Stress

Alleviate Work Related Stress with On-Line Mindfulness Training

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Mindfulness stress call center2 Allexandre

Alleviate Work Related Stress with On-Line Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Managers who practice mindfulness have discovered that it improves their ability to encourage calm and stability in the workplace. They actually increase productivity when they model “mindful manager” qualities, such as listening before acting and leading people by focusing less on hierarchical relationships. “Do this because I told you to” becomes “Let’s talk about how and why we do things this way.” – Ruth W. Crocker

 

Stress is epidemic in the western workplace. A recent Harris poll found that 80 percent of workers feel stressed about one or more things in the workplace. This stress can lead to physical and psychological problems for managers and employees, including personal and professional burnout, absenteeism, lower productivity, and lower job satisfaction. Indeed, 46.4% of employees, report having psychological distress.

 

Call centers can be particularly stressful due to a heavy workload, sustained fast work pace, repetitive tasks, lack of control over the job, the blurred relation between feelings and actions, a competitive environment, and being faced with losing a client. These stresses can lead to problems, including visual, auditory, and speech fatigue. Indeed, each year, 60% of employees take sick leave and 39.4% of employees showed psychological distress symptoms and 8.3% found themselves in a severe situation of psychological distress, and 24% were taking psychoactive drugs. This also produces high turnover, with the average employee leaving the job after only a year.

 

Mindfulness training of employees is a potential help with work related stress. It has been shown to reduce the psychological and physical reactions to stress overall and particularly in the workplace and to reduce burnout. A problem in implementing mindfulness programs in the workplace is the time required for the training. This makes many managers reticent to try it. So, it is important to develop programs that do not seriously impact on work time. A potential solution is to train mindfulness on-line. Indeed, training over the internet has been found to be effective for anxiety depression.

 

In today’s Research News article “A Web-Based Mindfulness Stress Management Program in a Corporate Call Center: A Randomized Clinical Trial to Evaluate the Added Benefit of Onsite Group Support.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1219305188093405/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768630/

Allexandre and colleagues implemented an 8-week on-line mindfulness stress management program for call center employees and compared its effectiveness to a wait-list control group. They implemented three different programs, a condition with on-line mindfulness training alone, a condition with mindfulness training combined with a support group, and a condition with mindfulness training and a support group led by a licensed clinical psychologist.

 

They found that all the on-line mindfulness training groups had greater reductions in perceived stress, and increases in emotional well-being, and emotional role functioning than the wait-list control group. These improvements were maintained at 8-weeks after the end of the training program. The addition of the support group produced greater satisfaction with the program and greater reductions in stress, and improvements in emotional well-being, and emotional role functioning than the mindfulness training alone group. Surprisingly, the addition of a clinical psychologist to the support group did not improve the support group’s effectiveness.

 

These results suggest that mindfulness training can be implemented over the internet and it can be effective in reducing stress and improving emotional well-being, and emotional role functioning for call center employees. It has been shown previously that mindfulness reduces the psychological and physiological responses to stress. These results demonstrate that this benefit can be produced with on-line training. They further demonstrate that adding a support group magnifies the effectiveness of the program. So, mindfulness can help, but mindfulness with support from other employees is substantially better. The sharing in support groups may well help the employee to see that their issues are shared by many, reducing their impact on the individuals work performance and well-being.

 

These findings suggest that a mindfulness training program that takes little time away from work can be successfully implemented and can have beneficial effects. This may be important for convincing managers and executives to implement such programs in their enterprises,

 

So, alleviate work related stress with on-line mindfulness training.

 

“Teaching mindfulness to employees can help them take a step back, think through a problem and consider all options. And that can improve decision making and positively affect the bottom line. One recent study, for example, showed that when call center employees took part in a mindfulness program, client satisfaction increased. Employees were also less stressed, anxious and fatigued on the job, thereby increasing productivity.” – Lisa Wirthman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

Allexandre, D., Bernstein, A. M., Walker, E., Hunter, J., Roizen, M. F., & Morledge, T. J. (2016). A Web-Based Mindfulness Stress Management Program in a Corporate Call Center: A Randomized Clinical Trial to Evaluate the Added Benefit of Onsite Group Support. Journal of Occupational and Environmental Medicine, 58(3), 254–264. http://doi.org/10.1097/JOM.0000000000000680

 

Abstract

Objective: The objective of this study is to determine the effectiveness of an 8-week web-based, mindfulness stress management program (WSM) in a corporate call center and added benefit of group support.

Methods: One hundred sixty-one participants were randomized to WSM, WSM with group support, WSM with group and expert clinical support, or wait-list control. Perceived stress, burnout, emotional and psychological well-being, mindfulness, and productivity were measured at baseline, weeks 8 and 16, and 1 year.

Results: Online usage was low with participants favoring CD use and group practice. All active groups demonstrated significant reductions in perceived stress and increases in emotional and psychological well-being compared with control. Group support improved participation, engagement, and outcomes.

Conclusion: A self-directed mindfulness program with group practice and support can provide an affordable, effective, and scalable workplace stress management solution. Engagement may also benefit from combining web-based and traditional CD delivery.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768630/

Keep Health Care Professionals from Burning Out with Mindfulness

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By John M. de Castro, Ph.D.

 

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

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. This is the fatigue, cynicism, emotional exhaustion, and professional inefficacy that comes with work-related stress. Healthcare is a high stress occupation. It is estimated that over 45% of healthcare workers experience burnout with emergency medicine at the top of the list, over half experiencing burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity.

 

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

 

Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses. Hence, preventing existing healthcare workers from burning has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout. One of the premiere techniques for developing mindfulness and dealing effectively with stress is Mindfulness Based Stress Reduction (MBSR) pioneered by Jon Kabat-Zinn. It is a diverse mindfulness training containing practice in meditation, body scan, and yoga. As a result, there have been a number of trials investigating the application of MBSR to the treatment and prevention of health care worker burnout.

 

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

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

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

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Improve Emotions in MS with Mindfulness

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By Dr. John M. de Castro

 

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

 

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

 

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

 

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

 

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

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

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

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

 

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

 

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

 

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

 

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

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Improve Gastrointestinal Disorders with Mindfulness

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By John M. de Castro, Ph.D.

 

 “The functional gastrointestinal disorders (FGIDs) are a group of more than 20 chronic and hard to treat medical conditions of the gastrointestinal tract that constitute a large proportion of the presenting problems seen in clinical gastroenterology.” – Jennifer Wolkin

 

Functional Gastrointestinal Disorders are the most common disorders of the gastrointestinal tract in the general population. The most common disorder in this group is Irritable Bowel Syndrome (IBS). Functional Gastrointestinal Disorders can involve the esophagus, stomach and/or intestines and are disorders of function (how these structures work), not structural or biochemical abnormalities. Estimates vary, but about 25% of people in the United States have one of these disorders. The conditions account for about 40% of GI problems seen by doctors and therapists.

 

The cause(s) of Functional Gastrointestinal Disorders are not known. But, emotion dysregulation is suspected to be involved. It is clear that psychological stress exacerbates the illnesses and anxiety amplifies the symptoms. This suggests that mindfulness or the lack thereof may be involved as mindfulness is known to be helpful in reducing the psychological and physical responses to stress and mindfulness is known to improve emotion regulation. In addition, contemplative practice has been shown to improve the symptoms of Irritable Bowel Syndrome. So, it would make sense to further investigate the relationship of mindfulness to emotion regulation, stress, and Functional Gastrointestinal Disorders.

 

In today’s Research News article “Difficulties in Emotion Regulation and Mindfulness in Psychological and Somatic Symptoms of Functional Gastrointestinal Disorders”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1178359818854609/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733315/

Mazaheri investigated the relationships between gastrointestinal symptoms, emotions, emotion regulation, and mindfulness in patients diagnosed with Functional Gastrointestinal Disorders. They found that the higher the levels of either depression, anxiety, or stress the greater the GI symptoms and that the lower the levels of emotion regulation the greater the symptoms. Significantly, they found that high levels of mindfulness were associated with lower levels of GI symptoms, depression, anxiety, and stress and with higher levels of emotion regulation.

 

The results support the contention that an inability to regulate emotions and stress are an important factor in Functional Gastrointestinal Disorders. In addition, they suggest that mindfulness is not only associated with lower levels of emotion and psychological stress but also with a greater ability to regulate these emotions. It should be noted that the results of this study are strictly observational and correlational and as such no conclusion about causation can be reached. But, the results give strong support to the need to perform a randomized controlled trial where mindfulness is trained and its effects on emotion regulation and Functional Gastrointestinal Disorders are measured.

 

With the caveat that causation hasn’t been established, it can be speculated that mindfulness training may be a safe and effective method for both the prevention and treatment of Functional Gastrointestinal Disorders. Mindfulness’ ability to improve emotion regulation may help the individual to be able to better experience emotions but respond to them in an effective and adaptive manner, lessening their impact. It remains for future research to investigate this exciting possibility.

 

So, improve gastrointestinal disorders with mindfulness.

 

“patients with heightened GI-specific anxiety may benefit from participation in a mindfulness programme as an adjunct to their usual clinical care.” – D. J. Kearney

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Age Healthily: Improve Cellular Health with Mindfulness

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“Simply responding to the physical symptoms of disease might make sense for treating an acute infection or fixing a broken leg, but to beat chronic age-related conditions such as diabetes, heart disease and dementia, we will need to embrace the fuzzy, subjective domain of the mind.” – Jo Marchant

 

Aging seems inevitable. But, different species age at different rates. Everyone knows for example that dogs’ life span is about 1/6th of the human life span. This suggests that there must be some biological mechanism that regulates aging. Recent genetic research is starting to uncover that mechanism. It has been found that the genes, coded on the DNA molecule, govern cellular processes in our bodies. One of the most fundamental of these processes is cell replication. Cells are constantly turning over. Dying cells or damaged are replaced by new cells. The cells turn over at different rates but most cells in the body are lost and replaced between every few days to every few months. Needless to say were constantly renewing ourselves.

 

As we age the tail of the DNA molecule called the telomere shortens. When it gets very short cells have a more and more difficult time reproducing and become more likely to produce defective cells. On a cellular basis this is what produces aging. As we get older the new cells produced are more and more defective. The shortening of the telomere occurs each time the cell is replaced. So, slowly as we age it gets shorter and shorter. This has been called a “mitotic clock.” This is normal. But, telomere shortening can also be produced by oxidative stress, which can be produced by psychological and physiological stress. This is mediated by stress hormones and the inflammatory response. So, chronic stress can accelerate the aging process. In other words, when we’re chronically stressed we get older faster.

 

Fortunately, there is a mechanism to protect the telomere. There is an enzyme in the body called telomerase that helps to prevent shortening of the telomere. It also promotes cell survival and enhances stress-resistance.  Research suggests that processes that increase telomerase activity tend to slow the aging process by protecting the telomere.  One activity that seems to increase telomerase activity and protect telomere length is mindfulness practice (see http://contemplative-studies.org/wp/index.php/2015/12/04/retreat-for-longevity/ and http://contemplative-studies.org/wp/index.php/2015/07/17/aging-healthily-yoga-and-cellular-aging/). Hence, engaging in mindfulness practices may protect the telomere and thereby slow the aging process.

 

In today’s Research News article “Telomerase activity and its association with psychological stress, mental disorders, lifestyle factors and interventions: A systematic review”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1168516629838928/?type=3&theater

Deng and colleagues review the published scientific literature on factors that influence telomerase activity. They report that chronic, long-term, psychological stress but not acute, short-term, stress reduced telomerase activity. They also report that Major Depressive Disorder is associated with reduced telomerase activity. Importantly, they find that diet, exercise, and mindfulness practices all increase telomerase activity. In particular, they found that “physical exercise, diet micronutrient supplementation, mindfulness meditation, Qigong practice or yoga mediation resulted in increase in telomerase activity.”

 

These are very exciting outcomes and suggest that mindfulness practices might contribute to longevity by reducing cellular aging. How might these very different practices increase telomerase activity? All of these mindfulness practices have been shown to reduce the psychological and physiological responses to stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/). Since, chronic stress has been shown to reduce telomerase activity and in turn accelerate cellular aging, it would seem reasonable to conclude that practices that reduce stress responses would protect the individual from the deleterious effects of stress and increase telomerase activity. There may be other mechanisms involved, but this would seem to be the obvious one.

 

These findings suggest that mindfulness practices may improve longevity by protecting us from the damaging effects of chronic stress. By making us more mellow, we age slower.

 

So, age healthily: improve cellular health with mindfulness.

 

“it is possible that greater presence of mind promotes a healthy biochemical milieu and, in turn, cell longevity,” – Elizabeth Blackburn

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Get College Students out of the Dumps with Mindfulness

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“College is a great time in a young person’s life. You get to grow in many aspects; socially, academically and even spiritually. . . . Yes, college can be one of the best times, but it also comes with some of the worst times in your life. The constant stress of classes, exams, organization obligations, friend drama and family issues can completely break a person. Sometimes we get so overwhelmed and overworked, that we feel absolutely hopeless.” – Mariah Nicole Wild

 

Depression is a common mental illness. It is debilitating by producing any or all of a long list of symptoms including: feelings of sadness or unhappiness, change in appetite or weight, slowed thinking or speech, loss of interest in activities or social gatherings, fatigue, loss in energy, sleeplessness, feelings of guilt or anger over past failures, trouble concentrating, indecisiveness, anger or frustration for no distinct reason, thoughts of dying, death and suicide. This can be difficult at any point in life, but for college students with the intense demands on them, it can be devastating. Depression in college students is extremely common with 36.4% of reporting some level of depression. Depression is the number one reason students drop out of school. It also can lead to other symptoms including suicide Indeed, suicide is the third leading cause of death among college students.

 

Major Depressive Disorder (MDD) is most commonly treated with drugs, but they can have problematic side effects and are not always effective. So, there is a need for alternative treatments for Major Depressive Disorder. Behavioral Activation (BA) has been shown to be effective for depression. It involves behavioral strategies to increase positive reinforcement and the encouragement of activities that produce pleasure and feelings of accomplishment in the patient’s life. Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment and is also effective for the prevention of its reoccurrence (see http://contemplative-studies.org/wp/index.php/category/research-news/depression/).

 

In today’s Research News article “Mindfulness-based therapy and behavioral activation: A randomized controlled trial with depressed college students”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1164985300192061/?type=3&theater

McIndoo and colleagues randomly assigned college students who suffered from Major Depressive Disorder to either Behavioral Activation, Mindfulness training, or to a wait list control group who did not receive treatment. Treatment occurred in one hour weekly sessions for four weeks. They found that both the Behavioral Activation and Mindfulness Training produced significant improvements in both self-reported and clinician assessed depression, perceived stress, and rumination, but not anxiety. The Mindfulness training alone produced increases in mindfulness. These were clinically significant changes of moderate to large effect sizes and these improvements were maintained at a one-month follow-up. Importantly, around two thirds of the treated groups attained remission from depression while only one quarter in the wait list group did.

 

These are impressive findings that a relatively brief treatment with either Mindfulness or Behavioral Activation training could produce such dramatic changes in the students. Since both approaches were clinically effective, the study findings suggest that either approach can be selected by clinicians tailored to the client. There were some indications that the Mindfulness training was preferred by the students, possibly because it is simpler and less stressful than Behavioral Activation. Regardless, both appear to be appropriate alternative treatments for major depressive disorder in college students.

 

So, get college students out of the dumps with mindfulness

 

“Imagine what effect it would have on you if someone stood behind you all day telling you how useless you were when you were trying desperately to cope with a difficult experience. Now imagine how much worse it would be if the criticism and harsh judgment came from inside your own mind.” ― Mark Williams
CMCS – Center for Mindfulness and Contemplative Studies

 

Rejuvenate Doctors Conveniently with Mindfulness

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“Mindfulness gives doctors permission to attend to their own health and well-being. But it also allows doctor to help patients by listening more, talking less, and seeing what the patients need.” – Dr. Mary Catherine Beach

 

“That’s the thing: You don’t understand burnout unless you’ve been burned out. And it’s something you can’t even explain. It’s just doing something you have absolutely no passion for.” – Elena Delle Donne

 

It is estimated that there is a shortage in the U.S. of over 9,000 physicians. The shortages are not just due to training insufficient numbers of healthcare provides but also due to high turnover rates. In part because of the shortage and high patient loads, physicians experience high stress and burnout. They experience a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. This is known as burnout.

 

In a recent survey 46% of all physicians responded that they had burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity. Since there is such a great need to retain experienced physicians, it is imperative that strategies be identified to decrease stress and burnout.

 

Mindfulness training has been shown to be effective for burnout of health care professionals (see http://contemplative-studies.org/wp/index.php/category/research-news/burnout/). But todays physicians are extremely busy and have little time to devote to mindfulness training. Hence, it is important to develop a mindfulness training that can be administered conveniently and is effective. In today’s Research News article “Brief Video-Module Administered Mindfulness Program for Physicians: A Pilot Study”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1160431203980804/?type=3&theater

Pflugeisen and colleagues developed a mindfulness training consisting of “three live sessions, eight online video trainings, and weekly teleconference coaching calls.”  Other than the live sessions all of the trainings could be accessed at a time and place of the physicians’ convenience. In a pilot study, they found that in comparison to pre-training the physicians showed large and significant decreases in stress and emotional exhaustion, and increases in feelings of personal accomplishment, and mindfulness. These improvements were still present 16-weeks later.

 

These pilot results are very encouraging. The program was not only effective in improving physician well-being, it was convenient for the physicians, as it was delivered for the most part when the physicians had time to engage. This makes this program much more likely to be initiated and completed by busy physicians. There is, of course, a need for a randomized controlled trial before rolling out this program for widespread use.

 

These results suggest that mindfulness is to some extent an antidote to high stress and burnout in physicians. There are a number of effects to mindfulness training that could be responsible for the reduced perceived stress and increased well-being. In particular mindfulness has been shown to reduce both physiological and psychological responses to stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/). Mindfulness has also been shown to increase emotion regulation, allowing the individual to experience and respond to emotional situations appropriately and constructively and thereby reduces stress (see http://contemplative-studies.org/wp/index.php/category/research-news/emotions/). Finally, mindfulness training is targeted to increasing focus on the present moment. This tends to reduce catastrophizing, worry, and anxiety which are focused on potential negative future events (see http://contemplative-studies.org/wp/index.php/category/research-news/worry/) and thereby can reduce psychological stress in physicians.

 

Regardless of the reason it is clear that mindfulness training can be delivered conveniently to busy physician and it can reduce burnout and improve well-being.

 

So, rejuvenate doctors conveniently with mindfulness

 

“If you asked my patients, I think they would say I listen more carefully since the training and that they feel they can explain things to me more forthrightly and more easily. Even the brief moments with patients are more productive. Are there doctors who desperately need this training? Yes, absolutely.” – Edward Stehlik, M.D.
CMCS – Center for Mindfulness and Contemplative Studies

 

Improve Your Stress Responses with Mindful Awareness

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“Researchers estimate that stress contributes to as many as 80 percent of all major illnesses, including cardiovascular disease, cancer, endocrine and metabolic disease, skin disorders, and infectious ailments of all kinds.” – Prescription for Nutritional Healing 4th edition

 

The mind and body are intimately connected and can never be completely separated. This can be witnessed in how the brain and the hormonal systems interact. The stress response is a case in point. Difficult, challenging, outside situations affect the mind which responds by producing psychological and physiological stress responses. These include the release of stress hormones such as cortisol. This prepares the body to fight off the potentially damaging stressors. This is normally a good thing, but if it persists over a prolonged period the stress response itself becomes damaging and a source of disease. Hence, it is important to not block the stress response but to insure that it doesn’t become a chronic condition.

 

The stress hormones including cortisol not only affect the peripheral physiology, they also affect the brain. The hippocampus and prefrontal cortex are particularly sensitive to cortisol. These are also sites that are affected by meditation (see http://contemplative-studies.org/wp/index.php/2015/08/01/this-is-your-brain-on-meditation/). In addition, it has been shown that meditation reduces the psychological and physiological responses to stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/). So, it is possible that meditation has its effects on stress responses in part by altering the brain structures that respond to stress hormones, that it changes the brains response to stress hormones.

 

In today’s Research News article “Can the neural–cortisol association be moderated by experience-induced changes in awareness?”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1151081218249136/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4649618/

Lau and colleagues separated meditation naïve adults into two groups, an awareness-based compassion meditation (ABCM) group and a relaxation group. The groups practiced for six weeks for comparable amounts of time. Following practice, they found that the meditation produced a significant increase in mindfulness while the relaxation actually reduced mindfulness. These changes in mindfulness were significantly related to cortisol levels with high mindfulness associated with low cortisol. In addition, they found that both increases in mindfulness and decreases in plasma cortisol levels were associated with increases in the synchronization of spontaneous brain activities of the Hippocampus. In other words, mindfulness moderates the ability of cortisol to affect the hippocampus. Hence, meditation increased mindfulness that in turn decreased both blood levels of the stress hormone cortisol and the ability of cortisol to affect brain function.

 

These results demonstrate that mindfulness affects the stress response, with higher mindfulness associated with lower levels of stress hormones. But, they also demonstrate another effect of mindfulness on the stress system. High mindfulness was associated with a greater effect of cortisol on the activity of the hippocampus. These results then demonstrate that mindfulness has a direct effect of reducing stress hormone levels and also indirect effects by affecting the influence of the stress hormones on the brain. This is a clear case of mind-body interaction.

 

The findings of Lau and colleagues demonstrate two physiological mechanisms through which mindfulness practice has powerful effects on reducing psychological and physiological responses to stress. These results further support the use of mindfulness practice to improve stress responding and thereby improve health and well-being. These effects of mindfulness on stress may be a major reason why mindfulness training is so beneficial to a wide array of health conditions.

 

So, improve your stress responses with mindful awareness.

 

“Cortisol could be described as “Miss Misunderstood” of hormones. Elevated levels of cortisol is not always bad. Low levels of cortisol is not bad either. Cortisol is there for a reason. The body uses cortisol to deal with stress and pain and it fluctuates according to the body’s demand. The problem arises when the stress is not dealt with for an extended period of time and as a result the body’s stress adaption mechanism breaks down and cortisol levels go crazy. In order to prevent such a fate, stress reduction could definitely offer significant help.” – YawnCentral

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Observe Mindfully and be Less Stressed

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“I wanted to share the experience of how yoga and meditation have transformed my life, how they have enabled me to observe who I am, first in my body, and then emotionally, and on to a kind of spiritual path.” – Mariel Hemingway

 

Stress is universal. We are constantly under some form of stress. In fact, if we don’t have enough stress, we seek out more. There appears to be an optimum level of stress for which we strive. If our stress level is too low, we feel bored and do things to increase it, such as riding a roller coaster, going out to an action movie, thrill seeking, engaging socially etc. On the other hand, if your stress level is too high, we feel tense and do things to decrease it, such as resting, taking depressant drugs like alcohol, withdrawing from social interactions, taking vacations etc.

 

Stress actually can strengthen us. Muscles don’t grow and strengthen unless they are moderately stressed in exercise. Moderate mental stress can actually increase the size and connectivity of brain areas devoted to the activity. Moderate social stress can help us become more adept in social interactions. Moderate work stress can help us be more productive and improve as an employee, etc. So, stress can be a good thing promoting growth and flourishing. The key word here is moderate or what we called the optimum level of stress. Too little or too much stress can be damaging.

 

Unfortunately for many of us living in a competitive modern environment stress is all too often higher than desirable. In addition, many of the normal mechanisms for dealing with stress have been eliminated. The business of modern life removes opportunities for rest, working extra hours, and limiting or passing up entirely vacations to stay competitive. Persistently high levels of stress are damaging and can directly produce disease or debilitation increasing susceptibility to other diseases. Chronic stress can produce a condition called distress which can lead to headaches, upset stomach, elevated blood pressure, chest pain, and problems sleeping and can make other diseases worse.

 

Stress is epidemic worldwide, but particularly in the United States. It has been found that over two thirds of Americans experienced symptoms of stress such as fatigue, irritability or anger, or changes in sleeping habits. Forty-three percent of all adults suffer adverse health effects from stress and 75% to 90% of all doctor’s office visits are for stress-related ailments and complaints.

 

It is beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the individual’s responses to stress and thereby reduce the conversion of stress to distress, reducing the damaging effects of chronic stress. Contemplative practices have been shown to reduce the psychological and physiological responses to stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/). Because of their ability to relieve stress, mindfulness trainings are increasingly being practiced by individuals and are even being encouraged in some workplaces.

 

Exactly what aspects of mindfulness are effective for stress are not known. There have been identified five facets of mindfulness; observing, describing, non-judging of inner experience, non-reactivity to inner experience, and acting with awareness. In today’s Research News article “The “Observing” Facet of Mindfulness Moderates Stress/Symptom Relations Only Among Meditators.”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1147269655296959/?type=3&theater

Neale-Lorello and colleagues investigate the relationship of these five facets of mindfulness with perceived levels of stress and physical symptoms of distress. They further separated their participants into experienced meditators and non-meditators. They found that meditators were higher in mindfulness, lower in perceived stress and had fewer physical symptoms than non-meditators demonstrating the efficacy of meditation for stress relief.

 

They further found marked differences between the groups in the relationships of the facets of mindfulness with stress and physical symptoms. In the non-meditators all of the facet except observing were negatively associated with both perceived stress and physical symptoms while for meditators none of the facets were associated with perceived stress while only non-judging and acting with awareness were negatively associated with physical symptoms. To some extent the lack of significant findings for the meditators may be the result of the fact that the meditators were already low in perceived stress and physical symptoms.

 

In a more complex analysis they found, not surprisingly, that life stress was positively associated with physical symptoms. But, this was not true for the meditators who were also high in the observing facet of mindfulness. “This result implies that mindfulness meditation training may allow people who attend closely to their experience to separate out the objective contents of what is observed from their cognitive and/or emotional reactions to them. Such a parsing would free up resources that might otherwise be expended on negative emotional responses … leaving the more mindful individual better able to deploy effective actions in response to stressors.” (Neale-Lorello).

 

These findings indicate that meditation increases mindfulness reducing the impact of stress on distress; physical symptoms. It does so, in part by increasing the observation of experience which appears to buffer the meditator from the negative physical effects of stress. So, meditation increases mindfulness, reduces perceived stress and physical symptoms and buffers the individual from the ability of stress to produce distress.

 

So, observe mindfully and be less stressed.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“You begin by letting thoughts flow and watching them. The very observation slows down the mind till it stops altogether. Once the mind is quiet, keep it quiet. Don’t get bored with peace, be in it, go deeper into it.” – Nisargadatta Maharaj

 

Distress Produces Less Stress with Mindfulness

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“If you want to conquer the anxiety of life, live in the moment, live in the breath.” ― Amit Ray

 

Psychological distress is related to an increase in physiological stress responses. That is, when the individual is anxious, ruminating, or having negative emotions, the physiology including the hormonal system reacts. The increased activity can be measured in heightened stress hormones in the blood and increased heart rate, blood pressure etc. These physiological stress responses on the short-term are adaptive and help to fight off infection, toxins, injury, etc. But when these stress responses are long lasting (chronic) they can themselves be a source of disease.

 

Chronic stress can produce a myriad of physical problems including mental health problems, such as depression, anxiety, and personality disorders; cardiovascular disease, including heart disease, high blood pressure, abnormal heart rhythms, heart attacks, and stroke; obesity and other eating disorders; menstrual problems; sexual dysfunction, such as impotence and premature ejaculation in men and loss of sexual desire in both men and women; skin and hair problems, such as acne, psoriasis, and eczema, and permanent hair loss; and gastrointestinal problems, such as gastroesophageal reflux disease (GERD), gastritis, ulcerative colitis, and irritable colon. Needless to say, chronic stress can be very harmful.

 

Unfortunately, psychological distress is often persistent and chronic and resulting in chronic stress which in turn can produce disease. Many of the symptoms of psychological distress have been shown to be related to a lack of mindfulness. Anxiety is often rooted in a persistent dread of future negative events while rumination is rooted in the past, with persistent replaying of negative past events. Since mindfulness is firmly rooted in the present it is antagonistic toward anything rooted in the past or future. Hence, high levels of mindfulness cannot coexist with anxiety and rumination. This has been repeatedly demonstrated (see http://contemplative-studies.org/wp/index.php/category/research-news/anxiety/ and http://contemplative-studies.org/wp/index.php/category/research-news/worry/). In addition, high mindfulness has been shown to be related to high levels of emotion regulation and positive emotions (see http://contemplative-studies.org/wp/index.php/category/research-news/emotions/). So, mindfulness would appear to be an antidote to psychological distress.

 

In today’s Research News article “It’s Not What You Think, It’s How You Relate to It: Dispositional Mindfulness Moderates the Relationship Between Psychological Distress and the Cortisol Awakening Response”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1141553695868555/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4503930/

Daubenmier and colleagues investigated whether mindfulness could blunt the stress hormone response to psychological distress. They measured the cortisol awakening response. Cortisol is a stress hormone whose levels are very low during sleep. Upon awakening they increase. How much they increase is related to the level of chronic stress the individual is under. So, the increase in cortisol shortly after awakening is a good measure of the individual’s level of chronic physiological stress.

 

They found that, as expected, that the magnitude of the cortisol awakening response was positively related to the individuals’ levels of psychological distress. But, high levels of mindfulness were related to a smaller cortisol awakening responses to psychological distress. In particular, two facets of mindfulness, the ability to describe and the ability to accept thoughts and emotions were negatively related to the cortisol awakening response. This suggests that the ability to consciously label or accept negative thoughts and emotions may buffer their impact on stress hormone activation. In other words, if thoughts and emotions are experienced with mindful awareness they have a less stressful impact.

 

Mindfulness by focusing the individual’s awareness on the present moment, improving their ability to experience, label, and accept their responses to stress, while interfering with rumination rooted in the past and anxiety rooted in the future, provides a greater tolerance for psychological stress. This would predict that mindful individuals would have less illness as a result of psychological stress. Future research will be needed to verify this prediction.

 

So, be mindful and be less stressed by psychological distress.

 

“All the suffering, stress, and addiction comes from not realizing you already are what you are looking for.” – Jon Kabat-Zinn
CMCS – Center for Mindfulness and Contemplative Studies