Slightly Improve Substance Use Disorder with Mindfulness

Slightly Improve Substance Use Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“though it may seem paradoxical, by increasing your ability to accept and tolerate the present moment, you become more able to make needed changes in your life. . . Also, practicing balanced emotional responses can reduce your stress level, and anxiety and stress are often triggers for substance abuse and addictive behavior. In addition, when you choose a neutral rather than a judgmental response to your thoughts and feelings, you can increase your sense of self-compassion rather than beating yourself up, which is often associated with addictive behaviors.” – Adi Jaffe

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 deaths annually. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to prevent these relapses.

 

Mindfulness practices have been shown to improve recovery from various addictions. Mindfulness-based Relapse Prevention (MBRP) has been developed to specifically assist in relapse prevention and has been shown to be effective. “MBRP integrates mindfulness practices with cognitive-behavioral Relapse Prevention therapy and aims to help participants increase awareness and acceptance of difficult thoughts, feelings, and sensations to create changes in patterns of reactive behavior that commonly lead to relapse. Mindfulness training in MBRP provides clients with a new way of processing situational cues and monitoring internal reactions to contingencies, and this awareness supports proactive behavioral choices in the face of high-risk relapse situation.” – Grow et al. 2015

 

In today’s Research News article “Mindfulness-based Relapse Prevention for Substance Use Disorders: 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/articles/PMC5636047/, Grant and colleagues review and perform a meta-analysis of the published research literature on the effectiveness of Mindfulness-based Relapse Prevention (MBRP) in treating substance use disorder. They identified 9 randomized controlled trials and examined the effects of MBRP on relapse, frequency and quantity of substance use, withdrawal/craving symptoms, treatment dropout, depressive and anxiety symptoms, negative consequences from substance use, and health-related quality of life and also its safety

 

They found that the summarized published research literature reported few and small positive effects. On most of the outcome measures there were no significant improvements produced by MBRP. Small significant improvements were found for withdrawal effects and cravings and the negative effects of substance use. They found that there were no adverse effects of MBRP. These are disappointing results that suggest that Mindfulness-based Relapse Prevention (MBRP) is safe but only slightly effective in treating substance use disorder.

 

These are surprising results as individual trials have reported significant effects. But, it appears that the different trials reported significant effects on different variables with some finding effects on a measure while others finding no effects on the same measure but reporting effects on different measures. When summarized, the reported effects appear to average away. Substance use disorder is such an important social and health issue where there are few viable treatment options, that further research on Mindfulness-based Relapse Prevention (MBRP) is warranted to investigate what components are effective and which not and how to optimize effectiveness.

 

So, slightly improve substance use disorder with mindfulness.

 

“Modeled after mindfulness-based cognitive therapy for depression and mindfulness-based stress reduction, MBRP tackles the very roots of addictive behavior by targeting two of the main predictors of relapse: negative emotions and cravings.” – Carolyn Gregoire

 

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

 

Sean Grant, Benjamin Colaiaco, Aneesa Motala, Roberta Shanman, Marika Booth, Melony Sorbero, Susanne Hempel. Mindfulness-based Relapse Prevention for Substance Use Disorders: A Systematic Review and Meta-analysis. J Addict Med. 2017 Sep; 11(5): 386–396. Published online 2017 Jul 19. doi: 10.1097/ADM.0000000000000338

 

Abstract

Objectives:

Substance use disorder (SUD) is a prevalent health issue with serious personal and societal consequences. This review aims to estimate the effects and safety of Mindfulness-based Relapse Prevention (MBRP) for SUDs.

Methods:

We searched electronic databases for randomized controlled trials evaluating MBRP for adult patients diagnosed with SUDs. Two reviewers independently assessed citations, extracted trial data, and assessed risks of bias. We conducted random-effects meta-analyses and assessed quality of the body of evidence (QoE) using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results:

We identified 9 randomized controlled trials comprising 901 participants. We did not detect statistically significant differences between MBRP and comparators on relapse (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.46–1.13, low QoE), frequency of use (standardized mean difference [SMD] 0.02, 95% CI −0.40 to 0.44, low QoE), treatment dropout (OR 0.81, 95% CI 0.40 to 1.62, very low QoE), depressive symptoms (SMD −0.09, 95% CI −0.39 to 0.21, low QoE), anxiety symptoms (SMD −0.32, 95% CI −1.16 to 0.52, very low QoE), and mindfulness (SMD −0.28, 95% CI −0.72 to 0.16, very low QoE). We identified significant differences in favor of MBRP on withdrawal/craving symptoms (SMD −0.13, 95% CI −0.19 to −0.08, I2 = 0%, low QoE) and negative consequences of substance use (SMD −0.23, 95% CI −0.39 to −0.07, I2 = 0%, low QoE). We found negligible evidence of adverse events.

Conclusions:

We have limited confidence in estimates suggesting MBRP yields small effects on withdrawal/craving and negative consequences versus comparator interventions. We did not detect differences for any other outcome. Future trials should aim to minimize participant attrition to improve confidence in effect estimates.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5636047/

Reduce Drug Addiction and Prison Recidivism with Mindfulness

Reduce Drug Addiction and Prison Recidivism with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Being in prison presents tremendous obstacles to cultivating a peaceful mind, the environment is conducive to negativity and can result in further harm. On every level, the basic antidote to inner and outer obstacles is mindfulness practice.” – Sakyong Mipham Rinpoche,

 

Around 2 ¼ million people are incarcerated in the United States. Many are serving time for drug related offenses. Even though prisons are euphemistically labelled correctional facilities very little correction actually occurs. This is supported by the rates of recidivism. About three quarters of prisoners who are released commit crimes and are sent back to prison within 5-years. The lack of actual treatment for the prisoners leaves them ill equipped to engage positively in society either inside or outside of prison. Hence, there is a need for effective treatment programs that help the prisoners while in prison and prepares them for life outside the prison.

 

Prison provides a great deal of time for reflection and self-exploration. This provides an opportunity for growth and development. Contemplative practices are well suited to this environment. Meditation teaches skills that may be very important for prisoners. In particular, it puts the practitioner in touch with their own bodies and feelings. It improves present moment awareness and helps to overcome rumination about the past and negative thinking about the future. It’s been shown to be useful in the treatment of the effects of trauma and attention deficit disorder. It also relieves stress and improves overall health and well-being. Finally, meditation has been shown to be effective in treating depressionanxiety, and anger. It has also been shown to help overcome trauma in male prisoners.

 

In addition, mindfulness can help to treat drug addictions that often underlie incarceration and promote recidivism after release. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Narcotics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to not only produce abstinence but also prevent relapses. Mindfulness training has been shown to be a safe and effective treatment for reducing addiction relapse. So, mindfulness training can be helpful in preventing recidivism.

 

In today’s Research News article “Prison Meditation Movements and Mass Incarceration.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4633398/, Lyons and Cantrell review the published research literature on the effectiveness of mindfulness trainings on reducing drug addiction and prisoner recidivism. They report that the research supports the effectiveness of mindfulness in combating drug addiction and its effects may last longer than other forms of addiction therapy even in prison populations. Importantly, improvements have been shown to be maintained after release from prison. Additionally, meditation programs in prison have been shown to produce significant reductions in prisoner hostility and increases in self-esteem and mood.

 

Hence, meditation training can be effective in the treatment of addictions and the psychological issues of prisoners and can have effects that continue post-release. Lyons and Cantrell postulate that the presence of a meditation group (Sangha) in prison creates a social context that is very important for success. They also suggest that linking the prisoners to meditation groups outside of prison can be helpful in maintaining benefits after release. They also suggest that focusing on experiences in meditation and empowering prisoners to lead their own groups may be help to potentiate effectiveness. So, meditation training in prison appears to be a promising practice to assist prisoners in coping with addiction and improving their psychological state while in prison and continuing after release. This is likely to help prisoners adjust to the outside world and reduce the likelihood that they will be arrested again and returned to prison.

 

So, reduce drug addiction and prison recidivism with mindfulness.

 

How do we bring sanity into one of the most hostile environments of our society ­- our prisons? . . . Mindfulness creates mental discipline and stability. This provides the inmates with the tools they need to cultivate a sense of ease, decency and compassion. Isn’t that the point of rehabilitation?” – Elizabeth Mattis Namgyel

 

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

 

Lyons, T., & Cantrell, W. D. (2016). Prison Meditation Movements and Mass Incarceration. International Journal of Offender Therapy and Comparative Criminology, 60(12), 1363–1375. http://doi.org/10.1177/0306624X15583807

 

Abstract

By some estimates more than half of inmates held in jails and prisons in the United States have a substance use disorder. Treatments involving the teaching of meditation and other contemplative practices have been developed for a variety of physical and mental disorders including drug and alcohol addiction. At the same time, an expanding volunteer movement across the country has been bringing meditation and yoga into jails and prisons. This review first examines the experimental research on one such approach – mindfulness meditation as a treatment for drug and alcohol addiction, as well as the research on mindfulness in incarcerated settings. We argue that in order to make a substantial impact on recidivism, such programs must mirror volunteer programs which emphasize interdependency and non-duality between the “helper” and the “helped,” and the building of meditation communities both inside and outside of prison.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4633398/

Reduce Compulsive Sexual Behavior with Mindfulness

Reduce Compulsive Sexual Behavior with Mindfulness

 

By John M. de Castro, Ph.D.

 

ve Sexual Behavior with Mindfulnessfeeling ashamed of one’s sexual desires, interests, fetishes, and so on, only makes one feel more obsessive and compulsive about them, rather than the opposite. . .. Mindfulness practice helps my clients to observe their reactions to themselves in accepting and non-judgmental ways. Also, they learn to catch and become aware of the negative thoughts and emotions that arise that make them feel compelled to act out.” – Michael Aaron

 

Sexual behavior is a very important aspect of human behavior, especially for reproduction. In fact, Sigmund Freud made it a centerpiece of his psychodynamic theory. At its best, it is the glue that holds families and relationships together. But, it is a common source of dysfunction and psychosocial problems. Compulsive sexual behavior “encompasses problems with preoccupation with thoughts surrounding sexual behavior, loss of control over sexual behavior, disturbances in relationships due to sexual behavior, and disturbances in affect (e.g., shame) due to sexual behavior.” It is also called sex addiction and hypersexuality. It is chronic and remarkably common affecting 3% to 17% of the population. In addition, it is associated with substance abuse in around half of people with compulsive sexual behavior.

 

Compulsive sexual behavior is frequently treated with psychotherapy, Cognitive Behavioral, Therapy, or drugs with mixed success. Since, it is also looked at as an addiction and mindfulness treatment has been found to be effective for both sexual dysfunction and for addictions, mindfulness may be affective for individuals with both substance abuse and compulsive sexual behavior. As a first step in evaluation this possibility, the relationship between mindfulness and compulsive sexual behavior needs to be investigated in these individuals.

 

In today’s Research News article “The relationship between mindfulness and compulsive sexual behavior in a sample of men in treatment for substance use disorders.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996480/, Shorey and colleagues recruited men in a residential treatment center for substance abuse. Upon admission to the facility and after withdrawal from drugs the men completed a battery of tests including measures of mindfulness, alcohol use, drug use, and compulsive sexual behavior, including preoccupation, loss of control, relationship disturbance, and affect (emotional) disturbance.

 

They found that the higher the level of mindfulness that the men had the lower the levels of drug use, alcohol use, and compulsive sexual behavior, including preoccupation, loss of control, relationship disturbance, and affect disturbance. These relationships with compulsive sexual behavior remained significant and negative even when drug and alcohol use were factored in. In contrast, drug use was not related to compulsive sexual behavior, except for a positive relationship with relationship disturbance. So, although there’s high comorbidity between substance abuse and compulsive sexual behavior, they don’t appear to be highly related.

 

These are encouraging results that suggest that mindfulness may be an antidote for compulsive sexual behavior in patients with substance abuse. These results, however, are correlative and so causation cannot be concluded and are only applicable to men. The next step, of course, will be to form a randomized clinical trial of the effects of mindfulness training on compulsive sexual behavior in patients with substance abuse in both men and women to establish the efficacy of mindfulness training as a treatment. It is possible that mindfulness training will be effective for the treatment of both substance abuse and compulsive sexual behavior in both genders.

 

So, reduce compulsive sexual behavior with mindfulness.

 

“findings tentatively support the usefulness of mindfulness in the effective treatment of sex addiction. In addition to helping bring about a reduction in dysfunctional sex-related actions, fantasies and thoughts, mindfulness training may help affected individuals gain improved emotional control, an increased ability to handle stressful situations and improved resistance to any potentially damaging sex-related urges that arise.” – The Ranch

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Shorey, R. C., Elmquist, J., Gawrysiak, M. J., Anderson, S., & Stuart, G. L. (2016). The relationship between mindfulness and compulsive sexual behavior in a sample of men in treatment for substance use disorders. Mindfulness, 7(4), 866–873. http://doi.org/10.1007/s12671-016-0525-9

 

Abstract

Substance use disorders (SUDs) are a serious worldwide problem. Despite years of research on the treatment of SUDs, relapse remains high. One factor that may complicate SUDs treatment for some patients is compulsive sexual behavior. Factors that are related to both SUDs and compulsive sexual behavior could be targeted in SUDs treatment. In the current study, we examined dispositional mindfulness, a protective factor for a range of mental health problems, and its relationship to compulsive sexual behavior in a SUDs treatment sample. This is the first study to examine this relationship in a SUDs sample. Medical records from men in residential SUDs treatment were reviewed for the current study (N = 271). Upon admission to treatment, men completed self-report measures on alcohol and drug use, dispositional mindfulness, and compulsive sexual behavior. Bivariate correlations demonstrated dispositional mindfulness to be negatively associated with a variety of indicators of compulsive sexual behavior. After controlling for alcohol and drug use and problems in hierarchical regression analyses, which were both associated with compulsive sexual behaviors, dispositional mindfulness remained negatively associated with all of the compulsive sexual behavior indicators. Our results provide the first empirical association between dispositional mindfulness and compulsive sexual behavior in a SUDs sample. Although continued research is needed in this area, our findings suggest that it may be beneficial for SUDs treatment to incorporate mindfulness-based interventions for individuals with comorbid compulsive sexual behavior.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996480/

Drugs Produce Loss of Self Like Spiritual Awakening

Drugs Produce Loss of Self Like Spiritual Awakening

 

By John M. de Castro, Ph.D.

 

“People tripping on psilocybin can experience paranoia or a complete loss of subjective self-identity, known as ego dissolution”Annamarya Scaccia

 

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

 

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

 

The fact that experiences, virtual identical to spiritual awakening experiences, can be induced by drugs and that drugs have their effects by altering the chemistry of the nervous system, has led to the notion that perhaps spiritual experiences are simply an altered state of the brain produced by intense spiritual practices. An important observation in this regard is that alterations of the brain can make it more likely that an individual will have a spiritual experience. Spiritual experiences can occur occasionally with epileptic seizures. This may provide clues as to what neural structures are involved in spiritual experiences.

 

In today’s Research News article “Looking for the Self: Phenomenology, Neurophysiology and Philosophical Significance of Drug-induced Ego Dissolution.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441112/, Millière reviews and summarizes the published literature on drug effects on the concept of the self. He reports that a number of different psychoactive substances produce similar effects of ego dissolution. This is a dramatic breakdown of a sense of self producing a sense of unity with all things. No boundary between self and other is felt. Instead, there is a feeling of oneness with everything.

 

All psychedelic drugs act on the nervous system. They appear to stimulate the serotonin system in the brain and appear to suppress the activity of a set of neural structures known collectively as the Default Mode Network (DMN). These structures include the cingulate and medial frontal cortices, the thalamus which have been shown to be important for the production of a sense of self.

 

Another class of psychoactive drugs are dissociative anesthetics. These also appear to produce a loss of the sense of self, but act on a different neurochemical system, tending to stimulate the NMDA glutamate receptors. Glutamate receptors are the brain’s primary excitatory receptors and are widespread throughout the nervous system. So, the effects of this class of psychoactive substances on the brain are quite different from those of psychedelic drugs.

 

A final class of psychoactive drugs that produce an ego dissolution are kappa opioid receptor agonists. These appear to act by affecting opioid receptors which in turn affect the dopamine neurochemical system. In addition, it has been shown that drugs that block opioid receptors tend to reverse the feelings of loss of self in psychotic patients.

 

These findings do not reveal a common set of effects on the nervous system that are associated with the loss of a sense of self that are produced by the three different classes of compounds that elicit an ego dissolution. Of course, that doesn’t mean that there isn’t a common mechanism, only that none has been identified. But, if there is not a common neural mechanism, then it would appear that the sense of self is fragile and can be disrupted by widespread and different effects on the nervous system. In addition, thinking about the self appears to increase activity in a completely different area of the brain and paying attention to non-self elements of experience changes still another set of structures. Hence, a sense of self appears to be produced by widespread different areas of the nervous system and disruption of widespread different areas and neurochemical systems can disrupt the sense of self.

 

One problem with the research on the neural systems responsible for the notion of self may be that what we call self may actually be a complex set of different processes. What we define as the “self” consists of a set of components including physiology, behaviors, personality, emotions, thoughts, beliefs, memories, etc. It is not a single thing rather it’s a set of things that in their entirety are considered a self. In other words, the self is a concept that summarizes a set of experiences and is not a thing unto itself. If this is the case then it is not surprising that disruption of different process may be responsible for common feelings of a loss of self.

 

All of this suggests that spiritual awakening may be an entirely different process than the effects of psychoactive drugs. They may each disrupt a different aspect of the set of components that we describe as the self. They further suggest that the sense of self is fragile and can be disrupted by disparate activities and psychoactive compounds affecting widespread and differing neural systems. Until there is greater clarity about which exact components of self are affected by each of the activities and drugs that produce an overall sense of loss of self, it will not be possible to answer the question as to whether spiritual awakening is due to organic changes produced by engagement in spiritual activities, or that they are representative of a totally different reality.

 

“There is ‘objective reality’ and then there is ‘our reality. Psychedelic drugs can distort our reality and result in perceptual illusions. But the reality we experience during ordinary wakefulness is also, to a large extent, an illusion.” – Enzo Tagliazucchi

 

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

 

Millière, R. (2017). Looking for the Self: Phenomenology, Neurophysiology and Philosophical Significance of Drug-induced Ego Dissolution. Frontiers in Human Neuroscience, 11, 245. http://doi.org/10.3389/fnhum.2017.00245

 

Abstract

There is converging evidence that high doses of hallucinogenic drugs can produce significant alterations of self-experience, described as the dissolution of the sense of self and the loss of boundaries between self and world. This article discusses the relevance of this phenomenon, known as “drug-induced ego dissolution (DIED)”, for cognitive neuroscience, psychology and philosophy of mind. Data from self-report questionnaires suggest that three neuropharmacological classes of drugs can induce ego dissolution: classical psychedelics, dissociative anesthetics and agonists of the kappa opioid receptor (KOR). While these substances act on different neurotransmitter receptors, they all produce strong subjective effects that can be compared to the symptoms of acute psychosis, including ego dissolution. It has been suggested that neuroimaging of DIED can indirectly shed light on the neural correlates of the self. While this line of inquiry is promising, its results must be interpreted with caution. First, neural correlates of ego dissolution might reveal the necessary neurophysiological conditions for the maintenance of the sense of self, but it is more doubtful that this method can reveal its minimally sufficient conditions. Second, it is necessary to define the relevant notion of self at play in the phenomenon of DIED. This article suggests that DIED consists in the disruption of subpersonal processes underlying the “minimal” or “embodied” self, i.e., the basic experience of being a self rooted in multimodal integration of self-related stimuli. This hypothesis is consistent with Bayesian models of phenomenal selfhood, according to which the subjective structure of conscious experience ultimately results from the optimization of predictions in perception and action. Finally, it is argued that DIED is also of particular interest for philosophy of mind. On the one hand, it challenges theories according to which consciousness always involves self-awareness. On the other hand, it suggests that ordinary conscious experience might involve a minimal kind of self-awareness rooted in multisensory processing, which is what appears to fade away during DIED.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441112/

Improve Substance Abuse Treatment with Mindfulness

Improve Substance Abuse Treatment with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It is most often the mind’s interpretation of a stressful life event, not the event itself, that creates the urgent need to get instant relief and leads to substance use or other unwanted behaviors. Mindfulness practices provide a break from stress, teach the client to listen to his/her mind, body, and emotions, and improve the self-acceptance that leads to greater hope and self-efficacy.“ – NAADAC

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Drug abuse is often more complex than a simple addiction to a substance. Addiction frequently is accompanied by other mental health issues, comorbidities. They include mood and anxiety disorders, antisocial and conduct disorder, smoking and alcohol abuse, and post-traumatic stress disorder (PTSD).

 

There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse, possibility because of the failure to address comorbidities. Hence, it is important to find an effective method to treat both addiction but also accompanying conditions. Mindfulness training has been shown to be a safe and effective treatment of addiction and relapse prevention. It has also been shown to be effective for a variety of other mental health issues including anxiety, depression, antisocial and conduct disorder, smoking and alcohol abuse, and post-traumatic stress disorder (PTSD). Hence, mindfulness training would appear to be a potential treatment that can be added to traditional substance abuse treatment programs to both address addiction and accompanying comorbid disorders.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement Versus CBT for Co-Occurring Substance Dependence, Traumatic Stress, and Psychiatric Disorders: Proximal Outcomes from a Pragmatic Randomized Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752876/

Garland and colleagues compared the effectiveness of a mindfulness-based addiction treatment program with another well-established therapy, cognitive behavioral therapy (CBT), and with the usual treatment for addiction. They recruited homeless men with a substance abuse disorder and comorbid mental health issues and randomly assigned them to either receive 10 weeks of a group-based Mindfulness-Oriented Recovery Enhancement (MORE) program, group-based cognitive behavioral therapy (CBT), or usual treatment. At the beginning and end of the 10-week treatment, they measured the participants’ trauma history, drug cravings, post-traumatic stress symptoms, psychiatric distress, mindfulness, positive and negative feelings, and readiness to change.

 

They found that all treatments improved depression, but Mindfulness-Oriented Recovery Enhancement (MORE) treatment produced improvements in drug cravings, post-traumatic stress symptoms, mindfulness, and negative feelings, that were significantly greater than cognitive behavioral therapy (CBT), or usual treatment. In addition, mediation analysis revealed that the improvements in drug cravings and post-traumatic stress symptoms was mediated by increases in mindfulness. That is the Mindfulness-Oriented Recovery Enhancement (MORE) treatment significantly improved mindfulness which, in turn, produced significant improvements in drug cravings and post-traumatic stress symptoms.

 

These are particularly compelling findings as MORE was found to be superior to a well-established treatment technique, cognitive behavioral therapy (CBT). This is a powerful research design that controls for most sources of confounding. So, it appears clear that adding mindfulness practice to addiction treatment significantly improves outcomes.

 

So, improve substance abuse treatment with mindfulness.

 

“mindfulness enhances our ability to be non-reactive. This is key in drug treatment because oftentimes we seek immediate gratification; we want to feel good right now, or we want the negative feeling we’re experiencing to stop right now. This leads to reactive thinking, feeling, and behaving, and can be a catapult for drug use. When we practice mindfulness we practice responding to our experience with a non-reactive, non-judgmental attitude. This helps us maintain autonomy over our behavior. We may not have control over whether a craving for a drug arises, but we can control how we respond to such a craving. The irony is that when we practice simply observing the craving; letting it arise and letting it pass away (rather than actively trying to push it away or avoid it), we are left with more of an ability to regulate ourselves.´- Center for Adolescent Studies

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Garland, E. L., Roberts-Lewis, A., Tronnier, C. D., Graves, R., & Kelley, K. (2016). Mindfulness-Oriented Recovery Enhancement Versus CBT for Co-Occurring Substance Dependence, Traumatic Stress, and Psychiatric Disorders: Proximal Outcomes from a Pragmatic Randomized Trial. Behaviour Research and Therapy, 77, 7–16. http://doi.org/10.1016/j.brat.2015.11.012

 

Abstract

In clinical settings, there is a high comorbidity between substance use disorders, psychiatric disorders, and traumatic stress. As such, transdiagnostic therapies are needed to address these co-occurring issues efficiently. The aim of the present study was to conduct a pragmatic randomized controlled trial comparing Mindfulness-Oriented Recovery Enhancement (MORE) to group Cognitive-Behavioral Therapy (CBT) and treatment-as-usual (TAU) for previously homeless men residing in a therapeutic community. Men with co-occurring substance use and psychiatric disorders, as well as extensive trauma histories, were randomly assigned to 10 weeks of group treatment with MORE (n=64), CBT (n=64), or TAU (n=52). Study findings indicated that from pre- to post-treatment MORE was associated with modest yet significantly greater improvements in substance craving, post-traumatic stress, and negative affect than CBT, and significantly greater improvements in post-traumatic stress and positive affect than TAU. A significant indirect effect of MORE on decreasing craving and post-traumatic stress by increasing dispositional mindfulness was observed, suggesting that MORE may target these issues via enhancing mindful awareness in everyday life. This pragmatic trial represents the first head-to-head comparison of MORE against an empirically-supported treatment for co-occurring disorders. Results suggest that MORE, as an integrative therapy designed to bolster self-regulatory capacity, may hold promise as a treatment for intersecting clinical conditions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752876/

 

Reduce Pain with Meditation Rather Than Drugs

 

By John M. de Castro, Ph.D.

 

“For some people with chronic pain, mindful meditation is an appealing pain management option because it has an unusual benefit; it is something that you personally control. Unlike pain medications or medical procedures, meditation is not done to you, it is something you can do for yourself.” – Stephanie Burke

 

Pain can be difficult to deal with, particularly if it’s persistent. But, even short-term pain, acute pain, is unpleasant. Pain, however, is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s important that pain signals not be blocked or prevented. They need to be perceived. Nevertheless, it would be useful to find ways to lower the intensity of perceived pain and improve recovery from painful stimuli. Pain signals are processed in the brain and the state of the brain can alter the perception of pain. Indeed, opioid drugs are very effective pain killers and they work by affecting opioid receptors in the brain that are important in the perception of pain.

 

Pain is affected by the mind. The perception of pain can be amplified by the emotional reactions to it and also by attempts to fight or counteract it. Pain perception can be reduced by aerobic exercise and mental states, including placebo effects, attention, and conditioning. Additionally, contemplative practices have been shown to reduce both chronic and acute pain. It has been shown that exercise and mental states affect pain perception via opioid receptors. Their effects on pain can be prevented by the injection of a drug, naloxone, that blocks opioid receptors. Hence, mental states appear to alter pain perception through effects on the opioid system in the brain. But, it is not known if contemplative practices act in the same way.

 

In today’s Research News article “Mindfulness-Meditation-Based Pain Relief Is Not Mediated by Endogenous Opioids.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1361495810541008/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792946/

Zeidan and colleagues examine the involvement of opioid receptors in the pain reduction produced by meditation practice. They recruited participants who had no experience with meditation and randomly assigned them to four groups. Two groups engaged in meditation for 20 minutes per day for four days, while two groups listened to an audiobook for 20 minutes per day for four days. One meditation group and one no-meditation group received a naloxone injection while the other two groups received injections of a non-active saline solution. Both participants and experimenters were blind as to whether they were receiving naloxone or saline. Before and after injection, participants were tested while meditating or resting for sensitivity to pain induced by heat to the skin. Participants rated their perceived pain to different levels of heat.

 

They found that mindfulness meditation reduced pain perception by 21% and pain unpleasantness by 36% relative to resting controls. This occurred for the meditation groups regardless of whether naloxone or saline was injected. So, the opioid receptor blocking drug naloxone had no effect on the reductions in pain produced by meditation. Hence, meditation, unlike other mental states, appears to reduce pain independent of the opioid pain system in the brain.

 

There are a number of effects of meditation that might underlie the reduction in pain perception. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Meditation practices have been shown to reduce stress responses and anxiety, and to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. So, it would seem reasonable that mindfulness practices would be helpful in pain management. In addition, pain is accompanied by, and frequently caused by, inflammation and meditation has been shown to reduce the inflammatory response. This may account for the mindfulness’ effects on the physical aspects of chronic pain.

 

So, reduce pain with meditation rather than drugs.

 

“Meditation teaches patients how to react to the pain. People are less inclined to have the ‘Ouch’ reaction, and are able to control their emotional reaction to pain.” – BRIAN STEINER

 

 

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

Fadel Zeidan, Adrienne L. Adler-Neal, Rebecca E. Wells, Emily Stagnaro, Lisa M. May, James C. Eisenach, John G. McHaffie, Robert C. Coghill. Mindfulness-Meditation-Based Pain Relief Is Not Mediated by Endogenous Opioids. J Neurosci. 2016 Mar 16; 36(11): 3391–3397. doi: 10.1523/JNEUROSCI.4328-15.2016

 

Abstract

Mindfulness meditation, a cognitive practice premised on sustaining nonjudgmental awareness of arising sensory events, reliably attenuates pain. Mindfulness meditation activates multiple brain regions that contain a high expression of opioid receptors. However, it is unknown whether mindfulness-meditation-based analgesia is mediated by endogenous opioids. The present double-blind, randomized study examined behavioral pain responses in healthy human volunteers during mindfulness meditation and a nonmanipulation control condition in response to noxious heat and intravenous administration of the opioid antagonist naloxone (0.15 mg/kg bolus + 0.1 mg/kg/h infusion) or saline placebo. Meditation during saline infusion significantly reduced pain intensity and unpleasantness ratings when compared to the control + saline group. However, naloxone infusion failed to reverse meditation-induced analgesia. There were no significant differences in pain intensity or pain unpleasantness reductions between the meditation + naloxone and the meditation + saline groups. Furthermore, mindfulness meditation during naloxone produced significantly greater reductions in pain intensity and unpleasantness than the control groups. These findings demonstrate that mindfulness meditation does not rely on endogenous opioidergic mechanisms to reduce pain.

SIGNIFICANCE STATEMENT Endogenous opioids have been repeatedly shown to be involved in the cognitive inhibition of pain. Mindfulness meditation, a practice premised on directing nonjudgmental attention to arising sensory events, reduces pain by engaging mechanisms supporting the cognitive control of pain. However, it remains unknown if mindfulness-meditation-based analgesia is mediated by opioids, an important consideration for using meditation to treat chronic pain. To address this question, the present study examined pain reports during meditation in response to noxious heat and administration of the opioid antagonist naloxone and placebo saline. The results demonstrate that meditation-based pain relief does not require endogenous opioids. Therefore, the treatment of chronic pain may be more effective with meditation due to a lack of cross-tolerance with opiate-based medications.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792946/

Making the Ego Go Away is a Mystical Experience

 

psychodelics-ego-dissolution2-nour

By John M. de Castro, Ph.D.

 

“When subjected to a scientific experiment, these characteristics proved to be identical for spontaneous and psychedelic mystical experiences.
1.
 Unity is a sense of cosmic oneness achieved through positive ego transcendence. Although the usual sense of identity, or ego, fades away, consciousness and memory are not lost; . . ., so that a person reports that he feels a part of everything that is, or more simply, that “all is One.”  – Walter N. Pahnke

 

The core experience that has been found to be present in spiritual awakenings is a loss of the personal self. What they used to refer to as the self is experienced as just a part of an integrated whole. People who have had these experiences report feeling interconnected with everything else in a sense of oneness with all things. Although awakening experiences can vary widely, they all contain this experience of oneness.

 

Millions of people worldwide seek out spiritual awakening by engaging in practices, such as meditation, yoga, and prayer. Others use drugs such as peyote, mescaline, LSD, ayahuasca and

psilocybin to induce spiritual awakenings. The experiences produced by the drugs have many characteristics which are unique to the experiencer, their religious context, and their present situation. But, the common, central feature of these drug experiences is a sense of oneness, that all things are contained in a single thing, a sense of union with the universe and/or God and everything in existence.

 

Hence, central to both practice induced awakenings and psychedelic drug experiences is a loss of self that is sometimes called an ego death or an ego dissolution. In today’s Research News article “Ego-Dissolution and Psychedelics: Validation of the Ego-Dissolution Inventory (EDI).” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1358413174182605/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4906025/

Nour and colleagues attempt to develop a psychometric scale measuring ego dissolution and its opposite ego inflation and compare the results on this scale for people who self-reported use of psychedelic drugs, cocaine, and alcohol. They recruited participants with on-line ads and obtained anonymous responses from 691 people. The ego dissolution inventory (EDI) contained 8 items; “I experienced a dissolution of my “self” or ego,”I experienced a dissolution of my “self” or ego,” “I felt at one with the universe,” “I felt a sense of union with others,” “I experienced a decrease in my sense of self-importance,” “ I experienced a disintegration of my “self” or ego,” “I felt far less absorbed by my own issues and concerns,” “I lost all sense of ego,” “all notion of self and identity dissolved away.” Items were rated 0–100, with zero defined as “No, not more than usually”, and 100 defined as “Yes, entirely or completely.”

 

They found that the ego dissolution inventory (EDI) had adequate psychometric properties suggesting reliability and validity of the scale. The scores on the EDI were extremely similar to the participant’s responses to unity experiences on the Mystical Experiences Questionnaire (MEQ) suggesting that ego-dissolutions were virtually identical to reported senses of oneness. Interestingly, they found that ego dissolution was highly related to well-being suggesting that loss of the self produces a sense of personal well-being. In terms of drugs, it was found that when psychedelic drug dose or intensity of experience was high, ego dissolution was also high. But, there was no such relationship with cocaine or alcohol, while when cocaine dose was high ego-inflation was also high. So, psychedelic use is associated with ego dissolution while cocaine use is associated with a heightened sense of self, ego-inflation.

 

The results demonstrate that the ego dissolution can be measured and that the EDI is a reliable and valid measure. They further indicate that ego dilution and unity experiences are virtually identical suggesting that they may be measures of the same experience. The results also show that psychedelic drug use, but not cocaine or alcohol are highly associated with ego dilution. All of this adds to the case that awakening experiences and psychedelic drug experiences are either extraordinarily similar or perhaps identical. Since psychedelic drugs alter the brain, the results further suggest that awakening experiences may be due to similar changes in the brain.

 

This study was strictly correlational and no causal connections can be determined. But, these interesting results strongly suggest that a double-blind clinical trial of drug effects on ego dissolution and inflation should be conducted. It is not possible to manipulate participants into having non-drug induced awakening experiences. But, the similarity between the two suggests that drug induced experiences may be an excellent model for the study of the neural changes that underlie spiritual awakening experiences

 

“Because the ego never actually exists, those who are most captivated by its illusion are still playing. They take it seriously and do not know that they are playing. By inducing ego-death and evolutionary perspectives, psychedelic drugs can counteract
the fear of death.”
– LSD Experience – Ego

 

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

Nour, M. M., Evans, L., Nutt, D., & Carhart-Harris, R. L. (2016). Ego-Dissolution and Psychedelics: Validation of the Ego-Dissolution Inventory (EDI). Frontiers in Human Neuroscience, 10, 269. http://doi.org/10.3389/fnhum.2016.00269

 

Abstract

Aims: The experience of a compromised sense of “self”, termed ego-dissolution, is a key feature of the psychedelic experience. This study aimed to validate the Ego-Dissolution Inventory (EDI), a new 8-item self-report scale designed to measure ego-dissolution. Additionally, we aimed to investigate the specificity of the relationship between psychedelics and ego-dissolution.

Method: Sixteen items relating to altered ego-consciousness were included in an internet questionnaire; eight relating to the experience of ego-dissolution (comprising the EDI), and eight relating to the antithetical experience of increased self-assuredness, termed ego-inflation. Items were rated using a visual analog scale. Participants answered the questionnaire for experiences with classical psychedelic drugs, cocaine and/or alcohol. They also answered the seven questions from the Mystical Experiences Questionnaire (MEQ) relating to the experience of unity with one’s surroundings.

Results: Six hundred and ninety-one participants completed the questionnaire, providing data for 1828 drug experiences (1043 psychedelics, 377 cocaine, 408 alcohol). Exploratory factor analysis demonstrated that the eight EDI items loaded exclusively onto a single common factor, which was orthogonal to a second factor comprised of the items relating to ego-inflation (rho = −0.110), demonstrating discriminant validity. The EDI correlated strongly with the MEQ-derived measure of unitive experience (rho = 0.735), demonstrating convergent validity. EDI internal consistency was excellent (Cronbach’s alpha 0.93). Three analyses confirmed the specificity of ego-dissolution for experiences occasioned by psychedelic drugs. Firstly, EDI score correlated with drug-dose for psychedelic drugs (rho = 0.371), but not for cocaine (rho = 0.115) or alcohol (rho = −0.055). Secondly, the linear regression line relating the subjective intensity of the experience to ego-dissolution was significantly steeper for psychedelics (unstandardized regression coefficient = 0.701) compared with cocaine (0.135) or alcohol (0.144). Ego-inflation, by contrast, was specifically associated with cocaine experiences. Finally, a binary Support Vector Machine classifier identified experiences occasioned by psychedelic drugs vs. cocaine or alcohol with over 85% accuracy using ratings of ego-dissolution and ego-inflation alone.

Conclusion: Our results demonstrate the psychometric structure, internal consistency and construct validity of the EDI. Moreover, we demonstrate the close relationship between ego-dissolution and the psychedelic experience. The EDI will facilitate the study of the neuronal correlates of ego-dissolution, which is relevant for psychedelic-assisted psychotherapy and our understanding of psychosis.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4906025/

 

Reduce Low Self-Control Drug Use with Mindfulness

Mindfulness drug use2 Tarantino

 

By John M. de Castro, Ph.D.

 

“The idea behind mindfulness meditation is to observe the present moment by paying attention to the breath and body, as well as thoughts and emotions. People with challenges related to addiction tend to act out on addictive behaviors to avoid uncomfortable feelings and to bring pleasure. . . . Mindfulness practices help the client to learn to face the present movement with all of its pleasant and unpleasant sensations, feelings and thoughts.” – Eric Millman

 

College students make up one of the largest groups of drug abusers nationwide. Alcohol is the most abused substance, but there are many others. These include: marijuana, prescription medications (including stimulants, central nervous system depressants, and narcotics), over-the-counter drugs, cocaine, heroin, and ecstasy. Of these marijuana is the most commonly abused substance by college students. In fact, 47% of college students have tried it at least once, with 30% admiting to using it in the past year. In addition, one in five college students admits to using amphetamine and 13% of college students admit to using ecstasy at least once in their lives.

 

These are sobering statistics and underscore the need to find effective methods to prevent and treat substance abuse in college students. It is established that problematic family environments are linked to college student substance abuse. It has also been established that mindfulness tends to counteract substance abuse. Indeed, mindfulness training has been shown to be a safe and effective treatment for reducing drug use and relapse after successful treatment. In today’s Research News article “Parent-Child Conflict and Drug Use in College Women: A Moderated Mediation Model of Self Control and Mindfulness.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1292270250796898/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175297/

Tarantino and colleagues investigate whether mindfulness modulates the effects of difficult family environments on substance abuse.

 

They recruited a large on-line sample of college women and measured perceptions of the relationship between the student and his/her parent, mindfulness, self-control, and drug use. They found that the higher the level of parent-child conflict the higher the level of substance abuse. They also found variables that tended to counteract substance abuse. The higher the levels of mindfulness, self-control, and being in a relationship, the lower the levels of substance abuse. But, by far the strongest negative relationship was between self-control and substance abuse. They also found that mindfulness and self-control modified the effects of parent-child conflict on substance abuse. Mindfulness tended to blunt the effects of parent-child conflict on substance abuse only when the women were low in self-control but not when they were high in self-control.

 

These results suggest that the ability of a problematic home environment to stimulate drug abuse is diminished primarily by high self-control. But, when self-control is low mindfulness blunts the effects of parent-child conflict on substance abuse. “This relation can best be understood as a compensatory effect wherein a higher degree of either self-control or mindfulness protects against a lower degree of the other.” The complexity of these findings suggest that different strategies for treating drug abuse may be needed for women who were low vs. high in self-control. Self-control is the most important factor, but mindfulness training may work well for women who have low self-control. Future research is needed to further clarify the utility of mindfulness training in women with low self-control.

 

So, reduce low self-control drug use with mindfulness.

 

“though it may seem paradoxical, by increasing your ability to accept and tolerate the present moment, you become more able to make needed changes in your life. This is due to your learning to deal with uncomfortable feelings that might accompany modified behaviors, rather than reacting on automatic pilot. Also, practicing balanced emotional responses can reduce your stress level, and anxiety and stress are often triggers for substance abuse and addictive behavior. In addition, when you choose a neutral rather than a judgmental response to your thoughts and feelings, you can increase your sense of self-compassion rather than beating yourself up, which is often associated with addictive behaviors.” Adi Jaffe

 

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

RESEARCH NEWS –

 

Tarantino, N., Lamis, D. A., Ballard, E. D., Masuda, A., & Dvorak, R. D. (2015). Parent-Child Conflict and Drug Use in College Women: A Moderated Mediation Model of Self Control and Mindfulness. Journal of Counseling Psychology, 62(2), 303–313. http://doi.org/10.1037/cou0000013

 

 

Abstract

This cross-sectional study examined the association between parent-child conflict and illicit drug use in a sample of female college students (N = 928). The mediating roles of self-control and mindfulness, as well as an interaction between self-control and mindfulness, were examined in a moderated mediation model for the purposes of expanding etiological theory and introducing targets for the prevention and treatment of drug abuse. Whereas deficits in self-control were found to facilitate the positive relation observed between parent-child conflict and the likelihood of experiencing drug-related problems, an interaction between mindfulness and self-control helped explain the association between parent-child conflict and intensity of drug-related problems. Parent-child conflict was related to low mindfulness when self-control was low, and low mindfulness in turn was related to a higher intensity of drug-related problems. This association did not exist for women with high self-control. Findings are consistent with developmental research on the etiology of drug use and the protective properties of mindfulness and self-control. Mindfulness as a potential target of intervention for drug users with low self-control to prevent drug-related problems is explored.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175297/

 

Lower Aggression in Substance Abusers with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When we practice mindfulness we practice responding to our experience with a non-reactive, non-judgmental attitude. This helps us maintain autonomy over our behavior. We may not have control over whether a craving for a drug arises, but we can control how we respond to such a craving. The irony is that when we practice simply observing the craving; letting it arise and letting it pass away (rather than actively trying to push it away or avoid it), we are left with more of an ability to regulate ourselves.” – Center for Adolescent Studies

 

Drug and alcohol abuse are highly related to aggressive behavior. Alcohol abuse has been found in 50%-72% of convicted rapists, 50% of incestuous offenders, 40%-83% of wife abusers and perpetrators of family violence, 29% of individuals with a history of injurious violent acts, 48-56% of individuals with a history of violent acts at home, 36%-83% of imprisoned murderers, 61% of adolescents convicted of homicides, and 33% of convicted felons. Other drugs are less problematic except that the difficulties in supporting an expensive habit can lead to violence and aggression. Obviously, treatment for drug abuse and the consequent violence and aggression is important both for the individual and for society in general.

 

Mindfulness training has been shown to be effective in drug abuse treatment. It has also been shown to lower aggression and to reduce maladaptive responses to emotions and anger. In addition, it has been shown to be inversely associated with aggression and violence in women entering treatment for substance abuse such that the higher the level of mindfulness the lower the levels of violence and aggression. But men are more violent and aggressive than women. In fact, approximately 75% of all violent crimes are committed by men. So, the relationship between mindfulness and aggression that is observed in women may be different in men.

 

In today’s Research News article “The Relation Between Trait Mindfulness and Aggression in Men Seeking Residential Substance Use Treatment.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1269818923042031/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363039/

Shorey and colleagues address the question of mindfulness’ relationship to aggression in men entering substance abuse treatment. They recruited adult males in residential substance abuse treatment facilities and measured mindfulness, aggression, and alcohol and drug use. They found, as expected, that the higher the levels of drug and alcohol abuse the higher the levels of aggression. They also found that the higher the level of mindfulness the lower the levels of overall aggression, aggressive attitude, verbal and physical aggression, and drug and alcohol use.

 

These are interesting and important findings that replicate for men the findings for women that mindfulness is related to lower drug and alcohol use and lower aggression. Since this study was correlative in nature, it cannot be concluded that high mindfulness caused lower drug us and aggression. It could be that lower drug use causes greater mindfulness or that aggressive people and not mindful people. It remains for future research to train substance abusers in mindfulness and measure for a decrease in aggression to determine if indeed mindfulness causes lower aggression in substance abusers. This will be important to demonstrate to establish that mindfulness should be included in therapy for drug abuse.

 

These results fit with the general findings that mindfulness improves the individual’s ability to regulate emotions, to be able to fully feel emotions yet act more adaptively. So, the mindful individual would be much less likely to respond to anger with aggression and violence. In addition, by focusing attention and thoughts in the present moment, the mindful individual would be less likely to ruminate about others past offenses, making it less likely that they would respond in a vengeful way toward them. Hence, since violence and aggression is so prevalent in substance abusers and mindfulness acts in opposition to aggression, mindfulness training should be considered for inclusion in drug abuse treatment.

 

So, lower aggression in substance abusers with mindfulness.

 

“Mindfulness also helps people learn to relate to discomfort differently. When an uncomfortable feeling like a craving or anxiety arises, people like Sophia are able to recognize their discomfort, and observe it with presence and compassion, instead of automatically reaching for a drug to make it go away.” – Sarah Bowen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Shorey, R. C., Anderson, S., & Stuart, G. L. (2015). The Relation Between Trait Mindfulness and Aggression in Men Seeking Residential Substance Use Treatment. Journal of Interpersonal Violence, 30(10), 1633–1650. http://doi.org/10.1177/0886260514548586

 

Abstract

There has been an abundance of research in recent years on mindfulness, including mindfulness within individuals seeking substance use treatment. However, to date, there has been no research on whether trait mindfulness is associated with increased aggression among individuals seeking substance use treatment. Past research has demonstrated that individuals in substance use treatment evidence higher levels of aggression than non-substance abusers, and preliminary research has shown that trait mindfulness is inversely associated with aggression in non-substance-use treatment-seeking populations. The current study examined whether trait mindfulness was associated with aggression among men seeking residential substance use treatment (N = 116). Results demonstrated that lower trait mindfulness was associated with increased aggression (physical, verbal, and aggressive attitude). Moreover, this relation held for both verbal aggression and aggressive attitude after controlling for alcohol use, drug use, and age, all known predictors of aggression. Findings provide the first evidence that mindfulness is negatively associated with aggression among men in substance use treatment, which could have important implications for intervention. That is, mindfulness-based interventions may prove helpful for the treatment of both substance use and aggression.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363039/

 

Prevent Depression Relapse Better with Both Mindfulness and Drugs

 

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

 

Major Depression is the most common mental illness, affecting over 6% of the population. It appears to be the result of a change in the nervous system that can generally only be reached with drugs that alter the affected neurochemical systems. But, depression can be difficult to treat. 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. In, addition, 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. So, it is important to not only treat the disease initially, but also to employ strategies to decrease or prevent relapse.

 

Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment and is also effective for the prevention of its recurrence. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. The combination of drugs along with MBCT has been shown to be quite effective in treating depression and preventing relapse. Since, drugs have troubling side effects and can lose effectiveness over time, it is important to determine if after remission, MBCT can continue to prevent relapse if the drugs are removed. In other words, after MBCT can the drugs be withdrawn.

 

In today’s Research News article “Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1200545726636018/?type=3&theater or see below:

Huijbers and colleagues recruited patients who had had three or more depressive episodes, were being treated with anti-depressive medications for at least six months, and were currently in remission. All patients then received an 8-week Mindfulness Based Cognitive Therapy (MBCT) program. MBCT included meditation, body scan, and mindful movement as well as exercises to bring present-moment awareness to everyday activities. Cognitive therapy included education, monitoring and scheduling of activities, identification of negative automatic thoughts and devising a relapse prevention plan. At the conclusion of treatment patients were randomly assigned to have the drugs withdrawn over five weeks or to continue receiving drugs.

 

Huijbers and colleagues found that at 15 months after MBCT treatment there was a 25% higher rate of relapse when the drugs were withdrawn compared to when they were maintained. In addition, the amount of time to relapse/recurrence was significantly shorter after discontinuation of the drugs. This suggests that withdrawing the drugs increases the risk of relapse/recurrence for patients in remission from major depression and suggests that the combination of MBCT along with a maintenance dose of drug is superior in preventing relapse.

 

So, prevent depression relapse better with both mindfulness and drugs.

 

“Because [mindfulness-based cognitive therapy] is a group treatment which reduces costs and the number of trained staff needed it may be feasible to offer MBCT as a choice to patients in general practice…We therefore have a promising relatively new treatment which is reasonably cost effective and applicable to the large group of patients with recurrent depression.” – Roger Mulder

 

CMCS – Center for Mindfulness and Contemplative Studies

 

 

Study Summary

 

Marloes J. Huijbers, Philip Spinhoven, Jan Spijker, Henricus G. Ruhé, Digna J. F. van Schaik, Patricia van Oppen, Willem A. Nolen,Johan Ormel, Willem Kuyken, Gert Jan van der Wilt, Marc B. J. Blom, Aart H. Schene, A. Rogier T. Donders, Anne E. M. Speckens. Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial. The British Journal of Psychiatry Feb 2016, DOI: 10.1192/bjp.bp.115.168971

Abstract

Background: Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied.

Aims: To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM.

Method: A multicentre randomised controlled non-inferiority trial (ClinicalTrials.gov: NCT00928980). Adults with recurrent depression in remission, using mADM for 6 months or longer (n = 249), were randomly allocated to either discontinue (n = 128) or continue (n = 121) mADM after MBCT. The primary outcome was depressive relapse/recurrence within 15 months. A confidence interval approach with a margin of 25% was used to test non-inferiority. Key secondary outcomes were time to relapse/recurrence and depression severity.

Results: The difference in relapse/recurrence rates exceeded the non-inferiority margin and time to relapse/recurrence was significantly shorter after discontinuation of mADM. There were only minor differences in depression severity.

Conclusions: Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT.