Be Less Impulsive with Mindfulness

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“The antithetical nature of mindfulness and automatic or impulsive behaviors provides theoretical promise for the efficacy of mindfulness skills in the treatment of impulse control disorders.” – Kelcey J. Stratton

 

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. In addition, 30 to 90 % of BPD cases are associated with high rates of early traumatic experiences including sexual, physical and emotional abuse. BPD is associated with high rates of co-occurring depression, anxiety disorders, substance abuse, eating disorders, self-harm, suicidal behaviors, and completed suicides. Needless to say it is widespread and debilitating.

 

Many of these symptoms occur in other mental illnesses. Impulsivity, however, distinguishes BPD from other disorders. In addition, it is the reason that the disorder is dangerous to the individuals as it can propel them, on the spur of the moment, to overreact to anger, take drugs, harm themselves, and even terminate their lives. BPD has not responded well to a variety of therapies with the exception of Dialectical Behavior Therapy (DPT). It is significant that a difference between DBT and other therapies is that it emphasizes mindfulness. This suggests that mindfulness training may be essential in treating Borderline Personality Disorder and impulsivity. Indeed, BPD sufferers who are high in mindfulness tend to be low in impulsivity. It would make sense, then, that the mindfulness training occurring in Dialectical Behavior Therapy (DPT) may be an effective treatment for the dangerous symptom of impulsivity.

 

In today’s Research News article “Effects of mindfulness training on different components of impulsivity in borderline personality disorder: results from a pilot randomized study”

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709962/

Soler and colleagues randomly assigned Borderline Personality Disorder (BPD) patients to receive 10-weeks of Dialectical Behavior Therapy (DPT) which was modified to include only Mindfulness Training (MT) or Interpersonal Effectiveness Training (IE). IE is designed to teach patients how to act more effectively in interpersonal interactions. They found that only the Mindfulness Training group showed a significant improvement in three self-reported aspects of impulsivity, motor impulsiveness (acting without forethought); attentional impulsiveness (the tendency to make quick, non-reflexive decisions), and non-planning impulsiveness (failure to prepare for future events). They also measured impulsivity with a series of laboratory tests designed to measure various aspects of impulsivity. They found that the Mindfulness Training group showed improvements in delaying gratification and in time perception.

 

These results are interesting. They suggest that the Mindfulness Training component of Dialectical Behavior Therapy (DPT) may be effective in treating the impulsivity characteristic of Borderline Personality Disorder (BPD) by improving the patients’ ability to delay gratification. Improved time perception may be responsible for better ability to delay gratification. It is important to note that impulsivity usually involves an inability to wait to get what is wanted. So, improved ability to delay gratification would be antithetical to impulsiveness. This may be the underlying mechanism by which mindfulness reduces impulsivity.

 

As mentioned BPD is a difficult disorder to treat and potentially dangerous to the self and others. It appears that the distinctive feature of BPD, impulsivity, is improved by DBT and that it is the mindfulness training that is responsible. This is particularly important as impulsivity is primarily responsible for the dangerous behaviors of BPD sufferers. It also appears that the mindfulness training acts to reduce impulsivity by improving time perception and the ability to delay gratification.

 

Impulsivity produces actions reflexively without awareness. Mindfulness training by improving the individual’s awareness of the immediate situation would tend to counteract impulsive action. So, mindfulness training may be essential to DBT’s ability to reduce impulsiveness by making the individual more aware of what they are doing. One cannot be mindful and impulsive at the same time.

 

So, be less impulsive with mindfulness.

 

“Decreased impulsivity has significant and wide implications for those suffering from it. This includes less general psychiatric morbidity, improved substance use outcomes, and general improvement in decision making skills, affecting every area of a person’s life in meaningful ways.” – Gisli Kristofersson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Reduce Healthcare Costs with Mindfulness

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“If we want to lower the costs of healthcare, we need to reduce the demand for healthcare services – not increase supply.” – Charles A. Francis

 

“Mindfulness is now more relevant than ever as an effective and dependable counterbalance to strengthen our health and well-being, and perhaps our very sanity.”  ― Jon Kabat-Zinn

 

In the United States the costs of healthcare are out of control. We pay more per capita by far than any other country in the world and yet our healthcare outcomes are mediocre at best. Healthcare spending per person in the U.S. is over $10,000 per year, 17% of the Gross Domestic Product, over $3 Trillion. Increasingly, Americans are having problems paying for care — 26 percent report they or a family member had problems paying medical bills in the past year. Fifty-eight percent of Americans reported foregoing or delaying medical care in the past year. Many patients stop taking medications or never fill prescriptions due to unaffordability.

 

Costs are putting a strain on the finances of individuals and the entire country. Obviously there is a need to somehow control costs while improving the quality of healthcare services. One strategy is to attempt to reduce the costs of providing care. This, however, has proved to be extremely challenging. Another tactic is to work toward reducing the need for services. This can include methods to prevent illness and shorten or dampen illnesses when they do occur. Mindfulness practices have been shown to do just that, preventing illness, decreasing symptoms, and improving recovery as a stand-alone treatment or as an adjunct to conventional treatments (see http://contemplative-studies.org/wp/index.php/category/research-news/health/ and http://contemplative-studies.org/wp/index.php/category/research-news/well-being/).

 

In today’s Research News article “The low risk and high return of integrative health services”

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Russo and colleagues review the studies of the effects of alternative treatments including mindfulness practices on costs for healthcare services. They found that the use of mindfulness techniques reduced overall hospital costs. This occurred due to reduced length of stay in the hospital prior to and immediately following surgery, decreased use of prescription drugs which in turn further reduced length of stay, post-operative co-morbidities, and drug dependence, while increasing patient self-care. The use of mindfulness practices also decreased anxiety, pain, and narcotic use and improve patient satisfaction.

 

The exact amount of money saved depends upon many complex factors such as the interventions used, the practices used, the structure of the program, and facilities used. But, some examples can highlight the magnitude of the savings. The application of yoga training to cancer treatment resulted in cost savings of $156 per day, nearly $300,000 annually. Application of mindfulness techniques to diabetes care resulted in estimated savings of $31,000 per person per year. These savings were calculated after all of the costs associated with running the programs were subtracted. Obviously, considerable savings can be obtained by hospitals with the use of mindfulness techniques.

 

To my knowledge, there have not been any estimates of the savings produced by mindfulness practices with outpatient and non-hospital healthcare cost reductions and by disease prevention. So, the actual impact of the use of mindfulness techniques on healthcare costs is unknown but logic suggests that the savings are huge.

 

These are important findings and underscore the economic consequences of the application of mindfulness techniques to healthcare. Unfortunately, in the American healthcare system there is no incentives to reduce the number of treatments employed as the providers are paid according to the number of services provided rather than value and effectiveness of the services. The move toward outcomes-based payments may help in this regard. But, clearly there is a need to change the incentives in the system to promote wellness and reduced costs. Mindfulness practices have been proven to do just that.

 

Regardless, it is clear that we can reduce healthcare costs with mindfulness.

 

“People don’t actually want to think about their own health and don’t take action until they are sick. Yet employers are very motivated to get their employees healthy, since they bear most of the burden of their health care costs.” – Clayton Christensen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Improve Caregiver Quality of Life with Yoga

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“Caring for someone with dementia is made up of an infinite number of small moments where we can go either way, adding more stress or bringing more ease. The problem when we are not mindful is our words come out and our actions unfold too quickly for us to have a chance to choose the wisest, most beneficial route. Mindfulness practice slows us down and takes some of the edge off our reactive tendencies.” – Marguerite Manteau-Rao

 

Caregiving for dementia patients is a daunting and all too frequent task. It is estimated that over 15 million Americans are dementia caregivers. It is an intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. In the last year, 59% of the caregivers report that they are effectively on duty 24/7. It is sad that 72% report relief when their loved one passes away.

 

This long and difficult process can take a major toll on the caregiver. On a practical level they frequently experience financial problems from lost income and have their careers interrupted. But, the greatest problems occur due to the intense levels of stress experienced by the caregivers. Around 2/3rd of caregivers report high emotional stress and over 1/3rd report high physical stress. This stress, in turn can have emotional consequences with over 1/3rd of caregivers reporting depression and many report family problems. In addition, dementia caregivers are more likely to have physical issues such as high levels of stress hormones, reduced immune function, increased hypertension, and coronary heart disease. Needless to say caregivers need care for themselves.

 

Reducing stress is very important for dementia caregivers. Stress not only jeopardizes their own health but also the quality of care they provide for their loved ones. Since mindfulness training has been shown to be effective in reducing both the psychological and physical responses to stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/), it would seem be potentially useful for the relief of caregiver stress. Indeed, mindfulness training has been shown to reduce stress and depression, improve the quality of caregiving, and improve the quality of life for the caregiver (see http://contemplative-studies.org/wp/index.php/category/research-news/caregiving/). Hence, it would seem reasonable to further explore mindfulness practices to care for the caregiver.

 

In today’s Research News article “Yoga and compassion meditation program improve quality of life and self-compassion in family caregivers of Alzheimer’s disease patients: A randomized controlled trial”

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Danucalov and colleagues applied an 8-week program of yoga and compassion meditation to a group of female Alzheimer’s caregivers and compared their response to those of a wait-list control group. At the end of yoga and compassion meditation training in comparison to before training and to the control group, the yoga group reported significant improvements in their quality of life including physical, psychological, environmental, and social domains. They showed increased mindfulness, improved vitality both immediately and in general, and increased self-compassion and self-kindness.

 

These findings are remarkable and potentially important. Yoga and compassion meditation training markedly improved the psychological and physical conditions for the caregivers producing a major improvement in quality of life. Training also increased their vitality which is critical given the intense fatigue that the caregiving can produce. How this practice might produce these benefits was not explored. But, the documented ability of yoga practice in reducing stress responses would seem a likely explanation. In addition, the compassion meditation may be a useful component as Loving Kindness Meditation has been shown to improve self-compassion and kindness toward others (see http://contemplative-studies.org/wp/index.php/category/contemplative-practice/loving-kindness/).

 

Regardless of the explanation, it appears clear that mindfulness training is effective in improving the physical and psychological problems experienced by dementia caregivers.

 

So, improve caregiver quality of life with yoga.

 

“Many of us follow the commandment ‘Love One Another.’ When it relates to caregiving, we must love one another with boundaries. We must acknowledge that we are included in the ‘Love One Another.” ― Peggi Speers

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Decreased Suicidality in Veterans with Spirituality

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“there are certain moral reactions to war and the experience of combat training that indicate a violation of moral conscience in war can have devastating inner consequences in soldiers.” – Rita Nakashima Brock

 

It has been widely reported that there are extremely high levels of suicides among veterans. But these reports are based upon the entire veteran population which includes large numbers of elderly veterans. Looking only at veterans discharged since 2001, the rates suicide rates observed were much lower consisting of about one suicide per day. The actual annual suicide rate these veterans was 29.5 per 100,000 veterans. This is roughly 50% higher than the rate among similar civilians. Interestingly, the rates of suicide are lower in veterans who were deployed to combat than those who were not. Deployed Veterans had a 41% higher suicide risk compared to the general U.S. population while Non-Deployed Veterans had a 61% higher suicide risk.

 

These figures are still alarming, although less so than common reports of veteran suicides. It also suggests that the transition back to civilian life may be as difficult as dealing with combat produced Post Traumatic Stress Disorder (PTSD). Regardless, it is important to investigate the causes of these suicides and discover methods that might prevent them. Mindfulness training is one important potentially helpful method to lower suicidal thoughts and prevent suicide. Mindfulness has been shown to has been shown to reduce suicidality (see http://contemplative-studies.org/wp/index.php/category/research-news/suicidality/) and to reduce the impact of trauma on the individual (see http://contemplative-studies.org/wp/index.php/category/research-news/trauma/). Another potentially important factor is spirituality. Indeed, spirituality has been shown to reduce suicide tendencies in the elderly (see http://contemplative-studies.org/wp/index.php/2015/07/17/spirituality-improves-end-of-life/). Unfortunately, there has been very little systematic research on spirituality relationships to suicide in either the general population or in veterans.

 

In today’s Research News article “Suicidal behavior and spiritual functioning in a sample of Veterans diagnosed with PTSD”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1169673129723278/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729329/

Kopacz and colleagues studied the relationships between spirituality and suicidality in a veteran sample undergoing residential treatment for PTSD. They compared three groups, a no suicide group who had not even thought about suicide, an Ideation group who had contemplated suicide, and an Attempt group who had attempted suicide. They found that the Ideation and Attempt group had greater amounts of spiritual struggle and lower level of forgiveness. They also found that low levels of thoughts about suicide (ideations) were associated with involvement in a spiritual community and high levels of spiritual experiences.

 

It should be noted that these results were correlative and thereby do not demonstrated a causal connection between spirituality and lower levels of suicidality. In fact, less suicidal ideation may prompt veterans to seek out spiritual experiences of some third factor such as religious upbringing is associated with both. In order to demonstrate causation, it will be necessary to actively increase spirituality and observe its effects on suicidality.

 

With these caveats in mind, the results may signal that being spiritual protects the individual from suicidal thoughts. It may do so by providing other higher ideas about the meaning of life and its sacredness. Higher levels of spirituality may also provide a community that is supportive of the individual and thus helps them cope with difficult thoughts and experiences. It is also possible that a key factor may be spiritual struggles, where the inability to find higher meaning makes suicide more likely. It is also possible that inability to forgive is the key, where the individual cannot forgive, particularly themselves, making destroying the self are seemingly reasonable solution.

 

Regardless, it is clear that spirituality is an important factor influencing suicidality in veterans. This clearly suggests that further research is warranted and that spirituality may be an important factor in suicide prevention in veterans.

 

“The Army’s “spiritual fitness” encourages soldiers to see events in a neutral light, rather than labeling them as good or bad, and to create a nightly list of positive things that happened that day. The lack of awareness is startling regarding what it might mean to ask someone to think of killing a child, losing a close friend or torturing detainees as neutral or positive.” – Rita Nakashima Brock

 

CMCS – Center for Mindfulness and Contemplative Studies

 

What’s Missing from the Present Moment

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“The mind is never satisfied with the objects immediately before it, but is always breaking away from the present moment, and losing itself in schemes of future felicity… The natural flights of the human mind are not from pleasure to pleasure, but from hope to hope.” – Samuel Johnson

 

One of the central tenets of Buddhism is that life is characterized by dukkha, which is usually translated as suffering. But, I prefer the less colorful translation as unsatisfactoriness. We in general constantly find ourselves and our lives to be unsatisfactory. It would appear to be a human characteristic to be constantly striving for something better. This can be a good thing as it’s been a driving force behind the development of agriculture, science, medicine, and engineering which has allowed us to improve our physical well-being. But, it has left us with intense feelings of unsatisfactoriness, dukkha.

 

This constant striving for something better results in seeing whatever is currently happening as flawed and needing improvement. Hence, we critically evaluate the present and find it unsatisfactory, not quite up to what it could be. As a result we impatiently wait for whatever is going on now to end so we can move on to the next thing. Unfortunately, when we get there, that too is seen as flawed and unsatisfactory and we again look forward to the next thing. But, that too is unsatisfactory. So we eagerly anticipate the next thing which of course is also found to be unsatisfactory, etc. etc. etc.

 

So we never enjoy anything for simply what it is. We are constantly looking for something better in the future, which of course it never is. So we move through life never happy, never appreciating all the beauty, wonder, and happiness that is present right now. What a sad treadmill! Constantly striving but never attaining the elusive perfect experience. A bit of thought quickly leads to the conclusion that the problem is that we never simply immerse ourselves in what is present. We’re always looking forward to something better resulting in us never truly enjoying what is.

 

When you’re on this treadmill and looking forward to a better future that never comes, break out of it by thinking “what exactly is missing from this very moment?” Examine what is actually present right here, right now, not in relation to the past or the future, but simply as it is right now. Is there anything that is actually missing? If you look deeply you’ll begin to see that nothing is missing. The present moment is complete and wonderful. Everything is perfect just as it is.

 

This takes some practice as our minds constantly want to find flaws and find ways to improve things. Don’t think about what might make it better. That involves memories of the past and expectations for the future. Simply, focus on what is. Look at what you’re experiencing. Listen deeply to the sounds that are present. The gnawing sound of the motorized lawn tools that is breaking up your peace is actually quite fascinating if you listen carefully. What a miracle it is that you experience it. Somehow you can sense which direction it’s coming from and how far away it is. How do you do that? What a wonder. Look carefully at what it is about it that makes you cringe and want it to go away. Realize that this unique sound will never be present again exactly as it is right now. How amazing is that? Here’s a one of a kind completely unique experience right here in your present moment.

 

Look at the intricacies and beauty available in the simplest things around you. Appreciate the incredible ability of the fly to soar through the air. Slowly you’ll begin to appreciate its completeness and its perfection. Look what is right in front of you. It may not be picturesque, perhaps a parking lot. But revel in the colors and forms that are witnessed. Appreciate the miracle of seeing. We take it so for granted. So, look at it deeply. What a wonder it is. What a delight!

 

Now let the greatest wonder of the present moment come front and center. Look at what is looking. Observe not just what’s being seen, but observe what’s seeing, what’s listening, what’s feeling, what’s knowing. What you’re observing is completely incomprehensible to science. It is one of the greatest mysteries in the universe, human consciousness, and you can view it right now within yourself. It’s only available in the present moment, but it’s truly one of the greatest wonders of all.

 

What could possibly be missing from this incredible moment? If you simply look at it deeply, honestly, without recourse to the past and future, you’ll find that it is absolutely complete and perfect as it is. You need not look to something else for happiness it’s right here, right now, in the miracle of existence, that’s always there in every moment.

 

“Always say ‘yes’ to the present moment… Surrender to what is. Say ‘yes’ to life – and see how life starts suddenly to start working for you rather than against you” – Eckhart Tolle

 

“The power for creating a better future is contained in the present moment: You create a good future by creating a good present.” – Eckhart Tolle

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Age Healthily: Improve Cellular Health with Mindfulness

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“Simply responding to the physical symptoms of disease might make sense for treating an acute infection or fixing a broken leg, but to beat chronic age-related conditions such as diabetes, heart disease and dementia, we will need to embrace the fuzzy, subjective domain of the mind.” – Jo Marchant

 

Aging seems inevitable. But, different species age at different rates. Everyone knows for example that dogs’ life span is about 1/6th of the human life span. This suggests that there must be some biological mechanism that regulates aging. Recent genetic research is starting to uncover that mechanism. It has been found that the genes, coded on the DNA molecule, govern cellular processes in our bodies. One of the most fundamental of these processes is cell replication. Cells are constantly turning over. Dying cells or damaged are replaced by new cells. The cells turn over at different rates but most cells in the body are lost and replaced between every few days to every few months. Needless to say were constantly renewing ourselves.

 

As we age the tail of the DNA molecule called the telomere shortens. When it gets very short cells have a more and more difficult time reproducing and become more likely to produce defective cells. On a cellular basis this is what produces aging. As we get older the new cells produced are more and more defective. The shortening of the telomere occurs each time the cell is replaced. So, slowly as we age it gets shorter and shorter. This has been called a “mitotic clock.” This is normal. But, telomere shortening can also be produced by oxidative stress, which can be produced by psychological and physiological stress. This is mediated by stress hormones and the inflammatory response. So, chronic stress can accelerate the aging process. In other words, when we’re chronically stressed we get older faster.

 

Fortunately, there is a mechanism to protect the telomere. There is an enzyme in the body called telomerase that helps to prevent shortening of the telomere. It also promotes cell survival and enhances stress-resistance.  Research suggests that processes that increase telomerase activity tend to slow the aging process by protecting the telomere.  One activity that seems to increase telomerase activity and protect telomere length is mindfulness practice (see http://contemplative-studies.org/wp/index.php/2015/12/04/retreat-for-longevity/ and http://contemplative-studies.org/wp/index.php/2015/07/17/aging-healthily-yoga-and-cellular-aging/). Hence, engaging in mindfulness practices may protect the telomere and thereby slow the aging process.

 

In today’s Research News article “Telomerase activity and its association with psychological stress, mental disorders, lifestyle factors and interventions: A systematic review”

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Deng and colleagues review the published scientific literature on factors that influence telomerase activity. They report that chronic, long-term, psychological stress but not acute, short-term, stress reduced telomerase activity. They also report that Major Depressive Disorder is associated with reduced telomerase activity. Importantly, they find that diet, exercise, and mindfulness practices all increase telomerase activity. In particular, they found that “physical exercise, diet micronutrient supplementation, mindfulness meditation, Qigong practice or yoga mediation resulted in increase in telomerase activity.”

 

These are very exciting outcomes and suggest that mindfulness practices might contribute to longevity by reducing cellular aging. How might these very different practices increase telomerase activity? All of these mindfulness practices have been shown to reduce the psychological and physiological responses to stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/). Since, chronic stress has been shown to reduce telomerase activity and in turn accelerate cellular aging, it would seem reasonable to conclude that practices that reduce stress responses would protect the individual from the deleterious effects of stress and increase telomerase activity. There may be other mechanisms involved, but this would seem to be the obvious one.

 

These findings suggest that mindfulness practices may improve longevity by protecting us from the damaging effects of chronic stress. By making us more mellow, we age slower.

 

So, age healthily: improve cellular health with mindfulness.

 

“it is possible that greater presence of mind promotes a healthy biochemical milieu and, in turn, cell longevity,” – Elizabeth Blackburn

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Manage Anger with Meditation

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“Anger is nothing more than a strategy for finding happiness in the midst of a challenging world, but it’s not a very effective strategy. Mindfulness and compassion work much, much better.” – Bodhipaksa

 

The Buddha once said that “holding on to anger is like grasping a hot coal with the intent of throwing it at someone else; you are the one who gets burned.” In other words, anger is usually more harmful to ourselves than to the source of our anger.

 

Reflect for a moment on the last time you became angry at another driver for cutting you off in traffic. Did you respond like most people with anger? Did that anger actually have any impact, at all, on the other driver? Usually not. Did it have any impact on you? Perhaps upsetting you and causing you to drive in an aggressive manner toward the other driver. Did that actually do any good or did it just put you at increased risk of an accident? Did the anger carry over beyond the actual incident and affect your driving afterward and your actions and mood later in the day? Now, reflect for a moment on the last time you became angry at your significant other. Was it effective? How did that person respond? Did it actually hurt the one you care about? Did it harm your relationship? Most times, anger is not only counterproductive, but destructive.

 

Anger not only produces changes in our behavior and mood, it also produces changes in our physiology. It activates the “fight or flight” system in the body, sympathetic nervous, and releases activating hormones. The net result is an increase in blood pressure, heart rate, respiration rate, sweating, especially the palms, feeling hot in the neck/face, shaking or trembling, and decreased heart rate variability. These physical effects can be used to objectively measure anger responses. They are also stressful and if prolonged can be damaging to the individual’s health.

 

If we can control our anger, we will generally be a happier person. But, at times, it is very difficult to do so. Mindfulness and meditation can help. It has been shown to improve our ability to regulate our emotions including anger (see http://contemplative-studies.org/wp/index.php/category/research-news/emotions/).  Mindfulness appears to improve our ability not to suppress our emotions, but to fully experience them and yet be better able to respond to them constructively and adaptively.

 

In today’s Research News article “A single session of meditation reduces of physiological indices of anger in both experienced and novice meditators”

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Fennell and colleagues investigated the effect of a single 20-minute meditation on anger responses in experienced and naïve meditators. They induced anger by having participants vividly recall a recent incident where they became angry and to briefly write about it. In the naïve meditators, this produced a significant increase in self-reported anger and increased blood pressure, respiration rate, and decreased heart rate variability. But, the experienced meditators had no physiological response to the induction. They then had their participants meditate for 20 minutes and induced anger a second time. After meditation, the anger induction had very little effect with no significant changes in self-reported anger or blood pressure and decreased heart and respiration rates. This blunting of the anger response after meditation occurred for both the experienced and naïve meditators.

 

These results are remarkable. Even a single brief meditation is capable of producing a significant reduction in both subjective and physiological responses to anger, actually making it look more like relaxation than anger. This response appears to be learned with repeated meditation as experienced meditators appear to have this blunted response even without meditation while naïve meditators require the meditation. Hence, meditation lowers immediate anger responses and experience with meditation makes this chronic, allowing for lower anger responsivity all of the time.

 

These results suggest that meditation is an antidote to anger. This control of anger may be responsible for many of meditation’s beneficial effects, cooling off the “hot coal” and preventing the individual from getting “burned.”

 

So, manage anger with meditation.

 

“Once we have recognized our anger, we embrace it. This is the second function of mindfulness and it is a very pleasant practice. Instead of fighting, we are taking good care of our emotion. If you know how to embrace your anger, something will change.” ~ Thich Nhat Hanh
CMCS – Center for Mindfulness and Contemplative Studies

 

Reduce Fatigue in Cancer treatment with Tai Chi

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 “If you’re fighting cancer, chances are you’re also fighting fatigue. Fatigue is being tired – physically, mentally, and emotionally. It’s the most common side effect of cancer treatment, and it often hits without warning. Everyday activities – talking on the phone, shopping for groceries, even lifting a fork to eat – can be overwhelming tasks.” – American Cancer Society

 

Fatigue accompanies cancer and its treatment in from half to all cancer patients depending upon the type of cancer and treatment regimen. The fatigue can continue even after completion of successful treatment. The patient feels weak, tired, weary, or exhausted all of the time and sleep does not relieve the tiredness. Symptoms can include prolonged, extreme tiredness following an activity, arms and legs feeling heavy and hard to move, lack of engagement in normal daily activities, trouble concentrating, thinking clearly, or remembering, feeling frustrated, irritable, and upset, putting less energy into personal appearance, and spending more time in bed or sleeping. The cause of cancer-related fatigue is unknown.

 

It is easy to confuse cancer-related fatigue with depression. Both are subjective experiences and have many common symptoms. The one distinguishing feature is that in depression the individual is unable to experience pleasure and feels sad or unworthy, while this is generally not true regarding cancer patients. Nonetheless, it is very difficult to distinguish the fatigue from depression. The best treatment for cancer-related fatigue appears to be encouragement to engage in moderate exercise along with relaxation and body awareness training. The ancient Chinese practice of Tai Chi has all of these properties. It’s a light exercise that produces relaxation and body awareness. So, it would seem reasonable to expect that Tai Chi practice would be effective in treating cancer-related fatigue. Indeed, Tai Chi has been shown to improve the immune system and reduce inflammation in cancer (see http://contemplative-studies.org/wp/index.php/2016/01/14/kill-cancer-with-tai-chi/).

 

In today’s Research News article “Tai Chi Exercise for Cancer Related Fatigue in Patients with Lung Cancer Undergoing Chemotherapy: A Randomized Controlled Trial”

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Zhang and colleagues randomly assigned lung cancer patients undergoing chemotherapy to either a Tai Chi or low-impact exercise program practiced every other day for one hour during the course of chemotherapy treatment. They found that during treatment overall fatigue increased in both groups, but the Tai Chi group showed a significantly smaller increase than the low-impact exercise group. The Tai Chi treatment decreased general and physical fatigue and increased vigor. These results were found both 6 and 12 weeks after treatment.

 

These results are especially significant because of the nature of the trial wherein Tai Chi exercise was compared to another comparable active physical exercise. The fact that Tai Chi was superior to low-impact exercise implies that Tai Chi has particular properties beyond its exercise property that are important for the relief of cancer-related fatigue. It is possible that the concentration and mindfulness components of Tai Chi practice are important for its effectiveness. Indeed, mindfulness programs in general have been shown to be effective in cancer treatment (see http://contemplative-studies.org/wp/index.php/category/research-news/cancer/). It remains for future research to further determine what are the crucial aspects of Tai Chi practice that counteract cancer-related fatigue.

 

Regardless of the mechanism it is clear that engagement in Tai Chi practice is an effective treatment for cancer-related fatigue in lung cancer patients undergoing chemotherapy. Future research should attempt to extend these findings to other forms of cancer and other stages of treatment and recovery.

 

So, reduce fatigue in cancer treatment with tai chi.

 

“Research unequivocally shows that Tai Chi helps cancer patients through a variety of ways. One point to remember, though, is that regular exercise is paramount for maximal, sustained benefits. For cancer patients to receive the best results possible, therefore, it is advisable that people embrace Tai Chi as a way of life and not a one-time thing.” Willian Betts

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Control Type 2 Diabetes with Yoga

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“Yoga-asanas in combination with conventional medical treatment provides a better metabolic control giving a feeling of general well being, alertness and attentiveness without any side effects.” – Savita Singh

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. Although this has been called adult-onset diabetes it is increasingly being diagnosed in children. It is estimated that 30 million people in the United States have diabetes and the numbers are growing. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world.

 

Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes. Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia.

 

A leading cause of this tissue resistance to insulin is overweight and obesity and a sedentary life style. Hence, treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Yoga would appear to be an excellent potential treatment for Type 2 Diabetes as it is both an exercise and a help in weight control (see http://contemplative-studies.org/wp/index.php/2015/07/17/heart-healthy-yoga/). Indeed, mindfulness practices in general have been shown to be helpful in managing diabetes (see http://contemplative-studies.org/wp/index.php/category/research-news/diabetes/) and yoga has been shown to help control body weight in diabetes (see http://contemplative-studies.org/wp/index.php/2015/08/24/control-weight-in-diabetes-with-yoga/) which has been shown to be critical for the treatment of Type 2 diabetes.

 

In today’s Research News article “Yoga for Adults with Type 2 Diabetes: A Systematic Review of Controlled Trials”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1166724740018117/?type=3&theater

Innes and Selfe review the published literature on the application of yoga practice to the treatment of Type 2 Diabetes. They report that yoga practice decreases body weight and body fat levels, and lowers insulin resistance and high blood sugar levels (hyperglycemia). Further they report that yoga improves blood fat profiles including reductions in levels of cholesterol, low-density lipoprotein cholesterol, and triglycerides, and increases good cholesterol (high-density lipoprotein cholesterol). Yoga also resulted in improved cardiovascular function including decreased blood pressure and lung function. Yoga also improved quality of life, psychological well-being, symptoms of distress, and insomnia. All of this resulted in reduced use of diabetes drugs.

 

These results are remarkable. They indicate that yoga practice has a wide variety of physiological and psychological benefits for the treatment of Type 2 Diabetes. Yoga is also safe with few detrimental side effects and has a wide variety of other physical and psychological benefits (see http://contemplative-studies.org/wp/index.php/category/contemplative-practice/yoga-contemplative-practice/). There are a number of possible mechanism of how yoga could produce these positive effects including the fact that yoga practice involves physical exercise and exercise has been repeatedly found to be beneficial for Type 2 Diabetes patients. For the most part the effects of yoga are not significantly different from those seen with other exercise programs. Yoga may also act by reducing body weight and body fat, improving the management of stress, reducing physiological activation by the nervous system, or through encouraging a generally healthier lifestyle. It will be up to future research to begin to discern how exactly yoga practice acts to improve Type 2 Diabetes.

 

Regardless, it is very clear that yoga practice is a safe and effective program for the treatment of Type 2 Diabetes.

 

“The good news is that diabetes patients have an alternative: They can practice yoga. Despite the fact researchers have been studying the health benefits of yoga in diabetes patients for decades, only now is yoga being proposed as an important part of a diabetes exercise program.” – Jennifer Van Pelt
CMCS – Center for Mindfulness and Contemplative Studies

 

Burnout Doctor Burnout with Mindfulness

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“Something very alarming is going on in the American healthcare system nowadays. Doctors aren’t happy, and neither are patients. The proverbial admonition, “Happy doctors make for happy patients” comes to mind with the caveat that the reverse is also true.” Thomas Murphy

 

With the advent of managed care and the Affordable Healthcare Act in the U.S., primary healthcare providers have become a critical component of the healthcare system. Unfortunately, there is a marked shortage of these providers. It is estimated that in the U.S. there are over 9,000 fewer primary care physicians than needed. The shortages are not just due to training insufficient numbers of healthcare providers but also due to high turnover rates. In part because of the shortage and high patient loads, primary healthcare providers experience high stress and burnout. They experience a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment.

 

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 primary healthcare providers, it is imperative that strategies be identified to decrease stress and burnout.

 

Burnout is not a unitary phenomenon. In fact, there appear to be a number of subtypes of burnout. The overload subtype is characterized by the perception of jeopardizing one’s health to pursue worthwhile results, and is highly associated with exhaustion. The lack of development subtype is characterized by the perception of a lack of personal growth, together with the desire for a more rewarding occupation that better corresponds to one’s abilities. The neglect subtype is characterized by an inattentive and careless response to responsibilities, and is closely associated with inefficacy.

 

Doctors appear to vary in resilience, in their ability to withstand the stress of practice and not burnout. They also vary in mindfulness which has been shown to be effective in preventing and treating healthcare professional burnout (see http://contemplative-studies.org/wp/index.php/category/research-news/burnout/). In today’s Research News article “Mindfulness, Resilience, and Burnout Subtypes in Primary Care Physicians: The Possible Mediating Role of Positive and Negative Affect”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1166142213409703/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681844/

Montero-Marin and colleagues investigate the relationship of resilience, mindfulness, and emotions to burnout in 622 Spanish primary care physicians. Using sophisticated statistical techniques, they found that the three types of burnout were highly positively associated, with high levels of each associated with high levels of all the other types. They also found that mindfulness and resilience were highly related, with higher levels of mindfulness associated with higher levels of resilience.

 

The overload type of burnout was directly associated with both negative emotions and mindfulness. In addition, both mindfulness and resilience appeared to affect overload indirectly by reducing negative emotions and thereby reducing overload burnout. The lack of development type of burnout was negatively associated with positive emotions and resilience was positively associated with positive emotions. So, resilience appeared to affect lack of development burnout by increasing positive emotions which in turn decrease lack of development burnout. Thereby, high levels of resilience were associated with low levels of lack of development. Finally, they found that resilience was negatively related to neglect burnout such that the higher the levels of resilience, the lower the neglect burnout.

 

These are complex interrelationships. But in general they suggest that the mindfulness and the resilience of the physicians were highly related and worked in consort to reduce all types of primary care physician burnout and they do so, at least in part, by affecting the positive and negative emotions of the physicians. They may do so by different mechanisms, mindfulness by reducing the psychological and physical responses to stress and resilience by increasing the ability to withstand the stress.

 

Regardless, burnout doctor burnout with mindfulness.

 

“The benefits of mindful practice extend beyond the practitioner to his or her patients. It is not only that mindful practitioners can listen attentively, but that their patients are empowered to make their voice heard in areas that matter to them.” – Mary Catherine Beach
CMCS – Center for Mindfulness and Contemplative Studies