Meditation as an Effective Method for Reducing Stress

Meditation as an Effective Method for Reducing Stress

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  MEDITATION AND STRESSREDUCTION PSYC347 ASSESSMENT AND INTERVENTION TAN MENG CHUAN, UOW ID: 4886628
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  Before We Begin •Experiential laboratory • Multiple stimuli • Notice where your attention is placed • Notice how fast your attention moves • End of session: What’s your experience?
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  Getting present •While youwere waiting…How stressed are you? •Quick exercise: Take 20 seconds and think of nothing. How far did you get before you had a thought?
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  Contents • Getting Present •Stress • Definitions • Classes • Meditation • Definitions • Types • Mechanisms and Rationale • Important Procedural Guidelines • Applications • Efficacy • Side Effects & Contraindications
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  Stress: Definitions • Thenon-specific response of the body to any demand for change (Selye, 1936) • State of psychological and/or physiological imbalance when the perceived demands are greater than the perceived resources to meet those demands (McGonigal, 2015)
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  Stress: Classes Acute EpisodicChronic Positive or negative, short term Stress as a way of life Never-ending, inescapable stress Dangerous, unhealthy Irritation, headache Type A personality Difficulties sleeping, frequent fatigue
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  Stress: Interventions Psychological BehaviouralLifestyle Alternatives Reframing Positive thinking Assertiveness Get organised Ventilation Humour Diversion and distraction Diet Cease smoking and alcohol Exercise Sleep Leisure Relaxation (Retail therapy) Conventional medicine Counselling and psychotherapy Relaxation Meditation Yoga Acupuncture Aromatherapy Herbalism Biofeedback Hypnotherapy Massage Reflexology
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  Meditation: Definitions • Theact or process of spending time in quiet thought (Merriam- Webster) • A practice where an individual trains the mind or induces a mode of consciousness, either to realise some benefit or for the mind to simply acknowledge its content without becoming identified with that content, or as an end in itself (Wikipedia) • The intentional self-regulation of attention, in the service of self-inquiry, in the here and now (Albeniz, 2000)
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  Meditation: Definitions • Methodsand States definitions • Methods: Meditation as a family of mental training techniques • States: Meditation by reference to the enhanced experiential states or altered states of consciousness which arise from the uses of these methods • Functional model: Meditation should encompass (Cardoso et al, 2004): • The use of a specific (clearly defined) technique • Muscle relaxation in some moment of the process • Logic relaxation • It must necessarily be a self-induced state • The use of “self-focus” skill
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  Meditation: Definitions • Processmodel (Nash and Newberg, 2013): • Meditation is an engagement of the process intended to be inclusive of several different possibilities, with the intention of attaining an enhanced mental state.
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  Meditation: types Insight-Oriented Concentrative Key Characteristics Canbe done anywhere Stay present in the moment Maintain alertness, awareness in a non-judgemental way. Just observe. Expand awareness from single-pointed to encompass external stimuli which arise Sometimes using breath as tools to return to a mindful state of attention Sit comfortably in silence Center attention by focusing mental awareness on a preselected object or process, always coming back to anchor Narrow awareness to a single-pointed consciousness Disengage usual mental processes Avoiding cognitive analysis or fantasy Analogy Searchlight Laser light beam Intended Effects Greater awareness of and insight into the personal conditioning of our minds and an understanding of the nature of mind itself Stability, calmness, unruffled mind Detached from emotional and interpersonal involvement Heightened awareness Mindfulness - the self-regulation of attention, providing a continuous moment-to-moment awareness of subjective experience, in a non-judgemental and accepting way (Zabat-Zinn, 1994) Slows down the speed and control the amount of thoughts that go through the mind
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  Mindfulness-Based Stress Reduction (MBSR) Transcendental Meditation(TM) Historical roots Buddhist tradition Vedic tradition Main personalities John Kabat-Zinn, 1970s Maharashi Mahesh Yogi, mid 1950 About Insight-oriented, Mindfulness Passive attention, open monitoring Concentrative: Mantra Automatic self-transcendence Effortless, settling the mind naturally EEG signals Theta brain waves – readiness to process incoming signals Alpha brain waves – relaxation Goals To have thought be on the present moment Transcending thought to experience a state of “pure awareness”, without an object of thought Practices Mindfulness meditation, Body scanning, Simple yoga postures Mantra meditation 15-20 minutes twice a day, eyes closed Program 8-week course taught by certified instructors with group meetings, homework, retreat One-on-one instruction Variety of programs: Transcendental Meditation Technique, TM-Sidhi program
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  Meditation: types • Morethan 100 types and variations • Virtually all involve a combination of approaches • Fundamentally: • Focused attention • Concept of self-observation • In the here and now • Acceptance of process rather than content • Enhanced mental state (mindfulness, awareness, calmness, transcendence. etc.)
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  Meditation: Mechanisms andRationale Physiological • Efficient functioning of the natural compensatory responses within the autonomic nervous system • Meditation intentionally activates calming responses of the Parasympathetic Nervous System • Increased cortical thickness (sensory, emotional) • Improved processing of emotionally salient material and adaptive decision making • Improved immune functions • Stronger physiological resilience • Reduced physiological arousal during stressful times
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  Meditation: Mechanisms andRationale Psychological • Hozel et al (2011) • Enhanced self-regulation • Attention regulation • Body awareness • Emotion regulation • Change in perspective on the self • Gu et al (2015) • Greater mindfulness • Reduction in repetitive negative thinking (worry and rumination) • Rumination: tendency to dwell on negative thoughts related to one’s condition • Reduction in cognitive and emotional reactivity • Extent to which a mild state of stress coupled with stress reactivates negative thinking and emotional patterns
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  Meditation: Applications • Withdifferent populations • Non-clinical • Clinical • In clinical settings • As adjunct to psychotherapies • In everyday settings • In personal lives • In corporate settings • In school settings
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  Meditation: Efficacy [Psychological measure] •Hoseman (2015) • Compared two types of meditators against non-meditators, non-clinical population • Australian public, n=695 • Freiburg Mindfulness Inventory and Perceived Stress Test Group n M Mindfulness (SD) M Stress (SD) Insight-Oriented 158 44.20 (6.19) 16.99 (5.95) Concentrative 158 42.84 (6.19) 17.67 (7.27) Non-meditators 158 35.29 (6.74) 25.62 (7.95)
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  Meditation: Efficacy [Psychological measure] •Paul, Elam & Verhulst (2007) • Deep Breathing Meditation on academic stresses • Medical students, n=64 • Survey on perceptions on stress Survey Questions Pretest M (SD) Posttest M (SD) Follow Up 8-months M (SD) Experience test anxiety 6.3 (2.25) 4.92 (2.09) 3.97 (2.27) Become nervous during exams 5.98 (2.31) 4.67 (2.0) 3.83 (2.22) Have self-doubt during exams 6.16 (2.29) 5.19 (2.32) 4.16 (2.23)
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  Meditation: Efficacy [PhysiologicalMeasure] • Turakitwanakan, Mekseepralard & Busarakumtragul (2013) • Mindfulness meditation on cortisol levels • Stress hormone • Chemical mediator to stress response • Second year medical students, n=30 • Significantly lower levels • This suggests that mindfulness meditation can lower stress, and decrease risk of diseases arising from stress • Recommends use in combination with standard treatment
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  Meditation: Efficacy [Physiological, PsychologicalMeasures] • Nidich et al (2009) • Transcendental Meditation vs wait- list control on psychological distress, coping and blood pressure • University students, n=298 • Randomized Controlled Trial • Decrease in blood pressure associated with decreased psychological distress and increased coping
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  Meditation: Efficacy [Meta-Analyses] • Khoury,Sharma, Rush & Fournier, 2015 • 29 studies, n=2668, healthy non-clinical population • Mindfulness-based Stress Reduction had a large reduction in stress, moderate effects on clinical measures of depression and anxiety • Mindfulness a central component of treatment effectiveness • Clinicians can recommend standard MBSR programs to reduce stress, distress, anxiety and depression and to increase quality of life regardless whether patients meet diagnostic criteria for a mental disorder.
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  Meditation: Efficacy [Meta-Analyses] • Goyalet al, 2014 • 47 studies, n=3515, clinical populations • Meditation programs can reduce negative dimensions of psychological stress • Mindfulness meditation programs show small improvements in anxiety, depression, and pain with moderate evidence and small improvements in stress/distress • Mantra meditation programs did not improve any of the outcomes, but the strength of this evidence varied from low to insufficient • No evidence of harm of meditation programs
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  Meditation: Efficacy • Thebigger picture: Strong but yet to be conclusive • Issues with many studies: • Small population → Lack strong statistical power • Heterogeneity in populations, application, variables and assessments • Long-term nature of meditation practices
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  Meditation: Side Effects& Contraindications • Relaxation-induced anxiety and panic • Paradoxical increases in tension • Less motivation in life • Boredom • Pain • Impaired reality testing • Confusion and disorientation • Feeling spaced out • Depression • Increased negativity • Being more judgmental • Feeling addicted to meditation • Feelings of defencelessness • Avoidance of real issues • Unpleasant affective experiences: fear, anger, apprehension, despair • Sobbing and hidden memories and themes from the past • Uncomfortable kinaesthetic sensation • Mild dissociation • Feelings of guilt • Via anxiety-provoking phenomena • psychosis-like symptoms • grandiosity • elation • destructive behaviour • suicidal feelings
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  Meditation: Side Effects& Contraindications • Shapiro, 1994 • Psychosis • Schizoid and schizotypal personality • Dissociative states • Hypochondrial and somatization disorders
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  Meditation: Important Procedural Guidelines •Importance of apprising clients of side-effects and destabilisation • Design client-oriented meditative exercises • Encourage prolonged periods of practice • Increase client motivation
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  Meditation: Important Procedural Guidelines •Monitor and support ego strength or emotional resilience • Distinguish between temporary discomfort and fragmentation of sense • Consider meditation as an adjunct to psychotherapy • Therapist credentials
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  Conclusion • Strong evidencefor effectiveness • Heterogeneity • Generally safe, but risks • Long-term nature • Increasing applications • Stand alone or adjunct
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  Bibliography • Barnes, V.A., Treiber, F. A., & Davis, H. (2001). Impact of Transcendental Meditation® on cardiovascular function at rest and during acute stress in adolescents with high normal blood pressure. Journal of psychosomatic research, 51(4), 597-605. • Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. The journal of alternative and complementary medicine, 15(5), 593-600. • Creswell, J. D., Pacilio, L. E., Lindsay, E. K., & Brown, K. W. (2014). Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress. Psychoneuroendocrinology, 44, 1-12. • Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., ... & Ranasinghe, P. D. (2014). Meditation programs for psychological stress and well-being: a systematic review and meta- analysis.JAMA internal medicine, 174(3), 357-368. • Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta- analysis of mediation studies. Clinical psychology review, 37, 1-12. • Hosemans, D. (2015). Meditation: a Process of Cultivating Enhanced Well-Being. Mindfulness, 6(2), 338-347.
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  Bibliography • Hölzel, B.K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective.Perspectives on Psychological Science, 6(6), 537-559. • Jain, S., Shapiro, S. L., Swanick, S., Roesch, S. C., Mills, P. J., Bell, I., & Schwartz, G. E. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction. Annals of behavioral medicine, 33(1), 11-21. • Kang, Y. S., Choi, S. Y., & Ryu, E. (2009). The effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. Nurse education today, 29(5), 538-543. • Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical psychology review, 31(6), 1041-1056. • Khoury, B., Sharma, M., Rush, S. E., & Fournier, C. (2015). Mindfulness-based stress reduction for healthy individuals: a meta-analysis. Journal of psychosomatic research, 78(6), 519-528. • Koszycki, D., Benger, M., Shlik, J., & Bradwejn, J. (2007). Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder. Behaviour Research and Therapy, 45(10), 2518-2526.
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  Bibliography • Lazar, S.W., Kerr, C. E., Wasserman, R. H., Gray, J. R., Greve, D. N., Treadway, M. T., ... & Rauch, S. L. (2005). Meditation experience is associated with increased cortical thickness. Neuroreport, 16(17), 1893. • Lee, S. H., Ahn, S. C., Lee, Y. J., Choi, T. K., Yook, K. H., & Suh, S. Y. (2007). Effectiveness of a meditation-based stress management program as an adjunct to pharmacotherapy in patients with anxiety disorder. Journal of Psychosomatic Research, 62(2), 189-195. • Nash, Jonathan D and Newberg, MD, Andrew B., "Toward a unifying taxonomy and definition for meditation." (2013). Jefferson Myrna Brind Center of Integration Medicine Faculty Papers. Paper 11. http://jdc.jefferson.edu/jmbcimfp/11 • Nidich, S. I., Rainforth, M. V., Haaga, D. A., Hagelin, J., Salerno, J. W., Travis, F., ... & Schneider, R. H. (2009). A randomized controlled trial on effects of the Transcendental Meditation program on blood pressure, psychological distress, and coping in young adults. American journal of hypertension, 22(12), 1326-1331. • Oman, D., Shapiro, S. L., Thoresen, C. E., Plante, T. G., & Flinders, T. (2008). Meditation lowers stress and supports forgiveness among college students: A randomized controlled trial. Journal of American College Health,56(5), 569-578. • Perez-De-Albeniz, A., & Holmes, J. (2000). Meditation: concepts, effects and uses in therapy. International Journal of Psychotherapy, 5(1), 49-58.
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  Bibliography • Paul, G.,Elam, B., & Verhulst, S. J. (2007). A longitudinal study of students' perceptions of using deep breathing meditation to reduce testing stresses.Teaching and learning in medicine, 19(3), 287-292. • Rosenzweig, S., Reibel, D. K., Greeson, J. M., Brainard, G. C., & Hojat, M. (2003). Mindfulness-based stress reduction lowers psychological distress in medical students. Teaching and learning in medicine, 15(2), 88-92. • Sedlmeier, P., Eberth, J., Schwarz, M., Zimmermann, D., Haarig, F., Jaeger, S., & Kunze, S. (2012). The psychological effects of meditation: A meta-analysis. Psychological bulletin, 138(6), 1139. • Simkin, D. R., & Black, N. B. (2014). Meditation and mindfulness in clinical practice. Child and adolescent psychiatric clinics of North America, 23(3), 487-534. • Turakitwanakan, W., Mekseepralard, C., & Busarakumtragul, P. (2013). Effects of mindfulness meditation on serum cortisol of medical students.Journal of the Medical Association of Thailand= Chotmaihet thangphaet, 96, S90-5.
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