Improve Complex Post-Traumatic Stress Disorder (CPTSD) Symptoms with Online Mindfulness Training

Improve Complex Post-Traumatic Stress Disorder (CPTSD) Symptoms with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Mindfulness can help people train themselves to get unstuck from a vicious cycle of negative thinking, often a cornerstone of trauma.” – Jennifer Wolkin

 

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

 

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

 

Recently, a new category has emerged of Complex Post-Traumatic Stress Disorder (CPTSD) that meets the criterion for PTSD but has the additional symptoms of disturbances in self-organization including affect dysregulation, negative self-concept, and disturbances in relationships. There are a number of therapies that have been developed to treat PTSD. Mindfulness-based therapies have been shown to be particularly effective. But it is not known if mindfulness-based therapies are also effective for CPTSD.

 

In today’s Research News article “Effects of Mindfulness-Based Internet Intervention on ICD-11 Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder Symptoms: a Pilot Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435188/ ) Dumarkaite and colleagues recruited college students who had been exposed to trauma including natural disasters, accidents, physical or sexual abuse, or assault. They were randomly assigned to either a wait-list control condition or to receive 8 weekly online mindfulness trainings sessions. They were measured before and after training for traumatic experiences, symptoms of Post-Traumatic Stress Disorder (PTSD) or Complex Post-Traumatic Stress Disorder (CPTSD), anxiety, depression, positive mental health, and satisfaction and usability of the online program.

 

They found that in comparison to baseline and the wait-list control group, the participants who received online mindfulness training had significant decreases in disturbances in self-organization including negative self-concept, and disturbances in relationships and increases in positive mental health. In addition, satisfaction and usability of the online program was high. But they did not find significant changes in PTSD symptoms. Because of the improvements in self-concept, relationships, and mental health it is likely that online mindfulness training is effective for Complex Post-Traumatic Stress Disorder (CPTSD).

 

These results are disappointing in that Mindfulness training has been shown in multiple studies to be effective in improving the symptoms of Post-Traumatic Stress Disorder (PTSD). The difference here is that the mindfulness training was online. This raises the possibility that the interpersonal connections involved in the face-to-face delivery of mindfulness training which is usually delivered in groups is essential for the success of the therapy in treating PTSD.

 

So, improve Complex Post-Traumatic Stress Disorder (CPTSD) symptoms with online mindfulness training.

 

Trauma and presence (or mindfulness) cannot coexist. Thus, mindfulness practices can help bring trauma victims back to the present and heal from disturbing past events.” – Jason Linder

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available on Twitter @MindfulResearch

 

Study Summary

 

Dumarkaite, A., Truskauskaite-Kuneviciene, I., Andersson, G., Mingaudaite, J., & Kazlauskas, E. (2021). Effects of Mindfulness-Based Internet Intervention on ICD-11 Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder Symptoms: a Pilot Randomized Controlled Trial. Mindfulness, 1–13. Advance online publication. https://doi.org/10.1007/s12671-021-01739-w

 

Abstract

Objectives

A substantial proportion of trauma survivors with posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) continue to experience symptoms even after trauma-focused therapies. Internet-based interventions could facilitate access to treatment for PTSD and CPTSD. The current pilot study aimed to investigate the effects of mindfulness-based internet intervention on PTSD and CPTSD symptoms.

Methods

A randomized controlled trial (RCT) design with two measurement points (pre-test and post-test) was used to investigate the effects of a structured mindfulness-based internet intervention on PTSD and CPTSD symptoms as well as anxiety, depression, and positive mental health. In total, 70 university students with high levels of PTSD and CPTSD symptoms based on ICD-11 criteria participated in the study: 31 in the intervention group and 39 in the waiting list control group.

Results

We found that the mindfulness-based internet intervention reduced CPTSD disturbances in self-organization (DSO) symptoms (ES = − 0.48 [− 0.96; 0.00]), particularly negative self-concept (ES = − 0.72 [− 1.21; − 0.24]) and disturbances in relationships (ES = − 0.55 [− 1.03; − 0.07]). Moreover, the intervention reduced the symptoms of PTSD sense of threat (ES = − 0.48 [− 0.96; − 0.01]) and promoted positive mental health (ES = 0.51 [0.03; 0.99]). High user satisfaction and good usability of the intervention were reported.

Conclusions

Promising treatment effects were found, indicating that mindfulness-based internet intervention can reduce CPTSD symptoms and have a positive effect on mental health among youth in general. The findings of the current study contribute to the further development of trauma care using internet-delivered interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435188/

 

Have Better Sex with Mindfulness

Have Better Sex with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindful sex involves being able to observe and describe what’s happening inside your body and mind without sorting experiences into “bad” and “good” or trying to change your feelings. When we are able to do that, we can “turn off the autopilot.” – Gina Silverstein

 

Sex is a very important aspect of life. Problems with sex are very common and have negative consequences for relationships. While research suggests that sexual dysfunction is common, it is a topic that many people are hesitant or embarrassed to discuss. Women suffer from sexual dysfunction more than men with 43% of women and 31% of men reporting some degree of difficulty. Hence, sex has major impacts on people’s lives and relationships. Greater research attention to sexual activity and sexual satisfaction and the well-being of the individual is warranted.

 

Mindfulness trainings have been shown to improve a variety of psychological issues including emotion regulationstress responsestraumafear and worryanxiety, and depression, and self-esteem. Mindfulness training has also been found to improve relationships and to be useful in treating sexual problems. But there is little empirical research on the relationship of mindfulness with sexuality in normal, non-clinical, individuals.

 

In today’s Research News article “Mindfulness in Sexual Activity, Sexual Satisfaction and Erotic Fantasies in a Non-Clinical Sample.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908537/ )  Sánchez-Sánchez and colleagues recruited online adults who were meditation naïve or who practiced meditation for at least 5 months. They completed measures online of mindfulness, body awareness, sexual satisfaction, sexual activity, and sexual fantasies.

 

They found that the meditation practitioners were significantly higher in emotion regulation, family, academics, relationships, sociability, attention, health, sexuality, and leisure and significantly lower in perceived stress. They were also significantly higher in mindfulness, body awareness, sexual satisfaction, sexual activity, and sexual fantasies. They also found that the higher the levels of mindfulness and the amount of mindfulness practice, the higher the levels of body awareness sexual satisfaction and sexual activity. Also, they found that the higher the levels of mindfulness the lower the levels of body dissociation.

 

It should be kept in mind that there was no random assignment and so the groups may be quite different, People who meditate may be systematically different from those who don’t in many ways including the variables measured in this study. But previous research including randomized studies demonstrated that mindfulness produced higher levels of emotion regulation, family, academics, relationships, sociability, attention, health, and sexuality, and lower levels of stress. So, the present findings likely also represent causal connections.

 

These findings suggest that mindfulness is associated with better psychological and physical health and well-being. They also suggest that mindfulness is associated with better sexual function in terms of sexual activity, satisfaction with sex, and relationship quality and even a better sexual fantasy life. Sex is such an important aspect of life that many of the other psychological and physical benefits of mindfulness may emanate from the improved sex life of the individuals. Much more research is needed.

 

So, have better sex with mindfulness.

 

Think of mindful sex as an invitation, as an opportunity to explore the mystery of sex. The reward is deeper intimacy, more meaningful connections, and (fingers crossed) greater physical pleasure.” – Kayti Christian

 

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

 

Sánchez-Sánchez, L. C., Rodríguez, M., García-Montes, J. M., Petisco-Rodríguez, C., & Fernández-García, R. (2021). Mindfulness in Sexual Activity, Sexual Satisfaction and Erotic Fantasies in a Non-Clinical Sample. International journal of environmental research and public health, 18(3), 1161. https://doi.org/10.3390/ijerph18031161

 

Abstract

The goal of this study is to better understand the relation between the practice of Mindfulness and the sexual activity, sexual satisfaction and erotic fantasies of Spanish-speaking participants. This research focuses on the comparison between people who practice Mindfulness versus naïve people, and explores the practice of Mindfulness and its relation with the following variables about sexuality: body awareness and bodily dissociation, personal sexual satisfaction, partner and relationship-related satisfaction, desire, subjective sexual arousal, genital arousal, orgasm, pain, attitudes towards sexual fantasies and types of sexual fantasies. The sample consisted of 106 selected adults, 32 men and 74 women, who completed six measures on an online survey platform: (a) Mindfulness Attention Awareness Scale (MAAS), (b) Scale of Body Connection (SBC), (c) New Sexual Satisfaction Scale (NSSS), (d) Scale of Sexual Activity in Women (SSA-W) and Men (SSA-M), (e) Hurlbert Index of Sexual Fantasy (HISF), (f) Wilson’s Sex Fantasy Questionnaire. In the MAAS, Body Awareness subscale (SBC), NSSS, SSA-W and SSA-M, HISF and intimate fantasies subscale (Wilson’s questionnaire), people in the Mindfulness condition showed higher scores and these differences were statistically significant. These results may have relevant implications in the sexuality of clinical and non-clinical samples.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908537/

 

Improve Romantic Relationship Well-Being with Brief Mindfulness or Relaxation Training

Improve Romantic Relationship Well-Being with Brief Mindfulness or Relaxation Training.

 

By John M. de Castro, Ph.D.

 

“When you are mindful of the love in your life you open yourself up to the opportunity for love to grow. And not just romantic love, but self-love, and loving friendships as well.” – Mindful

 

Relationships can be difficult as two individuals can and do frequently disagree or misunderstand one another. These conflicts can produce strong emotions and it is important to be able to regulate these emotions in order to keep them from interfering with rational solutions to the conflict. Mindfulness may be helpful in romantic relationships, as it has been shown to improve the emotion regulation and decrease anger and anxiety. It may be a prerequisite for deep listening and consequently to resolving conflict. Indeed, mindfulness has been shown to improve relationships. So, mindfulness may be a key to successful relationships.

 

One of the effects of mindfulness training is an increase in the ability to relax. It is possible that it is relaxation that is responsible for improvements in romantic relationships. In today’s Research News article “Comparing the effects of a mindfulness versus relaxation intervention on romantic relationship wellbeing.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7730385/ ) Karremans and colleagues recruited adult couples involved in a romantic relationship of at least 1 year in duration and living together. One member of each couple was randomly assigned to a 2-week program of either breath focused mindfulness training or progressive muscle relaxation training. The programs consisted of daily 10-minute audio guided practices. Before and after the interventions and one month later the participant and their partner completed measures of relationship satisfaction, relationship distress, perceived connectedness, partner acceptance, relationship excitement, and adherence to the training programs.

 

They found that after mindfulness training for both the participant and their partner there were significant increases in relationship satisfaction, perceived connectedness, and partner acceptance and decreases in relationship distress. These effects were still present at the 1-month follow-up. These findings did not significantly differ between the mindfulness and relaxation groups.

 

Because both groups had significant improvements in their relationship well-being it is possible that the results were produced by participant expectancy (placebo) effects rather than the interventions. But if this potential contaminant is disregarded, the results tend to suggest that both mindfulness and relaxation trainings improve romantic relationships. Previous research has also shown that mindfulness training improves relationships.

 

Relationships can be difficult but are fundamental to the well-being of the individuals. So, improving the relationships may have widespread implications for the individuals’ psychological health and well-being. The training procedures in the present study suggests that these benefits can be produced by a brief audio-guided mindfulness training program. This is important as it allows for more widespread and economical distribution of the treatment; improving relationships.

 

So, improve romantic relationship well-being with brief mindfulness or relaxation training.

 

if you want to build more secure attachment or be more successful in love, try learning mindfulness along with your partner! “ – Melanie Greenberg

 

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

 

Karremans, J. C., Kappen, G., Schellekens, M., & Schoebi, D. (2020). Comparing the effects of a mindfulness versus relaxation intervention on romantic relationship wellbeing. Scientific reports, 10(1), 21696. https://doi.org/10.1038/s41598-020-78919-6

 

Abstract

There is increasing scientific interest in the potential association between mindfulness and romantic relationship wellbeing. To date, however, experimental studies using active control groups and testing dyadic effects (i.e. examining both actor and partner effects) are lacking. In the current study, romantically involved individuals engaged for 2 weeks daily in either guided mindfulness exercises, or guided relaxation exercises. Participants, and their partners, completed measures of relationship wellbeing at pre- and post-intervention, and at 1-month follow up. The mindfulness intervention significantly promoted relationship wellbeing, for both participants (i.e. actor effects) and their partners (i.e. partner effects). However, these findings did not significantly differ from changes in relationship wellbeing in the relaxation condition. Theoretical implications of these findings for understanding the association between mindfulness and romantic relationship wellbeing are discussed. Moreover, the findings are discussed in light of recent debates about the relative lack of proper control groups in mindfulness research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7730385/

 

Dyadic Mindfulness Training Improves the Mental Health of Metastatic Cancer Patients and their Spouses

Dyadic Mindfulness Training Improves the Mental Health of Metastatic Cancer Patients and their Spouses

 

By John M. de Castro, Ph.D.

 

“Cancer is a traumatic event that changes a person’s life. Utilizing mindfulness tools can provide peace and hope. Practicing mindfulness on a daily basis can assist with long term effects of happiness and positivity. Even occasional mindfulness practice can help provide a break from the stress of cancer and fill patients with a sense of calm to confront the challenges they face.” – Erin Murphy-Wilczek

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in dealing with cancer. These issues extend not just to the patient but also to their partners in life. These symptoms markedly reduce the quality of life of both.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbancefear, and anxiety and depression. But cancer does not occur in isolation. It effects both the patient but also their significant others. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. But there is little research on treating the cancer patients and their spouses in mindfulness as dyads.

 

In today’s Research News article “A Mindfulness-Based Intervention as a Supportive Care Strategy for Patients with Metastatic Non-Small Cell Lung Cancer and Their Spouses: Results of a Three-Arm Pilot Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648356/ ) Milbury and colleagues recruited adult patients undergoing treatment for metastatic non‐small cell lung cancer and their romantic partners. Couples were randomly assigned to usual care or to receive 4 one-hour sessions via videoconference of either couple-based meditation or supportive-expressive practice. Couple-based meditation incorporated meditation and couple’s emotion sharing exercises. Supportive-expressive practice involved discussion of cancer-related issues that couples share. They were measured before and after treatment and 3 months later for depression, cancer-related stress symptoms, and spiritual well-being.

 

Attendance was high in both groups but the couple-based meditation reported that the sessions were more beneficial than the supportive-expressive practice group. They found that in comparison to baseline and the other groups at the 3-month follow-up the couple-based meditation patients and their significant others had significantly lower depression and cancer-related stress symptoms and higher spiritual well-being.

 

A strength of the study is that it had an active control condition, supportive-expressive practice, that contained therapeutic elements, expectancy effects and similar attention features to the couple-based meditation practice. This reduces the possibility of confounding variable being responsible for the results and suggests that the effects were due to the nature of the therapy. Another key aspect of this study is that the therapy was delivered via videoconference which may be responsible for the high attendance rates. This form of delivery is very convenient and flexible making it more likely to be effective.

 

There are great psychological and emotional problems co-occurring with cancer treatment for the patient and also for the patient’s romantic partner. So, these results are interesting and important suggesting that couple-based meditation practice can help relieve the suffering. The fact that the romantic partner was included was very important as the cancer effects both members of the dyad. Treating both prevents the suffering of one from interfering with the therapy for the other.

 

So, dyadic mindfulness training improves the mental health of metastatic cancer patients and their spouses.

 

Being in this present moment, letting go, practicing non-attachment and acceptance are so helpful in dealing with uncertainty and fear. Mindfulness is something that they use for the rest of their lives for really great benefit.” – Linda Carlson

 

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

 

Milbury, K., Li, Y., Durrani, S., Liao, Z., Tsao, A. S., Carmack, C., Cohen, L., & Bruera, E. (2020). A Mindfulness-Based Intervention as a Supportive Care Strategy for Patients with Metastatic Non-Small Cell Lung Cancer and Their Spouses: Results of a Three-Arm Pilot Randomized Controlled Trial. The oncologist, 25(11), e1794–e1802. Advance online publication. https://doi.org/10.1634/theoncologist.2020-0125

 

Abstract

Background

Although mindfulness‐based interventions have been widely examined in patients with nonmetastatic cancer, the feasibility and efficacy of these types of programs are largely unknown for those with advanced disease. We pilot‐tested a couple‐based meditation (CBM) relative to a supportive‐expressive (SE) and a usual care (UC) arm targeting psychospiritual distress in patients with metastatic lung cancer and their spousal caregivers.

Patients and Methods

Seventy‐five patient‐caregiver dyads completed baseline self‐report measures and were then randomized to one of the three arms. Couples in the CBM and SE groups attended four 60‐minute sessions that were delivered via videoconference. All dyads were reassessed 1 and 3 months later.

Results

A priori feasibility benchmarks were met. Although attendance was high in both groups, dyads in the CBM group indicated greater benefit of the sessions than those in the SE group (patients, CBM mean = 2.63, SE mean = 2.20, p = .003; spouses, CBM mean = 2.71, SE mean = 2.00, p = .005). Compared with the UC group, patients in the CBM group reported significantly lower depressive symptoms (p = .05; d = 0.53) and marginally reduced cancer‐related stress (p = .07; d = 0.68). Medium effect sizes in favor of the CBM compared with the SE group for depressive symptoms (d = 0.59) and cancer‐related stress (d = 0.54) were found. Spouses in the CBM group reported significantly lower depressive symptoms (p < .01; d = 0.74) compared with those in the UC group.

Conclusion

It seems feasible and possibly efficacious to deliver dyadic interventions via videoconference to couples coping with metastatic lung cancer. Mindfulness‐based interventions may be of value to managing psychological symptoms in the palliative care setting

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648356/

 

Mindfulness is Associated with Better Romantic Relationships

Mindfulness is Associated with Better Romantic Relationships

 

By John M. de Castro, Ph.D.

 

“Mindfulness comes from the Sanskrit words for “attend” and “stay.” Simply put, a mindful relationship is one where you pay attention to the other person, staying or being present to their here and now without judgment.” – Melinda Fouts

 

Relationships can be difficult as two individuals can and do frequently disagree or misunderstand one another. This is amplified in marriage where the couple interacts daily and frequently have to resolve difficult issues.

 

Attachment has been shown to affect the individual’s well-being and their relationships to others. There are a variety of ways that individuals attach to others. They are secure, insecure, avoidant, ambivalent, fearful, preoccupied, and disorganized attachment styles. Secure attachment style is healthy and leads to positive development and satisfying relationships while all of the others are maladaptive and unhealthy. These unhealthy attachment styles tend to stress relationships

 

Mindfulness trainings have been shown to improve a variety of psychological issues including emotion regulationstress responsestraumafear and worryanxiety, and depression, and self-esteem. Mindfulness training has also been found to improve relationships and to be useful in treating sexual problems.  In addition, mindfulness has been found to be an antidote to unhealthy attachment styles. So, it makes sense to investigate the associations of mindfulness and attachment styles with the satisfactoriness of couples’ relationships.

 

In today’s Research News article “Partners’ Relationship Mindfulness Promotes Better Daily Relationship Behaviours for Insecurely Attached Individuals.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579090/ )  Gazder and colleagues recruited romantic couples and had both members of the couples complete measures of relationship attachment style. They also maintained daily diaries for 14 days measuring relationship mindfulness and positive and negative relationship behaviors.

 

They found that the higher the levels of relationship mindfulness, the lower the levels of attachment avoidance and negative relationship behaviors and the higher the levels of positive relationship behaviors. High mindfulness was associated with higher levels of positive relationship behaviors and lower levels of negative relationship behaviors on the same day and on the next day. They also found that low mindfulness in insecurely attached individuals was associated with higher positive relationship behavior of their partners on the next day, suggesting making up on the day following.

 

These findings are correlational, so caution must be exercised in forming causal interpretations. Nevertheless, the results suggest that relationship mindfulness is important in encouraging positive behaviors and discouraging negative behaviors in the relationship. It also appears that insecure attachment is associated fewer positive behaviors and more negative behaviors in the relationship. But mindfulness is associated with less insecure attachment. Hence, mindfulness in romantic relationships promotes positive relationships while insecure attachment produces more problems in the relationship.

 

So, mindfulness is associated with better romantic relationships.

 

When you are mindful of the love in your life you open yourself up to the opportunity for love to grow. And not just romantic love, but self-love, and loving friendships as well.” – Mindful

 

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

 

Gazder, T., & Stanton, S. (2020). Partners’ Relationship Mindfulness Promotes Better Daily Relationship Behaviours for Insecurely Attached Individuals. International journal of environmental research and public health, 17(19), 7267. https://doi.org/10.3390/ijerph17197267

 

Abstract

Attachment anxiety and avoidance are generally associated with detrimental relationship processes, including more negative and fewer positive relationship behaviours. However, recent theoretical and empirical evidence has shown that positive factors can buffer insecure attachment. We hypothesised that relationship mindfulness (RM)—open or receptive attention to and awareness of what is taking place internally and externally in a current relationship—may promote better day-to-day behaviour for both anxious and avoidant individuals, as mindfulness improves awareness of automatic responses, emotion regulation, and empathy. In a dyadic daily experience study, we found that, while an individual’s own daily RM did not buffer the effects of their own insecure attachment on same-day relationship behaviours, their partner’s daily RM did, particularly for attachment avoidance. Our findings for next-day relationship behaviours, on the other hand, showed that lower (vs. higher) prior-day RM was associated with higher positive partner behaviours on the following day for avoidant individuals and those with anxious partners, showing this may be an attempt to “make up” for the previous day. These findings support the Attachment Security Enhancement Model and have implications for examining different forms of mindfulness over time and for mindfulness training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579090/

 

Attachment Insecurity Lowers Mindfulness and Increases Rumination Which Heightens Conflict

Attachment Insecurity Lowers Mindfulness and Increases Rumination Which Heightens Conflict

 

By John M. de Castro, Ph.D.

 

“Mindfulness, which has been shown to help mental, behavioral, and physical outcomes in both youth and adults, is a powerful tool that can help us respond to conflict in a non-reactive way.”Whitney Stuart

 

Relationships can be difficult as two individuals can and do frequently disagree or misunderstand one another. These conflicts can produce strong emotions and it is important to be able to regulate these emotions in order to keep them from interfering with rational solutions to the conflict. In fact, it has been asserted that the inability to resolve conflicts underlies the majority of divorces. Mindfulness may be helpful in navigating disputes, as it has been shown to improve the emotion regulation and reduce the repetitive thinking about the conflict, rumination. Indeed, mindfulness has been shown to improve relationships. So, mindfulness training may improve the ability to resolve conflict

 

Attachment has been shown to affect the individual’s well-being. There are a variety of ways that individuals attach to others. The particular strategies are thought to develop during childhood through attachments to caregivers. They are secure, insecure, avoidant, ambivalent, fearful, preoccupied, and disorganized attachment styles. Secure attachment style is healthy and leads to positive development while all of the others are maladaptive and unhealthy. These can lead to psychological difficulties and interfere with the individual’s ability to relate to others and resolve conflict.

 

The relationships between attachment style, mindfulness, rumination, and conflict have not been previously studied. In today’s Research News article “Being in the Moment So You Can Keep Moving Forward: Mindfulness and Rumination Mediate the Relationship between Attachment Orientations and Negative Conflict Styles.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559327/ ) Quickert and MacDonald recruited college students and had them complete measures of attachment orientation, experiential avoidance, relationship satisfaction, relationship mindfulness, romantic partner conflict styles, rumination, and mindfulness.

 

They found that the higher the levels of general mindfulness and relationship mindfulness the lower the levels of experiential avoidance, attachment anxiety, attachment avoidance, rumination, and relationship rumination. In addition, the higher the levels of attachment anxiety and attachment avoidance the higher the levels of experiential avoidance, rumination, and relationship rumination. Finally, the higher the levels of attachment anxiety and attachment avoidance the higher the levels of the conflict styles of avoidance, interactional reactivity, separation, domination and submission, and the lower the levels of relationship satisfaction. Performing a mediation analyses they discovered that mindfulness and rumination mediated the negative relationship between attachment insecurity and negative conflict styles, such that the higher the levels of attachment insecurity the lower the levels of mindfulness and the higher the levels of rumination which, in turn, were associated with higher levels of negative conflict styles.

 

It should be noted that this study is correlational and as such causation cannot be determined. Also, only relatively young college students were employed which limits the generalizability of the results. Nevertheless, the study suggests thar insecure attachment is related to poor conflict styles and that relationship occurs because of insecure attachment’s relationships with higher rumination and lower mindfulness.

 

It can be speculated that being mindful in a relationship leads to less worry and rumination and to better ability to deal with conflict. It can also be speculated that having attachment insecurity tends to disrupt this relationship. All in all, it may be that mindfulness can improve relationships, reducing conflict.

 

So, attachment insecurity lowers mindfulness and increases rumination which heightens conflict.

 

“Mindfulness skills have been shown to help with conflict management by decreasing self-centered focus, allowing for more collaborative dialogue, breaking the vicious cycle of automatic thoughts/feelings/behaviors that contribute to unproductive conversations, increasing emotional awareness of self and others, which promotes connection and understanding, strengthening attention and non-judgmental awareness, which can foster flexible and innovative problem-solving.” – Taylor Rush

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Quickert, R. E., & MacDonald, T. K. (2020). Being in the Moment So You Can Keep Moving Forward: Mindfulness and Rumination Mediate the Relationship between Attachment Orientations and Negative Conflict Styles. International journal of environmental research and public health, 17(18), 6472. https://doi.org/10.3390/ijerph17186472

 

Abstract

Attachment insecurity has been associated with negative behaviors during conflict and decreased relationship satisfaction. We theorize that individuals high in attachment anxiety and/or avoidance are less mindful during conflict with their romantic partners, and thus more likely to ruminate. Decreased mindfulness and higher levels of rumination may be important mechanisms in the relationship between attachment insecurity and conflict behavior, as it may be more difficult to engage in constructive problem-solving skills when one is distracted from the present moment. We conducted an online survey assessing 360 participants’ attachment orientations, levels of mindfulness and rumination, behavior during conflict, and experience with mindfulness activities. Using a serial mediation model, we found that mindfulness and rumination mediated the relationship between attachment insecurity and negative conflict behaviors. We further discovered that individuals high in attachment insecurity were more likely to report negative experiences with mindfulness activities (i.e., meditation and yoga), and that this relationship was mediated by higher levels of experiential avoidance, or a fear of engaging with one’s own thoughts and feelings. We discuss the importance of increasing mindfulness and decreasing both rumination and experiential avoidance to assist individuals high in attachment insecurity in navigating relationship conflict using more constructive and relationship-promoting strategies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559327/

 

Mindfulness May Mediate the Effects of Childhood Trauma on Romantic Relationships

Mindfulness May Mediate the Effects of Childhood Trauma on Romantic Relationships

 

By John M. de Castro, Ph.D.

 

“As mindfulness is the ever-unfolding compassionate, non-judgmental awareness of each and every moment, mindfulness practice and relationships go hand-in-hand.” – Gillian Florence Sanger

 

Childhood changes the victim forever. It changes the trusting innocence of childhood to a confused, guilt ridden, frightening, and traumatized existence. It not only produces short-term trauma which includes both psychological and physical injury, it has long-term consequences. It damages the victim’s self-esteem and creates difficulties entering into intimate relationship in adulthood.  Relationships under any conditions can be difficult. This is amplified in cohabitation where the couple interacts daily and frequently have to resolve difficult issues. All this can be amplified with when one of the partners has experienced childhood trauma.

 

Mindfulness trainings have been shown to improve a variety of psychological issues including emotion regulationstress responsestraumafear and worryanxiety, and depression, and self-esteem. Mindfulness training has also been found to improve relationships and to be useful in treating sexual problems. In addition, mindfulness has been shown to be helpful in resolving the residual symptoms of childhood trauma. But there is little empirical research on the influence of mindfulness on the relationships of couples where childhood trauma exists.

 

In today’s Research News article “Cumulative Childhood Trauma and Couple Satisfaction: Examining the Mediating Role of Mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7334265/) Gobout and colleagues recruited couples involved in romantic relationships and had them complete questionnaires measuring childhood trauma, couple satisfaction, and mindfulness. These data were then analyzed with regression and path analysis techniques.

 

Shockingly, they found that 87% of the sample had experienced some form of childhood trauma, including sexual or physical abuse, psychological violence or neglect, physical neglect, interparental physical or psychological violence, or bullying. They further found that the higher the levels of mindfulness, the higher the levels of couples’ satisfaction and the higher the levels of childhood trauma the lower the levels of couple satisfaction and mindfulness. A path analysis revealed that childhood trauma affected couples’ satisfaction by being associated with lower levels of mindfulness that in turn were associated with lower couples’ satisfaction. The mediation was significant for overall mindfulness and also the observing, describing inner experience, and non-judging facets of mindfulness.

 

These findings are correlational and as such causation cannot be determined. But prior research has shown the mindfulness is effective in treating the symptoms of childhood trauma and it also improves relationships. Hence, it is reasonable to suggest that the relationships observed in the current study represent underlying causal connections. This suggests the childhood trauma, at least in part, reduces mindfulness which is important for relationship satisfaction. This infers that mindfulness training may be effective in reducing the impact of childhood trauma on the individual’s ability to engage in satisfying relationships.

 

These results also suggest that being sensitive to inner experience and not judging it is important for relationships. In other words, being aware of one’s feelings but not judging them helps the individual to better relate to a partner. Experiencing childhood trauma appears to make the individual somewhat numb to their feelings making it more difficult to be aware of their emotions in relating to another. Overcoming tis effect of experience trauma in childhood may be a key for allowing these victims to relate effectively to their partners and thereby having a satisfying relationship.

 

So, mindfulness may mediate the effects of childhood trauma on romantic relationships.

 

“When you are mindful of the love in your life you open yourself up to the opportunity for love to grow. And not just romantic love, but self-love, and loving friendships as well.” – Mindful

 

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

 

Gobout, N., Morissette Harvey, F., Cyr, G., & Bélanger, C. (2020). Cumulative Childhood Trauma and Couple Satisfaction: Examining the Mediating Role of Mindfulness. Mindfulness, 11(7), 1723–1733. https://doi.org/10.1007/s12671-020-01390-x

 

Abstract

Objectives

Cumulative childhood trauma (CCT) survivors are at a higher risk of suffering from interpersonal problems including couple dissatisfaction. Dispositional mindfulness is increasingly proposed as a potential explanatory mechanism of post-traumatic symptomatology and has been documented as a predictor of couple satisfaction. Most authors operationalize mindfulness as a multidimensional disposition comprised of five facets (i.e., Describing, Observing, Non-judgment of inner experiences, Non-reactivity, and Acting with awareness), but the role of these facets in the link between CCT and couple satisfaction has yet to be understood. This study aimed to assess mindfulness as a potential mediator in the relationship between CCT and couple satisfaction and to examine the distinctive contributions of mindfulness facets in this mediation.

Methods

A sample of 330 participants from the community completed measures of couple satisfaction, mindfulness, and exposure to eight types of childhood maltreatment experiences.

Results

Path analysis results revealed that mindfulness mediated the relationship between CCT and couple satisfaction. More precisely, two mindfulness facets acted as specific mediators, namely, Describing and Non-judgment of inner experiences. The final integrative model explained 14% (p < .001) of the variance in couple satisfaction.

Conclusions

Findings suggest that mindfulness may be a meaningful mechanism in the link between CCT and couple satisfaction. They also highlight that description of inner experiences and a non-judgmental attitude of these experiences may act as key components to understand the influence of CCT on adults’ lower couple satisfaction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7334265/

 

Reduce Intimate Partner Violence with Mindfulness

Reduce Intimate Partner Violence with Mindfulness

 

By John M. de Castro, Ph.D.

 

“teaching men mindfulness and emotional intelligence will help them develop self-awareness in moments of emotional trigger . . . and avoid violent reactivity.” – Prison Mindfulness Institute

 

The human tendency to lash out with aggression when threatened was adaptive for the evolution of the species. It helped promote the survival of the individual, the family, and the tribe. In the modern world, however, this trait has become more of a problem than an asset. It results in individual violence and aggression such as physical abuse, fights, road rage, and even murders, and in societal violence such as warfare.

 

These violent and aggressive tendencies can lead to violence directed to intimate partners, including sexual and physical violence. In the U.S. there are over 5 million cases of domestic violence reported annually. Indeed, it has been estimated that 1 in 4 women and 1 in 7 men have experienced physical violence and 1 in 3 women and 1 in 6 men have experienced sexual violence from an intimate partner.

 

Obviously, there is a need to find ways to reduce intimate partner violence. Mindfulness training has been shown to reduce aggressionhostility and violence. Hence, mindfulness training may be effective in reducing intimate partner violence. In today’s Research News article “Cognitive behavioural group therapy versus mindfulness-based stress reduction group therapy for intimate partner violence: a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7169006/), Nesset and colleagues explored therapeutic techniques for perpetrators of intimate partner violence.

 

They recruited adult men who were referred by physicians for treatment for violence against intimate partners. They were randomly assigned to be treated with either 15 2-hour group Cognitive Behavioral Therapy (CBT) sessions or 8 2-hour group Mindfulness-Based Stress Reduction (MBSR) sessions. CBT explores and attempts to change inaccurate or negative thinking so the patient can view challenging situations more clearly and respond to them in a more effective way. The MBSR program consisting on training in meditation, body scan, yoga, and discussions of using mindfulness in everyday life. They were measured at baseline and 3, 6, 9, and 12 months later for violence over the prior 3 months reported by both the patient and the intimate partner, including physical injury, and physical, psychological, and sexual violence.

 

They found that in comparison to baseline both Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR) produced large and significant reductions in physical injury, and physical, psychological, and sexual violence over the 12-month follow-up period.

 

It is interesting that two very different therapeutic techniques were equally effective. This raises the possibility that the benefits may have been due to the confounding effects of participant expectancy (placebo) effects, demand characteristics, or experimenter bias effects. But the magnitude in the reductions in violence were striking and lasting. Confounding effects are usually short lived. So, it would seem that both therapies were effective in reducing violence in men with a history of intimate partner violence. Whether they act in different ways or share a common mechanism of action is a subject for future research.

 

So, reduce intimate partner violence with mindfulness.

 

Meditation is one of the most effective ways to calm the mind and clear built up stress from the nervous system.” – Diane Yeo

 

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

 

Nesset, M. B., Lara-Cabrera, M. L., Bjørngaard, J. H., Whittington, R., & Palmstierna, T. (2020). Cognitive behavioural group therapy versus mindfulness-based stress reduction group therapy for intimate partner violence: a randomized controlled trial. BMC psychiatry, 20(1), 178. https://doi.org/10.1186/s12888-020-02582-4

 

Abstract

Background

Violence in close relationships is a global public health problem and there is a need to implement therapeutic programs designed to help individuals who voluntarily seek help to reduce recurrent intimate partner violence. The effectiveness of such interventions in this population remains inconclusive. The aim of the present study was to compare the effectiveness of cognitive-behavioural group therapy (CBGT) vs mindfulness-based stress reduction (MBSR) group therapy in reducing violent behavior amongst individuals who are violent in intimate partnerships and who voluntarily seek help.

Methods

One hundred forty four participants were randomized using an internet-based computer system. Nineteen withdrew after randomization and 125 participants were randomly assigned to the intervention condition (CBGT, n = 67) or the comparator condition (MBSR, n = 58). The intervention condition involved two individual sessions followed by 15 cognitive-behavioural group therapy sessions. The comparator condition included one individual session before and after 8 mindfulness-based group sessions. Participants (N = 125) and their relationship partners (n = 56) completed assessments at baseline, and at three, six, nine and twelve months’ follow-up. The pre-defined primary outcome was reported physical, psychological or sexual violence and physical injury as measured by the revised Conflict Tactics Scale (CTS2).

Results

The intent-to-treat analyses were based on 125 male participants (intervention group n = 67; comparator group n = 58). Fifty-six female partners provided collateral information. Baseline risk estimate in the CBGT-group was .85 (.74–.92), and .88 (.76–.94) in the MBSR-group for physical violence. At 12-months’ follow-up a substantial reduction was found in both groups (CBGT: .08 (.03–.18); MBSR: .19 (.11–.32)).

Conclusion

Results provide support for the efficacy of both the cognitive-behavioural group therapy and the mindfulness-based stress reduction group therapy in reducing intimate partner violent behavior in men voluntarily seeking treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7169006/

 

Reduce Dating Violence Due to Perceived Infidelity with Mindfulness

Reduce Dating Violence Due to Perceived Infidelity with Mindfulness

 

By John M. de Castro, Ph.D.

 

It takes patience, mindfulness and knowledge of trauma-informed practices to effectively implement lasting and profound changes to victims of domestic and sexual violence.” – Sara Mahoney

 

Dating should be a time for young people to get together, get to know one another and have fun. But all too often, dating involves violence or aggression. Nearly 1.5 million high school students in the U.S. experience physical abuse from a dating partner each year, 33% are victims of physical, sexual, emotional or verbal abuse from a dating partner, and 10% have been purposefully hit, slapped or physically hurt. Dating violence doesn’t just occur in High School as 43% of college women experience violent or abusive dating behaviors. Sadly, only about a third of the victims ever tell anyone about the abuse. Hence it is important to find ways to prevent dating violence. Mindfulness has potential to reduce dating violence.

 

Dating violence is often linked to suspicions regarding the infidelity of the partner and frequently to alcohol intake. It is not known if mindfulness in some way affects the influence of infidelity suspicion on physical assault. In today’s Research News article “Dispositional Mindfulness as a Moderator of the Relationship Between Perceived Partner Infidelity and Women’s Dating Violence Perpetration. Journal of interpersonal violence.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6944186/), Brem and colleagues investigate the moderating influence of mindfulness on the relationship between perceived infidelity and violence perpetration.

 

They recruited college women who were involved in a romantic relationship. They were asked to complete measures of physical assault perpetration, mindfulness, perceived partner infidelity, and alcohol use. The majority of perceived infidelity reported consisted of their partner “checking out” or flirting with another.

 

They found that the higher the levels of mindfulness, the lower the levels of alcohol use and physical assault. Additionally, they found that the higher the levels of perceived infidelity the higher the levels of alcohol use and physical assault. They also found, taking alcohol intake into account, that the relationship between perceived infidelity and physical assault was significant for women low in mindfulness but not for women high in mindfulness, suggesting a moderating influence of mindfulness.

 

These results are correlational and as such causation cannot be determined. But, it has been demonstrated in previous research that mindfulness produces reductions in violent and aggressive tendencies. So, it is likely that the present findings are due to the causal consequences of mindfulness on violence and aggression. Nevertheless, the results suggest that mindfulness may lower perpetration of physical assault by preventing suspicions regarding infidelity being expressed as physical assault. This in turn suggests that mindfulness training may be useful in reducing violence and aggression in romantic relationships.

 

So, reduce dating violence due to perceived infidelity with mindfulness.

 

Although they are not designed specifically to reduce incidences of domestic violence, programs that teach people mindfulness and meditation have shown some promise in reducing incidences of violence in several settings.” – Michael Kraut

 

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

 

Brem, M. J., Wolford-Clevenger, C., Zapor, H., Elmquist, J., Shorey, R. C., & Stuart, G. L. (2018). Dispositional Mindfulness as a Moderator of the Relationship Between Perceived Partner Infidelity and Women’s Dating Violence Perpetration. Journal of interpersonal violence, 33(2), 250–267. https://doi.org/10.1177/0886260515604415

 

Abstract

Mindfulness gained increased attention as it relates to aggressive behavior, including dating violence. However, no known studies examined how the combined influences of dispositional mindfulness and perceived partner infidelity, a well-documented correlate of dating violence, relate to women’s dating violence perpetration. Using a sample of college women (N = 203), we examined the relationship between perceived partner infidelity and physical dating violence perpetration at varying levels of dispositional mindfulness, controlling for the influence of alcohol use. Results indicated perceived partner infidelity and dating violence perpetration were positively related for women with low and mean dispositional mindfulness, but not for women with high dispositional mindfulness. These results further support the applicability of mindfulness theory in the context of dating violence. Implications of the present findings provide preliminary support for mindfulness intervention in relationships characterized by infidelity concerns.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6944186/

 

Mindfulness Is Associated with Better Marital Quality in Military Couples

Mindfulness Is Associated with Better Marital Quality in Military Couples

 

By John M. de Castro, Ph.D.

 

Mindfulness helps partners to regulate their own responses and more fully accept one another,” the researchers suggest, “resulting in less negative fallout from conflict when it arises.” – Linda Graham

 

Relationships can be difficult as two individuals can and do frequently disagree or misunderstand one another. This is amplified in marriage where the couple interacts daily and frequently have to resolve difficult issues. These conflicts can produce strong emotions and it is important to be able to regulate these emotions in order to keep them from interfering with rational solutions to the conflict. The success of marriage can often depend upon how well the couple handles these conflicts. In fact, it has been asserted that the inability to resolve conflicts underlies the majority of divorces. All this can be amplified with military marriages where one partner may be away on deployment for long periods.

 

Mindfulness may be helpful in navigating marital disputes, as it has been shown to improve the emotion regulation and decrease anger and anxiety. It may be a prerequisite for deep listening and consequently to resolving conflict. Indeed, mindfulness has been shown to improve relationships. So, mindfulness may be a key to successful relationships. But little is known about mindfulness and military couples who are under the added stress of deployment.

 

In today’s Research News article “Actor-Partner Associations of Mindfulness and Marital Quality After Military Deployment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820699/), Zamir and colleagues recruited heterosexual couples with the male in the military and having been deployed. Both members of the dyad were measured for mindfulness and marital quality.

 

They found that for both men and women the higher the levels of mindfulness the greater the marital quality. In addition, for both men and women the higher the level of mindfulness in one member of the dyad the higher the level of marital quality reported not only by themselves but also by their partner. Hence mindfulness is associated with higher marital quality for both members of a military marriage.

 

These results are correlational and conclusions about causation cannot be reached. But in previous manipulative research studies mindfulness has been shown to improve relationships. Hence, it is reasonable to speculate that mindfulness also produces better relationships in this particular group of military heterosexual couples confronting deployment. One implication of the work is that the military might consider mindfulness training to help couples cope with the stresses of deployment and maintain strong marriages.

 

So, mindfulness is associated with better marital quality in military couples.

 

“Research continues to reveal benefits mindfulness training provides for soldiers both before and after combat. These benefits in some cases have the potential to be life-saving, both from improved situational awareness and stress resilience during battle and from decreasing the intensity and occurrence of posttraumatic stress symptoms, which are often linked to a high rate of veteran suicides.” – GoodTherapy

 

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

 

Zamir, O., Gewirtz, A. H., & Zhang, N. (2017). Actor-Partner Associations of Mindfulness and Marital Quality After Military Deployment. Family relations, 66(3), 412–424. doi:10.1111/fare.12266

 

Abstract

Objective:

To explore dyadic associations between mindfulness and marital quality and gender differences in these associations—that is, the relation of each dyad member’s mindfulness with his or her own marital quality and with his or her partner’s marital quality.

Background:

Recent studies have demonstrated the benefits of mindfulness for marital quality. However, associations of mindfulness and marital quality within and between partners are still unclear. In addition, despite marital challenges associated with deployment to war, the benefits of mindfulness for marital quality in military couples is yet unknown.

Method:

A sample of 228 military couples following deployment of the male partner to recent conflicts in Iraq or Afghanistan completed an online survey measuring mindfulness and marital quality.

Results:

Actor–partner interdependence (APIM) analysis showed that, for both men and women, greater mindfulness was associated with one’s own and one’s partner’s higher marital quality. There were no gender differences in this pattern.

Conclusion:

Mindfulness engenders intra- and interpersonal benefits for the marital system in men and in women following deployment to war.

Implications:

The results emphasize the importance of a dyadic approach when examining the role of mindfulness in marital or family relations, and suggest that interventions designed to facilitate change in marital relationships in the context of deployment may benefit from integrating mindfulness-based training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820699/