Well-being

Improve Diabetes Psychological Well-Being with Mindfulness

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“I am a type-2 diabetic, and they took me off medication simply because I ate right and exercised. Diabetes is not like a cancer, where you go in for chemo and radiation. You can change a lot through a basic changing of habits.” – Sherri Shepherd

 

It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Depression affects people with diabetes more often than people without it — up to 15 percent compared with 6.7 percent in the general population. When depression occurs along with a chronic illness like diabetes, the symptoms tend to be more severe. Compounding the problem further, the symptoms can become worse as depression can lead to missing medication doses, overeating, or skipping exercise. This may mean poorer blood glucose control, which, in turn, means more long-term health complications.

 

So, in treating diabetes it is important to treat not only the physical problem but also the psychological problems such as depression. Mindfulness training, especially Mindfulness-Based Cognitive Therapy Mindfulness-Based Cognitive Therapy (MBCT) has been demonstrated to be effective in treating depression (see http://contemplative-studies.org/wp/index.php/2015/08/15/spiraling-up-with-mindfulness/ and http://contemplative-studies.org/wp/index.php/2015/07/17/dealing-with-major-depression-when-drugs-fail/).

 

In today’s Research News article “Individual Mindfulness-Based Cognitive Therapy for People with Diabetes: a Pilot Randomized Controlled Trial”

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Schroevers and colleagues examined whether an individualized version of MBCT might be effective for depression in people with diabetes. In comparison to diabetic patients on a waiting list, MBCT resulted in clinically significant reductions in depressive symptoms and diabetes related psychological distress and increases in the levels of acting with awareness and attention regulation. These improvements were still present three months after completing the program.

 

These are impressive results and suggest that MBCT is an effective treatment for the psychological issues that frequently accompany diabetes. MBCT may be effective due to its emphasis on the present moment in mindfulness. Depression is often rooted in the past and the individual ruminates about the misery of the past. By shifting focus to the present moment, mindfulness can move the individual from being preoccupied with a troubling past to being focused  on addressing the manageable problems in the present. Indeed, Schroevers and colleagues demonstrated that MBCT produces an increase in acting with awareness. The individual then is more aware of what they’re doing. For the depressed diabetic individual this can help in the recognition of how he/she is acting in response to the depression or the diabetes. This allows them to reprogram their responses to be more appropriate to the circumstances of the present rather than responding to the depression itself.

 

Mindfulness also stresses non-judgmental awareness of the present. There is a decreased tendency to be constantly judging what is happening and instead just accept it as what is. This reduces worrying. Indeed, mindfulness practice has been shown to reduce worry (see http://contemplative-studies.org/wp/index.php/2015/07/17/stop-worrying/). Since worry involves concerns about future occurrences to some extent based upon past experiences, the more one can focus on the present the less opportunity there is for worries to arise. Mindfulness training also trains the individual to accept the worry, experience it, and then move on. This reduces the impact of the worry and prevents the development of worrying about worrying.

 

Another possibility is mindfulness’ ability to increase emotion regulation. That is mindfulness assists the individual in recognizing emotions as they arise and not over respond to them. It doesn’t prevent emotions. It simply allows the individual to better deal with them when they do arise. So when depression occurs the individual can recognize it, accept it, and then let it go and not respond to it. This liberates the individual to find new ways of responding to the environment and other people.

 

So, be mindful and improve psychological well-being with diabetes.

 

“Life is not over because you have diabetes. Make the most of what you have, be grateful.” – Dale Evans

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Improve Well-Being and Performance at Work with Mindfulness

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“In light of the mind’s tendency to wander, we view mindfulness (in the workplace and elsewhere) as a remarkable feat: situating the mind in present moment time despite psychological pressures to the contrary. In performing this mental feat in a dynamic work environment, individuals attend to a number of stimuli and events and, as a result, perform effectively.” – Erik Dane

 

We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our overall well-being, including our psychological and physical health. Indeed the work environment has even become an important part of our social lives, with friendships and leisure time activities often attached to the work environment. But, more than half of employees in the U.S. are unhappy at work and worldwide nearly 2/3 of workers are unhappy.

 

Workers indicate that interest in their work is the number one thing that makes them happy with work and the people with whom they work is the second. One way to accentuate interest in work is through mindfulness. Indeed, it has been demonstrated that meditation practice is associated with improved job performance, job satisfaction, and work engagement (see http://contemplative-studies.org/wp/index.php/2015/07/17/work-smarter-with-meditation/). In addition, mindfulness has been shown to improve workplace mental health (see http://contemplative-studies.org/wp/index.php/2015/11/04/healing-in-the-workplace-with-mindfulness/). Hence, further exploration of the relationship of mindfulness to work satisfaction is warranted.

 

In today’s Research News article “Mindfulness at Work: Antecedents and Consequences of Employee Awareness and Absent-mindedness”

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Reb and colleagues surveyed 231 workers and their supervisors in Singapore measuring their levels of mindfulness and work satisfaction and performance. They found that the more mindfully aware the employee was the higher the employees well-being, including higher levels of job satisfaction, need satisfaction, task performance, and work above expectations, and the lower the levels of emotional exhaustion and performance deviance.

 

These are interesting and potentially important findings that mindful awareness is significantly positively associated with greater employee well-being and superior job performance. Mindful workers not only feel better, they also perform better. It should be kept in mind that this study looked at existing levels of mindfulness and existing levels of well-being and performance and consequently does not demonstrate which is cause and which is effect or whether some other factor is responsible for the relationship. A study is needed where the effects of active mindfulness training on well-being and performance are assessed in the workplace.

 

Since mindfulness is known to be associated with improvements in attention and present moment awareness it would appear obvious that this would produce better job performance. In addition, mindfulness is known to reduce the psychological and physiological responses to stress. This would help in dealing with the difficulties encountered in everyday work. Finally, mindfulness has been shown to improve emotion regulation. This would allow a worker to clearly feel their emotional reactions to situations at work and to be able to appropriately and constructively respond to the emotions.

 

So, improve well-being and productivity at work with mindfulness.

 

“Toxic emotions disrupt the workplace, and mindfulness increases your awareness of these destructive patterns, helping you recognize them before they run rampant. It’s a way of reprogramming your mind to think in healthier, less stressful, ways.” – Drew Hansen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

ACT for Depression in Childhood Diabetes

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“Self-acceptance means you refuse to buy into your judgments your mind makes about you, whether they’re good judgments or bad ones. Instead of judging yourself, you recognize your strengths and your weaknesses, and you do what you can to be the person you want to be.” – Russ Harris

 

There is an image, a societal meme, of childhood being a time of great happiness, fancifulness, freedom, creativity, and play. But, the reality is frequently starkly different. It has been estimated that 2% to 4% of children are depressed. This is particularly true with children under intense stress from childhood illness, particularly chronic illness. Indeed, 2.4% of children suffer from childhood diabetes. The day to day struggle with diabetes and the feelings that they are burdens on the family frequently produces depression in these children.

 

Acceptance and Commitment Therapy (ACT) has been shown to be effective for depression in adults (see http://contemplative-studies.org/wp/index.php/2015/09/17/act-for-depression/). ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, ACT helps people strengthen aspects of cognition such as in committing to living according to their values. It is not known, however, if ACT is effective for depression in diabetic children

 

In today’s Research News article “Effectiveness of Acceptance and Commitment Therapy for Depression, Psychological Well-Being and Feeling of Guilt in 7 – 15 Years Old Diabetic Children”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1111453218878603/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575800/

Moghanloo and colleagues provided ACT modified for children and adolescents in ten weekly sessions to a randomly assigned group of 7-15 year old diabetic children. The change from before to after was compared to a no intervention control group of children. They found that the children treated with ACT reported lower depression and feelings of guilt and had improved psychological well-being. The effects sizes were large and clinically meaningful. Hence, ACT appeared to be effective in children as it’s been shown to be in adults.

 

It should be noted that there was no follow-up to determine if the effects persisted after the end of active therapy. Also, since the control group did not receive psychological treatment of any kind, it is impossible to determine if ACT is particularly effective or any form of therapy would have worked as well.

 

Like most mindfulness techniques ACT is targeted to improving awareness and acceptance of experiences in the present moment. These include emotions. This may be particularly important in children. By making the children more aware of how they’re feeling and why, they may become better able to deal with and accept these sometimes overpowering emotions. In addition, ACT supplies tools to look at their own thoughts about their disease and psychological state and recognize, accept, and form a different relationship with them. This allows the individual to be more psychologically flexible and mindful. In this way ACT can assist the children in coping with not only their emotions but also their disease and thoughts about it in a more accepting and productive fashion.

 

So, ACT for depression in childhood diabetes.

 

“We have not passed that subtle line between childhood and adulthood until… we have stopped saying “It got lost,” and say “I lost it.” – Sydney J Harris

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“Physician, Heal Thyself” with Mindfulness

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“As physicians we owe our patients two things– only two things– our time and our skill. We do not owe our patients our lives. To excessively devote our lives to the practice of medicine while we neglect other aspects of living may be tantamount to never having lived at all.” – Joseph D. Wassersug, M.D.

 

Primary healthcare provides are a critical component of any healthcare system. Yet there is a shortage of primary care providers. 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, primary healthcare providers experience high stress and burnout. They experience a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment.

 

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 primary healthcare providers, it is imperative that strategies be identified to decrease stress and burnout.

 

Mindfulness is a possible help in reducing perceived stress and burnout. Indeed, high mindfulness has been shown to be associated with less stress and burnout in emergency medicine personnel (see http://contemplative-studies.org/wp/index.php/2015/08/10/burnout-burnout-with-mindfulness/). This is promising and suggests theat there is a need for continued research into the relationship of mindfulness and stress in primary healthcare providers.

In today’s Research News article “Mindfulness, perceived stress, and subjective well-being: a correlational study in primary care health professionals”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1106301519393773/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557919/

Atanes and colleagues performed a survey of 450 primary healthcare provider in Brazil, including family physicians, registered nurses, nursing assistants, and community health workers. They measured mindfulness, perceived stress and subjective well-being and found that these groups reported high levels of perceived stress. Importantly, they found that high levels of mindfulness were associated with low levels of perceived stress and high levels of subjective well-being.

 

These results suggest that mindfulness is to some extent and antidote to high stress and burnout in primary healthcare providers. There are a number of benefits to mindfulness 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/2015/07/17/destress-with-mindfulness/). Mindfulness has also been shown to increase emotion regulation which prepares the individual to experience and respond to emotional situations appropriately and thereby reduces stress (see http://contemplative-studies.org/wp/index.php/2015/07/17/be-smart-about-emotions/). Finally, mindfulness is associated with higher levels of focus on the present moment. This tends to reduce catastrophizing, worry, and anxiety (see http://contemplative-studies.org/wp/index.php/2015/07/17/stop-worrying/) and thereby can reduce psychological stress in primary healthcare providers.

 

These results are potentially important and strongly suggest that the employment of mindfulness training might help primary healthcare providers deal with the stresses of their work environments. This need to be studied with controlled trials. Additionally, the results may have more far reaching applicability than just to the healthcare field. Mindfulness may help with all kinds of stresses in all kinds of situations. Obviously more research is needed in this promising area.

 

So, practice mindfulness and heal thyself from stress and burnout.

 

“Stress, burnout and strain on the human heart are all increasingly taking their toll for millions of hardworking people. However, even someone who is working in a job that simply ‘pays the bills’ can turn mundane and stressful tasks into pleasant activities with a slight adjustment in attitude and by adopting a daily mindful practice.” ― Christopher Dines
CMCS – Center for Mindfulness and Contemplative Studies

 

Yoga and Meditation Improves Well-Being in Prisoners

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“We consistently teach a practice to provide prisoners with a skill to become more sensitive to how they feel in their bodies. When you develop a close relationship with your own sensitivity, you are less apt to violate another. This is empathy. And empathy, when encouraged, leads to compassion. Gradually, the cycle of violence is interrupted.”  ~ James Fox

 

Prison is a very stressful and difficult environment for most prisoners. This is compounded by the fact that most do not have well developed coping skills. In addition, many have suffered from trauma, often experienced early in life such as abandonment, hunger, homelessness, domestic violence, sexual abuse, bullying, discrimination, drug and alcohol abuse, and witnessing crime – including murder. In addition, prisoners frequently suffer from attention deficit disorder. So, prisoners are often ill equipped to engage positively in society either inside or outside of prison.

 

Yet prison provides a great deal of time for reflection and self-exploration. This is an opportunity for growth and development. So, contemplative practices are well suited to this environment.

Yoga and meditation teach skills that may be very important for prisoners. In particular, they put the practitioner in touch with their own bodies and feelings. They improve present moment awareness and help to overcome rumination about the past and negative thinking about the future. They’ve been shown to be useful in the treatment of the effects of trauma and attention deficit disorder. They also relieve stress and improve overall health and well-being. Finally, these practices have been shown to be useful in treating depression, anxiety, and anger.

 

So, yoga and meditation would appear to be ideally suited to addressing the issues of prisoners. Over the last several years there have been a number of yoga and meditation programs implemented in prisons. In today’s Research News article “A Systematic Review and Meta-Analysis of Yoga and Mindfulness Meditation in Prison: Effects on Psychological Well-Being and Behavioural Functioning”

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Auty and colleagues summarize the research literature that has studied the effectiveness of these programs. They found that the research suggested that these programs are effective in a wide range of locations, from the UK and US to India and Taiwan, with a wide variety of ethnicities and ages, and with both males and females.

 

They found that the yoga and/or meditation programs almost universally produced improvements in psychological well-being in the prisoners. The magnitudes of the effects were significant and moderate, suggesting that these practices produce meaningful psychological changes. They also found that the longer term programs produced greater change than the shorter, more intense programs.

 

In addition to the psychological effects the yoga and/or meditation programs the research reports significant improvements in behavioral functioning. Overall, the magnitudes of the effects were significant and smaller than those found for psychological well-being. But, nevertheless the results suggest that these practices produce meaningful behavioral changes. These effects were particularly large for prisoners who had substance abuse problems.

 

This literature summary suggests that yoga and meditation programs are quite effective in prisons, improving the psychological health and well-being of the prisoners and improving their behavior while in prison. There are some suggestions in the literature that these programs decrease recidivism. It is to the benefit of society to assist the prisoners while incarcerated to improve their skills for dealing with themselves and others, as this would make them easier to deal with in prison and make it more likely that they would successfully transition back into society upon release.

 

So, yoga and meditation programs should be employed broadly in prisons for the benefit both of the prisoners and of society.

 

“With the barrage of negativity in prisons, they are unyielding breeding grounds for intense suffering, chaos, noise, overcrowding, violence, ineffective medical care and poor food. But occasionally, every so often, friendship, kindness, compassion and programs of meaningful substance come along. The Yoga program is a life-sustaining and meaningful one that I nurture and value because it is not only positive, it supports my growth and success as a young man. Yoga helps me navigate my life as a good and successful person. This practice is life-changing and will continue to enhance my life.” K.L.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Mindfully Improve Psychological Wellbeing

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Meditation, focusing, and CBT all have been shown to be effective treatments for a number of psychological problems. In previous research Sugiura and colleagues identified five factors in common to meditation, focusing, and Cognitive Behavioral Therapy (CBT), refraining from catastrophic thinking, self-observation, logical objectivity, detached coping, and acceptance. This raises the questions as to whether these common factors may be responsible for the common clinical outcomes, and which of these common factors is most important for each of a variety of disorders.

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

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

Sugiura and colleagues pursue these questions with a sample of undergraduate students.

They found that the greater the detached coping the lower the levels of obsessive-compulsive (OCD) symptoms. Detached coping emphasizes detachment and distancing from external conditions. This is exactly what mindfulness training is supposed to do, to allow us to see things objectively as they are. This suggests that mindfulness training is effective against obsessive-compulsive symptoms through its development of the skill of detached coping. Similarly, it was found that the greater the detached coping the lower the levels of depressive symptoms. This suggests that mindfulness training is effective against depression by allowing the individual to look at their situation more objectively, with detachment, and as a result not respond to it as something to feel bad about.

Worrying is also effectively reduced by mindfulness. The mechanism appears to be more complicated than that for OCD or depressive symptoms. It was found that the greater the level of refraining from catastrophic thinking the lower the levels of worrying, while the greater the level of self-observation the stronger the levels of worrying. Refraining from catastrophic thinking reflects the skills necessary to detach from and to suspend negative thinking, which frequently involves a fear of a future negative outcome, a worry. Mindfulness, by focusing on the present rather than the future interferes with worrying about the future and thus can be an effective antidote to worry.

Finally, Self-observation constitutes engagement in self-focus with curiosity and openness. Surprisingly it was associated with increased worrying. It appears that self-observation activates negatives beliefs about worrying. This suggests that it produces a worrying about worrying that increases worry.

So, it appears that the factors in common to meditation, focusing, and CBT of refraining from catastrophic thinking, self-observation, and detached coping are also associated with the symptoms common to psychological problems. But, that different factors are involved with different issues. This suggests that the three treatments may be effective by invoking common intermediaries for various disorders.

So, practice mindfulness and improve your psychological wellbeing.

CMCS

Spirituality Improves End of Life

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Death in inevitable, but that does not mean that it has to be awful. We don’t know how or when we will die, but we will die. It could be sudden or gradual or prolonged. We don’t know which it will be. But, regardless, how we approach it makes a huge difference.

Suzuki Roshi at the end of his life was in excruciating pain from cancer yet he told everyone around him “Don’t worry, It’s just Buddha suffering”. He passed with a smile on his face. Augustus Montague Toplady, the preacher author of the hymn “Rock of Ages” dying from tuberculosis said “”Oh, what delights! Who can fathom the joy of the third heaven? The sky is clear, there is no cloud; come Lord Jesus, come quickly!” These stories exemplify how our religiousness and spirituality can influence the quality of our passing.

In today’s Research News article “Religion, Senescence, and Mental Health: The End of Life Is Not the End of Hope”

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357420/

Van Ness & Larson showed that individuals with high levels of religiousness/spirituality had significantly higher levels of well-being and were less likely to be depressed or suicidal at the end of life.

Americans 65+ portray themselves as more religious than do their younger counterparts. Hence it would appear that people understand that religiousness/spirituality can help in confronting end of life. But, how exactly does religiousness/spirituality help when dealing with eminent death?

Religiousness/spirituality can function by providing hope that helps the individual overcome increasing disease, disability, and emotional difficulties. Indeed, it has been shown that people high in religiousness/spirituality are significantly lower in hopelessness. This hope may take the form of belief in a life after death, reincarnation, or rebirth. Such a hope may be interpretable as a symbol of personal integrity that survives the indignities of illness, disability, and dissolution. This can be a great comfort to the dying person improving well-being and decreasing depression.

Religiousness/spirituality in older individuals is associated with a higher sense of well-being. This in turn can help the individual cope with the afflictions and challenges they face as death approaches. It can also help to bring families and communities to the dying process. It is often these connections that are the most important to the dying.

When approaching death, religiousness/spirituality can provide the structure to grapple with the basic questions of existence. Without it the person may experience spiritual distress. “When our bodies are under assault from disease or illness and our minds are reeling from the threat of disability or death, our spirit is there to hold it all together.” (Rev. Dr. Walter J. Smith).

So, practice religiousness/spirituality to be better prepared for death.

CMCS