mindfulness

Posted on Pain Management

Mind over matter: Beating pain and painkillers

Women and pain
Women and pain


With nearly one-third of Americans suffering from chronic pain, prescription opioid painkillers have become the leading form of treatment for this debilitating condition. Unfortunately, misuse of prescription opioids can lead to serious side effects—including death by overdose. A new treatment developed by University of Utah researcher Eric Garland has shown to not only lower pain but also decrease prescription opioid misuse among chronic pain patients.

Results of a study by Garland published online Feb. 3 in the Journal of Consulting and Clinical Psychology, showed that the new treatment led to a 63 percent reduction in opioid misuse, compared to a 32 percent reduction among participants of a conventional support group. Additionally, participants in the new treatment group experienced a 22 percent reduction in pain-related impairment, which lasted for three months after the end of treatment.

The new intervention, called Mindfulness-Oriented Recovery Enhancement, or MORE, is designed to train people to respond differently to pain, stress and opioid-related cues.

MORE targets the underlying processes involved in chronic pain and opioid misuse by combining three therapeutic components: mindfulness training, reappraisal and savoring.

  • Mindfulness involves training the mind to increase awareness, gain control over one’s attention and regulate automatic habits.
  • Reappraisal is the process of reframing the meaning of a stressful or adverse event in such a way as to see it as purposeful or growth promoting.
  • Savoring is the process of learning to focus attention on positive events to increase one’s sensitivity to naturally rewarding experiences, such as enjoying a beautiful nature scene or experiencing a sense of connection with a loved one.

“Mental interventions can address physical problems, like pain, on both psychological and biological levels because the mind and body are interconnected,” Garland said. “Anything that happens in the brain happens in the body—so by changing brain functioning, you alter the functioning of the body.”

To test the treatment, 115 chronic pain patients were randomly assigned to eight weeks of either MORE or conventional support group therapy, and outcomes were measured through questionnaires at pre- and post-treatment, and again at a three-month follow-up. Nearly three-quarters of the group misused opioid painkillers before starting the program by taking higher doses than prescribed, using opioids to alleviate stress and anxiety or another method of unauthorized self-medication with opioids.

Among the skills taught by MORE were a daily 15-minute mindfulness practice session guided by a CD and three minutes of mindful breathing prior to taking opioid medication. This practice was intended to increase awareness of opioid craving—helping participants clarify whether opioid use was driven by urges versus a legitimate need for pain relief.

“People who are in chronic pain need relief, and opioids are medically appropriate for many individuals,” Garland said. “However, a new option is needed because existing treatments may not adequately alleviate pain while avoiding the problems that stem from chronic opioid use.”

MORE is currently being tested in a pilot brain imaging trial as a smoking cessation treatment, and there are plans to test the intervention with people suffering from mental health problems who also have alcohol addiction. Further testing on active-duty soldiers with chronic pain and a larger trial among civilians is planned. If studies continue to demonstrate positive outcomes, MORE could be prescribed by doctors as an adjunct to traditional pain management services.

Posted on Pain Management

Coping with Pain: A Mindfulness Meditation

Guided Mindfulness Meditation on Coping with Pain (20 minutes) - YouTube


This guided meditation session is designed for people who have practiced meditation in the past. Meditation has been shown to have many health benefits, including reducing pain, enhancing the body’s immune system and improving mood.



Posted on Sleep disorders

Counting sheep and still awake? Mindfulness therapy may help bring on the zzzs

Counting sheep and still awake? Mindfulness therapy may help bring on the zzz's
Counting sheep and still awake? Mindfulness therapy may help bring on the zzz’s

Sleep problems are common in the general population with up to half of Singaporean adults reporting insufficient or unsatisfying sleep. Sleep quality tends to worsen with age and poor sleep is a modifiable risk factor for multiple disorders, including cardiovascular disease and cognitive impairment.

Currently, insomnia is treated with either medication or psychological interventions. However, even frontline treatments such as cognitive-behavioural therapy have limitations – up to 40% of patients do not get relief from their insomnia symptoms after undergoing this treatment. Furthermore, in Singapore, the waiting time to receive such treatment is long, as it is typically delivered as individual therapy and there are limited available local providers.

To search for alternative approaches to treat insomnia, Principal Investigator Assistant Professor Julian Lim from the Centre for Sleep and Cognition at the National University of Singapore’s (NUS) Yong Loo Lin School of Medicine, together with the Singapore General Hospital’s Department of Psychology, looked towards mindfulness-based treatment. Mindfulness is the awareness of moment-to-moment thoughts, feelings, and bodily sensations, and the practice of accepting these experiences without judging or reacting to them. Backed by scientific evidence, practicing mindfulness is becoming increasingly popular as a means to reduce stress, treat mental health problems, and improve general well-being.

The randomised controlled study compared a Mindfulness-Based Therapy for Insomnia (MBTI) with an active Sleep Hygiene, Education, and Exercise Programme (SHEEP) to see if the former could improve sleep outcomes in older adults with sleep complaints. A total of 127 participants, aged 50-80, were randomised and allocated between the two programmes – 65 received MBTI while 62 went through SHEEP. Both interventions consisted of eight weekly sessions which were of two hours duration each.

The MBTI course included formal mindfulness exercises such as mindful eating, sitting meditation, mindful movement and body scans. This was followed by a group discussion of their experiences during the past week, as well as the application of practices and principles of mindfulness which directly addressed their sleep difficulties. In addition, participants were taught good sleep habits and behavioral strategies that they could use to improve their sleep.

On the other hand, the SHEEP course provided participants with information about sleep biology, self-monitoring of sleep behavior and taught changes to make in their habits and environment that could improve sleep quality. Participants also learned and practised sleep-promoting exercises such as diaphragmatic breathing, morning and evening stretching movements, and progressive muscle relaxation.

Although sleep quality improved across the board, the study found MBTI to be more effective in reducing insomnia symptoms than SHEEP. Additionally, MBTI led to observable improvements when sleep was measured objectively – using wrist-worn activity monitors, and by recording electrical brain activity while participants slept at home. These objective measurements showed that MBTI participants took less time to fall asleep, and spent less time awake during the night, while this was not seen among SHEEP participants.

Explaining the study’s findings, Assistant Professor Julian Lim said: “Insomnia is strongly linked to hyperarousal, or a failure to switch off the “fight-or-flight” system when it’s time to sleep. It typically starts because of a triggering stressful event, and persists because some individuals go on to develop bad sleep habits and dysfunctional thoughts about sleep. MBTI uses behavioural strategies to address the bad sleep habits directly, such as encouraging people to get out of bed if they have difficulty sleeping to rebuild the association between the bed and good sleep, and mindfulness techniques to equip people with more flexible strategies to deal with the dysfunctional or arousing thoughts.”

Assistant Professor Lim added, “The demonstration of the Mindfulness-Based Therapy as a viable treatment for insomnia presents possible valid alternatives for people who have failed or have no access to standard frontline therapies. Such treatment can be delivered in groups within and outside of a medical setting, providing members of the public with sleep issues easier and more efficient access to seek help.”

Posted on Autism

Mindfulness improves decision-making, attention in children with autism

School Bus

School-based mindfulness programs can improve decision-making skills and teach children with autism to focus attention and react less impulsively through breathing exercises that will allow them to reduce anxiety, according to Rutgers researchers.

The study, published in the journal Research in Developmental Disabilities, is the first to examine the effectiveness of a school-based mindfulness program that emphasizes self-awareness and controlled breathing in children on the autism spectrum.

Mindfulness practice trains people to focus their attention on awareness of the present moment. In neurotypical children, it has been shown to improve decision-making skills and to be effective in reducing anxiety, a common condition in the one in 68 children nationwide diagnosed with autism.

The researchers administered an eight-week mindfulness program to 27 high-functioning students with autism ages 10 to 17 at Newmark, a private school for children with special needs in New Jersey. Students were introduced to the basic tenets of mindfulness, then taught specific practices such as mindful breathing or focusing attention on the body, thoughts and emotions.

The students were tested on their impulse control, attention and decision-making before and after the program. “We found that the children improved their executive functions like controlling emotions, maintaining self-control, focusing attention and being flexible in changing their perspectives,” said lead investigator Helen Genova, a research assistant professor in the Department of Physical Medicine and Rehabilitation at Rutgers New Jersey Medical School and director of the Social Cognition and Neuroscience Laboratory at Kessler Foundation. “As in previous studies on school-based mindfulness programs and typically functioning children, we found that the practice taught the students to take a moment to stop and breathe. This reduced impulsiveness and allowed them to make better decisions.”

Regina Peter, co-executive director of Newmark, said the school promotes mindfulness every morning and before tests and competitions. “Practicing mindfulness teaches our students the important skill of treating the moment as something that needs to be attended to and to let everything else go,” she said. “The wonderful thing about mindfulness is that it is a tool they can take out when they need it. It is not a medication with side effects, and it’s free.”

Posted on Multiple Sclerosis, Patient Talk

Comparing the Benefits of Tai Chi and Meditation on MS Symptoms

Image result for Comparing the Benefits of Tai Chi and Meditation on MS Symptoms

Kinesiology researchers at the University of Massachusetts Amherst have received funding to compare the effects of tai chi and mindfulness meditation on both the physical balance and psychosocial well-being of people with multiple sclerosis (MS).

In a pilot study with 30 participants who have mild to moderate MS symptoms, researchers at the Motor Control Lab of Richard van Emmerik, professor of kinesiology, will use a one-year, $54,972 pilot grant from the National Multiple Sclerosis Society to measure the immediate and ongoing benefits of the two mind-body practices.

Julianna Averill, a doctoral student in motor control working in Van Emmerik’s lab, hopes the results will validate the approach of community-based classes and lead to a larger scale study across the commonwealth.

Tai chi, a Chinese martial art, involves stretching and slow, focused, flowing postures that keep the body in constant motion. Mindfulness-based stress reduction, the meditation component of the study, teaches various mindfulness practices, such as body scan meditation and loving kindness meditation.

“This is our first intervention study which has a teaching component,” Averill says. “The participants will be trained, and they will be able to practice on their own.”

Characterized by unpredictable periods of relapse and remission, MS is the most common disabling neurological disorder among young adults, with many diagnoses occurring between age 20 and 40, according to the National Institute of Neurological Disorders and Stroke.

People with MS may have a range of symptoms, including vision problems, muscle weakness, coordination and balance problems, tingling and burning sensations or numbness, extreme fatigue, fuzzy thinking and depression. The symptoms occur because the signals between the brain and body are disrupted when the fatty layer surrounding neurons in the brain and spinal cord – called the myelin sheath – is slowly destroyed.

“While MS symptoms vary depending on where the damage in the brain and spinal cord is located, balance issues are a common occurrence in MS,” Averill says. “Mind-body interventions are beneficial as they train dynamic balance, such as transitioning between postures, turning, reaching, etc., in a manner similar to movements in daily life.”

Finding ways to improve postural control and balance confidence is crucial to reducing the risk and fear of falls, a common and serious hazard for people with MS, which also affects their quality of life, Averill says. The study is designed to offer a fresh and expanded look at the effects of tai chi and mindfulness meditation.

“With mindfulness meditation, studies have been primarily looking at the mental constructs and not the impact on physical balance,” she says. Previous studies involving tai chi focused on standing balance, and UMass Amherst’s study will also seek to measure participants’ balance as they move.

Researchers are recruiting people with mild to moderate symptoms who are between age 21 and 70 and able to stand and move without assistance for 15 minutes. At three lab sessions over 10 weeks – before the classes start, after they end and two weeks later – participants will wear inertial sensors that collect postural sway data as they perform various movements. During the same sessions, the participants also will answer questionnaires that gauge their fall history, balance confidence, level of fatigue and ability to cope and adapt.

“We’re taking a more holistic look, considering the whole person and overall quality of life,” Averill says.

After the first data collection, participants will be randomly assigned to either eight weeks of free tai chi at YMAA Western Mass Tai Chi or free mindfulness meditation classes at Downtown Mindfulness, both local businesses that are partnering with UMass Amherst for the study. Participants will attend classes for 2.5 hours a week and have 2.5 hours of homework, either listening to meditation podcasts or watching tai chi videos on an innovative website that tracks participants’ activity.