Improve Fibromyalgia Symptoms with Qigong

Improve Fibromyalgia Symptoms with Qigong

 

By John M. de Castro, Ph.D.

 

Evidence is growing for the Traditional Chinese practice of qigong as a treatment for fibromyalgia..” – Adrienne Dellwo

 

Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers. Clearly, fibromyalgia greatly reduces the quality of life of its’ sufferers.

 

There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Qigong is an ancient Chinese practice involving mindfulness and gentle movements. They are easy to learn, safe, and gentle. So, it may be appropriate for patients with fibromyalgia where exercise can produce painful flares. This suggests that Qigong might also be effective. Qigong practice involves body movements and also breathing exercises and meditation. It is not known which of these components are essential to produce benefits,

 

In today’s Research News article “The therapeutic efficacy of Qigong exercise on the main symptoms of fibromyalgia: A pilot randomized clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235941/), Sarmento and colleagues recruited adult non-obese female patients with fibromyalgia and randomly assigned them to receive either Qigong practice or a sham Qigong control condition. They received 2 weekly 45-minute training sessions followed by 10 weeks of daily practice at home. Qigong practice consisted of “deep diaphragmatic breathing, mild body movements, and meditation, along with uttering six healing sounds.”  The sham Qigong practice consisted of the body movements only. They were measured before and after training for self-reported pain levels, pressure pain thresholds, fibromyalgia impact, sleep quality, fatigue, quality of life, depression, and anxiety.

 

They found that in comparison to baseline and the sham Qigong group the participants that practiced Qigong had significantly lower levels of self-reported pain, fibromyalgia impact, fatigue, depression, and anxiety and significantly higher pressure pain thresholds and levels of sleep quality. These results are very interesting in that they demonstrate that Qigong practice markedly improves the symptoms of fibromyalgia in women.

 

The results are also interesting in that they demonstrate that the body movements component of Qigong practice is not essential for the benefits. The fact that the exercise is not effective alone is not surprising as it’s been reported that exercise can actually increase the likelihood of a fibromyalgia flare. The results suggest that breath control and meditation are essential for Qigong practice to improve the symptoms of fibromyalgia. It would appear that the mindfulness components of Qigong practice are essential. Previous research has shown that mindfulness training can improve the symptoms of fibromyalgia. The present results further confirm the effectiveness of mindfulness in reducing the women’s suffering.

 

Fibromyalgia patients suffer greatly and to bring relief with a simple, gentle, safe practice is very important. Qigong is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Hence, Qigong practice would appear to be a wonderful effective treatment for the relief of the suffering of fibromyalgia patients.

 

So, improve fibromyalgia symptoms with qigong.

 

“qigong in fibromyalgia. . . . there are consistent benefits in pain, sleep, impact, and physical and mental function following the regimen, with benefits maintained at 4-6 months.” – Jane Sawynok

 

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

 

Sarmento, C., Moon, S., Pfeifer, T., Smirnova, I. V., Colgrove, Y., Lai, S. M., & Liu, W. (2020). The therapeutic efficacy of Qigong exercise on the main symptoms of fibromyalgia: A pilot randomized clinical trial. Integrative medicine research, 9(4), 100416. https://doi.org/10.1016/j.imr.2020.100416

 

Abstract

Background

Some of the most debilitating symptoms of fibromyalgia (FM) include widespread chronic pain, sleep disturbances, chronic fatigue, anxiety, and depression. Yet, there is a lack of effective self-management exercise interventions capable of alleviating FM symptoms. The objective of this study is to examine the efficacy of a 10-week daily Qigong, a mind–body intervention program, on FM symptoms.

Methods

20 participants with FM were randomly assigned to Qigong (experimental) or sham-Qigong (control) groups, with participants blinded to the intervention allocation. The Qigong group practiced mild body movements synchronized with deep diaphragmatic breathing and meditation. The sham-Qigong group practiced only mild body movements. Both groups practiced the interventions two times per day at home, plus one weekly group practice session with a Qigong instructor. Primary outcomes were: pain changes measured by the Short-Form McGill Pain Questionnaire, a visual analog scale for pain, pressure pain threshold measured by a dolorimeter. Secondary outcomes were: the Revised Fibromyalgia Impact Questionnaire the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale and the Quality of Life Scale.

Results

The experimental group experienced greater clinical improvements when compared to the control group on the mean score differences of pain, sleep quality, chronic fatigue, anxiety, depression, and fibromyalgia impact, all being statistically significant at p < 0.05.

Conclusion

Daily practice of Qigong appears to have a positive impact on the main fibromyalgia symptoms that is beyond group interaction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235941/

 

Mindfulness Improves the Emotion Regulation in Patients with Schizophrenia

Mindfulness Improves the Emotion Regulation in Patients with Schizophrenia

 

By John M. de Castro, Ph.D.

 

Mindfulness treatments do not aim to decrease the occurrence or severity of the symptoms of psychosis, but by helping to reduce the distress people experience, many of these treatments help indirectly to alleviate psychotic symptoms as well.” – Tania Lecomte

 

Schizophrenia is the most common form of psychosis. It effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by both positive and negative symptoms. Positive symptoms include hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. Negative symptoms include a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Mindfulness training has been shown to be beneficial for a variety of mental health problems, including psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. Patients with schizophrenia have difficulty regulating emotions and mindfulness training improves emotion regulation. Hence, it makes sense to investigate the effectiveness of mindfulness training in improving emotion regulation in patients with schizophrenia.

 

In today’s Research News article “The Effectiveness of a Mindfulness-Based Psychoeducation Programme for Emotional Regulation in Individuals with Schizophrenia Spectrum Disorders: A Pilot Randomised Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075335/), Lam and colleagues recruited adult patients diagnosed with schizophrenia-spectrum disorders and randomly assigned them to a treatment as usual control condition or to receive a 90 minute once a week for 8 weeks Mindfulness-Based Psychoeducation Program (MBPP) including “engagement and empowerment, mindfulness in daily living and problem solving, mindfulness in illness management and equip and prepare for the future.” Patients also performed daily mindfulness practice. They were measured before and after training and 3 months later for the emotion regulation processes of reappraisal and suppression, rumination, psychotic symptoms, mindfulness, anxiety, and depression.

 

Engagement in the Mindfulness-Based Psychoeducation Program (MBPP) was high with 85% of participants attending 6 or more sessions with average attendance of 6.88 sessions. The average amount of home practice was 31 minutes per week. Hence the program can be successfully implemented and is acceptable to the patients.

 

They found that in comparison to baseline and the treatment as usual group after Mindfulness-Based Psychoeducation Program (MBPP) there was a significant improvement in mindfulness and the emotion regulation strategy of reappraisal. These improvements were maintained for 3 months after the end of training. The results suggest that mindfulness training improves the emotion regulation strategy of reappraisal in patients diagnosed with schizophrenia-spectrum disorders.

 

Reappraisal is a cognitive strategy to reinterpret the origin and meaning of an emotional event to reduce its impact. This is an effective emotion regulation strategy to help the individual cope with emotions. Since, problems with emotions are common in schizophrenia, improving emotion regulation may be of great assistance to them in dealing with the symptoms of the disease.

 

So, mindfulness improves the emotion regulation in patients with schizophrenia.

 

“mindfulness-based psycho-educational intervention expressly designed for patients with schizophrenia can be well tolerated and result in better illness outcomes than either standard treatment alone or standard treatment supplemented by a more typical psycho-educational approach. This is an important finding because of the widely held belief that psychotic patients can neither tolerate nor benefit from mindfulness-based interventions.” – American Mindfulness Research Association

 

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

 

Lam, A., Leung, S. F., Lin, J. J., & Chien, W. T. (2020). The Effectiveness of a Mindfulness-Based Psychoeducation Programme for Emotional Regulation in Individuals with Schizophrenia Spectrum Disorders: A Pilot Randomised Controlled Trial. Neuropsychiatric disease and treatment, 16, 729–747. https://doi.org/10.2147/NDT.S231877

 

Abstract

Background

Emotion dysregulation has emerged as a transdiagnostic factor that potentially exacerbates the risk of early-onset, maintenance, and relapse of psychosis. Mindfulness is described as the awareness that emerges from paying attention to the present moment without judgment. It gently pulls the mind out of the negative emotions induced by the disparity between expectation and reality by focusing on the present moment, instead of worrying about the future or regretting the past. However, only a few research has ever focused on the efficacy of using a mindfulness-based intervention to improve emotion regulation in schizophrenia spectrum disorders.

Purpose

The purpose of this study was to examine the effectiveness of a Mindfulness-Based Psychoeducation Programme (MBPP) on the emotion regulation of individuals with schizophrenia, in particular, to access emotion regulation strategies. The objective of this study was to find out whether MBPP is feasible for improving emotion regulation strategies, in terms of rumination, cognitive reappraisal, and expressive suppression, with a sustainable effect at a three-month follow-up.

Patients and Methods

A single-blinded pilot randomised controlled trial with repeated-measures designs was adopted. Forty-six participants diagnosed with schizophrenia and its subtypes were randomised in either the 8-week mindfulness-based psychoeducation programme or treatment-as-usual (control) group.

Results

The results of the Generalised Estimating Equations test indicated that the MBPP group showed a significant improvement in reappraisal at a three-month follow-up (β = −6.59, Wald’s χ2=4.55, p=0.033), and a significant reduction in rumination across time. However, the Generalised Estimating Equations indicated no significant difference in rumination and expressive suppression in the MBPP group. Two participants reported having unwanted experiences, including feelings of terror and distress during the mindfulness practice.

Conclusion

The MBPP appeared to be effective for improving emotion regulation, which will contribute to future large-scale RCT to confirm the treatment effects in more diverse groups of schizophrenic patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075335/

 

Exercise on the Eightfold Path

mindful exercise running swimming walking | Stress Less Kzoo

Exercise on the Eightfold Path

 

By John M. de Castro, Ph.D.

 

“it’s possible to merge awareness and physical exercise together as one. This allows you to experience the present moment during your physical activity.” – Adam Brady

 

We often think of meditation or spiritual practice as occurring in quiet places removed from the hubbub of life. This is useful to develop skills and deep understanding. Unfortunately, most people do not have the luxury of withdrawing into solitary or monastic life. But it is possible to practice even in the midst of the chaos of everyday life. In fact, there are wonderful opportunities to practice presented to us all the time in the complexities of the modern world. I find that engagement in exercise is one of many wonderful contexts in which to practice the Buddha’s Eightfold Path, the Buddha’s prerequisites for the cessation of suffering; Right View, Right Intentions, Right Actions, Right Speech, Right Livelihood, Right Effort, Right Mindfulness, and Right Concentration. Engaging in exercise on the eightfold path can not only improve health but also can contribute to spiritual development. As a bonus it can make exercising more enjoyable.

 

As we well know, engaging in regular physical exercise is important for our physical and mental health. Similarly, practicing mindfulness is important for our physical, psychological, and spiritual well-being. Together they are a dynamite. But what needs to be done to combine them? With a little reflection, a myriad of opportunities to practice are available while exercising. The details will vary with the type of exercise and the individual, but these same opportunities are available regardless of the nature of the exercise.

 

An important component of developing the “Right View” is the recognition that all things are impermanent, they come and they go and never stay the same. When exercising it is easy to note that everything about the workout is impermanent. The body is stressed by exercise and this is a good thing as this is what leads to the beneficial effects of exercise. When moderately stressed muscles heal, they grow stronger. Sometimes the stress is pleasant and other times not so. But no matter what it will change, perhaps getting better or perhaps getting worse, but it will not stay the same. During exercise, the physical and mental state of the individual is constantly changing. The body fatigues and grows tired. Pain and discomfort may come and go. By recognizing how fleeting these feelings are, we witness the impermanence of all things. We grow to not only better understand the body and how it benefits from exercise but also see the operation of impermanence. This produces relaxation and acceptance of the body as it is, even as it’s changing, not only improving the exercise but reinforcing “Right View”.

 

A good example of this is practicing while running. I’m older and my knees are worn out so I practice this while speed walking. Noting the sensations from the foot each time in strikes the ground and as it lifts off the ground, it’s apparent that the sensations are constantly changing and never the same. Impermanence is on display. The same goes for the surrounding sights which are constantly changing. It’s impossible to hold onto any of the myriad of sensations occurring. They are constantly arising and passing away. Impermanence is on display.

 

Another important component of “Right View” is the recognition that everything is interconnected. This is readily apparent during exercise. During yoga practice all of the aspects of the body work together. As the muscles are stressed they increase the heart rate and respiration. With each pose the muscles produce heat, causing sweating and dilatation of the blood vessels at the surface. Moving into each pose produces changes in balance which produce automatic changes in other muscles to compensate and maintain balance and equilibrium. The senses are engaged in monitoring for pain and fatigue and guiding the exercise. Try paying attention to all of the parts of the body and how they are affected in performing a forward bend, a tree pose, or a lower cobra. By paying attention to these processes during this practice, how the entire body is engaged can be witnessed even if the exercise is targeted at only particular muscles. Interconnectedness is completely apparent. The awareness of this interconnectedness allows for better exercise while reinforcing “Right View”.

 

One practice I employ with exercise is to identify the limiting component. For me it’s breathing that seems to limit what I can do. My ability to play basketball is limited by the ability to get oxygen to the muscles while sprinting down the court. For others, it’s their knees or other joints, or cardiac capacity, or body temperature. There’s always something that keeps the individual from going faster, or being stronger or more accurate. The ability of the entire body to excel is limited by this factor. All other aspects of physical function are restrained by it. All other aspects are interconnected with it. as it all works together.

 

This interconnectedness is particularly apparent in team sports. In these contexts, participants affect one another, everyone on the team and everyone on the opposing team. In fact, that interconnectedness is part of the allure and enjoyment of team sports. As every athlete knows, performance is also affected by the individual’s psychological state. At times, exercisers just don’t feel like doing it but force themselves. While at other times, they feel great and can’t wait to get into it. In both cases this psychological state markedly alters the exercise. It’s all interconnected. Hence, the “Right View” of interconnectedness is readily apparent during exercise. Make it part of the exercise to pay attention to and recognize this interconnectedness. It’s on display.

 

Still another important component of “Right View” is the recognition of the presence of suffering and unsatisfactoriness in all activities. Exercising is a wonderful opportunity to observe this unsatisfactoriness and its roots. While cycling we want everything to be a certain way and when it isn’t, we are unhappy. We want to go faster, or with have greater strength for peddling up hills, or with greater endurance to ride further. The cyclist wants the weather to be just right, the wind to die down, to always be at the back, or for it to be cooler. We want the body’s discomforts to go away. In other words, rather than enjoy cycling, we make it unsatisfactory by not accepting how things are. All things, big and small, are almost always less than optimum. If we focus on this and crave it to be different, then we suffer. But, if we simply accept these conditions as they are, we can ride our bicycle with appreciation and enjoyment with unsatisfactoriness on display. Note, how this constantly arises in thoughts during exercise. Recognizing this can lead to greater understanding of how we make ourselves unhappy, and how by simply accepting things as they are produces better performance and greater enjoyment. Practicing this will reinforce “Right View.”

 

While exercising, playing sports, or being an observer there are frequent opportunities to practice “Right Intentions.” Here reducing or preventing harm and promoting greater happiness, wisdom, and well-being for all participants can be practiced. This is particularly important for team sports. It is useful, beforehand, to set this intention to make engaging in the game be beneficial for all participants. “Right Intentions” involves targeting what to do while exercising to increase peace, well-being, and happiness, including the abandonment of unwholesome desires.

 

If exercise particularly in competitive sports, is engaged in with anger, impatience, selfishness, and resentment it is likely to produce harm to everyone involved. Sports, such as football, can be dangerous and can produce physical harm to others. Obviously, games like football are particularly good candidates to play with “Right Intentions.” This way injury or harm can be minimized. It would seem obvious, but taking the time beforehand to establish “Right Intentions” may determine if the game is fun and wholesome or negative and harmful.

 

When I was young playing basketball with friends an opponent grabbed me as I ran toward the basket. I got angry and retaliated by shoving my friend away forcefully. He fell back so hard that he was momentarily paralyzed. This scared everyone and especially me. It made me recognize the potential harm that I could cause by acting on anger. If I had simply accepted that I was fouled and let it go, no harm would have occurred and play could have continued. The recognition that anger can only lead to more harm is wisdom that can lead to minimizing harm and promoting the greater good. Seeing the situation as it is, and seeing opponents with eyes of compassion leads to skillful actions promoting the happiness and well-being of all.

 

I’ve found that playing golf is a wonderful opportunity to practice. It has always amazed me how players make themselves so unhappy while engaging in something that’s supposed to be fun. I’ve seen players go into a rage after hitting a poor shot, screaming profanities, pounding their club into the ground or throwing or even breaking the club in rage. This can create a negative atmosphere that sweeps all the players up into a negative mood and destroys the fun and happiness that is the point of playing the game. “Right Intentions” can help here. I’ve learned to approach the game as just that, a game that is to be enjoyed, to laugh at my own incompetence, and joke with the other players about our plight.

 

We go around the course laughing and having a ball. What a difference it can make, I’ve had other players remark how much they admire me, not for my play which is horrible, but for my enjoyment of the game regardless of how well or more often terribly I play. It changes the atmosphere and infects those that I play with. Just setting the intention ahead of time to have fun regardless, to promote happiness, makes a world of difference. The ripples of good feelings that are created, may spill over from golf to home or work life enhancing life in general.

 

Playing sports with courtesy, with tolerance and understanding, with kindness and good will needs to be continuously worked on. It’s a practice. “Right Intentions” are a key. They become the moral compass. They tend to lead in the right direction even though at times there are stumbles.  It is often difficult or impossible to predict all of the consequences of actions. It is also very difficult avoid all harm. But forming “Right Intentions” and aspiring to create good and happiness will produce more harmony, good will, and happiness and for the practitioner it will produce progress along the eightfold path.

 

Exercising is another situation to practice “Right Actions.” To some extent taking care of our bodies is “Right Action” as it benefits our health and well-being, which relieves suffering and increases happiness. While working out “Right Actions” includes following the “Middle Way.” Exercising overly aggressively could produce injury while exercising too lightly is probably a waste of time. While exercising in social contexts such as in a gym or jogging with friends, there can be a tendency to show off. This can be harmful to others by promoting jealousy or decreasing their feelings of self-worth or causing them to try too hard potentially leading to injury.

 

I used to jog with a group that met at lunchtime. We would all wait around until everyone was there to begin our run. But as soon as we began, one particular runner always leapt ahead and ran well in front of the group for the entire run. At first many of us would try to keep up. This would simply lead to him running even faster to stay ahead. This was not good. We were exercising, not racing. It detracted from the good feelings and camaraderie of the group and caused many of us to run too fast for our ability and to suffer. After a while we learned to ignore him and enjoy running with the rest of the group. This was “Right Actions.” It did make me wonder what suffering was driving him to turn a healthy and fun social run into a race and what I might do to help relieve that suffering. But he always ran ahead and alone making it impossible to communicate.

 

In some sports lying and cheating occur frequently. Fishing and golf are wonderful examples. outright lied about. Golfers frequently do things such as surreptitiously move their ball to a better lie, or report a lower score than they actually had. This is not “Right Actions.” Scrupulous honesty on the long-term leads to greater happiness and well-being even in these kinds of small and often accepted dishonesties.

 

While engaging in competitive sports we should have the “Right Intentions” of promoting good and happiness, and relieve suffering in ourselves and others. We can do so by competing patiently and courteously with attention and good sportsmanship. Unfortunately, the prevalent attitude is that “winning is everything.” This works contrary to “Right Actions.” With “Right Actions” promoting happiness, and relieving suffering in everyone involved “is everything.”  We can only control our own actions while competing. So that is where we practice. But, when we compete with “Right Actions” it affects our competitors, making the game more enjoyable, healthier, and productive for everyone.

 

Verbal and non-verbal interactions are frequently present while exercising, playing sports, or even as a spectator. There are many opportunities to practice “Right Communications”. It involves communicating in such a way as to promote understanding and to produce good feelings. It is non-violent and non-judgmental communications. While engaging in exercise or sports it is important to think before communicating, is the communication true, is it necessary, and is it kind.

 

While playing golf we communicate verbally and non-verbally and try to do so with “Right Communications”. When someone makes a great shot, we celebrate with them, possibly teasing them as to why they can’t do that every time, and when they make a terrible shot kidding them that it was better than they usually do, or compare it to our own terrible shots. Note that teasing may not on the surface seem to be true, necessary, and kind. But it can lighten the atmosphere and the back and forth can promote good feelings. Non-verbally, we sometimes celebrate ridiculously, dancing around like a clown, when making a good shot, again promoting enjoyment.

 

Right Communications” often involves deep listening. It is impossible to respond appropriately to another if you haven’t listened carefully to exactly what the other said or looked carefully at their expressions or body language. In playing doubles tennis, watch and listen to your partner. They may show anger or slump after a poor shot. In this case “Right Communications” may involve encouraging the partner or pointing out that the shot that they were attempting was a great idea, or make light of it by saying something to the effect that the shot looked more like something you would do. What would be the right approach depends on the individual and the context. But watching and listening carefully can help to understand what communication may produce the most good and happiness.

 

Even as spectators it is useful to practice “Right Communications”. I’ve observed parents at youth soccer games yelling at referees, players, and coaches. My 13 year old grandson worked hard to become a referee for children’s soccer matches and earn extra money. But he has dropped it because of the abuse that these parents heaped on him for every decision. No matter what decision he made parents on one side or the other would chastise him. I’ve also seen the impact on the children as their parents yell at the referees or at them for their performance. It’s a truly sad display of wrong communications by the adults.

 

It’s quite simple to see that “Right Communications” are needed. If the parents had stopped and thought if what they were communicating was true, necessary, and kind, if they had listened deeply or watched with compassion, there may have been a completely different atmosphere at the games, my grandson may still be refereeing, and the children would feel good about playing and would be having fun. Such behavior is not confined to youth soccer. Simply observe fans at sporting events even at the professional level, yelling obscenities and insults at opponents or even at their own team’s players. Indeed, even the players are taunting, hurling insults, and “trash talking” to each other. It is clear that there is a great need to teach fans and players, not only good sportsmanship, but also “Right Communications”. We may not be able to change others but at least we can conduct “Right Communications”.

 

There are many ways that people can make a living with exercise and sports, from a professional athlete or coach to a personal trainer, to a general manager or executive. This can be itself “Right Livelihood”. It is if it is directed to creating good, helping people, keeping peace, and moving society forward in a positive direction. College coaches using student athletes to further their careers without regard to the furtherance of the players well-being or teaching player “dirty tricks” to harm or injure their opponents would definitely not be “Right Livelihood”.

 

One should reflect deeply on what they’re doing to ascertain whether it promotes good. It is not ours to judge the “rightness” of the livelihood of athletes, coaches, sports executives etc. This is a personal matter where intention matters, that must be reflected upon deeply. The process itself of evaluating “Right Livelihood” may heighten awareness of the consequences of participating in their careers and make them better able to see and correct where they may be going wrong. This can help move the individual along the Buddha’s path.

 

Exercise also presents a fine context to practice “Right Effort”. In fact, exercise has its maximum benefit when it is fairly strenuous but not too strenuous. If it’s overdone the body will provide appropriate feedback with aches and pains, hopefully not injuries. If it’s done lazily, the body will not improve. So, exercise is almost a perfect situation to teach “Right Effort”. It involves acting according to the “Middle Way.” That is, not trying too hard and getting hurt, but also not being lackadaisical.  “Right Effort” is a relaxed effort. The “Middle Way” is where effort should be targeted.

 

Experienced yoga practitioners know this all too well. Yoga can be very beneficial when practiced with “Right Effort” but can be injurious when done improperly. Poses must be held at the appropriate level, slightly backed off from the individual’s limit without going beyond. Struggling to go deeper, beyond the practitioner’s capability, is a formula for injury. Entering too lightly is a formula for wasting time and receiving no benefit. So, not only is yoga practice a good place to practice “Right Effort” it, in fact, provides feedback demonstrating what the “Right Effort” level should be.

 

Athletes know that to perform optimally they must relax and not press too hard. This is one of the reasons why meditation practice has proved so beneficial for athletes. It allows them to relax into the present moment and react appropriately to their body’s capabilities. I’ve found that with swimming, if I try too hard to go fast, I actually go slower. On the other hand, when I simply swim with moderate effort but with a relaxed body, it produces and efficient stroke and an appropriate body position in the water for optimum speed. So, “Right Effort” with exercise pays off with optimum performance, physical benefit, and progress on the eightfold path.

 

Exercise requires an accurate understanding of the state of our bodies and the environment in the present moment in order to determine what level of exercise are needed to promote good performance and enjoyment.  In other words, it requires “Right Mindfulness”. Unfortunately, for most of us mindless exercise is probably the norm. While exercising many people listen to music, talk on their cell phones, watch television, or carry on a conversation. But paying attention to what is being experienced while exercising or engaging in sports can turn the exercise into a meditative practice. It creates a richly textured experience of physical and mental activities. It heightens the experience and makes it much more enjoyable.

 

A prototype is walking meditation, where the individual practices “Right Mindfulness”. The meditator pays close attention to the sensations from the body while slowly walking. Observing each step, feeling the foot hit the ground and pull off the ground, observing each breath, feeling the air on the skin and the touch of the clothing, feeling the muscles contract and relax, experiencing the sights, smells and sounds in the environment. It’s an amazingly pleasant and productive practice.

 

With exercise, the same technique can be used but greatly speeded up. Jogging can be a speeded-up version of walking meditation. I use “Right Mindfulness” while swimming laps in a pool by doing a body scan. I start on the first lap with paying attention to the sensations from the toes, on the second lap I move to the tops of my feet, next to the bottoms of the feet, to the ankle, shin, knee, thigh etc. The feeling of the water and the movement of each body part is an exquisite practice. I was tired of the boredom of swimming until I developed this practice. It makes the drudgery of lap swimming mindful, interesting, and pleasurable, not to mention that my stroke becomes more efficient and the laps go by quickly. “Right Mindfulness” can be applied to virtually every exercise and sporting activity and will not only make it better but help the participant along the Buddha’s eightfold path.

 

“Right Concentration” is the practice of focusing the mind solely on one object or a specific unchanging set of objects. Mindfulness is paying attention to whatever arises, but concentration is paying attention to one thing to the exclusion of everything else. This is usually developed during contemplative practice such as meditation. It is difficult to practice during the complex activities involved in exercise. But during repetitive automatized exercises such as jogging concentration on the breath can be practiced.

 

Engaging in exercise on the eightfold path is a practice. Over time I have gotten better and better at it, but nowhere near perfect. Frequently the discursive mind takes over or my emotions get the better of me. But, by continuing the practice I’ve slowly progressed. I’ve become a better at seeing what needs to be accomplished. I am learning to be relaxed with a smile on my face when I engage in exercise and enjoy the workout.

 

Can we attain enlightenment through exercise? Probably not! But we can practice the eightfold path that the Buddha taught leads there. The strength of engaging exercise with the practices of the eightfold path is that it occurs in the real world of our everyday life. Quiet secluded practice is wonderful and perhaps mandatory for progress in spiritual development. But for most people it only can occur during a very limited window of time. By extending the practice directly into the mainstream of our lives we can greatly enhance its impact. I like to keep in mind the teaching that actions that lead to greater harmony and happiness should be practiced, while those that lead to unsatisfactoriness and unhappiness should be let go.  Without doubt, by practicing the eightfold path in our engagement in exercise leads to greater harmony and happiness and as such should definitely be included in our spiritual practice.

 

“The message is that mindfulness may amplify satisfaction, because one is satisfied when positive experiences of physical activity become prominent. For those experiences to be noticed, one must become aware of them. . . this can be achieved by being mindful.” – Kalliopi-Eleni Tsafou

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Lower Social Anxiety is Associated with Mindfulness in Nepalese Adolescents

Lower Social Anxiety is Associated with Mindfulness in Nepalese Adolescents

 

By John M. de Castro, Ph.D.

 

At the basic level, social anxiety refers to fear or worry related to interactions in social situations. It is normal for teens to get anxious about public speaking or going on a first date. However, for those with social anxiety, the fears and thoughts are too intense, cause high stress and make the person avoid activities of daily living that could bring joy into their life.” – Silvina Galperin

 

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.

 

Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD).

 

Mindfulness training was examined as a treatment for emotional disorders in affluent western populations which are not necessarily representative of the unique situations, cultures, and education levels of diverse populations. Hence, there is a need to investigate the effectiveness of mindfulness with diverse populations. There are indications that mindfulness therapies may be effective in diverse populations. But there is a need for further investigation the associations of mindfulness with emotional disorders in different populations.

 

In today’s Research News article “Social support, emotion regulation and mindfulness: A linkage towards social anxiety among adolescents attending secondary schools in Birgunj, Nepal.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7117668/), Singh and colleagues recruited adolescents from schools in Nepal and measured them for social anxiety, social support, emotion regulation, and mindfulness.

 

They found that the higher the levels of social anxiety the lower the levels of the mindfulness facets of describing and acting with awareness, the emotion regulation facets of awareness, clarity, and acceptance, and social support especially from friends, relatives, and teachers. They also found that social anxiety levels were higher in females and older adolescents. Taken together, mindfulness, emotion regulation, social support, age, and gender explained 41% of the variance in social anxiety in the adolescents.

 

These results are correlational and as such causation cannot be determined. The results also are similar to those observed in different ethnic groups with mindfulness associated with lower levels of social anxiety and greater levels of emotion regulation. This further suggests that mindfulness relationships with social anxiety in Nepal are similar to other cultures. This suggests that these association apply almost universally across cultures and ethnicities.

 

In many of the previous studies, mindfulness was trained and it was found to cause changes in social anxiety and emotion regulation. So, the current findings probably represent causal connections between these variables. They further imply that training in mindfulness may be helpful in lowering social anxiety and improving emotion regulation in Nepalese youth.

 

In the present study there was no attempt to determine mediation. Since mindfulness is associated with higher levels of emotion regulation and emotion regulation is associated with lower levels of social anxiety, it is possible that mindfulness decreases social anxiety directly and also indirectly by improving emotion regulation. In addition, social support is associated with higher mindfulness. So, it is possible that social support decreases social anxiety directly and also indirectly by improving mindfulness. It will remain for future research to explore these hypotheses.

 

So, lower social anxiety is associated with mindfulness in Nepalese adolescents.

 

If you are suffering with the symptoms of social anxiety disorder (SAD), regular practice will eventually improve your self-concept and ability to handle negative emotions. You will also learn how to better respond to troubling thoughts and treat yourself with more compassion.” – Arlin Cuncic

 

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

 

Singh, R., Singh, B., Mahato, S., & Hambour, V. K. (2020). Social support, emotion regulation and mindfulness: A linkage towards social anxiety among adolescents attending secondary schools in Birgunj, Nepal. PloS one, 15(4), e0230991. https://doi.org/10.1371/journal.pone.0230991

 

Abstract

There has been a growing burden of anxiety among Nepalese adolescents. Social anxiety in particular is one of the commonly reported symptoms indicating mental health problem among adolescents. The purpose of this study was to assess social anxiety, and identify how social support, emotion regulation and mindfulness uniquely contribute to social anxiety among adolescents in Birgunj, Nepal. The study was conducted by using a self-administered questionnaire among 384 adolescents (65.4% boys; M = 16.05 years, SD = 1.39) studying at secondary schools of Birgunj. Results show that there was a positive correlation between social anxiety symptoms and age, and girls reported more symptoms. Traits such as non-acceptance of emotions, lack of clarity and lack of awareness of emotions were related to increased social anxiety; while acting with awareness, non-reactivity, and better ability to describe emotions was related to decreased social anxiety. Finally, more social support from close friends was related to lower social anxiety. These results suggest that improving emotion regulation, dispositional mindfulness, and social support may be helpful for adolescents who are at risk of, or are suffering from, social anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7117668/

 

Reduce Blood Pressure in Patients with Noncommunicable Diseases with Mindfulness

Reduce Blood Pressure in Patients with Noncommunicable Diseases with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness practice can be an effective way to reduce blood pressure (and along with it, the risk of stroke or heart attack).” – NICABM

 

High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.  It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Treatment frequently includes antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely.

 

Obviously, there is a need for alternative to drug treatments for hypertension. Mindfulness practices have been shown to aid in controlling hypertension. Indeed, meditation, tai chi, and yoga, have also been shown to be helpful for heart health. Hypertension is frequently cooccurring with in patients with non-communicable diseases. In today’s Research News article “Mindfulness interventions reduce blood pressure in patients with non-communicable diseases: A systematic review and meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc), Intarakamhang and colleagues review, summarize and perform a meta-analysis of the effectiveness of mindfulness training in reducing blood pressure in patients with non-communicable diseases.

 

They defined non-communicable diseases (NCDs) to include cancers, cardiovascular diseases, respiratory diseases and diabetes and identified 14 published controlled studies including a total of 1117 patients. They report that the studies found that mindfulness training significantly reduced both systolic and diastolic blood pressure in the patients with NCDs.

 

The results are compatible with previous findings that mindfulness training reduces blood pressure in a wide variety of healthy and ill individuals. The present study demonstrates that mindfulness training is effective in reducing blood pressure in patients with non-communicable diseases (NCDs). This is reasonable given that mindfulness training has been shown to improve the symptoms of patients with the included NCDs, cancers, cardiovascular diseases, respiratory diseases and diabetes.

 

There are a number of possible mechanisms for this blood pressure reduction. Mindfulness training is known to reduce the physiological and psychological responses to stress and this may in turn lower blood pressure. Also mindfulness training has been shown to affect the autonomic nervous system increasing parasympathetic activity that tends to reduce blood pressure.

 

So, reduce blood pressure in patients with noncommunicable diseases with mindfulness.

 

“The hope is that if we can start mindfulness training early in life, we can promote a trajectory of healthy aging across the rest of people’s lives. That will reduce their chances of getting high blood pressure in the first place.” – Eric Loucks

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

Intarakamhang, U., Macaskill, A., & Prasittichok, P. (2020). Mindfulness interventions reduce blood pressure in patients with non-communicable diseases: A systematic review and meta-analysis. Heliyon, 6(4), e03834. https://doi.org/10.1016/j.heliyon.2020.e03834

 

Abstract

Purpose

Mindfulness based interventions (MBIs) are an emerging area of empirical study, not only in positive psychology, but also in clinical health care. This research aims to synthesize the evidence about whether MBIs reduce blood pressure (BP) in patients with non-communicable diseases (NCDs).

Methods

Relevant studies were identified via PubMed, the Cochrane Library, Embase and the CINAHL database between 2009 and 2019. The papers selected focused on mindfulness and the effect of these on the BP of patients with NCDs. The change in SBP and DBP were meta-analyzed, stratified by type of intervention (Breathing awareness meditation (BAM), Mindfulness Meditation (MM), and Mindfulness-based Stress Reduction (MBSR).

Results

Fourteen articles met eligibility criteria and were included in the final review. Among the studies using the type and duration of intervention, systolic BP was reduced after the mindfulness-based stress reduction for 8 weeks (-6.90 mmHg [95% CI: -10.82, -2.97], p < .050), followed by the breathing awareness meditation for 12 weeks (-4.10 mmHg [95% CI: -7.54, -0.66], p < .050) and the mindfulness-based intervention for 8 weeks (-2.69 mmHg [95% CI: -3.90, -1.49], p < .050) whereas diastolic BP was reduced after the mindfulness-based stress reduction for 8 weeks (-2.45 mmHg [95% CI: -3.74, -1.17], p < .050) and the mindfulness-based intervention for 8 weeks (-2.24 mmHg [95% CI: -3.22, -1.26], p < .050).

Conclusion

MBIs can provide effective alternative therapies to assist in blood pressure reduction for patients with NCDs.

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

 

Generalized Anxiety Disorder with Co-occurring Major Depression is Associated with Lower Mindfulness

Generalized Anxiety Disorder with Co-occurring Major Depression is Associated with Lower Mindfulness

 

By John M. de Castro, Ph.D.

 

attempts to avoid uncomfortable thoughts and feelings may worsen anxiety. The paradox here is that mindfulness helps us turn toward those and learn to change our relationship to the actual thoughts and the physical sensations, rather than try to change them in any way. By changing [that] relationship, we actually stop feeding those cyclical processes and they start to die off on their own.” – Judson Brewer

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments.

 

One of the premiere measurement tools for mindfulness is the Five Factors of Mindfulness Questionnaire. It measures overall mindfulness and also five facets; observing, describing, acting with awareness, non-judgement, and non-reactivity. People differ and an individual can be high or low on any of these facets and any combination of facets. It is not known what pattern of mindfulness facets are most predictive of the ability of mindfulness to improve anxiety disorders.

 

Depression often co-occurs with anxiety disorders. Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness has also been shown to be effective for depression. So, patients with generalized anxiety with co-occurring depression may have lower ability to be mindful.

 

In today’s Research News article “Facets of Mindfulness in Adults with Generalized Anxiety Disorder and Impact of Co-occurring Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662732/), Baker and colleagues recruited adult patients with Generalized Anxiety Disorder (GAD) and measured them for mindfulness, including observing, describing, acting with awareness, nonjudging, and nonreactivity facets, worry, depression, and severity of psychopathology.

 

The participants were separated into GAD with and without Major Depressive Disorder. They found that the GAD participants who also had co-occurring Major Depressive Disorder were lower in mindfulness, especially the acting with awareness facet of mindfulness. They also found that over the entire sample that higher levels of depression and worry were associated with lover levels of mindfulness. Looking at the facets of mindfulness they found that depression was negatively associated with acting with awareness and worry was negatively associated with the nonjudging and nonreactivity facets.

 

These are correlative findings and causation cannot be determined. But previous research has demonstrated that mindfulness training reduces anxiety and depression.  So, a causal connection is likely. The results, then, suggest that patients with Generalized Anxiety Disorder (GAD) are less likely to act with awareness if they also have Major Depressive Disorder. In addition, With GAD patients in general higher levels of depression were associated with lower levels of acting with awareness. Depression is associated with very low energy levels. So, it makes sense that the presence of depression would interfere with taking mindful action.

 

They also found that the higher the levels of worry the lower the levels of the nonjudging and nonreactivity mindfulness facets. This suggests that worry in patients with Generalized Anxiety Disorder (GAD) interferes with the ability to not judge and not react to inner experience. Conversely, worry promotes judging and reacting to inner experience. Patients who have high anxiety are worried about potential future negative occurrences and as such may judge inner experience as indicative of a problematic future and so react to it more.

 

So, the results indicate that Generalized Anxiety Disorder with co-occurring Major Depression is associated with lower mindfulness.

 

a way to reduce the symptoms of anxiety is to be fully, mindfully, anxious. As anxiety reveals itself to be a misperception, symptoms will dissipate.” – George Hofmann

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

Baker AW, Frumkin MR, Hoeppner SS, et al. Facets of Mindfulness in Adults with Generalized Anxiety Disorder and Impact of Co-occurring Depression. Mindfulness (N Y). 2019;10(5):903‐912. doi:10.1007/s12671-018-1059-0

 

Abstract

Anxiety and depressive symptoms are associated with lower levels of mindfulness, yet few studies to date have examined facets of mindfulness in adults with Generalized Anxiety Disorder (GAD). In this study, we examined differences in mindfulness between individuals with GAD with and without concurrent Major Depressive Disorder (MDD) and/or Dysthymic Disorder (DD). We also examined the associations of anxiety and depressive symptoms with facets (subscales) of mindfulness. We hypothesized that individuals with primary GAD and co-occurring MDD/DD would exhibit lower mindfulness than those without a concurrent depressive disorder. We also hypothesized that mindfulness would be negatively correlated with worry and depressive symptom severity. Subjects were 140 adults (M (SD) age = 33.4 (12.9); 73% female) with a primary diagnosis of GAD; 30.8% (n = 43) also met criteria for current MDD/DD as determined by a structured clinical interview for DSM-IV. Current worry and depressive symptoms were assessed using self-report measures at baseline of a 12-week treatment study. Individuals with GAD and co-occurring MDD/DD exhibited significantly lower mindfulness than those without a depressive disorder diagnosis and specifically lower scores on the Awareness sub-scale compared to individuals with primary GAD and no comorbid depression. In terms of the dimensional impact of worry and depression ratings, depression symptoms independently predicted lower Awareness scores and worry independently predicted lower levels of Nonreacting and Nonjudging sub-scales. This may have direct treatment implications. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662732/

 

Improve Balance in Parkinson’s Disease with Tai Chi and Yoga

Improve Balance in Parkinson’s Disease with Tai Chi and Yoga

 

By John M. de Castro, Ph.D.

 

In addition to easing balance problems, and possibly other symptoms, tai chi can help ease stress and anxiety and strengthen all parts of the body, with few if any harmful side effects. . . with Parkinson’s disease.” – Peter Wayne

 

Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. There are around seven million people worldwide and one million people in the U.S. living with PD and about 60,000 people are diagnosed with PD every year. PD is associated with aging as the vast majority of patients are diagnosed after age 50. In fact, it has been speculated that everyone would eventually develop PD if they lived long enough.

 

Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. PD itself is not fatal but is often associated with related complications which can reduce life expectancy, such as falls, choking, and cardiovascular problems. PD also has psychological effects, especially cognitive decline, anxiety, and depression. Balance is a particular problem as it effects mobility and increases the likelihood of falls, restricting activity and reducing quality of life.

 

There are no cures for Parkinson’s Disease (PD) or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients.  In addition, Tai Chi and yoga practices have been shown to improve the symptoms of Parkinson’s Disease. Hence, mind-body practices may be excellent treatments for the symptoms of PD. It is important to discover which of various exercises works best to improve balance and mobility in patients with PD.

 

In today’s Research News article “Effect of home-based Tai Chi, Yoga or conventional balance exercise on functional balance and mobility among persons with idiopathic Parkinson’s disease: An experimental study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136531/), Khuzema and colleagues recruited adult patients with Parkinson’s Disease and randomly assigned them to receive 5 days per week for 8 weeks for 30-40 minutes of either home based Tai Chi exercise, yoga exercise, or balance exercise training. They were measured before and after training for balance and mobility with a timed up and go test and a 10-minute walking test.

 

They found that all three exercise programs produced significant improvements in all measures. Balance increased significantly by 26.414%, 8.193% and 14.339%, Timed up and go time decreased by 22.695%, 7.187% and 8.902%, and 10-m Walk Time decreased by 24.469%, 5.914% and 8.986% in Tai Chi, yoga and balance exercise groups, respectively. Although, on average, Tai Chi exercise produced superior results on all measures, the study was too small (9 patients per group) to determine significant group differences. These results, however, support conducting a large randomized controlled trial in the future.

 

Tai Chi is an ancient mindfulness practice that involves slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Hence Tai Chi training should be recommended to improve balance and mobility in patients with Parkinson’s Disease.

 

So, improve balance in Parkinson’s Disease with Tai Chi and Yoga.

 

Benefits of Tai Chi and Yoga for those with Parkinson’s Disease:

  1. Promotes conscious awareness of movement and actions.
  2. Increases awareness of proper body alignment/posture
  3. Improves balance with reduced fall risk
  4. Enhances flexibility
  5. Affords a greater sense of well-being
  6. Offers relaxation which can help to lessen Parkinson’s symptoms (tremor, rigidity) or manage medication side effects such as dyskinesia
  7. Improves breath support and control
  8. Helps to build healthy bones through weight-bearing activities
  9. Increases strength, especially in core muscles” – National Parkinson’s Foundation

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

Khuzema, A., Brammatha, A., & Arul Selvan, V. (2020). Effect of home-based Tai Chi, Yoga or conventional balance exercise on functional balance and mobility among persons with idiopathic Parkinson’s disease: An experimental study. Hong Kong physiotherapy journal : official publication of the Hong Kong Physiotherapy Association Limited = Wu li chih liao, 40(1), 39–49. https://doi.org/10.1142/S1013702520500055

 

Abstract

Background:

Individuals with Parkinson’s disease (PD) invariably experience functional decline in a number of motor and non-motor domains affecting posture, balance and gait. Numerous clinical studies have examined effects of various types of exercise on motor and non-motor problems. But still much gap remains in our understanding of various therapies and their effect on delaying or slowing the dopamine neuron degeneration. Recently, Tai Chi and Yoga both have gained popularity as complementary therapies, since both have components for mind and body control.

Objective:

The aim of this study was to determine whether eight weeks of home-based Tai Chi or Yoga was more effective than regular balance exercises on functional balance and mobility.

Methods:

Twenty-seven individuals with Idiopathic PD (Modified Hoehn and Yahr stages 2.5–3) were randomly assigned to either Tai Chi, Yoga or Conventional exercise group. All the participants were evaluated for Functional Balance and Mobility using Berg Balance Scale, Timed 10 m Walk test and Timed Up and Go test before and after eight weeks of training.

Results:

The results were analyzed using two-way mixed ANOVA which showed that there was a significant main effect for time as F (1, 24) =74.18, p=0.000, ηp2=0.76 for overall balance in Berg Balance Scale. There was also significant main effect of time on mobility overall as F(1, 24) =77.78, p=0.000, ηp2=0.76 in Timed up and Go test and F(1, 24) =48.24, p=0.000, ηp2=0.67 for 10 m Walk test. There was a significant interaction effect for time×group with F(2, 24) =8.67, p=0.001, ηp2=0.420 for balance. With respect to mobility, the values F(2, 24) =5.92, p=0.008, ηp2=0.330 in Timed Up and Go test and F(2, 24) =10.40, p=0.001, ηp2=0.464 in 10 m Walk test showed a significant interaction. But there was no significant main effect between the groups for both balance and mobility.

Conclusion:

The findings of this study suggest that Tai Chi as well as Yoga are well adhered and are attractive options for a home-based setting. As any form of physical activity is considered beneficial for individuals with PD either Tai Chi, Yoga or conventional balance exercises could be used as therapeutic intervention to optimize balance and mobility. Further studies are necessary to understand the mind–body benefits of Tai Chi and Yoga either as multicomponent physical activities or as individual therapies in various stages of PD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136531/

 

Control Binge Eating Disorder with Mindfulness

Control Binge Eating Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

Psychotherapy approaches, including DBT, have been shown to be effective in helping a person with binge eating disorder overcome abnormal eating behaviors.” – Jacquelyn Ekern

 

Around 30 million people in the United States of all ages and genders suffer from an eating disorder; either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Binge eating disorder involves eating a large amount of food within a short time-period while experiencing a sense of loss of control over eating.

 

Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disordersAcceptance and Commitment Therapy (ACT) is a mindfulness-based therapy that has also been shown to alter eating behaviorDialectical Behavior Therapy (DBT) produces behavior change by focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness.

 

In today’s Research News article “Dialectical behavior therapy adapted for binge eating compared to cognitive behavior therapy in obese adults with binge eating disorder: a controlled study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285554/), Lammers and colleagues  recruited obese (BMI>30) adults who were diagnosed with binge eating disorder and engaged in emotional eating. They were randomly assigned to receive once a week for 20 weeks of either 3.75 hours of Cognitive Behavioral Therapy (CBT) or 2 hours of Dialectical Behavior Therapy (DBT). They were measured before and after treatment and 6 months later for eating disorders, emotion regulation, general psychopathology, depression, and body size.

 

They found that both groups had reduced eating disorder psychopathology after treatment and 6 months later with the Cognitive Behavioral Therapy (CBT) group having better outcomes with 65% of the patients shifting from dysfunctional to functional at follow-up as compared to 46% for the Dialectical Behavior Therapy (DBT) group.

 

These results were contrary to the researchers’ expectation that Dialectical Behavior Therapy (DBT) would be more efficacious than Cognitive Behavioral Therapy (CBT). One possible explanation for the superiority of CBT was that it contained a greater amount of therapeutic contact hours, 3.75 hours per week, than DBT, 2 hours per week. But the results clearly show that both treatments were effective in treating binge eating disorder in obese patients with emotional eating.

 

So, control binge eating disorder with mindfulness.

 

Integrating mindfulness techniques in binge eating disorder treatment has been shown to reduce binge eating, improve nutritional outcomes, improve weight management, as well as enhance diabetes management.” – Jacquelyn Ekern

 

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

 

Lammers, M. W., Vroling, M. S., Crosby, R. D., & van Strien, T. (2020). Dialectical behavior therapy adapted for binge eating compared to cognitive behavior therapy in obese adults with binge eating disorder: a controlled study. Journal of Eating Disorders, 8, 27. https://doi.org/10.1186/s40337-020-00299-z

 

Abstract

Background

Current guidelines recommend cognitive behavior therapy (CBT) as the treatment of choice for binge eating disorder (BED). Although CBT is quite effective, a substantial number of patients do not reach abstinence from binge eating. To tackle this problem, various theoretical conceptualizations and treatment models have been proposed. Dialectical behavior therapy (DBT), focusing on emotion regulation, is one such model. Preliminary evidence comparing DBT adapted for BED (DBT-BED) to CBT is promising but the available data do not favor one treatment over the other. The aim of this study is to evaluate outcome of DBT-BED, compared to a more intensive eating disorders-focused form of cognitive behavior therapy (CBT+), in individuals with BED who are overweight and engage in emotional eating.

Methods

Seventy-four obese patients with BED who reported above average levels of emotional eating were quasi-randomly allocated to one of two manualized 20-session group treatments: DBT-BED (n = 41) or CBT+ (n = 33). Intention-to-treat outcome was examined at post-treatment and at 6-month follow-up using general or generalized linear models with multiple imputation.

Results

Overall, greater improvements were observed in CBT+. Differences in number of objective binge eating episodes at end of treatment, and eating disorder psychopathology (EDE-Q Global score) and self-esteem (EDI-3 Low Self-Esteem) at follow-up reached statistical significance with medium effect sizes (Cohen’s d between .46 and .59). Of the patients in the DBT group, 69.9% reached clinically significant change at end of the treatment vs 65.0% at follow-up. Although higher, this was not significantly different from the patients in the CBT+ group (52.9% vs 45.8%).

Conclusions

The results of this study show that CBT+ produces better outcomes than the less intensive DBT-BED on several measures. Yet, regardless of the dose-difference, the data suggest that DBT-BED and CBT+ lead to comparable levels of clinically meaningful change in global eating disorder psychopathology. Future recommendations include the need for dose-matched comparisons in a sufficiently powered randomized controlled trial, and the need to determine mediators and moderators of treatment outcome.

Plain English summary

Binge eating disorder (BED) is mostly treated with cognitive behavior therapy (CBT). The treatment focusses on reducing efforts to diet. Yet, a substantial number of patients still suffer from binge eating after this treatment. We suggest that patients with BED are better served with a treatment that helps them cope with negative emotions in a healthier way. Dialectical behavior therapy for BED (DBT-BED) is one such treatment. To test this, we compared outcomes of DBT-BED to the intensive CBT program that is common in our treatment center. We did so, in individuals with BED who might especially benefit from DBT-BED: those who are overweight and eat in response to emotions. Greater improvements were observed in the CBT group regarding the number of objective binge eating episodes at the end of treatment, and regarding global eating disorder psychopathology and self-esteem 6 months after treatment. Yet, patients in the CBT group received more therapy hours than in the DBT-BED group, which may have advantaged the CBT treatment. Concurrently, in both groups a comparable percentage of patients showed clinically meaningful changes in global eating disorder psychopathology. In conclusion, our results overall support the intensive CBT program over DBT-BED. Yet, given the fact that DBT-BED is less time-consuming (so cheaper) and presents similar percentages of meaningful change in global eating disorder psychopathology, it is worthwhile to further test the effects of DBT-BED in future studies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285554/

 

Reduce the Risk of Major Depression Relapse with Mindfulness

Reduce the Risk of Major Depression Relapse with Mindfulness

 

By John M. de Castro, Ph.D.

 

a growing body of research is pointing to an intervention that appears to help prevent relapse by altering thought patterns without side effects: mindfulness-based cognitive therapy, or MBCT.” – Stacy Lu

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression.

 

Relapsing into depression is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs failMindfulness-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 attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior.

 

There has been considerable research demonstrating that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating depression.  In today’s Research News article “The effects of mindfulness-based cognitive therapy on risk and protective factors of depressive relapse – a randomized wait-list controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275325/), Schanche and colleagues investigate the ability of  MBCT to reduce risk factors associated with relapse in patients with major depressive disorder.

 

They recruited adult patients diagnosed with major depressive disorder who had at least 3 depressive episodes and who were currently in remission. They were randomly assigned to be on a wait list or to receive 8 weekly 2-hour sessions of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training for rumination, emotion regulation, anxiety, self-compassion, mindfulness, and depression.

 

They found that in comparison to baseline and the wait-list group after Mindfulness-Based Cognitive Therapy (MBCT) there were significant reductions in rumination, anxiety, emotional reactivity to stress and depression and significant increases in emotion regulation, self-compassion and mindfulness. Hence, MBCT significantly improved the psychological well-being of these patients.

 

These are interesting results that suggest that Mindfulness-Based Cognitive Therapy (MBCT) produces a reduction in the types of negative emotional symptoms that could promote a depressive relapse and an increase in factors that could promote resistance to relapse especially the ability to effectively cope with their emotions and compassion for themselves. Mindfulness training has been repeatedly shown in the past to reduce rumination, anxiety, emotional reactivity to stress and depression and increase emotion regulation and self-compassion. The present study demonstrates that these benefits occur in patients in remission from major depressive disorder. This suggests that MBCT is effective in improving the major depressive disorder patients psychological state in a way that suggests that they would be resistant to relapse in the future.

 

So, reduce the risk of major depression relapse with mindfulness.

 

MBCT and CT attempt to reduce the risk of relapse by promoting different skill sets. CT promotes challenging dysfunctional thinking and increasing physical activity level. MBCT promotes nonjudgmental monitoring of moment-by-moment experience, and decentering from thoughts or seeing thoughts as transient mental phenomena and not necessarily valid.” – American Mindfulness Research Association

 

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

 

Elisabeth Schanche, Jon Vøllestad, Endre Visted, Julie Lillebostad Svendsen, Berge Osnes, Per Einar Binder, Petter Franer, Lin Sørensen. The effects of mindfulness-based cognitive therapy on risk and protective factors of depressive relapse – a randomized wait-list controlled trial. BMC Psychol. 2020; 8: 57. Published online 2020 Jun 5. doi: 10.1186/s40359-020-00417-1

 

Abstract

Background

The aim of this randomized wait-list controlled trial was to explore the effects of Mindfulness–Based Cognitive Therapy (MBCT) on risk and protective factors for depressive relapse within the domains of cognition, emotion and self-relatedness.

Methods

Sixty-eight individuals with recurrent depressive disorder were randomized to MBCT or a wait-list control condition (WLC).

Results

Completers of MBCT (N = 26) improved significantly on measures assessing risk and protective factors of recurrent depression compared to WLC (N = 30) on measures of rumination (d = 0.59, p = .015), emotion regulation (d = 0.50, p = .028), emotional reactivity to stress (d = 0.32, p = .048), self-compassion (d = 1.02, p < .001), mindfulness (d = 0.59, p = .010), and depression (d = 0.40, p = .018). In the Intention To Treat sample, findings were attenuated, but there were still significant results on measures of rumination, self-compassion and depression.

Conclusions

Findings from the present trial contribute to evidence that MBCT can lead to reduction in risk factors of depressive relapse, and strengthening of factors known to be protective of depressive relapse. The largest changes were found in the domain of self-relatedness, in the form of large effects on the participants’ ability to be less self-judgmental and more self-compassionate.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275325/

 

Mindfulness is Associated with Lower Functional Impairment and Avoidance in Major Depressive Disorder

Mindfulness is Associated with Lower Functional Impairment and Avoidance in Major Depressive Disorder

 

By John M. de Castro, Ph.D.

 

People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating, impairing the ability of the patients to effectively conduct their lives. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Behavioral activation involves engaging with what is going on in the present moment and is thought to help with depression while avoiding symptoms and ruminating tend to exacerbate the depression. There is little data, however, of the interplay of activation and mindfulness in patients with major depression.

 

In today’s Research News article “Roles of Trait Mindfulness in Behavioral Activation Mechanism for Patients With Major Depressive Disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202344/), Takagaki and colleagues had adult patients with major depressive disorder complete questionnaires designed to measure behavioral activation for depression including subscales measuring activation, avoidance/rumination, work/school impairment, and social impairment; mindfulness including subscales measuring describe, observe, act with awareness, nonreactivity, and non-judging; depression; and disability.

 

They found that the greater the level of depression the greater the level of disability, avoidance/rumination, and mindful observing and the lower the levels of mindful describing, acting with awareness, nonreacting and non-judging. Similarly, they also found that the higher the levels of avoidance/rumination the greater the levels of depression, disability, and mindful observing and the lower the levels of mindful describing, acting with awareness, nonreacting and non-judging. Structural equation modelling revealed that mindful acting with awareness, nonreacting and non-judging was directly negatively related to avoidance/rumination which was in turn positively related to disability. In addition, mindful acting with awareness and nonreacting were directly negatively related to disability.

 

These results are correlative and caution must be taken in making causal inferences. Nevertheless, the results suggest that the degree of disability/impairment in patients with major depressive disorder is directly and indirectly associated with mindfulness with avoidance/rumination as an intermediary. That is, avoidance of a negative aversive state and engagement in rumination rather than active problem-solving to some extent mediates the association of mindfulness with lower levels of impairment in life. Hence, mindfulness is related to the patient’s ability to better conduct their life and it does so directly and indirectly by being associated with less avoidance of psychological pain and less rumination.

 

So, mindfulness is associated with lower functional impairment and avoidance in major depressive disorder.

 

Mindfulness training can “generate positive emotions by cultivating self-compassion and self-confidence through an upward spiral process, although behavioral activation is action oriented while mindfulness emphasizes the acceptance and awareness of present moment emotions, thoughts, and bodily sensations, the two can be complementary.” _ Amanda MacMillan

 

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

 

Takagaki, K., Ito, M., Takebayashi, Y., Nakajima, S., & Horikoshi, M. (2020). Roles of Trait Mindfulness in Behavioral Activation Mechanism for Patients With Major Depressive Disorder. Frontiers in psychology, 11, 845. https://doi.org/10.3389/fpsyg.2020.00845

 

Abstract

Behavioral activation and mindfulness have both been shown to engender improvement of functional impairment in patients with major depressive disorder. In behavioral activation, the practice of engaging with the direct experience of the present moment is central, especially when targeting avoidance. Consequently, mindfulness affects changes of avoidance in behavioral activation. This study was designed to assess exploratory relations among trait mindfulness, avoidance, and functional impairment in behavioral activation mechanism for depression. For 1042 participants with depression only or for depression with anxiety disorders, we used structural equation modeling to examine relations among trait mindfulness, avoidance, and functional impairment. Trait mindfulness non-reactivity, non-judging, and acting with awareness had a direct negative effect on avoidance. Trait mindfulness non-reactivity, trait non-judging, and trait acting with awareness had indirect negative effects on functional impairment. Results show that each trait mindfulness facet exhibited a distinct pattern of relations with avoidance and impairment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202344/