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Posts from the ‘Mindfulness Research’ Category

Mindfulness is a powerful painkiller that can dramatically enhance quality of life in chronic pain sufferers – latest research

Mindfulness is a powerful painkiller that can dramatically enhance quality of life in chronic pain sufferers, suggests new research. The findings add weight to previous studies which discovered that mindfulness can reduce pain severity by around 50 percent.

This new meta-analysis, published in the peer-reviewed journal Evidence Based Mental Health, analysed the evidence from 21 previous studies involving 2,000 chronic pain sufferers. It was designed to assess whether mindfulness was as effective as Cognitive Behavioural Therapy (CBT) for relieving chronic pain and its associated distress. CBT can be effective and has none of the side-effects of traditional painkillers such as lethargy and addiction. But, crucially, not everyone benefits from CBT.

Most of the participants in this new analysis were women aged between 35 and 65 and suffered largely from musculoskeletal pain. In nearly 40 percent of the studies, participants had endured their pain for more than a decade.

This new analysis suggests that mindfulness is just as effective as CBT when it comes to improving ‘physical functioning’. And both mindfulness and CBT were equally good at reducing pain and its associated conditions such as depression.

Dr Wei Cheng, lead researcher on the study carried out at the Ottawa Hospital, Ontario, Canada, said: “While CBT is considered to be the preferred psychological intervention for chronic pain, not all patients experience a clinically significant treatment response.

‘Although a number of recommendations have been proposed to improve CBT for patients with chronic pain, an additional solution may be to offer patients Mindfulness-Based Stress Reduction since it shows promise in improving pain severity and reducing pain interference and psychological distress.’

Previous work has shown that mindfulness meditation is highly effective at directly relieving chronic pain and also reducing the distress it causes. For example, work carried out by Fadel Zeidan at the Wake Forest Baptist Medical Centre in North Carolina discovered that mindfulness can reduce chronic pain by 57 percent. Accomplished meditators can reduce it by over 90 percent.

Dr Zeidan said: ‘Meditation produced a greater reduction in pain than even morphine or other pain-relieving drugs.’

As I explain in our book Mindfulness: A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeing, which is recommended by the British Medical Association, meditation achieves these remarkable results because it turns down the ‘volume’ control on pain. (Our book is published in the US as You Are Not Your Pain).

A typical meditation involves focusing on different parts of the body and simply observing with the mind’s eye what you find. This allows you to see your mind and body in action, to observe painful sensations as they rise and fall, and to let go of struggling with them. And when you do this, something remarkable happens: your suffering begins to melt away of its own accord. It also creates a relaxed state of mind that reduces the level of stress hormones in the body. Such deep relaxation enhances healing and boosts mental and physical health.

Imaging studies show that mindfulness soothes the brain patterns underlying pain and, over time, these changes take root and alter the structure of the brain itself, so that patients no longer feel pain with the same intensity. Many say that they barely notice it at all.

For these reasons, hospital pain clinics now prescribe mindfulness meditation to help patients cope with the suffering arising from a wide range of diseases such as cancer (and the side effects of chemotherapy), heart disease, diabetes and arthritis. It is also used for back problems, migraine, fibromyalgia, coeliac disease, chronic fatigue, irritable bowel syndrome and even multiple sclerosis.

You can download free meditations from You Are Not Your Pain/Mindfulness: A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeingfrom here.

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The Art Of Breathing: The Secret To Living Mindfully, by Dr Danny Penman, is published in the US by Conari Press

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Mindfulness Enhances the Performance of Elite US Special Forces

Mindfulness training significantly enhances the performance of elite US special forces, a new study has discovered. Even the simplest of mindfulness exercises were shown to enhance working memory, clarity of thought, and the ability to focus under extreme pressure.

‘Previous studies have found that mindfulness protects against the deterioration in cognitive performance during periods of high stress to help special forces sustain their performance and well-being over time,’ said Dr Amishi Jha, a Psychologist at the University of Miami and lead researcher on the study.[i] “Yet here, in a population already known for their peak cognitive ability, we found that mindfulness training may be able to enhance cognition, even under periods of high stress.’

Psychologists have known for many years that mindfulness meditation reduces anxiety, stress and depression. Scientific studies have shown that mindfulness not only prevents depression, but that it also positively affects the brain patterns underlying day-to-day anxiety, stress, depression and irritability so that when they arise, they dissolve away again more easily. Other studies have shown that regular meditators see their doctors less often and spend fewer days in hospital. Memory improves, creativity increases, and reaction times become faster (see http://franticworld.com/what-can-mindfulness-do-for-you/).

It is so effective that mindfulness meditation is now recommended for the treatment of anxiety, stress and depression by the UK’s National Health Service, many US Hospitals, and other healthcare systems around the world. Mindfulness seems to be particularly effective for relieving the worst forms of depression. Indeed, one programme – Mindfulness-Based Cognitive Therapy (MBCT) – is recommended for the most severe forms of depression by the UK’s National Institute for Health and Care Excellence, which evaluates treatments for the NHS.

In recent years, researchers have begun investigating whether mindfulness can also enhance mental performance rather than merely relieving suffering. In this recent study, Dr Jha and her colleagues wanted to see whether mindfulness could enhance the already formidable mental performance and resilience of elite special forces. To this end, the study followed 120 of the US Special Operations Forces for two months to see whether mindfulness training could help improve their working memory and ability to focus under extreme pressure.

The warriors (special forces dislike being called ‘soldiers’) were taught four different mindfulness meditations over either two or four weeks and asked to practice them for 15 minutes a day for eight weeks. Classroom sessions were used to both teach the meditations and explain their underlying logic. The control group received no training. Each session in the course, known as Mindfulness-Based Attention Training (MBAT), introduced a corresponding mindfulness exercise. They were first taught a simple Breathing meditation. In this, participants were asked to focus on their breathing and to return their attention to the breath each time they realised that their mind had wandered (you can listen to a similar one here: http://franticworld.com/aob/  They were then taught a guided Body Scan. This involved paying attention to the sensations in their body without making any value judgements about them by, for example, describing them as ‘painful’ or ‘pleasant’. You can listen to one here: http://franticworld.com/free-meditations-from-mindfulness/ Two other meditations were also taught. The Open Monitoring meditation involved expanding the field of awareness beyond the breath and noticing the rising, changing, and passing away of sensory and mental phenomena (e.g. sounds, body sensations, or thoughts). The final meditation, known as the Connection exercise, asked the warriors to express kindness and feelings of ‘connectedness’ towards themselves and to others.

Before and after the training, the soldiers’ ability to pay attention under pressure was measured using a computer-based task that required them to respond to numbers on a screen. To test working memory, they were presented with complex visual information (e.g., faces) to remember for short intervals while being bombarded by distracting negative images. The researchers then tracked the changes as they progressed through the course.

Jha’s team also wanted to see whether the benefits of mindfulness followed a ‘dose-response’ relationship, that is, more practice conferred a greater benefit than did less. To test this, they delivered two and four week versions of the course.

‘The two-week training was the shortest we have ever offered,’ said Dr Jha. “And we found that two weeks is too short. The bigger benefits come with the four-week MBAT programme, which resulted in significant improvements to both attention and working memory task performance.

‘In addition, we found that just like physical activity, the more time that participants engaged in daily mindfulness exercises, the more their working memory benefitted.’

‘Because these soldiers are required to do the most difficult and cognitively demanding tasks under extreme conditions, we want them to have the maximum amount of attention and working memory to succeed at those tasks,’ said Jha. ‘We found that after four weeks of mindfulness training, they may well be more capable of dealing with the humanitarian, environmental, and security challenges that our country and the world face.’

Mindfulness is garnering increasing support within the US military. Lt. Gen. Eric Shoomaker, M.D., 42nd Army Surgeon General and former commanding general of the U.S. Army Medical Command said: ‘Dr Jha and her colleagues have demonstrated that mindfulness training may provide the best prospect for success in demanding work. As more people are engaged in critical roles and tasks in which attentiveness and working memory play key roles in ensuring safety… mindfulness training is emerging as a powerful tool.’

Dr Jha believes that anyone who needs to perform for sustained periods at the highest of levels will benefit from mindfulness. But it is not just the likes of firefighters, police officers, athletes, trauma surgeons, nurses, and judges who might benefit says Dr Jha.

‘Mindfulness training may also help in stressful everyday moments by strengthening those cognitive capacities that get readily depleted when the mind is hijacked by anger, fear, worry, and rumination.’

 

i) Mindfulness training as cognitive training in high-demand cohorts: An initial study in elite military service members; Anthony P.Zanesco, Ekaterina, Denkova, Scott L.Rogers, William K.MacNulty, Amishi P.Jha; Progress in Brain Research; https://doi.org/10.1016/bs.pbr.2018.10.001

Can Mindfulness Help Relieve Tinnitus?

One in seven people will suffer from tinnitus at some point in their lives and yet its causes are unknown and treatments are only partially effective. A new clinical trial highlights the remarkable promise offered to sufferers by Mindfulness-Based Cognitive Therapy.

 

If you have ever suffered from tinnitus, you will understand what a surprisingly distressing condition it can be. It can lead to anxiety, stress, depression, insomnia and impaired hearing and concentration. Its medical definition of ‘the sensation of hearing sounds in the absence of any external sound’ barely reflects the impact it has on day to day life.

I suffered from tinnitus for several years and it still returns from time to time. I managed to control the condition using Cognitive Behavioural Therapy (CBT) and mindfulness. I was taught CBT at hospital where it was called Tinnitus Retraining Therapy and I used my own mindfulness sessions to enhance its effect. And I found it surprisingly effective. The tinnitus in my right ear disappeared completely. Some ringing returns to my left ear from time to time, but it no longer bothers me.

Nor is my experience an isolated case. New research shows that mindfulness can have a big impact on tinnitus. Dr Laurence McKenna of University College London Hospitals NHS Foundation Trust and Dr Liz Marks of the Department of Psychology at the University of Bath, have found that Mindfulness-Based Cognitive Therapy (MBCT) can help sufferers far more effectively than the relaxation-based treatments currently taught by many tinnitus clinics.

Dr Marks’ team compared MBCT to relaxation therapy, the normal treatment for people with chronic tinnitus, to determine if MBCT was a better option.

“In total, 75 patients took part in the trial at UCLH’s Royal National Throat, Nose and Ear hospital receiving either MBCT or relaxation therapy. The study found that both treatments led to a reduction in tinnitus severity, psychological distress, anxiety and depression for patients,” said Dr Marks.

“The MBCT treatment led to significantly greater reductions in tinnitus severity, and this improvement lasted for longer. In addition, 182 patients who completed MBCT routinely in our clinic showed a similar level of improvement.”

MBCT teaches patients to pay purposeful, present-moment attention to experiences, rather than trying to suppress them. In the case of tinnitus, patients were encouraged to meditate on sounds, including that of the tinnitus, and to follow how it rose and fell, how its pitch and timbre changed, and also to place it in the context of the wider ‘soundscape’. This cultivated a more helpful way of responding to tinnitus. People learnt how to allow and accept tinnitus rather than trying to fight or suppress it. Even though this mindful approach did not aim to change the nature of the tinnitus, it led to it becoming less intrusive to the point where it was no longer a problem. In many cases, it disappeared completely.

Dr Marks added: “MBCT turns traditional tinnitus treatment on its head – so rather than trying to avoid or mask the noise, it teaches people to stop the battle with tinnitus.

“The mindfulness approach is radically different from what most tinnitus sufferers have tried before, and it may not be right for everyone. We are confident, however, that the growing research base has demonstrated how it can offer an exciting new treatment to people who may have found that traditional treatment has not been able to help them yet. We hope the results of our research will be one of the first steps to MBCT becoming more widely adopted.”

So how does MBCT, and mindfulness in general, have this effect?

To answer this question, its first necessary to understand the true nature of tinnitus. While its cause is unknown, it is clear that tinnitus is not a disease or an illness in the normal sense. Rather, according to the British Tinnitus Association, it results from some type of change that can be either mental or physical and may be unrelated to hearing. It is probably akin to neuropathic pain, except patients hear non-existent sounds rather than feel the sensations of pain.

Neuropathic pain occurs in the nervous system and often normal investigations fail to discover a clear cause. It might result from damage to the nerves, spinal cord, or brain. But sometimes pain is felt even when there is no damage, or when healing seems to have completed at the site of an illness or injury.  Such neuropathic pain can also take the form of unusual sensations, such as burning or electric shocks, and can even ‘occur’ in amputated limbs. Or it can take the form of tinnitus.

It is believed that tinnitus arises when background electrical or ‘white noise’ in the sound processing systems of the ear and brain become unduly amplified. The auditory system is highly sensitive and the nervous system is naturally ‘noisy’. Normally, the auditory system screens out this background electrical noise. However, if the background electrical noise rises above this auditory threshold – or the threshold is lowered – then you will hear the hissing sound of white noise, or tinnitus. What happens next is crucial to the progress of the condition. In some people, the noise is perceived as alarming and the body’s fight or flight system is activated. This ensures that the brain begins to actively search for the sounds of tinnitus because they are seen as a threat that needs to be avoided. The brain and nervous system then responds by increasing its capacity to process the noisy tinnitus signals – rather as a computer devotes extra memory and circuits to an important task. So the brain begins to act like an amplifier that’s stuck on ‘high’.

How you then react to tinnitus determines whether it is amplified further or fades away of its own accord. If you learn to accept the condition by paying conscious attention to the sounds by, for example, mindfully following how it rises and falls, and its changes in pitch and timbre, then you begin to accept the background noise. You can begin relaxing into it. The brain then no longer sees the noise as alarming and begins to naturally screen it out once again. Mindfulness also reduces anxiety and stress, which probably reduces the level of ‘white noise’ in the nervous system. In addition, lowering anxiety and stress can take you off a hair-trigger, and, in effect, lowers the brain’s sound amplifiers still further.

The Sounds and Thoughts meditation seems to be particularly effective for tinnitus although the whole MBCT programme reinforces the benefits.

The researchers in London and Bath now hope to extend their research to see whether it can help with tinnitus related insomnia. Given that mindfulness is an effective treatment for insomnia in its own right, the chances for success are high.

You can try some shortened MBCT meditations here. These are taken from my bestselling book Mindfulness: Finding Peace in a Frantic World co-written with Professor Mark Williams, co-developer of MBCT.

You can also try some free meditations from my book Mindfulness for Health (published in US as You Are Not Your Pain) here.

Please seek medical guidance before you try incorporating mindfulness into your own tinnitus treatment.

Find out more about the condition from the British Tinnitus Association.

You can read the original research papers here and here.

 

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