Well-being

Mindfulness Improves Health in Primary Care

psyjdc Leave a comment

By John M. de Castro, Ph.D.

 

“people who have battled with health problems for years find relief through accepting and working with their condition in a new way, dropping the desperate struggle to make things different from how they are. Mindfulness training makes it possible for a different kind of healing to take place, creating an open space of awareness from which people can start choosing to live well, as best they can, even with a serious illness.” – Goguen-Hughes

 

Mindfulness training has taken its place in healthcare as a primary treatment or in combination with more traditional treatments for a wide variety of health issues. Most of the studies of these medical applications of mindfulness recruit patients who have been diagnosed with specific disorders. But, primary care physicians see patients with a mix of complaints that they treat and don’t require referral to a specialist. This raises the question of generalizability. It mindfulness training helpful for the heterogeneous kind of patients seen by primary care practitioners?

 

In today’s Research News article “The Efficacy of Mindfulness-Based Interventions in Primary Care: A Meta-Analytic Review.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1256377754386148/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639383/

Demarzo and colleagues reviewed the published studies employing mindfulness training for patients recruited from primary care physicians. They found that the appropriate literature was sparse with only 6 randomized controlled trials reported. But the results were rather consistent. Mindfulness training groups compared to randomly assigned control groups had significantly improved general health, psychological health, and quality of life. These benefits of the training were maintained, albeit at generally lower levels, 6-months after the conclusion of training.

 

Hence, they found that the small number of published research studies available report that mindfulness training improves health and well-being in patients treated by primary care providers. It makes sense that since mindfulness training appears to be effective for the individual conditions that it would also be effective for a mixed group of patients with these disorders. But, the patients treated in primary care generally have milder disorders. It is reassuring that mindfulness training is effective over a range of illness intensities.

 

How can mindfulness training be affective over such a wide range of physical and psychological illnesses at a wide range of intensities? I am not aware of any other treatment that even comes close to this widespread applicability. It is not known exactly how mindfulness training affects all of these conditions, but certain effects of the training appear to be helpful with almost any condition. In particular, the ability of mindfulness training to reduce the psychological and physiological responses to stress would ameliorate the exacerbation of the disorders produced by stress. Mindfulness training also appears to strengthen the immune system and reduce the inflammatory response, which would be helpful in preventing or fighting off many illnesses. Finally, the ability of mindfulness training to focus the individual on the present moment and reduce thinking about the past and future would reduce, anxiety, worry, and rumination which contribute to many psychological problems.

 

Mindfulness training is not a panacea. But, it is ubiquitously applicable and helpful to most patients. So, improve the health of patients in primary care with mindfulness.

 

“In fact, the health effects of meditation can be even more dramatic — a matter of life and death. Williams points to a National Institutes of Health study that showed a 23 percent decrease in mortality, a 30 percent decrease in death due to cardiovascular problems and a big decrease in cancer mortality as well. “This effect is equivalent to discovering an entirely new class of drugs (but without the inevitable side effects).” – Mark Williams

 

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

 

Study Summary

Demarzo, M. M. P., Montero-Marin, J., Cuijpers, P., Zabaleta-del-Olmo, E., Mahtani, K. R., Vellinga, A., … García-Campayo, J. (2015). The Efficacy of Mindfulness-Based Interventions in Primary Care: A Meta-Analytic Review. Annals of Family Medicine, 13(6), 573–582. http://doi.org/10.1370/afm.1863

 

Abstract

PURPOSE: Positive effects have been reported after mindfulness-based interventions (MBIs) in diverse clinical and nonclinical populations. Primary care is a key health care setting for addressing common chronic conditions, and an effective MBI designed for this setting could benefit countless people worldwide. Meta-analyses of MBIs have become popular, but little is known about their efficacy in primary care. Our aim was to investigate the application and efficacy of MBIs that address primary care patients.

METHODS: We performed a meta-analytic review of randomized controlled trials addressing the effect of MBIs in adult patients recruited from primary care settings. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines were followed. Effect sizes were calculated with the Hedges g in random effects models.

RESULTS: The meta-analyses were based on 6 trials having a total of 553 patients. The overall effect size of MBI compared with a control condition for improving general health was moderate (g = 0.48; P = .002), with moderate heterogeneity (I2 = 59; P <.05). We found no indication of publication bias in the overall estimates. MBIs were efficacious for improving mental health (g = 0.56; P = .007), with a high heterogeneity (I2 = 78;P <.01), and for improving quality of life (g = 0.29; P = .002), with a low heterogeneity (I2 = 0; P >.05).

CONCLUSIONS: Although the number of randomized controlled trials applying MBIs in primary care is still limited, our results suggest that these interventions are promising for the mental health and quality of life of primary care patients. We discuss innovative approaches for implementing MBIs, such as complex intervention and stepped care.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639383/

 

Improve Well-Being with Menstrual Disorder with Yoga Nidra

psyjdc 1 Comment

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

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

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

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

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

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

 

Abstract

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

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

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

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

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

 

Improve Marital Satisfaction with Mindfulness

psyjdc Leave a comment

By John M. de Castro, Ph.D.

 

“We are vulnerable creatures, we humans. In the act of exposing our heart and hopes, we also expose our fears and fragility. But we need not be slaves to the past, or to the external love object, be it bear or spouse. We can deliberately develop a more secure sense of attachment, training our mind to become a place of security, safety, and warm fuzzy reassurance simply by paying attention to now, not then.” – Cheryl Fraser

 

Infertility, the inability to become pregnant, is primarily a medical condition and due to physiological problems, most frequently, hormonal inadequacy. The diagnosis of infertility involves documenting a failure to become pregnant despite having carefully timed, unprotected sex for at least one year. Sadly, infertility is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women 15-44, have an impaired ability to get pregnant or carry a baby to term and about 6% are infertile.

 

Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives. Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack. Men’s reactions are more complicated. If the reason for the infertility is due to an issue with the woman, then men aren’t as distressed as the women. But if they are the ones who are infertile, they experience the same levels of low self-esteem, stigma, and depression as infertile women do. In addition, infertility can markedly impact the couple’s relationship, straining their emotional connection and interactions and the prescribed treatments can take the spontaneity and joy from lovemaking making it strained and mechanical.

 

The stress of infertility and engaging in infertility treatments may exacerbate the problem. These issues conspire to stress the marital relationship and interfere with the emotional health of the individuals. In today’s Research News article “The Effectiveness of Mindfulness-Based Cognitive Group Therapy on Marital Satisfaction and General Health in Woman with Infertility.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1253726174651306/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803966/

Shargh and colleagues randomly assigned women diagnosed with infertility to a group receiving Mindfulness Based Cognitive Therapy (MBCT) or a control group. They measured the marital satisfaction and emotional health of the women prior to and after an 8-week MBCT program presented in a group format or care as usual. They found that the MBCT program produced a significant increase in marital satisfaction, including communications, conflict resolution and ideal deviation, and a significant increase in emotional health including lower bodily complaints, anxiety, depression and social malfunction.

 

These results are potentially important as infertility places intense stress on marital relationships. The results seem reasonable, though, given the documented effectiveness of mindfulness training to relieve stress, anxiety, and depression, and improve social function and romantic relationships. It is important, however, to demonstrate that mindfulness training is similarly effective with women with infertility issues. This can have other positive consequences as there are indications that the relief produced by mindfulness training may improve the likelihood of these women successfully conceiving. It is also encouraging that these results can be obtained when MBCT is delivered in a group format. This makes it more efficient and cost effective.

 

So, improve marital satisfaction in couples struggling with infertility with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“Each of us has a different set of sexual experiences and needs. When we feel disconnected from pleasure, simply bringing non-judgmental awareness to our bodies can help us clear away the baggage of cultural narratives. And in doing so, we can uncover our own unique sexual story and gain compassion for ourselves, wherever we are at in our sexual journey.” – Pam Costa

 

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

 

Study Summary

 

Shargh, N. A., Bakhshani, N. M., Mohebbi, M. D., Mahmudian, K., Ahovan, M., Mokhtari, M., & Gangali, A. (2016). The Effectiveness of Mindfulness-Based Cognitive Group Therapy on Marital Satisfaction and General Health in Woman with Infertility. Global Journal of Health Science, 8(3), 230–235. http://doi.org/10.5539/gjhs.v8n3p230

 

Abstract

Infertility affects around 80 million people around the world and it has been estimated that psychological problems in infertile couples is within the range of 25-60%. The purpose of this study was to determine the effectiveness of Mindfulness-based cognitive group therapy on consciousness regarding marital satisfaction and general health in woman with infertility. Recent work is a clinical trial with a pre/posttest plan for control group. Covering 60 women who were selected by in access method and arranged randomly in interference (30) and control (30) groups. Before and after implementation of independent variable, all subjects were measured in both groups using Enrich questionnaire and marital satisfaction questionnaire. Results of covariance analysis of posttest, after controlling the scores of pretest illustrated the meaningful difference of marital satisfaction and mental health scores in interference and control groups after treatment and the fact that MBCT treatment in infertile women revealed that this method has an appropriate contribution to improvement of marital satisfaction and mental health. Necessary trainings for infertile people through consultation services can improve their mental health and marital satisfaction and significantly help reducing infertile couples’ problems.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803966/

 

Improve Symptoms in Breast Cancer Survivors with Mindfulness

psyjdc 17 Comments

 

By John M. de Castro, Ph.D.

 

“The mindfulness elements of accepting things as they are, turning towards rather than away from difficult emotional experience, and embracing change as a constant are helpful antidotes to these difficult realities. The emotion-regulation strategies practiced in mindfulness-based interventions help to prevent worry about the future and rumination over past events, and allow people to live more fully in the present moment, regardless of what lies ahead. The inevitability of loss, change and eventual death are helpful to face in general, but are both more challenging and more powerful for people directly facing a life threat like cancer.” – Linda Carlson

 

About 12.5% of women in the U.S. develop invasive breast cancer over their lifetimes and every year about 40,000 women die. Indeed, more women in the U.S. die from breast cancer than from any other cancer, besides lung cancer. Breast cancer diagnosis, however, is not a death sentence. It is encouraging that the death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%.

 

The improved survival rates mean that more women are now living with cancer. Surviving cancer, however, carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day. In addition, breast cancer survivors can have to deal with the consequences of chemotherapy, and often experience increased fatigue, pain, and bone loss, reduced fertility, difficulty with weight maintenance, damage to the lymphatic system, heightened fear of reoccurrence, and an alteration of their body image. With the loss of a breast or breasts, scars, hair shedding, complexion changes and weight gain or loss many young women feel ashamed or afraid that others will reject or feel sorry for them. As a result, survivors often develop psychological symptoms of stress, anxiety, depression, and impaired cognitive functioning.

Psychologically, cancer survivors frequently suffer from anxiety, depression, mood disturbance, Post-Traumatic Stress Disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission.

 

Unfortunately, most of these residual problems often go untreated. So, safe and effective treatments for the residual symptoms in breast cancer survivors are needed. Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual psychological symptoms and improve cognitive function. Most of the research, however, has been performed with postmenopausal women. But, 25% of breast cancer survivors are younger and premenopausal. In today’s Research News article “Mindfulness meditation for younger breast cancer survivors: A randomized controlled trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1252924528064804/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393338/

Bower and colleagues examine the efficacy of mindfulness training for premenopausal breast cancer survivors. They recruited premenopausal breast cancer survivors who had completed primary treatment at least 3 months prior to participation and randomly assigned them to either receive a 6-week Mindful Awareness Practice program or to a wait-list control group. The participants were assessed with a battery of psychological tests. They also measured a set of genetic markers of inflammation. Assessments were performed before and 1-2 weeks after treatment and also 3 months later.

 

They found that mindfulness training produced significant improvements in the patients’ psychological state. In comparison to control participants, the mindfulness training group had significant decreases in perceived stress, depression, fatigue, subjective sleep disturbance, and hot flashes/night sweats, and significant increases in positive emotions, peace and meaning. For the most part the effects were not maintained at 3-month follow-up. In addition, the mindfulness training appeared to decrease inflammation as the mindfulness trained group showed a reduction in pro-inflammatory genetic markers and an increase in anti-inflammatory genetic markers.

 

These results are encouraging and suggest that the psychological well-being and inflammation can be improved with mindfulness training for premenopausal breast cancer survivors. Previous studies have demonstrated that mindfulness training with healthy individuals improves their psychological and emotional state and reduces inflammation. These results suggest that breast cancer survivors benefit as well. These improvements are particularly important for the breast cancer survivors as they are generally struggling with the psychological, emotions, and physical ramifications of their diagnosis and treatment. It is reassuring that mindfulness training can help.

 

Of concern is the fact that the psychological treatment effects were not maintained 3-months later. It is unclear if the women maintained their mindfulness practices following training as they were encouraged to do. It is possible that more encouragement and perhaps booster sessions may be needed to maintain the benefits.

 

Regardless, improve symptoms in breast cancer survivors with mindfulness.

 

“We already know that psychosocial interventions like mindfulness meditation will help you feel better mentally, but now for the first time we have evidence that they can also influence key aspects of your biology.”  – Dr. 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

 

Study Summary

Bower, J. E., Crosswell, A. D., Stanton, A. L., Crespi, C. M., Winston, D., Arevalo, J., … Ganz, P. A. (2015). Mindfulness meditation for younger breast cancer survivors: A randomized controlled trial. Cancer, 121(8), 1231–1240. http://doi.org/10.1002/cncr.29194

 

Abstract

Purpose: Premenopausal women diagnosed with breast cancer are at risk for psychological and behavioral disturbances after cancer treatment. Targeted interventions are needed to address the needs of this vulnerable group.

Methods: This randomized trial provided the first evaluation of a brief mindfulness-based intervention for younger breast cancer survivors designed to reduce stress, depression, and inflammatory activity. Women diagnosed with early-stage breast cancer before age 50 who had completed cancer treatment were randomly assigned to a 6-week Mindful Awareness Practices (MAPS) intervention (n = 39) or wait-list control (n = 32). Participants completed questionnaires at pre- and post-intervention to assess stress and depressive symptoms (primary outcomes) as well as physical symptoms, cancer-related distress, and positive outcomes. Blood samples were collected to examine genomic and circulating markers of inflammation. Participants also completed questionnaires at a three-month follow-up.

Results: In linear mixed models, the MAPS intervention led to significant reductions in perceived stress (P = .004) and marginal reductions in depressive symptoms (P = .094), as well as significant reductions in pro-inflammatory gene expression (P = .009) and inflammatory signaling (P = .001) at post-intervention. Improvements in secondary outcomes included reduced fatigue, sleep disturbance, and vasomotor symptoms and increased peace and meaning and positive affect (Ps < .05). Intervention effects on psychological and behavioral measures were not maintained at three-month follow-up, though reductions in cancer-related distress were observed at this assessment.

Conclusions: A brief mindfulness-based intervention showed preliminary short-term efficacy in reducing stress, behavioral symptoms, and pro-inflammatory signaling in younger breast cancer survivors.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393338/

 

Alleviate Work Related Stress with On-Line Mindfulness Training

psyjdc Leave a comment

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/

Improve Caregiver Quality of Life with Yoga

psyjdc Leave a comment

“Caring for someone with dementia is made up of an infinite number of small moments where we can go either way, adding more stress or bringing more ease. The problem when we are not mindful is our words come out and our actions unfold too quickly for us to have a chance to choose the wisest, most beneficial route. Mindfulness practice slows us down and takes some of the edge off our reactive tendencies.” – Marguerite Manteau-Rao

 

Caregiving for dementia patients is a daunting and all too frequent task. It is estimated that over 15 million Americans are dementia caregivers. It is an intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. In the last year, 59% of the caregivers report that they are effectively on duty 24/7. It is sad that 72% report relief when their loved one passes away.

 

This long and difficult process can take a major toll on the caregiver. On a practical level they frequently experience financial problems from lost income and have their careers interrupted. But, the greatest problems occur due to the intense levels of stress experienced by the caregivers. Around 2/3rd of caregivers report high emotional stress and over 1/3rd report high physical stress. This stress, in turn can have emotional consequences with over 1/3rd of caregivers reporting depression and many report family problems. In addition, dementia caregivers are more likely to have physical issues such as high levels of stress hormones, reduced immune function, increased hypertension, and coronary heart disease. Needless to say caregivers need care for themselves.

 

Reducing stress is very important for dementia caregivers. Stress not only jeopardizes their own health but also the quality of care they provide for their loved ones. Since mindfulness training has been shown to be effective in reducing both the psychological and physical responses to stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/), it would seem be potentially useful for the relief of caregiver stress. Indeed, mindfulness training has been shown to reduce stress and depression, improve the quality of caregiving, and improve the quality of life for the caregiver (see http://contemplative-studies.org/wp/index.php/category/research-news/caregiving/). Hence, it would seem reasonable to further explore mindfulness practices to care for the caregiver.

 

In today’s Research News article “Yoga and compassion meditation program improve quality of life and self-compassion in family caregivers of Alzheimer’s disease patients: A randomized controlled trial”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1170247206332537/?type=3&theater

Danucalov and colleagues applied an 8-week program of yoga and compassion meditation to a group of female Alzheimer’s caregivers and compared their response to those of a wait-list control group. At the end of yoga and compassion meditation training in comparison to before training and to the control group, the yoga group reported significant improvements in their quality of life including physical, psychological, environmental, and social domains. They showed increased mindfulness, improved vitality both immediately and in general, and increased self-compassion and self-kindness.

 

These findings are remarkable and potentially important. Yoga and compassion meditation training markedly improved the psychological and physical conditions for the caregivers producing a major improvement in quality of life. Training also increased their vitality which is critical given the intense fatigue that the caregiving can produce. How this practice might produce these benefits was not explored. But, the documented ability of yoga practice in reducing stress responses would seem a likely explanation. In addition, the compassion meditation may be a useful component as Loving Kindness Meditation has been shown to improve self-compassion and kindness toward others (see http://contemplative-studies.org/wp/index.php/category/contemplative-practice/loving-kindness/).

 

Regardless of the explanation, it appears clear that mindfulness training is effective in improving the physical and psychological problems experienced by dementia caregivers.

 

So, improve caregiver quality of life with yoga.

 

“Many of us follow the commandment ‘Love One Another.’ When it relates to caregiving, we must love one another with boundaries. We must acknowledge that we are included in the ‘Love One Another.” ― Peggi Speers

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Headaches are a Headache – Reduce them with Mindfulness 2

psyjdc Leave a comment

“To diminish the suffering of pain, we need to make a crucial distinction between the pain of pain, and the pain we create by our thoughts about the pain. Fear, anger, guilt, loneliness and helplessness are all mental and emotional responses that can intensify pain.” ~Howard Cutler

 

Headaches are the most common disorders of the nervous system. It has been estimated that 47% of the adult population have a headache at least once during the last year. The most common type of headache is the tension headache with 80 to 90 percent of the population suffering from tension headaches at least some time in their lives. The second most common type of headache is the migraine headache. Around 16 to 17 percent of the population complains of migraines. It is the 8th most disabling illness in the world with more than 90% of sufferers unable to work or function normally during their migraine. American employers lose more than $13 billion each year as a result of 113 million lost work days due to migraine.

 

There are a wide variety of drugs that are prescribed for chronic headache pain with varying success. Most tension headaches can be helped by taking pain relievers such as aspirin, naproxen, acetaminophen, or ibuprofen. A number of medications can help treat and prevent migraines and tension headaches, including ergotamine, blood pressure drugs such as propranolol, verapamil, antidepressants, antiseizure drugs, and muscle relaxants. Drugs, however, can have some problematic side effects particularly when used regularly and are ineffective for many sufferers. So, almost all practitioners consider lifestyle changes that help control stress and promote regular exercise to be an important part of headache treatment and prevention. Avoiding situations that trigger headaches is also vital.

 

A Mindfulness Based Stress Reduction (MBSR) program has been shown to be an effective treatment for tension headache (see http://contemplative-studies.org/wp/index.php/2015/09/07/headaches-are-a-headache-reduce-them-with-mindfulness/). Unfortunately, migraine sufferers were not included in the study. In today’s Research News article “The Effectiveness of Mindfulness-Based Stress Reduction on Perceived Pain Intensity and Quality of Life in Patients with Chronic Headache”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1144418128915445/?type=3&theater

Bakhshani and colleagues examine the effectiveness of an 8-week Mindfulness Based Stress Reduction (MBSR) program compared to a treatment as usual (primarily drugs) control group for chronic headaches including tension and migraine headaches. They found that in comparison to the control group which primarily controlled pain with drugs the MBSR group had a clinically significant reduction in pain intensity with a moderate effect size. They also found that MBSR produced a significant improvement in quality of life including role limitation due to physical health, bodily pain, general health, energy and vitality, emotional health and physical and mental health. These results indicate that MBSR is a clinically meaningful effective treatment for both tension and migraine headaches, not only reducing pain but also improving the patients’ quality of life. Importantly, MBSR effects were superior to drug treatment.

 

MBSR is structured to reduce stress and has been empirically shown to significantly reduce both the physiological and psychological responses to stress (see http://contemplative-studies.org/wp/index.php/2015/07/29/get-your-calm-on/). Since tension headaches are primarily produced by stress and migraine headaches are frequently triggered by stress, it would seem reasonable to conclude that the stress reduction contributed to the effectiveness of MBSR for chronic headaches. Mindfulness training, by focusing attention on the present moment has also been shown to reduce worry and catastrophizing (see http://contemplative-studies.org/wp/index.php/category/research-news/worry/ and http://contemplative-studies.org/wp/index.php/2015/08/07/pain-is-a-pain-relieve-it-with-meditation/). Pain is increased by worry about the pain and the expectation of greater pain in the future. So, reducing worry and catastrophizing should reduce headache pain. In addition, negative emotions are associated with the onset of headaches. Mindfulness has been shown to increae positive emotions and decrease negative ones (see http://contemplative-studies.org/wp/index.php/2015/08/15/spiraling-up-with-mindfulness/). Finally, mindfulness has been shown to change how pain is processed in the brain reducing the intensity of pain signals in the nervous system.

 

Regardless of the mechanism, it is clear that MBSR is a safe and effective treatment that is more effective than drugs for chronic headaches. So, reduce headache pain and improve quality of life with mindfulness.

 

“The way to live in the present is to remember that ‘This too shall pass.’ When you experience joy, remembering that ‘This too shall pass’ helps you savor the here and now. When you experience pain and sorrow, remembering that ‘This too shall pass’ reminds you that grief, like joy, is only temporary.” ~Joey Green

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Mind-body Practices Promote Health and Well-being by Changing Gene Expression

psyjdc 3 Comments

 

“We can’t any longer have the conventional understanding of genetics which everybody peddles because it is increasingly obvious that epigenetics – actually things which influence the genome’s function – are much more important than we realised.” – Robert Winston

 

There is an accumulating volume of research findings to demonstrate that Mind-body therapies have highly beneficial effects on the health and well-being of humans. These include meditation, yoga, tai chi, qigong, biofeedback, progressive muscle relaxation, guided imagery, hypnosis, and deep breathing exercises. Because of their proven benefits the application of these practices to relieving human suffering has skyrocketed.

 

It is clear that Mind-body therapies affect the physiology. In other words, the mind can alter the body. In turn, the genes can affect our minds. In fact, the genes have been shown to affect an individual’s inherent level of mindfulness (see http://contemplative-studies.org/wp/index.php/category/research-news/genetics/). These interactions are well documented. The mechanisms by which they occur, however, are not well understood. It has been shown that contemplative practices help create balance in the inflammatory response (see http://contemplative-studies.org/wp/index.php/category/research-news/inflammatory-response/) which is very beneficial for health. But, the mechanism through which contemplative practices affect the immune system is not known.

 

The genes dictate all of the chemical processes in our bodies including immune and inflammatory responses. So, it would seem reasonable to investigate whether alterations in gene expressions might be the intermediary between mind-body therapies and health. In today’s Research News article “Functional Genomics in the Study of Mind-Body Therapies”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1140382739318984/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295747/

Niles and colleagues review the literature on the effects of mind-body therapies on the functional expression of the genes. Out of the vast number of genomic pathways that can be affected, they found one which appears to be altered by mind-body therapies in general. This was a reduction in activity (downregulation) of the expression of genes that elicit the inflammatory response. In other words mindfulness practices reduce inflammation by reducing the activity of the genes that produce it.

 

This finding is extremely important as an overactive inflammatory system underlies many chronic diseases. Inflammation is a normal response of the body to outside threats like stress, infection, injury, and toxic chemicals. It is designed to protect the body and ward off these threats. It works quite well for short-term infections and injuries and as such is an important defense mechanism for the body. But when inflammation is protracted and becomes chronic, it can itself become a threat to health. Chronic inflammation can produce autoimmune diseases such as colitis, Chron’s disease, arthritis, heart disease, increased cancer risk, lung disease, sleep disruption, gum disease, decreased bone health, psoriasis, and depression. Needless to say chronic inflammation can create major health problems. Indeed, the presence of chronic inflammation is associated with reduced longevity. So, it is important for health to control the inflammatory response, allowing it to do its job in fighting off infection but then reducing its activity when no external threat is apparent. Mind-body therapies appear to do just that by reducing the expression of the genes that produce inflammation.

 

Niles and colleagues also found that a number of mind-body therapies increase the activity of telomerase, an enzyme that protects the genes from deterioration, particularly during aging. Hence, mind-body therapies appear to have anti-aging properties by increasing the activity of genes the reduce age related deterioration (see http://contemplative-studies.org/wp/index.php/2015/07/17/aging-healthily-yoga-and-cellular-aging/).

 

All of these results suggest that mind-body therapies promote health and well-being by altering gene expression. This is interesting and important. The next question is what are the mechanisms by which these practices affect gene expressions? It will be up to future research to investigate this link in the causal chain from mind-body therapies to the promotion of health and well-being.

 

So engage in mind-body practices, change gene expression and promote health and well-being.

 

“Our genes are quite dynamic in their expression and …. the calmness of our mind can actually have a potential influence on their expression.” – Richard Davidson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

 

 

Improve Physical Well-being with Bikram Yoga

psyjdc Leave a comment

Yoga Bikram Hewett2

“My system works, as long as people let me do my job my way. It is not just the sequence, it is how you do it: the timing, the mirrors, the temperature, the carpet. But if people only do it 99% right, it is 100% wrong. When someone tries to mess with it, the people won’t get the yoga benefits.” – Bikram Choudhury

 

Yoga practice has been shown to improve physical well-being (see http://contemplative-studies.org/wp/index.php/category/contemplative-practice/yoga-contemplative-practice/). But, there are a large number of different types of yoga practice including Ansura, Ashtanga, Bikram, Hatha, Hot Yoga, Iyengar, Jivamukti, Kripalu, Kundalini, Prenatal, Restorative, Viniypga, Vinyasa, and yin. One problem with the research on yoga effects is that different researchers use different types of yoga. So, it is difficult to compare results. In addition, the studies do not establish the relative effectiveness of each type of yoga.

 

Bikram Yoga is somewhat unique in that it employs a set sequence of 26 poses (asanas) and two breathing exercises. It is practiced in a heated environment (105°F, 40.6°C, 40% humidity) and there is a unique programmed instructional dialogue. The hot environment is thought to soften the muscles making them more pliable and loosen the joints making them more flexible allowing the practitioner to go deeper into poses. The sweating that occurs is thought to help remove toxins and impurities.

 

In today’s Research News article “The Effects of Bikram Yoga on Health: Critical Review and Clinical Trial Recommendations”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1137653292925262/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609431/

Hewett and colleagues review the published research on the effectiveness of Bikram Yoga on physical well-being. They report that in terms of physical fitness, Bikram Yoga increases lower body range of motion, balance, isometric dead-lift strength, isometric maximal voluntary contraction, total hip bone density, and balance compared to the control group. It appears to improve cardiovascular fitness, increasing carotid artery compliance and decreasing beta-stiffness, and HDL and total cholesterol. In overweight and obese practitioners Bikram Yoga improved a number of metabolic markers including blood lipids, insulin resistance, and glucose tolerance. Psychologically, this form of yoga appears to reduce perceived stress and increase mindfulness.

 

These are important findings suggesting that Bikram Yoga is effective in improving fitness, cardiovascular, health, and psychological well-being. The reviewed research studies were limited and did not investigate many other physical and mental parameters and did not investigate Bikram Yoga’s applicability to the treatment of diseases. Unfortunately, the research studies reviewed did not compare Bikram Yoga to other forms of yoga, so it is not known what if any of the reported benefits are specific to Bikram Yoga and which are in common with other practices. This review is an important first step in documenting the effects of Bikram Yoga which are shown to be widely beneficial. It is clear that much more research is warranted comparing the effects of the different forms of practice.

 

Regardless, the results are clear that you can improve well-being with Bikram Yoga.

 

“To sweat is to pray, to make an offering of your innermost self. Sweat is holy water, prayer beads, pearls of liquid that release your past. Sweat is an ancient and universal form of self healing, whether done in the gym, the sauna, or the sweat lodge … The more you sweat, the more you pray. The more you pray, the closer you come to ecstasy.”  – Gabrielle Roth
CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

 

Improve Mental and Physical Well-being with Yoga

psyjdc 1 Comment

 

Yoga cognition Nagendra2

“The breathing and meditative exercises aim at calming the mind and body and keeping distracting thoughts away while you focus on your body, posture or breath. Maybe these processes translate beyond yoga practice when you try to perform mental tasks or day-to-day activities.” – Neha Gothe

 

If we are lucky enough to navigate life’s dangers we are rewarded with the opportunity to experience aging! The aging process involves a progressive deterioration of the body including the brain. It actually begins in the late 20s and continues throughout the lifespan. It’s inevitable. We can’t stop it or reverse it. But, it is becoming more apparent that life-style changes can slow down and to some extent counteract the process and allow us to live longer and healthier lives. This is true for both physical and mental deterioration including degeneration and shrinkage of the nervous system. Aging healthily to a large extent involves strategies to slow down the deterioration.

 

Contemplative practices including yoga practice (See links below) have been shown to reduce the physical deterioration that occurs with aging (see http://contemplative-studies.org/wp/index.php/category/research-news/aging/). Yoga practice has many physical and mental benefits including protection of brain structures from degeneration with aging (see http://contemplative-studies.org/wp/index.php/2015/07/17/age-healthily-protect-the-brain-with-yoga/). These structural changes have been demonstrated by neuroimaging techniques with yoga practitioners. They document change in the size and connectivity of brain structures that result from yoga practice.

 

Yoga is a mind-body practice that involves both physical and mental exercises. This is accompanied by changes in the activity of virtually every component of the body including general physiology and the peripheral and central nervous systems. So, another potential method to investigate yoga’s effects on the nervous system is to measure the electrical signals emanating from the nervous system.

 

In today’s Research News article “Cognitive Behavior Evaluation Based on Physiological Parameters among Young Healthy Subjects with Yoga as Intervention”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1136173913073200/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339827/

Nagendra and colleagues trained naive adults in yoga practice for a period of five months for 1.5 hours per day and compared physiological measure to a no-treatment control group. They found that yoga practice produced an increase in parasympathetic (vegetative) and decrease in sympathetic (activation) activity in the peripheral nervous system including a decrease in heart rate and heart rate variability. This indicates a calming and relaxing effect of yoga on the physiology.

 

Nagendra and colleagues also found significant differences in EEG activity of the central nervous system. The changes were complex and varied. But they are indicators that yoga practice produces alterations of brain activity in ways that are indicative of improved vigilance, alertness, attention, concentration ,memory, visual information processing, sense of wellbeing, responsiveness, emotion process, cognition, and executive function and reduced stress and strain. In other words the changes in the brain activity indicated vast improvements in mental processing produced by yoga practice.

 

It should be noted that these are indirect measures and the researchers did not directly measure the psychological variables. So, although suggestive they are not conclusive. They are, however, similar to findings of yoga effects in other research with direct measures (see http://contemplative-studies.org/wp/index.php/category/contemplative-practice/yoga-contemplative-practice/). But, even with this caution, the results suggest that yoga practice has widespread beneficial effects on the mental and physical well-being of the individual.

 

So, practice yoga and improve mental and physical well-being.

 

“True yoga is not about the shape of your body, but the shape of your life. Yoga is not to be performed; yoga is to be lived. Yoga doesn’t care about what you have been; yoga cares about the person you are becoming. Yoga is designed for a vast and profound purpose, and for it to be truly called yoga, its essence must be embodied.” — Aadil Palkhivala

 

CMCS – Center for Mindfulness and Contemplative Studies

 

 

Yoga and aging links

Yoga reduces physical degeneration in the elderly http://contemplative-studies.org/wp/index.php/2015/07/17/age-healthily-yoga/

Yoga reduces cellular aging http://contemplative-studies.org/wp/index.php/2015/07/17/aging-healthily-yoga-and-cellular-aging/

Yoga practice improves the symptoms of arthritis in the elderly http://contemplative-studies.org/wp/index.php/2015/08/14/age-healthily-yoga-for-arthritis/