Improve Elderly Cancer Survivors’ Health with Tai Chi

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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

 

Modern medicine has markedly improved the treatments for cancer. But, unfortunately, these treatments themselves can be difficult on the patient and produce great discomfort and suffering. In addition, if the treatment is successful, the cancer survivor is left with a whole different set of challenges. Fatigue accompanies cancer and its treatment in from half to all cancer patients depending upon the type of cancer and treatment regimen. The lasting impact of the cancer and its treatment are particularly evident and dangerous for the elderly. “Senior cancer survivors are a particularly vulnerable population because they have an increased risk for the development or progression of chronic diseases (e.g., cardiovascular, hypertension, stroke, Type 2 diabetes mellitus, arthritis, etc). . .  In senior cancer survivors, this is highly relevant as twice as many deaths occur as a result of chronic diseases other than cancer, with cardiovascular disease emerging as a leading cause of death” (Campo et al. 2016).

 

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. It has revealed that it is 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. All of these effects suggest that Tai Chi may be effective for elderly cancer survivors.

 

In today’s Research News article “Blood Pressure, Salivary Cortisol, and Inflammatory Cytokine Outcomes in Senior Female Cancer Survivors Enrolled in a Tai Chi Chih Randomized Controlled Trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1329823277041595/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344390/

Campo and colleagues examine the effectiveness of Tai Chi practice to improve the health of elderly (>= 55 yrs.) female cancer survivors. The women were randomly assigned to receive 12 weeks of Tai Chi practice or Health Education for one hour three times per week. They were measured before and after training for blood pressure, salivary cortisol levels, and inflammatory cytokines. Campo and colleagues found that the Tai Chi group had a significantly greater reduction in systolic blood pressure (12%) and salivary cortisol levels (24%), but not inflammatory cytokines, than the Health Education group.

 

These are excellent findings. The fact that Tai Chi improved systolic blood pressure suggests that it improved cardiovascular health. This is particularly significant as cardiovascular disease is the greatest threat to the longevity of these vulnerable patients. The fact that Tai Chi reduced the salivary cortisol levels, an indicator of stress, suggests that Tai Chi reduced the levels of physiological stress in these patients which is also associated with decreased health and longevity. Hence, Tai Chi practice lowers chronic illness risk factors in elderly female cancer survivors.

 

It is known that exercise lowers cardiovascular and stress related risk factors and Tai Chi is a gentle exercise. This may be responsible for its effectiveness. Mindfulness practice is also known to reduce these risk factors. So, it is also possible that this is the reason for the effectiveness of Tai Chi practice. Regardless, Tai Chi is an almost perfect practice for elderly cancer survivors. It is gentle, has virtually no adverse side effects, and can be practiced in groups or alone at home at very low cost.

 

So, improve elderly cancer survivors’ health with tai chi.

 

“The gentle approach makes tai chi an ideal physical and mental exercise for cancer patients. The world of cancer treatment is filled with messages that tell patients to fight a war against their cancer, which can make them feel at war with their own bodies. Tai chi is particularly beneficial for anyone affected by cancer because it teaches people to respond peacefully and mindfully to forces out of their control.” – Michelle Whitmer

 

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

Campo, R. A., Light, K. C., O’Connor, K., Nakamura, Y., Lipschitz, D., LaStayo, P. C., … Kinney, A. Y. (2015). Blood Pressure, Salivary Cortisol, and Inflammatory Cytokine Outcomes in Senior Female Cancer Survivors Enrolled in a Tai Chi Chih Randomized Controlled Trial. Journal of Cancer Survivorship : Research and Practice, 9(1), 115–125. http://doi.org/10.1007/s11764-014-0395-x

Abstract

Purpose: Older cancer survivors are a vulnerable population due to an increased risk for chronic diseases (e.g., cardiovascular disease) compounded with treatment late-effects and declines in physical functioning. Therefore, interventions that reduce chronic disease risk factors (i.e., blood pressure, chronic inflammation, & cortisol) are important in this population. Tai Chi Chih (TCC) is a mind-body exercise associated with reductions in chronic disease risk factors, but has not been examined with older cancer survivors. In a feasibility randomized controlled trial of TCC, we examined secondary outcomes of blood pressure, salivary cortisol, and inflammatory cytokines (interleukin (IL)-6, IL-12, tumor necrosis factor-α, IL-10, IL-4) due to their implications in chronic diseases.

Methods: Sixty-three senior female cancer survivors (Mage=67 years, SD=7.15) with physical functioning limitations (SF-12 physical functioning≤80 or role-physical≤72) were randomized to 12-weeks (60-minutes, three times a week) of TCC or Health Education control (HEC) classes. Resting blood pressure, 1-day salivary cortisol samples, and fasting plasma samples for cytokine multiplex assays were collected at baseline and 1-week post-intervention.

Results: Controlling for baseline values, the TCC group had significantly lower systolic blood pressure (SBP,p=0.002) and cortisol area-under-curve (AUC, p=0.02) at post-intervention than the HEC group. There was no intervention effect on inflammatory cytokines (p’s>0.05).

Conclusions: This TCC feasibility trial was associated with significant reductions in SBP and cortisol AUC in senior female cancer survivors. Larger, definitive trials are needed to confirm these findings.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344390/

 

Improve Type II Diabetes with Yoga Therapy

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By John M. de Castro, Ph.D.

 

 

“many people who practice yoga report a deep sense of relaxation, substantially increased flexibility and blood and oxygen supply after regular classes—regardless of aerobic exercise. In addition, some reports suggest that because yoga can decrease stress, it may be helpful in controlling glucose levels in people with either type 1 or type 2 diabetes.” – Jacqueline Shahar

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States have diabetes and the numbers are growing. 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. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world.

 

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 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.

A mindfulness practice that combines mindfulness with exercise is yoga and it has been shown to be helpful in the treatment of Type II Diabetes. Yoga practice is primarily provided in groups where everyone performs exactly the same postures, body scans, and meditation. Yoga Therapy, on the other hand, is a method of applying yoga practice for the treatment of mental and physical conditions that is customized to the individuals’ needs.

 

In today’s Research News article “Impact of individualized yoga therapy on perceived quality of life performance on cognitive tasks and depression among Type II diabetic patients.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1329115460445710/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959323/

Satish and Lakshmi apply yoga therapy, individualized practice, to the treatment of Type II Diabetes. Patients with Type II diabetes were recruited and assessed before and after yoga therapy treatment for diabetes quality of life, depression, cognitive ability, and postprandial blood sugar, fasting blood sugar, and glycosylated hemoglobin (HBA1c). Participants received yoga therapy in 12 individualized sessions over 3 months, including postures, breathing exercises, chants, and diet advice.

 

They found that following yoga therapy the patients showed significantly reduced depression levels and frequencies of depression and improvements in cognition, including improved attentional inhibition of irrelevant information and short-term memory. The patients with diabetes also showed lower fasting blood sugar levels. In addition, the patients reported improved quality of life, including better sleep quality, lower craving for food, and improved subjective well-being.

 

These results are encouraging and clearly demonstrates that yoga therapy is effective in treating Type II diabetes. There are a number of possible mechanism of how yoga could produce these positive effects including the fact that yoga practice involves physical exercise and exercise has been repeatedly found to be beneficial for Type 2 Diabetes patients. Yoga may also act by reducing body weight and body fat, improving the management of stress, reducing physiological activation by the nervous system, or through encouraging a generally healthier lifestyle. But it is unclear if the individualized yoga therapy is superior to group yoga practice. Future research is needed to compare the effectiveness of the two.

 

So, improve type ii diabetes with yoga therapy.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“there’s nothing to fret about because the condition can be controlled with a little awareness and care. Good food, regular exercise, and a few minutes of yoga practice everyday – the three golden rules to remember if you are a diabetic.” –  Art of Living

 

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

 

Study Summary

Latha Satish, V Subbu Lakshmi. Impact of individualized yoga therapy on perceived quality of life performance on cognitive tasks and depression among Type II diabetic patients. Int J Yoga. 2016 Jul-Dec; 9(2): 130–136. doi: 10.4103/0973-6131.183707

 

Abstract

Context: An individualized approach of providing yoga support can address many of the disease-related concerns indicated in the management of diabetes, specifically the impact on other life activities and long-term functional wellbeing.

Aim: To analyze the role of regular yoga practice as a self-management approach to achieve glycemic control and psychological wellbeing in Type II diabetic patients.

Methods: Ninety-one subjects of both sexes responded to the announcement and consented to participate in the study. This was a single group, before and after yoga evaluation without control comparison. The fasting and postprandial blood sugar, glycosylated hemoglobin (HBA1c), cognitive tasks, depression, cognitive failure, and diabetic-related quality of life (QOL) were measured as pretest. The subjects underwent one-to-one individualized yoga therapy sessions, which included 12 supervised sessions spread over a 3-month period. The posttest data were analyzed using paired t-test and Wilcoxon paired rank test.

Results: Showed significant reduction in fasting blood sugar. QOL of the diabetic patients had improved significantly. There was a significant reduction in the frequency (mean difference of 7.58, P > 0.01) of depressive symptoms and intensity of depression (mean difference 1.66, P > 0.05). Concentration and attention span improved significantly and mean discrepancy score reduced (mean difference 3.42, P > 0.01). There were no marked changes in the postprandial blood sugar and HBA1c.

Conclusion: Yoga practice enhances the subjective wellbeing, QOL, improves mood and concentration, and facilitates achievement of adequate glycemic control among Type II diabetic patients.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959323/

 

Reduce Mind Wandering Produced by the Brain with Mindfulness

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By John M. de Castro, Ph.D.

 

“the default mode network always takes you somewhere other than where you are. You are not focused on the immediate environment and will also be “time-travelling” in the past or future – never in the present moment. . . Interestingly, researchers have found that the default mode network is less active when people meditate.” – Mindful Call

 

Mindfulness is the ability to focus on what is transpiring in the present moment. It involves a greater emphasis on attention to the immediate stimulus environment. Mindful people generally have better attentional abilities and have fewer intrusive thoughts and less mind wandering. As a result, mindfulness has been shown to be associated with differences in thought processes. A system of the brain known as the Default Mode Network (DMN) becomes active during mind wandering and relatively quiet during focused on task behavior. It is involved when we are engaged in internally focused tasks such as recalling deeply personal memories, daydreaming, sleeping, imagining the future and trying to take the perspective of others. The DMN involves neural structures including the medial prefrontal cortex, anterior and posterior cingulate cortices, precuneus, inferior parietal cortex, and lateral temporal cortex. These areas of the DMN are functionally connected, such that they are simultaneously active during mind wandering.

 

Mindfulness training has been shown to alter the size and activity of neural structures including reducing the size and activity in the Default Mode Network (DMN) as a result of neuroplasticity. The DMN, however, is a network of interconnected structures which are, in turn, connected to a number of other neural structures. This interconnectivity reflects the ability of these structures to affect other structures in the brain, in other words, the effects of mind wandering on other brain systems. Hence, it is important to investigate the effects of mindfulness training on the functional connectivity of the structures of the Default Mode Network (DMN) and the neural structures connected to these structures.

 

In today’s Research News article “Data for default network reduced functional connectivity in meditators, negatively correlated with meditation expertise.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1328281653862424/?type=3&theater

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

http://www.sciencedirect.com/science/article/pii/S2352340916304504

Berkovich-Ohana and colleagues performed functional Magnetic Resonance Imaging (fMRI) of the brains of experienced meditators in comparison to similar individuals who did not meditate while at rest and during meditation.

 

They found that at rest the functional connectivity within the structures of the DMN and within the neural structures associated with vision were lower in meditators and that this functional connectivity decreased during meditation. They also found that the meditators had greater functional connectivity between the DMN and the visual system structures than the non-meditators and this also decreased during meditation. In addition, they found that the greater the experience with meditation the lower the functional connectivity between the DMN and other neural structures. These findings suggest that meditation lowers the ability of the structures associated with mind wandering to affect other structures in the nervous system. They also suggest that meditation practice produces less internal connectivity within these structures underlying mind wandering. Finally, these findings suggest that visualizations dissociated from the focus of attention may be higher in the meditators. This may indicate that when meditators’ minds wander they contain more vivid visual imagery.

 

These data are interesting and demonstrate that meditation alters the internal connectivity of the structures that produce mind wandering and their ability to affect other neural structures. Hence, the functional connectivity of brain structures reflects the experiences of meditators of reduced mind wandering. Meditation appears to change the brain to produce less mind wandering.

 

So, reduce mind wandering produced by the brain with mindfulness.

 

“What may happen when people practise mindfulness is that, over time, this weakens the connection between their thalamus and the rest of the default mode network. Their trait mindfulness score would climb as a result and they might just become more mentally robust and less prone to depression and other mental illnesses. That really would be brain plasticity in action.” – Plastic Brain

 

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

Berkovich-Ohana A, Harel M, Hahamy A, Arieli A, Malach R. Data for default network reduced functional connectivity in meditators, negatively correlated with meditation expertise. Data Brief. 2016 Jul 15;8:910-4. doi: 10.1016/j.dib.2016.07.015. eCollection 2016 Sep. PMID: 2750824

 

Abstract

FMRI data described here was recorded during resting-state in Mindfulness Meditators (MM) and control participants (see “Task-induced activity and resting-state fluctuations undergo similar alterations in visual and DMN areas of long-term meditators” Berkovich-Ohana et al. (2016) [1] for details). MM participants were also scanned during meditation. Analyses focused on functional connectivity within and between the default mode network (DMN) and visual network (Vis). Here we show data demonstrating that: 1) Functional connectivity within the DMN and the Visual networks were higher in the control group than in the meditators; 2) Data show an increase for the functional connectivity between the DMN and the Visual networks in the meditators compared to controls; 3) Data demonstrate that functional connectivity both within and between networks reduces during meditation, compared to the resting-state; and 4) A significant negative correlation was found between DMN functional connectivity and meditation expertise.

http://www.sciencedirect.com/science/article/pii/S2352340916304504

http://ac.els-cdn.com/S2352340916304504/1-s2.0-S2352340916304504-main.pdf?_tid=3b020506-60c4-11e6-bbcf-00000aacb360&acdnat=1471030840_5c9ab5e6d389861ca100e4384dec9a9f

 

Relieve Fatigue Accompanying Neurologic Disease with Mindfulness

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By John M. de Castro, Ph.D.

 

“Mindfulness meditation — or mentally focusing on being in the present moment — has also proven an effective tool to help people with cognitive and behavioral issues after TBI. With meditation of all kinds — from chanting to visual imagery — people can make peace with their new self and not get swept up in the constant maelstrom of mental obsessions.” – Victoria Tilney McDonough

 

Brain damage is more or less permanent. The neurons and neural structures that are destroyed when the brain is damaged for the most part do not regrow. Brain Injury is caused by a number of different events from a violent blow to the head (Traumatic Brain Injury, TBI), to interruption of the blood supply to the brain (strokes), and to demyelinating diseases such as Multiple Sclerosis (MS). These neurological diseases are common and disabling. In the United States it is estimated that annually 1.7 million people sustain Traumatic Brain Injury, while 400,000 people are diagnosed with Multiple Sclerosis, and about 800,000 people have strokes.

 

Regardless of the cause, the brain is damaged, and the tissues that are destroyed are permanently lost. But, we know that people can recover to some extent from brain injury.  How is it possible that recovery can occur when there is no replacement of the damaged tissue? There appears to be a number of strategies that are employed by the brain to assist in recovery. Other areas of the brain can take over some of the function, other behavioral strategies can be employed to accomplish the task, and non-injured areas of the brain can adapt and change to compensate for the lost function. Rehabilitation usually involves strategies to promote these recovery mechanisms.

 

Each of these neurologic diseases are accompanied by a profound fatigue. This disrupts rehabilitation as it makes it difficult for the patients to engage in the needed activities. In fact, the depth of fatigue is associated with lower levels of quality of life, everyday functioning, and life expectancy. So, it is important to find methods to reduce fatigue in patients with neurologic diseases. Mindfulness training has been found to be helpful in recover from Traumatic Brain Injury, Multiple Sclerosis, and stroke. It would seem likely then that mindfulness training reduces fatigue.

 

In today’s Research News article “Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1327481707275752/?type=3&theater

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

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.00912/full

Ulrichsen and colleagues review the published research literature on the effects on fatigue of mindfulness training on adult patients with neurologic diseases. In all of the studies 8-weeks of either Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) were employed as therapy. They found that mindfulness training significantly reduced fatigue with moderate effect size.

 

These are encouraging results as fatigue plays such a crucial role in the disease and its reduction is needed for other rehabilitation activities to be effective. It isn’t clear exactly how mindfulness training reduces fatigue. It is possible that by improving present moment awareness, especially of the patient’s physical state, that worry and rumination that contribute to the feelings of fatigue may be lowered or that the improved attentional mechanisms allows the patients to perform well in spite of fatigue.

 

Regardless, relieve fatigue accompanying neurologic disease with mindfulness.

 

“Imaging studies show that mindfulness soothes the brain patterns underlying pain and, over time, these changes take root and alter the structure of the brain itself, so that patients no longer feel pain with the same intensity. Many say that they barely notice it at all.” – Danny Penman

 

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

Ulrichsen KM, Kaufmann T, Dørum ES, Kolskår KK, Richard G, Alnæs D, Arneberg TJ, Westlye LT and Nordvik JE (2016) Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis. Front. Psychol. 7:912. doi: 10.3389/fpsyg.2016.00912

 

Abstract

BACKGROUND: Fatigue is a common symptom following neurological illnesses and injuries, and is rated as one of the most debilitating sequela in conditions such as stroke, traumatic brain injury (TBI), and multiple sclerosis (MS). Yet effective treatments are lacking, suggesting a pressing need for a better understanding of its etiology and mechanisms that may alleviate the symptoms. Recently mindfulness-based interventions have demonstrated promising results for fatigue symptom relief.

OBJECTIVE: Investigate the efficacy of mindfulness-based interventions for fatigue across neurological conditions and acquired brain injuries.

MATERIALS AND METHODS: Systematic literature searches were conducted in PubMed, Medline, Web of Science, and PsycINFO. We included randomized controlled trials applying mindfulness-based interventions in patients with neurological conditions or acquired brain injuries. Four studies (N = 257) were retained for meta-analysis. The studies included patients diagnosed with MS, TBI, and stroke.

RESULTS: The estimated effect size for the total sample was -0.37 (95% CI: -0.58, -0.17).

CONCLUSION: The results indicate that mindfulness-based interventions may relieve fatigue in neurological conditions such as stroke, TBI, and MS. However, the effect size is moderate, and further research is needed in order to determine the effect and improve our understanding of how mindfulness-based interventions affect fatigue symptom perception in patients with neurological conditions.

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.00912/full

 

Mindfully at Sea

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By John M. de Castro, Ph.D.

 

“my gaze shifts to the Atlantic. Each wave is completely new and distinctive. No matter the size of the wave or its intensity, the beach gladly accepts each one as an offering from the sea. I smile and feel the rise of gratitude in my body for this lesson and for my teacher, the seashore. Without any fanfare, the sea meets the land and the message is simple: welcome everything.”– Brandon Nappi

 

I’m on a cruise in the Pacific Ocean and seeing nothing but water. From horizon to horizon on the starboard side, on the port side, aft, and forward; nothing but ocean. Living on land away from the ocean I’ve lost track of the fact that the Earth is also called the water planet, with over two thirds of its surface covered in water. Looking out on the ocean mindfully I am struck by how much our existence is dependent upon these vast waters. I am reminded of how interconnected everything, including ourselves, is with the oceans and how the oceans are interconnected with us. And, in spite of my ego, I am humbled by how powerless, miniscule, vulnerable, and insignificant I am. The timelessness of the ocean underscores how brief my life is; an eye blink in geologic time. This resets my thinking and puts perspective on existence.

 

The ocean is the cradle of life. It is the birthplace, the origin, of all life on the planet. Only relatively recently did creatures emerge from the oceans to occupy land. But, even though new forms of life developed on land, they carried with them the oceans of origin. The blood has the same electrolytes at the same concentrations as sea water. In essence, rather than being divorced from the sea, I carry the sea with me. Even our terrestrial existence is dependent upon the seas. Without them there are no clouds in the sky, there is no rain, and there is no vegetation. Life on land is dependent upon the oceans. It reminds me of how interconnected I am to the entirety of my planet and how without those interconnections, I would not be able to exist or for that matter would never have existed at all.

 

Seeing the ocean helps me to realize how weak and vulnerable I am. My life dangles by threads. Should I fall overboard, I would not last long in the cold waters. It would be too far to swim to shore. No matter how powerful and strong I believed myself to be, the sea unmasks my vulnerability. Society and human advancement has to some extent provided protection, including the wonderful machine I’m riding on. This allows my ego to generate the illusion of strength. But, when there’s a storm at sea, or even when it is calm, the delusion of invulnerability is stripped away and my true condition revealed. This generates a mindful appreciation for my life and the precious seconds that compose it. It opens my eyes to my dependence on others and society for protection, for being my port in the storm. It creates vast gratefulness and appreciation for others and all that I have surrounding and protecting me. When I mindfully look at things this way, I can see interdependence and impermanence in action, moment to moment.

 

Looking out mindfully at the vast expanse of ocean I see myself as a speck on the surface. Self-importance melts away and a tremendous humility emerges. All the events in my life and accomplishments seem so insignificant. Looking out mindfully at the agelessness of the ocean I see my life as a microsecond of oceanic time not to mention cosmic time. My ego has convinced me of a delusion that what I do and have done is important. A mindful examination of the ocean corrects this delusion. My life is but a drop in the ocean. In some ways that seems sad, but seeing the truth is never sad, it can liberate, eliminate unsatisfactoriness, and produce great happiness. All of the difficulties with career, family, and society all now seem so minor that I can’t believe that they so defined my life and determined my happiness.

 

When I mindfully look at the ocean the sadness lifts as I become awed by the wondrous beauty and infinite wisdom of existence. I may not be able to change it or even alter it in minor ways, but I can experience and enjoy it. I can see my life as a supremely lucky accident in the vastness of time and space, a time to be savored, a time to enjoy and a time to appreciate and learn from, in other words, a time to be mindful. It is a gift from the cosmos to me, a time not to be squandered. The seeming timelessness of the ocean underscores the brevity of my own life, like a solitary wave building and passing away, impermanent and ever changing.

 

With this mindful perspective my trials and tribulations become laughable trivial constructs of my ego. In the face of such vastness, how can I see an interpersonal slight as meaningful, an unattained career step as important, or a new car or a bigger house in a better neighborhood as necessary. But, this perspective doesn’t just remove delusion, it replaces it with love, wisdom, and happiness. With the death of delusion comes the birth of equanimity; seeing things, myself, and others exactly as they are and finding them not just OK but extraordinary, not just static but ever evolving, and not just real but spiritual. With the death of delusion comes the birth of deep noncontingent love, for myself, those close to me and extending to all of humanity.

 

Putting these thoughts behind and becoming mindful as I speed walk around the upper deck I let the present moment come into and dominate my awareness. Looking out to the horizon I feel the peace, quiet, and serenity of the horizon to horizon sea. Watching the ocean race by, feeling the breeze on my skin, smelling the fresh salt air, feeling my leg muscles at work and the clothing against my skin, hearing the engines purring, the bow breaking against the water, and the waves breaking against the side of the ship, I feel so totally alive. With my mind clear of thoughts and the ego’s delusions, I am totally awake and loving every moment. Quieting the inner voice, I am mindfully blissful at sea.

 

“It really boils down to this: that all life is interrelated. We are all caught in an inescapable network of mutuality, tied into a single garment of destiny. Whatever affects one directly, affects all indirectly. We are made to live together because of the interrelated structure of reality.” – Dr. Martin Luther King, Jr.

 

CMCS – Center for Mindfulness and Contemplative Studies

Mindful Vacation

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By John M. de Castro, Ph.D.

 

“Fatigue sets in, rigidity applies, and all creativity and innovation are lost — both of which need time away for other activities to increase the probability of new ideas. Unhealthy overwork costs companies money for healthcare and creates stressful and unrewarding lives, both of which detract from the good work they are supposed to be furthering.” – Lotte Bailyn

 

The Buddha taught that we should follow the middle way. He taught that an instrument’s string, if it is too loose, it doesn’t produce a note and if it’s too tight it will break. It is best in the middle, producing beautiful music. So it is with us. To be successful in almost anything, but especially in our spiritual practice, we must follow the middle way. We should neither meditate too little or too much, we should neither work too little or too hard, we should not relax too much or too little, we should not eat too much or too little, etc. We should find the happy medium in all things.

 

Unfortunately, Americans do not follow the middle way. In their careers they work far too hard. Hard work is laudable and productive if balanced with sufficient rest, relaxation, exercise, and being with family and friends. But for far too many Americans, work has been overemphasized and has become over weighted in their lives’ balance sheets. One clear example of this is vacation time. It’s gotten so bad that America has been dubbed the “No-Vacation Nation.” Fully 41% of Americans took no vacation at all in 2015 and another 17% said that they took fewer than 5 vacation days. In other words, approximately 2/3rds of Americans took less than a full week of vacation in the entire year.

 

It is estimated that half a billion days of vacation that were available to Americans are not taken each year. In addition, many of the vacation days taken were used not for rest and relaxation, but for other work or medical needs. To make matters worse, Americans when they do take real vacation bring their laptops and cell phones with them and continue working even while supposedly relaxing on a beach somewhere. It is no wonder that Americans are so overworked, stressed, and unhappy. It is no wonder that Americans suffer from stress related diseases. As the Boston Globe commented “we are a nation of vacation-deprived, work-obsessed, business casual-attired zombies.”

 

Under the conditions of stress, overwork, and lack of sleep experienced by most Americans, vacation becomes terribly important. It can begin to rebalance life by increasing rest and replenishment. We have to give vacation a much higher priority and not only take our available vacation, but use it as it was intended. In addition, it is important that we not only prioritize and take vacations, but also that we take them mindfully. This means that we should invest vacation time in reconnecting with our world, ourselves, and our families. We should rest, relax, and have some fun, but do so totally in the present moment, without distraction.

 

To reconnect we need to disconnect; that is, we need to remove all of those distraction that so occupy our time and attention, that we end up without connection to those things that really matter. On the death bed there is no recorded incident where the person regretted not working enough or not making enough money, or sending enough emails, or not making more tweets or social media posts. What they regret is not having spent enough time with family and friends, not investing in their own happiness and that of others, and not being themselves and letting their emotions out. These are what we must reconnect to. This is what vacations are designed to do.

 

It’s really important to disconnect. Get away, staycations involve far too many distractions. Leave the computers and cell phones at home. Go somewhere where you can disconnect from the net. Go somewhere that you enjoy and where you can rest, the beach, the mountains, the wilderness, etc. Go there with the people you are closest too. It would be useful if TV and radio were unplugged; nothing to stand between you and a real vacation. This can be difficult to do as many vacation spots pride themselves in providing you with all of the things that distract you at home. But make the effort to either go somewhere where these things are absent or turn them off when you get there. In this way you can truly spend time in the present moment. Get to really know yourself and perhaps your family.

 

You should begin with sleep and rest. Before you set an agenda to do anything, first get physically rested. So many people in the modern world are actually sleep deprived and don’t realize it. When they go on vacation the first things they do is dive into activities and exhaust themselves further. The first step in having a vacation should always be to start letting your body rest and recover. Take my word on it, your vacation will be so much better if you do this. Sleep late, take naps, don’t schedule much on the first couple of days of vacation. There is a tendency to feel that vacation time is precious, which it is, and shouldn’t be wasted on doing nothing, but actually it should. This is much more important to the quality and effectiveness of your vacation than you can imagine. Prioritize it and you’ll be amazed at how much more you get out of your vacation.

 

Once you’ve disconnected, it’s time to reconnect. Spend some time just being still and quiet. Just look carefully and mindfully at your surroundings, hear the sound, smell the aromas, connect totally with your environment. Don’t feel that you need to finish and move on to the next thing, you’re doing the next thing. Recognize how hard it is for you to do this and see how conditioned you are to constantly return to those things that you’re trying to get away from. Watch your thoughts. See how they keep looking for something else other than what is right in front of you. Notice how they return again and again to work and your daily distractions. This may not be easy but it can be a revelation. It can show how much you need to reprogram yourself to achieve balance. If you stick with it, slowly, ever so slowly, it will begin to take hold and you’ll begin the long process of becoming truly mindful.

 

Spend time with you family and friends. But, do so without distractions. Don’t watch TV, go to a movie or send each other text messages. Really be with them. The most important thing that you have to give them and they you, is undivided attention. Once again, it may be hard to do. We’re so programmed to be with people while doing something else. Drop out the something else and you can truly be with people. Practice deep listening. As someone else is talking, don’t be thinking of your response or the next thing you’re going to say, simply listen, really listen, deeply listen, to what it is that they’re trying to communicate. Then, when it’s your turn, you’ll be continuing on the same theme they were. You’ll truly be responding to them, not showing how smart or clever or funny you are, but how compassionate, understanding, and caring you are. This also will take time. Your conditioning is deep and strong. But, if you stick with it, slowly, ever so slowly, it will begin to take hold and you’ll begin the long process of becoming truly connected to those you’re closest too and they to you.

 

Next, mindfully watch yourself. Take note of when you feel happy and when you don’t, when you feel relaxed and when you don’t, when the people around you are happy and when they’re not. Feel what it feels like when you happy at a visceral level, not in your mind, but in your body. Let theses explorations reveal to you what is really important for making yourself and others happy. Don’t look at peak moments, those are obvious. Rather look at the little moments of contentment and happiness. These are the ones that make up most of your life. If you can learn them, you can begin to arrange your life to promote happiness. If you stick with it, slowly, ever so slowly, it will begin to take hold and you’ll begin the long process of becoming truly happy.

 

Finally, don’t leave what you’ve gained on vacation behind. Try to take it with you as you return to work and everyday life. The lessons that you’ve learned need to be practiced there as well to insure that vacation has a continuing effect. It’s hard to do and probably shouldn’t be tried all at once with everything. Just see if you can incorporate some of what you’ve learned occasionally into daily life. Try listening deeply at least sometimes with some people, try getting a good night’s sleep as often as you can, try to notice how you feel at times when you’re happy, and try to occasionally be mindful. Give it a shot. The positive effects it has will reinforce it and slowly, ever so slowly, it will creep more and more into your life.

 

These are my recommendations for a mindful vacation. But, everyone is different. You’ll need to explore for yourself what works for you and what doesn’t. There are no rules and no mandatory processes or activities. Learn from your experiences and experiment with new experiences. Look at it as an investigation which is based upon what produces well-being and happiness in yourself and the people around you. In other words, vacation mindfully.

 

 “The benefits are huge. Not only is the society measurably happier, but workers are more rested and productive, relationships are closer and people are healthier.” – Terry Hartig

 

CMCS – Center for Mindfulness and Contemplative Studies

Improve Schoolchildren’s Thinking with Mindfulness

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mindfulness-school2-wimmer

 

By John M. de Castro, Ph.D.

 

“It may not be the typical way to start an English class, but Gonzalez’s students were familiar with these five-minute mindfulness exercises—from counting breaths and focusing on the sensations of breathing, to visualizing thoughts and feelings—that he uses to help train their attention, quiet their thoughts, and regulate their emotions.” – Lauren Cassani Davis

 

Childhood is a time of rapid learning and brain development. A key for the child is the development of the ability to focus, attentional ability. Children, in general, have relatively brief attention spans. In the modern world they are bombarded with a myriad of distractions, many of which require only brief moments of attention. For children to benefit maximally from learning opportunities, particularly in school, being able to focus attention is imperative. Mindfulness training in school, at all levels has been shown to have very positive effects. These include academic, cognitive, psychological, and social domains. Mindfulness practices, since they involve practicing attentional focus, have been shown, not surprisingly, to improve attention.

 

Since attentional ability is so crucial to children’s development, it is important to better understand what promotes its development and what methods can be implemented with children to improve it. In today’s Research News article “Cognitive Effects of Mindfulness Training: Results of a Pilot Study Based on a Theory Driven Approach.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1318387964851793/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940413/

Wimmer and colleagues randomly assigned German fifth grade school children to receive either a Mindfulness-Based Stress Reduction (MBSR) program that was adapted for children, a concentration training program, or no treatment. MBSR is a complex mindfulness development program that contains practices in meditation, body scan, and yoga. Training occurred over 25 weeks with twice weekly sessions of one hour each. The children were assessed prior to and after treatment with measures of sustained attention, cognitive flexibility, cognitive inhibition, and data-driven information processing.

 

They found that the MBSR group showed less of a decrease in sustained attention (vigilance task) than the no treatment group over the 25 weeks. All three groups improved in cognitive flexibility, demonstrating improved ability to look at things in different ways. MBSR training produced a significant improvement in cognitive inhibition, the ability to screen out certain stimuli in order to better process others, and in data-driven information processing. Hence, MBSR training produced significant benefits for the children improving their attention and ability to screen out distractors. This latter finding is important as children at this age, in general, have great difficulty in restraining themselves from responding to irrelevant stimuli in the environment.

 

These preliminary results suggest that mindfulness training may be of benefit to children in developing attentional abilities that are crucial to school performance. Since the MBSR program is complex, it cannot be ascertained whether training in meditation, body scan, or yoga or some combination of these practices was the crucial component that led to improved attentional abilities. This was a pilot study. It clearly suggests that further, more intensive, study is warranted which may begin to clarify what are the crucial aspects of the training for the development of attention in children.

 

So, improve schoolchildren’s thinking with mindfulness.

 

“Growing up as a child in East Harlem, where the poverty rate is extremely high, the asthma rate is extremely high and obesity rate is high — in addition to the complications our families deal with as a result of living in poverty — having a time to center yourself is important to allow our children to have access to learning.” – Eve Colavito

 

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

Wimmer, L., Bellingrath, S., & von Stockhausen, L. (2016). Cognitive Effects of Mindfulness Training: Results of a Pilot Study Based on a Theory Driven Approach. Frontiers in Psychology, 7, 1037. http://doi.org/10.3389/fpsyg.2016.01037

 

Abstract

The present paper reports a pilot study which tested cognitive effects of mindfulness practice in a theory-driven approach. Thirty-four fifth graders received either a mindfulness training which was based on the mindfulness-based stress reduction approach (experimental group), a concentration training (active control group), or no treatment (passive control group). Based on the operational definition of mindfulness by Bishop et al. (2004), effects on sustained attention, cognitive flexibility, cognitive inhibition, and data-driven as opposed to schema-based information processing were predicted. These abilities were assessed in a pre-post design by means of a vigilance test, a reversible figures test, the Wisconsin Card Sorting Test, a Stroop test, a visual search task, and a recognition task of prototypical faces. Results suggest that the mindfulness training specifically improved cognitive inhibition and data-driven information processing.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940413/

 

Mindfulness Training Equals Drugs in Effectiveness for Depression

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mbct-depression2-kuyken

Mindfulness Training Equals Drugs in Effectiveness for Depression

 

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 distinguishable from everyday sadness or grief by the depth, intensity, and range of symptoms. These can include feelings of sadness, tearfulness, emptiness or hopelessness, worthlessness , angry outbursts, irritability or frustration, even over small matters, loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports, sleep disturbances, tiredness and lack of energy, so even small tasks take extra effort, changes in appetite, anxiety, agitation or restlessness, slowed thinking, suicidal thoughts, and suicide attempts or suicide. Needless to say individuals with depression are miserable.

 

Depression is generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression appears to be the result of a change in the nervous system that is primarily treated with drugs that alter the affected neurochemical systems. But, depression can be difficult to treat. 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 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 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. The combination of drugs along with MBCT has been shown to be quite effective in treating depression and preventing relapse. Since, drugs have troubling side effects and can lose effectiveness over time, it is important to determine if after remission, MBCT can continue to prevent relapse if the drugs are removed. In other words, after MBCT can the drugs be withdrawn.

 

In today’s Research News article “The effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse/recurrence: results of a randomised controlled trial (the PREVENT study).” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1317432901613966/?type=3&theater

or see summary below or view the full text of the study at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781448/  Kuyken and colleagues randomly assigned patients with major depression who are taking antidepressant medications to either continue their medication or taper off the drugs and receive Mindfulness Based Cognitive Therapy (MBCT). Patients were followed for two years. They found that MBCT was as effective as continuing drugs in preventing reoccurrence of the depression, and reducing the number of depression free days, symptoms of depression, quality of life, and other psychological problems. Hence, MBCT was found to be a safe and effective alternative to continued drug treatment.

 

These results are striking. Mindfulness Based Cognitive Therapy (MBCT) can be used to replace drugs. It is not superior, but it appears to be equal to drug treatments in relieving depression and preventing its reoccurrence. The fact that its benefits were still present two years later indicates that MBCT produces lasting effects. Since MBCT does not have the troubling side effects that typically accompany the drugs, it may be a superior treatment. So, MBCT should be strongly considered to replace antidepressant drugs in the treatment of recurrent major depression

 

“Mindfulness is a valuable practice for improving the cognitive symptoms of depression, such as distorted thinking and distractibility. It helps individuals recognize these more subtle symptoms, realize that thoughts are not facts and refocus their attention to the present.” –

Margarita Tartakovsky

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

They are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Kuyken, W., Hayes, R., Barrett, B., Byng, R., Dalgleish, T., Kessler, D., … Byford, S. (2015). The effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse/recurrence: results of a randomised controlled trial (the PREVENT study). Health Technology Assessment (Winchester, England), 19(73), 1–124. http://doi.org/10.3310/hta19730

 

Abstract

BACKGROUND: Individuals with a history of recurrent depression have a high risk of repeated depressive relapse/recurrence. Maintenance antidepressant medication (m-ADM) for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to m-ADM. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce the risk of relapse/recurrence compared with usual care but has not yet been compared with m-ADM in a definitive trial.

OBJECTIVES: To establish whether MBCT with support to taper and/or discontinue antidepressant medication (MBCT-TS) is superior to and more cost-effective than an approach of m-ADM in a primary care setting for patients with a history of recurrent depression followed up over a 2-year period in terms of preventing depressive relapse/recurrence. Secondary aims examined MBCT’s acceptability and mechanism of action.

DESIGN: Single-blind, parallel, individual randomised controlled trial.

SETTING: UK general practices.

PARTICIPANTS: Adult patients with a diagnosis of recurrent depression and who were taking m-ADM.

INTERVENTIONS: Participants were randomised to MBCT-TS or m-ADM with stratification by centre and symptomatic status. Outcome data were collected blind to treatment allocation and the primary analysis was based on the principle of intention to treat. Process studies using quantitative and qualitative methods examined MBCT’s acceptability and mechanism of action.

MAIN OUTCOMES MEASURES: The primary outcome measure was time to relapse/recurrence of depression. At each follow-up the following secondary outcomes were recorded: number of depression-free days, residual depressive symptoms, quality of life, health-related quality of life and psychiatric and medical comorbidities.

RESULTS: In total, 212 patients were randomised to MBCT-TS and 212 to m-ADM. The primary analysis did not find any evidence that MBCT-TS was superior to m-ADM in terms of the primary outcome of time to depressive relapse/recurrence over 24 months [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.67 to 1.18] or for any of the secondary outcomes. Cost-effectiveness analysis did not support the hypothesis that MBCT-TS is more cost-effective than m-ADM in terms of either relapse/recurrence or quality-adjusted life-years. In planned subgroup analyses, a significant interaction was found between treatment group and reported childhood abuse (HR 1.89, 95% CI 1.06 to 3.38), with delayed time to relapse/recurrence for MBCT-TS participants with a more abusive childhood compared with those with a less abusive history. Although changes in mindfulness were specific to MBCT (and not m-ADM), they did not predict outcome in terms of relapse/recurrence at 24 months. In terms of acceptability, the qualitative analyses suggest that many people have views about (dis)/continuing their ADM, which can serve as a facilitator or a barrier to taking part in a trial that requires either continuation for 2 years or discontinuation.

CONCLUSIONS: There is no support for the hypothesis that MBCT-TS is superior to m-ADM in preventing depressive relapse/recurrence among individuals at risk for depressive relapse/recurrence. Both treatments appear to confer protection against relapse/recurrence. There is an indication that MBCT may be most indicated for individuals at greatest risk of relapse/recurrence. It is important to characterise those most at risk and carefully establish if and why MBCT may be most indicated for this group.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781448/

 

Improve Health with Tai Chi

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By John M. de Castro, Ph.D.

 

“Tai chi is often described as “meditation in motion,” but it might well be called “medication in motion.” There is growing evidence that this mind-body practice, which originated in China as a martial art, has value in treating or preventing many health problems. And you can get started even if you aren’t in top shape or the best of health.” – Harvard Health Watch

 

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. 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. In today’s Research News article “An evidence map of the effect of Tai Chi on health outcomes.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1316431988380724/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962385/  Solloway and colleagues review the published research literature on the health effects of Tai Chi practice. They summarized previously published reviews and meta-analyses of the research. In other words, they performed a summary of summaries.

 

They report that Tai Chi has been shown to be helpful for balance and fall prevention, particularly in the elderly, and with hypertension, reducing both systolic and diastolic blood pressure. It was also found to improve cognitive performance, pain, osteoarthritis pain and joint stiffness, muscle strength, improved chronic obstructive pulmonary disease (COPD), and relief of depression.

 

These results are very encouraging and suggest that Tai Chi is effective for a number of health conditions. It has so many advantages as a therapy that it should be considered for not only treatment but also prevention of disease and promotion of health especially in the elderly and vulnerable populations. Among its many advantages is low cost. Training can occur in relatively large groups and it can be practiced virtually anywhere alone or in groups. In addition, it’s safe, having no known adverse outcomes.

 

So, improve health with tai chi.

 

“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

 

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

Solloway, M. R., Taylor, S. L., Shekelle, P. G., Miake-Lye, I. M., Beroes, J. M., Shanman, R. M., & Hempel, S. (2016). An evidence map of the effect of Tai Chi on health outcomes. Systematic Reviews, 5, 126. http://doi.org/10.1186/s13643-016-0300-y

 

Abstract

Background: This evidence map describes the volume and focus of Tai Chi research reporting health outcomes. Originally developed as a martial art, Tai Chi is typically taught as a series of slow, low-impact movements that integrate the breath, mind, and physical activity to achieve greater awareness and a sense of well-being.

Methods: The evidence map is based on a systematic review of systematic reviews. We searched 11 electronic databases from inception to February 2014, screened reviews of reviews, and consulted with topic experts. We used a bubble plot to graphically display clinical topics, literature size, number of reviews, and a broad estimate of effectiveness.

Results: The map is based on 107 systematic reviews. Two thirds of the reviews were published in the last five years. The topics with the largest number of published randomized controlled trials (RCTs) were general health benefits (51 RCTs), psychological well-being (37 RCTs), interventions for older adults (31 RCTs), balance (27 RCTs), hypertension (18 RCTs), fall prevention (15 RCTs), and cognitive performance (11 RCTs). The map identified a number of areas with evidence of a potentially positive treatment effect on patient outcomes, including Tai Chi for hypertension, fall prevention outside of institutions, cognitive performance, osteoarthritis, depression, chronic obstructive pulmonary disease, pain, balance confidence, and muscle strength. However, identified reviews cautioned that firm conclusions cannot be drawn due to methodological limitations in the original studies and/or an insufficient number of existing research studies.

Conclusions: Tai Chi has been applied in diverse clinical areas, and for a number of these, systematic reviews have indicated promising results. The evidence map provides a visual overview of Tai Chi research volume and content.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962385/

 

Improve Bladder Problems with Mindfulness

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By John M. de Castro, Ph.D.

 

“Good news: You may be able to ease your bladder discomfort and Overactive Bladder Symptoms by tapping into mind-body techniques such as meditation. Slowing your breathing calms your autonomic nervous system, which slows your heart rate and can decrease spasms of the bladder.” – Karen Sebastian

 

Interstitial cystitis/bladder pain syndrome (IC/PBS) involves recurring discomfort or pain in the bladder and the surrounding pelvic region, including mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area and/or an urgent and frequent need to urinate. There are an estimated 3.3 million adult U.S. women, or 2.7 percent, and 1.6 million adult U.S. men, or 1.3 percent who suffer from IC/PBS. The causes of IC/PBS are unknown and the current treatments employed are aimed at relieving symptoms. These include drugs, diet, exercise, bladder training, physical therapy, bladder washing and distension, and even surgery. These treatments have varying effectiveness and may become ineffective over time. So, there is a need to develop other treatments for IC/PBS.

 

Mindfulness training, including Mindfulness-Based Stress Reduction (MBSR) have been repeatedly shown to be safe and effective treatments for a variety of painful conditions. In today’s Research News article “Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial” (See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1315503701806886/?type=3&theater

or see summary below), Kanter and colleagues randomly assigned female patients with interstitial cystitis/bladder pain syndrome (IC/PBS) to either receive treatment as usual or an 8-week Mindfulness-Based Stress Reduction (MBSR) program. MBSR is taught in 2-hour weekly sessions with home practice encouraged. It is a combination of training in body scan, meditation, and yoga. Prior to and after the 8-week treatment period the patients were assessed with measures of Global Response Assessment, symptom assessment, pain, pain coping ability, quality of life, sexual function.

 

They found that MBSR in comparison to treatment as usual produced significant improvements of 28% with IC/PBS symptoms, including a 22% improvement in total symptoms and a 38% improvement in symptom problems and of 25% with pain coping ability. Hence, MBSR was found to be effective in reducing the symptoms of interstitial cystitis/bladder pain syndrome (IC/PBS) and to improve the patient’s ability to cope with the pain. This may well have occurred because of mindfulness training’s proven ability to reduce the psychological and physiological responses to stress. This would in turn, reduce stress induced symptom exacerbation. MBSR training did not reduce pain per se. Instead, because of the development of focus on the present moment, it improves the ability of patients to cope with the pain, making it less disruptive in their lives. Mindfulness has been shown to reduce catastrophizing, worry and rumination. So, it decreases the patient’s responses that amplify the pain. All in all, MBSR training would appear to be a viable treatment for interstitial cystitis/bladder pain syndrome (IC/PBS).

 

Because the Mindfulness-Based Stress Reduction (MBSR) program is a complex treatment that includes body scan, meditation, and yoga, it is impossible to assess which components or combination of components were responsible for its’ effectiveness. Future research, perhaps a component analysis design, is needed to determine what parts of the MBSR program are responsible for the effects.

 

So, improve bladder problems with mindfulness.

 

“Being mindful is about being in the present, and the conscious choice to experience your life in the present moment. Being mindful may be able to help you associate overactive bladder as just another function of the body.” – Urology Experts

 

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

Kanter G, Komesu YM, Qaedan F, Jeppson PC, Dunivan GC, Cichowski SB, Rogers RG Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial. Int Urogynecol J (2016). doi:10.1007/s00192-016-3022-8

 

Abstract

INTRODUCTION AND HYPOTHESIS: Mindfulness-based stress reduction (MBSR) is a standardized meditation program that may be an effective therapy for interstitial cystitis/bladder pain syndrome (IC/BPS), a condition exacerbated by stress. The aims of this study were to explore whether MBSR improved IC/BPS symptoms and the feasibility/acceptability of MSBR among women with IC/BPS.

METHODS: This randomized controlled trial included women with IC/BPS undergoing first- or second-line therapies. Women were randomized to continuation of usual care (UC) or an 8-week MBSR class + usual care (MBSR). Participants completed baseline and 8-week post-treatment questionnaires, including the O’Leary-Sant Symptom Problem Index (OSPI), the visual analog pain scale (VAS), the Short Form Health Survey (SF-12), the Female Sexual Function Index (FSFI), and the Pain Self-Efficacy Questionnaire (PSEQ). The Global Response Assessment (GRA) was completed post-treatment. Analyses were performed using Student’s t test, Chi-squared, and MANOVA where appropriate.

RESULTS: Eleven women were randomized to UC and 9 to MBSR, without differences in group characteristics. More MBSR participants’ symptoms were improved on the GRA (7 out of 8 [87.5 %] vs 4 out of 11 [36.4 %], p = 0.03). The MBSR group showed greater improvement in the OSPI total (p = 0.0498) and problem scores (p = 0.036); the OSPI symptom score change did not differ. PSEQ scores improved in MBSR compared with UC (p = 0.035). VAS, SF-12, and FSFI change did not differ between groups. Eighty-six percent of MBSR participants felt more empowered to control symptoms, and all participants planned to continue MBSR.

CONCLUSIONS: This trial provides initial evidence that MBSR is a promising adjunctive therapy for IC/BPS. Its benefit may arise from patients’ empowerment and ability to cope with symptoms.