Pain is a Pain – Relieve it with Meditation

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In a previous post we discussed the application of Mindfulness Based Stress Reduction (MBSR) for the relief of pain in adult women.

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It was demonstrated that the combination of meditation, body scan, and yoga contained in MBSR was effective for pain management.

Not everything that is effective with adults is also effective with children and adolescents.

Hence, it is important to establish if mindfulness training is also effective with adolescents. In today’s Research News article “The Effects of Mindful Attention and State Mindfulness on Acute Experimental Pain among Adolescents”

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4027879/

Petter and colleagues investigated whether a very brief mindfulness session would affect pain sensitivity in 13-18 year-olds. Although the brief manipulation was not effective, they found that adolescents who were meditators and high in mindfulness had significantly lower pain in a standardized pain manipulation.

Hence it appears that mindfulness is associated with lower sensitivity to pain even in adolescents. It is noteworthy that meditation practice alone was associated with the reduction in pain perception. Hence, although the other components of MBSR, body scan and yoga, may also be helpful, they are not necessary for pain relief.

McGrath and colleagues then addressed how mindfulness might produce lower pain levels. They found that mindfulness reduced catastrophizing, the tendency to magnify the threat value of pain, to feel helpless in the face of pain, and to ruminate about pain. It was this reduction in catastrophizing that produced the pain relief. In other words catastrophizing mediated the effect of mindfulness on pain. These findings complement the theoretical work which places catastrophizing as playing a central role in adolescent chronic pain.

Hence, it appears that in adolescents pain is magnified by catastrophizing. In this form of thinking, the presence of pain brings forth unsettling memories of past pain and rumination about future pain. The individual then becomes focused on the pain and thoughts about the pain. This form of thinking builds on itself in a vicious cycle of catastrophizing magnifying pain which in turn magnifies catastrophizing.

Mindfulness can break this vicious cycle by focusing the individual on the present moment. This reduces the amount of thinking about the past and future which is the source of catastrophizing, which then tends to reduce the perception of pain. Hence, mindfulness emphasizes present moment awareness, reducing catastrophizing, and in turn reducing pain.

Mindfulness training is also known to directly affect the brain pathways and cortical areas that underlie pain perception and thereby reduce the magnitude of the pain signal in the brain. In addition, mindfulness reduces the emotional reactions and the arousal response to pain. This also mitigates pain perception.

This is important to discover a method to treat pain without drugs. The prescription pain medications, primarily opiates, are addictive, disorienting, and very dangerous with thousands of deaths each year attributable to overdoses of prescription pain medications. Mindfulness training is a great alternative, effective and safe. But beware, it has such positive benefits that it may become addictive!

So, practice mindfulness and stop pain being a pain.

CMCS – Center for Mindfulness and Contemplative Studies

Age Healthily – Treating Insomnia and Inflammation

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Disturbance of sleep is common in the elderly. It directly produces impairments in daily activities. But, it also increases the risk for chronic disease and mortality in older adults. In particular insomnia appears to increase inflammation. Heightened markers of inflammations are associated with cardiovascular disease and diabetes and autoimmune diseases such as arthritis. In fact, inflammation is either directly or indirectly involved in nearly all diseases.

Chronic inflammation is the real problem. On the short term inflammation can be helpful in fighting off initial infection. But, if it continues over a prolonged period of time it can produce or exacerbate many health conditions. Since sleep disturbance in the elderly tends to be chronic and it increases inflammation it can be very detrimental to the individual’s health and thereby can increase mortality.

Obviously, it is important to the elderly to routinely get a good night’s sleep.  In a previous post we discussed how insomnia affects older adults and contributes to decline in aging http://contemplative-studies.org/wp/index.php/2015/07/17/aging-healthily-sleeping-better-with-mindful-movement-practice/

In this post we reported that mindful movement practices such as Tai Chi was effective for the treatment of insomnia in the elderly. This study, however, did not compare mindful movements to other potential treatments and did not measure inflammation.

In today’s Research News article “Cognitive Behavioral Therapy vs. Tai Chi for Late Life Insomnia and Inflammatory Risk: A Randomized Controlled Comparative Efficacy Trial”

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4153053/

Irwin and colleagues demonstrated that indeed Tai Chi was effective for insomnia in older adults but that Cognitive Behavioral Therapy (CBT) was far superior, producing remission from insomnia in over half the participants treated with CBT compared to 30% for Tai Chi.

Importantly, Irwin and colleagues demonstrated that a marker of inflammation, C-reactive protein (CRP), was markedly reduced. CBT cut in half the proportion of participants with high inflammatory responses. In addition, the participants who had remission of insomnia had CRP levels that were nearly 50% lower. This is remarkable and indicates that CBT is highly effective in reducing not only insomnia but also the inflammatory response that frequently accompanies it. tai chi was also effective, but not to the same extent.

Although tai chi was not as effective as CBT it has marked advantages. CBT requires a formal treatment program with a trained therapist. This can be costly and inconvenient. Tai chi on the other hand can be engaged in without a therapist, at the convenience of the individual, and at virtually no cost. So, although CBT is superior in effectiveness, tai chi might be a better, more practical, alternative for many elderly.

So, it is important to treat insomnia in the elderly for their health and wellbeing. If practical choose Cognitive Behavioral Therapy but if that isn’t practical engage in tai chi practice.

CMCS – Center for Mindfulness and Contemplative Studies

Feeling Feelings: Getting in Touch with the Body

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Most of us spend the majority of our lives lost in thought. Even when we become aware of our surroundings it is principally of the sights and sounds surrounding us. It is usually only when something is very wrong that we become aware of our bodies, what is called interoceptive awareness. We are generally unaware of the signals from our bodies such as the breath, movements in the GI tract, heart beats accompanied with surges in blood pressure, the sensations from our muscles and joints, even the sensations from our skin. Adding to the lack of awareness of our bodies we are also unaware of our implicit beliefs and attitudes about our bodies and the emotions that accompany these attitudes.

To exemplify this, just for a moment start paying attention to the sensations coming from the contact of your clothing with your skin. You were in all probability totally unaware of these sensations until your attention was directed toward them. Now notice the feelings from your facial muscles. Are they tense, relaxed, or something in-between. You probably were not aware of their state yet they can be good indicators of stress and your emotional state.

This can be a real problem as interoceptive awareness is extremely important for our awareness of our emotional state which is in turn needed to regulate and respond appropriately to the emotions. Being aware of the state of our bodies is also important for maintaining health, both for recognizing our physical state and also for making appropriate decisions about health related behaviors. Interoceptive awareness is even fundamental to our sense of self and world view.

Obviously it is important that we find ways to improve our poor body awareness. Most contemplative practices focus attention on our internal state and thus should improve our body awareness. But, in fact there is little empirical evidence on the issue. In today’s Research News article “Differential changes in self-reported aspects of interoceptive awareness through 3 months of contemplative training”

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284997/

Bornemann and colleagues examine the effect of a 3-month training employing focused meditation and body scan meditation on interoceptive awareness. They found significant increases in five of the eight scales of interoceptive awareness compared to a control group.

It was found that meditation and body scan practice improved the regulatory aspects of interoceptive awareness. These include Self-Regulation which is the ability to control distress by paying attention to sensations from the body, Attention Regulation which is the ability to focus in a sustained way on the sensations from the body, and Body Listening which is the ability to gain insight into the physical and emotional state by listening to the signals from the body. These are important skills involved in being able to not only be aware of body sensations but to use these sensations to better understand and control their internal state and physical wellbeing.

Contemplative practice also improved Emotional Awareness, which is the ability to be aware of and understand the connection between body sensations and emotions, and Body Trusting, which is experiencing one’s own body as a safe place. These are also important abilities as they allow us to trust in the usefulness of the information from the body to better understand and control our emotions.

It is interesting that the contemplative practice did not increase Noticing of body sensations such as heart beat and breathing. Rather it appears to markedly improve our ability to use the information from our bodies to understand and regulate our emotional or motivational state. This is very important to our wellbeing both mental and physical. It puts us better in control by providing the signals we need to be better able to regulate our state.

These improvements in interoceptive awareness could also explain to some extent how mindfulness practices produce their well-documented significant improvements in physical and psychological health and wellbeing. It simply makes us better able to respond to and control our bodies and our emotions.

So engage in contemplative practice and learn how to feel your feelings and benefit your body’s signals.

CMCS – Center for Mindfulness and Contemplative Studies

Get Out of the Dumps with Loving-Kindness Meditation

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Depression is epidemic. It’s been estimated to affect one in ten Americans at one point or another.  Eleven percent of adolescents in the United States experience a depressive episode before the age of 18. If that isn’t bad enough somewhere up to 15% of those who are clinically depressed die by suicide.

The most common treatment for depression is antidepressant drugs. But they are not always effective, can actually increase the risk of suicide, and often have troubling side effects. As a result there is an ongoing search for alternative treatments for depression.

Recently, meditation, particularly in the form of Mindfulness Based Cognitive Therapy (MBCT) has emerged as a viable alternative treatment. There is also interest in another form of meditation, Loving-Kindness Meditation (LKM). In depression, the individual is usually very unhappy with themselves and their lives regardless of the actual conditions. LKM has been shown to help the individual show compassion and understanding toward themselves and others. It has also been shown to improve mood. Hence, LKM would appear to be well suited as a treatment for depression.

In addition, we recently posted a discussion of some research that LKM improves social interactions. https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1043328429024416/?type=1&theater

In depression, the individual frequently withdraws from social contact. This removes from the individual compassionate social contact that is actually essential for healing. So, LKM, again appears on the surface to have potential for the treatment of depression.

In today’s Research News article “Loving-Kindness Meditation to Target Affect in Mood Disorders: A Proof-of-Concept Study”

http://www.hindawi.com/journals/ecam/2015/269126/

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Hofmann and colleagues pilot the use of LKM for the treatment of depression and found very promising results. They found large, clinically significant effects of LKM in reducing both self-reported and clinician-reported depression. In addition LKM reduced negative emotions and increased positive emotions, increased emotion regulation, and markedly decreased the rumination that is so characteristic of depression.

These pilot results are exciting. They certainly stand as strong justification for a controlled trial being conducted in the future. LKM by having the individual wish themselves and others well repeatedly appears to improve self-compassion and compassion for others. It is impossible to have true compassion for oneself and at the same time not like oneself. This would seem to be a wonderful antidote for the issues present in depression.

So, practice Loving-Kindness Meditation and get out of the dumps.

CMCS – Center for Mindfulness and Contemplative Studies

Make the Brain more Efficient with Meditation

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Meditation has been shown to alter the nervous system. It changes the size of brain areas, their connectivity, and their activity. It even appears to protect the brain from the degeneration that normally occurs with aging. These changes are thought to underlie meditation effects on physical and psychological health. These effects of meditation were reviewed in a previous post

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http://contemplative-studies.org/wp/index.php/2015/08/01/this-is-your-brain-on-meditation/

The increased connectivity between brain areas implies that meditation may make the nervous system more efficient, processing information faster and more effectively. But, the prior studies do not directly measure information processing efficiency. In today’s Research News article “Neurophysiological Effects of Meditation Based on Evoked and Event Related Potential Recordings”

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http://www.hindawi.com/journals/bmri/2015/406261/

Singh and colleagues review studies that have used the electrical signals from the brain to track how fast and effectively sensory information is processed in the brain during meditation. They report that the research indicates that indeed the brain processes this information more efficiently while engaged in meditation.

There were two different types of improvements reported with meditation. The first is simple processing on sensory events, sending the signals from the sensory organs to the cortex where complex processing occurs. They found that this simple level processing was improved during meditation.

The second type of processing is more complex and involves making decisions about the sensory information. This type of processing was also found to be improved in meditators. There was improved attention and switching of attention, greater perceptual clarity, lower automatic reactivity to the information and its emotional content, greater emotional acceptance, and lower anticipation and fear of pain. These results are remarkable and suggest that meditation increases the efficiency of the brain, improving the distribution of limited brain resources.

How can such a simple practice such as meditation have such profound effects upon the nervous system. In meditation, information processing is greatly simplified and focused. By reducing intrusions and the onslaught of complex sensory experiences, thoughts, implicit speech, and ruminations, meditation may allow the brain to focus on a reduced number of tasks and thus learn to process them simply and more efficiently.

It is also the case that the nervous system adapts to the kind of processing that it’s asked to do in a process called neuroplasticity. By reducing the complexity of processing the brain may improve and allocate its resources to focused tasks, improving its speed and effectiveness in processing them. Simply put, by making the world simpler, with fewer distraction or discursions the nervous system can better learn how to effectively make sense of what’s present.

So, meditate and make the brain better.

CMCS – Center for Mindfulness and Contemplative Studies

Die More Peacefully

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“At the end of life, our questions are very simple… Did I live fully? Did I love well?” ―  Jack Kornfield

“Life is not separate from death. It only looks that way.” – Native American Saying

Many people fear death, in part, because they do not know what if anything will follow. It has long been believed that spirituality/religiousness provides an explanation and thus can be very comforting to the dying. But, there has been very little systematic empirical research investigating the relationship of spirituality/religiousness to the experiences of the dying.

It is very common for dying individuals to have transcendent experiences. It has been estimated that over half of all conscious dying people have these kinds of experiences. Although there are a wide variety of transcendent experiences they all have in common that they are experiences that are beyond the self and/or beyond empirical physical reality. There have been only a small number of empirical research studies into these phenomena and their relationship to the dying process.

In today’s Research News article “A Thematic Literature Review: The Importance of Providing Spiritual Care for End-of-Life Patients Who Have Experienced Transcendence Phenomena”

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Broadhurst and Harrington summarize the research on the effect on the dying individual of having experienced transcendent phenomena.

They found that the literature suggested that transcendence experiences provided psychological strength, peace of mind, and spiritual well-being. This was opposed to hallucinations which produced anxiety, fear, and confusion. The comfort produced by the transcendence experiences also affected the family and the caregivers causing them to feel better about the situation.

They also found that people who have had transcendence experiences had more peaceful and calm deaths. They also found more spiritual meaning in their lives producing greater inner peace. Finally they were better able to deal with unfinished business in their lives, particularly to mend family conflicts. This also led to greater inner peace.

It is clear that spirituality and transcendence experiences are important at the endo of life and can have highly beneficial effects on the dying, the family, and even the caregivers. It is unfortunate that doctors, nurses, and other caregivers have little or no training or experience with end of life spirituality let alone transcendence experiences of the dying. Hence, it is important that this be include in the training of future professionals so that they can better understand and work with the spiritual needs and experiences of the dying.

So, welcome spiritual and transcendence experiences in the dying and help them to a more meaningful, peaceful, and calm passing.

“When you were born, you cried and the world rejoiced.
Live your life so that when you die, the world cries and you rejoice.” – Native American Saying

This is Your Brain on Meditation

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“Our minds have the incredible capacity to both alter the strength of connections among neurons, essentially rewiring them, and create entirely new pathways. (It makes a computer, which cannot create new hardware when its system crashes, seem fixed and helpless).” ― Susannah Cahalan

There has accumulated a large amount of research demonstrating that meditation has significant benefits for psychological, physical, and spiritual wellbeing. Its positive effects are so widespread that it is difficult to find any other treatment of any kind with such broad beneficial effects on everything from mood and happiness to severe mental and physical illnesses. This raises the question of how meditation could do this.

The nervous system is constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. For example, the brain area that controls the right index finger has been found to be larger in blind subjects who use braille than in sighted individuals.  Similarly, cab drivers in London who navigate the twisting streets of the city, have a larger hippocampus, which is involved in spatial navigation, than predefined route bus drivers. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas.

In today’s Research News article “The Meditative Mind: A Comprehensive Meta-Analysis of MRI Studies”

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471247/

Boccia and colleagues summarize the current state of research on the effects of meditation on the nervous system. They show that meditation activates a network of brain areas that over time, in experienced meditators, increases in size and in the ability of these areas to interact (increased connectivity).

The particular parts of the brain that are affected by meditation are areas that have been demonstrated previously to be involved in self-referential processes, including self-awareness and self-regulation, attention, executive functions, and memory formations. The altered structures have functions that align perfectly with the types of changes observed in expert meditators. These include increases in present moment awareness of the self and the environment, sustained attention, cognitive ability, memory ability, the abilities to regulate emotions and responses to emotions.

Hence, it appears that meditation alters the nervous system in important ways that result in changes in the individual’s psychological and physical makeup that in turn affect health and wellbeing.

So, meditate and improve your brain.

CMCS – Center for Mindfulness and Contemplative Studies

Treating Adult ADHD with Mindfulness

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Attention Deficit Hyperactivity Disorder (ADHD) is most commonly found in children, but for about half it persists into adulthood. It’s estimated that about 5% of the adult population has ADHD. Hence, this is a very large problem that can produce inattention, impulsivity, hyperactivity, and emotional issues, and reduce quality of life.

The most common treatment is drugs, like methylphenidate, Ritalin, which helps reducing symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, including nervousness agitation, anxiety, irritability, sleep and appetite problems, head and stomach aches, nausea, dizziness, and heart palpitations. If that’s not enough they can be addictive and can readily be abused. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.

There are indications that mindfulness training may be a more effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mindfulness training are identical to those that are defective in ADHD, attention, impulse control, executive function, emotion control, and mood improvement. In addition, it is a relatively safe intervention that has minimal troublesome side effects.

In today’s Research News article “Mindfulness Meditation Improves Mood, Quality of Life, and Attention in Adults with Attention Deficit Hyperactivity Disorder”

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http://www.hindawi.com/journals/bmri/2015/962857/

Bueno and her colleagues apply mindful awareness training for the treatment of adult ADHD. They found large clinically significant improvements in sustained attention, detectability, mood, and quality of life. Particularly important was the finding that mindfulness significantly improved attention as prior studies were not able to detect attentional improvement.

It is actually surprising that individuals with ADHD can sit still to meditate. But, it appears that they not only can, they report that they like it and it relaxes them.

Mindfulness practice is training in attentional focus. So, it is not surprising that this training improved attentional ability in people with ADHD. The improvement was not just in general attentional ability but also in detectability, the ability to discriminate relevant from irrelevant visual signals. Hence, mindfulness training appears to be particularly helpful in improving the ability to pay attention to the intended target while decreasing the degree to which other stimuli in the environment might intrude and distract the individual.

Mindfulness training improves executive function, cognitive control. This combined by the reduced distractibility decreases impulsive behavior, keeping behavior better regulated by thoughtful intentional processes. People with ADHD often fault themselves for their impulsive behavior and judge themselves harshly when these behaviors emerge. So, with mindfulness the individuals begin to feel better about themselves. Mindfulness training has been shown to improve the individual’s ability to keep emotions in check, to feel the emotions but to respond to them appropriately.

All of these benefits of mindfulness training for people with ADHD make it easier for them to function in life and combined with mood enhancement, produces a significant increase in quality of life. Mindfulness seems to make many aspects of the individual’s life better.

So, use mindfulness training to help manage ADHD.

CMCS – Center for Mindfulness and Contemplative Studies

 

Stop Emotional Eating with Yoga

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Eating can occur because of a physiological need, signaling hunger. That is healthy eating. But eating can also happen for emotional reasons which can produce mindless unhealthy eating or an eating disorder, such as binge eating disorder.

Many people respond to stress, anxiety, or fear with coping strategies, one of which is eating. This is emotional eating. It results from distress and the individual’s attempts to deal with it. The eating behavior is used to reduce the distress. But, this is an unhealthy strategy. It’s not only directly detrimental to health by producing overeating but the emotional eating itself can become a source of stress and anxiety creating a vicious cycle. There is thus a need to find ways to teach the individual to respond to the distress with more adaptive strategies or to increase the individuals’ tolerance for the stress so they do not employ coping strategies like eating.

In today’s Research News article “The Effects of a Hatha Yoga Intervention on Facets of Distress Tolerance”

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http://www.researchgate.net/publication/276064952_The_Effects_of_a_Hatha_Yoga_Intervention_on_Facets_of_Distress_Tolerance

Medina and colleagues investigated whether Hatha Yoga could be successfully employed to reduce emotional eating. They found that and 8-week, twice weekly, yoga practice reduced emotional eating at a clinically significant level.

Medina and colleagues went further looking at the individuals’ tolerance for distress and found that the yoga practice also markedly improved the levels of distress tolerance. In addition, they found that the yoga practice appeared to have its effect on emotional eating by increasing distress tolerance. With the individual better able to deal effectively with the distress the need for the coping strategy, eating, was removed. Hence, yoga practice appeared to attack the root of the problem.

Looking more carefully, it was discovered that it was the cognitive components of distress tolerance that were improved by yoga. These included a facilitation of the thought processes needed to deal with distress and a decrease in the interference with attentional processes produced by the distress. Interestingly, the yoga did not affect the emotional and behavioral components in dealing with distress. So, it appears that yoga produces clearer thinking and thereby better, healthier, responses to the distress.

This makes sense as yoga practice trains the individual to pay attention in the present moment to exactly what they’re doing and how their feeling. It puts their behavior under conscious thoughtful control. The improved attentional and behavioral control produced by yoga could be responsible for clearer thinking about the distress and more appropriate responses to it.

This is an exciting and potentially important finding. There are other coping strategies other than emotional eating that other individuals display in response to distress. It would be important to look at these other strategies in future research to see if they too are improved with yoga.

So, practice yoga and get control of emotional eating

CMCS – Center for Mindfulness and Contemplative Studies

 

Get your Calm on!

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Mindfulness Based Stress Reduction (MBSR) is one of the first secular based mindfulness training programs in the west. In fact, it could be argued that the development of MBSR was what launched the mindfulness movement in the west. The movement took off probably because MBSR was shown to be so very effective in the treatment of a wide range of physical, psychological, and emotional issues that plague western culture.

Stress is rampant in competitive western culture producing physical and psychological damage. MBSR’s effectiveness at calming the reactions to stress and reducing anxiety has made it a very popular.

MBSR is not a single practice. Rather it is a combination of practices including meditation, yoga, and body scan meditation. Whether all of these components are necessary for effectiveness or if some components are more effective for some conditions while others are superior for others has yet to be established with empirical evidence. This is an important issue for the understanding of the exact mechanisms by which MBSR has its effects.

It is also not known how much MBSR or how much of each component is needed to have a maximum impact. In more scientific words, a dose response study is needed. This is important to produce optimum effectiveness.

In today’s Research News Article “Effectiveness of Brief Mindfulness Techniques in Reducing Symptoms of Anxiety and Stress’

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David Call and colleagues tested whether very brief, three weekly 45-min sessions of hatha yoga or body scan would be effective in reducing stress and anxiety in undergraduate students. Both practices reduced both anxiety and stress levels.

Interestingly, neither group showed a significant increase in mindfulness, possibly due to the lack of meditation practice and perhaps suggesting that yoga and body scan practices might act directly on stress and anxiety rather than by raising mindfulness that then reduced the symptoms. This contradicts the notion that mindfulness based increases in present moment awareness are the cause of the reduction in anxiety which is future oriented. It remains possible that the physiological effects of yoga and body scan on reducing the hormonal and neural responses to stress may be responsible.

The magnitude of the effects on stress and anxiety were quite large and clinically significant. It is amazing that such a brief treatment of 3 sessions of 45 minutes could have this large of an impact. It remains to be seen if the impact is lasting. Regardless, the fact that a brief simple intervention can markedly reduce stress and anxiety is exciting as it is highly scalable; rolling it out to large numbers of individuals.

So, practice yoga and/or body scan and get your calm on.

CMCS