Mindfulness and meditation dampen down inflammation genes

Meditation and tai chi don’t just calm the mind – they seem to affect our DNA too | New Scientist

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There’s evidence that such “mind-body practices” dampen the activity of genes associated with inflammation – essentially reversing molecular damage caused by stress.

Mind-body practices such as mindfulness meditation are widely claimed to protect against stress-related diseases from arthritis to dementia. But although there’s plenty of evidence that they can relieve stress, the scientific case for physical health benefits has not yet been proven.

Recent advances mean it’s now easier to study patterns of gene activity inside cells, and there has been growing interest in using this approach to investigate how nurturing inner peace might influence the immune system and disease risk.

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A head start with mindfulness

Don’t dismiss the meditation technique as a fad: its well documented benefits for those in demanding careers make a strong case for teaching it at university, says Craig Hassed | Times Higher Education

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Mindfulness is a hot topic these days, but its potential importance to higher education has not yet been broadly recognised. It can be described as a form of meditation and a way of living. It is a mental discipline that involves not only sharpening present-moment attention but also cultivating the attitude with which we pay attention: one of curiosity, acceptance, openness and compassion.

Mindfulness is easily marginalised by hard-nosed academic disciplines, and its mischaracterisation as a mere relaxation exercise means that its utility is commonly overlooked in the training of professionals such as doctors, lawyers and chief executives. Yet mounting evidence since the turn of the millennium is becoming increasingly difficult to ignore.

The tidal wave began with studies into the effectiveness of mindfulness-based cognitive therapy (MBCT) in preventing the recurrence of depression. Subsequently, many further applications have been documented, including combating addictions, chronic pain and infertility.

Indeed, some see mindfulness as a panacea. The reality, though, is probably more complex. Like physical exercise, cultivating awareness is a basic human need, but not everyone will be ready to learn about it or want to do it. Mindfulness demands application and perseverance and is sometimes uncomfortable.

As well as improving their attention, mindfulness has many other benefits for future professionals. For example, a 2004 Australian study tracked the mental health of medical interns throughout their first year of working life. It found that 75 per cent had burnout by the eighth month, and 73 per cent had a diagnosable mental illness (mostly depression and/or anxiety) at least once. Furthermore, a British Medical Journal study in 2008 found that a doctor with depression makes more than six times as many medication and prescribing errors as a doctor without. Considering that medical errors are the third most common cause of death in the US, this points to a major deficiency in our training of professionals destined for demanding jobs. It can’t just be about transferring technical skills and knowledge; enhancing practitioners’ mental health and preventing errors should be seen as aligned objectives.

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Six mindfulness techniques for physicians

What goes through your mind in the moment before you walk into the room to see your next patient? A flurry of thoughts about all the patients you’ve already seen and the mountain of admin tasks you need to finish later today? | Medical News Today

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But what if you paused – for just 3 seconds – as you touch the door handle, took a breath to be present, and let go of all that has gone before and all that is ahead of you?

Everyone has time to do this, Ronald M. Epstein, M.D. – a professor of medicine at the University of Rochester in New York, a family and palliative care physician, and author of Attending: Medicine, Mindfulness, and Humanity – told Medical News Today.

He uses the “doorknob” example in the many international lectures he gives each year on mindfulness, but readily admits that he is as skeptical as the next doctor.

“I don’t like this touchy feely stuff. I am not a new age kind of person. I am very skeptical,” Dr. Epstein explained. “Some people say ‘I can’t stop my thoughts.’ Well, it’s not about stopping your thoughts – it’s about paying attention to them,” he noted.

For Dr. Epstein, mindfulness is a powerful tool for medical professionals in dealing with personal stress, being more compassionate, and reducing clinical errors.

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Digital Mindfulness Applications

There has been a rapid increase of interactive apps designed for health and well-being. Yet, little research has been published on developing frameworks for design and evaluation of digital mindfulness facilitating technologies | Journal of Medical Internet Research

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Background: Many existing digital mindfulness applications are purely software based. There is room for further exploration and assessment of designs that make more use of physical qualities of artifacts.

Objective: The study aimed to develop and test a new physical digital mindfulness prototype designed for stress reduction.

Methods: In this case study, we designed, developed, and evaluated HU, a physical digital mindfulness prototype designed for stress reduction. In the first phase, we used vapor and light to support mindful breathing and invited 25 participants through snowball sampling to test HU. In the second phase, we added sonification. We deployed a package of probes such as photos, diaries, and cards to collect data from users who explored HU in their homes. Thereafter, we evaluated our installation using both self-assessed stress levels and heart rate (HR) and heart rate variability (HRV) measures in a pilot study, in order to measure stress resilience effects. After the experiment, we performed a semistructured interview to reflect on HU and investigate the design of digital mindfulness apps for stress reduction.

Conclusions: Our evaluation of HU indicated that HU could facilitate relaxed breathing and stress reduction. There was a difference in outcome between the physiological measures of stress and the subjective reports of stress, as well as a large intervariability among study participants. Our conclusion is that the use of stress reduction tools should be customized and that the design work of mindfulness technology for stress reduction is a complex process, which requires cooperation of designers, HCI (Human-Computer Interaction) experts and clinicians.

Full reference: Zhu, B. et al. (2017) Designing, Prototyping and Evaluating Digital Mindfulness Applications: A Case Study of Mindful Breathing for Stress Reduction.
Journal of Medical Internet Research. 19(6):e197

The need for incorporating emotional intelligence and mindfulness training in modern medical education

Although the study of medicine and the tradition of medical students gaining clinical experience on hospital wards have not significantly changed over the years, the experience of physicians practicing in the current climate has changed dramatically | Postgraduate Medical Journal

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Physicians are confronted with increasing regulations aimed at improving quality of care and are often overwhelmed by their position in a tug-of-war between administrators, staff, colleagues and most importantly, patients. With more than half of the US physicians experiencing professional burnout, questions arise regarding their mental health and work-life balance. Blendon et al. reported an overall decline in the public’s confidence and trust in physicians, which may be explained by cultural changes as well as displeasure with medical leaders’ responses to healthcare needs. As the next generation of physicians emerges in this evolving healthcare environment, adaptation to new practices and regulations will be imperative. Emotional intelligence (EI) and mindfulness provide a possible solution to the struggles physicians will invariably face.

The term EI, which refers to a person’s ability to recognise, discriminate and label their own emotions and those of others, was coined by Salovey and Mayer and popularised by Goleman. Mindfulness is the process by which an individual actively observes his or her thoughts and feelings without judgement. With foundations in Eastern meditation, mindfulness is now an accepted method of stress reduction in Western culture.

Full reference: Shakir, H.J. et al. (2017) The need for incorporating emotional intelligence and mindfulness training in modern medical education. Postgraduate Medical. Journal Published Online First: 06 June 2017.

Integrating Mindfulness into Family Therapy with Adolescents

Individual and group-based psychotherapeutic interventions increasingly incorporate mindfulness-based principles and practices | Family Process

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These practices include a versatile set of skills such as labeling and attending to present-moment experiences, acting with awareness, and avoiding automatic reactivity. A primary motivation for integrating mindfulness into these therapies is compelling evidence that it enhances emotion regulation. Research also demonstrates that family relationships have a profound influence on emotion regulation capacities, which are central to family functioning and prosocial behavior more broadly. Despite this evidence, no framework exists to describe how mindfulness might integrate into family therapy.

This paper describes the benefits of mindfulness-based interventions, highlighting how and why informal mindfulness practices might enhance emotion regulation when integrated with family therapy. We provide a clinical framework for integrating mindfulness into family therapy, particularly as it applies to families with adolescents. A brief case example details sample methods showing how incorporating mindfulness practices into family therapy may enhance treatment outcomes. A range of assessment modalities from biological to behavioral demonstrates the breadth with which the benefits of a family-based mindfulness intervention might be evaluated.

Full reference: Brody, J.L. et al. (2017) A Conceptual Model and Clinical Framework for Integrating Mindfulness into Family Therapy with Adolescents.  Family Process. Published online: 7 June 2017

Relationship Between Mindfulness and Non-Suicidal Self-Injury

This research explored whether lack of mindfulness or problems in mindfulness are involved in self-injury.

Non-suicidal self-injury is a complex behaviour, disturbingly prevalent, difficult to treat and with possible adverse outcomes in the long term. Previous research has shown individuals most commonly self-injure to cope with overwhelming negative emotions. Mindfulness has been shown to be associated with emotion regulation, and mindfulness-based interventions have shown effectiveness in a wide range of psychological disorders.

Pairwise comparisons revealed current self-injurers reported significantly lower mindfulness than past self-injurers and non-self-injurers, with medium effect sizes of d = 0.51 and d = 0.77, respectively. In logistic regression, low mindfulness significantly predicted self-injury (B = 0.04, p < .001). These findings have clinical implications, suggesting that mindfulness-based interventions may assist individuals to give up self-injurious behaviours and may be an important part of prevention strategies.

Full reference: Caltabiano, G. & Martin, G. (2017) Mindless Suffering: the Relationship Between Mindfulness and Non-Suicidal Self-Injury. Mindfulness. 8(788)