ACT for Mental Health

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“ACT work is based more on the psychology of the normal. I think we have every reason to believe that most of the things that people struggle with are based on the failure to bring out normal psychological processes.” – Stephen Hayes

 

Acceptance and Commitment Therapy (ACT) is a psychotherapy technique that is based upon Cognitive Behavioral Therapy (CBT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, ACT helps people strengthen aspects of cognition such as in committing to valued living. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

Mindfulness practices have in general been shown to be effective in treating depression (see http://contemplative-studies.org/wp/index.php/category/research-news/depression/) and anxiety disorders (see http://contemplative-studies.org/wp/index.php/category/research-news/anxiety/) Since Acceptance and Commitment Therapy (ACT) employs mindfulness training it is not surprising that it is also effective for a variety of mental health issues including depression (see http://contemplative-studies.org/wp/index.php/category/contemplative-practice/act/).

 

ACT contains a number of modules that allow the client to work on particular thoughts and actions that are relevant to the individual’s problems. This allows for component analysis research, where certain ACT modules are used or dropped out and the change in ACT effectiveness measured, thus allowing the assessment of the effectiveness of each component module. In today’s Research News article “Acceptance and Commitment Therapy modules: Differential impact on treatment processes and outcomes”

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Villatte and colleagues examined “two ACT component modules; one targeting openness to thoughts, feelings, and sensations and the other emphasizing engagement in meaningful actions.” Participants who were suffering from depression and/or anxiety disorders were randomly assigned to receive ACT therapy emphasizing one of the two modules.  In the ACT OPEN module, the client explores the thoughts and ideas about the depression or anxiety and are then encouraged to let go of these thoughts, to let them diffuse, “(e.g. thoughts are observed as if they are leaves floating on a stream).” In the ACT ENGAGED module the client’s own values are explored as guides to orient actions and as sources of satisfaction. They then explore their experiences with an eye toward allowing their values to guide them through the obstacles that occur in everyday life.

 

Villatte and colleagues found that both modules produced significant improvements in acting with awareness and nonreactivity to thoughts, feelings, sensations. They both also produced significant reductions in anxiety and depression symptom severity, but the ACT OPEN module was significantly more effective than the ACT ENGAGED module. The ACT OPEN module only produced significant improvements in cognitive diffusion and experiential acceptance. Both modules also produced clinically significant improvements in quality of life and values based action, but the ACT ENGAGED module was significantly more effective than the ACT OPEN module.

 

Hence they found that the module emphasizing letting go of thoughts and ideas about their problems, ACT OPEN, was more effective in reducing the symptoms of anxiety and depression than the module emphasizing applications of the individual’s own values to guide actions, ACT ENGAGED. This finding reinforces the importance of the emphasis of mindfulness practice on letting go of thoughts and focusing on present experience. It suggests that this may be a critical component in mindfulness applications to mental health issues. The fact that the module emphasizing applications of the individual’s own values to guide actions, ACT ENGAGED produced greater improvements in quality of life suggests that the emphasis in mindfulness practice on acting with awareness may be crucial to satisfying engagement in life.

 

It is possible that letting go is needed as a prerequisite before values based actions are effective. So, values based actions may not be as effective when practiced before practicing letting go. Future research should investigate presenting these modules in different orders. Regardless it is clear that Acceptance and Commitment Therapy (ACT) modules are effective in the treatment of anxiety and depression.

 

So, ACT for mental health.

 

“People don’t go into therapy when life is moving forward at a reasonable clip; they go in when life is stuck or going backwards. And it’s not that they get cured or fixed, because humans are not broken, they don’t need to be fixed. They need to be supported in a way that allows them to grow and do a better job over time with the things that they really care about—their kids, their work, their intimate relationships, their sense of participation and connection with the world around them.” – Stephen Hayes
CMCS – Center for Mindfulness and Contemplative Studies

Improve Fertility with Mindfulness

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“Using your mind to improve your fertility? Not as strange as you might think! If you have ever blushed, you’ll understand what I mean. That embarrassment you felt, visible to the world. Research shows emotions influence all body functions, especially fertility hormones. Fertility Mindfulness tips the odds of conceiving in your favor. Re-align your mindset and prepare for conception success, no matter what you have experienced.” – Helena Tubridy

 

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women 15-44, have an impaired ability to get pregnant or carry a baby to term and about 6% are infertile.

 

Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives. Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack. Men’s reactions are more complicated. If the reason for the infertility is due to an issue with the woman, then men aren’t as distressed as the women. But if they are the ones who are infertile, they experience the same levels of low self-esteem, stigma, and depression as infertile women do. In addition, infertility can markedly impact the couple’s relationship, straining their emotional connection and interactions and the prescribed treatments can take the spontaneity and joy from lovemaking making it strained and mechanical.

 

The stress of infertility and engaging in infertility treatments may exacerbate the problem. The anxiety and stress may actually make it more difficult to conceive. In fact, recent studies found that higher rates of infertility treatment success in people who were undergoing a mind–body interventions. So, reducing stress and anxiety may be beneficial for conception. Since mindfulness training has been shown to reduce anxiety (see http://contemplative-studies.org/wp/index.php/category/research-news/anxiety/) and stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/) it is reasonable to believe that mindfulness training may be helpful for conception in women with fertility issues.

 

In today’s Research News article “Effects of a mindfulness-based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilization treatment”

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Li and colleagues conducted a 6-week mindfulness training with women undergoing in-vitro fertilization treatment. In comparison to a treatment as usual control group, they found that the mindfulness training produced significant improvements in mindfulness, self-compassion, emotion regulation, improved coping responses and fertility quality of life. There was also a decrease in the influence of infertility on physical health, cognition, and behavior. Importantly, the treatment resulted in significantly higher proportion of the participants who had a viable pregnancy by virtue of in vitro fertilization.  Hence it appears that mindfulness treatment improves the women’s psychological and physical well-being and this in turn improves their ability to have a successful outcome to in vitro fertilization, becoming pregnant.

 

These are wonderful and encouraging findings that mindfulness can have such significant positive benefits for women with infertility. The fact that mindfulness is known to reduce the physical and psychological responses to stress, reduce anxiety, and improve emotion regulation is likely responsible for these benefits. This allows the women to better cope with the difficulties of infertility and its treatment.

 

Mindfulness training is a safe and effective treatment with many benefits for virtually everyone and for many psychological and medical issues. The results from this study add infertility treatment to the usefulness and positive effects of mindfulness training. This can be of great benefit to large numbers of women who struggle with infertility.

 

So, improve fertility with mindfulness.

 

“My bottom line is that if mindfulness and meditation are things that you would be interested in anyway, then using them as a strategy to help cope with fertility treatment sounds logical and beneficial.” – Erin Stronach

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Better Music with Mindfulness

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“The way yoga brings you to yourself can’t but help an artist tap into that deeper well. Yoga and art are actually very similar: The challenge of stretching beyond your comfort zone, of learning to breathe and surrender into places that are painful or tight, is sometimes also what allows a profound artistic opening.” – Diane Anderson

 

Effective musician craft is described as entering a state of “flow.” This refers to a state of complete immersion in an activity such that it becomes totally absorptive leaving no attention left for any distractions. The musician literally becomes totally lost in their music. Musicians report that when they are in “flow” they are at their best and the music is precise and nuanced. “Flow” and the quality of performance is disrupted by anxiety, which is common prior to and during performance, and confusion and uncertainty about the piece that they are playing. So, reductions in anxiety and confusion would be expected to improve “flow” and the resulting performance.

 

Contemplative practices are also geared to producing a state similar to “flow” where the practitioner becomes totally immersed in the present moment and distractions are minimized. The contemplative practice that are most similar to music performance are those that involve movement, yoga, tai chi, and qigong. Yoga practice has been shown to reduce anxiety (see http://contemplative-studies.org/wp/index.php/2015/11/11/yoga-improves-stress-responses-and-mood/ and http://contemplative-studies.org/wp/index.php/2015/09/03/keep-up-yoga-practice-for-anxiety-and-depression/) and improve movement (see http://contemplative-studies.org/wp/index.php/2015/08/11/improve-physical-health-with-yoga/).  So, it is reasonable to hypothesize that yoga practice might improve musical performance.

 

In today’s Research News article “Yoga Enhances Positive Psychological States in Young Adult Musicians”

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Butzer and colleagues trained a group of young professional classical musicians in yoga for 8-weeks and compared their ability to enter “flow”, mindfulness, and levels of confusion, and performance anxiety to a no-treatment control group. They found that the yoga group improved significantly in mindfulness and their ability to achieve “flow”, and a significant decrease in confusion. In addition, they found that higher levels of “flow” and mindfulness were associated with a decrease in performance anxiety. So, yoga practice appeared to improve mindfulness and “flow” and reduce confusion which in turn reduced performance anxiety in the musicians.

 

This is the first study that I am aware of that demonstrated that yoga practice could improve musician characteristics that are associated with superior musical performance. There are a number of ways that yoga practice might act to do this. Yoga practice improved mindfulness in the musicians. Hence, it improved the ability of the musicians to attend to the present moment which is a necessity to enter “flow.” Also, by reducing the ability of other stimuli and thoughts to intrude and distract attention, yoga should reduce confusion. Mindfulness is also known to improve emotion regulation and decrease anxiety levels. This would in turn allow the musician to reduce performance anxiety and be better able to respond constructively to it.

 

Regardless of the explanation, it is clear that yoga practice is beneficial for musicians producing the conditions for better performances. So, produce better music with mindfulness.

 

“When people get nervous, they think about what other people are thinking, rather than concentrating on the music. Yoga helps you to be more in the moment. When you are stressed you hold your breath, and the nervous energy makes you feel tight, and everything feels ‘up in the air.’ If you take a deep breath with a long exhale you can actually bring that energy back down and ground it.” – Mia Olson
CMCS – Center for Mindfulness and Contemplative Studies

 

Add Spirituality to Meditation and Improve Migraines

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“Migraine is a disorder of a hyper-excitable brain, and it makes sense for people with migraine to adopt a stress-reducing . . . One behavioral intervention that may be useful, not only for migraine, but also for life in general, is what is called mindfulness meditation.” – John Wendt

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head. They last from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. They disproportionately affect women with about 18% of American women and 6% of men suffering from migraine. In the U.S. they affect roughly 40 million men, women and children. While most sufferers experience attacks once or twice a month, 14 million people or about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/). So, they may be useful in preventing migraines. Indeed, it has been shown that Mindfulness Based Stress reduction (MBSR) practice can reduce tension headache pain (see http://contemplative-studies.org/wp/index.php/2015/09/07/headaches-are-a-headache-reduce-them-with-mindfulness/).

 

Wachholtz and colleagues have previously shown that adding a spiritual dimension to meditation can increase the effectiveness of meditation for increasing pain tolerance. In today’s Research News article “Effect of Different Meditation Types on Migraine Headache Medication Use”

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Wachholtz and colleagues randomly assigned migraine sufferers to four conditions, spiritual meditation, internal secular meditation, external secular meditation, and progressive muscle relaxation. The differences between the meditation groups was solely a phrase that the participants were asked to repeat a few times at the beginning of the meditation. The phrases were for spiritual meditation, “God is peace,” “God is joy,” God is good,” and “God is love,” or alternatively substituting the words “Mother Nature” for God; internal secular meditation, “I am content,” “I am joyful,” “I am good,” “I am happy;” and for external secular meditation, “Grass is green,” “Sand is soft,” “Cotton is fluffy,” “Cloth is smooth.” Practice continued 20 minutes once a day for 30 days.

 

They found that over the 30 days of practice all groups had a decrease in the frequency of migraines and the amounts of pain medications taken, but the spiritual meditation group had a significantly greater decrease in frequency and medication use than the other three groups. None of the treatments appeared to change the severity of the migraines. Hence, adding the spiritual dimension to the meditation enhanced its effectiveness with migraines. Unfortunately, once a migraine began, nothing altered its magnitude or duration.

 

There is evidence that meditation can reduce pain (see http://contemplative-studies.org/wp/index.php/category/research-news/pain/). But, it is not known how the addition of simple spiritual phrases at the beginning of the meditation might improve its effectiveness. It is possible that the spiritual phrases were more effective than the secular phrases in focusing attention for the meditation session and thereby making it more effective. It is also possible that the phrases increased the individual’s ability to let go of struggling by turning over responsibility to a higher power. But, these are pure speculations. It will take further research to clarify the mechanism of action. But, it is clear that adding a spiritual dimension to meditation increases its effectiveness against migraine headaches.

 

So, add spirituality to meditation and improve migraines.

 

“although mindfulness is often thought of as a method of spiritual enlightenment, the underlying principles for healing are based on science. In a nutshell, mindfulness is capable of changing our brain chemistry, which impacts each and every one of our systems and organs.” – Cynthia Perkins
CMCS – Center for Mindfulness and Contemplative Studies

 

Relativity of Time and Awareness

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“But Einstein came along and took space and time out of the realm of stationary things and put them in the realm of relativity—giving the onlooker dominion over time and space, because time and space are modes by which we think and not conditions in which we live.”- Dimitri Marianoff

 

Einstein’s theory of relativity is based upon the notion that everything that is observed has to be viewed relative to the observer. Indeed from the perspective of an observer on earth, the moon appears to be orbiting the earth. But, from the perspective of an observer on the moon, the earth appears to be orbiting the moon. One of Einstein’s great insights was that not only the position of things is observed relatively, but so is time. He postulated that time is not constant but also changes relative to the observer. In other words, time is not constant, but is variable. Indeed as an observer is moving relatively approaching the speed of light time slows down and at the speed of light time stops entirely. In other words space-time is not a constant but varies with relative position and speed of the observer.

 

It should be noted that an observer is a conscious entity. So, how might we look at the experience of the observer? Perhaps, we might look at awareness in a relativistic way. The observer’s awareness is of the present moment and only of the present moment. The past is gone and the future isn’t here yet, so all the observer has is the present. What the observer experiences in the present can be viewed in two very different ways. It can be looked at that the observer is moving through time and viewing the changes that occur in time. The observer’s awareness is of the different things that are occurring at different moments in time. The observer is simply watching the stream of different sensations. This is the usual and typical way that humans look at their internal observer, otherwise known as awareness.

 

Alternatively, we can look at the experience of the observer as time has stopped but things are moving in observer’s awareness. The observer’s awareness in the present moment is the movement in the observer’s awareness.  Experiences then are arising and falling away in that singular moment. Time is defined as change. Because the observer detects things changing, the observer concludes that time must be passing. But as Einstein said “time is an illusion.” It is only because change is observed in the present moment that the observer concludes that time has passed. Perhaps time hasn’t passed but awareness has moved.

 

Let’s translate these ideas to the meditation cushion. When meditating the individual can sit and watch things happening as time passes. Maybe it’s the movement associated with the breath, or the sounds of a bird song, or the light penetrating our eyelids, or the odors wafting through the room. That is how most people meditate. But, in essence we’ve just translated how we view the everyday world to the cushion, making meditation just like everyday experience. Perhaps that’s why many people meditate for years without becoming awakened. How can we expect to see things differently if we’re looking at them the same way?

 

On the other hand when meditating we can sit and observe things moving in our awareness at a fixed point in time called the present moment. This is a radically different approach that is unlike our everyday way of experiencing the world. The rising and falling of the breath, the bird song, the light, odors, are simply movements of our mind that awareness observes in a stationary present moment. Time has stopped, but things are moving in our awareness. Perhaps this could lead to a redefinition of experience as the product of a moving mind being observed by a stationary awareness. Now this is different. It is unlike our usual way of experiencing everyday life. Perhaps this change in the perspective of the observer can lead to a different view of reality. Perhaps this can lead to an awakening.

 

This perspective then needs to be broadened and employed with our everyday experience and not just in the cloistered environment of meditation. All that is happening in the “real world” should be viewed as sensations and thoughts simply arising in our awareness in a present moment that does not move in time. There is no time, only things entering, changing, and leaving in our awareness. From this perspective it is possible that we will begin to see that time is an illusion and our essence is pure awareness in which experiences are created. This may take a while, as lifelong mental habits of viewing everything occurring outside in time with us as simply an observer that is also moving along through time, has to be unlearned and replaced with the new perspective. For some this happens suddenly in a life altering opening termed an awakening experience. For others, it is a slow progressive change that is hardly noticeable, but move inexorably to the same point, awakening.

 

So, try looking relatively at your awareness and see where it leads.

 

“I had a sneaking suspicion that time was not constant, but I guess I could never prove it…. I even had a theory that time didn’t go in straight line at all…… I had the sneaking suspicion that everything had happened, was happening, or would happen was really happening all the time. There was no past, present, and future. Everything was going on all at once and forever. If that was true, then each moment was eternity.”  ― Mark A. Roeder

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Rejuvenate Doctors Conveniently with Mindfulness

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“Mindfulness gives doctors permission to attend to their own health and well-being. But it also allows doctor to help patients by listening more, talking less, and seeing what the patients need.” – Dr. Mary Catherine Beach

 

“That’s the thing: You don’t understand burnout unless you’ve been burned out. And it’s something you can’t even explain. It’s just doing something you have absolutely no passion for.” – Elena Delle Donne

 

It is estimated that there is a shortage in the U.S. of over 9,000 physicians. The shortages are not just due to training insufficient numbers of healthcare provides but also due to high turnover rates. In part because of the shortage and high patient loads, physicians experience high stress and burnout. They experience a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. This is known as burnout.

 

In a recent survey 46% of all physicians responded that they had burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity. Since there is such a great need to retain experienced physicians, it is imperative that strategies be identified to decrease stress and burnout.

 

Mindfulness training has been shown to be effective for burnout of health care professionals (see http://contemplative-studies.org/wp/index.php/category/research-news/burnout/). But todays physicians are extremely busy and have little time to devote to mindfulness training. Hence, it is important to develop a mindfulness training that can be administered conveniently and is effective. In today’s Research News article “Brief Video-Module Administered Mindfulness Program for Physicians: A Pilot Study”

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Pflugeisen and colleagues developed a mindfulness training consisting of “three live sessions, eight online video trainings, and weekly teleconference coaching calls.”  Other than the live sessions all of the trainings could be accessed at a time and place of the physicians’ convenience. In a pilot study, they found that in comparison to pre-training the physicians showed large and significant decreases in stress and emotional exhaustion, and increases in feelings of personal accomplishment, and mindfulness. These improvements were still present 16-weeks later.

 

These pilot results are very encouraging. The program was not only effective in improving physician well-being, it was convenient for the physicians, as it was delivered for the most part when the physicians had time to engage. This makes this program much more likely to be initiated and completed by busy physicians. There is, of course, a need for a randomized controlled trial before rolling out this program for widespread use.

 

These results suggest that mindfulness is to some extent an antidote to high stress and burnout in physicians. There are a number of effects to mindfulness training that could be responsible for the reduced perceived stress and increased well-being. In particular mindfulness has been shown to reduce both physiological and psychological responses to stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/). Mindfulness has also been shown to increase emotion regulation, allowing the individual to experience and respond to emotional situations appropriately and constructively and thereby reduces stress (see http://contemplative-studies.org/wp/index.php/category/research-news/emotions/). Finally, mindfulness training is targeted to increasing focus on the present moment. This tends to reduce catastrophizing, worry, and anxiety which are focused on potential negative future events (see http://contemplative-studies.org/wp/index.php/category/research-news/worry/) and thereby can reduce psychological stress in physicians.

 

Regardless of the reason it is clear that mindfulness training can be delivered conveniently to busy physician and it can reduce burnout and improve well-being.

 

So, rejuvenate doctors conveniently with mindfulness

 

“If you asked my patients, I think they would say I listen more carefully since the training and that they feel they can explain things to me more forthrightly and more easily. Even the brief moments with patients are more productive. Are there doctors who desperately need this training? Yes, absolutely.” – Edward Stehlik, M.D.
CMCS – Center for Mindfulness and Contemplative Studies

 

Log-on for Less Anxiety with Mindfulness

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“Needless anxiety and stress cannot burden us if the thoughts don’t enter our mind. And fortunately, we are only capable of focusing on one thing at a time. When you’re aware of only what you’re working on and the sensations of your body, conscious worry is not possible.” – Jordan Bates

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. (Source: National Institute of Mental Health). Generalized Anxiety Disorder (GAD) affects about 3.1% of the U.S. population. GAD involves excessive worry about everyday problems. People with GAD may excessively worry about and anticipate problems with their finances, health, employment, and relationships. They typically have difficulty calming their concerns, even though they realize that their anxiety is more intense than the situation warrants. Physically, GAD sufferers will often show excessive fatigue, irritability, muscle tension or muscle aches, trembling, feeling twitchy, being easily startled, trouble sleeping, sweating, nausea, diarrhea or irritable bowel syndrome, and headaches.

 

Anxiety disorders are not only a torment for the victims but they also place tremendous pressure on the health care system. People with an anxiety disorder are three to five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders. Anxiety disorders are treatable but only about a third of the sufferers get treatment. The most common treatment for GAD is drugs. Anxiolytic drugs are some of the most prescribed drugs in the U.S. Psychotherapy is another common form of treatment with Cognitive Behavioral Therapy particularly effective. Mindfulness practices are known to reduce anxiety (see http://contemplative-studies.org/wp/index.php/2015/11/02/be-open-or-focused-in-meditation-to-reduce-anxiety/,  http://contemplative-studies.org/wp/index.php/2015/07/17/the-mindfulness-cure-for-social-anxiety/, http://contemplative-studies.org/wp/index.php/2015/07/17/stop-worrying/), and appear to do so by altering brain activity (see http://contemplative-studies.org/wp/index.php/2015/08/13/get-the-brain-to-reduce-anxiety-with-meditation/).

 

The problems with these treatments is that drugs can have very troublesome side effects and psychotherapy can be expensive and time consuming. Therapy also demands that there be a qualified professional in the immediate area and the patient has the time and transportation available to attend therapy sessions. So, there is a need for cost-effective, convenient, and safe alternative treatments.

 

One way to lower costs and make therapy available for patients over wide geographical areas is to deliver therapy over the internet. In today’s Research News article “Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder: A randomized controlled trial”

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Dahlin and colleagues developed a form of mindfulness based Acceptance and Commitment Therapy (ACT) for delivery by a therapist over the internet. They recruited participants with GAD over the internet and assigned them randomly to either receive therapy for 9-weeks or to a waiting list control condition. They found significant improvement in Generalized Anxiety Disorder (GAD) and depression for the therapy group with large to moderate effect sizes. These improvements were still present 34-weeks later.

 

These are exciting results. Anxiety disorders are so prevalent and so infrequently treated that it’s important to demonstrate that a safe and effective therapy can be inexpensively delivered over the internet. This opens the door to widespread access to safe, convenient, effective, and inexpensive treatment. Future trials should employ a more active control condition and open up treatment to a wider array of GAD sufferers.

 

Mindfulness practices have a number of effects that appear to be helpful with anxiety disorders. They have been shown to improve emotion regulation. This allows the individual to experience the anxiety but react to it in a constructive way and thereby preventing an upward spiraling of anxiety as the patient becomes more anxious of becoming more anxious. Mindfulness practices also appear to blunt physiological and psychological reactions to stress. Since, high levels of anxiety are stressful, mindfulness practices may reduce the reactions to this stress, making the anxiety more bearable. Finally, anxiety involves worries about the future. By focusing the individual on the present, mindfulness practices interrupt worries about the future.

 

Regardless of the explanation, it is clear that mindfulness based Acceptance and Commitment Therapy (ACT) is effective for Generalized Anxiety Disorder (GAD) even when delivered over the internet.

 

So log-on for less anxiety with mindfulness.

 

“I confessed to him that I saw breathing exercises as an attempt to distract. He said, “Yes. It’s a tool. Mindfulness is all in the subtleties.” Then he paused and told me, “Instead, when thoughts and feelings come, you simply say to them ‘Hello. I see you. Welcome.’”” – Lucy Roleff


CMCS – Center for Mindfulness and Contemplative Studies

 

Yoga Helps the Blind Maintain Balance

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“One of the many misconceptions about the blind is that they have greater hearing, sense of smell and sense of touch than sighted people. This is not strictly true. Their blindness simply forces them to recognize gifts they always had but had heretofore largely ignored.” – Rosemary Mahoney
Falls are a standard of slapstick comedy and Americas Funniest Home Videos. But, falls are far from funny. They can cause serious injury and even death. “One out of five falls causes a serious injury such as broken bones or a head injury. Each year, 2.5 million older people are treated in emergency departments for fall injuries. Over 700,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture. Each year at least 250,000 older people are hospitalized for hip fractures. More than 95% of hip fractures are caused by falling,6 usually by falling sideways. Falls are the most common cause of traumatic brain injuries (TBI). Adjusted for inflation, the direct medical costs for fall injuries are $34 billion annually.” (Centers for Disease Control). Approximately 9,500 deaths in older Americans are associated with falls each year, making falls the leading cause of death from injury among people 65 and older.

 

Physical and sensory fitness and balance are important for the prevention of falls. The visual system is particularly important for maintaining balance and avoiding obstacles. Hence, it is not surprising that the visually impaired are 1.7 times more likely to have a fall and 1.9 times more likely to have multiple falls compared with fully sighted populations. The odds of a hip fracture are between 1.3 and 1.9 times greater for those with reduced visual acuity. So, finding methods to improve balance in the visually impaired may greatly reduce falls and subsequent injury.

 

Yoga has been shown to improve muscular strength, endurance, and flexibility (see http://contemplative-studies.org/wp/index.php/2015/08/11/improve-physical-health-with-yoga/) and to improve balance (see http://contemplative-studies.org/wp/index.php/2015/12/26/improve-physical-well-being-with-bikram-yoga/). So, it would seem reasonable to predict that yoga training may improve coordination, flexibility, and balance in the visually impaired and as a result reduce injuries.

 

In today’s Research News article “Ashtanga-Based Yoga Therapy Increases the Sensory Contribution to Postural Stability in Visually-Impaired Persons at Risk for Falls as Measured by the Wii Balance Board: A Pilot Randomized Controlled Trial”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1159236467433611/?type=3&theater

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0129646

Jeter and colleagues developed and pilot tested a yoga program for the legally blind and compared the results to those obtained from a wait-list control group. The participants practiced yoga once a week with an instructor and twice a week at home for eight weeks. As expected yoga produced an increase in lower body strength and flexibility. Using a balance on an unstable platform test they found that after yoga training the blind participants were better able to use somatosensory and vestibular information to maintain balance.

 

These findings suggest that yoga improves blind individuals physically and increases their balance by making them more sensitive to the information provided by touch and by the balance (vestibular) system. There was no direct test of propensity to fall, but the results suggest that the yoga training would improve balance and thereby lower the likelihood of a fall. It will take further research to directly test this conclusion.

 

It is clear, however, that yoga can improve sensitivity of the tactile and vestibular stimuli that are important for balance. So, practice yoga to improve balance in the blind.
“To be blind is not miserable; not to be able to bear blindness, that is miserable.”

John Milton
CMCS – Center for Mindfulness and Contemplative Studies

 

Disrupt Suicidal Thoughts with Mindfulness  

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“Did you really want to die?”
“No one commits suicide because they want to die.”
“Then why do they do it?”
“Because they want to stop the pain.”  ― Tiffanie DeBartolo

 

After cancer and heart disease, suicide accounts for more years of life lost than any other cause. Around 43,000 people take their own lives each year in the US. Someone dies from suicide every 12.3 minutes. Worldwide over 800,000 people die by suicide every year. (Suicide Awareness Voices of Education). It is much more prevalent with males who account for 79% of suicides. The problem is far worse than these statistics suggest as it has been estimated that for every completed suicide there were 12 unsuccessful attempts. In other words, about a half a million people in the U.S. attempt suicide each year. Yet compared with other life threatening conditions there has been scant research on how to identify potential suicide attempters, intervene, and reduce suicidality.

 

Depression and other mood disorders are the number-one risk factor for suicide. More than 90% of people who kill themselves have a mental disorder, whether depression, bipolar disorder or some other diagnosis, according to the National Alliance on Mental Illness (NAMI). So, the best way to prevent suicide may be to treat the underlying cause. For many this means treating depression. Mindfulness training has been shown to reduce suicidality in substance abusers (see http://contemplative-studies.org/wp/index.php/2015/11/30/decrease-suicidality-with-mindfulness/). Mindfulness training has also been shown to be effective for treating depression (see http://contemplative-studies.org/wp/index.php/category/research-news/depression/). Mindfulness-Based Cognitive Therapy (MBCT) was developed specifically to treat depression and prevent relapse. So, it would seem reasonable to expect that MBCT would be effective in suicide prevention.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy (MBCT) Reduces the Association Between Depressive Symptoms and Suicidal Cognitions in Patients with a History of Suicidal Depression”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1158656587491599/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655869/

Barnhofer and colleagues treated patients with a history of suicidal depression with eight weeks of either MBCT, Cognitive Psychoeducation (CE), or Treatment as Usual (TAU). They found that at the end of treatment the participants treated with MBCT had a significant reduction in suicidal thoughts while the other groups did not. For the CE and TAU groups there were strong and significant correlations between depression and suicidal thoughts. That is, for these groups, the higher the level of depression the higher the levels of suicidal thought. In contrast for the MBCT group the correlations were significantly weaker That is, there was a much weaker relationship between depression and suicidal thoughts after Mindfulness-Based Cognitive Therapy (MBCT) than Cognitive Psychoeducation (CE), or Treatment as Usual (TAU).

 

These are interesting and potentially important findings that MBCT can reduce suicidal thoughts and that it weakens the link between depression and suicidal thoughts. This makes sense as MBCT is designed to reprogram depressive thought processes, helping the patient to see that their typical ways of thinking about and assessing their experiences are faulty and tend to heighten depression and that looking at and interpreting their experiences in a more rational way can reduce depression. This, in turn, appears to reduce suicidal thinking.

 

These results clearly suggest that Mindfulness-Based Cognitive Therapy (MBCT) may be an effective program to prevent suicide in people with high levels of suicidal thinking. Since mindfulness training has been shown to reduce suicidality in drug abusers, the second most likely group to commit suicide, it would appear that mindfulness training is potentially an important method to prevent suicide.

 

So, disrupt suicidal thoughts with mindfulness.

 

“The thought of suicide is a great consolation: by means of it one gets through many a dark night.” 
― Friedrich Nietzsche
CMCS – Center for Mindfulness and Contemplative Studies

 

Improve Diabetes with Yoga

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“Many people with diabetes have found relief by incorporating yoga into their routine, and it can help at any stage.” –  Jasmine Lieb

 

It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Diabetes is the 7th leading cause of death in the United States. It is estimated that worldwide around 3.5 million deaths per year are attributable to diabetes. 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. Obviously, diabetes is a major health problem.

 

Type 2 diabetes is also known as adult onset diabetes, although it has recently surged in children. It involves not a lack of insulin but insulin resistance in tissues which become deficient in absorbing glucose from the blood. This results in high blood glucose levels. Most type 2 diabetes is preventable as it is associated with poor diet, overweight, and lack of exercise. Obviously, improved diet, exercise, and weight loss are helpful in treating type 2 diabetes.

 

Mindfulness practices have been shown to be effective for diabetes treatment (see http://contemplative-studies.org/wp/index.php/category/research-news/diabetes/) and yoga practice has been shown to help with weight control in diabetic patients (see http://contemplative-studies.org/wp/index.php/2015/08/24/control-weight-in-diabetes-with-yoga/). Since yoga is both a contemplative practice and an exercise, it would seem to be an excellent alternative practice for the treatment of type 2 diabetes. It would seem especially appropriate for elderly diabetes patients as it has other benefits for the health of the elderly (see links below).

 

In today’s Research News article “Yogic practice and diabetes mellitus in geriatric patients”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1158078897549368/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573543/

Beena and colleagues examined the effectiveness of yoga practice for the treatment of type 2 diabetes in 60 to 70 year olds. Yoga was practiced 90 minutes per day for 6 days a week for 3 months. The yoga group was compared to a treatment as usual control group. They found that the yoga group had a significant increase in blood glucose control as measured by plasma HbA1c and fasting glucose. Yoga also produced a significant improvement in blood fat levels including decreases in total cholesterol, LDL-cholesterol, triglyceride and T.chol/HDL ratio and a significant increase in HDL cholesterol. There was also a significant decline in markers of stress in the yoga group including a decrease in the stress hormone, cortisol, and MDA, a marker of oxidative stress. There was also a significant increase in catalase, an antioxidant enzyme that protects against damage caused by free radicals in the yoga group. Finally, the yoga practice produced a decrease in Ferritin levels, a marker of inflammation. So, yoga practice was found to significantly improve plasma indicators of glucose control, blood fat levels, stress, and inflammation in elderly type 2 diabetes patients.

 

These results are impressive and strongly suggest that yoga practice is an excellent treatment for type 2 diabetes in the elderly. It produces major improvements in many different aspects of physical health in patients with diabetes. Yoga improves diabetes both by its exercise properties and also by its ability to reduce the physiological and psychological responses to stress. Since it is known to be safe, with few if any negative side effects, and also have other physical and psychological benefits, it would seem to be an ideal treatment.

 

So, improve diabetes with yoga.

 

“The yogic treatment restores the normal functioning of the pancreas and other glands of the endocrinal system. When these glands begin to function properly, the individual is fully cured of the diabetic disorders and his health is restored to normal level.” – Dr. Phulgenda Sinha
CMCS – Center for Mindfulness and Contemplative Studies

 

Yoga for the Elderly Links

 

Age Healthily – Yoga for Arthritis

http://contemplative-studies.org/wp/index.php/2015/08/14/age-healthily-yoga-for-arthritis/

 

Aging Healthily – Yoga and Cellular Aging

http://contemplative-studies.org/wp/index.php/2015/07/17/aging-healthily-yoga-and-cellular-aging/

 

Age Healthily – Protect the Brain with Yoga

http://contemplative-studies.org/wp/index.php/2015/07/17/age-healthily-protect-the-brain-with-yoga/

 

Age Healthily – Yoga

http://contemplative-studies.org/wp/index.php/2015/07/17/age-healthily-yoga/