Meditation: Concepts, effects and uses in therapy

A study to assess the effect of yoga and diet on Framingham risk score among high-risk cardiovascular subjects

Introduction

Cardiovascular diseases (CVDs) are a cluster of disorders of blood vessels and the heart. As a form of physical activity, yoga postures, and pranayama have been shown to be beneficial in various health conditions, i.e. hypertension, prediabetes, and diabetes among high-risk subjects. This study aimed to evaluate the impact of yoga and diet on the Framingham risk score (FRS) among high-risk cardiovascular subjects.

Materials and Methods

The experimental interventional study was conducted at "RUHS College of Medical Sciences" and Associated Group of Hospitals", Jaipur among high-risk cardiovascular subjects. FRS was used as a measurement for the outcome of interest at baseline and six months of yoga diet intervention in the study and control groups.

Results

Mean age of participants was 48.43 ± 6.4 years. Baseline values (mean ± SD) of FRS 24.59 ± 10.15 after six months of yogic lifestyle 15.1 ± 7.05. After six months of yogic lifestyle FRS scores and estimated 10-year cardiovascular risk were statistically significantly (P < 0.0001) decreased. Pearson correlation analysis results depict that FRS correlation. There was a strong positive correlation between the FRS score and total cholesterol (r = 0.787; P < 0.001) and a negative strong correlation between the FRS score and high-density lipoprotein was observed (r =-0.621; P < 0.002).

Conclusion

The findings of this study conclude that six months of yoga and diet lifestyle intervention significantly decreased FRS among high-risk CVD subjects compared to the control group.

Spiritual healing in palliative care with clinical hypnosis: neuroscience and therapy

THIS PAPER REVIEWS

The neuroscientific features of inner consciousness, including its role in suffering and in accessing states of mind that relieve suffering; details salient meditative and hypnotic approaches appropriate for palliative settings of care; discusses core principles and orientations shared by effective approaches; and proposes early integration of hypnotic training as a coping skill and a platform for spiritual exploration, as desired.

Effects of meditation on pain intensity, physical function, quality of life and depression in adults with low back pain - A systematic review with meta-analysis

BACKGROUND

Low back pain (LBP) is a common biopsychosocial health problem. Meditation may provide a complementary treatment option for LBP patients.

OBJECTIVES

The aim of this systematic review with meta-analysis was to examine the effects of meditation on pain intensity, functional disability, quality of life, and depression in LBP populations.

METHODS

This systematic review was conducted according to the PRISMA Guidelines. PubMed, Web of Science, CENTRAL, CamQuest and PubPsych were searched up to a publication date of June 2020. Inclusion criteria were RCTs or non-RCTs with LBP patients, aged at least 18 years, the application of a specific meditation technique, and pain intensity and/or functional disability as outcomes. Pooled SMDs were calculated at post-treatment and follow up. The Cochrane risk-of-bias tool was used to estimate risk of bias. The overall quality of evidence was assessed using the GRADE approach.

RESULTS

12 studies with a total of 1005 participants were included in this review. Compared to controls, meditation solely showed a significant positive effect on pain intensity (SMD = -0.27 [CI -0.43; -0.11]; p = 0.001; based on 10 studies with 934 participants) and physical quality of life (SMD = 0.21 [CI 0.07; 0.36]; p = 0.005; based on 5 studies with 756 participants) at post-treatment. At follow up (mean 20 weeks, range 4-52) there were no significant effects anymore. The quality of the evidence was moderate due to study limitations and imprecision.

CONCLUSIONS

Meditation seems to be promising with regard to reducing short-term pain intensity in patients with LBP. However, additional well-designed and large trials are required in order to draw more reliable conclusions.

Effect of mindfulness-based stress reduction on stigma, coping styles, and quality of life in patients with permanent colorectal cancer stoma: A protocol for systematic review and meta-analysis

BACKGROUND

: Colorectal cancer patients with permanent colostomy may suffer stigma, negative coping style, and low quality of life at varying degrees, which may be improved by the mindfulness-based stress reduction (MBSR). In recent years, MBSR has been used in the comprehensive treatment of colorectal cancer with permanent colostomy, hoping to bring a positive outcome. However, the practical application effect of MBSR has not been elucidated so far. Therefore, this study conducted a meta-analysis to evaluate the effects of MBSR on stigma, coping style, and quality of life in colorectal cancer patients with permanent colostomy, providing reliable evidence for clinical application.

METHODS

: Randomized controlled trials (RCTs) reporting MBSR on stigma, coping style, and quality of life in patients with permanent stoma of colorectal cancer published before December 2021 will be searched in online databases such as the PubMed, Web of Science, The Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, and Chinese Scientific Journal Database. The quality of the literature will be evaluated using the risk of bias assessment tool in Revman 5.4. Meta-analysis will be performed using Revman 5.4 software.

RESULTS

: The Social Impact Scale (SIS), Simplified Coping Style Questionnaire (SCSQ), and quality of life scale will be used to evaluate the effects of MBSR on stigma, coping style, and quality of life in colorectal cancer patients with permanent colostomy.

CONCLUSION

: This study will provide a reliable evidence-based basis for MBSR to reduce stigma, improve coping style, and improve quality of life for colorectal cancer patients with permanent colostomy.

OSF REGISTRATION NUMBER

DOI 10.17605/OSF.IO/CD4PV.

Insights and Future Directions on the Combined Effects of Mind-Body Therapies with Transcranial Direct Current Stimulation: An Evidence-based Review

Mind-body therapies (MBTs) use mental abilities to modify electrical neural activity across brain networks. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that modulates neuronal membrane potentials to enhance neuroplasticity. A combination of these treatment strategies may generate synergistic or additive effects, and thus has been more commonly tested in clinical trials, fostering a novel yet promising field of research. We conducted a literature search in four different databases including only randomized clinical trials (RCTs) that tested the combination of MBTs with tDCS. Ten studies (n=461) were included. Combined protocols included meditation/mindfulness (8/10), biofeedback (1/10), and hypnosis (1/10). The RCTs were heterogeneous with regards to population, design, and types of outcomes. Based on the findings of this search, we provide here a content description, methodological and practical insights, and future directions for the field. We hope this review will provide future authors with information to facilitate the development of trials with improved protocols.

Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations

So far, the large and expanding body of research on meditation has mostly focussed on the putative benefits of meditation on health and well-being. However, a growing number of reports indicate that psychologically unpleasant experiences can occur in the context of meditation practice. Very little is known about the prevalence and potential causes of these experiences. The aim of this study was to report the prevalence of particularly unpleasant meditation-related experiences in a large international sample of regular meditators, and to explore the association of these experiences with demographic characteristics, meditation practice, repetitive negative thinking, mindfulness, and self-compassion. Using a cross-sectional online survey, 1,232 regular meditators with at least two months of meditation experience (mean age = 44.8 years ± 13.8, 53.6% female) responded to one question about particularly unpleasant meditation-related experiences. A total of 315 participants (25.6%, 95% CI: 23.1 to 28.0) reported having had particularly unpleasant meditation-related experiences, which they thought may have been caused by their meditation practice. Logistic regression models indicated that unpleasant meditation-related experiences were less likely to occur in female participants and religious participants. Participants with higher levels of repetitive negative thinking, those who only engaged in deconstructive types of meditation (e.g., vipassana/insight meditation), and those who had attended a meditation retreat at any point in their life were more likely to report unpleasant meditation-related experiences. The high prevalence of particularly unpleasant meditation-related experiences reported here points to the importance of expanding the scientific conception of meditation beyond that of a (mental) health-promoting and self-regulating technique. We propose that understanding when these experiences are constitutive elements of meditative practice rather than merely negative effects could advance the field and, to that end, we conclude with an overview of methodological and conceptual considerations that could be used to inform future research.

Is Rajyoga helpful in maintaining patient's biochemical and hematological profile during breast cancer treatment?

The present study is the case of a breast cancer patient who visited the local unit of the Brahma Kumaris (BK). Conversations with the patient revealed that the patient was being treated in the Post Graduate Institute of Medical Education and Research, Chandigarh, India. The treatment of the patient included the surgery, radiotherapy, and chemotherapy. The patient narrated her ability to manage the psychological stress associated with the cancer treatment. She ascribed it to the positive attitude developed by her practice of the Rajyoga meditation from last 15 years. Rajyoga involved the daily meditation and regular listening to the specified commentary recommended by BK. Patient's health remains stable during the whole treatment process as analyzed by the mammography, histopathology and PET scan. The patient was also able to maintain the total body weight, biochemical and hematological profile within normal physiological range. The present case study is an attempt to provide Rajyoga as supportive means to the maintenance of patient's biochemical and hematological profile, and overall general health during breast cancer treatment.

Mindfulness in psychotherapy: an introduction

‘Mindfulness' has become a popular topic among psychological therapists. This introductory article explains what mindfulness is and how it can be developed, before exploring how it has been incorporated within psychoanalytic and cognitive–behavioural psychotherapies. These reflect general as well as specific presumed therapeutic actions. At present, variations in the way mindfulness is understood, taught and applied mean that it is too early to fully assess its potential. They demonstrate how the use of attention and awareness in therapy cuts across traditional divisions and where mindfulness in therapy is most in need of further investigation.

Mindfulness-Based Heroism: Creating Enlightened Heroes

The field of mindfulness and the emerging science of heroism have a common interest in the causes and conditions of selfless altruism though up to this point there has been little cross-pollination. However, there is increasing evidence that mindfulness training delivers heroically relevant qualities such as increased attentional functioning, enhanced primary sensory awareness, greater conflict monitoring, increased cognitive control, reduced fear response, and an increase in loving kindness and self-sacrificing behaviors. Predicated on the notion of a “no self,” traditional mindfulness and its focus on enlightenment and selfless service may in fact be ideally suited to the development of the elusive “trait” (predictable) versus “state” (intermittent) heroic character. Interweaving observations and questions drawn from the science of heroism, the article explores the relevant theory, practices, and scientific outcomes of mindfulness. It finds that there is evidence that heroically relevant qualities are trainable with the suite of mindfulness techniques and that an enduring experience of selflessness and service of others (the enlightened hero) may well be within the grasp of the serious practitioner.

The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists

Buddhist-derived meditation practices are currently being employed as a popular form of health promotion. While meditation programs draw inspiration from Buddhist textual sources for the benefits of meditation, these sources also acknowledge a wide range of other effects beyond health-related outcomes. The Varieties of Contemplative Experience study investigates meditation-related experiences that are typically underreported, particularly experiences that are described as challenging, difficult, distressing, functionally impairing, and/or requiring additional support. A mixed-methods approach featured qualitative interviews with Western Buddhist meditation practitioners and experts in Theravāda, Zen, and Tibetan traditions. Interview questions probed meditation experiences and influencing factors, including interpretations and management strategies. A follow-up survey provided quantitative assessments of causality, impairment and other demographic and practice-related variables. The content-driven thematic analysis of interviews yielded a taxonomy of 59 meditation-related experiences across 7 domains: cognitive, perceptual, affective, somatic, conative, sense of self, and social. Even in cases where the phenomenology was similar across participants, interpretations of and responses to the experiences differed considerably. The associated valence ranged from very positive to very negative, and the associated level of distress and functional impairment ranged from minimal and transient to severe and enduring. In order to determine what factors may influence the valence, impact, and response to any given experience, the study also identified 26 categories of influencing factors across 4 domains: practitioner-level factors, practice-level factors, relationships, and health behaviors. By identifying a broader range of experiences associated with meditation, along with the factors that contribute to the presence and management of experiences reported as challenging, difficult, distressing or functionally impairing, this study aims to increase our understanding of the effects of contemplative practices and to provide resources for mediators, clinicians, meditation researchers, and meditation teachers.

The Quiet Ego: Assuaging Organizational Concerns About Mindfulness

Hyland, Lee, and Mills (2015) provide ample evidence regarding the value of mindfulness to individuals and the industrial–organizational community as a whole. However, as they noted, mindfulness programs and practices have not yet found widespread implementation among businesses and other organizations. Hyland et al. suggest two primary reasons for this. First, the move toward a nonjudgmental, presently aware, and accepting mind is a tall order for most individuals in our Western society who are heavily conditioned to be relatively self-interested, judgmental, and future oriented. Second, typical mindfulness programs (e.g., mindfulness based stress reduction; MBSR) may be too costly and time consuming for organizations.

Does a meditation protocol supported by a mobile application help people reduce stress? Suggestions from a controlled pragmatic trial

The aim of this study was to examine the efficacy of a 3 week mindfulness inspired protocol, delivered by an Android application for smartphones, in reducing stress in the adult population. By using a controlled pragmatic trial, a self-help intervention group of meditators was compared with a typical control group listening to relaxing music and a waiting list group. The final sample included 56 Italian workers as participants, block randomized to the three conditions. The self-reported level of perceived stress was assessed at the beginning and at the end of the protocol. Participants were also instructed to track their heart rate before and after each session. The results did not show any significant differences between groups, but both self-help intervention groups demonstrated an improvement in coping with stress. Nevertheless, meditators and music listeners reported a significant decrease in average heartbeats per minute after each session. Furthermore, both groups perceived a moderate but significant change in stress reduction perceptions, even if with some peculiarities. Limitations and opportunities related to the meditation protocol supported by the mobile application to reduce stress are discussed.

Looking After Me Looking After You: using positive cognitive behavioural techniques to improve emotional well-being

Stress and anxiety have been identified as among the most common reasons for sickness absence. Therefore, timely work-based well-being interventions are needed. Strengths-based Cognitive-Behaviour Therapy (CBT) approaches are of benefit therapeutically. Guided imagery approaches enable individuals utilize previous positive experiences and construct positive future templates potentially increasing the likelihood of better outcomes. One hundred and seventeen participants from a health service clinical/corporate environment participated in the Looking After Me Looking After You (LAMLAY) programme. It comprised three 3-hour or four 2-hour sessions weekly. Positive imagery and strengths-based cognitive-behavioural approaches were delivered via participant exercises and didactically. Completion rate was 77.8%; seventy-five participants (83% of completers) completed the Warwick–Edinburgh Mental Well-Being Scale (WEMWBS) pre-course (mean 46.4) and post-course (mean 52.4). Significant improvements in well-being were obtained (t = 9.32, d.f. = 74, p<0.0001, d = 0.82). An online follow-up survey demonstrated sustained improved scores on the WEMWBS (F2,223 = 17.04, p<0.001, η = 0.13). Satisfaction ratings indicated high approval levels. Participants’ well-being improved at the end of the LAMLAY programme and was sustained at follow-up. The potential impact of LAMLAY and the potential to deliver cost-effective benefits is discussed. Further development work is required including more systematic investigation over a longer term.

Effects of a yoga intervention on lipid profiles of diabetes patients with dyslipidemia

OBJECTIVE

The present study was conducted to assess the effectiveness of yoga in the management of dyslipidemia in patients of type 2 diabetes mellitus.

METHODS

This randomized parallel study was carried out in Medical College Trivandrum, Kerala, India. Hundred type 2 diabetics with dyslipidemia were randomized into control and yoga groups. The control group was prescribed oral hypoglycemic drugs. The yoga group practiced yoga daily for 1 h duration along with oral hypoglycemic drugs for 3 months. The lipid profiles of both the groups were compared at the start and at the end of 3 months.

RESULTS

After intervention with yoga for a period of 3 months the study group showed a decrease in total cholesterol, triglycerides and LDL, with an improvement in HDL.

CONCLUSION

Yoga, being a lifestyle incorporating exercise and stress management training, targets the elevated lipid levels in patients with diabetes through integrated approaches.

A way of being: bringing mindfulness into individual therapy

This paper reports a qualitative, idiographic study employing Interpretative Phenomenological Analysis to explore the experiences of therapists who have a mindfulness practice, looking at how this is brought into their individual therapeutic work. Findings focus on mindfulness, conceptualized as a way of being, which emerges as a central theme in all accounts. Three "way of being" related themes are used to illustrate therapists' experiences of mindfulness as part of their personal life and how this is brought into the therapy room both implicitly and explicitly. The application of mindfulness in therapy is discussed while drawing links with the mindfulness literature.

Integrating Buddhist psychology into grief counseling

The field of grief counseling has yet to see an integration of Buddhist psychology. Drawing on Buddhist psychology literature and Western models of grief, this article explores possible integrations of two approaches. To lay the foundation for this discussion, the authors introduced a brief overview of the history of Buddhism as well as a Buddhist conception of death and other relevant Buddhist concepts. Integrations of Buddhist psychology and Western models of grief are explored within the context of death and grief as part of life, grief as a process, balancing doing and being, and an interpersonal approach to grief counseling. Application of the Buddhist approach for individual and group practice was illustrated, followed by a cautionary note on the caveats of integrating two approaches. The article ends with a discussion on the implications of the Buddhist approach for counselor self-care.

Complementary and alternative medicine for noncancer pain

In summary, the past several years have shown an increase in the quality of trials examining the clinical efficacy of various CAM modalities for pain conditions. There is still need to raise the quality of the studies from a scientific and methodological point of view in many areas of CAM research by randomization, appropriate sample size, blinding, and developing more sophisticated sham procedures. However, much work still has to be done to find ways to preserve the clinical authenticity of CAM treatment methods when brought into the light of a research protocol. Recent attempts have been made to find a method of maintaining the standardization and reproducibility of research protocols while allowing the kind of flexible treatment that would normally be applied in a clinical setting. Other questions that should be answered with future studies include understanding how treatment length influences outcome, if maintenance treatments are needed for chronic conditions, and cost and risk comparisons with standard pharmacological treatment. Providing this kind of detail will assist both with reproducibility as well as help us gain a better understanding about whether certain treatment paradigms are superior to others for specific clinical conditions. Finally, physicians who have an interest in pursuing CAM research should educate themselves both about the methodological issues inherent with the particular area of interest as well as about ways to maintain the authenticity of the CAM treatment protocols so that the literature is not populated with more poorly designed studies. With the emerging interest in integrative medicine, there is a growing interest in collaboration and a greater number of physicians are interested in obtaining training in CAM modalities to help bridge this gap between CAM and conventional clinicians. For example, the American Academy of Medical Acupuncturists (AAMA) has been formed to help as both an educational and research forum for physician acupuncturists and the American Holistic Medical Association provides educational exposure in a broad range of Integrative and CAM modalities. The future of medicine will likely be Integrative and the more health care providers can educate themselves about this area of medicine, the better they will be able to provide the highest quality of care to their patients.

Electro-encephalogram based brain-computer interface: improved performance by mental practice and concentration skills

Mental imagination is the essential part of the most EEG-based communication systems. Thus, the quality of mental rehearsal, the degree of imagined effort, and mind controllability should have a major effect on the performance of electro-encephalogram (EEG) based brain-computer interface (BCI). It is now well established that mental practice using motor imagery improves motor skills. The effects of mental practice on motor skill learning are the result of practice on central motor programming. According to this view, it seems logical that mental practice should modify the neuronal activity in the primary sensorimotor areas and consequently change the performance of EEG-based BCI. For developing a practical BCI system, recognizing the resting state with eyes opened and the imagined voluntary movement is important. For this purpose, the mind should be able to focus on a single goal for a period of time, without deviation to another context. In this work, we are going to examine the role of mental practice and concentration skills on the EEG control during imaginative hand movements. The results show that the mental practice and concentration can generally improve the classification accuracy of the EEG patterns. It is found that mental training has a significant effect on the classification accuracy over the primary motor cortex and frontal area.