Reduce Chronic Pain with Mindfulness

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Mindfulness Pain2 Bawa

By John M. de Castro, Ph.D.

 

“If you move into pure awareness in the midst of pain, even for the tiniest moment, your relationship with your pain is going to shift right in that very moment. It is impossible for it not to change because the gesture of holding it, even if not sustained for long, even for a second or two, already reveals its larger dimensionality.” – Jon Kabat-Zinn

 

We all have to deal with pain. It’s inevitable, but hopefully mild and short lived. For many, however, pain is a constant in their lives. Chronic pain affects a wide swath of humanity.  At least 100 million adult Americans have common chronic pain conditions. It affects more Americans than diabetes, heart disease and cancer combined. Chronic pain accompanies a number of conditions. The most common form is low back pain affecting between 6% to 15% of the population. Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. In the U.S., osteoarthritis affects 14% of adults over 25 years of age and 34% of those over 65. Fibromyalgia is a mysterious disorder whose causes are unknown. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. It is very common affecting over 5 million people in the U.S., about 2% of the population.

 

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and prescription opioid overdoses kill more than 14,000 people annually. Fortunately, there are alternative treatments. Mindfulness and Yoga have been shown to specifically improve back pain and mind-body practices in general have been shown to reduce the gene expressions that underlie the inflammatory response which contribute to arthritis. So, it would seem reasonable to look further into the effectiveness of alternative and complementary practices in treating chronic pain.

 

In today’s Research News article “Does mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1296780620345861/?type=3&theater

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1296780620345861/?type=3&theateror see summary below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439829/

Bawa and colleagues review the published research literature on the use of mindfulness training to treat chronic pain. Most of the studies reviewed used either Mindfulness-based Stress Reduction (MBSR) or Mindfulness-based Cognitive Therapy (MBCT) programs. They found that the published literature reported that mindfulness practices in general produced a small but significant reduction in pain, depression, and anxiety and an increase in sleep quality. They also found moderate significant improvements in physical functioning, physical and psychological quality of life. Large significant effects of mindfulness training were reported for pain acceptance and perceived pain. Hence, the published literature reports many beneficial effects of mindfulness training for chronic pain. The largest effects were for the psychological aspects of pain, but, also for the physical aspects of pain, albeit smaller effects.

 

There are a number of effects of mindfulness training that might underlie these improvements in chronic pain. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Mindfulness practices have been shown to reduce stress responses and anxiety, and to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. So, it would seem reasonable that mindfulness practices would be helpful in pain management. In addition, pain is accompanied by, and frequently caused by, inflammation and mindfulness training has been shown to reduce the inflammatory response. This may account for the mindfulness’ effects on the physical aspects of chronic pain.

 

These are exciting findings that non-drug treatments can be effective for chronic pain. They are effective and importantly, safe. So, reduce chronic pain with mindfulness.

 

“a regular meditation practice is the best ongoing foundation for working with pain. Mindfulness practice is a wonderful opportunity to do just that. It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”).” – Christiane Wolf

 

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

Bawa, F. L. M., Mercer, S. W., Atherton, R. J., Clague, F., Keen, A., Scott, N. W., & Bond, C. M. (2015). Does mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis. The British Journal of General Practice, 65(635), e387–e400. http://doi.org/10.3399/bjgp15X685297

 

 

Abstract

Background: Chronic pain and its associated distress and disability are common reasons for seeking medical help. Patients with chronic pain use primary healthcare services five times more than the rest of the population. Mindfulness has become an increasingly popular self-management technique.

Aim: To assess the effectiveness of mindfulness-based interventions for patients with chronic pain.

Design and setting: Systematic review and meta-analysis including randomised controlled trials of mindfulness-based interventions for chronic pain. There was no restriction to study site or setting.

Method: The databases MEDLINE®, Embase, AMED, CINAHL, PsycINFO, and Index to Theses were searched. Titles, abstracts, and full texts were screened iteratively against inclusion criteria of: randomised controlled trials of mindfulness-based intervention; patients with non-malignant chronic pain; and economic, clinical, or humanistic outcome reported. Included studies were assessed with the Yates Quality Rating Scale. Meta-analysis was conducted.

Results: Eleven studies were included. Chronic pain conditions included: fibromyalgia, rheumatoid arthritis, chronic musculoskeletal pain, failed back surgery syndrome, and mixed aetiology. Papers were of mixed methodological quality. Main outcomes reported were pain intensity, depression, physical functioning, quality of life, pain acceptance, and mindfulness. Economic outcomes were rarely reported. Meta-analysis effect sizes for clinical outcomes ranged from 0.12 (95% confidence interval [CI] = −0.05 to 0.30) (depression) to 1.32 (95% CI = −1.19 to 3.82) (sleep quality), and for humanistic outcomes 0.03 (95% CI = −0.66 to 0.72) (mindfulness) to 1.58 (95% CI = −0.57 to 3.74) (pain acceptance). Studies with active, compared with inactive, control groups showed smaller effects.

Conclusion: There is limited evidence for effectiveness of mindfulness-based interventions for patients with chronic pain. Better-quality studies are required.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439829/

Unstick a Wandering Mind for Task Performance

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Mind Wandering Task Performance2 Van VogtBy John M. de Castro, Ph.D.

 

“people are substantially less happy when their minds are wandering than when they’re not, which is unfortunate considering we do it so often. Moreover, the size of this effect is large—how often a person’s mind wanders, and what they think about when it does, is far more predictive of happiness than how much money they make, for example.” – Matt Killingsworth

 

We spend a tremendous amount of time with our minds wandering and not on the task or the environment at hand. We daydream, plan for the future, review the past, ruminate on our failures, exalt in our successes. In fact, we spend almost half of our waking hours off task with our mind wandering. Mindfulness is the antithesis of mind wandering. When we’re mindful, we’re paying attention to what is occurring in the present moment. In fact, the more mindful we are the less the mind wanders and mindfulness training reduces mind wandering.

 

You’d think that if we spend so much time with the mind wandering it must be enjoyable. But, in fact research has shown that when our mind is wandering we are actually unhappier than when we are paying attention to what is at hand. There are times when mind wandering may be useful, especially in regard to planning and creative thinking. But, for the most part, it interferes with our concentration on the task at hand. People differ in the amount of time their mind wanders and, when the mind wanders, the difficulty they have disengaging from the off-task thoughts and returning to present moment attention. This is referred to as the stickiness of mind-wandering.

 

In today’s Research News article “Self-Reported Stickiness of Mind-Wandering Affects Task Performance.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1295900037100586/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870246/

Van Vugt and Broers investigate the relationship of this stickiness of mind-wandering to how well individuals do in performing a task that requires attention, a go, no-go decision task. On some of the trials the subjects, prior to task onset, were reminded of one of the things that were currently on their mind, as a means of evoking mind wandering. On other trials, no such reminders were present. Participants were asked what their mental state was during the trial and how difficult it was to disengage from the wandering thoughts and return to attention to the task, stickiness.

 

They found that establishing a current concern prior to the trial did not increase mind wandering, but decreased the accuracy of performance. But, as expected, when the mind was wandering, it interfered with performance of the attention demanding task. They also found that the more difficulty that the participant had in disengaging from wandering thoughts, stickiness, the more mind wandering occurred and the lower the accuracy of response in the task. So, not only the amount of mind wandering, but also the stickiness of the mind wandering was detrimental to performance on a task that demands attention.

 

These results are interesting and show that mind wandering and stickiness can be studied in the laboratory under controlled conditions. It remains to be seen if mindfulness training can improve this kind of task performance and reduce mind wandering and stickiness. It has been demonstrated that mindfulness improves attention and cognitive task performance. But, it is not known whether it can change stickiness. Regardless, it is clear that we must unstick a wandering mind for task performance.

 

“In mindfulness what gets stronger are the brain’s circuits for noticing when your mind has wandered, letting go, and returning to your chosen focus. And that’s just what we need to stay with during that one important task we’re working on.” – Daniel Goleman

 

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

Van Vugt, M. K., & Broers, N. (2016). Self-Reported Stickiness of Mind-Wandering Affects Task Performance. Frontiers in Psychology, 7, 732. http://doi.org/10.3389/fpsyg.2016.00732

 

Abstract

When asked to perform a certain task, we typically spend a decent amount of time thinking thoughts unrelated to that task–a phenomenon referred to as “mind-wandering.” It is thought that this mind-wandering is driven at least in part by our unfinished goals and concerns. Previous studies have shown that just after presenting a participant with their own concerns, their reports of task-unrelated thinking increased somewhat. However, effects of these concerns on task performance were somewhat inconsistent. In this study we take the opposite approach, and examine whether task performance depends on the self-reported thought content. Specifically, a particularly intriguing aspect of mind-wandering that has hitherto received little attention is the difficulty of disengaging from it, in other words, the “stickiness” of the thoughts. While presenting participants with their own concerns was not associated with clear effects on task performance, we showed that the reports of off-task thinking and variability of response times increased with the amount of self-reported stickiness of thoughts. This suggests that the stickiness of mind-wandering is a relevant variable, and participants are able to meaningfully report on it.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870246/

It’s the Causes of Suffering, Stupid

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By John M. de Castro, Ph.D.

 

“Basically, life is suffering. And we create our suffering by thirsting or craving for what we cannot have. But are these really all the causes of suffering? Do we really create all of our suffering? I would argue that there is more to suffering than what we cause with our craving. Fighting with reality surely adds to our suffering – if I do not accept that I am sick, for example, and moan the whole time that I shouldn’t be sick, I will suffer more.” – Rachel Buddeberg

 

In a previous essay http://contemplative-studies.org/wp/index.php/2016/08/07/its-the-suffering-stupid/

the first Noble Truth was discussed, reflecting the patently obvious fact that there is suffering, a.k.a. unsatisfactoriness. Although I previously overlooked and ignored this important truth, an investigation of my daily life revealed that it was chock full of unsatisfactoriness. It became clear that this unsatisfactoriness must be witnessed completely to see the Buddha’s wisdom. Life is so full of unsatisfactoriness that it’s impossible to move forward on a spiritual path until it is addressed. Unsatisfactoriness is at the very core of existence and a major impediment in attaining true happiness let alone enlightenment. It became evident to me that it was the suffering, stupid.

 

But, once this is clearly realized and a complete inventory is taken of unsatisfactoriness, what’s the next step. This is presented in the Second Noble Truth that there are causes to suffering. My initial naive thoughts were that the causes of suffering were obvious. If I stepped on a nail and experienced pain or contracted the flu and experienced malaise, the causes were obvious. But, once I realized that unsatisfactoriness was rampant in my life, I realized that I wasn’t always sure what caused it. Why should I care if someone thinks highly of me? Why should I try to avoid boredom? Why should I be unhappy when certain forms of music are played? Why should I be afraid of heights even when I know it’s safe? The causes here are subtler and more difficult to identify. But, it’s important to do so, as unsatisfactoriness can only be eliminated if we first know what’s producing it.

 

To put it simply, unsatisfactoriness arises whenever we want things to be different than they are. Struggling against what is, is the primary source of unsatisfactoriness. This is a simple and absolutely true statement. But as with everything there’s more to it. There are a number of sources that are either built into us or inculcated by our society that produce a desire for things to be different. But, keep in mind that no matter what the source, ultimately it’s the refusal to accept what is that’s the source of unsatisfactoriness.

 

Our attraction and aversion to sensory experiences is a big driver of wanting things to be different. We want pleasurable experiences, be they beautiful sights, music, the flavors of a good wine, perfumes, sexual orgasm, ocean waves hitting our skin, etc. There is nothing wrong with these desires. Many are programmed into us by evolution. The problem arises when we are attached to these sensations and are never satisfied unless they’re present. Hence, in order to obtain them we strive to change the ways things are. When we don’t accept their absence, we suffer. There’s nothing wrong with liking pleasant sensations. We can enjoy them when they’re present. After all that’s accepting the present as it is. In fact, we can even seek them out. Problems arise when we’re not OK when we can’t get them or when we strive to hold onto these experiences even though they will inevitably fade. Not accepting that this is the nature of these experiences causes us to grasp onto them and then suffer when they dissipate. These are seemingly subtle distinctions, but they’re crucial. Grasping is the key. If we don’t grasp, then there’s no unsatisfactoriness.

 

We are not only wired to seek out pleasant sensation we’re also wired to avoid or eliminate unpleasant sensations, be they ugly or disgusting sights, grating sounds (the noise from lawn tools is one of my aversions), the taste of spoiled wine, the odor of rotten eggs, feeling of being chilled or overheated, pain, etc. There is nothing wrong with not liking these sensations, avoiding them, or attempting to stop them. Again evolution has programmed many of them to help protect us. The problem arises when we do not accept that these sensations arise as they inevitably will, or when we grasp at their avoidance not accepting what is. So, rather than accepting that we’re experiencing a headache, we fight against it, which amplifies the pain. Sure, lie down, close your eyes, rest, take an analgesic, but also accept that pain is present. There’s no sense in denying it or fighting it. That’s what causes the unsatisfactoriness. Just accept it, and relax knowing that like all sensations it will eventually go away. Additionally, we suffer when we become fearful of the possibility that they might occur. So we worry about the next headache or ruminate about the last one. This is a waste of time and makes us miserable. There is no headache present. Enjoy your non-headache. Aversion to certain kinds of sensory stimuli can be a major source of unsatisfactoriness, but only when we don’t accept what is.

 

Another major source of unsatisfactoriness is the unwillingness to accept ourselves as we are, to desire to be different than what we are. We want to be more successful, more attractive, more knowledgeable, more liked, happier, healthier, more assertive, younger, older, slimmer, stronger, less fearful, a better parent, less fidgety, etc. Just look in the self-help section of a bookstore as evidence of its pervasiveness. This is especially true in western society, where most people simply don’t like themselves. They want to be different. Once again, this is not accepting what is, rather wanting things to be different, producing intense unsatisfactoriness. This lack of acceptance of the self can generate unhealthy jealousy of others who seeming have what we wish we had. It can also cause us to judge others, making us feel better about ourselves by denigrating others. Hence, this desire to be different than we are can be a major source of unsatisfactoriness.

 

This is not to say that we shouldn’t want to improve ourselves. There’s no problem with working hard to advance one’s career, to lose weight, to exercise, to change hair color, to save toward purchasing a house, etc. This is normal and healthy. The problem arises when we can’t accept what we are in the present moment, when we can’t see that we’re just fine as we are even though we’re working to improve ourselves. There is much about us that we can’t change. No matter how hard I try, I won’t be able to make myself taller, smarter, or unemotional. This is what I am. To be happy, I need to accept myself as I am in the present moment. Fighting it is a waste of time and energy and a major source of unsatisfactoriness.

 

It is easy to say “got it”, I see the causes of suffering, so let’s move on to how I get enlightened. But, it is important to thoroughly investigate the causes of unsatisfactoriness. It drives home how we go about making ourselves unhappy. Every time you wish that things were different than they are right now, ask the question, why? What’s wrong or missing from the present moment? This doesn’t have to be done for major agonizing suffering. It’s best to look at something simple, like we’re bored. Ask why? Why are we unsatisfied with what’s going on right now? Is it that we crave more sensory stimulation? Then take a careful look at the sensations you’re currently experiencing and ask why they’re not sufficient. It can be an amazing revelation to see how we’re bored because we’re used to and are ignoring the incredible wonder of what is right around us. We’re not happy with the same old experiences, we crave something new. Why?

 

Don’t try to move on too quickly. Take the time to explore this thoroughly. This morning I was out for a speed walk workout in the heat and humidity, wishing it were cooler. If it was, I thought, then I’d enjoy the walk. But, I explored this a bit more deeply and realized that I was missing the extraordinary feelings of my body being hot, the sweat on my brow, the sun on my face. Then I started to appreciate the present moment and started to enjoy the situation that I was in at the time. The exploration of unsatisfactoriness can lead to greater happiness and simple enjoyment of what is. So, explore the reasons for your unsatisfactoriness and begin to understand your mind and to learn to appreciate what you have right now.

 

“If we can recognize when incorrect comprehension has affected our mind states, we can then make more sound judgments. We can tell when we are seeing things correctly, because we can notice peacefulness inside of us. Only when incorrect comprehension is in action do we feel tension and agitation.” – Lisa Mitchell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Use Mindfulness for Major Depression Rather than Drugs

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MBCT Depression2 Eisendrath

By John M. de Castro, Ph.D.

 

“Many participants said that as time went on, the benefits of MBCT permeated their whole life. ‘Through relating mindfully to their own experiences and to others, they were feeling more confident and were engaging with an increased range of social activity and involvement’.” –  Emily Nauman

 

Depression is epidemic. Major depressive disorder affects approximately 14.8 million American adults, or about 7% of the U.S. population age 18 and older. Depression is more prevalent in women than in men. It also affects children with one in 33 children and one in eight adolescents having clinical depression. It is so serious that it can be fatal as about 2/3 of suicides are associated with depression. It makes lives miserable, not only the patients but also associates and loved ones, interferes with the conduct of normal everyday activities, and can come back repeatedly. Even after complete remission, 42% have a reoccurrence.

 

The first line treatment is antidepressant drugs. But, depression can be difficult to treat. Of patients treated initially with drugs only about a third attained remission and even after repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attain remission. This leaves a third of all patients treated still in deep 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 meditation is a safe alternative that has been shown to be effective for major depressive disorder even in individuals who do not respond to drug treatment. Mindfulness Based Cognitive Therapy (MBCT) was developed specifically to treat depression and has been shown to be very effective in treating existing depression and preventing relapse when depression is in remission. 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.

 

In today’s Research News article “A Preliminary Study: Efficacy of Mindfulness-Based Cognitive Therapy versus Sertraline as First-line Treatments for Major Depressive Disorder.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1294008510623072/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465797/

Eisendrath and colleagues tested the efficacy of 8-weeks of Mindfulness Based Cognitive Therapy (MBCT) alone vs. 8-weeks of an antidepressant drug (sertraline) alone for matched patients with Major Depressive Disorder. Patients were measured before and after treatment for depression, depressive symptoms, mindfulness, self-compassion, rumination, and decentering. They found that both MBCT and antidepressant drug treatments produced significant decreases in depressive symptoms. But the MBCT group showed significantly greater improvement. They also found that for the MBCT group, the greater the increase in mindfulness and decentering, the greater the improvement in depression.

 

These are excellent and important results. Mindfulness Based Cognitive Therapy (MBCT) as the sole treatment was more effective than an antidepressant drug in decreasing depressive symptoms in patients suffering from major depressive disorder. In addition, this greater improvement appeared to be due to increases in mindfulness. It is significant that MBCT is actually more effective than drugs. It remains to be seen if its effects continue, preventing relapse after the cessation of active treatment.

 

It is not known exactly how mindfulness relieves depression. It can be speculated that mindful meditation by shifting attention away from the past or future to the present moment interrupts the kinds of thinking that are characteristic of and support depression. These include rumination about past events, worry about future events, and catastrophizing about potential future events. Mindfulness meditation 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 depression, shifting attention to the present moment where situations are actually manageable, mindful meditation may disrupt depression.

 

Regardless of the speculations, it is clear that MBCT is a safe and effective treatment for major depressive disorder. So, use mindfulness for major depression rather than drugs.

 

“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

Eisendrath, S. J., Gillung, E., Delucchi, K., Mathalon, D. H., Yang, T. T., Satre, D. D., … Wolkowitz, O. M. (2015). A Preliminary Study: Efficacy of Mindfulness-Based Cognitive Therapy versus Sertraline as First-line Treatments for Major Depressive Disorder. Mindfulness, 6(3), 475–482. http://doi.org/10.1007/s12671-014-0280-8

 

 

Abstract

Major depressive disorder (MDD) is the leading cause of disability in the developed world, yet broadly effective treatments remain elusive. The primary aim of this pilot study was to investigate the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) monotherapy, compared to sertraline monotherapy, for patients with acute MDD. This open-label, nonrandomized controlled trial examined a MBCT cohort (N=23) recruited to match the gender, age, and depression severity of a depressed control group (N=20) that completed 8 weeks of monotherapy with the antidepressant sertraline. The 17-item clinician-rated Hamilton Depression Severity Rating Scale (HAMD-17) was the primary outcome measure of depression to assess overall change after 8 weeks and rates of response and remission. The 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16) was the secondary outcome measure to further assess depression severity. Both cohorts were demographically similar and showed significant improvement in depression ratings. No difference was found in the degree of change in HAMD-17 scores (t(34) = 1.42, p = .165) between groups. Secondary analysis showed statistically significant differences in mean scores of the QIDS-SR16 (t (32) = 4.39, p < 0.0001), with the MCBT group showing greater mean improvement. This study was limited by the small sample size and non-randomized, non-blinded design. Preliminary findings suggest that an 8-week course of MBCT monotherapy may be effective in treating MDD and a viable alternative to antidepressant medication. Greater changes in the self-rated QIDS-SR16 for the MBCT cohort raise the possibility that patients derive additional subjective benefit from enhanced self-efficacy skills.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465797/

 

Reduce Self-harm with Mindfulness-based Dialectical Behavior Therapy

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DBT self-harm2 Ruocco

 

By John M. de Castro, Ph.D.

 

“People who self-injure have often found themselves either the victims of abuse or otherwise powerless and helpless in the midst of terrible circumstances. Self-abuse often provides an escape from overwhelming feelings of isolation, fear, humiliation or fury. Some who self-injure explain that it gives a sense of control in a world where they feel helpless. It can also be a physical sign of emotional pain.” – CHRISTY MATTA

 

Self-injury is a disturbing phenomenon occurring worldwide, especially in developed countries, such as the U.S. and those in western Europe. Approximately two million cases are reported annually in the U.S. Each year, 1 in 5 females and 1 in 7 males engage in self-injury usually starting in the teen years. Frequently, untreated depression and other mental health challenges create an environment of despair that leads people to cope with these challenges in unhealthy ways. Nearly 50 percent of those who engage in self-injury have been sexually abused. Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. About ¾ of BPD patients engage in self-injurious behaviors.

 

One of the few treatments that appears to be effective for Borderline Personality Disorder (BPD) is Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic of BPD including self-injury. Behavior change is accomplished through focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DPT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. DBT reduces self-injurious behaviors in BPD patients. But, not all respond. In order to improve treatment for self-injurious behaviors in BPD is important to identify the factors associated with patients who respond to treatment vs. those who don’t.

 

In today’s Research News article “Predicting Treatment Outcomes from Prefrontal Cortex Activation for Self-Harming Patients with Borderline Personality Disorder: A Preliminary Study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1293102947380295/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870399/

Ruocco and colleagues studied the neural responses of Borderline Personality Disorder (BPD) patients who decrease self-injurious behaviors in response to Dialectical Behavior Therapy (DBT) vs. those who don’t respond. Patients had their brains scanned before and after 7-months of DBT. They found that a wide variety of self-harming behaviors were significantly reduced after the DBT. They also found that those patients who responded well and had large reductions in self-harming demonstrated less activation of the Dorsolateral Prefrontal Cortex before treatment than patients who didn’t respond well to treatment. After treatment the patients who responded to therapy showed greater activation of the Dorsolateral Prefrontal Cortex. These relationships were present even after controlling for depression and mania.

 

These are interesting and potentially important results. The Dorsolateral Prefrontal Cortex is known to be involved in behavioral regulations. It appears that patients low in this activation, in other words, low in behavioral regulation, benefit the most from treatment which increases this activity and increases self-control. Hence, these results suggest that BPD patients who respond best to treatment are those whose self-injurious behaviors are exacerbated by lack of ability to regulate behaviors. DBT appears to reduce self-harm by improving the patient’s ability to regulate their self-injurious behaviors. These findings also suggest that the best candidates for DBT are those who lack behavioral regulation ability.

 

So, reduce self-harm with mindfulness-based dialectical behavior therapy.

 

“Mindfulness teaches these teens to experience emotion without acting on it, thus building in a delay to self-harming behavior.” – Pat Harvey

 

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

Ruocco, A. C., Rodrigo, A. H., McMain, S. F., Page-Gould, E., Ayaz, H., & Links, P. S. (2016). Predicting Treatment Outcomes from Prefrontal Cortex Activation for Self-Harming Patients with Borderline Personality Disorder: A Preliminary Study. Frontiers in Human Neuroscience, 10, 220. http://doi.org/10.3389/fnhum.2016.00220

 

Abstract

Self-harm is a potentially lethal symptom of borderline personality disorder (BPD) that often improves with dialectical behavior therapy (DBT). While DBT is effective for reducing self-harm in many patients with BPD, a small but significant number of patients either does not improve in treatment or ends treatment prematurely. Accordingly, it is crucial to identify factors that may prospectively predict which patients are most likely to benefit from and remain in treatment. In the present preliminary study, 29 actively self-harming patients with BPD completed brain-imaging procedures probing activation of the prefrontal cortex (PFC) during impulse control prior to beginning DBT and after 7 months of treatment. Patients that reduced their frequency of self-harm the most over treatment displayed lower levels of neural activation in the bilateral dorsolateral prefrontal cortex (DLPFC) prior to beginning treatment, and they showed the greatest increases in activity within this region after 7 months of treatment. Prior to starting DBT, treatment non-completers demonstrated greater activation than treatment-completers in the medial PFC and right inferior frontal gyrus. Reductions in self-harm over the treatment period were associated with increases in activity in right DLPFC even after accounting for improvements in depression, mania, and BPD symptom severity. These findings suggest that pre-treatment patterns of activation in the PFC underlying impulse control may be prospectively associated with improvements in self-harm and treatment attrition for patients with BPD treated with DBT.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870399/

 

Reduce Low Self-Control Drug Use with Mindfulness

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Mindfulness drug use2 Tarantino

 

By John M. de Castro, Ph.D.

 

“The idea behind mindfulness meditation is to observe the present moment by paying attention to the breath and body, as well as thoughts and emotions. People with challenges related to addiction tend to act out on addictive behaviors to avoid uncomfortable feelings and to bring pleasure. . . . Mindfulness practices help the client to learn to face the present movement with all of its pleasant and unpleasant sensations, feelings and thoughts.” – Eric Millman

 

College students make up one of the largest groups of drug abusers nationwide. Alcohol is the most abused substance, but there are many others. These include: marijuana, prescription medications (including stimulants, central nervous system depressants, and narcotics), over-the-counter drugs, cocaine, heroin, and ecstasy. Of these marijuana is the most commonly abused substance by college students. In fact, 47% of college students have tried it at least once, with 30% admiting to using it in the past year. In addition, one in five college students admits to using amphetamine and 13% of college students admit to using ecstasy at least once in their lives.

 

These are sobering statistics and underscore the need to find effective methods to prevent and treat substance abuse in college students. It is established that problematic family environments are linked to college student substance abuse. It has also been established that mindfulness tends to counteract substance abuse. Indeed, mindfulness training has been shown to be a safe and effective treatment for reducing drug use and relapse after successful treatment. In today’s Research News article “Parent-Child Conflict and Drug Use in College Women: A Moderated Mediation Model of Self Control and Mindfulness.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1292270250796898/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175297/

Tarantino and colleagues investigate whether mindfulness modulates the effects of difficult family environments on substance abuse.

 

They recruited a large on-line sample of college women and measured perceptions of the relationship between the student and his/her parent, mindfulness, self-control, and drug use. They found that the higher the level of parent-child conflict the higher the level of substance abuse. They also found variables that tended to counteract substance abuse. The higher the levels of mindfulness, self-control, and being in a relationship, the lower the levels of substance abuse. But, by far the strongest negative relationship was between self-control and substance abuse. They also found that mindfulness and self-control modified the effects of parent-child conflict on substance abuse. Mindfulness tended to blunt the effects of parent-child conflict on substance abuse only when the women were low in self-control but not when they were high in self-control.

 

These results suggest that the ability of a problematic home environment to stimulate drug abuse is diminished primarily by high self-control. But, when self-control is low mindfulness blunts the effects of parent-child conflict on substance abuse. “This relation can best be understood as a compensatory effect wherein a higher degree of either self-control or mindfulness protects against a lower degree of the other.” The complexity of these findings suggest that different strategies for treating drug abuse may be needed for women who were low vs. high in self-control. Self-control is the most important factor, but mindfulness training may work well for women who have low self-control. Future research is needed to further clarify the utility of mindfulness training in women with low self-control.

 

So, reduce low self-control drug use with mindfulness.

 

“though it may seem paradoxical, by increasing your ability to accept and tolerate the present moment, you become more able to make needed changes in your life. This is due to your learning to deal with uncomfortable feelings that might accompany modified behaviors, rather than reacting on automatic pilot. Also, practicing balanced emotional responses can reduce your stress level, and anxiety and stress are often triggers for substance abuse and addictive behavior. In addition, when you choose a neutral rather than a judgmental response to your thoughts and feelings, you can increase your sense of self-compassion rather than beating yourself up, which is often associated with addictive behaviors.” Adi Jaffe

 

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

RESEARCH NEWS –

 

Tarantino, N., Lamis, D. A., Ballard, E. D., Masuda, A., & Dvorak, R. D. (2015). Parent-Child Conflict and Drug Use in College Women: A Moderated Mediation Model of Self Control and Mindfulness. Journal of Counseling Psychology, 62(2), 303–313. http://doi.org/10.1037/cou0000013

 

 

Abstract

This cross-sectional study examined the association between parent-child conflict and illicit drug use in a sample of female college students (N = 928). The mediating roles of self-control and mindfulness, as well as an interaction between self-control and mindfulness, were examined in a moderated mediation model for the purposes of expanding etiological theory and introducing targets for the prevention and treatment of drug abuse. Whereas deficits in self-control were found to facilitate the positive relation observed between parent-child conflict and the likelihood of experiencing drug-related problems, an interaction between mindfulness and self-control helped explain the association between parent-child conflict and intensity of drug-related problems. Parent-child conflict was related to low mindfulness when self-control was low, and low mindfulness in turn was related to a higher intensity of drug-related problems. This association did not exist for women with high self-control. Findings are consistent with developmental research on the etiology of drug use and the protective properties of mindfulness and self-control. Mindfulness as a potential target of intervention for drug users with low self-control to prevent drug-related problems is explored.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175297/

 

Increase Overall Mindfulness and Mental Health with Mindfulness Practice

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Mindfulness growth2 Kiken

 

By John M. de Castro, Ph.D.

 

“Studies show that the ways we intentionally shape our internal focus of attention in mindfulness practice induces a state of brain activation during the practice. With repetition, an intentionally created state can become an enduring trait of the individual as reflected in long-term changes in brain function and structure.” – Daniel Siegel

 

 “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgementally. It’s about knowing what is on your mind.” (Jon Kabat-Zinn). It has been shown to be highly related to the health and well-being of the individual. Mindfulness training has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, mindfulness training has been called the third wave of therapies. In fact, though, little is known about how training improves mindfulness.

 

It is amazing that so little is known about the development of mindfulness, given its effectiveness and increasing popularity. It is important to understand how it develops and what affects that development in order to optimize its use. In today’s Research News article “From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1291374517553138/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404745/

Kiken and colleagues study the development of mindfulness during 8-weeks of Mindfulness-Based Stress Reduction (MBSR) training. MBSR includes meditation, body scan, and yoga training. They measured the enduring tendency toward being mindful, called trait mindfulness, and also psychological distress before and after the 8-weeks of training. They also measured the individuals’ immediate states of mindfulness each week.

 

They found that mindfulness significantly increased in a linear fashion over the 8-weeks of training and simultaneously psychological distress decreased. In addition, trait mindfulness increased from the beginning to the end of training indicating that the training increased the enduring tendency to be mindful. This is important as it indicates that MBSR training doesn’t just produce momentary changes in mindfulness but produces lasting changes. Individual participants differed in how rapidly they increased mindfulness during training. Kiken and colleagues used a sophisticated statistical technique called Latent Growth Curve Analysis to investigate if these differences were responsible for differences in the change in trait mindfulness. They found that participants who increased in state mindfulness fastest over the 8-weeks ended up having the greatest increase in trait mindfulness and decrease in psychological distress.

 

These results are significant and interesting. They clearly show that Mindfulness-Based Stress Reduction (MBSR) training increases mindfulness weekly over the program and these increases are significantly related to increases in the enduring tendency to be mindful, trait mindfulness, and to decreases in psychological distress. In other words, the momentary changes in mindfulness are translated over time into more permanent changes in mindfulness and psychological health.

 

So, increase overall mindfulness and mental health with mindfulness practice.

 

“There is more than one way to practice mindfulness, but the goal of any mindfulness technique is to achieve a state of alert, focused relaxation by deliberately paying attention to thoughts and sensations without judgment. This allows the mind to refocus on the present moment. All mindfulness techniques are a form of meditation.” – Harvard Health Guide

 

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

Kiken, L. G., Garland, E. L., Bluth, K., Palsson, O. S., & Gaylord, S. A. (2015). From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness. Personality and Individual Differences, 81, 41–46. http://doi.org/10.1016/j.paid.2014.12.044

 

 

Abstract

Theory suggests that heightening state mindfulness in meditation practice over time increases trait mindfulness, which benefits psychological health. We prospectively examined individual trajectories of state mindfulness in meditation during a mindfulness-based intervention in relation to changes in trait mindfulness and psychological distress. Each week during the eight-week intervention, participants reported their state mindfulness in meditation after a brief mindfulness meditation. Participants also completed pre- and post-intervention measures of trait mindfulness and psychological symptoms. Tests of combined latent growth and path models suggested that individuals varied significantly in their rates of change in state mindfulness in meditation during the intervention, and that these individual trajectories predicted pre-post intervention changes in trait mindfulness and distress. These findings support that increasing state mindfulness over repeated meditation sessions may contribute to a more mindful and less distressed disposition. However, individuals’ trajectories of change may vary and warrant further investigation.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404745/

 

Reduce Anxiety and Depression Among Patients with Cancer with Mindfulness

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Mindfulness cancer2 Zhang

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation is known to have a positive emotional and psychological impact on cancer survivors. But some groundbreaking new research has found that meditation is also doing its work on the physical bodies of cancer survivors, with positive impacts extending down to the cellular level.” – Carolyn Gregoire

 

Receiving a diagnosis of cancer can have a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. But, cancer diagnosis is not a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly improving. It is estimated that 14,483,830 adults and children with a history of cancer alive in the United States today. So, there are a vast number of cancer survivors.

 

Surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day. Unfortunately, most of these residual problems go untreated. Psychologically, cancer survivors frequently suffer from anxiety, depression, mood disturbance, Post-Traumatic Stress Disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission.

 

Mindfulness training may be helpful for dealing with these psychological residual symptoms of cancer. It has been shown to improve recovery from cancer and to reduce anxiety and depression in people with a wide variety of conditions.  In today’s Research News article “Effectiveness of Mindfulness-based Therapy for Reducing Anxiety and Depression in Patients with Cancer: A Meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1290482744308982/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4912240/

Zhang and colleagues examine the published research literature investigating the effectiveness of mindfulness training for anxiety and depression in cancer patients. They report that the most common form of mindfulness training used in the published research for cancer were 8-week Mindfulness-Based Stress Reduction (MBSR) programs involving meditation, body scan and yoga practices. All studies examined contained a control condition, most commonly a treatment as usual wait-list group.

 

They found that the literature made a clear case that mindfulness based therapies produce significant improvements in both anxiety and depression in the cancer patients. Since mindfulness training involves training to focus on the present moment, it is easy to see how it could be effective against anxiety and depression. Anxiety involves fear of potential future problems while depression involves rumination about the past. The focus on what’s happening now, produced by mindfulness training, prevents thinking about the past producing depression and thinking about the future producing anxiety.

 

The findings in the research literature are important as depression causes great distress, impairs functioning, and might even make the person with cancer less able to follow their cancer treatment plan. In addition, high levels of anxiety are stressful, depleting the patient’s energy and reducing their ability to fight the cancer or other potential infections. Hence the ability of mindfulness training to reduce the depression and anxiety is important for not only the patients’ mental health but also for their physical ability to fight the cancer.

 

So, reduce anxiety and depression among patients with cancer with mindfulness.

 

“Cancer is not something that any of us would ever want to have happen to us, but it can be a tremendous opportunity to look at some of our conditioning. It can also be an opportunity to look deeply and make amends for some things we don’t like. We can come into a greater sense of peace with ourselves and with others.”  – Elana Rosenbaum

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

Zhang, M.-F., Wen, Y.-S., Liu, W.-Y., Peng, L.-F., Wu, X.-D., & Liu, Q.-W. (2015). Effectiveness of Mindfulness-based Therapy for Reducing Anxiety and Depression in Patients with Cancer: A Meta-analysis. Medicine, 94(45), e0897. http://doi.org/10.1097/MD.0000000000000897

 

Abstract

Anxiety and depression are common among patients with cancer, and are often treated with psychological interventions including mindfulness-based therapy.

The aim of the study was to perform a meta-analysis of the effectiveness of mindfulness-based interventions for improving anxiety and depression in patients with cancer.

Medline, the Cochrane Library, EMBASE, and Google Scholar were searched. The randomized controlled trials designed for patients diagnosed with cancer were included. Mindfulness-based interventions were provided.

The outcomes assessed were the changes in anxiety and depression scores from before to after the intervention. The treatment response was determined by calculating the standardized mean difference (SMD) for individual studies and for pooled study results. Subgroup analyses by cancer type, type of therapy, and length of follow-up were performed.

Seven studies, involving 469 participants who received mindfulness-based interventions and 419 participants in a control group, were included in the meta-analysis. Mindfulness-based stress reduction and art therapy were the most common interventions (5/7 studies). All studies reported anxiety and depression scores. The pooled SMD of the change in anxiety significantly favored mindfulness-based therapy over control treatment (−0.75, 95% confidence interval −1.28, −0.22, P = 0.005). Likewise, the pooled SMD of the change in depression also significantly favored mindfulness-based therapy over control (−0.90, 95% confidence interval −1.53, −0.26, P = 0.006). During the length of follow-ups less than 12 weeks, mindfulness-based therapy significantly improved anxiety for follow-up ≤12 weeks after the start of therapy, but not >12 weeks after the start of therapy.

There was a lack of consistency between the studies in the type of mindfulness-based/control intervention implemented. Patients had different forms of cancer. Subgroup analyses included a relatively small number of studies and did not account for factors such as the severity of anxiety and/or depression, the time since diagnosis, and cancer stage.

Mindfulness-based interventions effectively relieved anxiety and depression among patients with cancer. However, additional research is still warranted to determine how long the beneficial effects of mindfulness-based therapy persist.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4912240/

Reduce Stress during Pregnancy with Mindfulness

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Mindfulness pregnancy2 Muthukhrishian

By John M. de Castro, Ph.D.

 

“Mindful awareness practices helped me so much during the adventure of pregnancy and early motherhood that I began to turn my professional interest toward how mindfulness might help reduce stress and improve mood among pregnant women and early moms, enhance their connection with their babies, and really thrive through the transformation of motherhood.” – Cassandra Vieten

 

Pregnancy produces vast changes in the woman’s life, her body, her emotions, and her family. These changes may well be desired and welcomed, but they produce stress. Indeed, stress is a common experience in pregnancy. But, it must be controlled. Too much stress can produce sleeping problems, headaches, loss of appetite or its opposite, overeating. If the levels of stress are high and prolonged it can produce health problems such as hypertension (high blood pressure) and heart disease in the mother. It can also make it more likely that the baby will be born prematurely or with a low birthweight, both of which are indicators of health problems for the infant and in the later child’s life.

 

So, it is important to either control stress during pregnancy or find ways to better cope with it. Mindfulness training has been shown to reduce the individual’s psychological and physiological responses to stress. It does not lower stress. Rather, it lowers the individual’s responses to the stress. Mindfulness has been shown to be helpful during pregnancy. It can help to relieve the anxiety and depression that commonly accompany pregnancy and even appears to benefit the neurocognitive development of the infant. Hence, mindfulness training may be a safe and effective method to assist the pregnant woman in coping with the stresses of pregnancy.

 

In today’s Research News article “Effect of Mindfulness Meditation on Perceived Stress Scores and Autonomic Function Tests of Pregnant Indian Women.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1289644157726174/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4866093/

Muthukrishnan and colleagues studied the effects of mindfulness meditation on stress in pregnant women. They randomly assigned women who were 12 weeks of gestation to receive either 5-weeks of mindfulness meditation training in addition to treatment as usual or treatment as usual only. The meditation group received 2 training sessions per week and were asked to meditate at home for 30-minutes per day. The women were assessed prior to and after the training for perceived stress, heart rate, and heart rate variability responses normally and in response to a stressor.

 

They found that the meditation group had a significant decrease in perceived stress, respiration rate, and lower blood pressure changes in response to a physical and a mental stressor. There was also a significant increase in heart rate variability in the meditation group. These measures indicate that autonomic nervous system tone has been improved with an increase in vegetative (parasympathetic) activity. These are important findings that indicate that meditation training decreases the pregnant women’s responses to stress and improve her overall peripheral nervous system functioning.

 

Hence, mindfulness meditation is a safe and effective method to reduce the psychological and physical responses to the stress of pregnancy. So, practicing meditation should be encouraged for pregnant women.

 

“By cultivating a mindfulness practice in pregnancy you’ll be better able to switch off from worries and stay relaxed on the big day, allowing your amazing body to simply do what it is more than capable of doing: to give birth smoothly and without fear.” – Susan Morrell

 

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

Muthukrishnan, S., Jain, R., Kohli, S., & Batra, S. (2016). Effect of Mindfulness Meditation on Perceived Stress Scores and Autonomic Function Tests of Pregnant Indian Women. Journal of Clinical and Diagnostic Research : JCDR, 10(4), CC05–CC08. http://doi.org/10.7860/JCDR/2016/16463.7679

 

Abstract

Introduction: Various pregnancy complications like hypertension, preeclampsia have been strongly correlated with maternal stress. One of the connecting links between pregnancy complications and maternal stress is mind-body intervention which can be part of Complementary and Alternative Medicine (CAM). Biologic measures of stress during pregnancy may get reduced by such interventions.

Aim: To evaluate the effect of Mindfulness meditation on perceived stress scores and autonomic function tests of pregnant Indian women.

Materials and Methods: Pregnant Indian women of 12 weeks gestation were randomised to two treatment groups: Test group with Mindfulness meditation and control group with their usual obstetric care. The effect of Mindfulness meditation on perceived stress scores and cardiac sympathetic functions and parasympathetic functions (Heart rate variation with respiration, lying to standing ratio, standing to lying ratio and respiratory rate) were evaluated on pregnant Indian women.

Results: There was a significant decrease in perceived stress scores, a significant decrease of blood pressure response to cold pressor test and a significant increase in heart rate variability in the test group (p< 0.05, significant) which indicates that mindfulness meditation is a powerful modulator of the sympathetic nervous system and can thereby reduce the day-to-day perceived stress in pregnant women.

Conclusion: The results of this study suggest that mindfulness meditation improves parasympathetic functions in pregnant women and is a powerful modulator of the sympathetic nervous system during pregnancy.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4866093/

 

It’s the Suffering, Stupid

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I-teach-one-thing-and

By John M. de Castro, Ph.D.

 

” If you want to understand suffering you must look into the situation at hand. The teachings say that wherever a problem arises it must be settled right there. Where suffering lies is right where non-suffering will arise, it ceases at the place where it arises. If suffering arises you must contemplate right there, you don’t have to run away. You should settle the issue right there. One who runs away from suffering out of fear is the most foolish person of all. He will simply increase his stupidity endlessly. We don’t meditate to see heaven, but to end suffering.” – Ajahn Chah

 

When I was first introduced to the Buddha’s Four Noble Truths I was underwhelmed, to say the least. They said first that there’s suffering. Yeah, I thought, that’s obvious, there’s lots of suffering in this world. So, what’s new. Then they said that there are causes for suffering. Again, I thought, of course, there are causes for everything. So, when do we get to the good stuff. Then they said that there’s a way to end suffering. That’s clear and obvious, I thought. Of course, if you know what causes it then there’s always ways to end it. Let’s get to the meat. Lastly, they said that there was a path to the end of suffering. Yeah, yeah, of course, let’s move on and get to how do we attain enlightenment. How do we get to nirvana and eternal bliss?

 

I don’t believe that my response was unusual as my unscientific discussions with peers has revealed similar responses. I believe that part of the reason that we missed the importance of what was being taught was the word suffering itself. It’s a translation from the Pali word “dukkha” that was the language that was likely used by the Buddha. But, it can equally well be translated as “imperfect”, “unsatisfying”, or “incapable of providing perfect happiness.” I happen to favor unsatisfactory. Using this translation, I began to see what was being taught here. Suffering implied to me an extreme and painful experience, agony, which I saw as relatively rare. But, unsatisfactoriness, now that’s a different story. Most things in life are to one degree or another unsatisfactory. So, the teaching now seems to apply to a much wider range of experiences. This was the beginning of the revelation as to just how seminal this teaching is. It’s when I realized that “It’s the suffering, stupid.”

 

I should have noted the clear and precise teaching of the Buddha. When asked about how to attain enlightenment the Buddha said “I teach one thing and one thing only: that is suffering and the end of suffering.” This should have been a clear message that the pursuit of enlightenment is actually the pursuit of the end of “dukkha”, the end of unsatisfactoriness. It should have been obvious that the key to enlightenment is unsatisfactoriness, its causes, and how to eliminate them. But somehow, I wanted to jump ahead and missed the most important teaching of all.

 

Looking carefully at existence from the perspective of unsatisfactoriness, it is clear that unsatisfactoriness is ubiquitous, it’s everywhere.

 

The alarm goes off in the morning and I think, I want to sleep longer, but I can’t. The day starts off with unsatisfactoriness. I notice a slight ache in my neck and want it to go away, and this is more unsatisfactoriness. Rising out of bed in the morning there’s a need to use the bathroom. My state is unsatisfactory. When picking out some clothes to wear I find the outfit I want to wear is out at the cleaners and I’ll have to wear something less satisfactory. I feel a bit shabby and old fashioned in the clothes. Being late, a breakfast bar is grabbed as I rush out the door, wishing I could sit down and have some scrambled eggs but have to eat an unsatisfactory breakfast. I go outside and feel the cold and wish the day to be warmer. The temperature is unsatisfactory. Driving to work I get caught at a red light and want it to be green, feeling frustrated and unsatisfactory. Traffic is moving slower than I want, so I find driving unsatisfactory. At work my co-worker looks at me with a scowl and I’m unsatisfied because I think that she doesn’t like me. etc., etc., etc. The entire day is filled from one end to the other with unsatisfactoriness.

 

The more I look at it the more I see that some of the unsatisfactoriness is due to external circumstances, the red light, the outside temperature, and the neck pain that I have little control over. But, I see that the more insidious type of unsatisfactoriness is of my own making. I make myself suffer by my interpretation of how I look in the clothes I’m wearing or how I think about events like my co-worker’s scowl. I assumed it was because she didn’t like me and I want to be liked. But, that was my interpretation. I brought that unsatisfactoriness onto myself. She may have just had a bad morning or been called on the carpet by the boss. I make so many assumptions and interpret a large number of events as suggestive of some personal failure or fault when they probably have nothing to do with me whatsoever.

 

Once we take this perspective it begins to dawn that life is replete with unsatisfactoriness. There is no end to it. Now I get what the Buddha was talking about. It’s the suffering, stupid. It’s the unsatisfactoriness. I am constantly dissatisfied with virtually everything. What a miserable way to live. Seeing the all pervasiveness of my suffering, it becomes evident that I’m rarely truly happy and even then when it’s over I feel unsatisfied. This reveals another way that unsatisfactoriness arises. One that is produced by the impermanence of all things. Everything is constantly changing and I find it unsatisfactory when good stuff goes away or when bad stuff begins. I want pleasurable experiences never to end and unpleasant ones never to begin. This is perfectly reasonable, but nevertheless a major source of the unsatisfactoriness that fills my day.

 

So, life is inherently unsatisfactory. How can one ever experience eternal bliss, if unsatisfactoriness is everywhere? I guess that’s what the Buddha was talking about. It has been said that the way to nirvana is through samsara or in plain language we must go through suffering to get to bliss. If this is true, then we must fully experience and understand our unsatisfactoriness in order to make progress on the spiritual path toward enlightenment. The first step is to carefully explore our experiences and see where and what we find unsatisfactory.

 

So, begin with the suffering, stupid.

 

“On top of the sufferings of birth, aging, sickness, and death, we encounter the pains of facing the unpleasant, separating from the pleasant, and not finding what we want. The basic problem lies with the type of mind and body that we have. Our mind-body complex serves as a basis for present sufferings in the form of aging, sickness, and death, and promotes future suffering through our usual responses to painful situations.” – Dalai Lama

 

CMCS – Center for Mindfulness and Contemplative Studies