Improve Obesity with Yoga

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Improve Obesity with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga has an important role to play in the treatment of Obesity. Yoga techniques affect body, internal organs, endocrine glands, brain, mind and other factors concerning Body – Mind complex. Various Yoga techniques can be practiced effectively to reduce the weight and achieve normal healthy condition of Body and Mind.” – Prafulla Dorle

 

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 “Effect of Integrated Approach of Yoga Therapy on Male Obesity and Psychological Parameters-A Randomised Controlled Trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1461037563920165/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121695/

Rshikesan & Subramanya recruited overweight and obese males with Body Mass Indexes (BMIs) between 23 to 35 and randomly assigned them to either a treatment as usual control group or a yoga therapy group. The yoga therapy was administered 90 minutes per day, five days per week for 14 weeks and consisted of postures, breathing exercises, relaxation, and meditation. The participants were measured both before and after the treatment for height, weight, circumferences of the upper arm, waist, and hips, skin fold thicknesses, weight related acceptance and action, and perceived stress.

 

They found that in comparison to before treatment, the yoga therapy group had modest but significant reductions in weight, BMI, front skinfold thickness, arm and hip circumferences, perceived stress, and weight related acceptance and action while the control group did not. But, the differences between yoga and control groups were only significantly different for arm circumference and skinfold thickness. The yoga group consistently had better results on the average than the control group. This suggests that the study did not have large enough groups to statistically detect modest differences between groups. In addition, there was not an alternate exercise control condition, e.g. walking exercise. So, it cannot be concluded that yoga specifically and not any form of light exercise produced the benefits.

 

The results are encouraging but not spectacular and suggest that yoga therapy can produce modest improvements in overweight and obese males. Yoga, being a light exercise, can contribute to energy expenditure and improve body composition, shifting weight from fat to muscle mass. Yoga also has a wide variety of other physical and psychological benefits. So, the present study may underestimate the value of yoga practice for overweight and obese individuals.

 

So, improve obesity with yoga.

 

“Yoga is an excellent exercise and spiritual discipline for people of any size. For some fat students, simply being made aware of body mechanics differences and being made welcome in a class are enough to bolster their confidence and allow them to progress.” – 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

 

Study Summary

Rshikesan, P. B., & Subramanya, P. (2016). Effect of Integrated Approach of Yoga Therapy on Male Obesity and Psychological Parameters-A Randomised Controlled Trial. Journal of Clinical and Diagnostic Research : JCDR, 10(10), KC01–KC06. http://doi.org/10.7860/JCDR/2016/21494.8727

 

Abstract

Introduction: Obesity is a growing global epidemic and cause of non-communicable diseases. Yoga is one of the effective ways to reduce stress which is one of the causes of obesity.

Aim: To assess the effect of Integrated Approach of Yoga Therapy (IAYT) yoga module on adult male obesity in an urban setting.

Materials and Methods: RCT (Randomized Controlled Trial) was conducted for 14 weeks on obese male subjects with yoga and control groups. Total number of subjects were 72 and they were randomized into two groups (Yoga n=37, Control n=35). The subjects were from an urban setting of Mumbai and were doing yoga for the first time. Special yoga training of IAYT was given to yoga group for one and half hour for 5 days in a week for 14 weeks. The control group continued regular physical activities and no specific physical activity was given. The assessments were anthropometric parameters of weight, Body Mass Index (BMI), MAC (Mid Upper Arm Circumferences) of Left and Right Arm, Waist Circumference (WC), HC (Hip Circumference), WHR (Waist Hip Ratio), SKF(Skin Fold Thickness of Biceps, Triceps, Sub scapular, suprailiac and cumulative), Percentage body fat based on SKF and Psychological Questionnaires of Perceived Stress Scale (PSS) and AAQW (Acceptance and Action Questionnaire for Weight Related Difficulty). These were taken before and after intervention for both yoga and control groups. Within and between group analysis & correlation of differences from post to pre readings among the variables, were carried out using SPSS 21.

Results: The anthropometric and psychological parameters were improved in both the groups but changes were significant in yoga group.

Conclusion: Incorporating the IAYT for obese male in urban setting will be effective for obesity treatment and for reducing the obesity related problems.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121695/

 

Reduce Test Anxiety with Mindful Breathing

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Reduce Test Anxiety with Mindful Breathing

 

By John M. de Castro, Ph.D.

 

“Mindfulness training for students gives you tools to help you remain calm, sustain your attention, and be able to focus. It does this by helping you to pay attention to the present moment through simple breathing and meditation practices which increase awareness of thoughts and feelings so as to reduce stress and anxiety and boost levels of attention and concentration.” – Mindfulness for Students

 

It’s a normal human response to become anxious while being evaluated by others. In fact, the vast majority of students report that the stress and anxiety associated with being evaluated is greater than that produced by anything else in their lives. The majority of students are able to cope with the anxiety and perform on tests in spite of it. But, for a minority of students, somewhere around 16%-20%, the anxiety level is so high that it causes them to “freeze” on tests and markedly impair their performance. It is estimated that they perform 12 points lower, more than one letter grade, on average than students lower in anxiety. Counselling centers in colleges and universities report that evaluation anxiety is the most common complaint that they treat among students.

 

It has been demonstrated repeatedly that mindfulness counteracts anxiety and mindfulness training is an effective treatment for a variety of forms of anxiety. Mindfulness training has been shown to be effective for anxiety disorders in general and  in relieving test anxiety. But, mindfulness training has not been directly compared to other antianxiety therapies. Cognitive reappraisal is a therapeutic technique that prompts the individual to rethink their interpretations of events and their feelings about them. For example, a student failing a test may think that this demonstrates that they are stupid and unworthy. Cognitive reappraisal of this would result in thinking that anxiety interfered with their studying and their performance. This therapy has also been shown to be effective for anxiety disorders.

 

In today’s Research News article “The Effectiveness of Daily Mindful Breathing Practices on Test Anxiety of Students.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1459522354071686/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5072593/

Cho and colleagues test the effectiveness of both mindfulness training and cognitive reappraisal for test anxiety. They recruited highly anxious university students and randomly assigned them to either 7-days of mindful breathing exercises, cognitive reappraisal, or no treatment. Instruction in mindful breathing and cognitive reappraisal occurred in a 1 hour, therapist guided, training session followed by 7 days of verified daily practice. The students were measured both before and after training for test anxiety, positive thoughts, and positive emotions.

 

They found that both mindful breathing and cognitive reappraisal produced clinically significant decreases in test anxiety in comparison to the control condition. But, only mindful breathing produced increases in positive thoughts. Hence, both mindful breathing and cognitive reappraisal were found to be effective treatments for test anxiety, but, mindful breathing has an additional benefit of increasing the individual’s automatic positive thoughts about themselves. Although not tested here, this would suggest that mindful breathing would have more long lasting effects on test anxiety.

 

These are exciting results in that a brief therapy, only lasting a week, and involving only an hour per student of therapist time, produced a major reduction in test anxiety. This suggests that these therapies can be administered cost effectively to large numbers of test anxiety sufferers. This is important due to the large number of students effected by test anxiety and the limited resources available to treat them.

 

Both mindful breathing and cognitive reappraisal are thought to effect anxiety by producing a distancing and disidentification of themselves from the contents of their conscious thoughts and emotions. This is known as decentering and indicates a reduction in self-criticism, rumination, and anxiety that can arise when reacting to negative thinking patterns. This decentering then counteracts anxiety by depersonalizing the feelings, making them just feelings and not indicative of some problem with the individual. Mindfulness training is known to improve emotion regulation allowing the individual to fully experience the feelings yet react to them more adaptively. This may account for the additional benefit of mindful breathing of increasing positive thoughts.

 

So, reduce test anxiety with mindful breathing.

 

“Often, when you are trying to remember important information, it is natural to tense your body or strain your mind, but this actually impedes your ability to recall information. In fact, a deeply relaxed state can enhance your ability to access memories in the moment. No matter your skill level, going into a standardized test relaxed instead of stressed will probably earn you more points.” – Suzanne Pearman

 

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

Cho, H., Ryu, S., Noh, J., & Lee, J. (2016). The Effectiveness of Daily Mindful Breathing Practices on Test Anxiety of Students. PLoS ONE, 11(10), e0164822. http://doi.org/10.1371/journal.pone.0164822

 

Abstract

The present study examined the effectiveness of daily mindful breathing practices on test anxiety of university students. A total of 36 participants were randomly assigned to one of three conditions: a training mindful breathing condition (n = 12), a training cognitive reappraisal condition (contrast group, n = 12), and a non-training condition (control group, n = 12). Each of the participants trained by themselves for 6 days after they had taken one session of education for mindful or cognitive reappraisal practices. They wrote their experiences on daily worksheets and sent it by mobile with taking pictures that were confirmed by the researcher. Before and after training, each of the participants completed a questionnaire to assess: test anxiety, positive thought, and positive affect. The results of the study showed that both mindful breathing practice and cognitive reappraisal practice yielded large effect sizes in reducing test anxiety. In addition, the mindful breathing condition scored significantly higher on positive thoughts than the cognitive reappraisal and control conditions. The findings of this study suggest that both daily mindful breathing and cognitive reappraisal practices were effective in reducing test anxiety; however, mindful breathing increased positive automatic thoughts to a greater extent than cognitive reappraisal.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5072593/

 

Improve Heart Failure Patient Longevity with Spirituality

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Improve Heart Failure Patient Longevity with Spirituality

 

By John M. de Castro, Ph.D.

 

“Although difficult to study, spirituality has been evaluated and deemed to have a beneficial effect on multiple measures including global quality of life, depression and medical compliance in the treatment of patients with heart failure.” – J Naqhi

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” – Centers for Disease Control. Congestive heart failure (CHF) is a major type of cardiovascular disease. “CHF is a chronic progressive condition that affects the pumping power of your heart muscles. While often referred to simply as “heart failure,” CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently” (Healthline).

 

Congestive heart failure (CHF) is a very serious life-threatening condition. About 5.7 million adults in the United States have congestive heart failure. One in 9 deaths include heart failure as a contributing cause. The seriousness of CHF is underscored by the fact that about half of people who develop CHF die within 5 years of diagnosis. Hence, effective treatment is very important. There is a myriad of treatments that have been developed to treat CHF including a variety of surgical procedures and medications. Importantly, lifestyle changes have proved to be quite effective. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses.

 

Spirituality, a sense of inner peace and harmony, and religiosity are known to help with a wide range of physical and psychological problems. So, it would make sense to investigate the relationship of spirituality and religiosity to the treatment of congestive heart failure. In today’s Research News article “Spiritual Peace Predicts 5-Year Mortality in Congestive Heart Failure Patient.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1458465060844082/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4760860/.

Park and colleagues recruited a large sample of patients who had experienced congestive heart failure (CHF) of at least moderate severity. They were 64% male and averaged 69 years of age. The researchers measured severity of CHF, other health conditions, smoking, alcohol consumption, engagement in health behaviors, depression, social support, attendance at religious services, and spiritual peace. The patients were followed over a five year period to establish mortality rates.

 

At the five-year follow-up, almost a third (32%) of the patients had died. They found that age, other health conditions, and depression contributed to mortality. Controlling for these variables they found that smoking nearly tripled the risk of death, while alcohol consumption mildly reduced the risk. Adhering to a healthy lifestyle cut the risk in half and spirituality and engagement in religious practice was associated with greater engagement in healthy lifestyles. Controlling for all of these variables they found that spirituality was associated with a 20% reduction in mortality.

 

These results suggest that controlling lifestyle is critical for survival after CHF. This includes reducing smoking and increasing healthy lifestyle behaviors. But, in addition to these important factors, spirituality, but not engagement in religious practices, improves longevity. Although spirituality is associated with lifestyle, the analysis suggests that spirituality’s association with improved longevity occurs independently of lifestyle factors. These results have to be interpreted with caution since they are correlative and cannot prove causation. But, the fact that spirituality predicts longevity over a 5-year period after measurement, is compatible with an interpretation that spirituality causally contributes to longevity.

 

These results suggest that just being religious is not enough. One must be spiritual in order to obtain the longevity benefits. So, it is not enough to just believe in a greater power or attend religious services. Rather, a sense of spiritual peace and harmony is required. To some extent, this makes sense as this would reduce stress which is known to exacerbate disease processes. In addition, spirituality has been shown to improve adherence to treatment regimens for heart failure and this by itself could account for improved longevity. Regardless, the results make it clear that being spiritual can help extend the lives of patients with congestive heart failure (CHF).

 

So, improve heart failure patient longevity with spirituality.

 

“We found that more gratitude in these patients was associated with better mood, better sleep, less fatigue and lower levels of inflammatory biomarkers related to cardiac health,” – Paul J. Mills

 

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

Park, C. L., George, L., Aldwin, C. M., Choun, S., Suresh, D. P., & Bliss, D. (2016). Spiritual Peace Predicts 5-Year Mortality in Congestive Heart Failure Patients. Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association, 35(3), 203–210. http://doi.org/10.1037/hea0000271

 

Abstract

Objective: Spirituality is favorably related to depression, quality of life, hospitalizations, and other important outcomes in congestive heart failure (CHF) patients but has not been examined as a predictor of mortality risk in this population. Given the well-known difficulties in managing CHF, we hypothesized that spirituality would be associated with lower mortality risk, controlling for baseline demographics, functional status, health behaviors, and religiousness.

Method: Participants were 191 CHF patients (64% male; Mage = 68.6 years, SD = 10.1) who completed a baseline survey and were then followed for five years.

Results: Nearly one third of the sample (32%) died during the study period. Controlling for demographics and health status, smoking more than doubled the risk of mortality, while alcohol consumption was associated with slightly lower risk of mortality. Importantly, adherence to healthy lifestyle recommendations was associated with halved mortality risk. While both religion and spirituality were associated with better health behaviors at baseline in bivariate analyses, a proportional hazard model showed that only spirituality was significantly associated with reduced mortality risk (by 20%), controlling for demographics, health status, and health behaviors.

Conclusions: Experiencing spiritual peace, along with adherence to a healthy lifestyle, were better predictors of mortality risk in this sample of CHF patients than were physical health indicators such as functional status and comorbidity. Future research might profitably examine the efficacy of attending to spiritual issues along with standard lifestyle interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4760860/

 

Improve Irritable Bowel Syndrome (IBS) with Mindfulness

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Improve Irritable Bowel Syndrome (IBS) with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Dealing with irritable bowel syndrome (IBS) isn’t easy, but the stress (and the symptoms) involved may be lessened with mindfulness meditation.” – Andrew Weil

 

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder with worldwide prevalence rates ranging from 9–23%. In the U.S. the rates generally in the area of 10–15% affecting between 25 and 45 million people. IBS is not life threatening but it is very uncomfortable producing changes in bowel movement patterns, bloating and excess gas, and pain in the lower belly. It is also a major source of absenteeism both at work and in school. IBS is also associated with a marked reduction in the individual’s health quality of life, with disruption of the physical, psychological and social routines of the individuals. At present, there are no known cures for IBS and treatments involve symptomatic relief, often with fairly radical dietary changes.

 

It has been shown that meditation and yoga can help relieve IBS symptoms but there is a need for more research, particularly of the long-term effectiveness of mindfulness on the symptoms of IBS. In today’s Research News article “Long Term Effects of Mindfulness on Quality of life in Irritable Bowel Syndrome.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1457490580941530/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752522/

Zomorrodi and colleagues recruited adult (average age = 34) participants who had been diagnosed with irritable bowel syndrome (IBS). They randomly assigned them to either receive treatment as usual or treatment as usual combined with an 8-week, once a week for 2 hours, Mindfulness-Based Stress Reduction (MBSR) program. The participants were measured for health quality of life before, and after treatment and were followed-up 2 months later.

 

They found that the MBSR group had a clinically significant (25%) improvement in their health-related quality of life that was sustained at the 2-month follow-up whereas the treatment as usual group showed no improvement. Hence mindfulness training improves the physical, psychological and social impact of IBS on the lives of the patients. These results are important as they show a sustained, relatively long-term improvement produced by MBSR treatment.  Many studies only report improvements measured immediately after treatment. A treatment that is effective only as long as it is being actively administered is of limited usefulness, while one that lasts well beyond the actual time of treatment is much more valuable.

 

It is not known exactly how mindfulness training improve the health-related quality of life in IBS patients. It can be speculated, however, that the training, by focusing the patient on the present moment reduces the worry and catastrophizing about the future that usually accompanies disease. This would allow the patient to focus only on their current physical state and not amplify the symptoms with worry. In addition, mindfulness training is known to reduce the psychological and physiological responses to stress. Stress is well known to exacerbate disease states. So, stress reduction would tend to improve the symptoms of IBS and improve the health-related quality of life.

 

So, improve irritable bowel syndrome (IBS) with mindfulness.

 

“compared to the control group, participants in the mindfulness training group improved on IBS-related quality of life and gastrointestinal-specific anxiety, depression, and general functioning.” – Mindful

 

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

Zomorrodi, S., Rasoulzadeh Tabatabaie, S. K., Azadfallah, P., Ebrahimidaryani, N., & Arbabi, M. (2015). Long Term Effects of Mindfulness on Quality of life in Irritable Bowel Syndrome. Iranian Journal of Psychiatry, 10(2), 100–105.

 

Abstract

Objectives: This study aimed to investigate the long-term effects of mindfulness-based therapy on improving life quality of patients with irritable bowel syndrome.

Method: This was an experimental study including 24 patients (12 from each group) with IBS syndrome were selected based on the ROMEIII criteria and were randomly placed in the test and control groups. In both groups, the scales of the IBS-QOL34 Questionnaire were applied as assessment tool. Experiment group was subjected to the MFT (mindfulness-based therapy), while the control group received no intervention. After the two-month follow up, both groups were once again evaluated through the IBS-QOL34 scales.

Results: There is not significant difference between trial and control group in starting of the study in demographic and quality of life status. The findings of covariance analysis revealed that the difference between the experiment and the control groups at follow-up was significant (p = 0.01). The results showed that the MFT has long-term effects on the life quality of patients suffering from IBS.

Conclusion: The MFT could be considered as a new, effective and stable method in psychotherapy, particularly in psychosomatic disorders such as Irritable Bowel Syndrome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752522/

 

Improve Neural Regulation of Negative Emotions with Mindfulness

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Improve Neural Regulation of Negative Emotions with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation might help depression, stress and anxiety but it’s not a ‘positive thinking’ tool that pretends everything is fine when it isn’t. It’s a way of being able to be with things as they are, in pain or in grief. It’s a way of being able to experience those inevitable parts of life, without your brain running away with its thoughts and making things worse, or pushing them away and resisting them.  It’s a way of being happy when we are happy, and to be fully present with our happiness, without holding onto that feeling too tightly because we fear the alternative.  And that’s where true peace lives.” – Ruth Rosselson

 

We’re very emotional creatures. Without emotion, life is flat and uninteresting. They are so important to us that they affect mostly everything that we do and say and can even be determinants of life or death. Anger, fear, and hate can lead to murderous consequences. Anxiety and depression can lead to suicide. At the same time love, joy, and happiness can make life worth living. Our emotions also affect us physically with positive emotions associated with health, well-being, and longevity and negative emotions associated with stress, disease, and shorter life spans.

 

There is a prevalent popular notion that to effectively deal with negative emotions such as grief and sadness, they have to be fully expressed and experienced. This is in general true as repression of powerful emotions can have long-term negative consequences. But, overexpressing emotions such that they become a focus of worry and rumination also has negative consequences. So, the key to dealing with powerful negative emotions is the middle way, to allow their expression, but then letting them go and moving on. A method to enhance this middle way is mindfulness. It has been shown to improve emotion regulation. People either spontaneously high in mindfulness or trained in mindfulness are better able to be completely in touch with their emotions and feel them completely, while being able to respond to them more appropriately and adaptively. In other words, mindful people are better able to experience yet control emotions. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health.

 

Mindfulness appears to act on emotions by producing relatively permanent changes to the nervous system, increasing the activity, size, and connectivity of some structures while decreasing it for others in a process known as neuroplasticity. So, mindfulness practice appears to affect emotion regulation by producing neuroplastic changes to the structures of the nervous system that underlie emotion. In today’s Research News article “Minding One’s Emotions: Mindfulness Training Alters the Neural Expression of Sadness.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1456402104383711/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017873/

Farb and colleagues investigate the nervous system’s response to a negative emotion, sadness, in people trained in mindfulness. They recruited participants and randomly assigned them to either receive an 8-week Mindfulness-Based Stress Reduction (MBSR) program or to a wait-list control group. Before and after training the participants were measured for anxiety, depression, and symptoms of psychopathology. Following training the participants had sadness induced by having them watch 3-min film clips from sad vs. neutral movies. They watched the movies while their brains were scanned with functional Magnetic Resonance Imaging (f-MRI).

 

They found that MBSR produced significant decreases in anxiety, depression, and in symptoms of psychopathology that were not apparent in the wait-list control group. Watching the sad movie clips, the sadness induction, produced a significant increase in sadness and in the activity in the brain structures associated with the Default Mode Network (DMN) that normally gets activated by self-reflective and ruminating thinking. Significantly, they found that the group who received MBSR training had a significantly lower neural response in the DMN to the sadness induction. This occurred in spite of the fact that the sadness induction produced equivalent increases in sadness in both groups. At the same time, the MBSR group showed a greater activation of the visceral and somatosensory areas of the cortex.

 

These findings suggest that mindfulness training improves mental health by altering the neural response to negative emotional states, in this case sadness. The fact that the responses of the visceral and somatosensory areas were heightened in the mindfulness trained participants suggests that they felt the emotional state more deeply. At the same time, the reduced activation of the Default Mode Network (DMN) in the mindfulness trained participants suggests that sadness produced less self-reflection, worry, and rumination. This suggests that the brain better regulates the response to the emotions after mindfulness training. Hence the finding suggest that mindfulness training improves the brain’s emotion regulation processes and thereby reduces anxiety, depression and the symptoms of psychopathology.

 

So, improve neural regulation of negative emotions with mindfulness.

 

“When I despair, I remember that all through history the way of truth and love have always won. There have been tyrants and murderers, and for a time, they can seem invincible, but in the end, they always fall. Think of it – always.”- Mahatma Gandhi

 

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

Farb, N. A. S., Anderson, A. K., Mayberg, H., Bean, J., McKeon, D., & Segal, Z. V. (2010). Minding One’s Emotions: Mindfulness Training Alters the Neural Expression of Sadness. Emotion (Washington, D.C.), 10(1), 25–33. http://doi.org/10.1037/a0017151

 

Abstract

Recovery from emotional challenge and increased tolerance of negative affect are both hallmarks of mental health. Mindfulness training (MT) has been shown to facilitate these outcomes, yet little is known about its mechanisms of action. The present study employed functional MRI (fMRI) to compare neural reactivity to sadness provocation in participants completing 8 weeks of MT and waitlisted controls. Sadness resulted in widespread recruitment of regions associated with self-referential processes along the cortical midline. Despite equivalent self-reported sadness, MT participants demonstrated a distinct neural response, with greater right-lateralized recruitment, including visceral and somatosensory areas associated with body sensation. The greater somatic recruitment observed in the MT group during evoked sadness was associated with decreased depression scores. Restoring balance between affective and sensory neural networks—supporting conceptual and body based representations of emotion— could be one path through which mindfulness reduces vulnerability to dysphoric reactivity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017873/

 

Improve Epilepsy with Mindfulness

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Improve Epilepsy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“We found benefits of short-term psychotherapy on patients with drug-resistant epilepsy. Mindfulness therapy was associated with greater benefits than social support alone in quality of life, mood, seizure frequency, and verbal memory.” – Venus Tang

 

Epilepsy, also known as seizure disorder, is a chronic disorder that includes a wide variety of neurological dysfunctions with the common property of unpredictable seizures of the brain. The seizures can vary widely from individual to individual in intensity, duration, frequency and parts of the brain affected. Epilepsy occurs to about 4% of the population sometime during their lifetime with about 150,000 new cases each year in the U.S. The first order treatment for Epilepsy is anti-seizure drugs which are effective for about 70% of the cases. These drugs can produce mild side effects of feeling tired, stomach upset or discomfort, dizziness, or blurred vision. In some cases, surgery is called for, removing the portion of the brain where the seizures originate.

 

The 30% of epilepsy sufferers who do not respond to drugs are not only afflicted with uncontrollable seizures but also have high rates of anxiety and depression, poor quality of life, and cognitive problems. These secondary symptoms may actually worsen the epilepsy. Hence, there is a need to find safe and effective treatments for drug resistant epilepsy. Mindfulness training has been shown to produces changes in the brain and has been shown to be effective in treating anxiety, depression, and cognitive problems. So, it is possible that mindfulness training may help with drug resistant epilepsy.

 

In today’s Research News article “Pay Attention: Mindfulness in Epilepsy.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1455665217790733/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4988075/

Koubeissi provides a commentary on a study by Tang et. al “Mindfulness-Based Therapy for Drug-Resistant Epilepsy: An Assessor-Blinded Randomized Trial.” In this study, they recruited patients with drug resistant epilepsy and randomly assigned them to receive either social support or mindfulness-based therapy. Treatment occurred every other week for a total of four sessions. They found that the patients treated with mindfulness-based therapy had significantly greater reductions in depression, anxiety, and seizure frequency, and improvements in delayed memory. Importantly, these patients also reported a clinically significant increase in quality of life. Hence, they found that only four sessions of mindfulness-based therapy were very effective in improving the symptoms of drug resistant epilepsy.

 

Koubeissi commented on the importance of the finding of improved quality of life, with the mindfulness-based therapy group showing significant clinical improvement. He claims that this is what is most important to the patients. He attributes the improvements to the ability of mindfulness to improve anxiety, depression, and cognitive problems. By focusing attention on the present moment, mindfulness interrupts the past and future based thinking that results in fear, anxiety, worry, and catastrophizing. He concludes that these reductions relax the patient, allowing them to simply focus on the present symptoms and thereby prevent the exacerbation of the epilepsy. In other words, he concludes that mindfulness doesn’t directly improve epilepsy. Rather, it does so indirectly by preventing the amplification of the symptoms by anxiety and depression.

 

So, improve epilepsy with mindfulness.

 

“One of the scariest things about being epileptic is that you develop this fear of having a seizure in public. I started practicing mindful breathing in order to cope with this anxiety, and it’s especially helpful if I’m somewhere crowded or loud.” – Mango Helath

 

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

Koubeissi, M. (2016). Pay Attention: Mindfulness in Epilepsy. Epilepsy Currents, 16(4), 245–246. http://doi.org/10.5698/1535-7511-16.4.245

 

OBJECTIVE: To investigate the effectiveness of mindfulness-based therapy (MT) and social support (SS) in patients with drug-resistant epilepsy. METHODS: We performed an assessor-blinded randomized control trial. Sixty patients with drug-resistant epilepsy were randomly allocated to MT or SS (30 per group). Each group received 4 biweekly intervention sessions. The primary outcome was the change in the total score of the Patient-Weighted Quality of Life in Epilepsy Inventory (QOLIE-31-P). Secondary outcomes included seizure frequency, mood symptoms, and neurocognitive functions. The assessors were blinded to the patient’s intervention grouping. Results were analyzed using general linear model with repeated measure. RESULTS: Following intervention, both the MT (n=30) and SS (n=30) groups had an improved total QOLIE-31-P, with an improvement of +6.23 for MT (95% confidence interval [CI] +4.22 to +10.40) and +3.30 for SS (95% CI +1.03 to +5.58). Significantly more patients in the MT group had a clinically important improvement in QOLIE-31-P (+11.8 or above) compared to those who received SS (11 patients vs. 4 patients). Significantly greater reduction in depressive and anxiety symptoms, seizure frequency, and improvement in delayed memory was observed in the MT group compared with the SS group. CONCLUSIONS: We found benefits of short-term psychotherapy on patients with drug-resistant epilepsy. Mindfulness therapy was associated with greater benefits than SS alone in quality of life, mood, seizure frequency, and verbal memory. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that mindfulness-based therapy significantly improves quality of life in patients with drug-resistant epilepsy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4988075/

 

The Power of Retreat 7 – The Middle Way

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By John M. de Castro, Ph.D.

 

“Monks, these two extremes ought not to be practiced by one who has gone forth from the household life. (What are the two?) There is addiction to indulgence of sense-pleasures, which is low, coarse, the way of ordinary people, unworthy, and unprofitable; and there is addiction to self-mortification, which is painful, unworthy, and unprofitable. Avoiding both these extremes, the Tathagata (the Perfect One) has realized the Middle Path; it gives vision, gives knowledge, and leads to calm, to insight, to enlightenment and to Nibbana.”  – Siddhārtha  Gautama

 

This essay is the 7th of a continuing series of essays about the experience of silent meditation retreats. Click on the numbers to follow the links to the prior essays, titled “The Power of Retreat 1, 2, 3, 4, 5, and 6”. This essay is written as I return from a 5-day silent personal retreat at a beautiful retreat site located in Big Sur, California. In a sense, I was on vacation as everything was taken care of for me; beds made, towels and linens provided, and all meals prepared for me. All I had to do was show up, meditate, relax, do yoga, soak in a hot spring, and contemplate. I was terribly spoiled!

 

But retreat can also be very difficult. I have a life-long habit of trying too hard. In American culture, that is not considered a fault, but in the contemplative life it often is. The Buddha taught the middle way as the proper approach. He tried the extremes from the excess in the life of a prince to the opposite excess in the life of an ascetic. He found after years of futile effort that neither worked in ending suffering. But, when he rejected both and compromised, exerting effort but not too much, he found success and attained enlightenment. So, he taught his followers the middle way.

 

The Buddha likened the spiritual path to a stringed musical instrument. If no effort is exerted the string is slack and does not produce music. If too much effort is exerted, the string is tightened too much and breaks. Only when the string is tightened moderately does it produce beautiful music. He taught this middle way of moderation in all things to achieve success in all phases of life but particularly in spiritual endeavors.

 

I discovered that this wisdom also pertains to engagement in retreat. Some retreats are extremely rigorous, with meditation for hours a day for weeks, months, or even years. A teacher of mine refers to them as “Buddha Boot Camp.” For some, this may be an effective method. Indeed, the 12th century sage Milarepa attained enlightenment after meditating day and night for twelve years. For most people this is, for practical reasons, impossible. But, even rigorous limited modern day retreats I have found that I am simply unable to do this. The physical rigors create great pain and suffering and I do not find this to be conducive to deep meditation. Many teachers believe that this is necessary to attain a breakthrough, but others disagree and there are some reasons to believe that it might be dangerous for some. So, what is the correct path?

 

The modern sage Thich Nhat Hahn visited the San Francisco Zen Center; a center noted for its rigor. After his visit, he was asked by the leader how the Center could improve. He stated that first he would sleep later, and that they shouldn’t be so grim and dour, and should smile much more. What he was pointing to is the middle way; being less strict and rigorous and practicing with greater joy; keeping the body and spirit at a moderate level that allows for the practice to be relaxed and joyful.

 

I learned this lesson during this most recent retreat. It was a personal retreat with no one but myself setting the schedule of activities. The first couple of days it was raining hard, so I took the opportunity to meditate frequently and for extended periods; as it turns out too frequently and too long. After two days, I was physically and mentally exhausted. Meditation became painful and unproductive. I decided to take the afternoon and evening of the third day off. I simply rested, maintaining silence, but read a novel. Many teachers would reprimand me from breaking from the focus on silent meditation. But, as it turned out, it worked wonderfully. The next day I was refreshed, the pain was gone and my level of concentration was wonderful.

 

I scaled back on the frequency and duration of the meditation and rested more often and for longer times. There was no more novel reading or time off. I had learned the middle way as the way to practice in retreat. Previously on a formal retreat with scheduled meditations, I would scoff at participants who would skip a scheduled meditation or a dharma talk and believed that they were wasting a valuable opportunity. Now I see that I was being unfairly judgmental. I now realize that they were being wise, tailoring the retreat to their own level of energy and physical endurance. They were keeping the practice within the middle way.

 

Psychological research has demonstrated that there is an optimum level of motivation for any task and it is not at the extremes, but in the middle. The research has also demonstrated that what the optimum level is varies from person to person. For some, a low level works best, while for others only very high levels produce optimum results. For most, somewhere in the middle is best. It is up to each of us to find our own optimum level and practice accordingly. I found mine on this personal retreat and once I practiced at this level, the results were good. The Buddha taught to judge an activity, not by its nature, but by the results it produces. Clearly, following my own middle way had positive results for me.

 

So, in your practice and on retreat practice the middle way, finding the level of effort what works for you. Don’t string yourself too loosely or too tightly and play beautiful spiritual music on retreat.

 

“We are looking for happiness and running after it in such a way that creates anger, fear and discrimination. So, when you attend a retreat, you have a chance to look at the deep roots of this pollution of the collective energy that is unwholesome.” – Thich Nhat Hanh
CMCS – Center for Mindfulness and Contemplative Studies

 

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Improve Mental Health with Spirituality

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By John M. de Castro, Ph.D.

 

“As we learn more and more about the connections between the mind and body, it becomes clear that spirituality, religion and faith can help some individuals live well with mental health conditions. Some individuals and families turn to faith in times of crisis to help in their recovery while others find that spiritual practices help them continue to manage their mental health.” – National Alliance on Mental Health

 

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. Research from this body of work has shown that spirituality and religiosity serve as protective factors against a variety of psychiatric conditions, including depressive disorders, anxiety disorders, suicide, burnout, eating disorders, substance-related disorders and addiction recovery. But there is a need for more research into the influence of spirituality on mental health.

 

In today’s Research News article “Phenotypic Dimensions of Spirituality: Implications for Mental Health in China, India, and the United States.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1445184095505512/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5082226/

McClintock and colleagues examine the spirituality and mental health of a very large cross-cultural sample in China, India, and the United States. Participants completed 14 validated scales of spirituality and religiosity and 3 different scales of mental health. It took approximately 2 hours for the participants to complete all of the measures. The answers on all of the spirituality measures were lumped together and analyzed with sophisticated statistical techniques to uncover the underlying common factors of spirituality.

 

The analysis uncovered “five dimensions of universal spiritual experience, specifically: love, in the fabric of relationships and as a sacred reality; unifying interconnectedness, as a sense of energetic oneness with other beings in the universe; altruism, as a commitment beyond the self with care and service; contemplative practice, such as meditation, prayer, yoga, or qigong; and religious and spiritual reflection and commitment, as a life well-examined.” The five factors were labelled as Religious and Spiritual Reflection and Commitment, Contemplative Practice, Unifying Interconnectedness, Love, and Altruism.

 

The five factors were then examined to observe their relationships with mental health. McClintock and colleagues found that there were some cultural differences but universally, high levels of Love, Interconnectedness, and Altruism were associated with lower levels of mental health problems. That is the more the individuals expressed the spiritual characteristics of love, altruism, and a sense of interconnectedness with everything and everyone, the greater their mental health. Hence, these results clearly suggest that across diverse cultures containing diverse religious and spiritual practices, that spirituality is associated with positive psychological health.

 

It has to be acknowledged that this study was correlational and as such can only uncover relationships. It cannot determine causation. Hence, it cannot be concluded that spirituality causes improvements in mental health. It is equally likely that good mental health produces a greater likelihood of spirituality or that some other factor, such as family upbringing is responsible for both the levels of spirituality and mental health. It will remain for manipulative research in the future to determine the nature of the causal connections.

 

“Spirituality can help people maintain good mental health. It can help them cope with everyday stress and can keep them grounded. Tolerant and inclusive spiritual communities can provide valuable support and friendship. There is some evidence of links between spirituality and improvements in people’s mental health, although researchers do not know exactly how this works.” – Mental Health Foundation

 

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

McClintock, C. H., Lau, E., & Miller, L. (2016). Phenotypic Dimensions of Spirituality: Implications for Mental Health in China, India, and the United States. Frontiers in Psychology, 7, 1600. http://doi.org/10.3389/fpsyg.2016.01600

 

Abstract

While the field of empirical study on religion and spirituality in relation to mental health has rapidly expanded over the past decade, little is known about underlying dimensions of spirituality cross-culturally conceived. We aimed to bridge this gap by inductively deriving potential universal dimensions of spirituality through a large-scale, multi-national data collection, and examining the relationships of these dimensions with common psychiatric conditions. Five-thousand five-hundred and twelve participants from China, India, and the United States completed a two-hour online survey consisting of wide-ranging measures of the lived experience of spirituality, as well as clinical assessments. A series of inductive Exploratory Factor Analysis (EFA) and cross-validating Exploratory Structural Equation Modeling (ESEM) were conducted to derive common underlying dimensions of spirituality. Logistic regression analyses were then conducted with each dimension to predict depression, suicidal ideation, generalized anxiety, and substance-related disorders. Preliminary EFA results were consistently supported by ESEM findings. Analyses of 40 spirituality measures revealed five invariant factors across countries which were interpreted as five dimensions of universal spiritual experience, specifically: love, in the fabric of relationships and as a sacred reality; unifying interconnectedness, as a sense of energetic oneness with other beings in the universe; altruism, as a commitment beyond the self with care and service; contemplative practice, such as meditation, prayer, yoga, or qigong; and religious and spiritual reflection and commitment, as a life well-examined. Love, interconnectedness, and altruism were associated with less risk of psychopathology for all countries. Religious and spiritual reflection and commitment and contemplative practice were associated with less risk in India and the United States but associated with greater risk in China. Education was directly associated with dimensions of spiritual awareness in India and China but inversely associated with dimensions in the United States. Findings support the notion that spirituality is a universal phenomenon with potentially universal dimensions. These aspects of spirituality may each offer protective effects against psychiatric symptoms and disorders and suggest new directions for treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5082226/

Improve Mental Health with Mindfulness

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By John M. de Castro, Ph.D.

 

“Mindfulness-Based Cognitive Therapy (MBCT) is designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them.” – MBCT.com

 

About one out of every five people suffers from a mental disorder. In the U.S. that amounts to over 44 million people. For the U.S. adults about 1.1% live with schizophrenia, 2.6% with bipolar disorder.  6.9% with major depression, 18.1% with anxiety disorders, and 3% with substance use disorders. This places a tremendous burden on the individual, their families, and the health care system. Obviously there is a critical need to find safe, effective, and affordable treatments for these disorders.

 

Mindfulness training has been shown to be helpful in treating many of these disorders, including schizophrenia, depression, anxiety, and substance abuse. One form of therapy that includes mindfulness training is Mindfulness-Based Cognitive Therapy (MBCT). It was developed specifically to treat depression and has been found to reduce depression alone or in combination with antidepressive drugs. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate depression. It has proved so effective for depression that it has also begun to be applied to a variety of other mental disorders.

 

In today’s Research News article “Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials..” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1444323605591561/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030069/

Galante and colleagues review the published research literature on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for a variety of mental disorders. They found 11 published randomized controlled trials 10 of which compared MBCT to treatment as usual. There were only a sufficient number of studies to perform a meta-analysis for depression, depression relapse rates, and anxiety. They found that overall the research has demonstrated significant treatment effects for MBCT for the reduction in anxiety and depression. Importantly, MBCT had long-term beneficial effects as evidenced by a significant lowering of the relapse rates from depression on average by 40%.

 

These are important findings that strongly support the application of MBCT for the treatment of depression and anxiety disorders. The effects were not only robust but lasting, still being significantly better then treatment as usual a year after the end of treatment. It is unfortunate that there were not a greater number of studies of the effectiveness of MBCT for other mental disorders. This underscores the need for more research into the application of MBCT to disorders other than anxiety and depression. It has such powerful and lasting effects on anxiety and depression that it would be predicted that it would also be effective for other disorders.

 

It is not known exactly how MBCT relieves anxiety and depression. But, it can be speculated that MBCT, by shifting attention away from the past or future to the present moment, interrupts the kinds of thinking that are characteristic of and support anxiety and depression. These include rumination about past events, worry about future events, and catastrophizing about potential future events. Mindfulness has been shown to interrupt rumination, worry, and catastrophizing and focus the individual on what is transpiring in the present. By interrupting these forms of thinking that support anxiety and depression, shifting attention to the present moment where situations are actually manageable, mindfulness may disrupt depression. MBCT also improves the ability to see thoughts as objects of awareness and not something personal. This may be the most important change to improve anxiety and depression. This changes the relationship of the patients with their thoughts, making them less personal and thereby easier to cope with and change.

 

So, improve mental health with mindfulness.

 

“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

 

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

Galante, J., Iribarren, S. J., & Pearce, P. F. (2013). Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials. Journal of Research in Nursing : JRN, 18(2), 133–155. http://doi.org/10.1177/1744987112466087

 

Key points for policy, practice and research

  • Patients with recurrent depression (three episodes or more) treated with additive MBCT have on average 40% fewer relapses at one year of follow-up compared to patients undergoing treatment as usual.
  • Improvements in depression and anxiety with additive MBCT were significant at one year of follow-up but unstable in sensitivity analyses.
  • More studies with active control groups and long-term follow-ups are needed to better understand the specific effects of MBCT.
  • Depression is a symptom that is present in many conditions. More high quality RCTs are needed to evaluate MBCT in populations with varying depression severity as well as diagnosis with multiple co-morbidities.

Abstract

Objective: Mindfulness-based cognitive therapy (MBCT) is a programme developed to prevent depression relapse, but has been applied for other disorders. Our objective was to systematically review and meta-analyse the evidence on the effectiveness and safety of MBCT for the treatment of mental disorders.

Methods: Searches were completed in CENTRAL, MEDLINE, EMBASE, LILACS, PsychINFO, and PsycEXTRA in March 2011 using a search strategy with the terms ‘mindfulness-based cognitive therapy’, ‘mindfulness’, and ‘randomised controlled trials’ without time restrictions. Selection criteria of having a randomised controlled trial design, including patients diagnosed with mental disorders, using MBCT according to the authors who developed MBCT and providing outcomes that included changes in mental health were used to assess 608 reports. Two reviewers applied the pre-determined selection criteria and extracted the data into structured tables. Meta-analyses and sensitivity analyses were completed.

Results:Eleven studies were included. Most of them evaluated depression and compared additive MBCT against usual treatment. After 1 year of follow-up MBCT reduced the rate of relapse in patients with three or more previous episodes of depression by 40% (5 studies, relative risk [95% confidence interval]: 0.61 [0.48, 0.79]). Other meta-analysed outcomes were depression and anxiety, both with significant results but unstable in sensitivity analyses. Methodological quality of the reports was moderate.

Conclusion: Based on this review and meta-analyses, MBCT is an effective intervention for patients with three or more previous episodes of major depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030069/

 

 

Decrease Distress from Hearing Voices with Mindfulness

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By John M. de Castro, Ph.D.

 

“The mindfulness-based psychoeducation group reported significantly greater improvements in psychiatric symptoms, psychosocial functioning, insight into illness/treatment and duration of readmissions to hospital.” – Wai Chien

 

Hearing voices (auditory hallucinations) is seen as a prime symptom of psychosis and is considered a first rank symptom of schizophrenia. Neuroimaging has demonstrated that the voices that people hear are experienced as if there were a real person talking to them with the same brain areas becoming active during voice hearing as during listening to actual speech. So, it would appear that voice hearers are actually experiencing voices.

 

Hearing voices, however, is not always indicative of psychosis. Around 2% – 4% of the population reports hearing voices. But, only about a third of voice hearers are considered psychotic. On the other hand, about two thirds of voice hearers are quite healthy and function well. They cope effectively with the voices they’re hearing, do not receive the diagnosis of psychosis, and do not require psychiatric care. The differences between people with psychoses and healthy people who hear voices, is not in the form but the content of the heard speech. Non-psychotic individuals hear voices both inside and outside their head just like the psychotic patients but either the content is positive or the individual feels positive about the voice or that they are in control of it. By contrast the psychotic patients are frightened of the voices, the voices are more malevolent, and they feel less control over them.

 

Mindfulness has been shown to be negatively related to the distress felt by the individual about hearing voices, such that the higher the level of mindfulness, the lower the level of distress. But, it has not been demonstrated that increasing mindfulness with training can produce decreases in distress. Cognitive Behavioral Therapy (CBT) has been shown repeatedly to help relieve the symptoms of psychosis. So, it would seem reasonable to test the ability of a mindfulness based form of CBT to relieve the distress produced by hearing voices.

 

In today’s Research News article “Group mindfulness-based intervention for distressing voices: A pragmatic randomised controlled trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1443292212361367/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967452/

Chadwick and colleagues recruited participants who had reported hearing voices at least over the last year. The participants were randomly assigned to receive either treatment as usual or a Mindfulness-Based Cognitive Therapy (MBCT) program administered in a group format, weekly for 1.5 hours over 12 weeks. Before and after therapy and 6 months later the participants were measured for auditory hallucinations, anxiety, depression, and psychological distress. They found that the participants who received MBCT had significantly lower depression levels after treatment and 6 months later. In addition, the therapy produced a significant decrease in the distress felt about hearing voices and the participants perceived ability to control the voices.

 

These are interesting results that replicate the frequent finding that MBCT is effective in reducing depression. In addition, MBCT did not affect the severity of the voices heard. Rather it changed how people felt about the voices reducing how distressful they were to the individual and how well they felt that they could control them. So, MBCT doesn’t cause the voices to be heard differently, rather it simply helps the individuals to suffer less from the voices they hear. Being in the present moment may allow the voice hearer to feel more in control and to simply hear the voices without associating them with past or future problems making them much less distressful.

 

So, decrease distress from hearing voices with mindfulness.

 

“mindfulness with individuals with psychosis can facilitate a decrease in overall symptoms, and can promote a reduction in subjective distress and the believability of symptoms. Mindfulness has also been shown to provide participants with a sense of calm and relaxation, while also instilling a sense of power over their experience. Thus, mindfulness-based treatment interventions may be an effective adjunctive treatment approach for individuals with psychotic illnesses.” – Kolina Delgado

 

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

Chadwick, P., Strauss, C., Jones, A.-M., Kingdon, D., Ellett, L., Dannahy, L., & Hayward, M. (2016). Group mindfulness-based intervention for distressing voices: A pragmatic randomised controlled trial. Schizophrenia Research, 175(1-3), 168–173. http://doi.org/10.1016/j.schres.2016.04.001

 

Abstract

Group Person-Based Cognitive Therapy (PBCT) integrates cognitive therapy and mindfulness to target distinct sources of distress in psychosis. The present study presents data from the first randomised controlled trial investigating group PBCT in people distressed by hearing voices. One-hundred and eight participants were randomised to receive either group PBCT and Treatment As Usual (TAU) or TAU only. While there was no significant effect on the primary outcome, a measure of general psychological distress, results showed significant between-group post-intervention benefits in voice-related distress, perceived controllability of voices and recovery. Participants in the PBCT group reported significantly lower post-treatment levels of depression, with this effect maintained at six-month follow-up. Findings suggest PBCT delivered over 12 weeks effectively impacts key dimensions of the voice hearing experience, supports meaningful behaviour change, and has lasting effects on mood.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967452/