR) training, healthy participants were evaluated using a mindfulness questionnaire and an affect schedule, as well as via resting-state functional magnetic resonance imaging. Sixteen right-handed non-meditators were enrolled. Another 16 demographically matched healthy adults without any meditation experience were recruited as controls. Pre- and post-MBSR assessments were compared. Increased regional homogeneity in the right superior parietal lobule and left postcentral gyrus (PoCG), as well as altered functional connectivity in PoCG-related networks, were observed post-MBSR. The mindfulness questionnaire scores also improved and negative affect was significantly decreased after MBSR. Together with reduced involvement of the posterior brain, our results suggest a tendency toward stronger involvement of the parietal cortex in mindfulness beginners. This study provides novel evidence regarding the optimization of emotional processing with short-term mindfulness meditation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813410/

 

Enhance Enjoyment of the (Winter Solstice) Holidays with Mindfulness

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Enhance Enjoyment of the (Winter Solstice) Holidays with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Any picture-perfect image of the holidays we build up in our minds, filled with expectations of how life should be, rarely gets met for long..” – Mark Bertin

 

The end of December marks transitions. It marks the new year, transition from 2019 to 2020. It’s also the time of the winter solstice, the shortest day of the year, transitioning from shortening days to lengthening days. Since the beginning of recorded history, the solstice has been a time of celebration and merriment. For most of that time it was an extremely popular pagan celebration.

 

The Christians tried to suppress this pagan winter solstice celebration, but it was exceedingly popular and they were unsuccessful. So, instead they coopted it, turning it into a celebration of Jesus’ birth. There are no records of the actual date of Jesus’ birth, so any day could be chosen, and the time of the pagan solstice celebration was perfect. There are still many remnants of that pagan celebration carried into the Christmas celebration, including the tree, wreaths, mistletoe, holly, and even the name yule, the yule log, and the use of the word “jolly”.

 

The winter solstice is a reminder of the impermanence of all things. For months, the world has been becoming darker and colder. But the winter solstice marks the reversal of this trend. For the next several months the world will be becoming brighter and warmer. It’s a reminder that even the darkest moments are impermanent. This is true for all of the problems that occur in our lives. These too will pass.

 

Regardless of the purported reason, the end of December is a time of celebration. We now look on it as a time for giving, but the gifts are a relatively new addition that has been enthusiastically promoted by merchants. Should we be jaundiced about the celebration because of it’s confusing history, its crass commercialism, and varied religious meanings or should we participate with enthusiasm? Mindfulness tells us not to judge, just to experience what life has to offer in the moment. The holiday season has much to offer us. So, mindfulness would suggest that we don’t judge or criticize but engage mindfully in whatever way is appropriate for us.

 

Perhaps the greatest gift we can give to our family and friends at any time but especially during the holidays is our presence, not just our physical presence but our mindful attentive presence. We give to them when we deeply listen. So many conversations are superficial. So, engaging deeply with others is a special gift. It involves employing an underused skill of true listening with full attention to another, not listening on the surface while composing the next communication, but just listening with mindfulness. We in effect give to them our most precious gift, our fully engaged selves.

 

We may be surprised by what we now hear that we may have been missing for years, and what reactions occur to our deep listening. Just know that you’re giving what most people need most, to feel listened to, respected, valued and cared about. Deep listening is particularly valuable when the holiday conversation turns to controversial subjects such as politics. These conversations can be a mine field that can poison a holiday event. But deeply listen to what is being said is often sufficient, as the conversant often just wants to be heard. Making the effort to deeply listen, understand the other person’s point of view, and responding with compassion can quickly diffuse the situation.

 

The holidays are a time to focus on children. Here, also, mindfulness can improve the experience. If we mindfully observe and truly listen, we can see that what children desire most is our attention and love. Presents of toys and gadgets are opened with enthusiasm and glee. But the joy is short-lived. As with most things the happiness produced is fleeting. But, if you engage with the child, playing and giving your full attention to him/her the happiness is much more enduring. Doing this mindfully, without expectations or judgment will bring a joy and happiness to you that will also be enduring. Don’t engage with the child for personal gain, but enjoy the gain when it happens.

 

The holidays are also a time of revelry, with abundant parties and celebrations at work, with friends, and with family. Once again, engaging mindfully can improve the experience and help prevent excess. Being mindful can help us keep alcohol intake under control. By being aware of our state in the present moment we are better able to know when we reached our limit and especially, to know when to refrain from driving. Mindful eating can also help us enjoy all of the wonderful foods presented during the holidays while being aware of our actual physical state. It can help us to eat slowly, savoring the exquisite flavors, without overindulging. Engage socially mindfully without judging and deeply listening and you’ll enjoy the interactions all the more.

 

Mindfulness can also help with holiday depression. Because of the high expectations of what the holidays should be like in contrast to the experienced reality, many people get depressed. It is the time of the highest suicide rates of the year. Mindfulness is known to combat depression in ourselves. But, for the holidays we could use our mindfulness skills, particularly listening, to help vulnerable people deal with the holidays. Our compassion and loving kindness can go a long way toward helping people overcome negative mood states. Just a genuine smile can sometimes be a great mood enhancer. Mindfully give of yourself, without expectation of getting anything back. You’ll be amazed at how much good it does for others and at the benefit you will receive.

 

Finally, the underlying theme of the winter solstice and the holidays is transformation and renewal. Just as the slow decent into the short days of winter ends the slow ascent to the long days of summer begins. We can use this time to begin to transform and renew ourselves. What better way to transform ourselves than practicing mindfulness, not just on a meditation mat or in a yoga studio, but in everyday existence. Practicing mindfulness at work, while driving, while exercising, in our relationships can truly transform our lives.

 

The idea of personal transformation is reflected in the tradition of the New year’s resolution. Although this is a common tradition, few resolutions are entered into with sufficient dedication and energy to actually carry them out. We should use this holiday season to reflect mindfully on our own lives, looking deeply at what will truly help us and our families to thrive physically, emotionally, socially, and spiritually in the coming year. Then set realistic goals and concrete plans to fulfill them.

 

An excellent New Year’s resolution that can help to lead to a more fulfilling life is to simply make a commitment to be more mindful in the coming year. This should include a plan for engaging in regular practice and working to transfer mindfulness skills obtained outside of the practice. But, be realistic as to what can actually be accomplished, set small goals, and then develop a firm concrete plan to achieve them. It may be helpful to set periodic reminders in your smartphone of these plans. Pay special attention to what the effects are of engaging in the planned behaviors. It is important to recognize the progress that is being made and the positive impact that follows.

 

So, enhance the enjoyment of the (winter solstice) holidays with mindfulness.

 

“I hope that in this year to come, you make mistakes. Because if you are making mistakes, then you are making new things, trying new things, learning, living, pushing yourself, changing yourself, changing your world. You’re doing things you’ve never done before, and more importantly, you’re doing something.” – Neil Gaiman

CMCS – Center for Mindfulness and Contemplative Studies

 

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Augment Mystical Experiences in Meditation and Long-Term Well-Being with Psilocybin

Augment Mystical Experiences in Meditation and Long-Term Well-Being with Psilocybin

 

By John M. de Castro, Ph.D.

 

“Trying to harness the mind in meditation is a bit like holding a water wiggly—those tubular, slippery, jelly-filled toys that leap out of your hand whenever you try to hold onto them. With the addition of a psychedelic state of mind, it could be like grasping with a greased hand.” – Paul Austin

 

Psychedelic substances have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. Psychedelics produce effects that are similar to those that are reported in spiritual awakenings. They report a loss of the personal self. They experience what they used to refer to as the self as just a part of an integrated whole. They report feeling interconnected with everything else in a sense of oneness with all things. They experience a feeling of timelessness where time seems to stop and everything is taking place in a single present moment. They experience ineffability, being unable to express in words what they are experiencing and as a result sometimes producing paradoxical statements. And they experience a positive mood, with renewed energy and enthusiasm.

 

It is easy to see why people find these experiences so pleasant and eye opening. They often report that the experiences changed them forever. Even though the effects of psychedelic substances have been experienced and reported on for centuries, only very recently have these effects come under rigorous scientific scrutiny.

 

Psilocybin is a psychedelic substance that is found naturally in a number of varieties of mushrooms. It has been used for centuries particularly by Native Americans for their spiritual practices. When studied in the laboratory under double blind conditions, Psilocybin has been shown to “reliably occasion deeply personally meaningful and often spiritually significant experiences (e.g. mystical-type experiences).” Since the effects of meditation and psilocybin appear similar, it’s important to look at the effects of the combination of meditation with psilocybin.

 

In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813317/ ), Smigielski and colleagues recruited experienced adult meditators participating in a 5-day meditation retreat and randomly assigned them to receive either a high dose of psilocybin or a placebo. The participants were matched for age, gender, mindfulness level, and meditation experience. They were administered psilocybin or placebo on the fourth day of the retreat. Before and after and on each day of the retreat they were measured for mindfulness and meditation depth. Six hours after psilocybin or placebo administration they were measured for altered states of consciousness and mystical experiences. Four months after the retreat they were evaluated for changes in behavior by self-report and that of a significant other. They did not observe any adverse events associated with psilocybin administration.

 

They found that on the day of administration the psilocybin group had significantly greater depth of meditation and after the retreat significantly higher mindfulness. While the drugs were in effect the psilocybin group had large significant increases in altered states of consciousness, including unity, spiritual experience, blissfulness, insightfulness, and disembodiment and large significant increases in mystical experiences, including complex imagery, elementary imagery, audiovisual synesthesia, and changed meaning of percepts. Four months after the retreat the participants who were administered psilocybin had significant changes in behavior documented by themselves and a significant other including significantly greater appreciation for life, self-acceptance, quest for meaning/sense of purpose, and appreciation of death.

 

Meditation retreats have been shown to increase meditation depth, mindfulness, mystical experiences, and to produce changes in consciousness. The present results suggest that psilocybin administration produces large and significant amplifications of these effects. In fact, the participants who received psilocybin reported that the experience was equivalent to the greatest mystical experiences that they have ever had. Remarkably, the effects of the single administration were enduring, altering and deepening their acceptance of themselves as they are, their appreciation of life and death, and their sense of meaning and purpose. These results suggest that the combination of meditation with psilocybin may be a safe and effective means to improve psychological and spiritual health and well-being.

 

So, augment mystical experiences in meditation and long-term well-being with psilocybin.

 

“After the retreat, mushroom-assisted meditators reported less self-consciousness and more illusions and hallucinations than the control group. What’s more, their brains showed alterations in the functioning of the default mode network—a group of interacting brain regions linked to self-awareness and rumination—during open awareness meditation. . . . What is even more remarkable is that experienced meditators in the psilocybin group reported better social functioning four months later.” – Grace Bullock

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

Smigielski, L., Kometer, M., Scheidegger, M., Krähenmann, R., Huber, T., & Vollenweider, F. X. (2019). Characterization and prediction of acute and sustained response to psychedelic psilocybin in a mindfulness group retreat. Scientific reports, 9(1), 14914. doi:10.1038/s41598-019-50612-3

 

Abstract

Meditation and psychedelics have played key roles in humankind’s search for self-transcendence and personal change. However, neither their possible synergistic effects, nor related state and trait predictors have been experimentally studied. To elucidate these issues, we administered double-blind the model psychedelic drug psilocybin (315 μg/kg PO) or placebo to meditators (n = 39) during a 5-day mindfulness group retreat. Psilocybin increased meditation depth and incidence of positively experienced self-dissolution along the perception-hallucination continuum, without concomitant anxiety. Openness, optimism, and emotional reappraisal were predictors of the acute response. Compared with placebo, psilocybin enhanced post-intervention mindfulness and produced larger positive changes in psychosocial functioning at a 4-month follow-up, which were corroborated by external ratings, and associated with magnitude of acute self-dissolution experience. Meditation seems to enhance psilocybin’s positive effects while counteracting possible dysphoric responses. These findings highlight the interactions between non-pharmacological and pharmacological factors, and the role of emotion/attention regulation in shaping the experiential quality of psychedelic states, as well as the experience of selflessness as a modulator of behavior and attitudes. A better comprehension of mechanisms underlying most beneficial psychedelic experiences may guide therapeutic interventions across numerous mental conditions in the form of psychedelic-assisted applications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813317/

 

Mindfulness Reduces Addiction by Improving Pleasure Appreciation in Opioid Users

Mindfulness Reduces Addiction by Improving Pleasure Appreciation in Opioid Users

 

By John M. de Castro, Ph.D.

 

“mindfulness-based interventions could help people dependent on opioids increase their self-awareness and self-control over cravings and be less reactive to emotional and physical pain. Individuals with an opioid addiction could also be taught to change their negative thoughts and savor pleasant events, which may help them to regulate their emotions and experience more enjoyment.” – Science News

 

Substance abuse and addiction is a terrible problem, especially opioid pain relievers. Opioid addiction has become epidemic and is rapidly increasing affecting more than 2 million Americans and an estimated 15 million people worldwide. In the U.S more than 20,000 deaths yearly were attributed to an overdose of prescription opioids, and another 13,000 deaths from heroin overdose. These statistics, although startling are only the tip of the iceberg. Drug use is associated with suicide, homicide, motor-vehicle injury, HIV infection, pneumonia, violence, mental illness, and hepatitis. It can render the individual ineffective at work, it tears apart families, it makes the individual dangerous both driving and not.

 

An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates. Recent research is indicating that mindfulness has been found to be effective in treating addictionsMindfulness-Oriented Recovery Enhancement (MORE) was specifically developed to employ mindfulness training along with other proven methods to assist addicts in remaining off of drugs. MORE involves mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion.

 

One method to observe reward processing in the brain is to measure the changes in the electrical activity that occur in response to specific reward related stimuli. These are called event-related potentials or ERPs. The signal following a stimulus changes over time. The fluctuations of the signal after specific periods of time are thought to measure different aspects of the nervous system’s processing of the stimulus. The Late Positive Potential (LPP) response in the evoked potential (ERP) is a positive going electrical response occurring between a 4 to 8 tenths of a second following the target stimulus presentation. The LPP is thought to reflect attention to the emotional features of a stimulus.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement remediates hedonic dysregulation in opioid users: Neural and affective evidence of target engagement.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795512/), Garland and colleagues recruited chronic pain patients who were opioid users. They were randomly assigned to receive 8 weeks of either Mindfulness-Oriented Recovery Enhancement (MORE) or a therapist led support group. They were measured for brain activity with an electroencephalogram (EEG) before and after treatment and opioid use at 3-month follow-up. In one experiment they measure the EEG response (Late Positive Potential (LPP)) while being presented with opioid cues (pictures of pills and pill bottles) or a neutral picture either normally or while attempting to not react or judge the stimuli. In a separate experiment with a similar procedure except that the participants were presented with natural reward pictures (e.g., social affiliation, natural beauty, and athletic victories) or neutral pictures.

 

They found that before treatment opioid and natural reward stimuli reliably produced significantly larger Late Positive Potentials (LPP) indicating that the LPP reflected emotional responses to rewards. After treatment the group that received Mindfulness-Oriented Recovery Enhancement (MORE) had significantly smaller LPP responses to opioid related cues than the support group. When the participants were asked to not react or judge the stimuli the MORE group had significantly greater reductions in the LPP. Importantly, the participants in the MORE group had a significantly larger LPPs to natural reward stimuli and when the participants were asked to not react or judge the natural reward stimuli the MORE group had a significantly larger increases in the LPP.

 

They also investigated the subjective emotional responses of the participants to the opioid and natural reward stimuli and found that after Mindfulness-Oriented Recovery Enhancement (MORE) the participants had larger increases in response to natural reward stimuli and smaller responses to opioid related stimuli. At the 3 month follow-up they found that MORE reduced the use of opioids to a greater extent than the support group and that it did so directly and also indirectly by increasing natural reward responses which, in turn, reduced opioid use.

 

These results suggest that responses to the rewarding aspects of stimuli is important in opioid addiction and that Mindfulness-Oriented Recovery Enhancement (MORE) reduces opioid use in addicted individuals they demonstrate that MORE reduces emotional responses to opioid cues while amplifying responses to natural rewards. This suggests that mindfulness treatment reduces opioid use by altering the addict’s responses to stimuli related to the addiction and naturally rewarding stimuli; amplifying natural reward while suppressing opioid rewards. This makes opioids less rewarding and natural stimuli more rewarding.

 

So, mindfulness reduces addiction by altering pleasure appreciation in opioid users.

 

Mindfulness-Oriented Recovery Enhancement (MORE), increases the brain’s response to natural, healthy rewards while also decreasing the brain’s response to opioid-related cues.” – University of Utah

 

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

 

Garland, E. L., Atchley, R. M., Hanley, A. W., Zubieta, J. K., & Froeliger, B. (2019). Mindfulness-Oriented Recovery Enhancement remediates hedonic dysregulation in opioid users: Neural and affective evidence of target engagement. Science advances, 5(10), eaax1569. doi:10.1126/sciadv.aax1569

 

Abstract

Addiction neuroscience models posit that recurrent drug use increases reactivity to drug-related cues and blunts responsiveness to natural rewards, propelling a cycle of hedonic dysregulation that drives addictive behavior. Here, we assessed whether a cognitive intervention for addiction, Mindfulness-Oriented Recovery Enhancement (MORE), could restructure reward responsiveness from valuation of drug-related reward back to valuation of natural reward. Before and after 8 weeks of MORE or a support group control, prescription opioid users (N = 135) viewed opioid and natural reward cues while an electroencephalogram biomarker of target engagement was assessed. MORE was associated with decreased opioid cue-reactivity and enhanced capacity to regulate responses to opioid and natural reward cues. Increased positive affective responses to natural reward cues were associated with decreased craving and mediated MORE’s therapeutic effects on opioid misuse. This series of randomized experiments provide the first neurophysiological evidence that an integrative behavioral treatment can remediate hedonic dysregulation among chronic opioid users.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795512/

 

Change the Brain to Reduce Chronic Pain with Mindfulness

Change the Brain to Reduce Chronic Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

While many experts recommend mindfulness-based practices to manage pain, the goal of those practices is typically not to remove pain entirely, but to change your relationship with it so that you are able to experience relief and healing in the middle of uncomfortable physical sensations.” – Jon Kabat-Zinn

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings to demonstrate that mindfulness practices, in general, are effective in treating pain. Pain experiences are processed in the nervous system. So, it’s likely that mindfulness practices somehow alter the brain’s processing of pain. In today’s Research News article “The neural mechanisms of mindfulness-based pain relief: a functional magnetic resonance imaging-based review and primer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728003/), Zeidan and colleagues review and summarize the published research studies on the changes in the brain that accompany the relief of chronic pain by mindfulness-based treatments.

 

They report that mindfulness appears to reduce pain by increasing attention to the present moment. High levels of mindfulness are associated with lower pain experiences with chronic conditions and that these levels are associated with less activity in the, so called, default mode network in the brain (consisting of the medial prefrontal cortex, posterior cingulate cortex/precuneus, inferior, and lateral temporal cortices). The default mode network is thought to underlie self-referential thinking and mind wandering.

 

The research also reports that short-term meditation reduces chronic pain and increases communications between cortical areas and the thalamus suggesting top down control of pain sensitivity. On the other hand, long-term meditation practice reduces chronic pain by deactivating prefrontal cortical areas and activating somatosensory cortical regions. This suggests that long-term meditation reduces cognitive appraisals of arising sensory events. Finally, the research suggests that the neural mechanisms of mindfulness-based pain relief are different than opioid pain relief suggesting that there are different mechanisms involved.

 

Obviously, much more research is needed. But there is an evolving picture of the changes in the brain that occur with mindfulness practices that produce relief of chronic pain. It is different from that of opioid pain relievers and primarily involves high level, cortical, neural systems associated with attention to stimuli and the thought processes that arise evaluating those stimuli. In other words, mindfulness-based practices affect pain processing at the highest levels of attention and thinking.

 

So, change the brain to reduce chronic pain with mindfulness.

 

Chronic pain is frustrating and debilitating. The last thing we want to do is pay more attention to our pain. But that’s the premise behind mindfulness, a highly effective practice for chronic pain.” – Margarita Tartakovsky,

 

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

 

Zeidan, F., Baumgartner, J. N., & Coghill, R. C. (2019). The neural mechanisms of mindfulness-based pain relief: a functional magnetic resonance imaging-based review and primer. Pain reports, 4(4), e759. doi:10.1097/PR9.0000000000000759

 

Abstract

The advent of neuroimaging methodologies, such as functional magnetic resonance imaging (fMRI), has significantly advanced our understanding of the neurophysiological processes supporting a wide spectrum of mind–body approaches to treat pain. A promising self-regulatory practice, mindfulness meditation, reliably alleviates experimentally induced and clinical pain. Yet, the neural mechanisms supporting mindfulness-based pain relief remain poorly characterized. The present review delineates evidence from a spectrum of fMRI studies showing that the neural mechanisms supporting mindfulness-induced pain attenuation differ across varying levels of meditative experience. After brief mindfulness-based mental training (ie, less than 10 hours of practice), mindfulness-based pain relief is associated with higher order (orbitofrontal cortex and rostral anterior cingulate cortex) regulation of low-level nociceptive neural targets (thalamus and primary somatosensory cortex), suggesting an engagement of unique, reappraisal mechanisms. By contrast, mindfulness-based pain relief after extensive training (greater than 1000 hours of practice) is associated with deactivation of prefrontal and greater activation of somatosensory cortical regions, demonstrating an ability to reduce appraisals of arising sensory events. We also describe recent findings showing that higher levels of dispositional mindfulness, in meditation-naïve individuals, are associated with lower pain and greater deactivation of the posterior cingulate cortex, a neural mechanism implicated in self-referential processes. A brief fMRI primer is presented describing appropriate steps and considerations to conduct studies combining mindfulness, pain, and fMRI. We postulate that the identification of the active analgesic neural substrates involved in mindfulness can be used to inform the development and optimization of behavioral therapies to specifically target pain, an important consideration for the ongoing opioid and chronic pain epidemic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728003/