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Behavioral Science, Complementary Medicine, Events, Stanford News

His Holiness the 17th Karmapa discusses the nature of compassion

20150317-CCARE-17th-Karmapa-7343When he was taken from his village in eastern Tibet at age 7 after being identified as a religious leader, His Holiness the 17th Karmapa didn’t have aspirations to become a world-renowned spiritual leader. “My first thought was this new position would give me many more opportunities to play and many more friends to play with,” His Holiness said Tuesday, in one of his first appearances on a two-month tour of the United States.

Now 29, he certainly attracted many “friends” Tuesday; fans and followers packed Stanford’s sizable Memorial Hall for the evening talk. Though his English is quite good, His Holiness used an interpreter to tell tales of his childhood and escape to India at age 14 and to share his thoughts on the nature of compassion and hopes for the protection of the environment.

He told the audience that he learned about compassion early, while living with his parents and siblings in a one-room tent made of yak hair. Every morning, his parents prayed — “May all sentient beings be happy” — again in the evening, they prayed. And they taught him about the interdependence of all beings — even insects could not be smashed. “I really feel I was raised in a mandala, or circle, of compassion and love,” he said.

Even the way his parents gave him up, letting him leave to pursue his future as a spiritual leader, was altruistic, His Holiness said. “They embraced the idea the Karmapa would accomplish great, excellent benefits for the world.”

His Holiness said he has come to learn that compassion is all about thinking about the feelings, and interests, of others. “It’s all about developing a sense of responsibility in relation to the reality of interdependence,” he said, before elaborating:

 I think what compassion involves is not just looking at our own situation, but considering  the state or reality of other sentient beings, those similar to us and those dissimilar to us… and developing a concern for those people.

Compassion involves realizing that our experience of happiness and suffering is the same as everyone else’s. Compassion has this component of awareness to it and knowledge that everyone is wanting to be happy and free of suffering.

For example, His Holiness said he is hoping to teach others in Himalayan monasteries about the importance of caring for the environment. “Compassion means becoming more involved,” he said.

He explained that his passion for the environment stems from his experience growing up in rural Tibet, which he said was beautiful and unaffected by development or pollution. “If I were to return to Tibet, the sad thought occurs to me that maybe things wouldn’t be as beautiful as I remember,” he said.

Though there’s much work to do to protect the environment, and “the actions of one individual are not going to be enough,” he said he still believes “it’s really important for individuals to take up the cause.”

The event was sponsored by the Center for Compassion and Altrusim Research at Stanford and was followed by a Q&A session with James Doty, MD, center founder and director.

Previously: The Dalai Lama talks business, compassion and happiness, Dalai Lama and Stanford researchers explore the science of compassion and altruism and Buddhist teacher Jack Cornfield on practicing “sensitivity to now”  
Photo by Christopher Wesselman

Complementary Medicine, In the News, Mental Health, Neuroscience, Research

An oasis of peace in “the 500 channel universe”: Research on mindfulness and depression

An oasis of peace in "the 500 channel universe": Research on mindfulness and depression

1135112859_45dc222725_zEarlier this month, the American Psychological Association issued a feature on mindfulness and depression, highlighting research that suggests mindfulness is an effective way to ameliorate and treat mood disorders, particularly recurrent depression. Some of the featured research suggests a strong neurological basis for the association.

Zindel Segal, PhD, a psychologist at the University of Toronto who is quoted in the article and who was on the three-person team that created Mindfulness-Based Cognitive Therapy (MBCT), wonders if all the attention mindfulness is now receiving is part of a backlash against “the 500 channel universe” of distractions in modern society. It’s not a pill that can be taken and done with, though – it’s a restructuring of mental attitude that requires maintenance. Through MBCT, people learn to pay attention to sensations and feelings rather than evaluative thoughts.

The studies in the review suggest that MBCT works at least as well as medication to prevent recurrence, that it is effective for peri-natal depression, and that it may work especially well for people with histories of relapse or depression stemming from childhood. A brief prepared for the Department of Veterans Affairs found that mindfulness approaches were most effective against depression compared to other health conditions.

I found the neuroscience particularly interesting: Part of the reason for MBCT’s effectiveness may be that practicing mindfulness increases connectivity and tissue density in certain areas of the brain. This is a classic example of neuroplasticity – the idea that neurological pathways can adapt and change throughout one’s life.

Norman Farb, PhD, a neuroscientist at the University of Toronto, distinguishes two forms of self-reference that activate different areas of the brain: extended/narrative self-reference, which links experiences across time, and momentary/experiential self-reference, which is centered on the present. Mindfulness exercises emphasize the present, in contrast with destructive narrative patterns of thought common in those suffering from stress, anxiety, and depression. In Farb’s study, fMRI results show that regular mindfulness practice strengthens areas of the brain that focus on the moment. It suggests that although we habitually integrate these two forms of self-reference, they can be neurally dissociated through attentional training.

Neural differences may have effects even when someone is not actively engaging in mindfulness: A study led by Veronique Taylor at the University of Montreal showed that the experienced meditators has less activity in narrative self-referential areas than novice meditators even in a resting state. Another study led by Harvard University neuroscientist Sara Lazar, PhD, showed that over the course of an 8-week mindfulness stress reduction program, the gray matter in participants’ amygdala shrank in density, while density increased in areas related to sustained attention and emotion regulation. The amygdala is implicated in anxiety as well as depression, which correlates with the finding that the participants’ stress levels decreased.

According to the feature, Segal has been impressed with the dramatic rise in popularity of meditation over the past 20 years, which “resonates with people’s desires to find a way of slowing down and returning to an inner psychological reality that is not as easily perturbed,” he says. Perhaps most encouragingly, mindfulness practice has no adverse side-effects or contraindications, so I would expect to see more research into its efficacy, which could be good for all of us in our “500 channel universe.”

Previously: Mindfulness training may ease depression and improve sleep for both caregivers and patients, Using mindfulness-based programs to reduce stress and promote health, Using mindfulness therapies to treat veterans’ PTSD, How mindfulness-based therapies can improve attention and health and Study shows mindfulness may reduce cancer patients’ anxiety and depression.
Photo by ronsho

Behavioral Science, Complementary Medicine, Events, Research, Stanford News

Tend and befriend — helping you helps me

Tend and befriend — helping you helps me

7005743072_b8c1acb3d0_kHelping others helps you. That’s not new news — perhaps you’ve heard it from your mother or your priest or your great-uncle Joe for your entire life. But what is new is the firm biological basis of that old adage — the connections between altruism, caring and neuroscience. Health psychologist and Stanford lecturer Kelly McGonigal, PhD, drove that point home hard last week at a talk sponsored by the Stanford Center for Compassion and Altruism Research and Education.

The event kicked off with a meditation tailored to open hearts and minds outward — for participants to consider others as well as themselves. Even that five-minute exercise was enough to spur the release of oxytocin, sometimes called the “love hormone,” McGonigal said. It “fine tunes our social instincts,” she explained. It dampens fear, making it easier to help others and even improving one’s ability to read facial expressions.

“We can create this biology by choosing to have a social response to stress,” McGonigal told the audience. The academic term is “tend and befriend,” coined by UCLA psychologist Shelley Taylor, PhD. Rather than making her aggressive, Taylor and her colleagues found they softened when stressed, becoming more caring and pro-social.

A series of studies have demonstrated the power of the tend and befriend response. Urban teens who volunteer alleviate their own biological stress. Adults who contribute to charity are more resilient in the face of major life events. People feeling a time crunch — too much to do, too little time — can alleviate the feeling by spending time on others. And the list goes on.

“There’s something about this tend and befriend mindset that seems to create physical resilience,” McGonigal said.

Evolutionarily, the instinct makes sense in the event of a disaster, she said. “I have it so you all will survive if there’s an emergency. My having the tend and befriend instinct is mostly about you.”

Perhaps one of the most relevant illustrations of the tend and befriend response — and a lesson for adopting it — comes from study that just came out this week, McGonigal said. Two researchers asked 150 middle-age adults to tell the story of their lives. The stories from the mentally healthiest participants shared a similar theme: Personal suffering inspired them to do something to transform the suffering of others into something positive. They transformed their suffering from a negative into a positive.

“Helping others increases the chemistry of hope and courage and dampens fear and despair,” McGonigal said.

Previously: Ask Stanford Med: Stanford health psychologist Kelly McGonigal taking questions on willpower, Stanford health psychologist Kelly McGonigal discusses how stress shapes us and Why stress might not be so bad
Photo by David Hodgson

Behavioral Science, Complementary Medicine, Neuroscience, NIH, Patient Care, Research

“Tranceformation:” David Spiegel on how hypnosis can change your brain’s perception of your body

4254170454_4f55755317_zWhen we think of cognitive function, we usually think of having the power to alter our reasoning, while we passively respond to our perceptions. What if we could do the inverse: manipulate our perception, while merely responding to reasoning and language? That is the basic neurological explanation of hypnosis, says David Spiegel, MD, director of the Center on Stress and Health and medical director of the Center for Integrative Medicine.

Spiegel spoke on new research in hypnosis yesterday morning during the Integrative Medicine Research Lecture Series presented by the National Center for Complementary and Integrative Health (NCCIH). Despite its Greek etymology, hypnosis does not involve going to sleep; it’s more like a narrowing of attention. “Hypnosis is to consciousness what a telephoto lens is to a camera,” Spiegel explained.

When hypnotized, you put outside of awareness what would normally be in consciousness (dissociation), and become less likely to judge what people tell you (suggestibility). The idea of this often makes people nervous, because we’re evolved to respond to nuanced social cues. But a growing body of scientific evidence suggests that overcoming this nervousness can yield a wealth of health benefits.

Hypnosis can be an effective method for managing pain, and treating anxiety and stress-related disorders. Past studies have shown that people hypnotized before operative care have a shorter procedure time and a significant reduction in intraprocedural complications, such as hypoxemia and vomiting. One study showed that in select cases “hypnosis as sole anesthesia works extremely well,” Spiegel said.

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CDC, Complementary Medicine, Medicine and Society, NIH, Podcasts

Podcast explores Americans’ use of complementary medicine

Podcast explores Americans' use of complementary medicine

5007651053_935ec0fd58_zDo you do yoga, take probiotics, see a chiropractor, or follow a special diet? If so, you’re not alone; roughly 34 percent of Americans make use of complementary therapies, and these are among the most popular ways to do so.

You may have read about the CDC report (.pdf) that came out last month and showed the prevalence of complementary medical approaches among American adults. For more, check out this podcast from The Lancet, during which Josephine Briggs, MD, director of the National Center for Complementary and Integrative Health (NCCIH), and Richard Nahin, PhD, MPH, NCCIH’s lead epidemiologist, discuss the major findings of the report and some of the potential implications for public policy.

Previously: Study shows complementary medicine use high among children with chronic health conditions, More hospitals offering complementary medicine, Older adults increasingly turning to complementary medicine and Americans’ use of complementary medicine on the rise
Photo by lyn tally

Behavioral Science, Complementary Medicine, Neuroscience, Videos

This is your brain on meditation

This is your brain on meditation

For years, friends have been telling me I should try meditation. I’m embarrassed to admit it’s mostly because of (how can I put this delicately?) a temper that flares when I’m anxious or stressed out. But, as it is for many people, it’s one of those things I haven’t gotten around to. This video by AsapSCIENCE, though, describing the things scientists have discovered about meditators has me thinking about it again.

Meditation is linked to a decreased anxiety and depression, and increased pain tolerance. Your brain tunes out the outer world during meditation, and on brain scans of meditators, scientists can see increased activity in default mode network – which is associated with better memory, goal setting, and self-awareness. The part of the brain that controls empathy has also been shown to be more pronounced in monks who are long-time meditators. From the video:

“[Meditation] also literally changes your brain waves, and we can measure these frequencies. Medidators have higher levels of alpha waves, which have been shown to reduce feelings of negative mood, tension, sadness and anger.”

Much like hitting the gym can grow your muscles and increase your overall health, it seems that meditation may be a way of working out your brain—with extra health benefits.”

Other demonstrated benefits include better heart rate variability and immune system function. I’m glossing over a lot of the information that’s packed into this entertaining little video, but if you’re curious, check out this less-than-three-minute video yourself.

Previously: Study shows benefits of breathing meditation among veterans with PTSDResearch brings meditation’s health benefits into focusUsing meditation to train the brainCan exercise and meditation prevent cold and flu? and How meditation can influence gene activity
Video by AsapSCIENCE

Behavioral Science, Complementary Medicine, Mental Health, Parenting, Pediatrics, Research

Mindfulness and the fourth- and fifth-grade brain

Mindfulness and the fourth- and fifth-grade brain

Maths Homework

As a parent, this Time headline immediately grabbed my attention: “Mindfulness Exercises Improve Kids Math Scores.” But as I read the article, I learned that math scores were just one facet examined by the researchers and that mindfulness training was also shown to help children be less stressed and more caring.

The study, which was published in this month’s issue of Developmental Psychology, looked at a group of 99 fourth and fifth graders in British Columbia. For four months, half of the students were taught a pre-existing “personal responsibility” curriculum, while the rest learned about mindfulness through a program called MindUP that focuses on breathing exercises, mindful smelling and eating, and gratitude. The researchers then looked at cortisol levels, behavioral assessments, self-reports, along with those math scores. The article describes the results in more detail:

The results were dramatic. “I really did not anticipate that we would have so many positive findings across all the multiple levels we looked at,” says study co-author Kimberly A. Schonert-Reichl, a developmental psychologist at the University of British Columbia. “I was very surprised,” she says—especially considering that the intervention took place at the end of the year, notoriously the worst time for students’ self-control.

Compared to the kids in the social responsibility program, children with the mindful intervention had 15% better math scores, showed 24% more social behaviors, were 24% less aggressive and perceived themselves as 20% more prosocial. They outperformed their peers in cognitive control, stress levels, emotional control, optimism, empathy, mindfulness and aggression.

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Complementary Medicine, In the News, Mental Health, Pediatrics, Research, Stanford News

Stanford researchers to study effectiveness of yoga-based wellness program at local schools

Stanford researchers to study effectiveness of yoga-based wellness program at local schools

kids_yogaManaging stress and making healthy choices is a daily struggle for many of us. But what if way back in elementary school we had learned resiliency skills and mind-body practices to cope with anxiety, reduce incidents of bulling and violence, and boost our cognitive ability? Would this training have helped us keep our flight-or-fight response in check and live healthier lives?

A four-year study conducted by researchers at Stanford aims to answer these questions. The project will evaluate a yoga-based health and wellness program involving 3,400 students at the Ravenswood City School District. The program, which has been funded for three years by the Sonima Foundation, includes exercise-based on yoga, basic fitness regimes, relaxation techniques, mindfulness practices and nutrition. As the San Jose Mercury News reports:

The plan is to employ a multi-method approach that involves biology, physiology and psychology — a complete bio-psychosocial assessment — to measure [students’] emotions and behavior, academic and cognitive strengths and weaknesses, brain activity and structure, stress-related hormone levels, and sleep patterns.

“We’re really looking forward to a year from now — when I tell you this is effective — for you not to only take it on my word, but for you to also have data,” said Dr. Victor Carrion, a professor of psychiatry and behavioral sciences at [Stanford].

Carrion is also the director of the Stanford Early Life Stress and Pediatric Anxiety Program at Lucile Packard Children’s Hospital.

In 2012, he launched a mindfulness program in the Ravenswood City School District to treat post-traumatic stress disorder in teens that was featured on a PBS NewsHour segment. Jones and his wife happened to catch the broadcast, and because Carrion has done pro bono work with students and parents in the community for years, the partnership between the district, Stanford and the Sonima Foundation was forged.

The four-year study is also in partnership with the Center for Education Policy and Law at the University of San Diego.

“This is something that for years has been a gap in our educational system,” Carrion said. “There’s nothing… that teaches children to socialize and to be in touch with their emotions and to take care of their inner health.”

Previously: Stanford researchers use yoga to help underserved youth manage stress and gain focus, Yoga classes may boost high-school students’ mental well-being and Study shows meditation may lower teens’ risk of developing heart disease
Photo by Nicole Mark

Cancer, Complementary Medicine, Events, Patient Care

Knitting needles cancer while helping patients

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It may sound unusual, but knitting is one way to cope with difficult experiences, such as undergoing cancer treatment. Rhythmic and relaxing, knitting can sooth the mind and soak up the downtime that’s a big part of cancer treatment, according to Holly Gautier, RN, a nurse and director of the Cancer Supportive Care Program at Stanford.

“It’s the repetitive motion that you have with knitting… You’re focused on the stitching and your mind becomes somewhat blank – it really feels good to be making something new,” Gautier explained to me recently.

Although she administers a slew of programs – from yoga to art – Gautier said she’s particularly excited about a new knitting class, which meets weekly at the Stanford Cancer Center.  It’s free and open to all cancer patients and their families — not just those being treated at Stanford.

The class is led by a volunteer knitters, who provide supplies and teach the basic stitches. They can even accompany patients to treatment rooms to answer questions or undo an error, Gautier said. And they’re happy to put together “knitting-to-go” care packages for those who can’t stay.

While participants are welcome to work on other projects, such as scarves and hats, the class is currently making squares to create a quilt to raffle off at an upcoming benefit for the Cancer Survivorship Program. Gautier said the quilt project provides patients with an opportunity to give back – something that nearly all patients yearn to do.

Although the first session last Tuesday drew eight female patient-knitters, Gautier said she hopes other patients and caregivers, particularly men, stop by in coming weeks. More details on the Knitting with Friends program can be found here.

Previously: Knitting as ritual — with potential health benefits?, Image of the Week: Personalized brain activity scarves and A look at how helping others can be healing
Photo by meknits

Aging, Complementary Medicine, Health and Fitness, Mental Health, Neuroscience, Research

Mindfulness training may ease depression and improve sleep for both caregivers and patients

Mindfulness training may ease depression and improve sleep for both caregivers and patients

meditatingDepression and poor sleep often affect both dementia patients and their caregivers. Now new research shows that caregivers and patients who undergo mindfulness training together experience an improvement in mood, sleep and overall quality of life.

While past studies have shown that yoga and simple meditations can relieve caregivers’ stress, researchers at Northwestern University wanted to determine if patients and caregivers could be trained together.

In the small study (subscription required), pairs of patients and caregiver participated in an eight-week mindfulness program. Patients were diagnosed with dementia due to Alzheimer’s disease or mild cognitive impairment, often a precursor to dementia. Caregivers included spouses, adult children or other relatives. The training was designed specifically to meet the needs of  individuals with memory loss due to terminal neurodegenerative illness and their caregivers. Researchers evaluated participants within two weeks of starting the program and two weeks of completing it.  Lead author Ken Paller, PhD, explained the results in a release:

We saw lower depression scores and improved ratings on sleep quality and quality of life for both groups… After eight sessions of this training we observed a positive difference in their lives.

Mindfulness involves attentive awareness with acceptance for events in the present moment… You don’t have to be drawn into wishing things were different. Mindfulness training in this way takes advantage of people’s abilities rather than focusing on their difficulties

Since caregivers often have limited personal time, mindfulness programs that accommodate them as well as patients could be an effective approach to helping both groups regularly attend sessions, said researchers.

The findings were published Monday in the American Journal of Alzheimer’s Disease and Other Dementias.

Previously: Regularly practicing hatha yoga may improve brain function for older adults, Study suggests yoga may help caregivers of dementia patients manage stress and How mindfulness-based therapies can improve attention and health
Photo by Alex

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