Mindfullness, Cortisol and Stress

PTSD: Mindfulness Exercises Improve Symptoms, Cortisol Level

Norra MacReady

May 31, 2013

Mindfulness-based stretching and deep breathing exercises (MBX) may elicit symptom relief in intensive care unit nurses with posttraumatic stress disorder (PTSD), a new study shows.

PTSD is associated with disruption of the hypothalamic-pituitary-adrenal axis, Sang Hwan Kim, PhD, and colleagues write in an article published online May 29 in the Journal of Clinical Endocrinology and Metabolism. This change, characterized in part by abnormally low levels of cortisol, "is one of the distinct neuroendocrine profiles that differentiates PTSD from other mental illnesses," they write. Citing a study showing a high level of PTSD among intensive care unit nurses, because of the stressful and often traumatic nature of their work, the authors investigated the effect of low- to moderate-intensity exercise on regulation of basal cortisol levels in this population. They included a mindfulness component to help with cognitive function and emotional regulation.

The participants were recruited through advertisements at the University of New Mexico Hospital in Albuquerque. At baseline, each volunteer completed the PTSD Checklist-Civilian version (PCL-C), in which they rated 17 symptoms on a scale of 1 (not at all) to 5 (extremely). Participants scoring at least 28 in total or at least 3 on 1 or more individual items were considered positive for PTSD and randomly assigned to either the MBX or the control group.

The 8-week MBX intervention consisted of twice-weekly hour-long sessions that included stretching and balancing movements combined with breathing and a focus on mindfulness. The authors describe mindfulness as "a quality of consciousness that is associated with control of attention and awareness promoting a direct awareness of bodily movement, sensations, and surroundings, thus often inducing positive psychological and behavioral responses." There was no specific intervention for the control group.

Of 29 nurses who met the inclusion criteria, 22 had PTSD and were assigned to either the MBX or the control group. Seven volunteers without PTSD were placed in a healthy group (BASE) to provide comparison data for cortisol levels. The researchers measured serum cortisol in all 3 groups at baseline and at weeks 4 and 8 of the study. For the MBX group, they also measured it at week 16. PTSD symptoms also were assessed at baseline and at weeks 4, 8, and 16.

Twenty-eight women and 1 man enrolled in the study, with 11 participants each in the MBX and CON groups and 7 in the BASE group. One participant in the control group dropped out because of family issues.

At baseline, the mean PCL-C score in the MBX group was 43.1 (standard deviation [SD], 11.2); it was 42.6 (SD, 12.7) in the control group. The BASE group had a mean PCL-C score of 21.8 (SD, 3.4). At 8 weeks, the mean PCL-C score in the MBX group was 24.3 (SD, 3.3), for a difference of 18.8 points (95% confidence interval [CI], 11.7 - 25.9), or a 44% decrease. In the control group, the mean 8-week PCL-C score was 41.0 (SD, 16.3), for a decrease of 1.6 points (95% CI, −6.3 to 9.5), or 3.8%. The mean changes between the groups were statistically significant (P = .01).

Mean cortisol in the MBX group was 9.6 µg/dL at baseline (SD, 4.1) and 14.6 µg/dL (SD, 5.7) at 8 weeks, for an increase of 5.1 µg/dL (95% CI, 2.0 - 8.1 µg/dL). In the control group, mean cortisol at baseline was 12.9 µm/dL (SD, 6.9); it was 13.8 µg/dL (SD, 5.7) at 8 weeks, for an increase of 0.8 µm/dL (95% CI, −2.2 - 3.8 µg/dL; P = .01 for mean changes between the groups).

The researchers found that every unit increase in cortisol was associated with a mean decrease in PCL-C score of 0.75 points, "demonstrating that as PTSD symptoms improved cortisol levels normalized." The changes in the MBX group persisted at week 16.

"During the eight-week program, some participants reported that they experienced improved sleep, stress resilience, energy levels, and emotional regulation under stress, and a resumption of pleasurable activities which they had previously discontinued. At the end of the intervention, over half of the participants expressed a desire to continue," the authors write.

Study limitations include the small number of participants and a paucity of male participants, which might limit generalizability. Nonetheless, the authors conclude, "[c]onsidering that early intervention is critical in ameliorating the development of PTSD and that PTSD symptoms are strongly correlated with the degree of distress immediately following trauma, mind-body interventions such as MBX may provide an effective non-pharmacological treatment for individuals with PTSD symptoms."

The authors have disclosed no relevant financial relationships.

J Clin Endocrinol Metabol. Published online May 29, 2013. Abstract

Pouring

Pouring

By Lee Wedlake

The term “pouring” is a popular one used in describing how one transfers weight from one leg to the other when doing tai chi. I feel it’s a good one for getting the mental picture of just how that transfer occurs.

“Shifting” is ok but just does not quite illustrate how we want the change to occur. The word pouring describes a controlled moving of a fluid from one vessel to another. This bars our notions of pouring down rain or emotions verbally pouring forth since they impart the idea of an uncontrolled event. Using the thought of pouring water from a pitcher to a glass is much better.

We don’t dump the weight from one leg to the other, an equivalent of splashing. One who plods or stomps along is splashing their weight. The tai chi practitioner carefully, mindfully moves weight from one leg to the other in a slow, controlled manner. We know what it is like when a clumsy person attempts to fill a glass; missing, splashing or over-filling it. It’s not the picture of what we want to do when we step.

If we think of chi as a fluid, pouring is the perfect fit. As we move from posture to posture in our slow, controlled way, we transfer that fluid from one place to another without missing (not the right weight moving), splashing (stomping) or overflowing (too much going everywhere). Our goal is the perfect pour every time.

This takes time and thoughtful practice. One goal is developing the discipline to do this since it’s not prone to immediate and consistent results. In the long term we want the ability to unconsciously place the weight where we need it so that when our step is disturbed by catching a toe or an unstable or slick surface, our practice allows us to compensate in a flash. It’s the basis behind using tai chi for fall prevention.

Pouring, as a term, is a nice tool in getting our mind and body to work together in this process since it produces a valuable visual to work with. I’ve written of it in the context of shifting weight but the idea works with the whole body. Since the legs are the base for the rest of the body it stands to reason our focus will be there, particularly for beginners.

I believe we should do this with conscious efforts, the aforementioned mindfulness, to get the feel of how it works. As we progress we’ll make it more subconscious and be able to sense the movement of chi and later be able to direct it, should be we desire.

Until next time,

Lee    

More on Meditation from Harvard University

Meditation’s Effects on Emotion Shown to Persist

By TRACI PEDERSEN Associate News Editor
Reviewed by John M. Grohol, Psy.D. on June 23, 2013

Meditation affects a person’s brain function long after the act of meditation is over, according to new research.

“This is the first time meditation training has been shown to affect emotional processing in the brain outside of a meditative state,” said Gaelle Desbordes, Ph.D., a research fellow at the Athinoula A. Martinos Center for Biomedical Imaging at Massachusetts General Hospital and at the Boston University Center for Computational Neuroscience and Neural Technology.

“Overall, these results are consistent with the overarching hypothesis that meditation may result in enduring, beneficial changes in brain function, especially in the area of emotional processing.”

The researchers began the study with the hypothesis that meditation can help control emotional responses.

During meditation, a part of the brain called the amygdala (known for the processing of emotional stimuli) showed decreased activity. However, when the participants were shown images of other people that were either good, bad, or neutral for a practice known as “compassion meditation,” the amygdala was exceptionally responsive.

The subjects were able to focus their attention and greatly reduce their emotional reactions. And over an eight-week period, the participants retained this ability.

Even when they were not engaged in a meditative state, their emotional responses were subdued, and they experienced more compassion for others when faced with disturbing images.

Around the same time, another group at Harvard Medical School (HMS) began to study the effect of meditation on retaining information. Their hypothesis was that people who meditate have more control over alpha rhythm — a brain wave thought to screen out everyday distractions, allowing for more important information to be processed.

“Mindfulness meditation has been reported to enhance numerous mental abilities, including rapid memory recall,” said Catherine Kerr of the Martinos Center for Biomedical Imaging and the Osher Research Center, both at HMS.

“Our discovery that mindfulness meditators more quickly adjusted the brain wave that screens out distraction could explain their superior ability to rapidly remember and incorporate new facts.”

Both studies used participants that had no previous experience with meditation.

Over an eight-week period and a 12-week period, both groups showed a marked change in their daily normal brain function, while they were meditating and while they were involved in medial activities.

Some researchers believe that meditation might be the key to help ease off dependency on pharmaceutical drugs.

“The implications extend far beyond meditation,” said Kerr.

“They give us clues about possible ways to help people better regulate a brain rhythm that is deregulated in attention-deficit hyperactivity disorder and other conditions.”

Source:  Harvard University

Antioxidants

Comment from Doc Rowe on this article from the Journal of Physiology - My conclusion, when possible get your antioxidants from natural products, tea, spices, herbs, fruits and vegetables because the "package" is important and the body knows what to take and what to leave.  If you have an inflammatory condition such as  gout, chronic  viral infection, or arthritis supplements may be a helpful way to hold low grade chronic inflammation in check and suppress flares.

 

Antioxidants counteract benefits of exercise

A compound in red grapes, including red wine, has been shown to potentially counteract exercise benefits, research shows.

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In older men, a natural antioxidant compound found in red grapes and other plants – calledresveratrol – blocks many of the cardiovascular benefits of exercise, according to research published in The Journal of Physiology.

Resveratrol has received widespread attention as a possible anti-ageing compound and is now widely available as a dietary supplement; much has been made of its role in explaining the cardiovascular health benefits of red wine, and other foods.

But now, new research at The University of Copenhagen surprisingly suggests that eating a diet rich in antioxidants may actually counteract many of the health benefits of exercise, including reduced blood pressure and cholesterol.

Opposite effect

In contrast to earlier studies in animals in which resveratrol improved the cardiovascular benefits of exercise, this study in humans has provided surprising and strong evidence that in older men, resveratrol has the opposite effect.

What is emerging is a new view that antioxidants are not a fix for everything, and that some degree of oxidant stress may be necessary for the body to work correctly. This pivotal study suggests that reactive oxygen species, generally thought of as causing ageing and disease, may be a necessary signal that causes healthy adaptations in response to stresses like exercise. So too much of a good thing (like antioxidants in the diet) may actually be detrimental to our health.

Lasse Gliemann, a PhD student who worked on the study at The University of Copenhagen, explains how they conducted the research, and the results they found: "We studied 27 healthy, physically inactive men around 65 years old for eight weeks. During the 8 weeks all of the men performed high-intensity exercise training and half of the group received 250 mg of resveratrol daily, whereas the other group received a placebo pill (a pill containing no active ingredient). The study design was double-blinded, thus neither the subjects nor the investigators knew which participant that received either resveratrol or placebo.

"We found that exercise training was highly effective in improving cardiovascular health parameters, but resveratrol supplementation attenuated the positive effects of training on several parameters including blood pressure, plasma lipid concentrations and maximal oxygen uptake."

Ylva Hellsten, the leader of the project, says:"We were surprised to find that resveratrol supplementation in aged men blunts the positive effects of exercise training on cardiovascular health parameters, in part because our results contradict findings in animal studies.

"It should be noted that the quantities of resveratrol given in our research study are much higher than what could be obtained by intake of natural foods."

This research adds to the growing body of evidence questioning the positive effects of antioxidant supplementation in humans.

Michael Joyner, from The Mayo Clinic USA, says how the study has wider implications for research: "In addition to the surprising findings on exercise and resveratrol, this study shows the continuing need for mechanistic studies in humans. Too often human studies focus on large scale outcomes and clinical trials and not on understanding the basic biology of how we adapt."

 

This was sent to me by Doc Rowe.

Susan Smalley, PHD, is  a hard nosed researcher in genetics (Professor Emeritus, Department of Psychiatry and Biobehavioral Sciences at UCLA). She wrote this about herself as a scientist who had something happen to her ( a melanoma) and as a result she took time to look inside herself and it changed her life.

Why Mindfulness Matters

If someone asked me 13 years ago, if 'mindfulness matters' I would have said a resounding no, and then rolled my eyes at them for their 'new age' thinking. That was a time when I felt rational thought was the only means of understanding the nature of reality and applied it through my work as a scientist in genetics. One year later I had a freckle removed from my arm that proved to be an early stage melanoma, a disruption in my extremely busy life (raising three kids and being a prof at a major university). The deadliest form of skin cancer raised my stress level to high alert and I took a short leave of absence from the university to 'get well'. During that break, my brain had a bit of a reorganization as well and suddenly I was open to exploring anything and everything alternative that might help prevent cancer. Yoga, meditation, macrobiotic diet, shamans, etc. etc., I dove headfirst into an alternative world of healing. In it I suddenly discovered something beyond the physical healing I so desperately sought. I experienced a profound sense of our deep interconnected nature - what I called a 'oneness of theuniverse' - and with that arose a giant sense of compassion, joy, and bliss. Negative emotions of greed, envy, and anger couldn't find their way into this voluminous space of love. And, I found myself in the present moment, fully aware of the beauty in moment to moment experiences.

In the aftermath of that epiphany of sorts, I returned to the university and began to study meditation and other practices that invoke a state of mind comparable to what I had experienced. I discovered it was called mindfulness and that there was a growing body of research around it - spanning neuroscience, immunology, genetics, psychiatry and other fields. (sound familiar?)

So if you had asked me 10 years ago, 'why mindfulness matters', I would have told you because it has the power to heal oneself and help find authentic happiness.

Today, if you asked me why mindfulness matters, I would add to that sentiment one more thing, perhaps the most powerful reason to venture into the world of mindfulness. It is a means of discovering our interdependent or interconnected nature, to not only 'know' it from a lens of reason (i.e. genetics, ecology, psychology) but to experience it firsthand, to feel and know intuitively that we are 'one', all part of a unity that might be called evolution, humanity, or to those spiritually minded, some version of the concept of God.

I recently discovered an object of art that reflects this value of mindfulness visually and textually. It is a fishing vessel or vat from India created by Indian artist Subodh Gupta. The vessel is 65 feet in length and crammed with objects - fishing nets, an old television, tables, chairs, a bed, pots and pans, tea kettles, etc. - everything a single fisherman might collect in a lifetime. The title of the piece is 'what does the vessel contain, that the river does not', a quote from the Muslim poet Rumi in the 13th century. The river is the metaphor for the oneness that I experienced and we all may find through an awareness of consciousness, self, and the nature of reality from an intuitive experience. The boat represents an individual life and the collection of objects - life experiences - that are unique and a reflection of our single lifetimes.

But the saying implies that we are all a microcosm of the whole, as we each evolve and unfold, so too does our shared humanity, so too does our 'whole', our 'oneness'. As we evolve, we discover our own evolution. As we discover, we begin to know the constancy of the continuum of change itself, the river.

A.A. Milne - the author of Winnie the Pooh stories - understood this well. He saw the river as the metaphor for this constancy of knowledge, of understanding. He wrote,

Sometimes, if you stand on the bottom rail of a bridge and lean over to watch the river slipping slowly away beneath you, you will suddenly know everything there is to be known.

So take time to find a river and watch it flow. It may be realized in a practice of mindfulness of whatever sort - yoga, tai chi, meditation, reflection, pondering, sitting in silence, attending to the present with your full attention.

This is perhaps the greatest reason behind 'why mindfulness matters'.

Push hands for beginners

Push Hands

The well-known martial arts author, the late Robert W. Smith, said he thought “pushing hands” should be renamed as “sensing hands”.  It makes sense but I don’t think it caught on. Pushing hands is more commonly called push hands. It’s one of the three legs of the tai chi stool, the others being the form and the sword. If you’re unfamiliar, it’s the two-person applications done in a flow. One goal is to be able to unbalance a partner with the classic four-ounces of force. The purpose of this article is not to expound on all the aspects of doing push hands. Books have been written on the subject. It’s a basic explanation of what the reason for doing it is.

It’s probably not a good idea to be exposed to push hands right of the bat. One should become very familiar with the basics before moving to this. Traditionally the Oriental arts are taught with many months or even years of basic training before instruction in form or application. The Western society we live in wants results NOW and we tend to spend less time on those basics. This contributes to the frustration many of our students have but many will stick with it and trust their instructor to give them the “good stuff” when the time is right.

Time spent of getting the postures correct will pay off well in the push hands. Get the stance and Six Harmonies (fingers/toes, elbows/knees, shoulder/hip) right and there’s less of a challenge in learning and doing the push hands.

Al this is done “in the air”, meaning there is no physical body before you, no incoming forces to measure and deal with-and no ego other than your own. The story changes when these elements are presented.

The basics you learned in the practice of the form include four components you’ll need to start the drill. They are ward-off, roll-back, press and push. And that’s the order you normally do them in the form, so it’s ingrained. A challenge in the push hands is that the sequence gets changed, along with the side on which you do them. You’re likely used to doing roll-back with the right foot and right arm forward and applying the move. In the push hands you’ll have to do it right foot/left handed. This throws most people off, so don’t be alarmed if it “feels funny” and you’re not getting it right away.

My teacher, Tom Baeli, taught me there was a push hands form in which you practiced it in the same sequence as the applications as I wrote above. It helps. Yet, for many of us, having the body there can facilitate learning the sequences.

Be advised there is etiquette to starting the exercise and that is to allow the senior to choose whether to give or receive. For example, when I approach my teacher he either holds up his ward off, meaning I give with push, or he holds up his push and I receive with ward-off. You set your feet proportionally; front foot parallel to front foot and aligned so the toes are aimed at their rear foot. It makes a kind of box that you work within.

Know also that this is the hardest version to work with because you don’t get to move your feet to escape force. It forces you to deal with what’s there with limited tools and that’s an idea used in many systems. Once you get better at dealing with the movement and the variations to come, then you get to move your feet, as in real combat, and you start the Dance of Death, which what fights were called by some.

The presence of another human being “in your space” changes the context of what you’ve been practicing just to get here. Now you’re faced with handling incoming and outgoing energy, the probability of ego getting involved since some are more aggressive than others in this practice and dealing with the mental aspects of this sensory and emotional input. You will have to work on getting your timing and position right so you can handle the physical energies. You’ll be pushed off-balance often until you get it. That can be frustrating. How others interact with you and your energy is also key. You’ll find that everyone you push with has a different feel to them and that’s a huge value. Being a bit introspective about how you react, or don’t react, to that will teach you about yourself, too. Nobody says it’s easy but the payoff in increased confidence, physical and mental discipline and even more strength and flexibility can be substantial.

What you learn as a beginner in push hands should be done gently, with that “sensing hands” idea in mind. Using strength alone just intimidates, feeds the ego and generally produces poor technique. Competition push hands is a different animal and that’s not what we’re after right now. So hang in there, kid, you’ll be ok.

Until next time,

Lee Wedlake

The Theoretical Basis of Tai Chi Ch’uan by Robert Burns Amacker.

A serious book for a serious student.

I met Bob many years ago when he did a tai chi seminar at my studio in Florida. I was immediately impressed when he said “If you can’t throw a side kick, you’re not doing tai chi”. He’s a fighter. This book could not be written by someone with less years and experience. It’s technical and conceptual, and that means it’s not a quick read. It’s nicely chaptered and that makes it easier to absorb the related subjects. He starts with defining “the Principle” and moves to yielding, adherence, discharge, the civil and martial tai chi and more. This is not a book for the dabbler.
He only had 150 printed, hardbound and they even have a gold fabric bookmark. I hate to tease you but I don’t know where you can get one, Bob sent a copy to me. He says it may appear in e-book form on Amazon.