Improve the Aging Brain’s Cognition with Mindfulness

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Improve the Aging Brain’s Cognition with Mindfulness

 

By John M. de Castro, Ph.D.

 

“there is a small but growing body of evidence that regular meditation really can slow ageing – at least at the cellular level.” – James Kingsland

 

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decreases during aging. The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our mental abilities which decline with age including impairments in memory, attention, problem solving ability, and emotion regulation. It is inevitable and cannot be avoided. There is some hope for these age-related declines, however, as there is evidence that they can be slowed. There are some indications that physical and mental exercise can reduce the rate of cognitive decline and lower the chances of dementia. For example, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging.

 

Using modern neuroimaging techniques, scientists have been able to view the changes that occur in the nervous system with aging. In addition, they have been able to investigate various techniques that might slow the process of neurodegeneration that accompanies normal aging. They’ve found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of mindfulness practitioners have been found to degenerate less with aging than non-practitioners.

 

Since the global population of the elderly is increasing at unprecedented rates, it is imperative to investigate methods to slow physical and mental aging and mitigate its effects. In today’s Research News article “Mindful Aging: The Effects of Regular Brief Mindfulness Practice on Electrophysiological Markers of Cognitive and Affective Processing in Older Adults.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241348/

Malinowski and colleagues recruited individuals between the ages of 55 and 75 years and randomly assigned them to either receive mindfulness training or to an active brain training. Mindfulness training consisted of breath following meditation practice. The brain training condition involved performing mental arithmetic problems that required effortful cognitive processing. Both mindfulness and braining training groups practiced for 10 minutes, 5 days per week, for eight weeks. Before and after training participants were measured for mindfulness, self-efficacy, and mental well-being and were assessed for cognitive and emotion regulation abilities by performance of an eStroop task while their brains’ electrical responses, Electroencephalogram (EEG), were recorded. In the eStroop task the participants viewed a computer screen where one to four words were presented simultaneously. The participants were asked to simply press one of four keys to indicate the number of words presented. There were four conditions; emotionally positive words (love), emotionally negative words (sad), emotionally neutral words (box), and incongruent words. In the incongruent condition the words, one, two, three, or four were presented, with the number of words different from the meaning of the words, e.g. the word three presented two times.

 

They found that from pre-test to post-test the mindfulness training, but not the brain training group increased in mindfulness and increased their response speed (reaction time) in the eStroop task under all conditions. So, the breath meditation increased mindfulness and made for quicker reactions in the cognitive task. The N2 negative going neural response occurring 0.27 to 0.34 seconds after the presentation of the words, was significantly stronger in the mindfulness than the brain training group. The electrical response was measured over the frontal central cortex, components of the network regulating attention. This result suggests that mindfulness training improves the brains ability to regulate attention.

 

This study is particularly strong because the control condition was active and required similar commitment of time and energy and belief that the treatment would produce improvements. As a result, the conclusions from the study are very clear. The results suggest that mindfulness training produces improved attentional ability resulting from improved neural responses. These effects were produced in an older group of participants. This suggests that mindfulness training may reduce the cognitive-attentional decline that normally occurs with aging.

 

This is an exciting proposition, that mindfulness training may improve our ability to cognitively age healthily. As the population continues to live longer and the number of older and elderly individuals increases, the problem of cognitive decline will place an increasing burden on caregivers and stress the healthcare system. So, being able to delay and reduce this decline could have profound effects on individuals and society. Hence, promoting mindfulness training for the elderly could reap substantial benefits for the elderly and the system that supports them in their declining years..

 

So, improve the aging brain’s cognition with mindfulness.

 

“Our modern assumptions, ideas, beliefs, and cultural narratives about growing old are too small for us to inhabit. Our thinking about aging is often hijacked by fear, negativity, and ageism. The authentic experience of aging is a source wonder, curiosity, and fascination. Mindful aging is a skillful means to embrace the process of growing older in order to cultivate a deeper understanding and appreciation of the natural flow of all life.” – Brian Alger

 

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

Malinowski, P., Moore, A. W., Mead, B. R., & Gruber, T. (2017). Mindful Aging: The Effects of Regular Brief Mindfulness Practice on Electrophysiological Markers of Cognitive and Affective Processing in Older Adults. Mindfulness, 8(1), 78–94. http://doi.org/10.1007/s12671-015-0482-8

 

Abstract

There is growing interest in the potential benefits of mindfulness meditation practices in terms of counteracting some of the cognitive effects associated with aging. Pursuing this question, the aim of the present study was to investigate the influence of mindfulness training on executive control and emotion regulation in older adults, by means of studying behavioral and electrophysiological changes. Participants, 55 to 75 years of age, were randomly allocated to an 8-week mindful breath awareness training group or an active control group engaging in brain training exercises. Before and after the training period, participants completed an emotional-counting Stroop task, designed to measure attentional control and emotion regulation processes. Concurrently, their brain activity was measured by means of 64-channel electroencephalography. The results show that engaging in just over 10 min of mindfulness practice five times per week resulted in significant improvements in behavioral (response latency) and electrophysiological (N2 event-related potential) measures related to general task performance. Analyses of the underlying cortical sources (Variable Resolution Electromagnetic Tomography, VARETA) indicate that this N2-related effect is primarily associated with changes in the right angular gyrus and other areas of the dorsal attention network. However, the study did not find the expected specific improvements in executive control and emotion regulation, which may be due to the training instructions or the relative brevity of the intervention. Overall, the results indicate that engaging in mindfulness meditation training improves the maintenance of goal-directed visuospatial attention and may be a useful strategy for counteracting cognitive decline associated with aging.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241348/

 

 

Improve Obesity with Yoga

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Improve Obesity with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga is a powerful activity that connects mind, body and a sense of self to achieve endless health benefits, including maintaining weight-loss. The philosophy of yoga fosters a healing practice that brings peace and acceptance to the self no matter where you are in your life.” – Laurel Dierking

 

Obesity has become an epidemic in the industrialized world. In the U.S. the incidence of obesity, defined as a Body Mass Index (BMI) of 30 or above has more than doubled over the last 35 years to currently around 35% of the population, while two thirds of the population is considered overweight or obese (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 obesity, alter eating behavior and improve health in obesity. This suggests that mindfulness training may be an effective treatment for overeating and obesity alone or in combination with other therapies. Yoga practice has been shown to have a myriad of physical and psychological benefits. These include significant loss in weight and body mass index (BMI), resting metabolism, and body fat in obese women with Type 2 diabetes and improve health in the obese. Hence it would seem reasonable to investigate the benefits of yoga therapy on the weight and body composition of the obese.

 

In today’s Research News article “Yoga Practice for Reducing the Male Obesity and Weight Related Psychological Difficulties-A Randomized Controlled Trial.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198375/

Rshikesan and colleagues recruited overweight and obese (BMI > 25) male participants. They were randomly assigned to either receive Integrated Yoga Therapy or a no-treatment control condition. The yoga therapy instruction was conducted for 90 minutes per day, 5 days per week, for 14 weeks, consisting of lecture, stretching, yoga sun salutations, postures, breathing exercises and meditation This was followed by 3 months of home yoga practice. The participants were measured prior to training, after 14 weeks of training and after the 3-month home practice, for body weight, Body Mass Index (BMI), waist and hip circumference, body shape index, skinfold thickness, % body fat, perceived stress, and acceptance of weight related problems.

 

They found that compared to the no-treatment control condition that showed non-significant improvements, the yoga therapy group had significant decreases in weight, arm circumference, % body fat, Body Mass Index (BMI), and skinfold thickness and a decrease in perceived stress. Hence, Integrated Yoga Therapy produced a significant improvement in the physical and psychological manifestations of obesity.

 

These are encouraging results but the conclusions from the study need to be tempered as the improvements were relatively small, with a 3%, ~ 2 kg, reduction in weight after over a half a year of practice. In addition, the control condition did not include any programmed exercise or dietary activity. So, the results could have been produced by any increase in exercise induced caloric expenditure, or potentially by a placebo, experimenter bias, or attentional effect. Also, it has long been known that upon initiating an exercise program there is a small decrease in weight initially, but no further reductions occur with continued practice. So, it cannot be concluded that the yoga practice would continue to reduce weight and improve body shape. Regardless, the program did improve the physical and psychological manifestations of obesity.

 

So, improve obesity with yoga.

 

“What matters is having other fat people around, supporting each other and improving together. Fat people spend their whole lives trying to fit into a world that neither fits nor accepts them. Having a separate space to explore one’s physical self — and one’s spirituality — with others who have the same goals, is tremendously healing.” – Kay Erdwinn

 

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

Rshikesan, P. B., Subramanya, P., & Nidhi, R. (2016). Yoga Practice for Reducing the Male Obesity and Weight Related Psychological Difficulties-A Randomized Controlled Trial. Journal of Clinical and Diagnostic Research : JCDR, 10(11), OC22–OC28. http://doi.org/10.7860/JCDR/2016/22720.8940

 

Abstract

Introduction

Obesity is a health disorder and increasing all over the world. It is also a cause for many non-communicable diseases. Yoga practice reduces the stress level which may improve the eating habits and help in weight reduction.

Aim

To assess the final outcome of the effects after 3 months of the 14 weeks yoga training on obesity of adult male in an urban setting.

Materials and Methods

This was a randomized controlled trial with parallel groups (Yoga and Control groups) on male obese. Total 80 subjects with Body Mass Index (BMI) between 25 to 35 kg/cm2 were enrolled and randomized into two equal groups in which 72 subjects (yoga n = 37 and control n=35) completed the trial. Yoga group mean age ± SD was 40.03±8.74 and Control group mean age±SD was 42.20±12.06. A 14 weeks special IAYT (Integrated Approach of Yoga Therapy) yoga training was given to the Yoga group and no specific activity was given to Control group. The interim results of this study at 14 weeks were covered in another article which is under process. After the 14 weeks of yoga training the Yoga group was asked to continue the yoga practice for the next 3 months and the Control group was not given any physical activity. The final outcome is covered in this paper.

The assessments were anthropometric parameters of body weight (Wt), BMI (Body Mass Index), MAC (Mid-upper Arm Circumferences of left and right arm), WC (Waist Circumference), HC (Hip Circumference), WHR (Waist Hip Ratio), SKF (Skin Fold Thickness) of biceps, triceps, sub scapular, suprailiac and cumulative skin fold thickness value), Percentage body fat based on SKF and Psychological questionnaires of PSS (Perceived Stress Scale) and AAQW (Acceptance and Action Questionnaire for Weight related difficulty). Assessments were taken after 3 months of yoga training, for both Yoga and Control groups. Within group, between group and correlation analyses were carried out using SPSS 21.

Results

Improvement in anthropometric and psychological parameters such as Wt, Percentage body fat, PSS were observed in the final outcome. Also, some of the improvements such as AAQW score were lost in the final outcome, compared to interim results.

Conclusion

The yoga practice is effective for obesity control for adult male in an urban setting.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198375/

 

What’s Wrong with Meditation II – Improper Instruction

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Image result for upset with meditation

What’s Wrong with Meditation II – Improper Instruction

 

By John M. de Castro, Ph.D.

 

“The next biggest danger is that no one thinks there are or can be any dangers to meditation, so there is almost no discussion and information-gathering on the subject. Everyone is just going blah blah about the benefits. As a consequence, meditators are constantly being blindsided and derailed by things that should be trivial hazards, easily dismissed or bypassed. If we compare meditation to a day at the beach, it is as if people are saying, “Oh, don’t worry, you can never get enough direct sunlight. Just soak it up. You don’t even need a hat. And swim out in the ocean as far as you want. It’s a lake. With dolphins that will love you.”” – Lorin Roche

 

As was discussed in the prior essay on What’s Wrong with Meditation I – Expectations there are three essential problems with the way meditation has been presented in the west that have produced problems, misconceptions, and misunderstandings. First, meditation has been presented in a way that has evoked beliefs, ideas, and images that are overly idealized and not reflective of the typical experiences of meditation practice. Secondly, is the focus of the present essay, that immediately jumping into meditation practice has been encouraged, without the provision for proper background information, study, or instruction. Lastly, the jargon used to describe the process, experiences, obstacles, and results is extreme, evoking images and expectations that far exceed normal experience.

 

The Dalai Lama was brought on a tour of a major new meditation center in the United States. At the end of the tour, he simply asked “where’s the library?” He was astonished when he was told that there wasn’t one. He commented that before any of his new monks were allowed to meditate that had to spend at least a couple of years studying before they were allowed to meditate. He stressed that it is imperative that the practitioner have a proper background to understand the practical and theoretical basis for meditation before starting. This story exemplifies the difference between ancient Tibetan practice and meditation as it’s taught in the west where practitioners are launched into meditation practice with only minimal instruction. Hence people dive in without knowledge of obstacles and dangers hidden beneath the surface.

 

This western practice would be fine if meditation was straightforward and there weren’t any difficulties and traps that could ensnare the meditator. But, meditation practice is not simple and straightforward and without instruction in what to expect and how to recognize true progress, the practitioner is left to grope and stumble their way through the process. Beginners are generally not instructed, except in very general terms, as to what is the goal and how to recognize it if they attain it. They are frequently told to just follow and/or count the breath but receive no instruction as to what to do when their mind inevitably wanders. They are told simply return to following the breath. This was exactly how I was instructed when I began meditation practice.

 

As a result of this lack of instruction, beginners deride themselves for mind wandering making the process unpleasant. They are not told that this is effectively punishing themselves for recognizing that their mind has wandered. This makes it less likely that the individual will recognize and return from mental discursions. With a little instruction, they can learn that minds do what minds do, and that’s OK. They’re going to wander. Get used to it! But, they also need to be instructed to celebrate their recognizing it and returning to the meditative focus. This instruction produces reward for recognizing that the mind has wandered making it more likely that it will be recognized again and sooner. If beginners were simply given this much simple instruction their meditation practice will be much more enjoyable and productive and they’ll be much less likely to give up the practice.

 

Beginning meditators are frequently told that they should quiet the mind but are never instructed as to exactly what that means. They often confuse a quiet mind with a total blank, believing that a quiet mind is one without content. If they are simply instructed that they are to quiet the internal chatter, not everything. There’ll still be sounds, sights, odors, touches, etc. But when the mind is quiet there is no verbal commentary accompanying them. They are simply observing these stimuli as they are without categorization, judgment, labelling, reflection on past stimuli, or projections as to the future course of the stimuli. That’s a quiet mind. But few beginners are taught this. A completely blank mind can and will happen later in practice, but only after the mind has been quieted, not stopped. If beginning meditators were simply provided instruction about what is their goal and what a quiet mind is actually like their meditation practice will be much more enjoyable and productive.

 

A very important instruction for beginners is to warn them about the troubling kinds of thoughts and memories that often spontaneously arise during meditation. People come with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. The strength here is that meditation is a wonderful occasion to begin to deal with these issues. But, often the thoughts or memories are overwhelming. Proper instruction is needed on how to work with issues gradually, avoiding delving too deeply too soon. At retreats, there are always boxes and boxes of tissues available for the inevitable copious tears shed by some of the participants as they are dealing with deeply troubling issues. Yes, in meditation you try to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories are likely to emerge. The practitioner needs proper instruction beforehand of the likelihood of this happening and how to deal effectively with it. Knowing that this is normal, healthy, and part of the process, helps immeasurably to lessen the impact of these thoughts and memories on the individual and increases the likelihood that they can be effectively resolved. At times, professional therapeutic intervention may be needed. Once again, if this is understood ahead of time, the individual is more likely to seek assistance.

 

Meditation practice can also produce some troubling experiences beyond unmasking deep psychological issues. These are rarely presented or discussed with people before engaging in meditation. Not the least of these experiences are awakening experiences themselves. These can occur at any time and even to beginners. If they are not properly understood, they can lead to sometimes devastating consequences. These experiences are so powerful and unusual that they can be misinterpreted. Awakening experiences have been misdiagnosed as psychotic breaks and the individual placed on powerful drugs and/or institutionalized. There are no systematic studies of the extent of this problem, but a number of psychiatrists who meditate and understand awakening experiences have said that it is quiet extensive. At the very least, the individual may believe that they are losing their sanity or as one has said, “I just got used to the idea that occasionally I would have just one of those days.” This is one of the reasons why the Dalai Lama insists that beginners study first, so they can recognize what is happening to them if and when these experiences arise.

 

Meditation practice can sometimes produce energetic states that can vary in intensity, location, and duration. If and when these occur, they are usually quite surprising and unexpected. Many practitioners never experience these states or only experience very mild energy states. But, for those that do, if they have no prior instruction they can readily misinterpret them. They are sometimes called Kundalini energy states and involve energy focused in specific parts of the body or overall. They can feel like nervousness, tension, or almost like electrical currents flowing through the body and can produce spontaneous and undirected movements. These can be minor or overwhelmingly intense and can last from a few days to years. With these states sleep can be quite difficult and the individual may go days at a time without any sleep whatsoever. These energy states are usually found to be aversive and difficult to cope with. If the practitioner hasn’t been instructed about these states, they may seek out medical help. Unfortunately, the medical professions are not trained to recognize these states and often prescribe powerful anxiolytic drugs that can stupefy the individual but not affect the energies. Monasteries and major retreat centers are often equipped to recognize and treat these energies states. But, the vast majority of meditators and meditation instructions are completely devoid of an understanding of Kundalini energies. A little prior study and instruction can go a long way toward preventing misinterpretations and getting assistance from experienced teachers.

 

Another state that can be produced by awakening experiences has been termed as the “dark night of the soul.” After awakening there is, almost inevitably, a honeymoon period of happiness and bliss. But this is frequently followed by an aversive state that has been described as a spiritual desert. These have been reported by awakened individuals throughout the centuries, including the Christian and Sufi mystics and saints, Buddhist masters, and everyday practitioners. In these states the individual loses interest in life and seemingly has no motivation to do virtually anything. They feel emotionally dry and lament the loss of what they call the juice of life. Everything is flat and the individual often becomes deeply depressed. This dark night can last for months or years. To deal with dark nights the individual needs sophisticated instruction from accomplished teachers. No preparatory instruction will help to stop or prevent this from occurring. But, with proper instruction the individual can be better prepared to understand what is happening to them and what to expect in the future. This again can prevent misinterpretation and consequent maladaptive responses and harmful consequences.

 

At this point it should be clear why the Dalai Lama is so insistent upon extensive study and instruction prior to engaging in meditation. It can prevent potential negative reactions and consequences to some of the unexpected consequences of meditation. It has been my experience that the less instruction a person has prior to engaging in meditation the greater the likelihood that problems occur and the greater the likelihood of them being misinterpreted and counterproductive and even damaging responses occurring. So, study about meditation, work with an experienced teacher, and prepare yourself ahead of time before getting deeply involved in meditation practice. If you do, the rewards can be maximized and the pitfalls minimized, making practice productive and potentially profoundly altering.

 

The issues discussed above can seem off putting. You may be asking yourself if it makes any sense at all to engage in a meditation practice with all these potential problems. The answer is a resounding yes. The amazing benefits of meditation practice on your psychological, emotional, physical, and spiritual health make it well worth the effort. In fact, it has the potential to change you in profound ways for all of existence. The above caveats should be taken as indicators that study and guidance should be undertaken and that meditation should be practiced with understanding of what to expect both good and bad ahead of time. These warnings are important but should not be taken a stop signs, only caution signs. Know what you’re getting into, be prepared, and then reap the extraordinary benefits.

 

“It’s a kind of re-birth.  The dark night of the soul is a kind of death that you die.  What dies is the egoic sense of self.  Of course, death is always painful, but nothing real has actually died there – only an illusory identity.  Now it is probably the case that some people who’ve gone through this transformation realized that they had to go through that, in order to bring about a spiritual awakening.  Often it is part of the awakening process, the death of the old self and the birth of the true self.” – Eckhart Tolle
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

 

Improve the Psychological Well-Being of Patients with Multiple Chronic Diseases with Yoga

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Improve the Psychological Well-Being of Patients with Multiple Chronic Diseases with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga can be beneficial for individuals with disabilities or chronic health conditions through both the physical postures and breathwork. Each pose can be modified or adapted to meet the needs of the student. Yoga asanas can be performed while seated in a chair or wheelchair.” – National Center on Health, Physical Activity and Disability (NCHPAD)

 

The prevalence of chronic diseases has increased with population ageing with around 18% of the elderly having debilitating chronic diseases. “The most common diagnoses are diabetes, stroke, hypertension, cancer, arthritis, asthma, fractures, the presence of an artificial knee or hip, fatigue, multiple sclerosis, demyelinating diseases of the central nervous system, gonarthrosis, ataxia, COPD, dependence on renal dialysis, malignant neoplasm of breast/prostate, depressive episodes, and pure hypercholesterolemia” (Curtis et al., 2016) and dementia.

 

The situation, however, is much more complex as over half have an additional chronic disease (multimorbidity). This situation has been termed Complex Chronic Disease and Disability (CCDD). Although there are a myriad of combinations, the disease pairs that were significantly associated with the highest likelihood of disability contained dementia (dementia–hip fracture, dementia–cardiovascular disease, and dementia–depression). These individuals are very frail, often confined to bed or wheelchairs. They provide a difficult challenge for caregiving and treatments to help relieve their suffering are badly needed.

 

Yoga practice has been found to be effective for the prevention and treatment of a large array of chronic psychological and physical problems, even for the elderly in hospice, with cancer, COPD, Kidney Disease, anxiety and depression, and dementia. Hence, it would seem reasonable to hypothesize that yoga may be effective for patients with Complex Chronic Disease and Disability (CCDD). In today’s Research News article “Evaluation of a Specialized Yoga Program for Persons Admitted to a Complex Continuing Care Hospital: A Pilot Study.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223015/

Curtis and colleagues performed a pilot study of the effectiveness of yoga practice for male and female elderly (average age 63 years) in an institution with Complex Chronic Disease and Disability (CCDD). Most were in wheelchairs or had severe mobility issues.

 

The patients were provided with a Hatha Yoga program modified for practice in a sitting position, once a week for 8 weeks and were provided with recordings to guide personal daily practice. The practice included relaxation, body scan, and yoga postures. They were measured prior to, midway through, and after the practice for pain, pain catastrophizing, including rumination, magnification, and helplessness, perceived stress, anxiety and depression, perceived injustice, mindfulness, self-compassion, and spiritual well-being, including peace and meaning. They found that the yoga practice benefited the patients increasingly as the practice continued over the 8 weeks producing significant reduction in anxiety and pain magnification, and increases in self-compassion.

 

These are interesting results and suggest that yoga practice may be beneficial for chronically disabled patients with multiple diseases, improving their psychological well-being. This is a very difficult group to care for and treat and as such, the fact that yoga practice may be helpful, is exciting. It should be mentioned that this was a pilot study, without a control condition, and thus no firm conclusions can be reached. But, the results provide evidence and a rationale for conducting a large randomized controlled clinical trial in the future. A program that can help ease the suffering of these afflicted individuals would certainly be warmly welcomed both by the patients and the caregivers.

 

“Yoga therapy is very much about the whole person. It is complementary to physical therapy, but we take into account that back pain may be related to an emotional element, or it may be from lifestyle, some pattern that is not serving them, physical movement patterns or other patterns.” – Janice Gate

 

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

Curtis, K., Kuluski, K., Bechsgaard, G., Ridgway, J., & Katz, J. (2016). Evaluation of a Specialized Yoga Program for Persons Admitted to a Complex Continuing Care Hospital: A Pilot Study. Evidence-Based Complementary and Alternative Medicine : eCAM, 2016, 6267879. http://doi.org/10.1155/2016/6267879

 

Abstract

Introduction. The purpose of this study was to evaluate a specialized yoga intervention for inpatients in a rehabilitation and complex continuing care hospital. Design. Single-cohort repeated measures design. Methods. Participants (N = 10) admitted to a rehabilitation and complex continuing care hospital were recruited to participate in a 50–60 min Hatha Yoga class (modified for wheelchair users/seated position) once a week for eight weeks, with assigned homework practice. Questionnaires on pain (pain, pain interference, and pain catastrophizing), psychological variables (depression, anxiety, and experiences with injustice), mindfulness, self-compassion, and spiritual well-being were collected at three intervals: pre-, mid-, and post-intervention. Results. Repeated measures ANOVAs revealed a significant main effect of time indicating improvements over the course of the yoga program on the (1) anxiety subscale of the Hospital Anxiety and Depression Scale, F(2,18) = 4.74, p < .05, and ηp2 = .35, (2) Self-Compassion Scale-Short Form, F(2,18) = 3.71, p < .05, and ηp2 = .29, and (3) Magnification subscale of the Pain Catastrophizing Scale, F(2,18) = 3. 66, p < .05, and ηp2 = .29. Discussion. The results suggest that an 8-week Hatha Yoga program improves pain-related factors and psychological experiences in individuals admitted to a rehabilitation and complex continuing care hospital.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223015/

Improve Type 2 Diabetes Management with Acceptance and Commitment Therapy

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Improve Type 2 Diabetes Management with Acceptance and Commitment Therapy

 

By John M. de Castro, Ph.D.

 

Acceptance and Commitment Therapy (ACT) – “Be more present to the “here-and-now.” This focus helps to decrease being caught up in what happened in the past. It also frees individuals from worrying too much about the future. Being present helps you to more fully connect to and enjoy the moment. Observe thoughts and feelings in such a way that they no longer keep you stuck in life. Learning to observe through openness and acceptance can help you find freedom from negative thoughts and feelings. Clarify your values and then take action. Finding what is most meaningful to you and choosing to act on these values are important parts of the therapy. This will be part of the process of building a rich and full life.” – VA Mental Health Services

 

Diabetes is a major health issue. 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.

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. Although this has been called adult-onset diabetes it is increasingly being diagnosed in children. Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. A leading cause of this tissue resistance to insulin is overweight and obesity and a sedentary life style. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control.

 

Recently, mindfulness practices have been shown to be helpful in managing diabetes. Acceptance and Commitment Therapy (ACT) is a mindfulness based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. It has been shown to be affective for a number of physical and psychological issues. The effectiveness of ACT to enhance management of Type II Diabetes is not known.

 

In today’s Research News article “A Randomized Controlled Trial of Acceptance and Commitment Therapy for Type 2 Diabetes Management: The Moderating Role of Coping Styles.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5132195/

Shayeghian and colleagues recruited adult (40-60 years of age) patients with Type II Diabetes and randomly assigned them to either receive a one day diabetes health education training or health education plus 10 weeks, once a week two hour session, of group Acceptance and Commitment Therapy (ACT). The participants were measured prior to, after, and 3 months after the intervention for Glycated hemoglobin (HbA1C), diabetes self-care activities, acceptance of diabetes-related thoughts and feelings, and coping styles.

 

They found that ACT, in comparison to education only, resulted in significantly lower glycated hemoglobin, higher self-care activities and higher acceptance scores. This suggests that ACT promotes self-care and acceptance of their disease which translates into better plasma glucose management. Importantly, these benefits were still significant three months after treatment, suggesting that the effects are enduring. They also found that patients with effective coping styles had a greater impact of ACT on their self-care, suggesting that ACT works better for people who use effective strategies to cope with their disease.

 

These are exciting results, as Type II diabetes is so prevalent and effective self-care so important to the health of the patient. They suggest that ACT  improves the self-care that is so important for successful disease management. But the conclusions must be tempered with the fact that the control condition did not have an additional active intervention, e.g. exercise. So, the results could have been due to placebo effects, experimenter bias, attentional effects, etc. These results, though provide support for implementing a larger randomized controlled clinical trial with an active control condition or comparison to other active treatments.

 

So, improve Type 2 Diabetes management with Acceptance and Commitment Therapy.

 

“Results show that participants walked significantly further following the programme, and had lower levels of anxiety, depression and diabetes-related distress. Average blood glucose levels (HbA1c) were shown to have reduced by 0.6%. Qualitative interviews showed that participants found ACT Now! to be engaging, acceptable, attractive and helpful.” – NHS Grampian

 

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

Shayeghian, Z., Hassanabadi, H., Aguilar-Vafaie, M. E., Amiri, P., & Besharat, M. A. (2016). A Randomized Controlled Trial of Acceptance and Commitment Therapy for Type 2 Diabetes Management: The Moderating Role of Coping Styles. PLoS ONE, 11(12), e0166599. http://doi.org/10.1371/journal.pone.0166599

 

Abstract

Background and Aim

Evidence of the efficacy of existing psychological interventions for self-management in diabetes is limited. The current study aimed at assessing the effects of group-based ACT on self-management of patients with T2DM, considering the moderating role of coping styles.

Methods

One hundred and six patients with type 2 diabetes were randomly assigned either to the education alone (n = 53) or to a combination of education and group-based acceptance and commitment therapy (n = 53) over a period of 10 sessions. In each group, 50 participants completed a 3 month follow-up assessment.

Results

After 3 months, compared to patients who received education alone, those in the group-based acceptance and commitment therapy condition were more likely to use effective coping strategies, reported better diabetes self-care, and optimum glycated hemoglobin (HbA1C) levels in the target range.

Conclusions

Consideration of the role of coping style for a more accurate evaluation of the effects of acceptance and commitment therapy may be a useful addition to services provided for patients with type 2 diabetes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5132195/

Improve Treatment Resistant Depression with Mindfulness

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Improve Treatment Resistant Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat and usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But, drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression.

 

Being depressed and not responding to treatment (Treatment Resistant Depression) or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can be applied when the typical treatments fail. Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. In order to identify the best possible treatment, it is particularly important to investigate MBCT’s efficacy for Treatment Resistant Depression relative to other treatments that place equivalent demands upon the patients.

 

In today’s Research News article “A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756643/

Eisendrath and colleagues compared the relative efficacy of MBCT to a structurally equivalent active comparison condition, a Health-Enhancement Program. They recruited adults who were diagnosed with Major Depressive Disorder who were taking antidepressant medication. They were encouraged to continue their antidepressant medication while participating in the study. They were randomly assigned, stratified by gender, to receive 8-weeks of either standard Mindfulness Based Cognitive Therapy (MBCT) treatment or the Health-Enhancement Program. Both groups met once a week for 2 ¼ hours and were assigned 45 minutes of homework 6 days per week. The MBCT program included training in skills to identify cognitive distortions and to disengage from depression-focused ruminative thinking patterns, body scans, sitting meditations, three-minute breathing spaces, and mindful movement. The Health-Enhancement Program included aerobic exercise, functional movement, music therapy, and dietary education. The participants were evaluated for depression levels, and expectancies of treatment effects before and after treatment and mid-treatment (4-weeks).

 

They found that MBCT, in comparison to the Health-Enhancement Program produced a significantly greater reduction in depression (36.6% vs. 25.3%). In addition, MBCT treatment had a significantly greater proportion of patients respond to treatment. MBCT also produced higher, albeit not significantly different, rates of depression remission (22.4%). The two groups did not differ in their expectations that treatment would be successful, suggesting equivalent placebo effects. Hence, MBCT, was found to be superior to a structurally equivalent Health-Enhancement Program treatment in reducing depression in patients with Treatment Resistant Depression (TRD).

 

These are exciting results and strengthen the case that Mindfulness Based Cognitive Therapy (MBCT) is an effective treatment for the very difficult to treat Treatment Resistant Depression. MBCT uses mindfulness training and cognitive training to allow the patients to reprogram their thought patterns and how they interpret experiences, recognizing that their thoughts are only, just that, thoughts and not reflective of their selves. They learn to experience their emotions but adaptively react to them, seeing them as simply experiences that come and go. This helps them release rumination about past and future problems and focus on the present. This appears to go to the core of the psychological aspects of the disorder and greatly enhance the patient’s ability to cope with their depression.

 

So, improve treatment resistant depression with mindfulness.

 

“MBCT enables people to relate mindfully to the self and with others. The key, it seems, lies in the way MBCT enhances relationships: Less stress about relationships in turn helps prevent future episodes of depression.” – Emily Nauman

 

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

Eisendrath, S. J., Gillung, E., Delucchi, K. L., Segal, Z. V., Nelson, J. C., McInnes, L. A., … Feldman, M. D. (2016). A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression. Psychotherapy and Psychosomatics, 85(2), 99–110. http://doi.org/10.1159/000442260

 

Abstract

Background

Due to the clinical challenges of treatment-resistant depression (TRD), we evaluated the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) relative to a structurally equivalent active comparison condition as adjuncts to treatment-as-usual (TAU) pharmacotherapy in TRD.

Methods

This single site, randomized controlled trial compared 8-week courses of MBCT and the Health-Enhancement Program (HEP), comprising physical fitness, music therapy and nutritional education, as adjuncts to TAU pharmacotherapy for outpatient adults with TRD.

The primary outcome was change in depression severity, measured by percent reduction in total score on the 17-item Hamilton Depression Rating Scale (HAM-D17), with secondary depression indicators of treatment response and remission.

Results

We enrolled 173 adults, mean length of current depressive episode was 6.8 years (sd = 8.9). At the end of 8-week treatment, a multivariate analysis showed that relative to the HEP condition, the MBCT condition was associated with a significantly greater mean percent reduction on the HAM-D17 (36.6% versus 25.3%; p=.01) and a significantly higher rate of treatment responders (30.3% versus 15.3%; p=.03). Although numerically superior for MBCT than for HEP, the rates of remission did not significantly differ between treatments (22.4% versus 13.9%; p=.15). In these models, state anxiety, perceived stress, and the presence of personality disorder had adverse effects on outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756643/

Reduce Medical Student’s Stress Response with Yoga

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Reduce Medical Student’s Stress Response with Yoga

 

By John M. de Castro, Ph.D.

 

“By reducing perceived stress and anxiety, yoga appears to modulate stress response systems. This, in turn, decreases physiological arousal — for example, reducing the heart rate, lowering blood pressure, and easing respiration.” – Harvard Mental Health Letter

 

Medical School is challenging both intellectually and psychologically. Stress levels are high and burnout is common. It’s been estimated that 63% of medical students experience negative consequences from stress while symptoms of severe stress were present in 25% of students. The prevalence of stress is higher among females than among males. High stress levels lead to lower performance in medical school and higher levels of physical and mental health problems, especially anxiety and depression. Indeed 50% of medical students report burnout and 11% have considered suicide in the last year.

 

Obviously, there is a need to either lower stress levels in medical education or find methods to assist medical students in dealing with the stress. One promising possibility is mindfulness training. It has been shown to reduce both the psychological and physiological responses to stress. It has also been shown to reduce stress in students, to help with the negative consequences of stress, and to reduce burnout in medical professionals. So, it would seem reasonable to suspect that mindfulness would be helpful in assisting medical students cope with the stress of their training.

 

Yoga practice is a mindfulness technique that has been found to have extensive physical and psychological benefits and has the additional benefit of being also a physical exercise. This may be particularly beneficial for stressed medical students. In today’s Research News article “Medical Students’ Stress Levels and Sense of Well Being after Six Weeks of Yoga and Meditation.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174168/

Prasad and colleagues recruited male and female medical students who did not practice yoga. The participants attended a one hour Hatha yoga class, twice a week, for six weeks. They were measured before and after training for perceived stress, happiness, peace, focus, endurance, positivity, personal satisfaction, self-confidence, patience, and fatigue.

 

They found that after the yoga practice there was a significant reduction in perceived stress and significant increases in peace, focus, and endurance. In addition, there were no adverse effects and the students were very positive about participation. Hence, they found that after yoga practice there was significant improvement in the medical students’ stress levels and psychological state.

 

This study is a pilot, proof of concept study, that did not include a control condition. So, conclusions need to be tempered. Without an active control condition a large number of confounding factors, including placebo effects, attention effects, experimenter bias, maturation effects, etc., are potential explanations for the significant improvements. The study, though is encouraging and provides evidence supporting conducting a large randomized controlled clinical trial of the effectiveness of yoga for the treatment of stress in medical students.

 

“The science is now in: practice in mindfulness meditation decreases stress and can help you avoid the negative outcomes of burnout and loss of empathy. Mindfulness practice can also help you study more efficiently and retain more information from class lectures. It can increase your quality of life and, in some people, it protects against depression. And of all of these effects are founded upon changes in basic brain structures and function. “ – Brown University School of Medicine

 

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

Prasad, L., Varrey, A., & Sisti, G. (2016). Medical Students’ Stress Levels and Sense of Well Being after Six Weeks of Yoga and Meditation. Evidence-Based Complementary and Alternative Medicine : eCAM, 2016, 9251849. http://doi.org/10.1155/2016/9251849

 

Abstract

Objective. To determine the effect of six weeks of yoga and meditation on medical students’ levels of perceived stress and sense of wellbeing prior to taking their exams. Methods. We conducted a prospective case-control study of first-through-third-year medical students at our academic institution, measuring levels of perceived stress and sense of wellbeing before and after a six-week yoga and meditation intervention. Questionnaires used for evaluation included the perceived stress scale (PSS) and self-assessment surveys (SAS). The postintervention surveys were completed on the day of the students’ written exams. Results. A total of thirteen women and fourteen men participated. Median age was 28 (24 yrs–32 yrs). 48.1% were Caucasian, 7.4% Black, 11.1% Hispanic, 11.1% Asian, and 22.2% other. Paired t-tests showed a statistically significant reduction in perceived stress (18.44 versus 14.52; p = 0.004) after the six-week yoga and meditation program. After the yoga intervention, self-assessment survey results showed a significant improvement in feelings of peace, focus, and endurance. Improvements in happiness, positivity, personal satisfaction, and self-confidence were also seen. An improvement in unsubstantiated parameters such as patience and fatigue was observed. Conclusion. Yoga and meditation may be effective in reducing stress levels and improving aspects of personal wellbeing in medical students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174168/

Improve Social and Physical Conditions in the Isolated Elderly with Tai Chi

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Improve Social and Physical Conditions in the Isolated Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“A growing body of carefully conducted research is building a compelling case for tai chi as an adjunct to standard medical treatment for the prevention and rehabilitation of many conditions commonly associated with age,” – Peter M. Wayne

 

We all want to live longer. We celebrate the increasing longevity of the population. But, aging is a mixed blessing. The aging process involves a systematic progressive decline in every system in the body, the brain included. It cannot be avoided. Our mental abilities may also decline with age including impairments in memory, attention, and problem solving ability. These are called age related cognitive decline. In addition, many elderly experience withdrawal and isolation from social interactions. There is some hope as there is evidence that the cognitive declines can be slowed. For example, a healthy diet and a regular program of exercise can slow the physical decline of the body with aging. Also, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging.

 

Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Only recently though have the effects of Tai Chi practice been scrutinized with empirical research. But, it has been found to be effective for an array of physical and psychological issues. It appears to strengthen the immune system, reduce inflammation and increase the number of cancer killing cells in the bloodstream.

 

Because Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. Tai Chi has been shown to help the elderly improve attention, balance, reducing falls, arthritis, cognitive function, memory, and reduce age related deterioration of the brain. The research, however, has studied socially active elderly. Unfortunately, many elderly individuals are socially isolated and do not often interact with others. These have been called the “hidden elderly.” It is not known if Tai Chi practice can be implemented and be effective with these socially isolated elderly individuals.

 

In today’s Research News article “Effects of tai chi qigong on psychosocial well-being among hidden elderly, using elderly neighborhood volunteer approach: a pilot randomized controlled trial.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221552/

Chan and colleagues recruited elderly (66 to 103, mean 77, years of age) who were socially isolated and did not engage in any social activities. They were randomly assigned to receive either treatment as usual (control group), including social worker visits and reminders of available services, or Tai Chi practice for 60 minutes, twice a week, for 3 months and they were encouraged to continue practice at home. They were measured before and after the 3-month practice period and again 3 months later for social support, loneliness, mental health, self-esteem, and quality of life.

 

They found that Tai Chi practice produced a significant reduction in loneliness, significant increase in total satisfaction with social support, and physical quality of life with large effect sizes that were maintained for 3 months after the end of the intervention. In addition, the participants stated that they enjoyed the Tai Chi practice and 82% planned to continue. Importantly, there were no adverse effects recorded from engaging in the practice. Hence Tai Chi practice was successfully implemented with the “hidden elderly” and was found to be a safe and effective practice to improve their social and physical conditions.

 

It should be noted that this was a small group pilot study which did not contain a control group. Hence, conclusions must be tempered. The study, however, does provide evidence that implementation of Tai Chi practice with the “hidden elderly” is feasible and provides a strong rationale to perform a large randomized controlled clinical trial with active control conditions. Regardless, it appears that Tai Chi practice may improve the social and physical conditions in the isolated elderly.

 

“The benefits of Tai Chi for seniors are incredible. If you are looking for a low-impact, relaxing form of exercise that only requires about 20 minutes a day and rewards your efforts, Tai Chi is for you.“ – Ryan Malone

 

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

Chan, A. W., Yu, D. S., & Choi, K. (2017). Effects of tai chi qigong on psychosocial well-being among hidden elderly, using elderly neighborhood volunteer approach: a pilot randomized controlled trial. Clinical Interventions in Aging, 12, 85–96. http://doi.org/10.2147/CIA.S124604

 

Abstract

Purpose

To test the feasibility and preliminary effectiveness of a tai chi qigong program with the assistance of elderly neighborhood volunteers in strengthening social networks and enhancing the psychosocial well-being of hidden elderly.

Patients and methods

“Hidden elderly” is a term used to describe older adults who are socially isolated and refuse social participation. This pilot randomized controlled trial recruited 48 older adults aged 60 or above who did not engage in any social activity. They were randomized into tai chi qigong (n=24) and standard care control (n=24) groups. The former group underwent a three-month program of two 60-minute sessions each week, with the socially active volunteers paired up with them during practice. Standard care included regular home visits by social workers. Primary outcomes were assessed by means of the Lubben social network and De Jong Gieveld loneliness scales, and by a revised social support questionnaire. Secondary outcomes were covered by a mental health inventory and the Rosenberg self-esteem scale, and quality of life by using the 12-Item Short Form Health Survey. Data was collected at baseline, and at three and six months thereafter.

Results

The generalized estimating equations model revealed general improvement in outcomes among participants on the tai chi qigong program. In particular, participants reported a significantly greater improvement on the loneliness scale (B=−1.32, 95% confidence interval [CI] −2.54 to −0.11, P=0.033) and the satisfaction component of the social support questionnaire (B=3.43, 95% CI 0.10–6.76, P=0.044) than the control group.

Conclusion

The pilot study confirmed that tai chi qigong with elderly neighborhood volunteers is a safe and feasible social intervention for hidden elderly. Its potential benefits in improving social and psychological health suggest the need for a full-scale randomized controlled trial to reveal its empirical effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221552/

Improve ADHD in Children with Yoga

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Improve ADHD in Children with Yoga

 

By John M. de Castro, Ph.D.

 

“For individuals with the ADD/ADHD wiring, who have a tendency toward addiction and extreme behavior, building awareness is essential. Mindfulness and the ability to focus go hand-in-hand. I think of mindfulness as a muscle that can be strengthened through meditation/prayer, yoga, exercise, and self-discipline.” – Michael Ferguson

 

Attention Deficit Hyperactivity Disorder (ADHD) is currently epidemic in the US. Roughly 6.4 million American children have been diagnosed with ADHD and 6.4% of American children are being treated with medication. There has been a 42% increase in the diagnoses of ADHD in the last 8 years. It should be emphasized that this increase in diagnoses probably represents an increase in awareness and willingness to diagnose ADHD rather than an increase in cases of ADHD. “Many children who like to run and jump may be high-energy. But that doesn’t mean they are hyperactive. To count as ADHD, symptoms have to be on the extreme side and have to cause problems in the child’s life. Also, they have to have been doing this for at least 6 months.” – WebMD

 

What can be done about this huge problem that is affecting such a large proportion of American children and adults? The most common treatment is drugs, like methylphenidate, Ritalin, which helps reduce symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, including nervousness agitation, anxiety, irritability, sleep and appetite problems, head and stomach aches, nausea, dizziness, and heart palpitations. They can also be addictive and can readily be abused. If that’s not enough using drugs that alter the brain in children during the time of brain development is fraught with long-term risks. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.  Is there a better way?

 

There are indications that mindfulness training may be a more effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mindfulness training are identical to those that are defective in ADHD, attention, impulse control, executive function, emotion control, and mood improvement. Yoga would appear to be particularly appropriate as it’s also an exercise and as such an outlet for some of the excess energy.

 

In today’s Research News article “Effects of an 8-week yoga program on sustained attention and discrimination function in children with attention deficit hyperactivity disorder.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237364/

Chou and Huang examine the ability of yoga training as a treatment for Attention Deficit Hyperactivity Disorder (ADHD). They recruited children between the ages of 8 to 12 who had been diagnosed with ADHD. They were assigned based upon their school district to either be in a no-treatment control group or receive yoga training for 40 minutes, twice a week, for 8 weeks. They were measured before and after training for concentrated targeted perception (visual pursuit task), for their “discrimination ability for reaction speed, attention deficits, and reactive stress tolerance in the presence of continuous but rapidly changing acoustic and optical stimuli” (Determination test), and physical fitness.

 

They found that the yoga practice resulted in a significant increase in accuracy and faster reaction time in the visual pursuit task, indicating improved concentration. They also found that the yoga practice produced a significant increase in accuracy and faster reaction time in the Determination test, indicating improves discrimination ability. Hence, it appears that yoga practice improves attention, both concentrated and selective in children with ADHD.

 

It needs to be remembered that the control group in the study did not receive any active treatment or exercise training. So, it cannot be determined if yoga practice was specifically responsible for the improvements or that any exercise or any intervention would have similar effects. It is possible that the increased attention, placebo effect, or experimenter bias effect might have been responsible. Future research should improve the control condition by including exercise and placebo control conditions. Regardless it is clear that the children treated with yoga practice markedly improved their attentional abilities.

 

So, improve ADHD in children with yoga.

 

“Those diagnosed with ADHD are often stressed, distracted and unable to focus. The benefits of yoga include stress relief, increased focus, self-awareness, meditation as well as confidence all things those with ADHD can benefit from without the use of medication.” – Carol Traulsen

 

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

Chou, C.-C., & Huang, C.-J. (2017). Effects of an 8-week yoga program on sustained attention and discrimination function in children with attention deficit hyperactivity disorder. PeerJ, 5, e2883. http://doi.org/10.7717/peerj.2883

 

Abstract

This study investigated whether a yoga exercise intervention influenced the sustained attention and discrimination function in children with ADHD. Forty-nine participants (mean age = 10.50 years) were assigned to either a yoga exercise or a control group. Participants were given the Visual Pursuit Test and Determination Test prior to and after an eight-week exercise intervention (twice per week, 40 min per session) or a control intervention. Significant improvements in accuracy rate and reaction time of the two tests were observed over time in the exercise group compared with the control group. These findings suggest that alternative therapies such as yoga exercises can be complementary to behavioral interventions for children with attention and inhibition problems. Schools and parents of children with ADHD should consider alternatives for maximizing the opportunities that children with ADHD can engage in structured yoga  exercises.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237364/

What’s Wrong with Meditation 1 – Expectations

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What’s Wrong with Meditation 1 – Expectations

 

By John M. de Castro, Ph.D.

 

“When you meditate, whether you know it or not, you unconsciously setup expectations or conditions. This starts off simple enough. You expect to relax, you expect to release tension from your muscles or core, you expect to find some relief from your day-to-day concerns etc. These expectations, although they may be subconscious and we aren’t aware of them, they are there and often feed the babbler. More so, they greatly limit the depth of meditation you will experience. For the novice, it can make the difference of finding yourself frustrated half way through your meditation because you are dissatisfied that you are not relaxing as much as you had hoped or expected. So by default your session has ended or ironically created more frustration and self-disappointment.” – Eric Pepin

 

How many time have I heard people say, “I tried meditation, but I can’t do it,” or “I tried meditation, but it scared me,” or “I stopped meditating since it didn’t seem to be going anywhere,” or “It’s against my religion to engage in a heathen practice.” These statements are reflective of the large numbers of people who could benefit from meditation but refuse to try it, abandon the practice, or feel that they failed at the practice and abandoned it. All of these statements reflect the prevailing misconceptions and misunderstandings about meditation.

 

I believe that there are three essential problems with the way meditation has been presented in the west that have produced problems, misconceptions, and misunderstandings. First, meditation has been presented in a way that has evoked beliefs, ideas, and images that are overly idealized and not reflective of the typical experiences of meditation practice. Secondly, immediately jumping into meditation practice has been encouraged, without the provision for proper background information, study, or instruction. Lastly, the jargon used to describe the process, experiences, obstacles, and results is extreme, evoking images and expectations that far exceed normal experience.

 

These three problems set up expectations about what the meditator is supposed do and what should be experienced. Unfortunately, that is simply not what actually occurs. As a result, new practitioners quickly give up the practice as they find that they can’t meditate like their image of what meditation should be, they get overwhelmed by the unexpected and powerful psychological issues that arise, sometime precipitating negative consequences, or they are thoroughly disappointed as they discover the promised benefits are subtler than they were led to believe. I’ll admit it, that I was a victim of inaccurate expectations and I’d be willing to bet that at the beginning of a meditation practice most westerners also have them.

 

The media, including print, video, books, and the internet have presented idealized images of meditation, including blissfully meditating people in serene settings. They are presented on the seashore, on mountain tops, at waterfalls, in gorgeous temples, in meditation groups populated by extremely attractive young people, and even floating in the clouds. Just do a google search on meditation pictures and this is what you’ll find. These can be wonderful settings, except perhaps clouds, but are not the usual or even common setting where meditation occurs. Meditation not only doesn’t require this it actually distorts reality. For example, the meditation hall in one of the first meditation centers in the U.S., the San Francisco Zen Center, is located at street level on a noisy, busy city street.

 

Establishing a relatively quiet place to meditate is helpful, but meditation can occur virtually anywhere. I frequently meditate while sitting at the gate at an airport waiting for my flight to board, while in flight, or in a car when I’m a passenger on a long trip. When the weathers nice I like to meditate in my back yard, with the breeze blowing, with noise from traffic barking dogs, and planes passing overhead prevalent. In fact, I find meditation in real-world settings to be particularly beneficial. After all, meditation is useful only to the extent that it transfers to the real world. If meditation only produced effects that only occurred in a quiet room, it wouldn’t be very useful. For meditation effects to transfer to real life, what psychologists call generalization, then the more similar the meditation environment is to the real world, the better. It can be difficult to meditate with all the hubbub and distraction of the real world, but you can learn more, practicing observing without judgment when there’s lots present that you normally judge.

 

The media also presents images of meditating people in perfect lotus posture, with serene, peaceful, and blissful expressions. But, meditation is rarely blissful. It’s wonderful when it is. But, this is the rare exception, not the rule. For that matter it’s rarely peaceful and serene. Once again, it’s great on the rare occasions when it is, but this is not the usual experience. Meditation is often chaotic, sometimes stressful, sometimes troubling, but, if you take an open attitude, it’s always beneficial. That is not to say that meditation does not bring serenity, happiness, and occasional bliss. It does. But, not at first and not with every meditation. These states grow over time. I had people commenting about how I’d changed before I even realized it myself. Be patient. It will happen.

 

Also, very few meditators can comfortably maintain a lotus position. Most find that they are better off sitting in a chair, kneeling with a bench, sitting with a back-jack, or with their feet up in a recliner. We’re taught that getting too comfortable promotes sleepiness and therefore erect sitting postures on a mat are preferred. What is not taught is how excruciating painful these postures can be and how pain is not conducive to meditation. The truth is, each individual needs to experiment to find what works best for them and discard the media’s image of what should be. Meditation is best when the individual is alert but comfortable. Every individual needs to find the position and posture that produces this state of alert comfort best for them.

 

One of the most frequent misunderstandings is that meditation produces a quiet mind. This is generally what is taught and expected with meditation. It’s true with continued practice the mind does settle down and occasionally becomes quiet. But, again, this is not the typical experience, particularly for new meditators. I have frequently asked groups of people who are not practiced meditators to simply try to close their eyes and count breaths while concentrating on their breathing for two minutes. They are often astounded to find that they can’t do this. Within a brief time after beginning their minds wander. I point out to them that they were unable to control their mind even for two minutes. It’s important that the beginning meditator should take note that they can’t control their mind and reflect upon the fact that their notions of control are delusions. They are not in control at all. This is eye opening. It is rarely taught to the beginning meditator, but is perhaps the most important teaching of all before entering into a meditation practice. You can learn from looking at what the mind does rather than trying to quiet it and getting frustrated. You can learn a great deal from the so called “monkey mind.” Fighting it is doomed to failure. Instead watch it and learn. Learn that you are not your mind!

 

It is important that we teach the realities of meditation rather than the ideal. Beginning meditators need to be instructed not to expect to be able to control their minds, but to relax, learn from the internal chaos, don’t fight it and don’t invite it in, just observe it. Don’t worry about perfect posture and position. Explore what works best that produces a state of sustainable alert comfort. Don’t only meditate in quiet comfortable surroundings. Rather, meditate where you are when reflective time is available. It doesn’t have to be for a fixed period of time. Again, experiment and find what works and don’t be afraid to change it. Think of meditation practice as an experiment with one participant. See how it goes, keep what works, and change what doesn’t. Finally, leave expectation at the door. See for yourself. Be open. Let it flow. The benefits will come but only when you stop trying to make them happen.

 

 “‘It is hard to have a balanced view when the media is full of articles attesting to the benefits of meditation and mindfulness. We need to be aware that reports of benefits are often inflated … whereas studies that do not discover significant benefits rarely pick up media interest, and negative effects are seldom talked about.” – Catherine Wikholm

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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