Published on April 14, 2008
Medical Applicationsof Mindfulness Meditation: Medical Applications of Mindfulness Meditation Thanh V. Huynh, M.D. JAB School of Medicine University of Hawaii Slide3: Cultivating the body Cultivating the Mind: Meditation (Bhavana) Concentration and Mindfulness: Concentration and Mindfulness Concentration: One-pointedness of mind which is absorbed in a chosen physical object (the breath, light, sounds…) or mental object (Mantra or prayers). Mindfulness: Dynamic moment to moment choiceless awareness of the most obvious object (real life experience). What is Mindfulness?: What is Mindfulness? Mindfulness is the non-judging attention to observe present time life experiences as they really are. It is associated with patience and acceptance, without expectation of outcome, without clinging to the pleasant experience or rejecting the unpleasant one. Slide6: Mindfulness is a beautiful or wholesome mental factor that coexists only with other beautiful mental qualities in the particular moment that it is present. Metaphore: Metaphore Mindfulness is like a torch in a dark night clarifying the path we are following Four Aspects of Mindfulness:: Four Aspects of Mindfulness: Body: the breath, postures, movements and physical sensations. Feeling tone (pleasant, unpleasant, neutral). Mind (consciousness): thoughts, mental states, emotions. Mental contents CONCEPT AND REALITY: CONCEPT AND REALITY Concept: the apparent form; what we conventionally name or perceive through our preconceived ideas which is colored by our past experience or misconception. Reality: How things really are at the “cellular/microscopic” level of perception through mindful awareness: the four physical elements, the true characteristics of life which is a stream of continuously changing mind/body process. Benefits of Mindfulness: Benefits of Mindfulness By embracing all life experiences, whether pleasant or unpleasant, one develops insights into the true nature of life (changing, unsatisfactory and impersonal), having more patience and acceptance. One therefore acts with clarity of mind rather than reacts and encounters less stress, more joy and inner peace. Medical Applications: Medical Applications Results of your search: mindfulness.m_titl. Viewing 1-25 of 131 Results Go to #: 1. Chatzisarantis NL. Hagger MS. Mindfulness and the intention-behavior relationship within the theory of planned behavior. [Journal Article] Personality & Social Psychology Bulletin. 33(5):663-76, 2007 May. UI: 17440208 Authors Full Name Chatzisarantis, Nikos L D. Hagger, Martin S. | 2. Berking M. von Kanel M. [Mindfulness training as a psychotherapeutic tool. Clarification of concept, clinical application and current state of empirical research]. [Review] [71 refs] [German] [English Abstract. Journal Article. Review] Psychotherapie, Psychosomatik, Medizinische Psychologie. 57(3-4):170-7, 2007 Mar-Apr. At HML online--see E-Journals web pages UI: 17427100 Authors Full Name Berking, Matthias. von Kanel, Miriam. | 3. Horton-Deutsch S. O'Haver Day P. Haight R. Babin-Nelson M. Enhancing mental health services to bone marrow transplant recipients through a mindfulness-based therapeutic intervention. [Journal Article. Research Support, Non-U.S. Gov't] Complementary Therapies in Clinical Practice. 13(2):110-5, 2007 May. UI: 17400146 Authors Full Name Horton-Deutsch, Sara. O'Haver Day, Pamela. Haight, Regina. Babin-Nelson, Michele. | 4. Gregg JA. Callaghan GM. Hayes SC. Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. [Journal Article. Randomized Controlled Trial] Journal of Consulting & Clinical Psychology. 75(2):336-43, 2007 Apr. UI: 17469891 Authors Full Name Gregg, Jennifer A. Callaghan, Glenn M. Hayes, Steven C. Glenn-Lawson, June L. | 5. Santorelli SF. Mindfulness and medicine. Interview by Bonnie J. Horrigan. [Interview] Explore-The Journal of Science & Healing. 3(2):136-44, 2007 Mar-Apr. UI: 17362849 Authors Full Name Santorelli, Saki F. | 6. Kingston J. Chadwick P. Meron D. Skinner TC. A pilot randomized control trial investigating the effect of mindfulness practice on pain tolerance, psychological well-being, and physiological activity. [Comparative Study. Journal Article. Randomized Controlled Trial] Journal of Psychosomatic Research. 62(3):297-300, 2007 Mar. At HML online--see E-Journals web pages UI: 17324679 Authors Full Name Kingston, Jessica. Chadwick, Paul. Meron, Daniel. Skinner, T Chas. | 7. Jain S. Shapiro SL. Swanick S. Roesch SC. Mills PJ. Bell I. Schwartz GE. A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction. [Comparative Study. Journal Article. Randomized Controlled Trial. Research Support, Non-U.S. Gov't] Annals of Behavioral Medicine. 33(1):11-21, 2007 Feb. UI: 17291166 Authors Full Name Jain, Shamini. Shapiro, Shauna L. Swanick, Summer. Roesch, Scott C. Mills, Paul J. Bell, Iris. Schwartz, Gary E R. | 8. Silverman J. Mindfulness meditation and public health. [Journal Article] Connecticut Medicine. 71(1):35, 2007 Jan. UI: 17288105 Authors Full Name Silverman, Joel. | 9. Davis JM. Fleming MF. Bonus KA. Baker TB. A pilot study on mindfulness based stress reduction for smokers. [Journal Article. Research Support, N.I.H., Extramural] BMC Complementary & Alternative Medicine. 7:2, 2007. UI: 17254362 Authors Full Name Davis, James M. Fleming, Michael F. Bonus, Katherine A. Baker, Timothy B. | 10. Issel LM. Right and left brain of health administration: experiments and mindfulness. [Journal Article] Health Care Management Review. 32(1):1, 2007 Jan-Mar. At HML in print--see Library Holdings UI: 17245196 Authors Full Name Issel, L Michele. | 11. Ditto B. Eclache M. Goldman N. Short-term autonomic and cardiovascular effects of mindfulness body scan meditation. [Journal Article. Research Support, Non-U.S. Gov't] Annals of Behavioral Medicine. 32(3):227-34, 2006 Dec. UI: 17107296 Authors Full Name Ditto, Blaine. Eclache, Marie. Goldman, Natalie. | 12. Abercrombie PD. Zamora A. Korn AP. Lessons learned: providing a mindfulness-based stress reduction program for low-income multiethnic women with abnormal pap smears. [Journal Article] Holistic Nursing Practice. 21(1):26-34, 2007 Jan-Feb. UI: 17167329 Authors Full Name Abercrombie, Priscilla D. Zamora, Anita. Korn, Abner P. | 13. Sephton SE. Salmon P. Weissbecker I. Ulmer C. Floyd A. Hoover K. Studts JL. Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: results of a randomized clinical trial. [Journal Article. Randomized Controlled Trial. Research Support, Non-U.S. Gov't] Arthritis & Rheumatism. 57(1):77-85, 2007 Feb 15. At HML in print--see Library Holdings, At HML online--see E-Journals web pages UI: 17266067 Authors Full Name Sephton, Sandra E. Salmon, Paul. Weissbecker, Inka. Ulmer, Christi. Floyd, Andrea. Hoover, Katherine. Studts, Jamie L. | 14. Arch JJ. Craske MG. Mechanisms of mindfulness: emotion regulation following a focused breathing induction. [Journal Article. Randomized Controlled Trial] Behaviour Research & Therapy. 44(12):1849-58, 2006 Dec. At HML online--see E-Journals web pages UI: 16460668 Authors Full Name Arch, Joanna J. Craske, Michelle G. | Slide12: Serious research on TM (Transcendental Meditation) first appeared in the scientific literature about three decades ago, and inspired, as listed on PsycINFO, 147 articles from 1973 to 1982 (during this time, 88 studies focused on Zen and mindfulness). In the present decade (1993-2002), mindfulness research has been on the rise, with over 140 articles to date (75 for TM). Mindfulness-based stress reduction and health benefits A meta-analysis Paul Grossman, a, , , Ludger Niemannb, Stefan Schmidtc and Harald Walachc, d J Psychosom Res. 2004 Jul;57(1):35-43.: Mindfulness-based stress reduction and health benefits A meta-analysis Paul Grossman, a, , , Ludger Niemannb, Stefan Schmidtc and Harald Walachc, d J Psychosom Res. 2004 Jul;57(1):35-43. Slide14: Table 2. Mean effect size, d, 95% confidence intervals (CIs) and P values (two-tailed) calculated for the difference between mindfulness meditation and control group on mental health and physical health variables for all controlled studies Slide15: Table 3. Effect of mindfulness training based on a pre–post comparison for mental and physical health variables (k, number of studies; N, number of subjects; d, mean effect size; P value, two-tailed) Case Presentation: Case Presentation Nine-year-old Victoria had been struggling with nausea and epigastric pain caused by gastroesophageal reflux (GER) for many months. When initial medical treatment failed and her symptoms worsened, an endoscopy was performed. As a result of the biopsy and pathology findings, different medications were prescribed. The new medications offered little relief from the nausea and vomiting, and Victoria was experiencing anxiety about her condition that was manifested in sleep disturbance. Her gastroenterologist and primary nurse felt she could benefit from complementary care intervention. Victoria, accompanied by her mother, was referred for a nonpharmacological intervention. Mindfulness meditation played an important role in the treatment of Victoria's plan for pain and symptom management. Slide17: Over time, Victoria was surprised to learn, through self-observation and being mindful of her experience, that there were physical changes that she experienced before feeling sick. With continued practice, she became more aware of her bodily sensations and developed keen observational skills. Victoria found mindfulness meditation and the body scan effective interventions for the distress she experienced. She was able to decrease the amount of medication she required and at the same time experienced a decrease in physical symptoms. Once again she was able to sleep peacefully and wake well rested. She also discovered that when she took a couple minutes to breathe before taking tests in school, it helped her to calm down and think better - an unexpected benefit. Slide18: A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction. Jain S, Shapiro SL, Swanick S, Roesch SC, Mills PJ, Bell I, Schwartz GE. Ann Behav Med. 2007 Feb;33(1):11-21 Slide19: Compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress. Slide20: Mindfulness-based stress reduction as an adjunct to outpatient psychotherapy. Weiss M, Nordlie JW, Siegel EP Psychother Psychosom. 2005;74(2):108-12. Slide21: The MBSR group's gains on a novel measure of goal achievement were significantly greater than those of the comparison group. In addition, the MBSR group terminated therapy at a significantly greater rate than the comparison group Chronic Pain: Chronic Pain Kabat-Zinn, J., Lipworth, L., Burney, R. and Sellers, W. Four year follow-up of a meditation-based program for the self-regulation of chronic pain: Treatment outcomes and compliance. Clin. J. Pain (1986) 2:159-173. Abstract: 225 chronic pain patients were studied following training in mindfulness meditation. Large and significant overall improvements were recorded post-intervention in physical and psychological status. These gains were maintained at follow-up in the majority of subjects. Follow-up times ranged from 2.5 to 48 months The impact of a meditation-based stress reduction program on fibromyalgia.Kaplan KH, Goldenberg DL, Galvin-Nadeau M.Arthritis-Fibromyalgia Center, Newton Wellesley Hospital, Massachusetts.: The impact of a meditation-based stress reduction program on fibromyalgia. Kaplan KH, Goldenberg DL, Galvin-Nadeau M. Arthritis-Fibromyalgia Center, Newton Wellesley Hospital, Massachusetts. 77 patients meeting the 1990 criteria of the American College of Rheumatology for fibromyalgia took part in a 10-week group outpatient program. Outcome measures included visual analog scales to measure global well-being, pain, sleep, fatigue, and feeling refreshed in the morning 51% showed moderate to marked improvement Psoriasis: Psoriasis Kabat-Zinn, J., Wheeler, E., Light, T., Skillings, A., Scharf, M.S., Cropley, T.G., Hosmer, D. and Bernhard, J. Influence of a mindfulness-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosomat Med (1998) 60:625-632. Thirty-seven patients were randomly assigned to one of two conditions: a mindfulness meditation-based stress reduction intervention guided by audiotaped instructions during light treatments, or a control condition consisting of the light treatments alone Conclusions: A brief mindfulness meditation-based stress reduction intervention delivered by audiotape during ultraviolet light therapy can increase the rate of resolution of psoriatic lesions (the meditators cleared at approximately four times the rate of controlled subjects) . Mindfulness meditation to reduce symptoms after organ transplant: a pilot study.Gross CR, Kreitzer MJ, Russas V, Treesak C, Frazier PA, Hertz MI.College of Pharmacy and School of Nursing, University of Minnesota, USA.: Mindfulness meditation to reduce symptoms after organ transplant: a pilot study. Gross CR, Kreitzer MJ, Russas V, Treesak C, Frazier PA, Hertz MI. College of Pharmacy and School of Nursing, University of Minnesota, USA. Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer OutpatientsCarlson, Linda E. PhD; Speca, Michael PsyD; Patel, Kamala D. PhD; Goodey, Eileen MSW: Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Carlson, Linda E. PhD; Speca, Michael PsyD; Patel, Kamala D. PhD; Goodey, Eileen MSW Forty-nine (49) patients with breast cancer and 10 with prostate cancer participated in an 8-week MBSR program. Demographic and health behavior variables, quality of life (EORTC QLQ C-30), mood (POMS), stress (SOSI), and counts of NK, NKT, B, T total, T helper, and T cytotoxic cells, as well as NK and T cell production of TNF, IFN-[gamma], IL-4, and IL-10 were assessed pre- and post-intervention Slide31: Results: Significant improvements were seen in overall quality of life, symptoms of stress, and sleep quality. T cell production of IL-4 increased and IFN-[gamma] decreased, whereas NK cell production of IL-10 decreased. These results are consistent with a shift in immune profile from one associated with depressive symptoms to a more normal profile. Alterations in Brain and Immune Function Produced by Mindfulness Meditation.Davidson, Richard J. PhD; Kabat-Zinn, Jon PhD; Schumacher, Jessica MS; Rosenkranz, Melissa BA; Muller, Daniel MD, PhD; Santorelli, Saki F. EdD; Urbanowski, Ferris MA; Harrington, Anne PhD; Bonus, Katherine MA; Sheridan, John F. PhD: Alterations in Brain and Immune Function Produced by Mindfulness Meditation. Davidson, Richard J. PhD; Kabat-Zinn, Jon PhD; Schumacher, Jessica MS; Rosenkranz, Melissa BA; Muller, Daniel MD, PhD; Santorelli, Saki F. EdD; Urbanowski, Ferris MA; Harrington, Anne PhD; Bonus, Katherine MA; Sheridan, John F. PhD Brain electrical activity was measured before and immediately after, and then 4 months after an 8-week training program in mindfulness meditation. Twenty-five subjects were tested in the meditation group. A wait-list control group (N = 16) was tested at the same points in time as the meditators. At the end of the 8-week period, subjects in both groups were vaccinated with influenza vaccine. . Slide33: The mindfulness group (compared with the wait-list control group) displayed significant increases in left-sided anterior activation (previously associated with positive affect) and increases in antibody titers to influenza vaccine Mean trait anxiety from the Spielberger State-Trait Anxiety Inventory : Mean trait anxiety from the Spielberger State-Trait Anxiety Inventory Means ± SE antibody rise from the 3- to 5-week to the 8- to 9-week: Means ± SE antibody rise from the 3- to 5-week to the 8- to 9-week Scatter plot for the meditation group only showing the relation between the change in asymmetric anterior activation at baseline from Time 1 to Time 2 in C3/C4 and the magnitude of rise in antibody titers to the influenza vaccine from the week 3 to 5 to the week 8 to 9: Scatter plot for the meditation group only showing the relation between the change in asymmetric anterior activation at baseline from Time 1 to Time 2 in C3/C4 and the magnitude of rise in antibody titers to the influenza vaccine from the week 3 to 5 to the week 8 to 9 Slide37: Neural Correlates of Dispositional Mindfulness During Affect Labeling From the Department of Psychology (J.D.C., B.M.W., M.D.L.) and Cousins Center for Psychoneuroimmunology (N.I.E.), University of California, Los Angeles, Los Angeles, California. Slide38: Results: Dispositional mindfulness was associated with greater widespread prefrontal cortical activation, and reduced bilateral amygdala activity during affect labeling, compared with the gender labeling control task. Strong dissociations were found between areas of prefrontal cortex and right amygdala responses in participants high in mindfulness but not in participants low in mindfulness. Mindfulness in Medicine and Law and Sports: Mindfulness in Medicine and Law and Sports Medicine In the medical field, the University of Massachusetts Medical Center has used mindfulness practice for over twenty-five years. Founded by Dr. Jon Kabat-Zinn, the Center for Mindfulness in Medicine, Health Care and Society, has been instructing patients, doctors, medical students and a host of others in mindfulness practice to reduce suffering and enhance the quality of their lives. The program's success has lead to its replication in over 240 medical institutions around the world. Law The legal profession has also found great use for mindfulness practice. Harvard Law School's Program on Negotiation sponsored the seminar "Mindfulness in the Law and Alternative Dispute Resolution" in 2002 in response to Professor Leonard Riskin's influential paper "The Contemplative Lawyer" (link: www.law.missouri.edu/csdr/contempl_lawyer.htm) published in the Harvard Negotiation Law Review. Mindfulness programs have been taught to students, professors of Harvard, Yale, Stanford and Columbia Law Schools, Boalt Hall of UC Berkeley, the University of Missouri-Columbia (www.law.missouri.edu/csdr/mindfulness.htm) and Pepperdine University as well as practicing lawyers and judges from around the nation. Professional Sports Mindfulness practice has also been used to great success in professional sports. Former Chicago Bulls Coach Phil Jackson, now of the Los Angeles Lakers, (see his book: Sacred Hoops) has used mindfulness practice in basketball training for many years. Olympic athletes like US Gold Medalist Speed skater Apolo Ohno and golf star Tiger Woods have also employed mindfulness practice as part of their training. Effects of mindfulness-based stress reduction on medical and premedical students.Shapiro SL, Schwartz GE, Bonner G.Department of Psychology, University of Arizona, Tucson 85719, USA.The inability to cope successfully with the enormous stress of medical education may lead to a cascade of consequences at both a personal and professional level.A short-term effects of an 8-week meditation-based stress reduction intervention on premedical and medical students using a well-controlled statistical design.Findings indicate that participation in the intervention can effectively (1) reduce self-reported state and trait anxiety, (2) reduce reports of overall psychological distress including depression, (3) increase scores on overall empathy levels, and (4) increase scores on a measure of spiritual experiences assessed at termination of intervention.: Effects of mindfulness-based stress reduction on medical and premedical students. Shapiro SL, Schwartz GE, Bonner G. Department of Psychology, University of Arizona, Tucson 85719, USA. The inability to cope successfully with the enormous stress of medical education may lead to a cascade of consequences at both a personal and professional level. A short-term effects of an 8-week meditation-based stress reduction intervention on premedical and medical students using a well-controlled statistical design. Findings indicate that participation in the intervention can effectively (1) reduce self-reported state and trait anxiety, (2) reduce reports of overall psychological distress including depression, (3) increase scores on overall empathy levels, and (4) increase scores on a measure of spiritual experiences assessed at termination of intervention. Slide43: Feedback from a Hawaiian intermediate school student after a brief introduction to Mindfulness: “…I really enjoyed the message that you sent to us. It taught me a lot about how to take life as it comes. It was a great way to be mindful of myself. It really is starting to help me because I’m becoming less stressed about everything. I also really enjoyed the “Breathe in Breathe out” song. The food activity with the pretzel helped me to understand that once you eat the food it will soon become a part of me. I always mindfully enjoy what I do daily… Love,“ Kahala. Study Title: A Feasibility Study of Online Mindfulness Meditation For Newly Diagnosed Cancer PatientsStudy Coordinator: Carolyn Gotay, PhD (psychology), Professor, University of Hawaii Cancer Research Center of HawaiiStudy Team: Brian Issell, MD (medical oncology), Thanh Huynh, MD (radiation oncology): Study Title: A Feasibility Study of Online Mindfulness Meditation For Newly Diagnosed Cancer Patients Study Coordinator: Carolyn Gotay, PhD (psychology), Professor, University of Hawaii Cancer Research Center of Hawaii Study Team: Brian Issell, MD (medical oncology), Thanh Huynh, MD (radiation oncology) Supported by: Developmental Funds, Cancer Research Center of Hawaii Primary Study Objective: To examine the feasibility of a web-based mindfulness intervention for patients beginning chemotherapy or radiation therapy Study Summary: The target sample size of 15 was achieved. To date, exit interviews have been completed with the 11 patients who have completed the intervention (four are currently in the midst of the program). . Ten of 11 patients reported many positive benefits due to participation, including stress reduction, relaxation, easing pain, and counteracting negative feelings. Ten said that they would recommend it to other cancer survivors, and nine said they would continue MM practice after the study conclusion. Attitude of Practicing Mindfulness: Attitude of Practicing Mindfulness Preparing the soil: Non Harming commitments. Non-expectation. Relaxed, persisting joyous interest. Formal and informal practice in daily life.