Meditation Programs for Psychological Stress and Well-being

En metaanalyse av studier på meditasjonsprogrammer. Konkluderer med at effekten er såpass stor og viktig at leger bør prate med sine pasienter om meditasjon.

http://archinte.jamanetwork.com/article.aspx?articleid=1809754

Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months), depression (0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months), and pain (0.33 [0.03- 0.62]) and low evidence of improved stress/distress and mental health–related quality of life.

Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress.

Reviews to date report a small to moderate effect of mindfulness and mantra meditation techniques in reducing emotional symptoms (eg, anxiety, depression, and stress) and improving physical symptoms (eg, pain).7– 26

Among the 9 RCTs43,44,47,54,55,63,64,73,74 evaluating the effect on pain, we found moderate evidence that mindfulness-based stress reduction reduces pain severity to a small degree when compared with a nonspecific active control, yielding an ES of 0.33 from the meta-analysis. This effect is variable across painful conditions and is based on the results of 4 trials, of which 2 were conducted in patients with musculoskeletal pain,55,64 1 trial in patients with irritable bowel syndrome,43 and 1 trial in a population without pain.44 Visceral pain had a large and statistically significant relative 30% improvement in pain severity, whereas musculoskeletal pain showed 5% to 8% improvements that were considered nonsignificant.

Pain Sensitivity and Analgesic Effects of Mindful States in Zen Meditators: A Cross-Sectional Study

Nevner hvordan smerteopplevelse blir mindre med meditasjon, men viser også til at det sannsynligvis er pustefrekvensen som gir den smertestillende effekten. Pluss den nevner hvordan frontallappen bidrar med smertestillende opioider.

http://www.psychosomaticmedicine.org/content/71/1/106.long

These results indicated that Zen meditators have lower pain sensitivity and experience analgesic effects during mindful states. Results may reflect cognitive/self-regulatory skills related to the concept of mindfulness and/or altered respiratory patterns.

Mindfulness can be described as an equanimous state of observation of one’s own immediate and ongoing experience.

Mindfulness has been described as “intentional self-regulation of attention from moment to moment … of a constantly changing field of objects … to include, ultimately, all physical and mental events….” (5). Furthermore, an attitude of acceptance toward any and all experience is stressed. Traditional accounts of mental and emotional transformation accompanying mindful practice (6,7) are supported by scientific findings of psychological and biological effects on practitioners (8–10) and patients (5,11–15).

Mindfulness-based therapies have reported success treating anxiety (11,15), obsessive compulsive disorder (13), and depression (12,14). Positive correlations between meditation experience of Buddhist monks and positive affect (10) have been reported. Increases in positive affect have also been observed in a longitudinal study in which naïve subjects were trained to meditate (8).

It is well known that cognitive manipulations, such as hypnosis, attention, expectancy or placebo, can influence the experience of pain and the associated neurophysiological activity (17–19). There is also mounting evidence that mindfulness may be effective in treating chronic pain.

Significant positive improvements were found on all measures immediately after the 10-week training program. However, follow-up evaluation showed stable improvements on most measures with the exception of present moment pain. The authors interpreted the results as the acquisition of an effective coping strategy for pain, where the pain itself did not change but the relation or stance taken toward the pain was positively altered.

Changes in pain were further examined in relationship to meditation training. The amount of meditation experience of individual practitioners predicted the degree of pain intensity modulation (i.e., versus baseline) with more hours of experience leading to greater reductions in pain intensity during the mindfulness condition [r(9) = −.82, p< .01].

Notably, pain modulation induced by mindfulness (relative to baseline-1) was correlated with the corresponding changes in respiratory rate across all subjects [intensity: r(23) = .37, p = .03; unpleasantness: r(23) = .42, p = .02]. Furthermore, the significant decrease in pain intensity reported above in the meditators during the mindfulness condition relative to baseline-1 (Figure 2) did not reach significance after including the changes in respiration as a covariate [F(1,11) = 3.02, p = .11]. In contrast, the significant increase in pain intensity reported by the control subjects in the concentration condition remained significant after accounting for changes in respiratory rates [F(1,11) = 20.94, p = .001]. These effects suggest that the changes in pain induced by mindfulness, but not concentration, may be at least partly accounted for by changes in respiration.

The main findings are the following:

  • 1) Meditators required hotter temperatures than controls to experience moderate pain.
  • 2) As hypothesized, meditators experienced less pain while attending mindfully, whereas control subjects did not show such modulation.
  • 3) Unexpectedly, analgesic effects of mindfulness were more clear on the sensory dimension of pain (i.e., perceived intensity) than the affective dimension of pain (i.e., pain unpleasantness), although effects were observed in the same direction.
  • 4) The magnitude of the analgesic effect of mindfulness was predicted by the number of hours of meditation practice in meditators.
  • 5) When attention was directed toward the stimulation, with no mention of attending mindfully, control subjects showed the expected increase in pain intensity and unpleasantness whereas meditators did not differ from baseline.
  • 6) Physiologically, meditators had slower breathing rates than controls, consistent with their self-assessed reduced reactivity. Importantly, changes in respiratory rate predicted the changes in felt pain and the analgesic effect of mindfulness states was no longer significant after accounting for changes in respiratory rates (covariance).
  • 7) On a mindfulness scale, meditators scored higher on the tendency to be observant and nonreactive. Higher scores on these dimensions of mindfulness were further associated with lower pain sensitivity and slower respiratory rates.

Zen meditation was associated with lower pain sensitivity as demonstrated by the higher temperatures required to produce moderate pain. The observed difference (49.9°C versus 48.2°C) should be considered large as it typically corresponds to an increase of about 50% on a ratio scale of pain perception or 20 to 25 points on a 0 to 100 numerical pain scale, based on similar psychophysical methods (28,33).

While attending mindfully, the Zen practitioners showed reductions of 18% pain intensity. Remarkably, individuals with more extensive training experienced greater reduction in pain. This finding is extremely important as it suggests that the observed pain reduction may not simply reflect a predisposition to meditation (individual differences) but may also involve experience-dependent changes associated with practice. This is in line with other studies linking meditation training with mindfulness, medical symptoms, and well-being (16); attention performance, anxiety, depression, anger, cortisol and immunoreactivity (34); an inverted U-shaped function of attention-related brain activity (35); electrophysiological markers of positive affect (10); positive affect and stronger immune responses (8); and cortical thickness and gray matter density (9,36,37).

The analgesic effects of mindful attention may relate to the physiological state induced as suggested by the respiration data. Overall, the meditators breathed at a slower rate than control subjects in all conditions and their mean respiratory pattern followed that of their pain ratings. In contrast, respiratory rate did not change noticeably across conditions in the control subjects. Slower breathing rates (typically meditators) were associated with less reactivity and with lower pain sensitivity. These relationships suggested that the meditators were in a more relaxed, nonreactive physiological state throughout the study, which culminated in the mindfulness condition and which influenced the degree to which they experienced pain.

The covariance analysis suggested that this analgesic effect could be mediated at least in part by the observed change in respiration.

A neuro-chemical model of meditation put forth by Newberg and Iversen (47) offers a possible explanation for our results. Meditation practice, involving volitional regulation of attention, seems to activate prefrontal cortex (35,48,49); this has been observed during Zen practice (50). Increases in prefrontal activation can stimulate the production of b-endorphin (e.g., in the arcuate nucleus of the hypothalamus) (47). B-endorphin is an opiate associated with both analgesia and a reduction in respiratory rate as well as decreases in fear and increases in joy and euphoria (47). Interestingly, the direction of attention toward breathing and the volitional control of breathing rates are part of many meditative techniques; however, causation can obviously not be inferred from those observations.

Another related possibility is that meditation leads to reductions in stress and stress-related chemicals, such as cortisol which interact with the opiate system. A reduction of cortisol can greatly enhance the binding potential/efficacy of endogenous opioids (27), possibly contributing to a downregulation of nociceptive responses. Studies have reported evidence of reduced cortisol responses in meditators (34,52,53).

YOGA OF PSYCHIC HEAT (GTUM-MO) RESEARCH TECHNIQUES AND RESULTS

En russisk artikkel fra en forsker som har interessante teorier om tummo og varmegenereringen. Spesielt det som skjer i lungenes blod hvor fettsyrer forbrennes og dermed skaper varme. Forfatteren nevner at kolestrolnivået synker etter bare 10 minutter med tummo. Interessante teorier som er verdt å undersøke videre, men fullstendig umulig å bruke denne artikkelen som vitenskapelig grunnlag.

http://www.worldscientists.ru/psychology-and-pedagogy/38-yoga-of-psychic-heat-gtum-mo-research-techniques-and-results.html

«Technique of inner fire awakening is described in Yoga Kundalini Upanishad as follows: “When Apana on its way up reaches the place of fire then fire awaken by the wind inflates and grows. Then Prana itself ignites with the came fire and then fire overwhelms all body with continuous burning”»

«In the 50-ies of the 20th century K.S. Trincher, the physiologist, proved it and published his monograph Heat-Generating Function and Alkalinity of Pulmonary Tissue Response [13] in which he stated that under some conditions human lungs could perform not only respiratory but also non-respiratory functions. In particular, non-fermentative blood lipids peroxidation could take place in lungs. Energy releasing reaction of aerobic lipids peroxidation results in significant alteration of thermodynamic characteristics of the body.»

«First experiment was taken in March, 2004. During experiment venous blood sampling was taken after which Tummo was practiced during 10 minutes. Then repeated venous blood sampling was taken. Blood was analyzed for blood lipids. The analyses revealed cholesterol, lipoproteins and triglycerides quantity reduction. It was found that the author’s total cholesterol was 6.54 mmole/l before practice and 6.14 mmole/l after practice (N 3.6 – 5.2).»

«»

Neurocognitive and Somatic Components of Temperature Increases during g-Tummo Meditation

Viktig studie om tummo som oppklarerer flere misforståelser og beskriver mange aspekter som tidligere ikke er beskrevet. Nevner bl.a. at vestlige også kan øke sin kroppstemperatur med disse teknikkene.

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0058244

«Reliable increases in axillary temperature from normal to slight or moderate fever zone (up to 38.3°C) were observed among meditators only during the Forceful Breath type of g-tummo meditation accompanied by increases in alpha, beta, and gamma power.»

«Overall, the results suggest that specific aspects of the g-tummo technique might help non-meditators learn how to regulate their body temperature, which has implications for improving health and regulating cognitive performance.»

«The authors reported that three g-tummo meditators showed a dramatic increase of up to 8.3°C in peripheral body temperature (fingers and toes), more modest skin temperature increases of 1.9°C in the navel and lumbar regions, and no increase in rectal temperature. Unfortunately, these findings have subsequently been distorted in reports in other sources, possibly due to confusion between Fahrenheit and Centigrade scales or lack of clear specification regarding the anatomical sites of temperature measurement, leading to general claims of temperature increases during g-tummo ranging from “… up to 15 degrees only within a few moments of concentration” [3] to “17 degrees in peripheral body temperature” [8]

«The visual effect of steaming sheets reported by eye-witnesses of the g-tummo ceremony cannot be taken as evidence of elevated body temperature. Wet sheets wrapped around a practitioner’s body would steam and dry due to the significant temperature difference between the wet sheets (heated by a human body) and the cold air outside, even if the practitioners simply maintain their normal body temperature.»

«Furthermore, they did not exceed the peripheral body temperature increases reported in clinical studies of (non-meditating) individuals who were able to increase hand or finger temperature by up to 11.7°C during biofeedback alone or in combination with hypnosis, mental imagery, or autogenic training[9][11]. Subsequent clinical research, however, reported that such peripheral temperature increases were primarily mediated by somatic (e.g., altered respiration and/or tensing and contracting of muscles) but not cognitive factors [12]

«The g-tummo practice involves both somatic and neurocognitive components. The somatic component involves specialized breathing techniques as well as isometric exercises (i.e. exercises performed in static positions, rather than incorporating a range of motion) involving muscle tensing and contraction. The neurocognitive component involves meditative visualization requiring the generation and maintenance of mental images of flames at specific locations in the body accompanied by intense sensations of bodily heat in the spine.»

«Recent studies report that raising body temperature might be an effective way to boost immunity and treat infectious diseases and immunodeficiencies [13][15] as well as to induce synaptic plasticity in the hippocampus [16]. It has been long recognized that increased body temperature (in the zone of a slight fever) is associated with higher alertness, faster reaction time, and better cognitive performance on tasks such as visual attention and working memory [17][19]. »

«Some, but not all, of these monasteries test their practitioners’ capabilities at the end of a three-year retreat with a ceremony where the practitioners dry wet sheets. As a testament to the importance of the g-tummo practice at Gebchak nunnery, this ceremony is held annually, at dawn, and all of the experienced practitioners walk slowly for a few hours around the nunnery complex in −25°C to −30°C weather, wearing only short skirts and shoes and a wet sheet draped around their naked torsos.»

«The g-tummo practice is characterized by a special breathing technique, “the vase”, accompanied by isometric muscle contractions, where after inhalation, during a period of holding their breath (apnea), the practitioners contract both abdominal and pelvic muscles so that the protruding lower belly takes the shape of a vase or pot [1]

Tilsvarerer akselereringsfasen i vårt tummo konsept.
«FB is forceful and vigorous, while GB is gentle and without any strain. Whereas the goal of FB is to raise “psychic heat”, the goal of GB is to maintain it. During FB, attention is focused on visualizing a rising flame that starts below the navel and with each breath rises up to the crown of the head, whereas GB is accompanied by visualization of the entire body being filled with a surging sensation of bliss and heat.»

Man kan enkelt måle kjernetemperatur selg med termometer i armhulen eller munnen.
«We recorded EEG activity of the meditators as well as their peripheral (left fifth finger) and core body temperature (left armpit) during g-tummo practices»
«Although not as precise as an internally taken rectal or oral measurement of core body temperature [20], axillary measurements are less intrusive. Importantly, they are not affected by muscle contractions (e.g., anal sphincter), or the airflow through the mouth, during the vase breathing.»

«The results indicated peripheral (finger) temperature increases between 1.2°C to 6.8°C during different conditions»

«During BFB, the maximum CBT increase was 1.14°C (participant #3) and the maximum temperature reached was 37.45°C (participant #4).»
«The maximum CBT increase from the beginning of the experiment to the end of MFB was 2.2°C (participant #3), and the maximum temperature reached was 38.30°C (participant #5).»


«Figure 3. CBT increases for Study 1 participants #1, #3, and #4 during BFB, BGB, MFB, and MGB performed in a continuous sequence.
Since the duration of each of the four practices varied from participant to participant, to simplify the figure presentation, the duration of each practice is rescaled from 0 to 1, with t0 the starting point of each practice, and t1 the ending point.»

«During FB (either BFB or MFB), participants’ CBTs typically exhibited a step-like pattern, with a period of steady temperature increase followed by a plateau or equilibrium phase corresponding to the “temperature saturation point”, above which the participants were not able to raise their CBT further despite their efforts to continue with FB. This pattern of CBT increases is very similar to that usually observed during induction of systemic hyperthermia (i.e., deliberate heating of a patient’s body to achieve an elevated core temperature for therapeutic purposes), where the equilibrium phase indicates the beginning of heat losses due to physiological mechanisms (e.g. vasodilation, evaporation) limiting the rate of heating that can be achieved, and thus protecting the body from excessively high temperatures [22]


«we defined the rise time (ΔTr) as the time taken for the CBT to rise from 10% to 90% of its final value »

«In summary, the results suggest that although CBT increases during BFB were not as dramatic as during MFB, participants were able to produce body heat, utilizing only the somatic component of the FB practice (breathing and isometric techniques). However, the meditators were able to reach an elevated CBT, significantly above the normal axillary temperature, only during MFB practice. As for GB practice, consistent with practitioners’ reports that it is used to maintain (but not to increase) body heat, no significant changes in participants’ CBT were observed during either GB baseline or meditation.»

«Furthermore, the higher the increases in alpha power developed by participants during FB meditation, the larger their increases in CBT during FB meditation, while the CBT increases during BFB were achieved without any changes in alpha power. This suggests that different mechanisms may be affecting CBT increases during MFB versus BFB, and that meditative visualization characterized by significant increases in alpha power might uniquely contribute to overall CBT increases beyond the contribution of the vase breathing technique.»

«In summary, our findings indicate that the two parameters, apnea duration and increases in alpha power achieved during meditative visualization are significant predictors of the overall CBT increases during FB practice. The apnea duration is significantly related to the rate of CBT increase. The increase in alpha power developed during FB meditation is related to the CBT rise time, that is, it predicts how long the meditators are capable of sustaining their CBT increases without reaching equilibrium.»

«The average initial CBT of all the participants before BFB was 36.38°C (SD = 0.23), while the average temperature at the end of BFB reached 36.99°C (SD = 0.13), only marginally above the normal axillary temperature of 36.6°C in the healthy population [one sample two-tailed t(10) = 2.02, p = 0.07]. The maximum CBT reached during BFB was 37.02°C. «

«The average apnea duration of the participants was 30.38 sec (SD = 6.35), ranging from 19 to 41 sec; the apnea duration correlated with the rate of CBT increase during BFB: r = 0.60, p = 0.050.»

«all the Western non-meditator participants returned to their baseline CBT during the next 20 minutes. This is in contrast to Tibetan practitioners performing GB (Study 1) who did not show any decreases in their CBTs during either BGB or MGB (δ = 0.011°C/min and δ = 0.002°C/min respectively), and were able to maintain an elevated body temperature throughout the whole duration of MGB (on average 21.50 min). This further confirms that the GB practice facilitates maintenance of body temperature.»


«Figure 7. CBT increases during FB as performed by a Western non-meditator and a Western g-tummo practitioner.»

«In summary, the results of Study 2 indicate that the BFB technique brings about significant increases in CBTs not only in meditators but also in those individuals who do not have any prior experience in meditation. »

«As for the increased gamma activity observed during FB meditation, studies on meditation consider it a signature of “samadhi” (deep meditative states of consciousness), but the regions of increase have varied, with recent studies reporting in some cases a frontally distributed increase in gamma [28], and in other cases an increase in gamma at posterior and occipital electrodes [29]. »

«In the case of FB meditation, one of the possible mechanisms preventing heat loss could be the mental imagery of flames and heat. Indeed, previous research has regarded mental imagery as a potentially effective technique in influencing peripheral body temperature, blood flow, and local vasodilation [38][41]. »

«If future studies show that it is possible to self regulate CBT, by mastering vase breathing in conjunction with guided mental imagery without extensive meditation experience, it will open a wide range of possible medical and behavior interventions, such as adapting to and functioning in hostile (cold) environments, improving resistance to infections, boosting cognitive performance by speeding response time, and reducing performance problems associated with decreased body temperature as reported in human factor studies of shift work and continuous night operations[44], [45]

The effects of slow breathing on affective responses to pain stimuli: an experimental study.

Viktig studie om pustens regulering av smerte som nevner at å senke pustefrekvens demper smerte betraktelig for frisk mennesker, men hos Fibromyalgi er det ikke nok i seg selv som smertedemping.

http://www.ncbi.nlm.nih.gov/pubmed/20079569

Dropbox link: https://dl.dropboxusercontent.com/u/17457302/Forskning%20mappe%20for%20terapi/STUDIE%20-%20The%20effect%20of%20slow%20breathing%20on%20affective%20responses%20to%20pain%20stimul.pdf
Dropbox link til kommentar om fibromyalgi: https://dl.dropboxusercontent.com/u/17457302/Forskning%20mappe%20for%20terapi/Respiration-induced%20hypoalgesia%20-%20%20Additional%20evidence%20for%20pain%20modulation%20deficits%20in%20fibromyalgia.pdf

«M and HC were exposed to low and moderate thermal pain pulses during paced breathing at their normal rate and one-half their normal rate. »

«Participants who reported higher levels of trait positive affect prior to the experiment showed greater decreases in negative affect as a result of slow versus normal breathing.  »

«FM patients and normal controls were instructed to breathe at either their normal rate or 1/2 that rate during four blocks of four trials.  »

«An inspection of resting breathing rates for the two groups revealed no differences between groups: an average rate of 13.68 (SD = 3.54) breaths per minute for FM patients, and 13.63 (SD = 2.17) for HCs.  »

Skjermbilde 2013-05-12 kl. 11.31.28

«These findings are consistent with those of an observational investigation, which found lower breathing rates were associated with reduced pain intensity and unpleasant- ness ratings when participants meditated while receiving pulses of painful heat [12]. »

«Since all participants were administered trials where pain was administered, the potential benefit of interventions that include the practice of meditation in the treatment of pain patients is sup- ported. However, the mixed findings for FM patients give us pause. It may be more difficult to engender states of relaxation needed to endure pain in FM patients through slow paced breathing alone. »

«Taken together these findings are consistent with the model of pain as a homeostatic emotion. In this model, the neurophysiologi- cal processes that underlie how slow breathing influences pain begins with the increased bronchiopulmonary afferent activity. This activity produces increased activation in the left mid-insula and anterior insula [24], as well as increased activation in the left anterior cingulate associated directly with increased heart rate variability [18], corresponding with a shift in sympathovagal tone. This activation counterbalances the acute activation in the right anterior insula produced by painful stimulation [2] by virtue of opnent interaction [4].»

«The findings indicate that a slower breathing rate is a useful target in interventions for patients in pain. Reductions in pain and negative affect may be ex- pected when people are guided to halve their respiration rate.  »

«However, for FM patients, the data suggest that med- itative breathing alone is insufficient. Clinical interventions that address positive affective disregulation, appear necessary to assist FM patients in the management of their chronic pain. «

Acute increases in night-time plasma melatonin levels following a period of meditation

Viser hvordan melatonin øker om kvelden etter en meditasjonsøkt. Melatonin er viktig for mange ting i kroppen. Det er best kjent som et søvnhormon, men det er også kroppens «master restitution hormone».

http://www.ncbi.nlm.nih.gov/pubmed/10876066

http://www.sciencedirect.com/science/article/pii/S0301051100000351

» It is concluded that meditation, at least in the two forms studied here, can affect plasma melatonin levels. It remains to be determined whether this is achieved through decreased hepatic metabolism of the hormone or via a direct effect on pineal physiology.»