The Research Tsunami

The scientific research into mindfulness and meditation has exploded in the last twenty years. From the graph below we see that from the early 1970s, when mindfulness first began to emerge in western society, there were barely a handful of scientific investigations into the practice.

As of 2015 there were over 1200. Considering how funding for this type if investigation relies predominately on private grounds, such as academic grants etc, this level of interest from the scientific community in mindfulness practice is impressive. As of 2018, the increase has not abated and it is estimated that over 6000 studies have now been completed into the many different aspects of mindfulness practice[1].

[1] Daniel Goleman and Richard.J.Davidson, The Science of Meditation:how meditation changes your brain, mind, and body, Penguin Life, 2017, p.194

The research tsunami

It is important to mention that Goleman et al, upon rating the these 6000 studies have found the vast majority of them to fail to meet the gold standard of research which would enable solid and categorical conclusions on their results.

As a result we have selected only the most rigorous studies here and also those that point to what they call a ‘trait effect’, as opposed to a ‘state effect’. A trait effect can be understood as a lasting significant change from mindfulness practice which occurs over time. A state effect occurs predominately during a mindfulness practice[2].

From the image below we can see the four main neural pathways of our brains that are affected by mindfulness practice. We will be focusing here predominately on the Amygdala and its interaction with the pre-frontal cortex. But first a look at some research emerging on mindfulness and young people.

[2] Ibid. P.91

four main areas of our brains that are affected by mindfulness practice

Young People, Mental Health and Mindfulness Practice

The research undertaken on the role of mindfulness and meditation practice in the lives of children and young adults is scant, and is a burgeoning field at present. However, a couple of studies mentioned here have shown to be in line with the findings for adults. In a study conducted by the University of Edinburgh in 2017 [3]
the researchers interviewed participants who had taken part in The Kids Programme (a mindfulness based curriculum developed by youthmindfulness.org) and found the following:

98%

Of children reported benefits to their emotional wellbeing, or ability to focus and pay attention.

92%

Of children reported being able to handle strong emotions better.

98%

Reported improvements in peer and family relationships.

72%

Said they were less aggressive, and engaged less in confrontation

77%

Said that mindfulness helps them focus, pay attention and concentrate.

55%

More than half said mindfulness helps them enjoy life more and feel happier.

In 2013 Filip Raes et al[4] Investigated the role of a school-based mindfulness programme in the prevention and reduction of depression in Adolescents in America. At this time 12.5 per cent of the population of the U.S aged 12-17 reported having a depressive episode in the preceding year. This equates to over 3 million teenagers. A depressive episode was not categorized by clinical signs alone, but also as more subtle signs of depression such as, persistent negative thinking, severe self-criticism, trouble sleeping or thinking and a shortness of breath.

What Raes et al discovered was that a “mindfulness program designed for teens reduced overt depression and such subtle signs mentioned above, even up to six months after the course”[5].

Despite the scant research what is becoming clear, through anecdotal evidence from educators, parents and general public perception, alongside recent studies on youth mental health, is that distress among young people has increased dramatically in recent years. Data from Northern Ireland and the Republic of Ireland supports this view.  The 2016 Healthy Ireland annual survey reported that, amongst those surveyed, negative mental health was most prevalent among 15–24-year-olds[6]. Similarly, data trends observed in the Health Survey Northern Ireland show that that indicators of mental health problems are widespread among young females aged 16–24 years[7].

There is interest gathering in the field of what psychologists describe as Adverse Childhood Experiences or ACEs. This has arisen from a study in 1998 and one of the largest investigations into childhood maltreatment and its effect on well-being[8]. The results were startling. Researchers found that 30% of participants reported to having experience one or more ACEs. 15% reported 4 or more experiences of this nature.

“The more ACEs experienced by an individual in childhood, the greater the risk of developing a range of mental, social and physical health issues as an adult. Those who had experienced 4 or more ACEs were more likely to experience health problems or engage in health risk behaviours. The study also found that, on average, people with 6 or more ACEs died 20 years earlier than those with none”[9].

The early research into the effects of mindfulness practice for young people is very positive. The more long-standing research into adults, both psychologically and physiologically however is compelling.

References

[3] http://youthmindfulness.org/mindfulness-kids-programme/

[4] Filip Raes et al., “A School-Based Prevention and Reduction of Depression in Adolescents’ cluster-randomized controlled trial of a mindfulness group, “Mindfulness, March 2013;doi:10.1007/s12671-013-0202-1.

[5] Daniel Goleman and Richard.J.Davidson, The Science of Meditation: how meditation changes your brain, mind, and body, Penguin Life,2017, p.197

[6] Department of Health,2017.

[7] NISRA,2017.

[8] Felitti, M. D., Anda, R. F., Nordenberg, M. D. et al (1998) ‘Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study’ American Journal of Preventative Medicine. 14.

[9] https://www.connectedforlife.co.uk/blog/2017/6/17/the-adverse-childhood-experiences-ace-study

Our Radar For Threat – THE AMYGDALA

The Amygdala, located in the temporal lobe (behind the ear) is part of the limbic system of the brain. The limbic system is often called ‘ the old brain’,  in evolutionary theory it is seen as the part of the brain that pre-dated the human capacity to think and formulate concepts.

The amygdala predominately functions as our radar for threat. Its main responsibility is associated with emotions, particularly fear and the subsequent biological responses; the freeze, flight, or flight response being one.

The amygdala is often responsible for the stress responses that lead to anxiety and depression. Below is brief look at some studies which looked at the relationship between, the amygdala, mindfulness and anxiety and depression, and also disturbing events.

ANXIETY

Researchers at Stanford University studied a group of patients with social anxiety disorder who underwent the standard eight week MBSR (Mindfulness based stress reduction) program[10]. Before and after training they went into a brain imaging scanner while being presented with stressors (statements taken from their own social meltdowns and their thoughts about these meltdowns,  such as “ I am Incompetent” or “ I am ashamed of my shyness”.

As these stressful thoughts were presented, the patients used: mindful awareness of their breath or distraction by doing mental arithmetic. Only mindfulness of their breath both lowered activity in the Amygdala – mainly via a faster recovery – and strengthened it in the brains attention networks, while the patients also reported less stress reactivity. The same benefits were observed in patients who compared mindfulness techniques and aerobics.

DISTURBING EVENTS

In this study at Emory[11], people who had never meditated before were randomly assigned to practice Mindful Attention Training, or a compassion meditation. A third group went through a series of discussions on health.

The participants were scanned (using an fmri brain scanner) before and after they underwent eight weeks of training. While in the scanner they viewed a set of images (standard practice in emotion research) which includes a few upsetting pictures and also pictures of a burn victim. The Mindful Attention group showed reduced Amygdala function. This reduced activity in the amygdala was evident over 8 weeks later which suggests the seeds of a trait change.

DEPRESSION

The early research into the role mindfulness in treating depression is compelling. In 2000, at the University of Oxford Teasdale et al[12] looked at the role of mindfulness based interventions in depression. Their research showed that mindfulness based treatments cut the possibility of relapse by half – a statistic no medication has ever achieved.

In 2014 John Hopkins University published a study for the Agency of Healthcare Research and Quality[13] (an agency which directs guidelines for American physicians). John Hopkins undertook a meta-analysis, looking at over 18,000 journal Articles. The study looked at patients suffering from distress ranging from depression and pain to sleep problems and all qualities of life.

The conclusion of this review study showed that meditation, and in particular mindfulness practice, has a major role in treating depression, anxiety, and pain – about as much as medications yet without any side-effects.

Resources

[10] Philippe. R. Golden and James J. Gross, Effects of Mindfulness – Based Stress Reduction on Emotional Regulation in Social Anxiety Disorder. Emotion 10:1 (2010) 83-91

[11] Gaelle Despordes, “Effects of Mindful-Attentionand Compassion Meditation Training on AmygdalaResponse to Emotional Stimuli in Ordinary, Non-Meditative State”, Frontiers in human Neuroscience 6:92 (2012). P.87

[12] John Teasdale et al., Mindfulness -based Cognitive Therapy for Depression (New York:Guilford Press, 2003); John Teasdale et al., “ Preventation of Relapse/Recurrence in Major Depression by Mindfulness-Based Cognitive Therapy,” Journal of Consulting and Clinical Psychology 68:4 (2000):615-23.

[13] Madhav Goyal et al,. “ Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-Analysis,” JAMA Internal Medicine, published online January 6, 2014; doi:10.1001/jamaintermed.2013.13018.

Physical Health, Stress and Mindfulness Practice

There is a rising interest in the medical field into the role of stress in disease. Much of this work is focused on the role of emotions and its effect on the four main pathways for disease. Psycho (the mind) Neuro (the brain) Immuno (the immune system) Endocrinology (the hormonal system). Coined Psychneuroimmunoendocronology, or PNI, what this field of research is beginning to show is that these systems of brain , mind, defence, and response, all act as a super system and are interconnected through vast and intricate pathways. This goes against the grain of the previous medical understanding that would have supposed these differing systems of the body to function independently. This area of medical interest has a particular interest in how these systems interact and in particular the role of stress in disease. Hans Seyle was the pioneer in the field of stress and its role in disease. His lifetime of work in this drew him to conclude that for human beings the most powerful sources of stress are emotional[14].

Several decades ago a British Chest Surgeon, David Kissen reported that patients with Lung Cancer were frequently characterized by the tendency to ‘bottle-up emotions’. In a number of subsequent studies Kissen found similar results[15], namely lung cancer patients ‘ have poor and restricted outlets for expression of emotion, as compared to non-malignancy lung patients and also normal control groups’.

Kissen’s early insights were confirmed by a ground-breaking study conducted in Cvrenka, in the former Yugoslavia in 1985. Researchers were investigating the psychosocial risk factors to mortality[16].

“Nearly ten per-cent of the town’s inhabitants were selected, around one thousand men, and four hundred women. Each were interviewed in 1965-66 with a 109-item questionnaire that delineated such risk factors as adverse life events, a sense of long-lasting hopelessness, and a hyper-rational, non-emotional coping style. Physical parameters like cholesterol levels, weight, blood pressure, and smoking history were also recorded. By 1976, a decade later, over 600 participants in the study had died of cancer, heart disease, stroke, or other causes. The single biggest risk for death – and especially for cancer death – was what the researchers called rationality and anti-emotionality, or R/A. The eleven questions identifying R/A measured a single trait : the repression of anger.

“Indeed cancer incidence was some 40 times higher in those individuals who answered positively to 10 or 11 of the questions for R/A than in the remaining subjects who answered positively to only 3 or for of the R/A questions…We found that smokers had no incidence of lung cancer unless they also had R/A scores of 10 or 11, suggesting that any effect of smoking on the lung is essentially limited to a susceptible minority”[17]

These findings in no way absolve tobacco companies of their responsibility in the deaths of lung cancer patients. In fact all of the 38 participants in the Cvrenka studies who died from lung cancer had been smokers. The results however indicate that for lung cancer to occur, tobacco alone is not enough: emotional repression must somehow potentiate the effects of smoke damage on the body”

In the 21st century we are dying from diseases that never existed in our ancestors. Heart disease, diabetes, inflammation related cancers, auto-immune diseases, Alzymers. This rise in new dis-ease led Hans Seyle to bracket these illness as ’diseases of adaption’. As Gabor Mate, author of When the Body Says No, explains “ The relationship between stress, immunity and illness has given rise to the concept of ‘diseases of adaption’. The flight or fight response was indispensable when early human beings had to face a world full of predators and other dangers. In civilised society, the flight or fight response is triggered in situations where it is neither necessary or helpful., since we no longer face the kind of mortal threats to our existence. The bodies physiological stress mechanisms are often triggered inappropriately, leading to disease.

The research into effects of Mindfulness practice on our physical health are compelling. It is well recognised now that inflammation in the body is a pre-cursor to these diseases of adaption, such as diabetes etc. In a study in 2016 researchers investigated the role a 3 day intensive programme of mindfulness training compared to a relaxation program had on a unemployed men (often considered to be some of the most stressed group of males).
Blood samples after revealed the mindfulness group, but not those taking the mindfulness program, had significant reductions in a key-pro-inflammatory cytokine[18].

Similar research into physical pain, Kabit – Zinn(1988), Rosenkranz et al (2013), Cash et al (2015), Morone et al (2016) Grossman et al (2017), all show the profound impact Mindfulness practice has on the systems in the body that impact healing and dampen stress. What the research suggests also is that these effects are more substantial the longer the mindfulness practice is[19].

Resources

[14] Gabor Mate(2019). When The Body Says No: exploring the stress-disease connection.

[15] D.M. and H.G. Eysenck, “ Personality in Male Lung Cancer Patients,”Journal of Psychosomatic 6 (1962),123.

[16] Gabor Mate(2019) p.86

[17] Grossarth-Matieck et al., “Psychosocial Factors as Strong Predictors of Mortality from Cancer, Ischaemic Heart Disease and Stroke: The Yogoslav Prospective Study”, Journal of Psychsomatic Research 29, No 2 (1985),167-76.

[18] David Creswell et al., Alterations in Resting-State Functional Connectivity Link Mindfulness Meditation with Reduced Interleukin-6: A Randomized Controlled Trial,” Biological Psychiatry 80 (2016): 53-61.

[19] Daniel Goleman and Richard.J.Davidson, The Science of Meditation:how meditation changes your brain, mind, and body, Penguin Life, 2017, p.165-91.