Improve Eating Regulation and Emotions in the Obese with Mindfulness

Improve Eating Regulation and Emotions in the Obese with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Researchers are learning that teaching obese individuals mindful eating skills—like paying closer attention to their bodies’ hunger cues and learning to savor their food—can help them change unhealthy eating patterns and lose weight. And, unlike other forms of treatment, mindfulness may get at the underlying causes of overeating—like craving, stress, and emotional eating—which make it so hard to defeat.” – Jill Suttie

 

Obesity has become an epidemic in the industrialized world. In the U.S. the incidence of obesity, has more than doubled over the last 35 years to currently around 35% of the population, while two thirds of the population are considered overweight or obese (Body Mass Index; BMI > 25). Although the incidence rates have appeared to stabilize, the fact that over a third of the population is considered obese is very troubling. This is because of the health consequences of obesity. Obesity has been found to shorten life expectancy by eight years and extreme obesity by 14 years. This occurs because obesity is associated with cardiovascular problems such as coronary heart disease and hypertension, stroke, metabolic syndrome, diabetes, cancer, arthritis, and others.

 

Obviously, there is a need for effective treatments to prevent or treat obesity. But, despite copious research and a myriad of dietary and exercise programs, there still is no safe and effective treatment. Mindfulness is known to be associated with lower risk for obesityalter eating behavior and improve health in obesity. Mindfulness training is also known to increase spirituality. This suggests that mindfulness training may be an effective treatment for overeating, overweight, and obesity. The relationship of spirituality to mindfulness and eating has not been previously explored.

 

In today’s Research News article “Mindful Eating: Connecting With the Wise Self, the Spiritual Self.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.01271/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_755938_69_Psycho_20180904_arts_A ), Kristeller and colleagues recruited obese adults (BMI>35) and randomly assigned them to either receive Mindfulness-Based Eating Awareness Training (MB-Eat) or to a wait-list control condition. Mindfulness-Based Eating Awareness Training (MB-Eat) was delivered in 12, 2-hour sessions, once a week for 10 weeks and 2 monthly booster sessions. The participants were trained in meditation, including general mindfulness meditation, guided eating meditations, and “mini-meditations” used at meal time and throughout the day. They also received instructions on recognizing inner experiences related to hunger and food intake and also on nutritional and healthy eating. Participants were measured before, during and immediately after training and also at 1, 2, and 4 months later for eating and weight related issues, emotional regulation, state mindfulness, depression, anxiety, and spiritual well-being.

 

They found that in comparison to baseline and the wait-list group, the participants who received Mindfulness-Based Eating Awareness Training (MB-Eat) had increased spiritual well-being particularly in the meaning/peace and faith factors that continued to grow all the way to the 2-month follow-up. They also found that the greater the increase in the meaning/peace and faith factors, the greater the decrease in depression, anxiety, and binge eating. Finally, they performed a mediation analysis that showed that increases in mindfulness were associated with decreases in both depression and binge eating directly and indirectly by being associated with increases in spiritual well-being meaning/peace which in turn was significantly related to decreases in both depression and binge eating.

 

These results suggest that obese individuals benefit from Mindfulness-Based Eating Awareness Training (MB-Eat) training by developing mindfulness which helps develop spiritual well-being and these factors both contribute to an improved emotional state and less disordered eating. It appears that the effect of mindfulness on the benefits is in part mediated by spiritual well-being. Mindfulness training has been shown previously to improve eating behavior and reduce depression. This study, however, is the first to indicate that the effectiveness of mindfulness is in part due to its effects on the individual’s spirituality.

 

So, improve eating regulation and emotions in the obese with mindfulness.

 

 

“Some of the simplest, safest lessons to help adolescents combat obesity may be raising their awareness of what they are eating and whether they are even hungry.” – Phil Jones

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Kristeller JL and Jordan KD (2018) Mindful Eating: Connecting With the Wise Self, the Spiritual Self. Front. Psychol. 9:1271. doi: 10.3389/fpsyg.2018.01271

 

In the Mindfulness-Based Eating Awareness Training program (MB-EAT) (Kristeller and Wolever, 2014Kristeller and Woleverin press), mindfulness practice is taught, mindful eating is cultivated, and self-acceptance and spiritual well-being are enhanced. An integrative concept is the value of cultivating ‘wisdom’ in regard to creating a new and sustainable relationship to eating and food. ‘Wisdom’ refers to drawing on personal experience and understanding in a flexible, insightful manner, rather than strictly following external rules and guidelines. Several clinical trials involving variations of MB-EAT have documented substantive improvement in how people relate to their eating, including individuals with both binge eating disorder (BED) and subclinical eating issues. Based on the traditional value of contemplative practices for cultivating spiritual engagement, and on evidence from related research showing that spiritual well-being increases in the Mindfulness-Based Stress Reduction (MBSR) program and is related to other effects, we hypothesized that the MB-EAT program would also engage this aspect of experience, as assessed by the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being subscale (FACIT-Sp), and that increases in spiritual well-being would relate to other measures of adjustment such as emotional balance and improvement in disordered eating. Participants (N = 117) with moderate to morbid obesity, including 25.6% with BED, were randomly assigned to MB-EAT or a wait-list control, and assessed on the FACIT-Sp and other measures at baseline, immediate post (IP), and 2-month followup (F/Up). Both FACIT-Sp factors [Meaning/Peace (M/P) and Faith] increased significantly in the MB-EAT group and were stable/decreased in the control group. Increases in these factors related to improvement in emotional adjustment and eating regulation at IP and at F/Up, and to increases in aspects of mindfulness measured by the Five Facet Mindfulness Questionnaire (FFMQ). Increases in M/P during treatment mediated effects of the FFMQ Observe factor on eating regulation and depression at IP. Results are discussed in terms of the role that mindfulness practice plays in cultivating ‘wise mind’ and the related value of spirituality. It is argued that the core elements of the MB-EAT program lead to meaningful spiritual engagement, which plays a role in people’s ability to improve and maintain overall self-regulation.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.01271/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_755938_69_Psycho_20180904_arts_A

 

Improve the Ability to Control the Brain’s Activity with Prayer and Meditation

Improve the Ability to Control the Brain’s Activity with Prayer and Meditation

 

By John M. de Castro, Ph.D.

 

“You can sculpt your brain just as you’d sculpt your muscles if you went to the gym. Our brains are continuously being sculpted, whether you like it or not, wittingly or unwittingly.” – Ritchie Davidson

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. For example, the brain area that controls the right index finger has been found to be larger in blind subjects who use braille than in sighted individuals.  Similarly, cab drivers in London who navigate the twisting streets of the city, have a larger hippocampus, which is involved in spatial navigation, than predefined route bus drivers. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, meditation practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

 

Prayer and meditation can be quite similar. It is possible that they can both produce changes to the brain. Since, both involve a degree of self-control, it is possible that they both change the brain to enhance self-control mechanisms. In today’s Research News article “Ability to Gain Control Over One’s Own Brain Activity and its Relation to Spiritual Practice: A Multimodal Imaging Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442174/ ), Kober and colleagues studied the ability of meditation and prayer to alter the nervous system and improve self-control. They recruited healthy adults who reported either a low or a high frequency of prayer or meditation. They were measured for spirituality and religiousness, mindfulness and locus of control. In addition, the participants had their brains scanned with Magnetic Resonance Imaging (MRI).

 

The participants had their brain activity measured with an electroencephalogram (EEG). They were shown a display with three bars the height of which was determined by brain activity in the 4-7 hertz (Theta), 12-25 hertz (SMR- Sensory-motor rhythm), and 21-35 hertz (Beta) range respectively. They received rewards (points) whenever their SMR was above a prescribed threshold and both their Theta and Beta were below a certain threshold. In other words, whenever their EEG reflected a specific prescribed pattern. If the participant was able to increase their SMR and decrease their Theta and Beta rhythms over training, it indicated and ability to control their brain activity.

 

They found, not surprisingly, that the high frequency group had higher levels of religiosity and mindfulness than the low frequency group. Importantly, they found a significant difference in the groups in their ability to control their brains. In particular, they found that the high frequency of meditation or prayer group was able to significantly increase their SMR while decreasing their Theta and Beta rhythms over training, while the low frequency group was not. When asked about their mental strategies to control their brain waves, the high frequency group reported significantly more “doing nothing”, similar to meditating or praying, than the low frequency group. Hence, the group who meditated and prayed often showed an ability to control their brains activity by employing a meditative strategy.

 

These are striking results. It has been known that with reward (biofeedback) people could learn to change their brain activity. But, it has never been shown before that people who prayed or meditated often would be significantly better at it than those who didn’t. The high frequency group is “assumed to be experts in focusing attention on inner states and self-referential processes.” This suggests that focused meditative practice improves the individual’s ability to control their brain activity. In other words, spiritual practice made them better at “doing nothing” and preventing thoughts from disrupting control of brain activity.

 

So, improve the ability to control the brain’s activity with prayer and meditation.

 

“The idea that there’s something specific about religious practices that changes your brain is just ridiculous. Everything changes your brain. Your brain is changing now, as is mine, as we’re having this conversation. There’s nothing special or magical about engaging in religious practices and showing certain changes in brain structure or function.” – Richard Sloan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Kober, S. E., Witte, M., Ninaus, M., Koschutnig, K., Wiesen, D., Zaiser, G., … Wood, G. (2017). Ability to Gain Control Over One’s Own Brain Activity and its Relation to Spiritual Practice: A Multimodal Imaging Study. Frontiers in Human Neuroscience, 11, 271. http://doi.org/10.3389/fnhum.2017.00271

 

Abstract

Spiritual practice, such as prayer or meditation, is associated with focusing attention on internal states and self-awareness processes. As these cognitive control mechanisms presumably are also important for neurofeedback (NF), we investigated whether people who pray frequently (N = 20) show a higher ability of self-control over their own brain activity compared to a control group of individuals who rarely pray (N = 20). All participants underwent structural magnetic resonance imaging (MRI) and one session of sensorimotor rhythm (SMR, 12–15 Hz) based NF training. Individuals who reported a high frequency of prayer showed improved NF performance compared to individuals who reported a low frequency of prayer. The individual ability to control one’s own brain activity was related to volumetric aspects of the brain. In the low frequency of prayer group, gray matter volumes in the right insula and inferior frontal gyrus were positively associated with NF performance, supporting prior findings that more general self-control networks are involved in successful NF learning. In contrast, participants who prayed regularly showed a negative association between gray matter volume in the left medial orbitofrontal cortex (Brodmann’s area (BA) 10) and NF performance. Due to their regular spiritual practice, they might have been more skillful in gating incoming information provided by the NF system and avoiding task-irrelevant thoughts.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442174/

Improve Mood with Religion and Spirituality

Improve Mood with Religion and Spirituality

 

By John M. de Castro, Ph.D.

 

“my Church serves as a safe haven where I can thank God, or ask for grace, strength and guidance to face the tribulations of daily life. There’s peace and contentment in this.” – Joseph Wegmann

 

Psychological well-being is sometimes thought of as a lack of mental illness. But, it is more than just a lack of something. It is a positive set of characteristics that lead to happy, well-adjusted life. These include the ability to be aware of and accept one’s strengths and weaknesses, to have goals that give meaning to life, to truly believe that your potential capabilities are going to be realized, to have close and valuable relations with others, the ability to effectively manage life issues especially daily issues, and the ability to follow personal principles even when opposed to society.

 

Religion and spirituality have been promulgated as solutions to the challenges of life both in a transcendent sense and in a practical sense. What evidence is there that these claims are in fact true? The transcendent claims are untestable with the scientific method. But, the practical claims are amenable to scientific analysis. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health.

 

In today’s Research News article, Use of Daily Phone Diary to study religiosity and mood: Convergent validity See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360558/, Szczesniak and colleagues studied the relationships between spiritual / religious practice and thee individual’s mood. Adult participants completed measures of depression, religiosity, and spiritual coping and were asked to recall events, lasting more than 5 minutes, that happened over the prior 24 hours and their mood associated with each event on a 7-point scale from negative to positive.

 

They found that during religious / spiritual activities there was a high probability of improved mood. This improvement was greater in females than in males and in Protestants and Catholics than in non-denominational Christians. In addition, this mood improvement after participation in religious / spiritual activities was highly likely to be maintained for the remainder of the 24-hour recording period. These results suggest that engaging in religious / spiritual activities is associated with more positive emotions and this improved mood continues afterward. This emotional improvement may, at least in part, be responsible for the positive mental health benefits of spirituality and religiosity.

 

So, improve mood with religion and spirituality.

 

“If you want to feel peaceful, loving, and joyful, surround yourself with as many uplifting people and things as possible, Fishel says. “We are all energetic beings. We become what we eat, what we watch, the people we surround ourselves with.”” – Claudia Pinto

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Szczesniak, R. D., Zou, Y., Dimitriou, S. M., Quittner, A. L., & Grossoehme, D. H. (2017). Use of Daily Phone Diary to study religiosity and mood: Convergent validity. Journal of Health Care Chaplaincy, 23(2), 67–85. http://doi.org/10.1080/08854726.2016.1253955

 

Abstract

Studies of religious/spiritual behavior frequently rely on self-reported questionnaire data, which is susceptible to bias. The Daily Phone Diary (DPD) was developed to minimize bias in reporting activities and behavior across a 24-hour period. A cross-sectional study of 126 parents of children with cystic fibrosis was used to establish the validity of the DPD to study religious/spiritual behaviors. Longitudinal models were used to determine the odds of improved mood during religious/spiritual activities. Convergent validity was found. Participants had increased odds of improved mood during religious/spiritual activities compared to non-religious/spiritual activities. Associations with gender and religious affiliations were found. The DPD is a valid tool for studying religious/spiritual activities and opens novel avenues for chaplaincy research and the development of chaplaincy interventions incorporating these findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360558/

Spirituality is Related to Resilience in Older Women

By John M. de Castro, Ph.D.

 

“An improved understanding and respect for individual spiritual practices can help shape personalized medical care for older adults, and improve health outcomes.” – Helen Lavretsky

 

Psychological well-being is sometimes thought of as a lack of mental illness. But, it is more than just a lack of something. It is a positive set of characteristics that lead to happy, well-adjusted life. These include the ability to be aware of and accept one’s strengths and weaknesses, to have goals that give meaning to life, to truly believe that your potential capabilities are going to be realized, to have close and valuable relations with others, the ability to effectively manage life issues especially daily issues, and the ability to follow personal principles even when opposed to society. But, the aging process to some extent interferes with the individual’s ability to achieve these goals as a result of a systematic progressive decline in every system in the body, the brain included, producing declines in mental abilities including impairments in memory, attention, and problem solving ability.

 

Religion and spirituality have been promulgated as solutions to the challenges of life both in a transcendent sense and in a practical sense. What evidence is there that these claims are in fact true? The transcendent claims are untestable with the scientific method. But, the practical claims are amenable to scientific analysis. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. Research from this body of work has shown that spirituality and religiosity serve as protective factors against a variety of psychiatric conditions, including depressive disordersanxiety disorderssuicideburnouteating disorderssubstance-related disorders and addiction recovery.

 

Perhaps spirituality counteracts the challenges to well-being produced by aging. In today’s Research News article “Correlates of Spirituality in Older Women.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017739/

Vahia and colleagues examine the relationships between religiosity/spirituality and well-being in aging women. They examined measures obtained in 2005 from the “Women’s Health Initiative (WHI), a large NIH-funded multi-center study of the predictors of morbidity and mortality among post-menopausal women.” These included measures of successful aging, religiosity/spirituality, resilience, stressful life events, optimism, attitude toward aging, depression, and physical and mental functioning. They analyzed these measures with bivariate and multivariate regression analyses.

 

They found that high levels of religiosity/spirituality were directly associated with high levels of morale toward aging, resilience, and optimism and low levels of stressful life events. Applying a multiple regression, however, they found that religiosity/spirituality was only significantly associated with higher resilience, and demographic issues of lower income, lower education, and lower likelihood of being in a committed relationship. Hence, in these postmenopausal women, spirituality appeared to be associated with resilience and negative life circumstances. It should be emphasized, though, the results are correlational and therefore do not demonstrate causal connections.

 

The association with resilience is particularly interesting. It suggests that aging women who have high levels of spirituality are also highly resilient and are therefore better able to cope with problematic life circumstances. It remains for future research to investigate whether being spiritual promotes resilience, the other way around, or some third factor may be responsible for the covariation.

 

“Seniors are always somewhere in the grief process. For most, their experience is dominated by losses such as the deaths of loved ones, decreases in physical functioning, and reductions in income. The accumulation of such losses – and the increasing awareness of their own deaths – can lead seniors to an exploration of spiritual issues.” – NAP411

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Vahia, I. V., Depp, C. A., Palmer, B. W., Fellows, I., Golshan, S., Thompson, W., … Jeste, D. V. (2011). Correlates of Spirituality in Older Women. Aging & Mental Health, 15(1), 97–102. http://doi.org/10.1080/13607863.2010.501069

 

Abstract

Introduction

The role of spirituality in the context of mental health and successful aging is not well understood. In a sample of community-dwelling older women enrolled at the San Diego site of the Women’s Health Initiative study, we examined the association between spirituality and a range of variables associated with successful cognitive and emotional aging, including optimism, resilience, depression, and health-related quality of life (HRQoL).

Methods

A detailed cross-sectional survey questionnaire on successful aging was completed by 1,973 older women. It included multiple self-reported measures of positive psychological functioning (e.g., resilience, optimism,), as well as depression and HRQoL. Spirituality was measured using a 5-item self report scale constructed using two items from the Brief Multidimensional Measure of Religiosity/Spirituality and three items from Hoge’s Intrinsic Religious Motivation Scale

Results

Overall, 40% women reported regular attendance in organized religious practice, and 53% reported engaging in private spiritual practices. Several variables were significantly related to spirituality in bivariate associations; however, using model testing, spirituality was significantly associated only with higher resilience, lower income, lower education, and lower likelihood of being in a marital or committed relationship.

Conclusions

Our findings point to a role for spirituality in promoting resilience to stressors, possibly to a greater degree in persons with lower income and education level. Future longitudinal studies are needed to confirm these associations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017739/

Improve Psychological Well-Being in Gay Men with Spirituality

Improve Psychological Well-Being in Gay Men with Spirituality

 

By John M. de Castro, Ph.D.

 

“spirituality can offer a vision of hope and meaning in a world that sometimes appears to be a hopeless miasma of pain and suffering. At its best, spirituality bestows vision and love of life. It widens our perspective. It sensitizes us to beauty and vitality–the very things at which gay men excel.” – Toby Johnson
Psychological well-being is sometimes thought of as a lack of mental illness. But, it is more than just a lack of something. It is a positive set of characteristics that lead to happy, well-adjusted life. These include the ability to be aware of and accept one’s strengths and weaknesses, to have goals that give meaning to life, to truly believe that your potential capabilities are going to be realized, to have close and valuable relations with others, the ability to effectively manage life issues especially daily issues, and the ability to follow personal principles even when opposed to society. These are also all characteristics that the great psychologist Abraham Maslow labelled self-actualization.

 

These are lofty goals that only few truly accomplish completely. But, we can strive to improve at each. Religion and spirituality encourage such personal growth. Indeed, spirituality appears to be associated with more positive attitudes toward physical and psychological difficulties and improved overall psychological well-being. For gay men, there can be a conflict between their religion and their sexual identity as “many religious/spiritual institutions continue to hold conservative and/or hostile attitudes toward same-sex behaviors.” As a result, the relationship between religion/spirituality and psychological well-being can be complicated for gay men.

 

In today’s Research News article “Psychological well-being among religious and spiritual-identified young gay and bisexual men.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289650/

Meanley and colleagues study the relationship of religion and spirituality to psychological well-being in gay men. They recruited male gay men and transsexuals between the ages of 18 to 29 years to complete an on-line survey containing measures of religious commitment, participation, and coping, self-esteem, life purpose, internalize homophobia, and community stigma. Interestingly, 80% of the sample identified as religious and or spiritual.

 

As evidence that religion and spirituality can produce a conflict with sexual identity they found that participants who identified as religious/spiritual had significantly high internalized homophobia. Importantly, they also found that religiosity was associated with higher community stigma and internalized homophobia and lower purpose in life and self-esteem. But, on the other hand, spirituality was associated with higher purpose in life and self-esteem.

 

These results are interesting and suggest that for young gay men, adherence and commitment to a religion is associated with poorer psychological well-being while spirituality is associated with better psychological well-being. This makes sense as many traditional religions have teachings contrary to same sex sexual behaviors. But, the spiritual domain does not contain any particular dogma. By adhering to spirituality as opposed to religion gay men can bypass the conflict and reap the benefits of spirituality for psychological well-being.

 

So, improve psychological well-being in gay men with spirituality.

 

“many homosexuals naturally embody the traits of sensitivity and gentleness that religion is intended to teach. Gay men are often saints and moral exemplars. In spite of the contrary examples that can be offered, there is a goodness and virtue that runs through gay men’s lives, and a demonstration of real spirituality in how many of us resolve the problem of making sense of religion in the modern world.” – Toby Johnson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Meanley, S., Pingel, E. S., & Bauermeister, J. A. (2016). Psychological well-being among religious and spiritual-identified young gay and bisexual men. Sexuality Research & Social Policy : Journal of NSRC : SR & SP, 13(1), 35–45. http://doi.org/10.1007/s13178-015-0199-4

 

Abstract

Religiosity and spirituality are often integral facets of human development. Young gay and bisexual men (YGBM), however, may find themselves at odds when attempting to reconcile potentially conflicting identities like religion and their sexual orientation. We sought to explore how different components of religiosity (participation, commitment, spiritual coping) are linked to different markers of psychological well-being (life purpose, self-esteem, and internalized homophobia). Using data collected in Metro Detroit (N = 351 ages 18–29 years; 47% African American, 29% Non-Latino White, 8% Latino, 16% Other Race), we examined how components of religiosity/spirituality were associated with psychological well-being among religious/spiritual-identified participants. An overwhelming majority (79.5%) identified as religious/spiritual, with most YGBM (91.0%) reporting spirituality as a coping source. Over three quarters of our religious/spiritual sample (77.7%) reported attending a religious service in the past year. Religious participation and commitment were negatively associated with psychological well-being. Conversely, spiritual coping was positively associated with YGBM’s psychological well-being. Programs assisting YGBM navigate multiple/conflicting identities through sexuality-affirming resources may aid improve of their psychological well-being. We discuss the public health potential of increasing sensitivity to the religious/spiritual needs of YGBM across social service organizations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289650/

Spiritual Concerns Decrease Quality of Life in Cancer Patients

 

Spiritual Concerns Decrease Quality of Life in Cancer Patients

 

By John M. de Castro, Ph.D.

 

“For some, a cancer diagnosis has the opposite effect on their sense of spirituality. It makes them doubt their beliefs or religious values, challenges their faith, and can cause spiritual distress. Some people become angry with God for allowing them to get cancer or wonder if they are being punished. Spiritual distress can make it harder for patients to cope with cancer and its treatment.” –  National Comprehensive Cancer Network

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Religion and spirituality become much more important to people when they’re diagnosed with cancer, when living with advanced cancer, and at end of life care. It is thought that people take comfort in the spiritual when facing their own mortality. There is very little information available, however, regarding the effectiveness of religion and spirituality in relieving the psychological burdens of cancer or on the quality of life of advance cancer patients. Additionally, the impact of spiritual concerns that the patient might have are not known. Concerns such as feelings of being abandoned by God or needing forgiveness for actions in their lives might lead to anxiety and worry rather than comfort.

 

In today’s Research News article “The Relationship of Spiritual Concerns to the Quality of Life of Advanced Cancer Patients: Preliminary Findings.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206727/

Winkelman and colleagues study the relationship of patients’ spiritual concern to their quality of life with advanced cancer. They recruited terminal cancer patients who were undergoing palliative radiation treatments. They completed measures of religiousness, spirituality, spiritual concerns including spiritual struggles and spiritual seeking, and quality of life including physical and existential quality of life. The patients died on average of 180 days after completing the measures.

 

The majority of the patients experienced one or more forms of spiritual struggle (58%), and most (82%) experienced spiritual seeking. Their struggles included “wondering why God has allowed this to happen” and “wondering whether God has abandoned me.” The most common spiritual seekings were “seeking a closer connection to God” and “thinking about what gives meaning to life.”  They found that the greater the spiritual concerns, spiritual struggles, or spiritual concerns, the lower the patient’s quality of life. Virtually all of the patients indicated that spiritual care was important in their treatment.

 

These results are somewhat surprising in that religiousness and spirituality were not associated with comfort but with poorer quality of life in these terminal cancer patients. In particular, it appears that concerns about the spiritual meaning of their situation were very common and greatly troubled the patients leading to poorer quality of life. Being at peace with God is a very important goal of these patients and their concerns interfered with attaining that peace. Hence, it appears that in hospice and palliative care there should be greater attention paid to the religiousness and spirituality of the patients, particularly to their spiritual concerns, struggles, and seeking. This is important as spiritual concerns trouble them deeply and decrease the quality of life of terminal cancer patients.

 

 “When we took a closer look, we found that patients with stronger spiritual well-being, more benign images of God (such as perceptions of a benevolent rather than an angry or distant God), or stronger beliefs (such as convictions that a personal God can be called upon for assistance) reported better social health. In contrast, those who struggled with their faith fared more poorly.” – Allen Sherman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Winkelman, W. D., Lauderdale, K., Balboni, M. J., Phelps, A. C., Peteet, J. R., Block, S. D., … Balboni, T. A. (2011). The Relationship of Spiritual Concerns to the Quality of Life of Advanced Cancer Patients: Preliminary Findings. Journal of Palliative Medicine, 14(9), 1022–1028. http://doi.org/10.1089/jpm.2010.0536

 

Abstract

Purpose

Religion and/or spirituality (R/S) have increasingly been recognized as key elements in patients’ experience of advanced illness. This study examines the relationship of spiritual concerns (SCs) to quality of life (QOL) in patients with advanced cancer.

Patients and Methods

Patients were recruited between March 3, 2006 and April 14, 2008 as part of a survey-based study of 69 cancer patients receiving palliative radiotherapy. Sixteen SCs were assessed, including 11 items assessing spiritual struggles (e.g., feeling abandoned by God) and 5 items assessing spiritual seeking (e.g., seeking forgiveness, thinking about what gives meaning in life). The relationship of SCs to patient QOL domains was examined using univariable and multivariable regression analysis.

Results

Most patients (86%) endorsed one or more SCs, with a median of 4 per patient. Younger age was associated with a greater burden of SCs (β = −0.01, p = 0.006). Total spiritual struggles, spiritual seeking, and SCs were each associated with worse psychological QOL (β = −1.11, p = 0.01; β = −1.67, p < 0.05; and β = −1.06, p < 0.001). One of the most common forms of spiritual seeking (endorsed by 54%)—thinking about what gives meaning to life—was associated with worse psychological and overall QOL (β = − 5.75, p = 0.02; β = −12.94, p = 0.02). Most patients (86%) believed it was important for health care professionals to consider patient SCs within the medical setting.

Conclusions

SCs are associated with poorer QOL among advanced cancer patients. Furthermore, most patients view attention to SCs as an important part of medical care. These findings underscore the important role of spiritual care in palliative cancer management.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206727/

Improve Physician Care of Patients and Themselves with Religious Practice

 

By John M. de Castro, Ph.D.

 

“Patients need to believe in their doctor. An empathetic touch can make all the difference and also be the key to medical success. . . The tragedy of burnout is that it effaces genuine empathy, spirituality, and commitment. Nietzsche put it best: “Physician, heal thyself: Then wilt thou also heal thy patient.” – Tom Murphy

 

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 and teaching are high stress occupations. 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 frequently results from emotional exhaustion. This exhaustion not only affects the healthcare providers personally, but also the patients, as it produces a loss of enthusiasm, 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 burnout has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout. Religiosity and spirituality are also known to help improve mental health and well-being.

 

In today’s Research News article “An exploration of the role of religion/spirituality in the promotion of physicians’ wellbeing in Emergency Medicine.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1313533765337213/?type=3&theater

or see summary below or view the full text of the study at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929145/, Salmoirago-Blotcher and colleagues surveyed emergency room physicians measuring burnout, maladaptive behaviors, malpractice, religiosity, religious affiliation, spirituality, private religious/spiritual practice, and religious commitment. They found that high levels of burnout were associated with being single or divorced, and not surprisingly with high numbers of patients seen, hours on call, and shifts each month. There were no significant relationships between religiosity/spirituality and burnout. They did find, however, that the greater the observance of a religious day of rest, the lower the levels of malpractice and maladaptive behaviors. In addition, the greater the attendance at religious services the lower the level of maladaptive behaviors.

 

These results are interesting and suggest that although not directly associated with burnout, religious practice was associated with higher quality of medical services provided to the patients, as evidenced by fewer malpractice suits, and the better care the physicians took of themselves, as evidenced by low maladaptive behaviors. The maladaptive behaviors included smoking, drug use and addiction, and alcohol use. It is interesting that the results were not due to the levels of spirituality or religiosity themselves but rather to participation in religious services and taking a religious day of rest. This suggests that the effects may be the result taking time off to go to church and rest may be important for physicians well-being. Since, this was a correlational study, however, it’s possible that the causation was in the opposite direction with the kinds of physicians who participated in religious practices also being the type of physicians who take better care of themselves and others.

 

So, improve physician care of patients and themselves with religious practice.

 

“We can’t afford to ignore the potential effect of spirituality and religion on health.”  – Alexandra Shields

 

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

Salmoirago-Blotcher, E., Fitchett, G., Leung, K., Volturo, G., Boudreaux, E., Crawford, S., … Curlin, F. (2016). An exploration of the role of religion/spirituality in the promotion of physicians’ wellbeing in Emergency Medicine. Preventive Medicine Reports, 3, 189–195. http://doi.org/10.1016/j.pmedr.2016.01.009

 

Abstract

Background: Burnout is highly prevalent among Emergency Medicine (EM) physicians and has significant impact on quality of care and workforce retention. The objective of this study was to determine whether higher religion/spirituality (R/S) is associated with a lower prevalence of burnout among EM physicians (primary outcome). A history of malpractice lawsuits and maladaptive behaviors were the secondary outcomes. Methods: This was a cross-sectional, survey-based study conducted among a random sample of physicians from the Massachusetts College of Emergency Physicians mailing list. Burnout was measured using a validated 2-item version of the Maslach Burnout Inventory. Maladaptive behaviors (smoking, drinking, and substance use) and medical malpractice were self-reported. R/S measures included organized religiosity, religious affiliation, private R/S practice, self-rated spirituality, religious rest, and religious commitment. Logistic regression was used to model study outcomes as a function of R/S predictors. Results: Of 422 EM physicians who received the invitation to participate, 138 completed the survey (32.7%). The prevalence of burnout was 27%. No significant associations were observed between burnout and R/S indicators. Maladaptive behaviors (adjusted OR = 0.42, CI: 0.19 to 0.96; p = 0.039) and history of medical malpractice (adjusted OR = 0.32; CI: 0.11 to 0.93; p = 0.037) were less likely among physicians reporting to be more involved in organized religious activity and to observe a day of rest for religious reasons, respectively. Conclusion: This study provides preliminary evidence for a possible protective association of certain dimensions of R/S on maladaptive behaviors and medical malpractice among EM physicians.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929145/

 

Meditate to Pray. Pray to Meditate

Meditate to Pray. Pray to Meditate

 

By John M. de Castro, Ph.D.

 

“Silence is God’s first language; everything else is a poor translation.” ― Thomas Keating

 

Prayer takes a number of different forms most of which are not meditative. Prayers of adoration are prayers focused on the worship of God, without any reference to circumstances, needs, or desires. They are often recited by rote. Prayers of thanksgiving are expressions of gratitude towards God, made in reference to specific positive life experiences. Prayers of supplication “taps requests for God’s intervention in specific life events for oneself or others”. Prayers of confession involve the admission of negative behaviors, and a request for forgiveness. Obligatory prayers are required prayers consist primarily of fixed prayers repeated at each worship time. All of these types of prayer generally don’t parallel meditation and might be characterized as self-serving.

 

The final type, on the other hand, prayers of reception are very similar to meditation. These are prayers in which “one more passively awaits divine wisdom, understanding, or guidance”. They are “characterized by a contemplative attitude of openness, receptivity, and surrender, resulting in experiences ranging from peaceful/quiet to rapture/ecstasy”. The following story exemplifies this form of prayer:

“Mother Theresa was once asked about her prayer life.

The interviewer asked, “When you pray, what do you say to God?”

Mother Teresa replied, “I don’t talk, I simply listen.”

Believing he understood what she had just said, the interviewer next asked, “Ah, then what is it that God says to you when you pray?”

Mother Teresa replied, “He also doesn’t talk. He also simply listens.”

There was a long silence, with the interviewer seeming a bit confused and not knowing what to ask next.

Finally, Mother Teresa breaks the silence by saying, “If you can’t understand the meaning of what I’ve just said, I’m sorry but there’s no way I can explain it any better.” –  David Matthew Brown

 

This is the kind of prayer described by Mother Theresa is the form of contemplative prayer engaged in by the Christian or Sufi mystics. Receptive prayer might be characterized as the deepest most profound form of prayer. In this prayer the mind is quieted and there is no specific goal as in meditation. The practitioner simply quiets the mind and patiently monitors experience, just like meditation. So, not only can contemplative prayer be viewed as a form of meditation, but meditation can be viewed as a form of prayer. Both involve quieting the mind and simply resting peacefully observing whatever transpires.

 

This idea is further evidenced by what is arguably the most famous definition of prayer from St John Damascene ,‘Prayer is the raising of the mind and heart to God’. It is also evident in the sermons of the highly regarded Christian mystic, Meister Eckhart. He states that

The most powerful form of prayer, and the one which can virtually gain all things and which is the worthiest work of all, is that which flows from a free mind. The freer the mind is, the more powerful and worthy, the more useful, praiseworthy and perfect the prayer and the work become. A free mind can achieve all things. But what is a free mind? A free mind is one which is untroubled and unfettered by anything, which has not bound its best part to any particular manner of being or devotion and which does not seek its own interest in anything but is always immersed in God’s most precious will, having gone out of what is its own. (Talks of Instruction 2 in Davies, 1994).”

 

So, prayers of reception are essentially meditations. They involve quieting the mind and simply observing what transpires. The difference is simply one of intent. In the case of prayer, the practitioner has the intent of becoming one with the Deity, while in the case of meditation the practitioner has the intent of becoming one with the universe. Simply thinking of the universe as the expression of the Devine makes contemplative prayer and meditation identical. It’s all a matter of the label put on it. The meditator calls the ultimate product of meditation as awakening or enlightenment while the contemplative prayer practitioner calls the ultimate product of the prayer Devine revelation. It could be argued that these two are identical except for the labels put on them. In fact, the mystical experiences reported by the Christian and Sufi mystics only differ from those reported by meditators in the labels put on them. In their essence they are identical and lead to effectively the same place.

 

So, meditate to pray and pray to meditate!

 

“Spiritual meditation is the pathway to Divinity. It is a mystic ladder which reaches from earth to heaven, from error to Truth, from pain to peace.” ~James Allen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

Religiosity Protects against Alcohol and Drug Abuse

“Research investigating the relationship between religious commitment and drug use consistently indicates that those young people who are seriously involved in religion are more likely to abstain from drug use than those who are not; moreover, among users, religious youth are less likely than non-religious youth to use drugs heavily” – Gerald Bachman

 

Alcohol intake is a ubiquitous fact of life. In the United States 87% of adults reported that they drank alcohol at some point in their lifetime; 71% reported that they drank in the past year; 56% reported that they drank in the past month. If alcohol intake is tempered by moderation and caution it can be enjoyed and may be potentially beneficial. But as alcohol intake gets out of control it can lead to binge drinking and alcoholism. It is reported that 25% of U.S. adults reported that they engaged in binge drinking in the last month and 7% have what is termed an alcohol use disorder.

 

This is troubling as it can be very dangerous and potentially fatal. Nearly 88,000 people in the US and 3.3 million globally die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States. Drunk driving accounted for over 10,000 deaths; 31% of all driving fatalities. Excessive alcohol intake has been shown to contribute to over 200 diseases including alcohol dependence, liver cirrhosis, cancers, and injuries. It is estimated that over 5% of the burden of disease and injury worldwide is attributable to alcohol consumption. So, clearly, it is important to control excessive alcohol intake.

 

Spirituality and religiosity have been shown to be associated with successful treatment and relapse prevention with substance abuse in general including alcoholism. Alcohol intake and binge drinking rates are higher in sexual minorities than in heterosexuals, especially women. So, it makes sense to further investigate the relationship of spirituality and religiosity with alcohol intake in sexual minority women. In today’s Research News article “Religiosity as a protective factor for hazardous drinking and drug use among sexual minority and heterosexual women: Findings from the National Alcohol Survey”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1173823035974954/?type=3&theater

Drabble and colleagues revisit a major national survey of alcohol intake patterns and investigate participation in religion and alcohol intake in sexual minority women.

 

They found that sexual minority women had significantly higher rates of drug use in general including alcohol intake, higher rates of hazardous drinking and lower rates of being lifetime abstainers from alcohol. Sexual minority women had significantly lower rates of high religiosity and participation in religions that had norms unfavorable to alcohol intake. This was particularly true with lesbian women. So, sexual minority women are more likely to drink and misuse alcohol and are less religious than heterosexual women. They also found that religiosity was associated with higher rates of lifetime abstinence of alcohol regardless of sexual orientation. But, religiosity and participation in religions that had norms unfavorable to alcohol intake were associated with lower rates of hazardous alcohol or illicit drug use in heterosexual women but not in sexual minority women. So, religiosity appears to have less of an impact on alcohol intake in sexual minority women than heterosexual women.

 

Why is religiosity associated with lower overall and hazardous use of alcohol? One possible reason is that religions in general have negative teachings about alcohol. Buddhism teaches that intoxication is an impediment to spiritual development. Other religions completely prohibit alcohol while many decry the behaviors that occur during alcoholic stupor.  This provides a cognitive incompatibility between drinking and religiosity. The recognition that drinking is not an OK thing to do might provide the extra motivation to help withstand the cravings. In addition, religious groups tend to be populated with non-alcoholics. So, increased religiosity also tends to shift the individual’s social network away from drinking buddies to people less inclined to provide temptation. It is very difficult to not drink when those around you are not only drinking themselves but encouraging you to drink. So shifting social groups to people who either abstain or demonstrate controlled drinking can help tremendously.

 

But, why does religiosity appear to have a smaller effect on sexual minority women than heterosexual women? One possibility is that many religions are associated with negative teachings regarding homosexuality. For sexual minority women, their rejection of these teachings may generalize to affect their adherence to the other teaching of the religion including alcohol intake. As a result, being religious has less of an impact on alcohol and drug use for these women. It would be interesting to investigate the relationship of religiosity and alcohol intake in sexual minority women who belong to religions that are very tolerant to homosexuality versus religions who are intolerant.

 

Regardless, protects against alcohol and drug abuse with religiosity.

 

“Religious involvement can protect against substance use by providing opportunities for prosocial activities, which themselves may promote antidrug conduct norms, and for interaction with nondeviant peers. Youth who are involved in religious activities tend to form peer groups with youth who are involved in similar activities, and they are less likely to form friendships with deviant peers.” – Flavio Marsiglia

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Get more Spiritual with Mindfulness

 

“While the stillness and connecting with one’s inner self cultivated through mindfulness are certainly an important part of a spiritual practice, feelings of wonder and awe — the amazement we get when faced with incredible vastness — are also central to the spiritual experience. And according to new research, mindfulness may actually set the stage for awe.” – Carolyn Gregoire

 

Mindfulness practices developed primarily as spiritual practices. Contemplative practices developed millennia ago and were seen in Hinduism, Buddhism, Islam, Judaism, and Christianity and many native (so called primitive) religions. They were used to heighten the practitioner’s experience with ultimate reality, whether that be a deity or seeing the nature of reality. By calming the mind and reducing the internal chatter contemplative practices are thought to open up a transcendent reality not otherwise attainable. So, mindfulness and spirituality/religion have been intimately linked. (see http://contemplative-studies.org/wp/index.php/2015/08/16/why-are-we-spiritualreligious/).

 

It has only been in the last few decades that mindfulness has been practiced as a secular activity. This allowed it to flourish in a skeptical west which saw it as a heathen religious practice. As a result, mindfulness practices were employed for secular purposes such as improvement of health, psychological well-being, and cognitive development. But, now because their secular benefits have been firmly established by science, mindfulness practices have become accepted and firmly embedded in western life. The establishment of their acceptability, has led to a re-emergence of their initial purpose of the development of spirituality.

 

Adolescence is often a time of rapid spiritual development as the teens begin to seek deeper understandings of reality and life. But, there has been very little research into the emergence of spirituality and religious practice in adolescents. In today’s Research News article “Support for adolescent spirituality: contributions of religious practice and trait mindfulness”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1153755041315087/?type=3&theater

Cobb and colleagues explore spirituality, religious practices, and mindfulness in 11 to 16-year old adolescents. They asked “two questions: (1) do different portraits of spiritual life exist for adolescents involving religious practice and spiritual experience and (2) might religious practice and trait mindfulness offer support for the development of spiritual experience.” They used statistical techniques to identify different clusters of activity and discovered four unique profiles of spirituality and religious practices: Highest Overall Spirituality, Spiritual Experience, Religious Practice, and Lowest Overall Spirituality.

 

The adolescents indicating Highest Overall Spirituality had a strong religious practice and strong spiritual beliefs and experiences. The Spiritual Experience group had a moderate-high level of spiritual experience and Spiritual Self-Discovery, but generally did not religiously practice. Religious Practice group was defined by moderate-high levels of private religious practice and religious identity and relatively low spiritual experience and values. Finally, the Lowest Overall Spirituality group had low levels of spiritual experience and low levels of religious practice.

 

Spirituality/religious practice groups and percentage of adolescents in each group.

Spirituality
High Low
High 28% 11%
Religious Highest Overall Spirituality Religious Practice
Practice Low 28% 34%
Spiritual Experience Lowest Overall Spirituality

 

Cobb and colleagues also found that the adolescents in the high spirituality groups had significantly higher mindfulness than those in the low spirituality groups regardless of the level of religious practice. This analysis implies that high mindfulness is associated with spirituality while religious practice is not.

 

The authors speculate that mindfulness is a “gateway” to great spiritual awareness and ultimately a more integrated spiritual life. That would certainly fit with the origins of mindfulness practices as means to attain spiritual development. But, their results do not demonstrate that mindfulness causes spirituality as there was no active manipulation of either. It is possible that high levels of spirituality cause high mindfulness or that some third factor such as familial spirituality might simultaneously increase both spirituality and mindfulness. Research is needed wherein mindfulness training is implemented and its effects on spirituality measured. In addition, it will be important to explore these relationships in older individuals to establish that the relationship of mindfulness and spirituality is not simply restricted to adolescents.

 

Regardless, it is clear that spirituality and mindfulness are intimately connected, that an ability to quiet the mind and look inside is highly associated with spiritual experience. So, get more spiritual with mindfulness.

 

“My religion consists of a humble admiration of the illimitable superior spirit who reveals himself in the slight details we are able to perceive with our frail and feeble mind.” ― Albert Einstein
CMCS – Center for Mindfulness and Contemplative Studies