Anxiety

Improve Well-Being with Menstrual Disorder with Yoga Nidra

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By John M. de Castro, Ph.D.

 

“The ancient practice of yoga nidra, also known as yogic sleep, is a meditative practice that results in conscious deep sleep. Current research suggests that yoga nidra can help relieve menstrual problems, diabetes symptoms and post-traumatic stress disorder (PTSD).” – Elaine Gavalas

 

Menstrual disorders are associated with disruptive physical and/or emotional symptoms just before and during menstruation, including heavy bleeding, missed periods and unmanageable mood swings. Symptoms can include abnormal uterine bleeding, which may be abnormally heavy or absent or occurs between periods, painful menstrual periods, premenstrual syndrome, or premenstrual dysphonic disorder (depression). These disorders are all very common and most women experience some of these symptoms sometime during their premenopausal years, while around 20% experience them throughout their fertile years.

 

Yoga has documented benefits for the individual’s psychological and physical health and well-being. It has also been shown to improve menstrual problems. Yoga, however, consists of a number of components including, poses, breathing exercises, yoga nidra (meditation), concentration, and philosophy/ethics.  So, it is difficult to determine which facet or combination of facets of yoga are responsible for which benefit. Hence, it is important to begin to test each component in isolation to determine its effects.

 

In today’s Research News article “Psycho-Biological Changes with Add on Yoga Nidra in Patients with Menstrual Disorders: a Randomized Clinical Trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1255064667850790/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794540/

Rani and colleagues randomly assigned women who displayed menstrual disorders for more than 6-months to either a yoga Nidra or treatment as usual group. Yoga nidra is generally practiced while lying on the back on a mat on the floor with the arms out at the sides and the palm facing up. This is the what’s known as the corpse pose in yoga. It is generally a deep guided meditation practice. It usually begins with a systematic body scan meditation and then moves into a deep meditative state. The most easily observable effect of the yoga nidra practice is the extremely deep relaxation of the nervous system and healing of the body by allowing it the rest and recharge it usually lacks in our all too busy lifestyles. Yoga nidra produces a state of deep relaxation and sedation without the individual actually going to sleep.

 

At baseline Rani and colleagues measured psychological general well-being, and a variety of hormone levels. The yoga nidra group then received 30-35-minute yoga nidra, 5 days per week for 3 months and practiced at home for the subsequent 3 months. Measurements were then repeated at the end of the 6-month program. Control participants received their normal medical treatments during the 6-month period. They found that the yoga Nidra group showed significant improvements in anxiety, depression, positive well-being, general health, and vitality while the control group did not. Similarly, they found that the yoga Nidra group had significant decreases in 4 hormone levels; thyroid-stimulating hormone, follicle-stimulating hormone, luteinizing hormone, and prolactin. Hence, yoga Nidra produced positive benefits for psychological well-being and also for endocrine (hormonal) function.

 

These are exciting findings. Yoga Nidra practice improved psychological well-being in women with menstrual disorder. Yoga practice and meditation practice have these same benefits for practitioners. But, it’s interesting that these psychological benefits can be produced by yoga nidra practice alone. The findings of decreased hormone levels are significant. Pituitary hormones, follicle stimulating hormone, luteinizing hormones, prolactin and thyroid hormones are very much involved in the menstrual cycle and are required for normal development of ova. Yoga Nidra practice may be helping with menstrual disorder by producing better regulation of these crucial hormones. Future research will be required to investigate this idea.

 

It is important to note that the control group did not receive any new active treatment. It is possible that the effects observed were not due to yoga Nidra, but to the expectations of the participants that the yoga nidra would improve their disorder. It will be important for future research to include and active or placebo control condition.

 

Regardless, the results suggest that well-being can be improved in women with menstrual disorder with yoga nidra.

 

“Yoga nidra for me is like a ‘super nap’ that recharges me in no time. It is a complete rejuvenation package – a must to relieve ourselves of daily stress in today’s busy world.” – Pritika Nair

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Rani, K., Tiwari, S. C., Kumar, S., Singh, U., Prakash, J., & Srivastava, N. (2016). Psycho-Biological Changes with Add on Yoga Nidra in Patients with Menstrual Disorders: a Randomized Clinical Trial. Journal of Caring Sciences,5(1), 1–9. http://doi.org/10.15171/jcs.2016.001

 

Abstract

Introduction: Menstrual disorders are common problems among women in the reproductive age group. Yuga interventions may decrease the physical and psychological problems related to menstrual disorders. The present study was aimed to assess the effect of Yoga Nidra on psychological problems in patients with menstrual disorders.

Methods: A total number of 100 women recruited from the department of obstetrics and gynecology and were then randomly allocated into two groups: a) intervention received yogic intervention and medication for 6 month, and b) control group received no yogic intervention and they only received prescribed medication). Psychological General Well-Being Index (PGWBI) and hormonal profile were assessed at the time of before and after six months on both groups.

Results: The mean score of anxiety, depression, positive well-being, general health, and vitality scores, as well as hormonal levels, in posttest were significantly different in intervention group as compared with pretest. But there was no significant difference in control group.

Conclusion: Yoga Nidra can be a successful therapy to overcome the psychiatric morbidity associated with menstrual irregularities. Therefore, Yogic relaxation training (Yoga Nidra) could be prescribed as an adjunct to conventional drug therapy for menstrual dysfunction.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794540/

 

Improve Neuroticism with Mindfulness

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Mindfulness Neuroticism2 Armstrong

By John M. de Castro, Ph.D.

 

“Self-deprecating comedians and complainers wear their neuroticism as a badge of honor. In truth, the negatively biased are more prone to depression, anxiety, self-consciousness and hypochondria, to name just a few behavioral tripwires. Neuroticism is no fun for anyone.” – Psychology Today

 

We often speak of people being neurotic. But, do we really know what we’re talking about? Do we really know what it is? Neurosis is actually an outdated diagnosis that is no longer used medically. The disorders that were once classified as a neurosis are now more accurately categorized as post-traumatic stress disorder, somatization disorders, anxiety disorder, panic disorder, phobias, dissociation disorder, obsessive compulsive disorder and adjustment disorder.

 

Neuroticism, however, is considered a personality trait that is a lasting characteristic of the individual. It is characterized by negative feelings, repetitive thinking about the past (rumination), and worry about the future, moodiness and loneliness. It appears to be linked to vulnerability to stress. People who have this characteristic are not happy with life and have a low subjective sense of well-being and recognize that this state is unacceptable. There is some hope for people with high neuroticism as this relatively stable characteristic appears to be lessened by mindfulness training. This is potentially important and deserves further investigation.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy for Neuroticism (Stress Vulnerability): A Pilot Randomized Study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1245647922125798/?type=3&theater

or below

Armstrong and Rimes examined the ability of Mindfulness Based Cognitive Therapy (MBCT) to treat individuals high in neuroticism. They randomly assigned participants with high neuroticism to either an 8-week, once a week for 2-hours, MBCT treatment group or and on-line self-help treatment control group. Measures were taken before and 4-weeks after treatment of mindfulness, neuroticism, impairment in everyday functioning, anxiety, depressive symptoms, self-compassion, beliefs about emotions, rumination, and decentering.

 

They found that after treatment in comparisons to the control group the MBCT group had significantly lower neuroticism scores, and rumination, and a trend toward lower functional impairment due to stress. In addition, the MBCT group had significantly higher self-compassion and decentering and trends toward lessened unhelpful beliefs and emotions and higher mindfulness. Surprisingly, since MBCT was developed specifically to treat depression, there were no significant differences in anxiety or depression.

 

These results are interesting and potentially important. This, however, was a pilot study that had relatively small group sizes (17). The fact that significant differences were detected nonetheless indicates that the effects were fairly strong. The results clearly indicate that a larger randomized controlled trial is called for.

 

Mindfulness may affect neuroticism in a number of ways. By focusing the individual on the present moment, mindfulness should lessen the neuroticism characteristics of rumination about the past and worry about the future. Mindfulness is also known to reduce the psychological and physiological responses to stress and stress is known to contribute to neuroticism. Finally, mindfulness has been shown to produce heightened emotion regulation. So, the mindful individual feels and appreciates their emotions but responds appropriately and adaptively. This should lessen the moodiness, negative feelings, and loneliness characteristic of neuroticism. So, it is not surprising the mindfulness based treatments would be effective in lowering neuroticism. This is a hopeful development, as people high in neuroticism are very unhappy people. Mindfulness may provide some relief and help them toward a happier life.

 

So, improve neuroticism with mindfulness.

 

“Being in the moment with those thoughts and recognizing them for what they are has really helped me to kind of shove them aside, or to kind of diffuse them,” she says. “I think it’s really helped me become a more aware person of what other people might be feeling.” – JoSelle Vanderhooft

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Armstrong L, Rimes KA. Mindfulness-Based Cognitive Therapy for Neuroticism (Stress Vulnerability): A Pilot Randomized Study. Behav Ther. 2016 May;47(3):287-98. doi: 10.1016/j.beth.2015.12.005. Epub 2016 Jan 5. PMID: 27157024. doi:10.1016/j.beth.2015.12.005

 

Highlights

  • A new MBCT intervention for neuroticism versus online general self-help is examined
  • Compared with self-help, MBCT results in significantly lower levels of neuroticism
  • Rumination and self-compassion improved more in the MBCT group than the control group
  • MBCT is an acceptable and feasible intervention for neuroticism
  • Neuroticism may be amenable to change through psychological intervention

Abstract

Objective: Neuroticism, a characteristic associated with increased stress vulnerability and the tendency to experience distress, is strongly linked to risk of different forms of psychopathology. However, there are few evidence-based interventions to target neuroticism. This pilot study investigated the efficacy and acceptability of mindfulness-based cognitive therapy (MBCT) compared with an online self-help intervention for individuals with high levels of neuroticism. The MBCT was modified to address psychological processes that are characteristic of neuroticism. Method: Participants with high levels of neuroticism were randomized to MBCT (n = 17) or an online self-help intervention (n = 17). Self-report questionnaires were administered preintervention and again at 4 weeks postintervention. Results: Intention-to-treat analyses found that MBCT participants had significantly lower levels of neuroticism postintervention than the control group. Compared with the control group, the MBCT group also experienced significant reductions in rumination and increases in self-compassion and decentering, of which the latter two were correlated with reductions in neuroticism within the MBCT group. Low drop-out rates, high levels of adherence to home practice, and positive feedback from MBCT participants provide indications that this intervention may be an acceptable form of treatment for individuals who are vulnerable to becoming easily stressed. Conclusions: MBCT specifically modified to target neuroticism-related processes is a promising intervention for reducing neuroticism. Results support evidence suggesting neuroticism is malleable and amenable to psychological intervention. MBCT for neuroticism warrants further investigation in a larger study.

 

Promote Adaptive Emotions with Mindful Non-Judgment

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By John M. de Castro, Ph.D.

 

“By cultivating such mindfulness of emotions, we can build our resiliency to handle all of the intense experiences associated with urban living. We can limit our ability to get hijacked by emotions, which can carry us away to undesired places (like getting on the wrong subway).” – Jonathan Kaplan

 

We are very emotional creatures. Without emotion, life is flat and uninteresting. Emotions provide the spice of life. We are constantly having or reacting to emotions. We often go to great lengths in an attempt to create or keep positive emotions and conversely to avoid, mitigate, or get rid of negative emotions. They are so important to us that they affect mostly everything that we do and say and can even be determinants of life or death. Anger, fear, and hate can lead to murderous consequences. Anxiety and depression can lead to suicide. At the same time love, joy, and happiness can make life worth living. Our emotions also affect us physically with positive emotions associated with health, well-being, and longevity and negative emotions associated with stress, disease, and shorter life spans.

 

The importance of emotions is only surpassed by our ignorance of them. Our rational side tries to downplay their significance and as a result research studies of emotions are fairly sparse and often ridiculed by politicians. So there is a great need for research on the nature of emotions, their effects, how they are regulated or not, and what factors affect them. One important factor is mindfulness, which has been shown to affect our ability to regulate emotions. Research has demonstrated that people either spontaneously high in mindfulness or trained in mindfulness are better able to be completely in touch with their emotions and feel them completely, while being able to respond to them more appropriately and adaptively. In other words, mindful people are better able to experience yet control emotions.

 

In today’s Research News article “Mindfulness and Emotional Outcomes: Identifying Subgroups of College Students using Latent Profile Analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1235541963136394/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269250/

Pearson and colleagues explore the components of mindfulness and how they relate to emotions in college students. They measured mindfulness with the Five Facet Mindfulness Questionnaire (FFMQ) which measures the mindfulness components of observing, describing, acting with awareness, non-judging, and non-reactivity. Using sophisticated statistical analysis they were able to identify 4 distinct classes of student responses; a high mindfulness group that were relatively high on every facet of mindfulness; a low mindfulness group that were relatively low on every facet of mindfulness; a judgmentally observing group that is high in observing but very low on non-judging of inner experience and acting with awareness;  and a non-judgmentally aware group that were high on non-judging of inner experience and acting with awareness, but very low on the observing facet of mindfulness.

 

They found that the “high mindfulness” and “non-judgmentally aware” groups did not differ and had lower depressive symptoms, anxiety symptoms, affective lability, and distress intolerance. On the other hand, the “judgmentally observing” groups had higher depressive symptoms, anxiety symptoms, affective lability, and distress intolerance. Finally, they found that the “low mindfulness group” was in the middle significantly better than the “judgmentally observing” group, but significantly worse than the “non-judgmentally aware” and “high mindfulness groups” in adaptive emotionality. Hence, having high mindfulness and being aware without judging are associated with relatively positive emotional states while observing while judging experiences is associated with relatively negative emotional states. Simply being low in mindfulness is associated with an average emotional state.

 

These results suggest that mindfulness is associated with positive emotional states but judging experience is associated with poor emotional states. So, being overall mindful and particularly non-judging leads to the most adaptive emotional states. This reinforces the previous findings of mindfulness promotion emotional regulation. But, they extend this understanding to emphasize just how important judging experience is; if its judged it leads to poor emotional outcomes while if it’s not, it leads to positive emotional outcomes. Although correlational these observations suggest that emotional states can be elevated with mindful non-judgement.

 

So, promote adaptive emotions with mindful non-judgment.

 

“For many of us, instead of feeling our emotions, we criticize ourselves for having them. We call ourselves weak, dramatic, stupid, too sensitive. . . we get angry with ourselves for feeling scared or upset. We become disgusted when we’re jealous of others. We get frustrated when we’re still grieving a breakup or a fight. The key is to accept our emotions.” – Margarita Tartakovsky

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Pearson, M. R., Lawless, A. K., Brown, D. B., & Bravo, A. J. (2015). Mindfulness and Emotional Outcomes: Identifying Subgroups of College Students using Latent Profile Analysis. Personality and Individual Differences,76, 33–38. http://doi.org/10.1016/j.paid.2014.11.009

 

Highlights

  • We used latent profile analysis to group college students based on mindfulness scores
  • A 4-class solution was selected, leading to four subgroups of college students
  • High mindfulness and non-judgmentally aware groups had adaptive outcomes
  • Low mindfulness and judgmentally observing groups had maladaptive outcomes
  • We discuss the implications of person-centered analyses for studying mindfulness

Abstract

In non-meditating samples, distinct facets of mindfulness are found to be negatively correlated, preventing the meaningful creation of a total mindfulness score. The present study used person-centered analyses to distinguish subgroups of college students based on their mindfulness scores, which allows the examination of individuals who are high (or low) on all facets of mindfulness. Using the Lo-Mendell-Rubin Adjusted LRT test, we settled on a 4-class solution that included a high mindfulness group (high on all 5 facets, N = 245), low mindfulness group (moderately low on all 5 facets, N = 563), judgmentally observing group (high on observing, but low on non-judging and acting with awareness, N =63), and non-judgmentally aware group (low on observing, but high on non-judging and acting with awareness, N =70). Consistent across all emotional outcomes including depressive symptoms, anxiety symptoms (i.e., worry), affective instability, and distress intolerance, we found that the judgmentally observing group had the most maladaptive emotional outcomes followed by the low mindfulness group. Both the high mindfulness group and the non-judgmentally aware group had the most adaptive emotional outcomes. We discuss the implications of person-centered analyses to exploring mindfulness as it relates to important psychological health outcomes.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269250/

Cope with Violence Trauma with Mindfulness

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By John M. de Castro, Ph.D.

 

“People with PTSD ruminate, and rumination is all about not being present. It’s all about focusing on something terrible that happened in the past or something frightening that will happen in the future, so these patients are stuck in a rut. My personal bias is that mindfulness-based therapy has a big effect on rumination, and decreasing rumination allows people to experience the present moment, which expands their awareness of different possibilities and increases their ability to pay attention to things they have avoided in the past,” – Anthony King

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. Many, but, only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life.

 

PTSD can be produced by traumatic events occurring to anyone in a variety of different contexts. These include interpersonal violence (IPV). It is defined “as the intentional use of physical or sexual violence against another person within the context of a relationship. This includes physical or sexual violence committed by a family member, intimate partner, friend, or acquaintance.” A frequent form of IPV is intimate partner violence. Indeed, 27% of women and 11% of men have reported that they had been harmed by sexual or physical violence at some time during their lives.

 

PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

 

Obviously, these are serious and troubling symptoms that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective. In today’s Research News article “Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results from a Stage I RCT.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1227840437239880/?type=3&theater

or below

Kelly and Garland randomly assigned adult female survivors of interpersonal violence (IPV) to either an 8-week mindfulness training or wait-list control condition. The intervention was a form of Mindfulness Based Stress Reduction (MBSR) that was modified for treatment with trauma survivors.

 

They found that the treatment produced a clinically significant decrease in PTSD symptoms to the point where a significant number of participants could no longer be classified as PTSD sufferers. The more the participant practiced the mindfulness training the greater the reduction in PTSD symptoms. There were also significant decreases in the mindfulness group in depression and anxious attachment. Anxious attachment is a symptom of PTSD that involves “vacillating between attempts to draw in significant others with endearing attention-seeking behaviors and attempts to attract attention through emotional outbursts of crying or anger.” Reducing anxious attachment allows the sufferer to conduct much healthier interpersonal relationships.

 

These are very promising results that suggest that the modified form of Mindfulness Based Stress Reduction (MBSR) is a safe and effective treatment for PTSD caused by interpersonal violence (IPV). It is not known how mindfulness training could be so effective for PTSD. It can be speculated that the improvement in present moment awareness might have helped by focusing on the individual on the present rather than the past when the trauma occurred and by reducing rumination about the past. In addition, mindfulness training is known to improve emotion regulation and this may allow the PTSD sufferers to not avoid but fully experience the emotions and then respond to them in a constructive fashion. Finally, mindfulness training is known to reduce the physiological and psychological responses to stress. This lowered stress levels may reduce the intensity of their response to memories of the trauma, allowing the individual to be able to internally address the events directly.

 

Regardless of the mechanism, it is clear that mindfulness training is an effective treatment for PTSD symptoms caused by interpersonal violence (IPV). So, cope with violence trauma with mindfulness.

 

“Mindfulness-based stress reduction teaches individuals to attend to the present moment, to attend to what they are experiencing — their thoughts, their feelings — in a nonjudgmental, accepting manner. We think that teaching people these mindfulness skills helps them to have a different relationship with their PTSD symptoms — a willingness to let thoughts be there without trying to push them away,” -Melissa Polusny

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

Kelly, A. and Garland, E. L. (2016), Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results From a Stage I RCT. J. Clin. Psychol., 72: 311–328. doi:10.1002/jclp.22273

 

Abstract

OBJECTIVE: This pilot randomized controlled trial evaluated a novel trauma-informed model of mindfulness-based stress reduction (TI-MBSR) as a phase I trauma intervention for female survivors of interpersonal violence (IPV).

METHOD: A community-based sample of women (mean age = 41.5, standard deviation = 14.6) with a history of IPV was randomly assigned to an 8-week TI-MBSR intervention (n = 23) or a waitlist control group (n = 22). Symptoms of posttraumatic stress disorder (PTSD) and depression as well as anxious and avoidant attachment were assessed pre- and postintervention.

RESULTS: Relative to the control group, participation in TI-MBSR was associated with statistically and clinically significant decreases in PTSD and depressive symptoms and significant reductions in anxious attachment. Retention in the intervention was high, with most participants completing at least 5 of the 8 sessions for the intervention. Minutes of mindfulness practice per week significantly predicted reductions in PTSD symptoms.

CONCLUSION: TI-MBSR appears to be a promising and feasible phase I intervention for female survivors of interpersonal trauma.

 

Keep Health Care Professionals from Burning Out with Mindfulness

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By John M. de Castro, Ph.D.

 

“Through practicing mindfulness we become more aware of subtle changes in our mood and physical health, and can start to notice more quickly when we are struggling. Rather than waiting for a full meltdown before we take action, we can read the signals of our minds and bodies and start to take better care of ourselves.” – The Mindfulness Project

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. 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 with emergency medicine at the top of the list, over half experiencing burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity.

 

Burnout is not a unitary phenomenon. In fact, there appear to be a number of subtypes of burnout. The overload subtype is characterized by the perception of jeopardizing one’s health to pursue worthwhile results, and is highly associated with exhaustion. The lack of development subtype is characterized by the perception of a lack of personal growth, together with the desire for a more rewarding occupation that better corresponds to one’s abilities. The neglect subtype is characterized by an inattentive and careless response to responsibilities, and is closely associated with inefficacy. All of these types result from an emotional exhaustion. This exhaustion not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion.

 

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 has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout. One of the premiere techniques for developing mindfulness and dealing effectively with stress is Mindfulness Based Stress Reduction (MBSR) pioneered by Jon Kabat-Zinn. It is a diverse mindfulness training containing practice in meditation, body scan, and yoga. As a result, there have been a number of trials investigating the application of MBSR to the treatment and prevention of health care worker burnout.

 

In today’s Research News article “Outcomes of MBSR or MBSR-based interventions in health care providers: A systematic review with a focus on empathy and emotional competencies”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1197241983633059/?type=3&theater

http://www.complementarytherapiesinmedicine.com/article/S0965-2299(15)30014-5/fulltext

Lamothe and colleagues summarize the published literature on the effectiveness of Mindfulness Based Stress Reduction (MBSR) for healthcare worker burnout. They found that the preponderance of evidence from a variety of different trials indicated that MBSR treatment is effective for burnout. In particular, the research generally reports that MBSR treatment significantly improves mindfulness, empathy, and the mental health of healthcare workers. It was found to significantly relieve burnout, and reduce anxiety, depression, and perceived stress.

 

Hence, the published literature is highly supportive of the application of MBSR for the prevention and treatment of healthcare worker burnout. It appears to not only help the worker, but the improvement in the empathy of the worker projects positive consequences for the patients. In addition, the reduction in burnout suggests that MBSR treatment may help to reduce healthcare workers leaving the field, helping to relieve the systemic lack of providers. These are remarkable and potentially very important results.

 

Mindfulness training makes the individual more aware of their own immediate physical and emotional state. Since this occurs in real time, it provides the individual the opportunity to recognize what is happening and respond to it effectively before it contributes to an overall state of burnout. Indeed, mindfulness training has been shown to significantly improve emotion regulation. This produces clear experiencing of the emotion in combination with the ability to respond to the emotion adaptively and effectively. So, the healthcare worker can recognize their state, realize its origins, not let it affect their performance, and respond to it appropriately, perhaps by the recognition that rest is needed.

 

So, keep health care professionals from burning out with mindfulness.

 

“It helps people to undo some of the sense of the time pressure and urgency that makes it so hard to feel present for your patient, and it helps your patients feel like you’re really there, really listening and that you really care. What you learn is to undo the distractedness that comes with worrying about what happens next, and the concern with what’s already over and done with. It doesn’t take more time; it takes an intention and practice to do it successfully.” –  Dr. Michael Baime

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Better Measurement of Mindfulness, Anxiety, and Depression

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By John M. de Castro, Ph.D.

 

“Thus, differing assessments may support implicitly distinct theoretical positions with respect to operationalizing mind- fulness. . . . researchers must be well informed and intentional in their selection of assessment tools because the breadth of currently available assessments provides researchers with a variety of measures, each with specific strengths and weaknesses. Not surprisingly, the various measures resulting from the diverse operational definitions of mindfulness have, at times, been found to be uncorrelated or only modestly associated, providing further evidence of confusion within the mindfulness literature.” – Adam Hanley

 

A prerequisite in science is that in order to study something you have to be able to measure it. With many concepts such as mindfulness, depression, and anxiety that reflect subjective states, there are currently no objective means to measure them. Measurement then falls to some kind of after the fact test or to a self-report. Traditionally, these variables have been measured with paper and pencil psychometric tests, such as the Cognitive Affective Mindfulness Scale-Revised, the Beck Depression Inventory, or the Profile of Mood States. They ask the participant to answer the question in regard to how they generally feel. These forms are filled out before and again after an intervention to assess the effect of the intervention on these subjective states.

 

With the advent of smart phones, a different kind of assessment method has emerged and is gaining greater popularity. It is sometimes called ecological momentary assessment (EMA). Individuals receive messages on their smart phones periodically asking them to answer questions about their state at the present moment. This can be done on multiple, somewhat randomly selected, occasions over the day or longer. It provides a measure that doesn’t require the participant to estimate how they feel in general, but rather uses an average of measures provided by the participant at various times.

 

In today’s Research News article “Ecological momentary assessment versus standard assessment instruments for measuring mindfulness, depressed mood, and anxiety among older adults”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1184314174925840/?type=3&theater

Moore and colleagues recruited elderly (over 65 years of age) participants with clinically significant anxiety distress. They compared the results for participants’ levels of mindfulness, depression, and anxiety measured either by traditional paper and pencil measures of how they were in general to those measured with an ecological momentary assessment (EMA) using smart phones. To obtain the EMA measures participants were sampled 3 times per day for ten days. The participants were randomly assigned to receive Mindfulness Based Stress Reduction (MBSR) program or a health education program. They were compared both before and after the interventions with both the traditional and EMA measurements.

 

Mindfulness Based Stress Reduction (MBSR) involves training in meditation, body scan, and yoga. It has been shown previously to increase mindfulness, and to decrease depression and anxiety levels in normal individuals and those with anxiety disorders, including the elderly. Moore and colleagues found in their study that on average both measures showed an increase in mindfulness and decreases in depression and anxiety, but, the effects were only statistically significant for ecological momentary assessment (EMA) and not for the traditional paper and pencil measures. These results suggested that EMA measurement in more sensitive and less unstable than traditional measures. To further document this, they calculated the number of participants that would be needed to show a statistically significant effects for the two measurement types and found that EMA measures required nearly half as many participants as the traditional measures. Hence, they found that EMA measure are substantially more sensitive and is capable of detecting differences with fewer participants.

 

These results indicate that ecological momentary assessment (EMA) is a better way to assess the states of research participants. Obtaining measures at a variety of points in time appears to produce more accurate results than asking the participant to estimate their overall states. This makes sense that actual measures are superior to participant estimates. The EMA technique is more expensive, takes more time and effort, and is more intrusive into the daily lives of the participants, but may be worth it for the improved accuracy and sensitivity.

 

“If you’ve ever struggled with depression, take heart. Mindfulness, a simple yet powerful way of paying attention to your most difficult emotions and life experiences, can help you break the cycle of chronic unhappiness once and for all.” – Mark Williams

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Improve Psychological and Physical Effects of HIV with Yoga

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By John M. de Castro, Ph.D.

 

“Yoga is not just about the physical side, it’s also about the mind-body connection. I think having that awareness and accepting their condition can help them when they go out into the world, and lift up their self-esteem. Life is fast – yoga can help them be calm and still.” – Surang Sengsamran

 

HIV is a virus that gradually attacks the immune system. It destroys a type of white blood cell called a T-helper cell (CD4 Cell). This isn’t a problem unto itself, but the immune system is our body’s natural defense against illness. Hence, HIV infection makes it harder to combat other infections and diseases. If HIV is untreated, these secondary infections produce chronic illness and eventually death. It is important, then, in treating HIV infection to strengthen the immune system and increase the levels of CD4 in the blood to fight off disease.

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20 year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Hence, patients with HIV infection, even when controlled with drugs, have a reduction in their quality of life.  There is thus a need to find methods to improve the quality of life in people who are living with HIV infection.

 

Mindfulness has been shown to strengthen the immune system. It also improve psychological and physical well-being in people suffering from a wide range of disorders including depression and anxiety. It has also been shown that mindfulness is associated with psychological well-being and lower depression in patients with HIV infection. Integrated Yoga is a contemplative practice that includes postures, breathing practices, relaxation techniques, and meditation. It has been shown to increase mindfulness, and reduce anxiety and depression. So, it would stand to reason that Integrated Yoga would be beneficial for people who are living with HIV infection.

 

In today’s Research News article “Effect of Integrated Yoga (IY) on psychological states and CD4 counts of HIV-1 infected patients: A randomized controlled pilot study”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1183625434994714/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728960/

Naoroibam and colleagues randomly assigned patients with HIV infection to either a one-hour per day, six-days per week Integrated Yoga practice for one-month or to a treatment as usual condition. Compared to before treatment and the control group, they found that the Integrated Yoga practice produced a significant reduction in anxiety and depression levels and an increase in T-helper cell (CD4 Cell) counts in the blood. It should be kept in mind that there was not an active control condition. So, it is unclear if the effectiveness of Integrated Yoga practice was due to exercise effects or perhaps to expectancy effects, researcher bias effects, etc. It will remain for future research to sort out exactly what is responsible to the improvement in the HIV patients.

 

Regardless, these are exciting and potentially important results suggesting that Integrated Yoga practice may not only improve the psychological well-being of HIV infected patients but also strengthen the immune system. This would make them better able to combat other infections and diseases.

 

So, improve psychological and physical effects of HIV with yoga.

 

“As you become more adept at yoga, you learn which poses can help you, depending on how you are feeling physically. There are certain poses that assist in relieving fatigue, diarrhea, anxiety, depression. You do learn about the nature of self, but you also learn that so much is beyond your control. It helps you realize, somehow, to trust in a higher being.” – Steve McCeney

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

 

Improve Psychological Health of Veterans with a Mantra

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Improve Psychological Health of Veterans with a Mantra

 

By John M. de Castro, Ph.D.

 

“Asking for clarity provides a way to begin to see a path out of the pain of personal issues. With spiritual support the pain begins to be released, the path becomes clearer and the next step to create the rest of life begins to emerge.” – The Merritt Center

 

Alternative and Complementary techniques have been growing in acceptance and use over the last couple of decades. With good reason. They have been found to be beneficial for physical and mental health. Contemplative practices have been shown to improve health and well-being. These include mindfulness practices, meditation, yoga, mindful movement practices such as tai chi and qigong, and spiritual practices such as contemplative prayer. One ancient practice that is again receiving acceptance and use is mantra practice.

 

In today’s Research News article “Multi-site evaluation of a complementary, spiritually-based intervention for Veterans: The Mantram Repetition Program”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1182903115066946/?type=3&theater

Butner and colleagues investigate the effectiveness of a form of mantra practice, Mantram Repetition Practice (MRP) on the mindfulness, mental health, and spirituality of veterans. The MRP involves the repetition of a sacred word or phrase over and over again to slow the individual down and produce one-pointed attention. It is effectively a mindfulness meditation practice, except that there are no formal practice periods. The participant is trained to engage in MRP during their daily activities, periodically and as needed, particularly during times of confusion and stress. The individual selects a sacred word or phrase for use in MRP from a list that have particular meaning to them and within their preferred religious practice. Typical Christian words and phrases are “My God and My All”, “Jesus, Jesus”, “Son of God”, “Hail Mary”, “Mother of Jesus”, “Lord Jesus Christ”, “Son of God, have mercy on me.”

 

Butner and colleagues recruited veterans and measured mindfulness, physical and mental health, and spirituality before and after an 8-week Mantram Repetition Program (MRP) training. The veterans attended weekly training sessions, were encouraged to do homework and to use the MRP during their daily lives. Typical times were while waiting, doing mechanical tasks such as doing dishes, exercising, when encountering annoying situations, while eating, before bed, and to manage unwanted emotions. They found that after 8-weeks of MRP training and practice the veterans demonstrated significantly higher mindfulness and spirituality including greater peace, more meaning in life, and greater faith. After training the veterans also had significant reductions in psychological distress, including reduced somatization, depression and anxiety.

 

It should be noted that there was not an active control group. Improvement was documented by comparing before to after training scores. Because of the lack of active control, there are many confounding, alternative, explanations for the findings. These include participant expectancy effects, experimenter bias effects, simple improvement over time, occurrences between the beginning and end of the treatment period, etc. The results clearly demonstrate that the veterans improved substantially over the 8-weeks. It will remain for future research to verify that it was the Mantram Repetition Practice (MRP) and not a confounding variable that was responsible for the changes.

 

These caveats notwithstanding, the finding for MRP are compatible with those produced by other mindfulness programs with the exception of increased spirituality. It is possible that MRP produces its beneficial effects due to its development of mindfulness. Alternatively, spirituality, by itself, has been shown to be related to better physical and psychological health. So, MRP may be effective due to its improvement of spirituality in the veterans. It may also be that the combination of increased mindfulness and increased spirituality improves effectiveness or that the two have additive effects.

 

So, improve psychological health of veterans with a mantra.

 

“The veterans experiences with spirituality were real and unique, significantly contributing to growth. They needed the inclusion of Christian spirituality as part of their process in posttraumatic growth, and it was the key element in them moving forward.” – Sharon Flowers

 

CMCS – Center for Mindfulness and Contemplative Studies

Promote Physical and Mental Well-Being with Tai Chi

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By John M. de Castro, Ph.D.

 

“Tai Chi exercise had positive effects on the self-assessed physical and mental health of college students. Scores on the mental health dimension appeared to be particularly sensitive to change. Colleges/universities might consider offering Tai Chi as a component of their ongoing physical activity programs available to students.” – Y. T. Wang

 

Many people have fond memories of their college years. It is likely, however, that they forgot about the stress and angst of those years. The truth is that college is generally very stressful for most students, from the uncertainty of freshman year, to the social stresses of emerging adulthood, to the anxiety of launching into a career after senior year. Evidence for the difficulties of these years can be found in college counseling centers which are swamped with troubled students. In fact, it’s been estimated that half of all college students report significant levels of anxiety and depression.

 

Being able to perform at an optimum level is important in college. It would be very helpful if a

safe and effective way could be found to reduce stress, depression and anxiety in college students. Mindfulness training has been shown to reduce anxiety, stress, and depression . So, mindfulness training would appear to be well suited to deal with the problems of college students. The ancient eastern practice of mindful movement Tai Chi has been shown to reduce stress, depression, and anxiety. Hence, it would make sense to investigate whether Tai Chi practice might be effective for improving college student angst.

 

In today’s Research News article “A systematic review of the health benefits of Tai Chi for students in higher education”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1180406471983277/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733099/

Webster and colleagues review the published literature on the effectiveness of Tai Chi practice in improving college student physical and psychological states. They found that that the preponderance of evidence in the literature reported that Tai Chi practice significantly improved muscular flexibility. But the most interesting effects were in the psychological domain with Tai Chi practice significantly reducing depression, anxiety, symptoms of compulsion, somatization symptoms, hostility, and symptoms of phobia, and improved interpersonal sensitivity.

 

Hence, the published scientific literature suggests that Tai Chi practice can be of significant benefit for college students, improving them physically and improving their psychological well-being. Tai Chi practice is a gentle mindful movement practice. It is safe, having few if any adverse consequences, and effective with college students. This suggests that the engagement in Tai Chi practice should be encouraged in college promoting the physical and mental well-being of the students.

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“Of all the exercises, I should say that T’ai Chi is the best. It can ward off disease, banish worry and tension, bring improved physical health and prolong life. It is a good hobby for your whole life, the older you are, the better. It is suitable for everyone – the weak, the sick, the aged, children, the disabled and blind. It is also an economical exercise. As long as one has three square feet of space, one can take a trip to paradise and stay there to enjoy life for thirty minutes without spending a single cent.” ~T.T. Liang

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Improve Emotions in MS with Mindfulness

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By Dr. John M. de Castro

 

“Mindfulness practice appears to be a safe, drug-free approach to coping with stress and anxiety, which may in turn help reduce your MS symptoms.” – Amit Sood

 

“Multiple sclerosis (MS) is the most widespread disabling neurological condition of young adults around the world. more than 400,000 people in the United States and about 2.5 million people around the world have MS. About 200 new cases are diagnosed each week in the United States. The most common early symptoms of MS are: fatigue vision problems tingling and numbness vertigo and dizziness muscle weakness and spasms problems with balance and coordination.” – Healthline

 

MS is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis.  There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms. Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life.

 

Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. But, the emotional symptoms are the most problematic with clinically significant depression present in 50% of MS sufferers and anxiety in about a third of MS sufferers. Since mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, and emotion regulation, it would seem likely that mindfulness would affect the quality of life in MS patients.

 

In today’s Research News article “Effect of Mindfulness-Based Stress Reduction on Anxiety, Depression and Stress in Women with Multiple Sclerosis”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1179736912050233/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733502/

Kolahkaj and Zargar compared MS patients who were randomly assigned to receive either Mindfulness Based Stress Reduction (MBSR) or treatment as usual. They were compared prior to the intervention, after and two months later. They found that MBSR produced clinically significant reductions in depression, anxiety, and stress that were maintained two months after the end of active treatment.

 

The size and endurance of the effectiveness of MBSR is striking. But, it should be remembered that the control condition did not receive any active intervention, only receiving treatment as usual. Hence, the effectiveness of MBSR could be due to a number of contaminants including expectancy effects, experimenter bias effects, attention effects, etc. or social effects as MBSR is conducted in groups. It remains for future research to compare MBSR to other active interventions. In addition, Mindfulness Based Stress Reduction (MBSR) involves meditation, body scan, and Hatha yoga. It is a potent combination. But, it leaves the question open as to which of the components is effective against the various symptoms of MS. Once again, future research is needed to begin to separate out effective from ineffective components.

 

MBSR is known to reduce the psychological and physiological responses to stress. Since MS produces considerable stress in the sufferers, reducing the responses to stress may be a very important component of MBSR’s effectiveness for depression and anxiety. Also the yoga component of MBSR may be helpful in helping the MS sufferers to better deal with the effects of MS on motor movements and this may reduce stress, anxiety, and depression. Both meditation and yoga are known to improve emotion regulation, allowing the patient to better experience their emotions, yet respond to them adaptively and positively. This could markedly reduce anxiety, depression, and in turn, stress.

 

Regardless of the mechanism, it is clear that Mindfulness Based Stress Reduction (MBSR) produces marked improvement in the levels of anxiety, depression, and stress of MS patients. So, improve emotions in MS with mindfulness.

 

“I dissolved into a spiral of negative thinking. But since I started to practise mindfulness, I can control my negative thoughts and fears about the future. My stress levels are the lowest they’ve ever been and I’m back at work full-time.

I think mindfulness is even having a physical effect on the progression of the disease – my disability progression continues to be slow, even though I’ve been diagnosed for five years now.” – Gareth Walker

 

CMCS – Center for Mindfulness and Contemplative Studies