Reduce General Practitioner Burnout with On-Line Mindfulness

Reduce General Practitioner Burnout with On-Line Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness practice — the cultivation of a focused awareness on the present moment — can improve physicians’ performance by not only preventing burnout, but also by helping them better connect with their patients.”Carolyn Gregoire

 

“General Practitioners confront stress on a daily basis. Even moderate levels of stress when prolonged, all too frequently results in a professional burnout. This is the fatigue, cynicism, emotional exhaustion, and professional inefficacy that comes with work-related stress. Healthcare is a high stress occupation. It is estimated that over 45% of healthcare workers experience burnout. Regardless of the reasons for burnout or its immediate presenting consequences, 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. Hence, preventing existing healthcare workers from burning out has to be a priority.

 

Mindfulness has been demonstrated to be helpful in coping with stress and in treating and preventing burnout. But, General Practitioners (GPs) are pressed for time and it is difficult for them to commit the time to mindfulness training on a schedule at a therapist’s location. Mindfulness training over the internet is an alternative training for people who find face-to-face training difficult and inconvenient. Online mindfulness training has shown great promise with effectiveness equivalent to face-to-face training.

 

In today’s Research News article “Impact of a Blended Web-Based Mindfulness Programme for General Practitioners: a Pilot Study.” (See summary below). Montero-Marin and colleagues recruited General Practitioners and provided them with on-line mindfulness training with both audio and video instruction in 45-minute sessions occurring twice a week for 4 weeks. Before and after training the GPs were measured for mindfulness, positive and negative emotions, resilience, and burnout.

 

They separated the GPs according to their participation rates into completers who completed two or more practices per week and non-completers who completed on average less than one practice per week. They found that the completers in contrast to the non-completers had significant increases in mindfulness and positive emotions. They also found that the amount of practice had a direct effect on positive emotions and also and indirect effect by increasing mindfulness which in turn increases positive emotions.

 

Hence, on-line mindfulness training appeared to enhance mindfulness and positive feelings in those GPs who completed the provided practices. To some extent the results were disappointing as there were a large proportion of the GPs who did not complete the program’s practice requirements (approximately 80% of those recruited). This could be due to the busy schedules of the GPs or that the program was not sufficiently engaging to motivate participation. In addition, there were no significant effects of the practice on negative emotions, resilience, or burnout. This may be due to the relatively small amount of practice. Perhaps a longer duration program might have more positive effects. Indeed, previous research has shown significant reductions in GP burnout with 8 weeks of in-person mindfulness training. Hence, it is possible that the program in the present study needs to be longer. It is also possible that on-line presentation is not effective for GP burnout.

 

The program, when completed, did produce greater mindfulness and positive emotions. So, there is reason to believe that it may be effective. This suggests that a modified more engaging and longer program should be developed and tested in a randomized controlled trial as an effective treatment for GPO burnout is sorely needed.

 

“When I talk or listen to peers and colleagues, I am amazed at how many healthcare professionals are already integrating mindfulness, meditation or relaxation techniques into their lives on a regular basis in order to ground themselves and find headspace and calm.” – Jon Kabat-Zin

 

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

 

Montero-Marin, J., Gaete, J., Araya, R. et al. Impact of a Blended Web-Based Mindfulness Programme for General Practitioners: a Pilot Study. Mindfulness (2017). doi:10.1007/s12671-017-0752-8

 

Abstract

General practitioners (GPs) report high levels of distress. This study examined whether a brief blended web-based mindfulness intervention could be effective at enhancing well-being for GPs and assessed the possible mediating role of awareness. An open uncontrolled trial, with pre-post measurements, was conducted. The programme comprised one face-to-face meeting (4 h) and eight online practice sessions with no support (two weekly sessions over 4 weeks). The primary outcome was positive affect (PANAS-positive). The secondary outcomes were as follows: negative affect (PANAS-negative), awareness (MAAS), resilience (CDRISC), and the burnout subtypes (BCSQ-12). Mixed-effects analysis for repeated measures and mediation analysis by regression models were performed. Two hundred ninety Spanish GPs took part in the study, attending the face-to-face meeting. Nearly one out 10 participants (n = 28) completed ‘one weekly practice’, and 10.4% (n = 30) accomplished ‘two or more weekly practices’. There were benefits for those with ‘two or more weekly practices’ in PANAS-positive (B = 2.97; p = 0.007), and MAAS (B = 4.65; p = 0.023). We found no benefits for those with ‘one weekly practice’ in any of the outcomes. There were mediating effects of MAAS in PANAS-positive (explaining a 60.8% of total effects). A brief blended mindfulness intervention, with minimum face-to-face contact and web-based practice sessions, seems to confer improvements in the well-being of Spanish GPs. The benefits may be mediated by awareness. The implementation of this kind of programme might enhance the well-being among GPs, but there is a need to improve adherence to practice. Further research using randomized controlled designs will be needed to support the evidence found in our study.

Improve Psychotic Symptoms with Mindfulness

Improve Psychotic Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“there is now sufficient published research, backed up by considerable clinical experience, to encourage careful clinical practice and research exploring the efficacy and effectiveness of adapted mindfulness interventions for people struggling to cope with psychotic experience.” – Paul Chadwick

 

Psychoses are mental health problems that cause people to perceive or interpret things differently from those around them. This might involve hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t objectively there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion, and behavior, making it difficult if not impossible to function in society without treatment. Psychoses appear to be highly heritable and involves changes in the brain.

 

The symptoms of psychoses usually do not appear until late adolescence or early adulthood. There are, however, usually early signs of the onset of psychoses which present as cognitive impairments. Psychoses are very difficult to treat with psychotherapy and are usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Hence, there is a need for safe and effective alternative treatments for psychosis.

 

Mindfulness training has been shown to be beneficial with patients with psychosis. In today’s Research News article “Mindfulness- and acceptance-based interventions for psychosis: Our current understanding and a meta-analysis.” (See summary below). Louise and colleagues summarize and perform a meta-analysis on the published research literature on the effectiveness of mindfulness based therapies for the symptoms of psychosis and compare their effectiveness when performed in group vs individual therapies. They identified and included 10 published randomized controlled research studies. About half of the studies used group based mindfulness training while half used individual training. Only 4 studies used and active control group while most used treatment as usual or wait-list control conditions.

 

They report that the published research indicates that mindfulness based training results in a significant reduction in psychotic symptoms and depression and a significant increase in mindfulness. Group based mindfulness training appeared to be more effective than individual based training. This is confounded, however, as most of the individual based trainings involved a different therapeutic protocol which included mindfulness training, Acceptance and Commitments Therapy.

 

The published research suggests that mindfulness based training is an effective treatment for the symptoms of psychosis. Mindfulness training has been repeatedly shown to be effective for depression. The current analysis, though, extends this effectiveness to depression in patients with psychosis. There were no specific reported differences between the effects on positive and negative symptoms of psychosis. Hence, mindfulness training was effective for overall psychotic symptoms. It is clear, however, that there is a need for more randomized clinical trials that employ better active control conditions so that placebo, attention, and bias effects can be better eliminated as alternative explanations for the results.

 

These are exciting findings, however, as psychosis has been found to be difficult to treat with standard psychotherapies. The results suggest that mindfulness techniques may be, at least in part, a solution to the treatment of psychoses.

 

So, improve psychotic symptoms with mindfulness.

 

“The decentered awareness in mindfulness facilitates the experience of cognitions as mental events in a broader context, and thereby facilitates a more metacognitive stance of decentering or defusing rather than getting “caught” in or reacting to thoughts or delusions, images, and hallucinated voices. The awareness and acceptance of thoughts, images, sounds, and/or hallucinated voices (positive or negative) diminishes the processes of judgment and self-criticism, including the internalized self-stigma that is so often present in those who experience psychosis.” – NewHarbinger

 

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

 

Louise, S., et al., Mindfulness- and acceptance-based interventions for psychosis: Our current understanding and a metaanalysis, Schizophr. Res. (2017), http://dx.doi.org/10.1016/j.schres.2017.05.023

 

Abstract

In promoting optimal recovery in persons with psychosis, psychological interventions have become a key element of treatment, with cognitive behavioural therapy being widely recommended in clinical practice guidelines. One key area of development has been the trialling of “third wave” cognitive behavioural interventions, which promote mindfulness, acceptance and compassion as means of change. Trials to date have demonstrated encouraging findings, with beneficial effects observed on measures of psychotic symptoms. This meta-analysis evaluated the efficacy of third wave interventions for the treatment of psychosis in randomised controlled trials, with psychotic symptoms as the primary outcome. Overall, 10 studies were included. The primary outcome demonstrated a small but significant effect (g=0.29) for third wave interventions compared with control post-treatment. Trials of group format mindfulness-based interventions showed larger effects (g=0.46) than individual acceptance and commitment therapy based interventions (g=0.08), although methodological differences between trials were noted. Among secondary outcomes, a moderate, significant treatment effect (g=0.39) was found for depressive symptoms, but no significant effects were found on specific measures of positive and negative symptoms, hallucination distress, or functioning/disability. A moderate effect on mindfulness (g=0.56) was observed, but not on acceptance. Overall, findings indicate that third wave interventions show beneficial effects on symptoms in persons with psychotic disorders. However, further research is required to determine the efficacy of specific models of treatment.

Reduce Mind Wandering and Negative Mood with Mindfulness

Reduce Mind Wandering and Negative Mood with Mindfulness

 

By John M. de Castro, Ph.D.

 

“being in a mind-wandering state – instead of aware of present moment activities – is not such a happy state. We are generally happier when we are not mind-wandering.” – Susan Smalley

 

We spend a tremendous amount of waking time with our minds wandering and not on the present environment or the task at hand. We daydream, plan for the future, review the past, ruminate on our failures, exalt in our successes. In fact, we spend almost half of our waking hours off task with our mind wandering. Mindfulness is the antithesis of mind wandering. When we’re mindful, we’re paying attention to what is occurring in the present moment. In fact, the more mindful we are the less the mind wanders and mindfulness training reduces mind wandering.

 

You’d think that if we spend so much time with the mind wandering it must be enjoyable. But, in fact research has shown that when our mind is wandering we are actually less happy than when we are paying attention to what is at hand. There are times when mind wandering may be useful, especially in regard to planning and creative thinking. But, for the most part, it interferes with our concentration on the present moment and what we’re doing and makes us unhappy. Hence, it makes sense to study the relationship of mindfulness to mind wandering and negative emotions.

 

In today’s Research News article “Does Mind Wandering Mediate the Association Between Mindfulness and Negative Mood? A Preliminary Study.” (See summary below). Wang and colleagues recruited meditation naïve college students. They completed measures of mindfulness, positive and negative moods, and mind wandering during a 15-minute breath following meditation period. Correlations and sophisticated mediation model analysis were conducted on the students’ responses.

 

They found that the higher the levels of mindfulness the higher the levels of positive emotions and the lower the levels of mind wandering and negative emotions. Hence, more mindful students had more positive and less negative emotions and less mind wandering. The mediation analysis revealed that mind wandering partially mediated the relationship between mindfulness and negative emotions but not positive emotions. In other words, mindfulness was directly related to less negative emotions and also indirectly by being related to less mind wandering which in turn was related to less negative emotions.

 

This is a correlational study, so no conclusions can be reached about causation. But there is evidence from other studies that mindfulness training improves mood. So, it is likely that mindfulness caused the greater positive emotions and lower negative emotions in the students in this study. These are interesting results that add to the understanding of how mindfulness affects human emotions. They show that mindfulness influences mood directly and also improves negative mood via reduced mind wandering.

 

So, reduce mind wandering and negative mood with mindfulness.

 

“mindfulness training may have protective effects on mind wandering for anxious individuals. . . . meditation practice appears to help anxious people to shift their attention from their own internal worries to the present-moment external world, which enables better focus on a task at hand.” – Mengran Xu

 

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

 

Yuzheng Wang, Wei Xu, Capella Zhuang, Xinghua Liu. Does Mind Wandering Mediate the Association Between Mindfulness and Negative Mood? A Preliminary Study. Psychological Reports, Vol 120, Issue 1, pp. 118 – 129, 2017. 10.1177/0033294116686036

 

Abstract

The aim of this study was to assess the relationship between trait mindfulness and mood and to examine whether the relationship is mediated by mind wandering. Eighty-two individuals (M age = 24.27 years, SD = 5.64, 18 men, 22%) completed a series of measures including the Five-Facet Mindfulness Questionnaire, the Profile of Mood States Questionnaire, and Meditation Breath Attention Exercise. Results showed that the level of mindfulness was significantly correlated with positive and negative mood, and the association between mindfulness and negative mood was mediated by mind wandering. This study indicated the important role of mind wandering in the relation between mindfulness and negative mood. Limitations and future research directions are discussed.

Improve Mental Health in the Elderly with Mindfulness

Improve Mental Health in the Elderly with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The interconnectedness of mind and body lies at the heart of mindfulness and this makes it highly relevant to older people who are more likely to experience physical health problems with associated psychological issues ­ such as reduced mobility and depression. It is thought that mindfulness can be particularly empowering to older people as it focuses on abilities rather than difficulties which may help older people to feel more engaged in decisions about their care.” – MyAgingParent.com

 

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decline during aging. As we age, there are systematic progressive declines in every system in the body, the brain included. This includes our mental abilities and results in impairments in memory, attention, and problem solving ability. It is inevitable and cannot be avoided. Aging also results in changes in mental health. Depression is very common in the elderly. The elderly cope with increasing loss of friends and family, deteriorating health, as well as concerns regarding finances on fixed incomes. All of these are legitimate sources of worry. In addition, many elderly experience withdrawal and isolation from social interactions. But, no matter how reasonable, the increased loneliness, worry and anxiety add extra stress that can impact on the elderly’s already deteriorating physical and psychological health.

 

Mindfulness appears to be effective for an array of physical and psychological issues that occur with aging. It appears to strengthen the immune system and reduce inflammation. It has also been shown to be beneficial in slowing or delaying physical and mental decline with aging. and improve cognitive processes. It has also been shown to reduce anxiety, worry, and depression and improve overall mental health. Since the global population of the elderly is increasing at unprecedented rates, it is imperative to investigate safe and effective methods to slow physical and mental aging and improve mental health in the elderly.

 

In today’s Research News article “Meditation in Stressed Older Adults: Improvements in Self-Rated Mental Health Not Paralleled by Improvements in Cognitive Function or Physiological Measures.” (See summary below). Oken and colleagues recruited health elderly between the ages of 50-85 (average age = 60 years) who did not evidence cognitive decline and who were at least mildly stressed. They were randomly assigned to either receive 6 weeks of mindfulness meditation practice or to a wait-list control condition. Mindfulness meditation practice included one-on-one instruction in body scan, sitting meditation, and breathing exercises. The participants were measured before and after training for mindfulness, perceived stress, positive and negative emotions, neuroticism, fatigue, quality of life, self-efficacy, sleep, executive function, memory, attention, physiological vital signs, and salivary cortisol levels.

 

They found that the mindful meditation group in comparison to the wait-list group and the baseline measures showed significant reductions in negative emotions, neuroticism, and perceived stress following training and significant increases in mindfulness, vitality, self-efficacy, agreeableness and conscientiousness. Hence, mindfulness meditation produced significant improvements in the overall mental health of the participants, but did not alter physical health or cognitive abilities.

 

These are important results that suggest that mindfulness meditation practice produces major improvements in the mental health of the elderly. The participants, however, were relatively young elderly with an average age of 60 and only one participant over 75. They were all in good health and demonstrated no cognitive issues. Hence, the failure to demonstrate any effects of mindfulness meditation on the physical health or cognitive ability of this group may have been due to the fact that they were high functioning at the beginning making it difficult to produce further improvements. Regardless, the results clearly show large and important effects of mindfulness meditation on the overall mental health of these young elderly. This suggests that mindfulness meditation should be incorporated into the lives of the elderly to improve their psychological state during their declining years.

 

So, improve mental health in the elderly with mindfulness.

 

“Mindfulness practice has a definite positive impact on issues such as recurrent depression, stress, anxiety, chronic physical pain and loneliness. For elderly people, loneliness is a major risk factor for health problems-such as cardiovascular disease and Alzheimer’s. Mindfulness meditation training can be used as a novel approach for reducing loneliness and the risk of disease. Research suggests that mindfulness meditation training is a promising intervention for improving the health of older adults.”Bláthnait Ní Mhurchú

 

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

 

Oken, B.S., Wahbeh, H., Goodrich, E. et al. Meditation in Stressed Older Adults: Improvements in Self-Rated Mental Health Not Paralleled by Improvements in Cognitive Function or Physiological Measures. Mindfulness (2017) 8: 627. doi:10.1007/s12671-016-0640-7

 

Abstract

To determine if mindfulness meditation (MM) in older adults improves cognition and, secondarily, if MM improves mental health and physiology, 134 at least mildly stressed 50–85-year olds were randomized to a 6-week MM intervention or a waitlist control. Outcome measures were assessed at baseline and 2 months later at visit 2. The primary outcome measure was an executive function/attentional measure (flanker task). Other outcome measures included additional cognitive assessments, salivary cortisol, respiratory rate, heart rate variability, Positive and Negative Affect Schedule (PANAS), Center for Epidemiologic Studies Depression (CESD), Perceived Stress Scale (PSS), Neuroticism-Extraversion-Openness (NEO) personality traits, and SF-36 health-related quality of life. One hundred twenty-eight participants completed the study though visit 2 assessments. There was no significant change in the primary or other cognitive outcome measures. Even after statistical adjustment for multiple outcomes, self-rated measures related to negative affect and stress were all significantly improved in the MM intervention compared to waitlist group (PANAS-negative, CESD, PSS, and SF-36 health-related quality of life Vitality and Mental Health Component). The SF-36 Mental Health Component score improved more than the minimum clinically important difference. There were also significant changes in personality traits such as Neuroticism. Changes in positive affect were not observed. There were no group differences in salivary cortisol or heart rate variability. These moderate-sized improvements in self-rated measures were not paralleled by improvements in cognitive function or physiological measures. Potential explanations for this discrepancy in stress-related outcomes are discussed to help improve future studies.

Stay Abstinent from Smoking Mindfully

Stay Abstinent from Smoking Mindfully

 

By John M. de Castro, Ph.D.

 

“I liken it to having weeds in your garden. Standard treatments—for example, avoiding triggers such as ashtrays and lighters or using substitutes such as eating carrot sticks and chewing on your pen—just pull the heads off the weeds, so they grow back. These treatments don’t uproot the craving itself. In contrast, mindfulness really gets in there and pulls up the roots.” – Judson Brewer

 

“Tobacco use remains the single largest preventable cause of death and disease in the United States.” (Centers for Disease Control and Prevention). So, treating nicotine addiction and producing smoking cessation could greatly improve health. But, smoking has proved devilishly difficult to treat. There are a wide variety of methods and strategies to quit smoking which are to only a very limited extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful.

 

One problem is that nicotine is one of the most addictive substances known and withdrawal from nicotine is very stressful, producing many physical and psychological problems, including negative emotional states and depression. In essence, the addict feels miserable without the nicotine. This promotes relapse to relieve the discomfort. Better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness practices have been found to be helpful in treating addictions, including nicotine addiction, and reducing the risk of relapse.

 

In today’s Research News article “Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867253/, Heppner and colleagues recruited African American smokers who smoked at least 5 cigarettes per day for at least one year and enrolled in a smoking cessation treatment program. They were measured 19 and 5 days before quitting smoking and 3 days, 31 days, and 26 weeks after quitting for cigarettes smoked per day, smoking abstinence, mindfulness, positive and negative emotions, dependence and withdrawal symptoms, self-efficacy, and social support.

 

They found that the number of participants remaining abstinent dropped precipitously over 26 weeks but mindfulness mattered. Abstinence dropped to around 7% of participants who were low in mindfulness but to only 14% of participants who were high in mindfulness. Of those participants who relapsed at day 3 after treatment high mindfulness participants were significantly more likely to recover abstinence by day 31 and week 26. They also found that the improvement in abstinence at day 3 produced by mindfulness occurred primarily as a result of mindfulness producing lower levels of sadness, anger, and depression, lower use of smoking to control emotions, and more social support which in turn were associated with better abstinence rates.

 

These results are interesting but correlational, so causation cannot be determined. But, prior research has shown that mindfulness training improves treatment for nicotine addiction. So, it is likely that the relationships between mindfulness and smoking cessation observed in the present study were due to mindfulness causing the improved abstinence. Mindfulness acted through intermediaries of improved emotion regulation and improved social support to support abstinence. These results suggest that mindfulness is very helpful in remaining abstinent after quitting smoking and should become a component of all smoking cessation treatment packages.

 

So, stay abstinent from smoking mindfully.

 

“each time the individual does not succumb to the craving, the craving becomes weaker until eventually it no longer gets triggered. Moreover, with each moment of mindfulness, the smoker regains a sense of control and understanding regarding their mind and body, which can be empowering.”Azadeh Aalai

 

 

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

 

Heppner, W. L., Spears, C. A., Correa-Fernández, V., Castro, Y., Li, Y., Guo, B., … Wetter, D. W. (2016). Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery. Annals of Behavioral Medicine : A Publication of the Society of Behavioral Medicine, 50(3), 337–347. http://doi.org/10.1007/s12160-015-9759-3

 

Abstract

Background

Although mindfulness has been hypothesized to promote health behaviors, no research has examined how dispositional mindfulness might influence the process of smoking cessation.

Purpose

The current study investigated dispositional mindfulness, smoking abstinence, and recovery from a lapse among African American smokers.

Methods

Participants were 399 African Americans seeking smoking cessation treatment (treatments did not include any components related to mindfulness). Dispositional mindfulness and other psychosocial measures were obtained pre-quit; smoking abstinence was assessed 3 days, 31 days, and 26 weeks post-quit.

Results

Individuals higher in dispositional mindfulness were more likely to quit smoking both initially and over time. Moreover, among individuals who had lapsed at day 3, those higher in mindfulness were more likely to recover abstinence by the later time points. The mindfulness-early abstinence association was mediated by lower negative affect, lower expectancies to regulate affect via smoking, and higher perceived social support.

Conclusions

Results suggest that mindfulness might enhance smoking cessation among African American smokers by operating on mechanisms posited by prominent models of addiction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867253/

Improve Borderline Personality Disorder and Reduce Suicidal Thoughts with Mindfulness

Improve Borderline Personality Disorder and Reduce Suicidal Thoughts with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation encourages recognition of the wide palate of human emotions, but also keenly encourages one not to fixate on these temporary feelings. Work in mindfulness meditation includes labeling these emotions in a non-judgmental manner and allowing them to pass just as freely as they came. The misery and the suffering those with BPD experience in life often come from our denial of some of these emotions.” – Blaise Aguirre

 

Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. BPD is associated with high rates of co-occurring depression, anxiety disorders, substance abuse, eating disorders, self-harm, suicidal behaviors, and completed suicides. BPD is dangerous as it can propel the sufferer, on the spur of the moment, to overreact to anger, take drugs, harm themselves, and even terminate their lives.

 

BPD has not responded well to a variety of therapies with the exception of Dialectical Behavior Therapy (DBT). It is significant that a difference between DBT and other therapies is that it emphasizes mindfulness. This suggests that mindfulness training may be essential in treating Borderline Personality Disorder (BPD). Mindfulness training has been found to be helpful intreating substance abuse and decreasing suicidal thoughts. Hence, there appears to be a relationship between mindfulness and Borderline Personality Disorder (BPD), substance abuse and suicidal thoughts.

 

In today’s Research News article “The relationship between dispositional mindfulness, borderline personality features, and suicidal ideation in a sample of women in residential substance use treatment.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834542/, Shorey and colleagues recruited adult women with Borderline Personality Disorder (BPD) who were also undergoing treatment for substance abuse. The women completed measures of mindfulness, BPD features, including affective, identity problems, negative relationships, and self-harm, suicidal thoughts, alcohol abuse, drug use, and impression management. They then conducted regression analyses to investigate the relationship between mindfulness and BPD, suicidality, and drug use.

 

They found that in these patients the higher the levels of mindfulness the lower the levels of BPD features, including affective, identity problems, negative relationships, and self-harm, the lower the levels of suicidal thoughts, and the higher the levels of impression management. Hence, mindfulness was significantly negatively associated with BPD symptoms and suicidality. These relationships, with the exception of self-harm, remained significant even after statistically accounting for alcohol use, drug use, age, and impression management.

 

These results suggest that mindfulness may be an antidote to Borderline Personality Disorder (BPD) symptoms and suicidal thoughts. It is possible that this results from the ability of mindfulness to improve emotion regulation. Mindful people to experience their emotions deeply but are able to respond to them rationally and adaptively. Characteristically, patients with BPD avoid experiencing negative emotions. So, mindfulness, by promoting the experience of these emotions may counteract one of the core features of BPD.

 

It should be recognized that these results are correlational. So, causality cannot be determined. But, since Dialectical Behavior Therapy (DBT) which contains mindfulness training is the only known therapy that has been shown to be effective for BPD. It would seem reasonable to suggest that mindfulness causes changes in BPD symptoms. A randomized clinical trial of mindfulness training for BPD symptoms and suicidality should be conducted in the future to test these ideas. The potential for mindfulness training to improve the symptoms of this devastating and dangerous mental illness mandates that such a trial be conducted.

 

So, improve borderline personality disorder and reduce suicidal thoughts with mindfulness.

 

“Mindfulness meditation training can help people with BPD to feel less “stuck” in their emotions, and less judgmental of the emotions and themselves. Mindfulness meditation training may also help individuals with BPD be more effective in applying healthy coping skills in the midst of emotional pain, because mindfulness skills allow you to get just a little bit of space to be able to notice the emotion and be more strategic in terms of how you will act in the face of the emotion.” – Line Goguen-Hughes

 

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

 

Shorey, R. C., Elmquist, J., Wolford-Clevenger, C., Gawrysiak, M. J., Anderson, S., & Stuart, G. L. (2016). The relationship between dispositional mindfulness, borderline personality features, and suicidal ideation in a sample of women in residential substance use treatment. Psychiatry Research, 238, 122–128. http://doi.org/10.1016/j.psychres.2016.02.040

 

Highlights

  • Theory suggests mindfulness is inversely related to BPD/suicidal ideation
  • We investigated this in a sample of women in treatment for substance use
  • Dispositional mindfulness was negatively associated with BPD
  • Dispositional mindfulness was negatively associated with suicidal ideation

Abstract

Borderline personality disorder (BPD), which is characterized by unstable moods, behavior, and relationships, is also associated with heightened suicidal ideation. Prior research has demonstrated that BPD and suicidal ideation are prevalent among women in substance use treatment. Efforts to treat substance use in this population are made difficult due to the severity of BPD, and it is possible that mindfulness-based interventions specific to substance use could be an effective approach for this population. However, basic research is needed on the relationship between dispositional mindfulness, BPD, and suicidal ideation among women in treatment for substance use to support their associations, which was the purpose of the present study. Pre-existing medical records were reviewed from a residential substance use treatment center. A total of 81 female patients were included in the current study. Patients completed self-report measures of mindfulness, BPD, suicidal ideation, substance use, and impression management at treatment intake. Findings demonstrated dispositional mindfulness to be negatively associated with BPD features and suicidal ideation. With the exception of self-harm, this negative relationship was found even after controlling for age, substance use, and impression management. Future research should examine whether mindfulness-based interventions are an effective treatment for comorbid substance use and BPD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834542/

Reduce Drinking Motives and Problematic Drinking with Mindfulness

Reduce Drinking Motives and Problematic Drinking with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It may not be possible for people to completely escape cravings, but they can learn to live with them. Mindfulness meditation is an excellent tool that allows the individual to have increased control over their mind. There is a saying that, the mind is a wonderful servant but a terrible master.” – Alcoholrehab.com

 

Inappropriate use of alcohol is a major societal problem. In fact, about 25% of US adults have engaged in binge drinking in the last month and 7% have what is termed an alcohol use disorder. Alcohol abuse is very dangerous and frequently fatal. Nearly 88,000 people in the US and 3.3 million globally die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States. Drunk driving accounted for over 10,000 deaths; 31% of all driving fatalities. Excessive alcohol intake has been shown to contribute to over 200 diseases including alcohol dependence, liver cirrhosis, cancers, and injuries. It is estimated that over 5% of the burden of disease and injury worldwide is attributable to alcohol consumption.

 

Alcohol abuse often develops during adolescence and it on display with college students where about four out of five college students drink alcohol and about half of those consume alcohol through binge drinking. About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall. More than 150,000 students develop an alcohol-related health problem. This drinking has widespread consequence for not only the students but also the college communities, and families. More than 690,000 students are assaulted by another student who has been drinking. More than 97,000 students are victims of alcohol-related sexual assault or date rape. 599,000 students receive unintentional injuries while under the influence of alcohol. Significantly, 1,825 college students die each year from alcohol-related unintentional injuries and between 1.2 and 1.5 percent of students indicate that they tried to commit suicide within the past year due to drinking or drug use.

 

These are striking and alarming statistics and indicate that controlling alcohol intake is an important priority for the individual and society. There are a wide range of treatment programs for alcohol abuse, with varying success. Recently, mindfulness training has been successfully applied to treatment. One attractive feature of this training is that it appears to increase the ability of the drinker to control their intake, resulting in less binge drinking and dangerous inebriation. It appears that one way that mindfulness increases the control of intake is by reducing the desire to use alcohol to cope with emotional problems. Since, mindfulness appears to hold promise as a treatment for excessive alcohol intake, there is a need to better understand its mechanisms of action in order to maximize its effectiveness.

 

In today’s Research News article “Drinking Motives Mediate the Relationship between Facets of Mindfulness and Problematic Alcohol Use.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998974/. Vinci and colleagues recruited college students and had them complete measures of problem drinking, drinking characteristics, including frequency, quantity, and binge drinking, drinking motives including coping, enhancement, social, and conformity, and mindfulness. They performed regression and structural modelling analyses on these data.

 

They found that the higher the level of the mindfulness facet of acting with awareness that the students had the lower the levels of problem drinking. In addition, the association of acting with awareness with lower problem drinking occurred through two routes, a direct effect of acting with awareness on problem drinking and indirect effects through lower levels of using drinking for coping with negative emotions and lower levels of drinking to conform to the social situation. Hence, mindfulness is directly associated with less problem drinking and with lower levels of susceptibility to use drinking to sooth negative feelings and to conform to the behaviors of others.

 

Since, problem drinking is such a major societal and individual problem that develops during adolescence, the fact that mindfulness may help to lower problem drinking in college students suggests that mindfulness training may be an important intervention during these formative years. It remains for future research to determine if  active mindfulness training in college students can lead to decreased problem drinking.

 

So, reduce drinking motives and problematic drinking with mindfulness.

 

“Mindfulness also helps people learn to relate to discomfort differently. When an uncomfortable feeling like a craving or anxiety arises, people are able to recognize their discomfort, and observe it with presence and compassion, instead of automatically reaching for a drug to make it go away. Awareness of our experience and the ability to relate to our experience with compassion gives us more freedom to choose how we respond to discomfort, rather than defaulting to automatic behaviors.” – Sarah Bowen

 

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

 

Vinci, C., Spears, C. A., Peltier, M. R., & Copeland, A. L. (2016). Drinking Motives Mediate the Relationship between Facets of Mindfulness and Problematic Alcohol Use. Mindfulness, 7(3), 754–763. http://doi.org/10.1007/s12671-016-0515-y

 

Abstract

Mindfulness is a multi-faceted construct, and research suggests that certain components (e.g., Acting with Awareness, Nonjudging) are associated with less problematic alcohol use. Recent research has examined whether specific drinking motives mediate the relationship between facets of mindfulness and alcohol use. The current study sought to extend this research by examining whether certain drinking motives would mediate the relationship between facets of mindfulness and problematic alcohol use in a sample of 207 college students classified as engaging in problematic drinking. Participants completed the Five Facet Mindfulness Questionnaire (FFMQ), Drinking Motives Questionnaire-Revised (DMQ-R), and Alcohol Use Disorders Identification Test (AUDIT). Results indicated that lower levels of Coping motives significantly mediated the relationship between greater Acting with Awareness and lower AUDIT score and between greater Nonjudging and lower AUDIT score. Lower levels of Conformity motives significantly mediated the relationship between greater Acting with Awareness and lower AUDIT score. These findings offer insight into specific mechanisms through which mindfulness is linked to less problematic drinking, and also highlight associations among mindfulness, drinking motives, and alcohol use among a sample of problematic college student drinkers. Future research should determine whether interventions that emphasize Acting with Awareness and Nonjudging facets of mindfulness and/or target coping and conformity motives could be effective for reducing problematic drinking in college students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998974/

Reduce Stress with Preventative On-line Mindfulness Training

Reduce Stress with Preventative On-line Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Mindfulness not only reduces stress but also gently builds an inner strength so that future stressors have less impact on our happiness and physical well-being.” – Shamash Alidina

 

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

 

The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This produces costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules. As a result, there has been attempts to develop on-line mindfulness training programs. These have tremendous advantages in decreasing costs and making training schedules much more flexible. But, the question arises as to whether these programs are as effective as their traditional counterparts.

 

In today’s Research News article “Effects of preventive online mindfulness interventions on stress and mindfulness: A meta-analysis of randomized controlled trials.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5199155/, Jayawardene and colleagues reviewed and conducted a meta-analysis of the published research literature on the effectiveness of preventative mindfulness training on-line with normal, non-clinical, individuals for the relief of stress effects. They found 8 published randomized controlled trials. Most used modifications of the Mindfulness-Based Stress Reduction (MBSR) program and lasted from 2 to 12 weeks. MBSR includes body scan, meditation, and yoga practices.

 

They found that the published studies report significant reductions in perceived stress of moderate effect sizes and increases of mindfulness of small effect sizes following mindfulness training in comparison to baseline and control conditions. These effects persisted up to several months after the end of training. They also found that the older the participant the larger the reduction in perceived stress produced by mindfulness training.

 

These results are significant but not unexpected as Mindfulness-Based Stress Reduction (MBSR) was developed specifically to target perceived stress. What is significant is that this effectiveness occurs even when the training occurs strictly over the internet and with normal, non-clinical, populations. This is important as it suggests that inexpensive mindfulness training can be offered to widespread audiences. In addition, online training is convenient for the participants, as they do not have to go to a practitioners site on a particular schedule. This, in turn, allows for the application of mindfulness training for the prevention and treatment of psychological and physical disorders with busy people, low income people, and even people in remote locations, thus greatly expanding the numbers of people who can benefit.

 

Mindfulness training has been shown to have a myriad of physical and psychological benefits. The present findings are exciting in that they suggest that mindfulness training can occur inexpensively to disparate populations. The on-line mindfulness training may then, by reducing stress effects in normal people, act to prevent the many physical and psychological problems that result from chronic stress, improving their health and well-being.

 

So, reduce stress with preventative on-line mindfulness training.

 

“These are difficult times right now for a lot of people. Learning to become more “present,” frees us to be more flexible and creative – and ultimately, more resilient, enjoying better health and well-being.’”– Elisha Goldstein

 

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

 

Jayawardene, W. P., Lohrmann, D. K., Erbe, R. G., & Torabi, M. R. (2017). Effects of preventive online mindfulness interventions on stress and mindfulness: A meta-analysis of randomized controlled trials. Preventive Medicine Reports, 5, 150–159. http://doi.org/10.1016/j.pmedr.2016.11.013

 

Abstract

Empirical evidence suggested that mind-body interventions can be effectively delivered online. This study aimed to examine whether preventive online mindfulness interventions (POMI) for non-clinical populations improve short- and long-term outcomes for perceived-stress (primary) and mindfulness (secondary). Systematic search of four electronic databases, manuscript reference lists, and journal content lists was conducted in 2016, using 21 search-terms. Eight randomized controlled trials (RCTs) evaluating effects of POMI in non-clinical populations with adequately reported perceived-stress and mindfulness measures pre- and post-intervention were included. Random-effects models utilized for all effect-size estimations with meta-regression performed for mean age and %females. Participants were volunteers (adults; predominantly female) from academic, workplace, or community settings. Most interventions utilized simplified Mindfulness-Based Stress Reduction protocols over 2–12 week periods. Post-intervention, significant medium effect found for perceived-stress (g = 0.432), with moderate heterogeneity and significant, but small, effect size for mindfulness (g = 0.275) with low heterogeneity; highest effects were for middle-aged individuals. At follow-up, significant large effect found for perceived-stress (g = 0.699) with low heterogeneity and significant medium effect (g = 0.466) for mindfulness with high heterogeneity. No publication bias was found for perceived-stress; publication bias found for mindfulness outcomes led to underestimation of effects, not

studies. POMI had substantial stress reduction effects and some mindfulness improvement effects. POMI can be a more convenient and cost-effective strategy, compared to traditional face-to-face interventions, especially in the context of busy, hard-to-reach, but digitally-accessible populations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5199155/

Improve Pregnancy and Birthing with Mindfulness

Improve Pregnancy and Birthing with Mindfulness

 

By John M. de Castro, Ph.D.

 

“There could not be a better time to learn mindfulness than during pregnancy and early motherhood. For one thing, this is a time when most people have a strong motivation to become the best person they can be in a relatively short period of time. When you realize the full enormity of the responsibility you have taken on by becoming a mom, the primary source of care for another whole human being, not to mention one that you love more than you thought you could ever love, there is a really high level of motivation to try your best to get yourself into the best mental and emotional shape possible.” Cassandra Vieten

 

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427564/, Duncan and colleagues recruited women who were pregnant with their first child, in their third trimester, and planning on having a hospital birth. They received standard childbirth education and instruction and were then randomly assigned to receive either an additional childbirth course or Mind in Labor training; “a brief intervention for pregnant women and their partners specifically designed to target labor-related fear and pain by teaching tailored mindfulness-based coping strategies.” Training was conducted over a weekend for a total of 18 hours of instruction. It included body scan, yoga, and meditation practices. The women were measured at baseline before treatment on average at 29.4 weeks gestation, at the completion of training, and around 4-6 weeks after birth for childbirth self-efficacy, maladaptive pain, perceived pain in labor, use of pain medications in labor, birth satisfaction, depression, interoceptive awareness, and mindfulness.

 

The mindfulness group but not the control group had a marked and significant increase in childbirth self-efficacy and body awareness and decrease in pain catastrophizing after the intervention. The control group had a significant increase in depression from baseline to post-treatment and a further significant increase at the post-birth follow-up while the mindfulness group has a significant decrease in depression after treatment that was maintained at the post-birth follow-up. There was also a trend for the mindfulness group to be less likely to use opioid analgesics.

 

These are interesting and significant results that suggest that the addition of mindfulness training to standard birth education improves the women’s psychological state prior to and after birth. It decreases depression and worries about pain and makes the women feel more aware of their bodies and in better control of the childbirth process. Mindfulness training is known to decrease depression, and improve emotion regulation. It also focuses the individual on what is transpiring at the present moment which is much more manageable than the worst fears of the women. By focusing on now rather than the scary future, catastrophizing is minimized. These are important benefits that may have consequences for the later health and well-being of not only the mother but also the child.

 

So, improve pregnancy and birthing with mindfulness.

 

“Cue the spotlight on mindfulness. When nausea or aching ligaments can’t be alleviated with medication, or I can’t get away for a much-needed nap, or even just get through the morning without eight trips to the restroom, I try to dwell less on my misery and choose to be mindful instead.” – Ashley Jonkman

 

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

 

Duncan, L. G., Cohn, M. A., Chao, M. T., Cook, J. G., Riccobono, J., & Bardacke, N. (2017). Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison. BMC Pregnancy and Childbirth, 17, 140. http://doi.org/10.1186/s12884-017-1319-3

 

Abstract

Background

Childbirth fear is linked with lower labor pain tolerance and worse postpartum adjustment. Empirically validated childbirth preparation options are lacking for pregnant women facing this problem. Mindfulness approaches, now widely disseminated, can alleviate symptoms of both chronic and acute pain and improve psychological adjustment, suggesting potential benefit when applied to childbirth education.

Methods

This study, the Prenatal Education About Reducing Labor Stress (PEARLS) study, is a randomized controlled trial (RCT; n = 30) of a short, time-intensive, 2.5-day mindfulness-based childbirth preparation course offered as a weekend workshop, the Mind in Labor (MIL): Working with Pain in Childbirth, based on Mindfulness-Based Childbirth and Parenting (MBCP) education. First-time mothers in the late 3rd trimester of pregnancy were randomized to attend either the MIL course or a standard childbirth preparation course with no mind-body focus. Participants completed self-report assessments pre-intervention, post-intervention, and post-birth, and medical record data were collected.

Results

In a demographically diverse sample, this small RCT demonstrated mindfulness-based childbirth education improved women’s childbirth-related appraisals and psychological functioning in comparison to standard childbirth education. MIL program participants showed greater childbirth self-efficacy and mindful body awareness (but no changes in dispositional mindfulness), lower post-course depression symptoms that were maintained through postpartum follow-up, and a trend toward a lower rate of opioid analgesia use in labor. They did not, however, retrospectively report lower perceived labor pain or use epidural less frequently than controls.

Conclusions

This study suggests mindfulness training carefully tailored to address fear and pain of childbirth may lead to important maternal mental health benefits, including improvements in childbirth-related appraisals and the prevention of postpartum depression symptoms. There is also some indication that MIL participants may use mindfulness coping in lieu of systemic opioid pain medication. A large-scale RCT that captures real-time pain perceptions during labor and length of labor is warranted to provide a more definitive test of these effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427564/

Mindful Independence Day

Mindful Independence Day

 

By John M. de Castro, Ph.D.

 

“If today is a celebration of freedom, I think we as a nation, as a people, have squandered an opportunity. We have sought outer freedoms and ignored inner freedoms. We have pursued these freedoms with scandal, exploitation, and domination. Today, instead, I urge you to consider inner freedom.” – Arnie Kozak

 

Virtually every country in the world sets aside one day each year to celebrate its independence. In the U.S. that day is July 4th. On this day the country’s citizens celebrate their freedom and independence and the fight that achieved it. It’s a pleasant holiday filled with patriotism, flags, parades, picnics, and fireworks displays. Although the founding of the great American democracy is something to celebrate, a mindful look at it produces a recognition that there are significant limitations on independence and freedom. We are nowhere near as free and independent as we think we are.

 

Independence from what? It’s certainly not from the imposition of government on the individual. July 4th only celebrates the changeover from government by the British monarchy to government by a more local political system. It’s certainly not independence from the imposition of laws and restrictions on the individual’s freedom. Perhaps there was a change of a few laws and regulations, but actually only a small number. It’s certainly not even the production of self-determination. In fact, the U.S. democracy was crafted and established by a few elite individuals and not by each individual in the country. In addition, democracy is rule by the majority, with the will of a significant number of people ignored. What we appear to be celebrating is the replacement of one system of control with another, perhaps better, system of control, but nevertheless a system of control; hardly independence.

 

Mindful reflection quickly produces an understanding that we’re never really independent. It’s certainly not even complete independence from another country. To this day the U.S. and the U.K. are very much dependent upon one another for trade of goods, ideas, culture, and mutual security. They’re locked together by treaties, cultural similarities, and close economic ties. The current political system that we’re celebrating is itself a recognition of how dependent upon one another we are. The system functions to set down the rules by which our relationships with one another are conducted. It’s there to insure orderly cooperation supposedly for the benefit of all participants.

 

Mindful reflection reveals that we’re not only dependent upon each other but we’re also dependent upon our environment, animate and inanimate. We’re dependent upon the air we breathe that is in turn dependent upon all other living organisms. We’re dependent upon the water we drink that is in turn dependent on global weather systems and solar evaporative power. We’re dependent upon the food we drink that is in turn dependent upon air, water, soil, and sun, and the farmers who grow it. In fact, we are so dependent upon everything and everybody that it may be more appropriate to be celebrating Dependence Day.

 

Well maybe then on July 4th we’re celebrating freedom and liberty. But, is any individual truly free. As the French philosopher Jean-Jacques Rousseau said “Man is born free: and everywhere else he is in chains. One thinks himself the master of others, and still remains a greater slave than they.” Regardless of the political independence each individual’s behavior is highly regulated by law and regulation. Our freedoms are actually very limited. They are bounded not only by law but also the practicalities of earning a living, maintaining a residence, having a family, and limitations on resources. Our freedom is also highly constrained by the laws of physics, chemistry, and biology. After all, we can’t fly, become taller, change our eye color, stay underwater for protracted periods, stay awake continuously, or withstand cold or heat outside of a fairly small range, and we’re not faster than a speeding bullet. How much freedom do we actually have in any particular day?

 

Independence Day, though, does celebrate acquiring many soft freedoms. The freedoms to think and express our opinions and ideas, to worship as we please, to vote for whoever we like, to associate with whomever we choose, to live wherever we like, etc. Although there are bounds to many of these freedoms by the requirements of public safety, economics, cultural norms, and the practicalities of existence, these are very important and significant freedoms. Perhaps that is what we’re really celebrating, these soft freedoms that were provided by our Constitution as a result of the War for Independence.

 

Regardless, Independence Day should be celebrated mindfully. It is often spent with family and friends and the pleasure of these interactions can be amplified by doing it mindfully; by being truly present for them and deeply listening to them rather than thinking about our next response. By being mindful we can see them with compassion and understanding. Being in, and focusing on, the present moment we can enjoy these interactions, we can enjoy the picnics and parades, we can enjoy the fireworks, rather than thinking about where we would rather be or where we’re going next. We can find happiness precisely where we are.

 

But are we truly free. A bit of mindful reflection reveals that we find existence very unsatisfactory. In fact, unsatisfactoriness is everywhere. We’re not satisfied with things as they are and want them to be different. We’re not satisfied with where we live and want to have a nicer home.  We’re not satisfied with our appearance and want to lose weight. We’re not satisfied with what people think of us and want to be universally liked. We’re not satisfied with how we’re treated by our spouses and want them to be more understanding. We’re not satisfied with our children and want them to be obedient, respectful, straight “A” students and star athletes. We’re not satisfied with our health and want to have fewer aches and pains. We’re not satisfied with our jobs and want to make more money, have more time off and be appreciated by our bosses and coworkers. Even on the very short-term, things are not satisfactory. We want the car ahead of us to be moving faster, we want time to pass quickly so that we can be done with work for the day, we want to stop ruminating about past indiscretions, we want to finish a meal quickly so we can get back to the TV, etc. In other words, we’re not free from our desires. In fact, we’re slaves to them. We’re not happy with the way things are. In fact, we seem to want everything to be different. So, we can’t be truly free as long as we’re slaves to our desires.

 

True freedom can only be produced when we are liberated from our incessant needs and wants. That is not to say that we shouldn’t have desires, but rather that we will not be controlled by them. True freedom comes from equanimity. It comes when we’re able to desire something, seek it out, but be OK whether we get it or not. It comes when we not only accept the way things are but enjoy each second for what it is, a precious moment in a limited lifetime. It comes when what other people do and say is seen as a reflection of them and not of us and comes when we look at them with compassion and understanding. In other words, we can want ourselves, things, people, and circumstances to be different but we accept them as they are and appreciate and enjoy life and each experience as a gift.

 

This sounds wonderful, but is it achievable? It sure doesn’t seem so as ourselves and the people we know haven’t achieved it. Is it possible to actually get to this state of complete freedom? It is, but it takes effort and discipline. There have been many instances throughout history and there are many exemplars present right now of people who have achieved complete equanimity. Jesus is a wonderful example. He worked hard and suffered to make his world a better place but in the end accepted what was. The Buddha, Christian mystics, Sufi masters, Zen masters, Gandhi, and a host of everyday people have all achieved true liberation. So, it is possible.

 

We do not, however, have to be aiming only at complete liberation. It is far better to work to simply improve on our current state and thereby become more and more liberated. We can do this by engaging in mindfulness practices such as meditation, yoga, tai chi, contemplative prayer, etc. we can learn to focus more and more on the present moment. We can learn to appreciate what is. We can learn to enjoy every moment. Just by improving a little we can become happier and happier, more accepting, and more liberated from our desires. We can achieve greater equanimity and with it greater freedom. But, we get there slowly and incrementally, building toward our complete liberation. Now wouldn’t that be a reason to celebrate Independence Day.

“Happy 4th of July.  Celebrate your freedom mindfully- express love and gratitude for all situations, people, places and things you encounter today. This practice of loving what is, is a mindful behavior. When we celebrate our freedom as a country, we bring love to the abundance we are free to encounter today. Take each situation you encounter as an opportunity to express your love, gratitude  – any kindness will do – that is freedom!” –  Regina Huelsenbeck

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