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Category Archives: mindfulness

February 22, 2013 · 7:12 PM

Mindfulness vs. PTSD

The Washington Post reported this week on new studies addressing Post-Traumatic Stress Disorder with mindfulness. Research has already found regular practice may help those with PTSD recover faster. New findings suggest it may do even more.

Elizabeth A. Stanley, PhD, of Georgetown University

Elizabeth A. Stanley, Ph.D is professor of security studies at Georgetown University. She’s not a psychologist, but she ‘s among those who’ve found regular mindfulness practice significantly eased their post-traumatic symptoms. Per the Post’s article, Stanley’s new study tracked 320 marines through simulated combat training. The results showed those schooled in mindfulness weren’t just calmer during the exercises, they also responded faster to new threats.

This is crucial, says Tom Minor, a University of California at San Diego neuroscientist who was one of the researchers. “That was one thing we worried about: ‘Are we going to take a bunch of Marines and turn them into chanting monks who couldn’t generate a stress response?’ But they didn’t get too relaxed.”

“Too relaxed,” is a fear for many traumatized people. With a constant perception of danger, it can be unnerving to think one might be lackadaisical about threats. Clinical evidence that mindfulness reduces response time can be a major selling point to the hypervigilant.

Opens with the titular Vietnam vet practicing mindfulness in a Buddhist monastery. Discuss.

In the “Baba Rum Raisin” days of the late 1960s and early 1970s, meditation was peddled as a cure for everything. Skepticism bordered on cynicism. This article cites peer-reviewed, clinically-validated studies such as Thomas F. Minor‘s research, which indicates meditation boosts the hormones that repair stress-related damage and decreases the chemicals that cause it. It also mentions Martin M. Paulus’ work that shows mindfulness boosts activity in areas of the brain devoted to awareness and control of emotions. The sample sizes are too small and the results need to be reproduced a few more times, but the findings on mindfulness and PTSD have started to verge on Maharishi-esque territory.

Of all the goodies in the Post article, the most tantalizing (and least empirically-supported) is the suggestion that mindfulness practice may reduce the risk of developing post-traumatic symptoms:

(Marine medic Del) Cochran says he believes meditation helped him stay much calmer during his second tour in Iraq. “The first tour, I was freaked out all the time,” he says. “There was so much static. With meditation, you’re much more in tune — what is a target, what is not a target. You are much more focused on what you are doing.”

Meta-analyses of studies of traumatized children shows pre-existing anxiety may increase one’s vulnerability to PTSD. Who wants to fund a study comparing PTSD rates among veterans from countries with a cultural tradition of mindfulness practice and those without?

Citations:

Kohn, David (2013, February 18) Mindfulness and meditation training could ease PTSD symptoms, researchers say. The Washington Post. Retrieved on February 22, 2013.

Examining the protective effects of mindfulness training on working memory capacity and affective experience. By Jha, Amishi P.; Stanley, Elizabeth A.; Kiyonaga, Anastasia; Wong, Ling; Gelfand, Lois

Emotion, Vol 10(1), Feb 2010, 54-64.

Why mindfulness works – The behavioral view

Photo @2005-2011 Juanita de Paola - http://www.juanita.it/

Experts have known since 500 BCE that mindfulness practice can lead to greater feelings of equanimity and contentment. Mindfulness- based therapies have been part of western psychology at least since 1979, when Jon Kabat-Zinn opened the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. Unlike many other “eastern” treatments, empirical studies have accumulated to support claims of effectiveness against depression[i] and anxiety disorders such as generalized anxiety disorder[ii], obsessive-compulsive disorder[iii], and even irritable bowel syndrome[iv].

What has been less well understood is how it works. Michael Treanor, of the University of Massachusetts published a meta-analysis[v] this February that suggests exposure is key. Since Joseph Wolpe’s time (and before), we’ve known if you expose yourself long enough to something that causes anxiety, your amygdala and sympathetic nervous system will (eventually) realize it’s not so dangerous. The difficulty has always been how to stay with the phobic object when every part of you wants to run. Treanor’s meta-analysis finds empirical support for the idea that mindfulness works as a conditioned inhibitor – meaning, in this case, it eases the urge to flee.

Treanor’s findings were anticipated in a 2005 article[vi] by Shapiro, Carlson et al. They defined mindfulness as choosing to focus one’s attention on the present moment, with an open, accepting attitude, and the intention of calming, exploring, or regulating oneself. Marsha Linehan made it part of Dialectical Behavioral Therapy because it helped her chronically suicidal clients stay present with their emotions long enough to recognize and tolerate them. For those overwhelmed by dysphoria, mindfulness can be like the difference between watching a football game from the 50-yard line, and being tackled and trampled by players on the field.

Exposure, naturally, is the key intervention in Edna Foa’s prolonged exposure therapy, which is the U.S. military’s treatment of choice for Post-Traumatic Stress Disorder. This article tells how Sgt. Richard Low, a veteran of 280 combat missions in Iraq, recovered from PTSD symptoms with help from Sudarshan Kriya yoga:

When he came back from the service, he didn’t think his experience affected him in any major way. He had nightmares, and he startled easily, but he chalked that up to just something veterans live with.

Then he enrolled in a study he initially wrote off as “just some hippie thing,” where he learned about yoga breathing and meditation. A year later, Low, 30, sums up his experience with two words: “It works.”

Heads-up to tough guys of the world: Mindfulness is not just a hippie thing. It’s also a Shaolin Monk thing.

[i] Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010 Apr;78(2):169-83.

[ii] Evans S, Ferrandoa S, Findlera M, Stowella C, Smart C, Haglina D. Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, Volume 22, Issue 4, May 2008, Pages 716-721. (doi:10.1016/j.janxdis.2007.07.005)

[iii] Hanstede M, Gidron Y, Nyklíček, I. The Effects of a Mindfulness Intervention on Obsessive-Compulsive Symptoms in a Non-Clinical Student Population. Journal of Nervous & Mental Disease: October 2008 – Volume 196 – Issue 10 – pp 776-779 (doi: 10.1097/NMD.0b013e31818786b8)

[iv] Ljótsson B, Andréewitch S, Hedman E, Rück C, Andersson G, Lindefors N. Exposure and mindfulness based therapy for irritable bowel syndrome–an open pilot study. Journal of Behavior Therapy and Experimental Psychiatry. 2010 Sep;41 (3):185-90. Epub 2010 Jan 7.

[v] Treanor, M. The potential impact of mindfulness on exposure and extinction learning in anxiety disorders. Clinical Psychology Review, Volume 31, Issue 4, June 2011, Pages 617-625

[vi] Shapiro S, Carlson L, Astin J, Freedman B. Mechanisms of mindfulness. Journal of Clinical Psychology, March 2006, Volume 62, Issue 3, pages 373–386.