Yoga, Mindfulness and Benefits of Breath-work, revisited

I posted back in November 2015 about my personal journey with yoga. I started off with videos and home practice in 2007 and the personal changes that have occurred since then, through integration of classes with others, following the direction of personal yogis (who may or may not practice yoga, but they're still inspirational trailblazers to me), are phenomenal. Crow pose is still my favorite - I have yet to master the ego.

Crow Pose - Bakasana



I produced and edited (very sloppily, I might add) an article about the benefits of yoga and mindful breath. I have edited and re-formatted it to be easier on the eyes, the heart, and hopefully -- your soul.

 

∞Yoga on, my friends. Yoga on.∞

 

Overview:

Yoga and mindfulness, by association, are based on the concept of integration of the mind-body connection; by keeping the practitioner mindful, this in turn reduces emotional responsivity to internal or external triggers. The result is a direct impact on physiological response to environmental stressors, which influences physical health, emotional health, and spiritual connectedness (for those interested in these benefits).

 

• Physical Stress Response includes:

     ■ Breathing: typically short and shallow when a person is stressed

           ►Increased CO²/ decrease O² effects:

               ○ CO² can induce: Visual disturbances - Headache - Reduction in reasoning ability - A sense of “air hunger” or dyspnea (asphyxiation); In other words, if a person "forgets" to be mindful of their breath, the body thinks it is choking to death; the reduction in reasoning ability suggests that yoga and connected breathing sequences would enhance reasoning ability, and consequently, decision-making capability.

     ■ Stress response and fatigue

            ►Increased cortisol levels -- the effects of this response include:

                    ○ Weight gain

                    ○ Decrease in immune system function

                    ○ Memory impairment

 

• Short-term "fixes"

       ■ Alcohol Use and Abuse (once-a-month bingeing to daily use)

               ►Short-term effect: decrease in perceived stress (the body continues to react as if stress level had not changed though; this is a cognitive change or an illusion the mind creates)

               ►Long-term effect: raised cortisol levels

       ■ Caffeine Use and Abuse (yes, you can abuse caffeine; it's now in the Diagnostic and Statistical Manual's latest version)

               ►Short-term effect: increases the perceived wakefulness of the consumer

               ►Long-term effect: raises cortisol levels

 

 ∞•∞•∞

"Short term pain, long term happiness;

Short term happiness, long term pain.

Which do you choose?

 ∞•∞•∞

 

Physical body benefits of yoga and meditation

•Body systems affected: nervous system, respiratory system, cardiovascular system, diabetes, cancer, immunity, and the list goes on.

 

        ■ Specific examples of effects of yoga and meditation on particular body systems and/or disorders:

                    ►Diabetes/Blood sugar

                          ○ Postures that stimulate the pancreas lead to renewed ability of pancreas to manufacture insulin and increased insulin sensitivity.

                               ∙ This suggests that we may benefit non-diabetic patients by increasing productivity and efficiency of the pancreas (which reacts when we eat) through yoga practice.

 

                    ►Sleep and Circadian Rhythm Processes

                           ○ Transcendental Meditation (TM): increases melatonin production (melatonin is often a supplement taken to enhance sleepiness, but is actually produced by the body naturally, if given proper rest and support)

 

                     ► Response time

                             ○ Meditation, in general, increases the speed of attention location/relocation (decreasing response time and increasing information processing efficiency)

 

                     ► Mind-body connection        

                             ○ Increase in the mind's ability to focus on the present (mindfulness)

 

 ∞•∞•∞

 

Definition and overview of mindfulness meditation

» "A family of self-regulation practices that focus on training attention and awareness in order to bring mental processes under greater voluntary control and thereby foster general mental well-being and development and/or specific capacities such as calm, clarity, and concentration (Walsh & Shapiro, 2006, p. 228).”

 

»  Mindfulness meditation (in contrast to other forms of meditation) “has been shown to stimulate the middle prefrontal brain associated with both self-observation and metacognition (Cahn; Polich, 2006; Siegel, 2007b) and foster specific attentional mechanisms (Valentine; Sweet, 1999).”

 

∞•∞•∞

 

Empirically-supported benefits of mindfulness and regular yoga practice

 

 »  Emotional Regulation (based on Mindfulness-Based Stress Reduction treatment, or MBSR)

   ► Benefits

        a. Decreased reactivity to internal and external stimuli

        b. Interpersonal benefits

        c. Intrapersonal benefits (those that occur within the self and relationship with the self)

              › Studies suggest a detached frame of mind results from mindfulness practice, stopping the trigger-thought-craving-use cycle, which is the addiction cycle (sugar counts, too!)

              › If a “lapse” occurs (i.e., a “slip”), acceptance that is learned through practicing mindfulness regularly may reduce making a negative situation worse and may reduce the resulting shame/blame, which helps the person get back on track more quickly to recovery.

 

»  Clinical Research Studies

     1. University of Utah study; correlation between physical changes and yoga practice

          a.  12 yogis; 14 fibromyalgia patients; 16 healthy volunteers

          b.  Fibromyalgia patients tend to perceive pain with less stimulus than those without fibromyalgia; yoga and mindfulness practices are beneficial to these patients.

 

    

     2. German study performed in 2005 with 24 “emotionally distressed” women

          a.  Effects of yoga practice on stress, depression, anxiety; yoga practice two times per week at 90-minute sessions

               › Depression scores: improved by 50%

               › Anxiety scores: improved by 30%

               › Overall well-being: improved by 65%

               › Somatic complaints such as headaches, back pain, and poor sleep: higher resolution rate (no specific measurement available)

    

     3. Descriptive 2005 study, New Hampshire; inpatients, 113 participants with bipolar disorder, major depression, and schizophrenia

          a.  Short term positive effects: decrease in scores on tension, anxiety, depression, anger, hostility, and fatigue (during a Profile of Mood states) – (FYI: a state is changeable; a trait is static)

          b.  Improves quality of life for elderly, dementia caregivers, breast cancer survivors, epilepsy patients

    

     4. Sudarshan Kriya yoga (SKY): cyclical breathing study with 45 participants who were inpatient clients receiving treatment for depression

          a. Description of yoga "treatment"

               ∙ 30 minutes, 6 times per week for 4 weeks

                  ∙ The yoga group outcomes were compared to ECT and tricyclic antidepressant

                    ∙∙ Remission rates per group: 93% ECT; 73% antidepressant; 67% breathing

    

     5. Study of 60 alcohol dependent men; 1-week detox, 2-week SKY

          a. SKY group treatment compared to alcoholism treatment

               ∙ Results included:

                  ∙∙ A drop in depression scores: 75% in SKY group vs. 60% in tx group

                  ∙∙ Decrease in both cortisol and corticotropin (the chemical that “boosts” cortisol production) in the SKY group, but not in the treatment group

 

∞•∞•∞

 

PTSD and comorbidity with substance use and/or abuse 

Substance use is often accompanied by trauma; though it may not result in clinical PTSD (e.g., a diagnosis), but can have long-lasting effects that mimic this disorder due to the environment the user allows themselves to interact with to acquire and use and/or abuse drugs and alcohol.

There is a perception by the patient that past traumatic experiences are occurring in the here-and-now based on being triggered by cues that are similar to the original event (often flashbacks, loud noises or other environmental factors)

The traumatic memory is triggered more easily due to its storage in the short-term memory system.

 
Future research directions and implications for trauma-affected populations:

■  FACT:  20% war veterans are diagnosed with PTSD

    □ Disabled Australian Vietnam veterans with PTSD study; alcohol and antidepressants

        ·5-day course of: breathing techniques, yoga, stress-reduction education, guided meditation

        ·Pre-treatment ranking via CAPS (Clinician Administered PTSD Scale); this measure rates how severe the PTSD symptoms are

        ∙Post-tx ranking at 6 weeks and 6 months dropped from average of moderate/severe symptoms to mild/moderate while the control group (who remained on the waiting list) experienced no improvement.

■  FACT: Those who have a history of substance use and/or abuse also tend to have a history of trauma, either prior to or after his or her first episode of substance use.

    □ Mindfulness Study: MBRP (Mindfulness Based Relapse Prevention) 8-week group post inpatient/outpatient substance use treatment (n=168) versus TAU (treatment as usual) group

       · Outcome: lower rates of substance use per 4-month post-intervention period measures. This included lower rates of craving, increase in acceptance and mindful action.

 

 

 

REFERENCES

    ∙Harvard Health Publications, Harvard Medical School, “Yoga for anxiety and depression” (Harvard Mental Health letter), April 1, 2009. http://www.health.harvard.edu/mind-and-mood/yoga-for-anxiety-and-depression

 

    ∙Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., Hsu, S., Grow, Marlatt, A. (2009). Mindfulness-Based Relapse Prevention for Substance Use Disorders: A Pilot Efficacy Trial. Substance Abuse, 30(4), 295–305. http://doi.org/10.1080/08897070903250084

 

    ∙Dartmouth Undergraduate Journal of Science, “The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis” (Posted by Michael Randall ’12), Fall 2010, http://dujs.dartmouth.edu/fall-2010/the-physiology-of-stress-cortisol-and-the-hypothalamic-pituitary-adrenal-axis#.Vh6UAXpViko

 

    ∙Physiological Responses to Oxygen and Carbon Dioxide in the Breathing Environment, W. Jon Williams, Ph.D. National Institute for Occupational Safety and Health, USA NIOSH Public Meeting September 17, 2009, Pittsburgh, PA

 

    ∙Balaji, P. A., Varne, S. R., and Ali, S. S. (2012). Physiological

 

     Effects of Yogic Practices and Transcendental Meditation in

     Health and Disease. North American Journal of Medical

     Sciences, 4(10), 442–448. http://doi.org/10.4103/1947-2714.101980

  

►In progress (and taken word-for-word):

Practically speaking, you do your brain-body a lot of good. Among the benefits of TM:

• It’s the only meditation practice shown to lower blood pressure.

• The practice can help increase insulin resistance.

• TM is the most effective meditation technique to slow biological aging (my favorite!).

• It can also ease feelings of anxiety in people with anxiety disorders.

              • http://www.everydayhealth.com/columns/voices-of-experience/why-transcendental-meditation-works-stress-relief/?xid=nl_EverydayHealthLivingWithBipolarDisorder_20151122

 

∞   Yoga on, my friends. Yoga on.  ∞

 ©Nichol Elise 2015-2016, all rights reserved.

Gaps in coverage - both on this blog and with insurance

I love double entendres. Only, this one's not meant to be risqué.

I was reviewing my blog entries, as I do from time to time. I noticed a *major* gap in coverage, so to speak. Meaning, I didn't post between the two dates below:

◘  7/20/12 to 10/12/15 -- *this is more than 3 years!

    ○ Reasons I believe this happened:

        ◙ I started my traineeship with a local non-profit as a volunteer therapist in March, 2012. I held this position while I completed school and my Master's Thesis.
        ◙ In July, 2012, I started working in earnest with my thesis advisor regarding collecting data for the thesis. This involved all the nitty gritty details of writing the informed consent document to University standards, establishing validity/reliability of the instruments being used to collect the data, and finding professors on campus willing to let me collect data during class times they were teaching.
        ◙ I began collecting data, analyzing it (hired a scoring sheet intern with my Thesis Advisor's help and entering the data into SPSS) and writing the thesis in earnest. I continued to edit (and revise, revise, revise) the overall content of the document with my Thesis Advisor's help and completed it in time for graduation. It was labor and time-intensive and took 5 quarters to complete. Thanks, Selby!
        ◙ I graduated with my M.S. in Psychology in June 2013, and became employed working with a co-occurring disorders program for clients with primary substance use disorder who also were diagnosed with a secondary mental health diagnosis.

I retained both that position and my volunteer position with the non-profit until June 2014, when I was hired on full-time as a permanent employee as the Coordinator of a forensic program (forensic = legally-involved clients) with mental health and substance use disorders (about 80% of the total caseload were co-occurring, as in, had both).

As Coordinator, I did a lot of duties. And, "other duties as assigned." ☺
        --In other words, I had a lot going on.-- This part just covered the career aspect of my life.

When my younger daughter became ill, the focus became her recovery. The disclosure of any and all information pertaining to my daughter's health issues is to encourage others to speak up, to gain and give support from and to others, and to have a venue in which I can find solace knowing that I am not alone.

In October 2015, as soon as I wrote again, the focus became advocacy, due to the hardships I have had, and others included, in what we dub "the system." While I'm grateful that the health care system exists, it is far too complicated to navigate and leaves considerable gaps in coverage that are not necessarily covered by supplemental programs (if the program exists or is accessible if one does exist).

When my daughter became so ill that it became *crystal clear* to me that I needed to take time off, it was time to take action by not only speaking up in "real life", but also expressing my concerns on this blog.

We continue to fight. Every day. We are going to the neurology consult at UCLA in March. There have been several agencies that by the Higher Power of the Universe (whatever you determine yours to be) have chosen to help us. For the roadblocks we have encountered, we will continue to challenge and will continue to do so until a solution is reached.

In the meantime, I am her primary support person, her mom, her coach, her reminder of her positive qualities, her reminder that this fight may not end, but we will remain strong, and perhaps help others as a result.

I can see by the numbers that people are accessing this blog (18,000+ views and growing), and that certain posts are viewed more than others (given the higher count next to the post). It seems as though the "hot button topic" posts are the ones that get the most attention. However, not many of you comment. I hope you start!

♥Won't you please help another person (or yourself) by simply commenting and stating a need, a solution, or simply venting?♥

I'm open to all these options.

We, and others, need to hear your voice now. Please.

My voice/opinions and such are growing old to me, and I need to be able help others with all the knowledge I've gathered over the many years I've accessed our "system".

I've been talking about these issues far longer than I've been writing on this blog about it. I need a fresh perspective, an angle I haven't tried. But, MOST OF ALL...

...Take care of yourselves and each other. We're all in this world together. ♥
     

Helloooo...THESIS!

Alright. It's. About. Time. Time that I came up with a topic on which to do my Master's Thesis, that is. I find it extraordinarily interesting that I've stumbled into a Master's Program that has NO Thesis requirement to speak of, yet this overachiever had to take that option when it was given. I have two classmates who are doing one as well (So, ha! I'm not the only crazy one. Yes, "crazy" is a technical term.)

Onto the Thesis topic (it is spelled with a capital T because it's THAT dang important): The connection between perfectionism and substance use among college freshman. Particularly, I'd like to explore the differences between community college freshman and state university freshman. Call it a convenience sample if you must, but I think it's a topic that lends itself to studying college students, not non-college folk. Additionally, I'd like to point out that a community college has less stringent requirements for entry than a university does, so there may be a difference in perfectionism levels between the two types of students.

DISCLAIMER: This is a work in progress. Not only must I run this past one of my professors, but I also must get a Thesis committee together to undertake this task. It will take me some time to complete. Therefore, it -- the process and the Thesis itself -- will undergo numerous revisions and changes. I look forward to this. That's why I'm still in school.


So, here's the deal: I want your input! I'm getting weary of seeing that people truly are interested in my blog, but fail to comment on most of my entries. I'm wondering why this is? So, if you just want to comment on how I can get more comments on my blog, that's great! However, I'm really looking for input on the intricacies and such of my topic itself. So, comment away. Or, not. It's your choice. Enjoy reading!

Family Therapy and Multicultural Perspectives

Following are my thoughts on multicultural diversity and marriage family therapy. I typed it for a class (so, yes, it's homework) but it seems worthy of publication on my blog because the issues addressed don't typically get talked about on this page. Hope you enjoy!
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Given the many facets of a human being, it is appropriate to approach family work with “cultural”, “ecological,” and “contextual” sensitivity. It would seem an implausible task to try to understand a client, let alone help them if their environment and context are not taken into account.

In Bronfenbrenner’s article on the ecology of the family (1986), he discusses how many of the different interactions between mesosytems of the identified patient affect the clients in question by the use of his Ecological Model. He points out different dynamics between the Microsystems within the mesosystems and one of the points he made was in regards to the existence of a “support system” outside the home; he pointed to the fact that when the church is included in this support system, there is a lower occurrence of neglect in the home. Also, with regard to father’s job, an exosystemic influence, he showed how the father’s type of work skills are mirrored in the types of skills he uses to parent his children.

In McGoldrick’s  (1995) article on family trees, she explains how the microsystem of the immediate family affects the outcome of the identified patient. Using Ben Franklin’s life as a template for this theory, she shows how the attention of an uncle can influence the importance the identified patient places on family. Ben Franklin formed an alliance with his granddaughter in much the same was as his son formed an alliance with his own granddaughter. Furthermore, the father-child relationships were strained in much the same way between Franklin and his son William and William and his daughter Temple. Family inheritances involve much more than just money and genes and a pattern of behavior can be easily traced back through generations. One must consider the context of the family as it pertains to current behavior in the identified patient in order to understand all the influences that are working upon the dynamics between the identified patient and others in his/her life.

When working with diverse families, it is important to adjust our theoretical orientation to encompass the needs of the client, not simply our understanding of the client at that time. It takes time to truly get to know the inner workings of a client and the environmental influences that affect the client in unique ways. Traditional family therapy concentrates on the “nuclear family” that only exists in 6% of U.S. homes (McGoldrick & Hardy, 2008). We fail to address the true needs of our clients if we fail to take into account the individual differences between our clients and their families. In consideration of family hierarchies in individualistic versus collectivist cultures, it is important to note that individualistic cultures have a much more egalitarian marital couple unit and that deference to those higher on the family hierarchy is stressed in collectivist cultures (Falicov, 1998). It can be challenging to treat a client or clients who have different worldviews than our own; trying to get a couple to reach a compromise may be appropriate for a Western family unit, but may be inappropriate and even harmful to an Eastern-influenced couple. Therapeutic interventions must be adjusted in accordance with the values of the family being treated. There is no cookie-cutter approach to therapy; the unique inner workings of the family must be accounted for when deciding what therapeutic intervention will be most suitable.

Another point-of-view difference between traditional Western families (individualistic) and Eastern or collectivist cultures is the existence of family triangles. It may be challenging to watch what we deem to be a pathological interaction between our clients without attempting to change it. Triangulation is seen as pathology in families of Western descent (Falicov, 1998), however it may be a functional mode of conflict resolution for more collectivist cultures. In families of German descent, it is common for the children to take precedence privately with the mother, whereas she pays deference to the father only when he is around (Falicov, 1998). This may be seen as “keeping secrets” or being dishonest or disloyal by Western standards. It is important not to pathologize interactions between family members if the family is functioning well in spite of the existence of what we may term pathology – it may be a knee-jerk reaction to try to get our clients to interact with each other on a seemingly more “honest” level, but we may do more damage than good if we make the decision for them. Exploring the ways in which a family’s system is working for them first, is important in determining what needs to change.

According to McGoldrick and Hardy (2008), the disorders of our society seem to be heavily influenced by sociopolitical forces at play. Slavery, as an example, gave rise to distinct disorders named in the DSM – disorders that no longer exist because of society’s views on slavery changing (McGoldrick & Hardy, 2008). In much the same way, family therapy has neglected to take into account race and other demographic factors because they were not deemed as important to family therapy specifically (McGoldrick & Hardy, 2008). It is of paramount importance for family therapists to place emphasis on the historical background of their clients in order to properly treat the issues the client is having. Family therapists should have training experience that includes perspectives taught from a non-European-American viewpoint in order to include other race/ethnicity’s viewpoints (McGoldrick & Hardy, 2008). It seems imperative at this point to open our minds up to what’s working, regardless of the origin.

It is important to not impress our worldview upon our clients. We must take into account the society in which we live as well as the historical background of the client. In our money-driven society (Laszloffy, 2008), we tend to focus on luxury issues instead of the living problems our clients may have. Not all of our clients are going to be as affluent or as poor as we are. It is important to take into account the client’s socioeconomic status as well as the cultural background to integrate appropriate and feasible interventions with our clients; it is inappropriate and unhelpful to expect a client to attend three-times-weekly meetings if transportation is an issue for them. It is of vital importance to assist the client in helping themselves and we cannot do this if we fail to take into account their resources. Social class is a barrier to therapy, but it can be overcome with creativity and ingenuity.

If we, as therapists can open our minds up to other cultures and their teachings, we open the door to exploring a multitude of other influences such as spirituality and indigenous healing practices (McGoldrick & Hardy, 2008). It seems that as long as we don’t decide that we are the final authority over our clients and that we develop a working alliance with them, we will help the client overcome difficulties and that our interventions will be pertinent to their lives.

 

REFERENCES

Bronfenbrenner, U. (1986). Ecology of the family as a context for human development: Research perspectives. Developmental Psychology, Vol. 22 (No. 6), 723-742.

Falicov, C.J. (1998). The cultural meaning of family triangles. In McGoldrick, M. (Ed.), Re-Visioning family therapy (pp. 37-49). New York: Guilford.

Laszloffy, T.A. (2008). Social class: Implications for family therapy. In McGoldrick, M. & Hardy, K.V. (Eds.), Re-Visioning family therapy (pp. 48-60). New York: Guilford.

McGoldrick, M. (Ed.). (1995). You can go home again: Reconnecting with your family. New York: W.W. Norton & Co.

McGoldrick, M. & Hardy, K.V. (2008). Re-Visioning family therapy from a multicultural perspective. In McGoldrick, M. & Hardy, K.V. (Eds.), Re-Visioning family therapy (2^nd ed.) (pp. 3-24). New York: Guilford.