Improve Obsessive-Compulsive Disorder With Mindfulness

Improve Obsessive-Compulsive Disorder With Mindfulness

 

By John M. de Castro, Ph.D.

 

“To be able to focus on what is really happening in any given moment, as opposed to dwelling on the past or anticipating the future, takes away the power of OCD.” – Janet Singer

 

Obsessive-Compulsive Disorder (OCD) sufferer have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

 

Fortunately, OCD can be treated and Mindfulness training has been shown to be effective in treating OCD. In addition, changing the maladaptive thought processes occurring in OCD through Cognitive Restructuring (CR) has also been shown to be effective. In today’s Research News article “A randomized waitlist-controlled trial comparing detached mindfulness and cognitive restructuring in obsessive-compulsive disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426247/), Rupp and colleagues compare the effectiveness of mindfulness training and cognitive restructuring in treating Obsessive-Compulsive Disorder (OCD).

 

They recruited patients with Obsessive-Compulsive Disorder (OCD) and randomly assigned them to receive either cognitive restructuring or detached mindfulness training or to a wait-list control condition. The treatments were delivered in 100-minute sessions, twice a week for two weeks and contained homework assignments. Cognitive restructuring targets distorted thinking that underlies OCD and teaches the patient to observe the thoughts and question the appraisals produced by the thoughts. Detached mindfulness training also targets the distorted thinking that underlies OCD but teaches the patient to observe the thoughts and detach from them, see them as separate from themselves. They were measured before and after training and 4 weeks later for intelligence, depression, psychological disorders, and Obsessive-Compulsive Disorder (OCD) symptoms.

 

They found that compared to baseline and the wait-list control group both treatments resulted in significant reductions in OCD symptoms that were clinically significant and maintained at the 4-week follow-up. There were also small deceases in depression levels in the patients after both treatments. Hence, both treatments improved the symptoms of patients suffering from Obsessive-Compulsive Disorder (OCD). Hence brief training in cognitive restructuring or detached mindfulness are effective in treating OCD symptoms.

 

It has previously been demonstrated that Mindfulness training is effective in treating OCD. The current study suggests that an unusual mindfulness technique, detached mindfulness, may also be effective. It appears that very different types of treatments, cognitive restructuring and detached mindfulness are effective in treating the symptoms of Obsessive-Compulsive Disorder (OCD). The control condition, however, received no treatment. So, it is possible that the improvements observed may have been due to subject expectancy effects (placebo effects) and not to the treatments. Future research should include placebo control conditions.

 

So, improve obsessive-compulsive disorder with mindfulness.

 

“a person trapped by an endless cycle of washing, checking, or cleaning is experiencing exactly the same struggle with accepting thoughts, feelings, and sensations as people with intrusive thoughts.  So, mindfulness is really for anyone who wants to stop feeling like what is going on inside their mind is a burden.  It’s hard to imagine anyone with OCD who would wish to continue feeling that way.” – John Hershfield

 

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

 

Rupp, C., Jürgens, C., Doebler, P., Andor, F., & Buhlmann, U. (2019). A randomized waitlist-controlled trial comparing detached mindfulness and cognitive restructuring in obsessive-compulsive disorder. PloS one, 14(3), e0213895. doi:10.1371/journal.pone.0213895

 

Abstract

Objective

Whereas research has demonstrated the efficacy of cognitive restructuring (CR) for obsessive-compulsive disorder (OCD), little is known about the efficacy of specific metacognitive interventions such as detached mindfulness (DM). Therefore, this study compared the efficacy of CR and DM as stand-alone interventions.

Design

We conducted a randomized waitlist-controlled trial. n = 43 participants were randomly assigned to either DM or CR. Out of those participants, n = 21 participants had been previously assigned to a two-week waitlist condition.

Materials and methods

In both conditions, treatment comprised four double sessions within two weeks. Assessment took place at baseline (Pre1), after treatment (Post) and four weeks after the end of treatment (FU). There was a second baseline assessment (Pre2) in the waitlist group. Independent evaluators were blinded concerning the active condition. Adherence and competence ratings for the two therapists were obtained from an independent rater.

Results

40 patients completed the treatment. Two patients dropped out because of exacerbated depression. There were no further adverse events. Both CR and DM were shown to be superior to waitlist and equally effective at reducing OCD symptoms from pre to post assessment as measured with the Y-BOCS (CR: d = 1.67, DM: d = 1.55). In each of the two treatment conditions, eight patients (40%) exhibited a clinical significant change at post assessment.

Conclusions

The results of this clinical trial suggest the potential efficacy of DM as a stand-alone intervention for OCD, however, our findings need to be interpreted with caution. Results indicate that both CR and DM should be considered as possible alternative treatments for OCD, whereas the working mechanisms of DM have yet to be elucidated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426247/

 

Improve the Symptoms of Obsessive-Compulsive Disorder with Mindfulness

Improve the Symptoms of Obsessive-Compulsive Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“most OCD sufferers I know who practice mindfulness find it very helpful in fighting their disorder. To be able to focus on what is really happening in any given moment, as opposed to dwelling on the past or anticipating the future, takes away the power of OCD.” – Janet Singer

 

Obsessive-Compulsive Disorder (OCD) sufferer have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life. Fortunately, OCD can be treated and Mindfulness training has been shown to be effective in treating OCD.

 

In today’s Research News article “New-wave behavioral therapies in obsessive-compulsive disorder: Moving toward integrated behavioral therapies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343420/ ), Manjula and colleagues review and summarize the published research literature on new treatments for Obsessive-Compulsive Disorder (OCD). They included in their review studies involving two mindfulness treatment techniques; Mindfulness-Based Cognitive Therapy (MBCT) and Acceptance and Commitment Therapy (ACT).

 

MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behaviors and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

They find that the literature reports that both MBCT and ACT are successful in treating adults and children with Obsessive-Compulsive Disorder (OCD) symptoms and produces improvements in anxiety, depression, experiential avoidance, believability, the need to respond to obsessions, obsessions, and compulsions. These benefits were found to be sustained 6 months later. But the authors caution that the studies are often performed with small numbers of participants and often have methodological problems. They conclude that the present research is promising but larger better controlled trials need to be performed especially with comparisons to other therapies for OCD that do not include mindfulness training.

 

So, improve the symptoms of obsessive-compulsive disorder with mindfulness.

 

mindfulness is really for anyone who wants to stop feeling like what is going on inside their mind is a burden.  It’s hard to imagine anyone with OCD who would wish to continue feeling that way.” – John Hershfield

 

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

 

Manjula, M., & Sudhir, P. M. (2019). New-wave behavioral therapies in obsessive-compulsive disorder: Moving toward integrated behavioral therapies. Indian journal of psychiatry, 61(Suppl 1), S104-S113.

 

Abstract

New-wave behavioral therapies in obsessive-compulsive disorders (OCDs) comprise of third-wave therapies and newer cognitive therapies (CTs). This review covers outcome studies published in English until December 2017. A total of forty articles on mindfulness-based CT, metacognitive therapy, acceptance and commitment therapy, and danger ideation reduction therapy in the form of single-case studies, case series, open-label trials, two-group comparison studies, and randomized controlled studies were included. Results show that studies on these therapies are limited in number. Methodological limitations including lack of active control groups, randomized controlled trials, small sample sizes, and short follow-up periods were also noted. However, the available literature demonstrates the feasibility and utility of these therapies in addressing the issues unresolved by exposure and response prevention (ERP) and cognitive behavior therapy (CBT). These therapies were often combined with traditional ERP and CBT based on the profile and response of the client; hence, it is unclear whether they can be used as standalone therapies in the larger segment of the OCD population. Supplementary use of these strategies alongside established therapies could provide better utilization of resources. In view of the need for such integration, further research is warranted. The use of sound methodologies and establishing the mechanism of action of these therapies would assist in choosing the techniques for integration.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343420/

 

Lessen the Frequency and Impact of Obsessional Intrusive Thoughts with Mindfulness

Lessen the Frequency and Impact of Obsessional Intrusive Thoughts with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindfulness is a useful technique for decreasing anxiety because of its emphasis on accepting your thoughts. When an intrusive thought pops up, you let it exist in your mind without providing it any weight. You experience the thought, but don’t judge it, change it or try to make it go away. You wait until it passes instead of thinking it should or shouldn’t be there.” – OCD

 

Obsessive-Compulsive Disorder (OCD) sufferer have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people, are affected at some time in their life. Mindfulness training has been shown to be effective in treating OCD.

 

Obsessional thoughts are not restricted to those diagnosed with OCD. In fact, many normally functioning individuals have occasional obsessional intrusive thoughts. It is not known if mindfulness affects these thoughts in otherwise high functioning adults. In today’s Research News article “Which Facets of Mindfulness Protect Individuals from the Negative Experiences of Obsessive Intrusive Thoughts?” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6061236/ ), Emerson and colleagues examined the relationships of dispositional mindfulness with obsessional intrusive thoughts in normal adults.

 

They recruited staff, students or alumni of a university and had them complete a number of psychometric scales on-line. These scales measured obsessive compulsive symptoms, obsessional intrusive thoughts, and mindfulness. The relationships among these variables were then explored with univariate and multivariate regression analysis.

 

They found that the higher the individual’s level of dispositional mindfulness the lower the levels of obsessional intrusive thoughts, the less of an emotional reaction they had to them, the less difficulty they had controlling them, the lower the levels of dysfunctional appraisals they engaged in, the fewer the control strategies they applied, and the fewer compulsions they had. In other words, mindfulness predicted significantly lower obsessional intrusive thoughts and lessened reactions to them. They further found that the facets of mindfulness of nonjudgment, nonreactivity and acting with awareness were associated with fewer obsessional intrusive thoughts and less difficulty controlling them. In contrast, the observing facet of mindfulness was associated with a greater number of obsessional intrusive thoughts and more difficulty controlling them.

 

The results suggest that dispositional mindfulness overall tends to counteract obsessional intrusive thoughts in normal adults. This is especially true for acting toward them with awareness, treating them without judgement, and without reacting to them. But, mindfully observing these thoughts by itself tends to heighten them. These results also suggest that mindfulness training might be effective in lessening the frequency of obsessional intrusive thoughts and their effects on the individual.

 

So, lessen the frequency and impact of obsessional intrusive thoughts with mindfulness.

 

“most OCD sufferers I know who practice mindfulness find it very helpful in fighting their disorder. To be able to focus on what is really happening in any given moment, as opposed to dwelling on the past or anticipating the future, takes away the power of OCD.” – Janet Singer

 

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

 

Emerson, L.-M., Heapy, C., & Garcia-Soriano, G. (2018). Which Facets of Mindfulness Protect Individuals from the Negative Experiences of Obsessive Intrusive Thoughts? Mindfulness, 9(4), 1170–1180. http://doi.org/10.1007/s12671-017-0854-3

 

Obsessive intrusive thoughts (OITs) are experienced by the majority of the general population, and in their more extreme forms are characteristic of obsessive–compulsive disorder (OCD). These cognitions are said to exist on a continuum that includes differences in their frequency and associated distress. The key factors that contribute to an increased frequency and distress are how the individual appraises and responds to the OIT. Facets of mindfulness, such as nonjudgment and nonreactivity, offer an alternative approach to OITs than the negative appraisals and commonly utilised control strategies that often contribute to distress. Clarifying the role of facets of mindfulness in relation to these cognitions offers a means to elucidate individual characteristics that may offer protection from distress associated with OITs. A sample of nonclinical individuals (n = 583) completed an online survey that assessed their experiences of OITs, including frequency, emotional reaction and appraisals, and trait mindfulness. The findings from a series of multiple regression analyses confirmed that specific facets of mindfulness relating to acting with awareness and acceptance (nonjudgment and nonreactivity) consistently predicted less frequent and distressing experiences of OITs. In contrast, the observe facet emerged as a consistent predictor of negative experiences of OITs. These findings suggest that acting with awareness and acceptance may confer protective characteristics in relation to OITs, but that the observe facet may reflect a hypervigilance to OITs. Mindfulness-based prevention and intervention for OCD should be tailored to take account of the potential differential effects of increasing specific facets of mindfulness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6061236/

 

Improve Mental Health with Mindfulness

Improve Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“While mindfulness will not solve all of our problems, it is a powerful tool with great potential to help us all transform our relationship with our problems when it is not possible, or desirable, to eliminate them.” – Elana Miller

 

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

 

In today’s Research News article “Mindfulness-Based Interventions in Psychiatry.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870875/ ), Shapero and colleagues review and summarize the published research literature on the application of mindfulness techniques to the treatment of mental illnesses.

 

They report that the most commonly used mindfulness technique for the treatment of mental illness is Mindfulness-Based Cognitive Therapy (MBCT) particularly for the treatment of major depressive disorder. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs.

 

Mindfulness-based interventions (MBIs) have also been found to improve mood and relieve anxiety in patients suffering from anxiety and mood disorders and treat the symptoms of Bipolar Disorder, Obsessive Compulsive Disorder, Generalized Anxiety Disorder, and eating disorders. They have also been found to reduce drug cravings and use as well as reduce substance abuse relapse after treatment.

 

They further report that the research suggests that Mindfulness-based interventions (MBIs) produce these benefits by focusing on the present moment in a non-reactive and non-judgmental way and improving emotion regulation and thereby decreasing negative thought patterns, emotional reactivity, rumination, and worry, and increasing self-compassion. In the cognitive realm, MBIs appear to produce a different relationship with the thoughts of the individuals by noticing them and developing different ways of relating and reacting to them.

 

One way that MBIs appear to have their effects is by altering the nervous system in a process known as neuroplasticity. These include changes to eight brain regions, including areas associated with meta-awareness (frontopolar cortex), exteroceptive and interoceptive body awareness (sensory cortices and insula), memory consolidation and reconsolidation (hippocampus), self and emotion regulation (anterior and mid cingulate; orbitofrontal cortex), and intra- and interhemispheric communication (superior longitudinal fasciculus; corpus callosum).

 

These are striking findings that strongly suggest that Mindfulness-based interventions (MBIs) are safe and very effective treatments for a wide array of psychiatric disorders. They appear to work by altering thought processes, emotion regulation, and focus on the present moment. They appear to alter the brain to produce these benefits. This suggests that MBIs should be widely prescribed to relieve the symptoms and suffering produced by mental illness.

 

So, improve mental health with Mindfulness.

 

“Mindfulness and the traditional way psychiatry is practiced are really more divergent than anything else. Psychiatry is about removing emotional pain, whereas mindfulness teaches us the value of being present with our pain. It was through the practice of mindfulness that I started to learn this new perspective and started to relate to my own pain differently. Instead of running away from it, I was taught to welcome it; to befriend it and thus convert it into a source for my own emotional and spiritual growth.” – Russel Razzaque

 

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

 

Shapero, B. G., Greenberg, J., Pedrelli, P., de Jong, M., & Desbordes, G. (2018). Mindfulness-Based Interventions in Psychiatry. Focus (American Psychiatric Publishing), 16(1), 32–39. http://doi.org/10.1176/appi.focus.20170039

 

Abstract

Mindfulness meditation has a longstanding history in eastern practices that has received considerable public interest in recent decades. Indeed, the science, practice, and implementation of Mindfulness Based Interventions (MBIs) have dramatically increased in recent years. At its base, mindfulness is a natural human state in which an individual experiences and attends to the present moment. Interventions have been developed to train individuals how to incorporate this practice into daily life. The current article will discuss the concept of mindfulness and describe its implementation in the treatment of psychiatric disorders. We further identify for whom MBIs have been shown to be efficacious and provide an up-to-date summary of how these interventions work. This includes research support for the cognitive, psychological, and neural mechanisms that lead to psychiatric improvements. This review provides a basis for incorporating these interventions into treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870875/

 

Reduce Psychological Symptoms of Trauma with Mindfulness

Reduce Psychological Symptoms of Trauma with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Focusing on the present moment? Those with OCD rarely do that. Instead they either find themselves immersed in the world of “what ifs,” worrying about everything that might go wrong, or agonizing over things they think might have already gone wrong. Lots of thinking about the future and the past. Not so much about the present.” – Janet Singer

 

Trauma leaves in its wake a syndrome of posttraumatic symptoms which can haunt the victims for the rest of their lives. These include persistent recurrent re-experiencing of the traumatic event, including flashbacks and nightmares, loss of interest in life, detachment from other people, increased anxiety and emotional arousal, including outbursts of anger, difficulty concentration, and jumpiness, startling easily. Unfortunately, experiencing trauma is quite common. It has been estimated that over half of adults will experience a significant traumatic event during their lifetime. It’s been estimated that of adolescents, 8% have been exposed to sexual assault, 17% physical assault, and 39% had witnessed violence. This is tragic unto itself, but childhood trauma can continue to affect mental and physical health throughout the individual’s life.

 

How individuals cope with trauma helps determine the effects of the trauma on their mental health. Trying to avoid thinking about or being in touch with internal experiences, experiential avoidance, disallows the individual from confronting the experiences and could exacerbate the negative effects of the trauma. On the other hand, experiencing the feelings and thoughts completely would allow for better coping. This would be provided by mindfulness. Indeed, mindfulness has been found to be effective for relieving trauma symptoms. In today’s Research News article “Effects of Traumatic Experiences on Obsessive-Compulsive and Internalizing Symptoms: The Role of Avoidance and Mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654743/ ), Kroska and colleagues investigate the roles of mindfulness and experiential avoidance on psychiatric symptoms of trauma in adolescents.

 

They recruited troubled students from an alternative High School and had them complete measurements of childhood trauma, experiential avoidance, mindfulness, and obsessive-compulsive symptoms. They also recruited college students and had them complete the same measure and additional measures of internalizing, including anxiety and depression. They then performed a statistical analysis of the responses including a mediation analysis.

 

They found that with the troubled youths, experiential avoidance was associated with greater obsessive-compulsive symptoms. They found that childhood trauma was associated with lower levels of mindfulness, while high levels of mindfulness were associated with lower levels of obsessive-compulsive symptoms. Hence, for the troubled youths, experiential avoidance was associated with greater psychiatric symptoms while mindfulness was associated with lower symptoms and that childhood trauma tended to impair mindfulness.

 

With the college students they found that childhood trauma was associated with both greater experiential avoidance and with lower mindfulness, especially the observing facet of mindfulness. In addition, obsessive-compulsive symptoms were associated with higher levels of avoidance and lower levels of mindfulness. In looking at internalizing, anxiety and depression, a similar pattern emerged. Childhood trauma was associated with both greater experiential avoidance and with lower mindfulness and internalizing symptoms were associated with higher levels of avoidance and lower levels of mindfulness.

 

These results suggest that childhood trauma is associated with higher levels of psychiatric symptoms including both obsessive-compulsive and internalizing symptoms and that these associations of childhood trauma are mediated by higher levels of experiential avoidance and lower levels of mindfulness. This further suggests the nature of the mechanisms for trauma effects on mental health, with trauma acting through increasing avoidance and decreasing mindfulness to impair mental health.

 

These findings may help to improve therapeutic interventions for the treatment of the symptoms of trauma. They suggest that treatments targeted at increasing mindfulness and lowering experiential avoidance would produce great mental health benefits for survivors of childhood trauma.

 

“Our results suggest that mindfulness may provide some resilience against the poor adult health outcomes that often result from childhood trauma,” – Robert Whitaker

 

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/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Kroska, E. B., Miller, M. L., Roche, A. I., Kroska, S. K., & O’Hara, M. W. (2018). Effects of Traumatic Experiences on Obsessive-Compulsive and Internalizing Symptoms: The Role of Avoidance and Mindfulness. Journal of Affective Disorders, 225, 326–336. http://doi.org/10.1016/j.jad.2017.08.039

 

Abstract

Background

Trauma exposure is associated with adverse psychological outcomes including anxiety, depression, and obsessive-compulsive (OC) symptoms. Adolescence is increasingly recognized as a period of vulnerability for the onset of these types of psychological symptoms. The current study explored the mediating roles of experiential avoidance and mindfulness processes in the association between retrospective reports of childhood trauma and current internalizing and OC symptoms in adolescents.

Method

A group of at-risk adolescents (N =51) and a group of college students (N =400) reported on childhood trauma, experiential avoidance, mindfulness, anxiety, depressive, and OC symptoms. Mediation analyses were performed to examine the mechanistic roles of avoidance and mindfulness in the association between trauma and internalizing and OC-specific symptoms.

Results

In the group of at-risk adolescents, experiential avoidance and mindfulness both significantly mediated the association between childhood trauma and OC symptoms. In the college student sample, experiential avoidance mediated the association between trauma and OC symptoms. Experiential avoidance, as well as the observe, act with awareness, and nonjudgmental facets of mindfulness all significantly mediated the association between trauma and internalizing symptoms.

Limitations

The group of at-risk adolescents was small, and the college student group was demographically homogeneous. All data was self-report and cross-sectional.

Conclusion

The current study demonstrated that experiential avoidance and mindfulness processes may be the mechanisms through which the association between trauma and obsessive-compulsive and trauma and internalizing symptoms exist in adolescents. These findings provide potential targets for clinical intervention to improve outcomes for adolescents who have experienced trauma.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654743/

Reduce Obsessions with Mindfulness

Reduce Obsessions with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness may be very beneficial for those of us who struggle with obsessive impulses, not just because it makes us more aware of them, but also because it enables our brains to deal with them better, in the same way that exercising makes our muscles stronger and more able to deal with stresses and strains.” – Mindfulness Project

 

Obsessive-Compulsive Disorder (OCD) sufferer have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. At any point in time about 1% of the U.S. population suffers from OCD and about 2% of the population, 3.3 million people, are affected at some time in their life. Hence, the problem is widespread and there is a need for effective treatments.

 

OCD is often treated with drugs, but these are not always effective and relapse is common. In addition, the drugs can produce significant side effects. Cognitive Behavioral Therapy (CBT) has been shown to be effective in overcoming the symptoms of OCD. However, in many cases obsessions occur without overt compulsive behaviors and it is not known if CBT is effective for this subgroup. Mindfulness training has also been shown to be effective in treating OCD. So, the combination of Cognitive Behavioral Therapy (CBT) with mindfulness training Mindfulness-Based Cognitive Therapy (MBCT) may be especially effective.

 

In today’s Research News article “Efficacy of mindfulness-integrated cognitive behavior therapy in patients with predominant obsessions.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5270259/

Kumar and colleagues examined the effectiveness of combined mindfulness training and CBT on patients suffering from OCD with obsessive thoughts only. They recruited OCD patients diagnosed with obsessions only and treated them with Mindfulness-Based Cognitive Therapy (MBCT) tailored specifically for obsessions. It was delivered in 12-16 weeks of once a week, 90-minute sessions. The participants were also assigned homework. They were measured before treatment, mid-treatment, after treatment, and at 3-month follow-up on measures of obsessions, obsessive-compulsive severity, insight, global severity of illness, depression, anxiety, socio-occupational functioning, and quality of life.

 

They found that at the completion of treatment and at the 3-month follow-up there were significant reductions in obsessions, severity of illness, disability, depression, and anxiety and a significant improvement in the quality of life. Two thirds of the patients achieved clinical remissions. Hence, the MBCT treatment effectively improved the symptoms of OCD sufferers with only obsessions to a clinically significant extent. This was, however, an open label trial without a control group. As such, the conclusions must be tempered with the understanding that a number of alternative interpretations, including placebo effects, attentional effects, experimenter bias, etc. are also viable explanations.

 

Cognitive Behavioral Therapy (CBT) is targeted at altering aberrant thought processes which is the nature of obsessions. So, its effectiveness would seem predictable. By including mindfulness training, however, the effectiveness may be potentiated by adding increased non-judgmental awareness of the present moment. So, the patients are more aware of their thoughts and feelings in real time and also recognize the defective thought processes leading to them. This makes them better able to counteract and overcome obsessions.

 

So, reduce obsessions with mindfulness.

 

“Obsessive thinking is a tenacious addiction, a way of running from our restlessness and fears. Yet, like all false refuges, it responds to mindful awareness—to an interested and caring attention. We can listen to the energies behind our obsessive thinking, respond to what needs attention, and spend less and less time removed from the presence that nurtures our lives.” – Tara Brach

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Kumar, A., Sharma, M. P., Narayanaswamy, J. C., Kandavel, T., & Janardhan Reddy, Y. C. (2016). Efficacy of mindfulness-integrated cognitive behavior therapy in patients with predominant obsessions. Indian Journal of Psychiatry, 58(4), 366–371. http://doi.org/10.4103/0019-5545.196723

 

Abstract

Background:

Cognitive behavior therapy (CBT) involving exposure and response prevention is the gold standard psychotherapeutic intervention for obsessive-compulsive disorder (OCD). However, applying traditional CBT techniques to treat patients with predominant obsessions (POs) without covert compulsions is fraught with problems because of inaccessibility of mental compulsions. In this context, we examined the efficacy of mindfulness-integrated CBT (MICBT) in patients with POs without prominent overt compulsions.

Materials and Methods:

Twenty-seven patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of OCD were recruited from the specialty OCD clinic and the behavior therapy services of a tertiary care psychiatric hospital over 14 months. Patients had few or no overt compulsions and were free of medication or on a stable medication regimen for at least 2 months prior to baseline assessment. All patients received 12–16 sessions of MICBT on an outpatient basis. An independent rater (psychiatrist) administered the Yale–Brown Obsessive-Compulsive Scale (YBOCS) and the Clinical Global Impression Scale at baseline, mid- and post-treatment, and at 3-month follow-up.

Results:

Of the 27 patients, 18 (67%) achieved remission (55% reduction in the YBOCS severity score) at 3-month follow-up. The average mean percentage reduction of obsessive severity at postintervention and 3-month follow-up was 56 (standard deviation [SD] = 23) and 63 (SD = 21), respectively.

Conclusions:

Our study demonstrates that MICBT is efficacious in treating patients with POs without prominent overt compulsions. The results of this open-label study are encouraging and suggest that a larger randomized controlled trial examining the effects of MICBT may now be warranted.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5270259/

 

Promote Physical and Mental Well-Being with Tai Chi

 

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.

.

 

“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

 

Mindfully Stop Compulsive Checking

 

“OCD is not a disease that bothers; it is a disease that tortures.”– J. J. Keeler

 

Have you ever returned to your home to make sure that you turned off the coffee pot, locked the back door, or shut off the sprinklers. That wouldn’t be unusual. We’ve all done it. But, now picture yourself doing it every time you leave the house and maybe even multiple times each leaving. Now that is when it becomes compulsive checking and is indicative of Obsessive Compulsive Disorder (OCD). In fact repetitive checking is the most common symptom of OCD.

 

An OCD sufferer has anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce anxiety (compulsions). For example, many are concerned about germs and are unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. But, the sufferer comes to not trust their own memory for what has been done previously, so the thoughts and anxieties and ritualized behaviors come back again quickly. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them.

 

At any point in time about 1% of the U.S. population suffers from OCD and about 2% of the population is affected at some time in their life. Hence, the problem is widespread and there is a need for effective treatments. Cognitive Behavioral Therapy (CBT) has been shown to be effective and one component of CBT, cognitive restructuring, has been shown to be effective on its own. However, these methods are not always effective and relapse is common.

 

Research has demonstrated that mindfulness helps in overcoming the symptoms of OCD (see http://contemplative-studies.org/wp/index.php/2015/07/17/mindfully-improve-psychological-wellbeing/ and http://contemplative-studies.org/wp/index.php/2015/08/25/alter-your-thinking-with-meditation-for-mental-health/).  One mindfulness based technique, Detached Mindfulness is designed to assist the OCD sufferer to look more mindfully and objectively at their obsessive thoughts as they arise. In theory, this should help them disengage from the biases underlying their thinking.

 

In today’s Research News article “Cognitive restructuring and detached mindfulness: Comparative impact on a compulsive checking task.”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1096256090398316/?type=3&theater

Ludvik and colleagues compared a no-treatment control to Cognitive Restructuring and to

Detached Mindfulness for their effectiveness in treating the thoughts underlying repetitive checking behaviors in OCD.  They found that both the Cognitive Restructuring and Detached Mindfulness were effective in reducing rechecking behaviors. The repeated checking behaviors in OCD produce distrust for the individual’s memories. Detached Mindfulness was shown to be superior to Cognitive Restructuring in relieving this distrust of memory. Thus, it appears that a simple mindfulness exercise can be effective in intervening in OCD thoughts and behaviors and improving the individual’s trust for their own memory.

 

It should be mentioned that these results occurred with a laboratory model of OCD employed with undergraduate students. It remains for future research to demonstrate the effectiveness of Detached Mindfulness in the real world treatment of OCD. But, it would seem reasonable that a technique that brought about a real time non-judgmental awareness of the obsessive thoughts would be of significant help in relieving the individual from the torture of OCD.

 

So, practice mindfulness and stop compulsive checking.

 

I have got this obsessive compulsive disorder where I have to have everything in a straight line, or everything has to be in pairs.” – David Beckham

 

CMCS – Center for Mindfulness and Contemplative Studies

 

 

 

Buffer Yourself from Neuroticism with Mindfulness

We have long observed that every neurosis has the result, and therefore probably the purpose, of forcing the patient out of real life, of alienating him from actuality.Sigmund Freud

 

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.

 

But, neuroticism is considered a personality trait that is a lasting characteristic of individuals. It is characterized by negative feelings, repetitive thinking about the past (rumination), and worry about the future, moodiness and loneliness. 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.

 

This relatively stable characteristic appears to be lessened by mindfulness training. Mindfulness training also has been found to improve individuals’ subjective well-being. So, it makes sense to think that mindfulness may be involved in the link between neuroticism and low subjective well-being. This possible link is explored in today’s Research News article “Curb your neuroticism – Mindfulness mediates the link between neuroticism and subjective well-being”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1094124517278140/?type=3&theater

Wenzel and colleagues studied individuals high in neuroticism and found that they tended to have negative mood and low vitality and general interest in life; that is low subjective well-being.

 

Wenzel and colleagues then added mindfulness to the prediction and found that mindfulness in part mediated the relationship between neuroticism and low subjective well-being especially in individuals who had high levels of neuroticism. It thus appears that neuroticism lowers mindfulness which in turn results in negative mood and low vitality and general interest in life. This suggests that being mindful may in part protect an individual from the effects of neuroticism on their well-being.

 

There are a number of potential explanations for these effects of mindfulness. Neuroticism is characterized by rumination and worry, which are thought processes centered on the past and future. Mindfulness, on the other hand, is an ability to focus on the present moment. Hence, mindfulness could be seen as an antidote to the past and future orientation in neuroticism.

 

Neuroticism is also characterized by moodiness and loneliness. Mindfulness has been shown to improve emotion regulation; the ability to feel and recognize an emotional state but be able to understand it and respond to it appropriately (see http://contemplative-studies.org/wp/index.php/2015/08/20/regulate-emotions-with-mindfulness/ and http://contemplative-studies.org/wp/index.php/2015/07/17/control-emotions-the-right-way-with-mindfulness/). So mindfulness would also appear to be an antidote for the moodiness involved in neuroticism. Indeed, it has been shown that mindfulness can reduce feelings of anger and depression and improve self-control among people with high neuroticism.

 

So, buffer yourself from neuroticism with mindfulness.

 

Mindfulness has helped me succeed in almost every dimension of my life. By stopping regularly to look inward and become aware of my mental state, I stay connected to the source of my actions and thoughts and can guide them with considerably more intention.” – Dustin Moskovitz

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Alter Your Thinking with Meditation for Mental Health

 

Meditation has been shown to have significant promise as a treatment for a variety of mental illnesses, including depression (see http://contemplative-studies.org/wp/index.php/2015/07/17/dealing-with-major-depression-when-drugs-fail/), obsessive compulsive disorder (see http://contemplative-studies.org/wp/index.php/2015/07/17/mindfully-improve-psychological-wellbeing/), and worrying (see http://contemplative-studies.org/wp/index.php/2015/07/17/stop-worrying/). It is known that one mechanism by which meditation works is by improving emotion regulation, making the individual better able to control and deal with emotions. Meditation also produces cognitive (thought) changes that appear to assist in improving mental challenges.

In today’s Research News article “Common Factors of Meditation, Focusing, and Cognitive Behavioral Therapy: Longitudinal Relation of Self-Report Measures to Worry, Depressive, and Obsessive-Compulsive Symptoms Among Nonclinical Students.”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1077150092308916/?type=1&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4432024/

Sugiura and colleagues investigate how these cognitive effects of meditation might work to improve the symptoms of worry, depression, and obsessive-compulsive disorder. They studied five psychological states affected by meditation, refraining from catastrophic thinking, logical objectivity, self-observation, acceptance, and detached coping.

They found that detached coping was associated with a decrease in both depressive and obsessive compulsive symptoms. Detached coping is a cognitive skill involving detachment and distancing from external events. This is cultivated by meditation in developing non-judgmental awareness of what is transpiring in the present moment. This allows the individual to simply observe what is happening around them without becoming identified with the events, which then are taken much less personally and thereby have a much smaller impact on depression and obsessions and compulsions.

Sugiura and colleagues also found that refraining from catastrophic thinking was associated with a decrease in worrying. Refraining from catastrophic thinking involves cognitive skills to analyze and reinterpret negative thoughts. This effect was meditated by negative beliefs about worrying, where refraining from catastrophic thinking is associated with fewer and less intense negative beliefs about worrying which in turn was associated with reduced worrying. Worrying about worrying is a problem in that it tends to intensify worrying. By reducing the negative beliefs about worrying meditation interrupts this process disabling the worrying about worrying. In this way meditation helps reduce worrying.

These findings indicate that, of the cognitive (thought) processes that are affected by meditation detached coping and refraining from catastrophic thinking are particularly important for relief of symptoms of troubling mental conditions. Both of these cognitive processes involve distancing the individual from the events and thoughts about the events that occur. This suggests that distancing attitudes are useful for long-term reduction of various psychological symptoms. It further emphasizes the importance of the non-judgmental observing that is cultivated by meditation.

So, meditate, improve non-judgmental observing, and improve mental health.

CMCS – Center for Mindfulness and Contemplative Studies