Meditation for the Failing Heart
There is a remarkable study in the current issue of the journal Ethnicity and Disease that seems to show that Transcendental Meditation significantly decreases the severity of congestive heart failure.
Researchers from the University of Pennsylvania evaluated 23 African American men and women with an average age of 64 years, who had recently been hospitalized with New York Heart Association Functional Class II or III congestive heart failure. Participants were randomized to either the Transcendental Meditation (TM) technique or health education, in addition to usual medical care.
The investigators used a standard battery of tests to measure changes in heart function with a six-minute walk test, and scales to evaluate quality of life, depression, and re-hospitalizations. They analyzed changes in outcomes from baseline to three and six months after treatment.
The TM group improved significantly on the six-minute walk test after both three and six months of TM practice compared with the control group. The TM group also showed improvements in quality of life measurements, depression, and they had fewer re-hospitalizations.
Congestive heart failure is a serious illness carrying a very significant morbidity and mortality. According to the American Heart Association, congestive heart failure accounts for more than 2.5 million hospital admissions per year in the U.S. Each year, nearly 500,000 new patients are diagnosed with congestive heart failure – and 300,000 patients die annually from this disease. Despite advances in treatment, the number of deaths from congestive heart failure increased steadily over the past decade.
African Americans have twice the mortality rates from congestive heart failure as white Americans.
It is most likely that TM improves the functioning of the heart by reducing the stress associated activation of the sympathetic nervous system that is known to contribute to the failing heart.
The study was sponsored by the National Institutes of Health – National Center for Complementary and Alternative Medicine (NIH-NCCAM) in a collaboration between the University of Pennsylvania with the Institute for Natural Medicine and Prevention at Maharishi University of Management.
“Meditation is the tongue of the soul and the language of our spirit.”
–Jeremy Taylor (English Anglican Clergyman, Writer and Bishop, 1613-1667)
"The purpose of meditation is not enlightenment, it is to pay attention even at extraordinary times, to be of the present, nothing-but-in-the-present, to bear this mindfulness of now into each event of ordinary life.”
–Peter Matthiessen (American Naturalist and Writer, 1927-)
Mindfulness and Eating Disorders
There is a very interesting report about a study that is going on at Griffith University in Brisbane, Australia.
They are using a psychological technique called "mindfulness" that is firmly rooted in Buddhist philosophy, in which a person becomes intentionally aware of his or her thoughts and actions in the present moment, non-judgmentally. Mindfulness is applied to both bodily actions and the mind’s own thoughts and feelings.
The idea is to help them understand and deal with the emotions that trigger their binges. Unlike many other therapies used in the treatment of eating disorders, there is less focus on food and controlling eating and more on providing freedom from negative thoughts and emotions.
Psychologists Michelle Hanisch and Angela Morgan said that women who binged were often high-achievers and perfectionists and when they perceived that they didn’t measure up to self-imposed standards or were not in control of situations, they indulged in secretive eating binges.
It is well known that many women with eating disorders develop elaborate methods of hiding the evidence of their binges. Some feel so guilty afterwards they also induce vomiting, overuse laxatives or exercise excessively to counteract the effects of the binge.
The researchers say, "Binge eating is largely a distraction – a temporary escape from events and emotions that nevertheless can cause long-term physical problems including electrolyte imbalances. Instead, women need to learn how to react in a different way… Women who have been through the program report less dissatisfaction with their bodies, increased self-esteem and improved personal relationships," and "They learn that thoughts and emotions don’t have any power over us as they are just passing phenomena and aren’t permanent."
Mindfulness involves techniques and exercises that are very similar to meditation. They could help people live more in the moment, and develop a healthy acceptance of self and become aware of potentially destructive habitual responses.
There is quite a large literature on the use of mindfulness in a variety of clinical situations including substance abuse, oncology, chronic stress, reducing symptoms after organ transplantation, chronic headache and perhaps anxiety.
It will be interesting to see the final results of this study: I shall keep you informed about this and other studies on mindfulness, meditation and acceptance and committment therapy (ACT).
“Peace can be reached through meditation on the knowledge which dreams can give. Peace can also be reached through concentration upon that which is dearest to the heart.”
–Patanjali (Indian Philosopher said to be the Compiler of the Yoga Sutras, Dates Unknown)
"Meditation is not to escape from society, but to come
back to ourselves and see what is going on. Once there is
seeing, there must be acting. With mindfulness, we know
what to do and what not to do to help.”
Thich Nhat Hanh (Vietnamese Buddhist Monk, 1926-)
“Generosity is another quality which, like patience, letting go, non-judging, and trust, provides a solid foundation for mindfulness practice. You might experiment with using the cultivation of generosity as a vehicle for deep self-observation and inquiry as well as an exercise in giving. A good place to start is with yourself. See if you can give yourself gifts that may be true blessings, such as self-acceptance, or some time each day with no purpose. Practice feeling deserving enough to accept these gifts without obligation — to simply receive from yourself, and from the universe.”
–Jon Kabat Zinn (American Mindfulness Meditation Teacher and Associate Professor of Medicine at the University of Massachusetts Medical School, 1944-)
The Maharishi Effect
In 1976, researchers associated with the Maharishi Mahesh Yogi first described that in communities where there were large numbers of serious meditators, crime rates went down as the number of meditators went up. This has become known as the “Maharishi effect,” and some of this research has been published in highly reputable journals. You can see a summary of some of the research here. I also discuss this whole fascinating issue in more detail in Healing, Meaning and Purpose.
As you can imagine, it is controversial and has stirred up some heated arguments. But mounting research is pointing to evidence of a global consciousness that is developing and evolving.
More data on this effect was presented at a news conference on Wednesday, November 1, at Maharishi University of Management in Fairfield, Iowa. Scientists reported on a rigorous, controlled econometric analysis of the first 100 days of a $12 million scientific demonstration project to monitor the effects of 1200 advanced Transcendental Meditation practitioners on quality of life indicators.
The research is said to show that since the project began on July 23, 2006, the Dow Jones Industrial Index and the S&P 500 have posted total gains of approximately 12%, and the NASDAQ has climbed nearly 18%. The Dow has repeatedly hit all-time record levels, the S&P reaching a 5.5-year high, and the NASDAQ climbing to a five-year high.
If true, this is astonishing.
I don’t doubt the sincerity or scientific expertise of any members of the research teams. I’ve checked out some of the other work that each has done, and it has all been of the highest order. The one problem is that this is like a pharmaceutical company having a press conference to tell the world about a new wonder drug before anyone outside the company has had a chance to check out the research. Yes the data is out there, but there are a hundred and one messy little details that need to be checked over.
We have no reason to doubt, except that doubt has to be the perpetual mind set of the scientist. Many factors can make the markets go up and down. And until the research has been checked and validated by every interested person in the world we have to remain skeptical.
Let me tell you how this checking is done. Last week I was sent a research paper by a prestigious journal with a personal note from the editor asking me to see what I thought of the research. I read through the paper in great detail, checking the citations, the methodology, statistics and even the spelling.
This is a task undertaken by every senior academic, often once or twice a week. We don’t get paid for doing it, and the whole process is anonymous: I don’t know who did the research and they don’t know who is passing judgment on their labors. We do this work for the common good. Earlier this evening I completed my report to the editor. But it doesn’t stop there. One or two other experts will have done the same with the paper and then the editor decides based on all of our reports.
Then there are two more steps. If the editor decides to publish, then the global scientific community will crawl all over the research to see if we reviewers have missed anything and if the research looks okay. Finally others will have to replicate the study.
This is why research often seems to progress at a snail’s pace. In actual fact it isn’t. It is going very quickly, but each step is being checked extremely carefully. Even with all of this conscientious effort, research regularly gets published that turns out not to be correct after all.
And with such extraordinary claims we require extraordinarily good proof.
If, as I suspect, the research is indeed found to be correct, it could change the world forever.
Music Therapy
Music therapy has been in use for millennia: in the Bible David played his harp to try to ease the suffering of King Saul and there are whole systems of musical healing in the traditional healing systems of China and India. I have commented before on the extraordinary power of music.
Apart from our experience, there is an astonishingly large and diverse body of scientific literature on music therapy, not just to help individuals, but also on possibly improving the performance of health care providers. Many surgeons attest that they do a better technical job if they are listening to music.
This month’s issue of the British Journal of Psychiatry carries an interesting article about the value of music therapy in people with schizophrenic illnesses. Though small, it indicates that music therapy can be helpful, and speaks to the integrity of many components of the nervous systems of people with this large and diverse group of problems.
There is good evidence that music therapy may help with:
- Treatment-related distress in people having treatment for several cancers
- Autistic spectrum disorders
- Calming people who are having cardiac catheterization procedures
- Pain relief
- Distress after total knee replacement
- Pain after leg fractures
- Apathy in people with dementia
- Sleep and heart rate patterns in pre-term babies
This is by no means an exhaustive list: I have found several hundred studies, many of which are quite well designed. There are also several professional organizations such as the American Music Therapy Association.
It is clearly important to choose the right kind of music: I would guess that Metallica is less likely to soothe the fevered brow than Steve Halpern.
Background music can be wonderful for improving the ambience of your home or workplace. But you can also be more focused in your use of music to help or support other types of health and wellness programs.
Select the music that you like: there are now many wonderful programs geared toward using music for healing: I can give you a list of some that I have tested. The good ones will entrain your heart rate, some of your brain rhythms and the subtle systems of your body.
If you can find 20 minutes, the right music listened to while sitting or lying with your eyes closed can be as effective as a short meditation. For this to work well, it is best to use good quality headphones and to allow the music to wash over and soak you like a warm bath, while gradually slowing and deepening your breath.
I’ve also made extensive use of specifically chosen music during massage, acupuncture, yoga, and while practicing t’ai chi ch’uan and qigong. Some purists don’t like using music while doing these activities, but I’ve usually found that music can enhance each type of practice.
Try it and see what you think.
Attention Deficit Disorder and Executive Functioning
“Not to have control over the senses is like sailing in a rudderless ship, bound to break to pieces on coming in contact with the very first rock.”
–Mahatma Gandhi (Indian Nationalist and World Teacher, 1869-1948)
The Mahatma’s statement could apply to most people stuggling with attention deficit disorder.
There is an important idea in neurology and psychology called “Executive functioning.” This refers to our ability to be able to make and carry out plans, direct our attention, focus and also to control our internal states: our impulses and emotions and to be able to switch from one task to another. In other words it is a key part of our ability to self-regulate our behavior, mind and emotions.
Most evidence now indicates that executive function is mediated by the regions of the dorsolateral prefrontal cortex. It happens that these same regions are amongst those that seem to undergo beneficial changes in people who practice meditation.
For people interested in attention deficit disorder, I’d like to recommend a book, “Attention Deficit Disorder: The Unfocused Mind in Children and Adults,” by Thomas E. Brown. In the book he encapsulates some up-to-date research indicating that one way of conceptualizing some of the difficulties faced by people with attention deficit disorder, is to break them down into the six major “domains” of executive functioning:
- Activation: Organizing, prioritizing and getting to school or work
- Focus: Tuning in, maintaining focus and shifting attention
- Effort: Sustaining effort, regulating alertness and adjusting processing speed
- Emotions: Modulating emotions and managing frustration
- Memory: Holding and manipulating information and retrieving memories
- Action: Monitoring and regulating actions
It can be very helpful for people to understand why they face the problems that they do, and how each may be amenable to a different type of help.
What we have done below is to re-draw and slightly simplify an extremely helpful diagram from Dr. Brown’s book, that will make it easier for you to see that kind of problems you or a loved one may be facing, and how treatment and coping strategies will be directed toward whichever of these is causing the most trouble in a person’s life.
(You can click on the diagram to see a large version of it.)
Intuitive Knowing and the Real Rainman
In 1988 the Dustin Hoffman won the Academy Award for Best Actor for his portrayal of Raymond Babbit in the movie Rainman.
The character was actually inspired by a real person named Kim Peek. Now in his mid-fifties, Kim has memorized more than 11,000 books, and can read a page of any book in about ten seconds. It has recently been discovered that each of his eyes can read a separate page simultaneously, absorbing every word. He can also do instant calculations on things related to the calendar and several other very specialized topics.
He and his brain has been studied in great detail by a Dr. Darold Treffert at University of Wisconsin Medical School. It is quite different from the rest of the population. He does not have the great bridge – the corpus callosum – that connects the two hemispheres in most people. Instead he just has one solid hemisphere. The right cerebellum is in several pieces. None of this really explains his abilities, though perhaps having no corpus callosum means that the right side of his brain is freed from dominance by the left. Darold Treffert makes a good point when ha says that Kim’s father is partly responsible for his brilliance: his belief in his son and his unconditional love for him may have more to do with bringing forth his remarkable skills than the wiring of his brain.
There have been many other cases of savants who had remarkable and seemingly effortless abilities. For years now I’ve collected reports about some of them. Srinivasa Ramanujan who complied over 3000 mathematical theorems in less than four years. Vito Magniamele who at the age of 10 could compute almost instantly the square root of any large number. Then there was a six-year-old child named Benjamin Blythe, who while out walking with his father in 1826, asked, “What time is it?” After being told, he gave – accurately – the exact number of seconds that he had been alive, including the two leap years. In one of his books, Oliver Sachs, describes a pair of twins in a psychiatric hospital who are said to have below “normal” intelligence, but who amuse themselves by swapping enormous prime numbers. Even the English chess grandmaster John Nunn reported how, as a child, he could do instant calculations in his head. And, at the age of fifteen, he became the youngest undergraduate at Oxford University in 300 years. Most strong chess masters will "know" where to put the pieces, but then come up with the logical reasons later on.
These abilities: to read and memorize, to do instant calculations and to have instant deep knowledge of topics is remarkably interesting and important for all of us. If complex mathematics can be done by people who have no training or intellectual sophistication, what other gifts and talents may we have lying undiscovered within us?
These observations lead to the questions; first, can anyone do the same feats as Kim Peek? Second, where does instant mathematical information come from? Third, can anyone access it? And fourth, is this similar to the way that shamans and Babylonian mathematicians obtained their information?
In Healing, Meaning and Purpose we learn that there is powerful evidence to suggest that we do have access to a whole seam of knowledge about the world around us. The anthropologist Jeremy Narby studied shamans in the Amazonian rainforest who have found safe and effective herbal treatments among the 80,000 plants available to them. They are usually used in combinations, and to have tested all the plants and all the possible combinations would have taken hundreds of thousands of years. So it cannot have been done by trial and error. I have seen something similar in traditional Chinese herbal medicine, where combinations are invariably used, and once again, if the effective ones had been discovered by trial and error, it would have taken armies of physicians working for countless thousands of years.
I don’t expect everyone to be able to become lightning calculators. Neither would most us want to be. But there are a number of ways of getting much better at tapping this intuitive knowing. It is important to tap your intuition and to use it as the ally of your reasoning.
- Relaxation, meditation or prayer are all excellent for starting the process. Meditation to explore your inner nature may take hours a day for many years, but when we use it to improve our inner knowing, a few minutes a day is all that you need. Just long enough slightly to alter your state of consciousness
- Visualize a place that you really like that you can return to at will. I learned this trick from a shaman, and it’s immensely useful. You might remember, visualize or create a space for yourself. For instance you might like to imagine going to a beach that you like.
- Ask a question: remember that the quality of your answers is dependent on the quality of your questions. So be precise and be calm when you ask you question.
- Agree with yourself that you will take action on what you learn. And that leads me to the last point for today:
- I just got an email question about how to differentiate between an impulse and an intuition. The answer to that is your response: an impulse impels you to immediate action, an intuition gives you time to reflect and to thank the Universe for what you’ve just been told.
“At every moment there is in us an infinity of perceptions, unaccompanied by awareness or reflection. That is, of alterations in the soul itself, of which we are unaware because the impressions are either too minute or too numerous.”
–Baron Gottfried Wilhelm von Leibniz (German Philosopher and Mathematician, 1646-1716)
Yoga for Attention Deficit Disorder?
Apart from a sizeable number of pharmacological treatments coupled with psychological and family therapies, an enormous number of unorthodox treatments have been tried for attention deficit disorders and attention deficit hyperactivity disorders (ADD/ADHD). One of the best reviews was published in the Annals of the New York Academy of Sciences. I have the privilege of being a member of the Academy.
There have been some recent attempts to see if ADD/ADHD might be helped with yoga or meditation.
The first study came from Australia and was published in 2004. It was small: only eleven boys with ADHD were enrolled in a 20-session yoga class, but nonetheless, the results were encouraging. The yoga was done as an adjunct to conventional treatment with medications. The authors concluded that yoga increased concentration, promoted mental and physical discipline and induced confidence. The parents of the boys thought that the kids doing yoga were rather less hyperactive.
Another study has just been published from Heidelberg in Germany. The main paper is in German, but there is a short summary in English. This again was a pilot study, this time involving 19 children. These researchers felt that yoga practice, and in particular forward bends that improve breathing were the key to helping the children develop better concentration.
There is a nice summary of mainly peer-reviewed papers on research into yoga. This website doesn’t critically evaluate the research, but it’s a good starting point if you are interested in some of the research going on into the potential health benefits of yoga and some related practices.
Multiple Selves
There is a most interesting report from the Weizmann Institute of Science in Israel. This study relates back to some of my previous posts about meditation and hyperfocus. I think that we’ve all had the experience of losing ourselves in any activity: playing a game, watching a movie, sex or an enthralling novel. The researchers showed that during intense sensory tasks, the introspective self-related functions of the brain shut down. The experimental subjects were asked to look at pictures or listen to music. For sensory processing, the subjects were asked to answer yes/no questions about the items. To study introspection, the subjects were asked to indicate whether emotionally they felt strongly or neutrally about the image or musical passage. While they were doing all this, their brains were being scanned using functional MRI (fMRI).
As expected, regions of the brain activated during sensory processing or self-reflective introspection were quite distinct and segregated. Sensory processing activated the sensory cortex and related structures, while introspection activated the prefrontal cortex. But the important finding was that activity in the self-related prefrontal cortex was damped down during intense sensory processing. What this seems to indicate, is that the self-related cortex isn’t involved in the awareness of perceptions, but is involved in allowing us to reflect upon perceptions, to judge their importance to us, and to allow us to report our experiences to the outside world.
I have a quibble with something that they say at the end of the paper: “Thus, the term “losing yourself” receives here a clear neuronal correlate. This theme has a tantalizing echoing in Eastern philosophies such as Zen teachings, which emphasize the need to enter into a “mindless,” selfless mental state to achieve a true sense of reality.”
As interesting as the study is, I think that these comments betray a rather one-dimensional view of the “self.” There are clearly many aspects to the “self:”
- Physical
- Sensory
- Psychological: the Conscious, Preconscious and Unconscious Selves
- Relational: (Have a look back at my post form March 15th
- Subtle
- Spiritual
My 35-year experience and understanding of the Eastern traditions is not of simply switching off one or other of these “selves,” but of bringing full mindful attention to everything that is going on. I just came across a brief piece by Professor Charles Tart , in which he is saying something very similar, and points out, with characteristic wit, that the Eastern mindfulness teachings don’t require us to enter into a “mindless” state to find reality. After all, if you are belabored about the head and shoulders with a stout cudgel, that should also achieve that aim!
So we return to a theme on which I’ve been expounding for some time now: these studies are fascinating and interesting, but they only deal with one part of the human experience. Let me refer you back to Ken Wilber for his important views on this issue, and the long section in Healing, Meaning and Purpose, that discusses this in considerable detail. The neurological findings represent correspondences and not causes.
Another blogger, Neurocritic, picked up an amusing error in a report of this study in New Scientist . Well spotted!
Technorati tags: Charles Tart, losing yourself, One Taste, Ken Wilber
Hypnosis and Electrical Activity In the Brain
Following my post on Meditation and the Brain a perceptive reader just asked a great question:
“Has any of the research found any difference between hypnosis and meditation as it relates to brainwaves. And do people in a state of hypnosis demonstrate these high gamma waves?”
This is so interesting that I thought it was worth a short note of its own.
On the first occasion that I was hypnotized during my training, I remember thinking that the experience was very like the first stage of meditative practice: I was primarily using Vipassana back then. Subsequent subjective experiences have all tended to confirm that view: there are some similarities between trance and early meditative experiences.
There is a good amount of empirical research that tends to confirm that. John Gruzelier’s group at Imperial College in London has published some very fine work using not just electroencephalographic (EEG) measurements, but also functional MRI (fMRI). Gamma waves are between 30 to 100 Hertz, or cycles per second, and appear to reflect the way in which cells exchange information about the environment and form mental impressions. Gamma oscillations have a role in the subjective experience of pain. Not only has Gruzelier’s group shown some of the same gamma wave coherence, but also, research published in October of last year suggests that individual differences in hypnotic susceptibility are linked with the efficiency of the frontal lobe attention system. Hypnosis appears to involve a dissociation of the prefrontal cortex from other neural functions. Both the meditation and hypnosis studies have indicated that the key regions are primarily in the left frontal lobe.
The difference is that although people can demonstrate similar gamma wave activity when hypnotized, in the experienced meditators the gamma wave activity was there all the time, but would increase dramatically when meditating. How dramatic? Thirty fold higher activity than in a non-meditator. The trained brain is physically different from the untrained one.
Bob McCarley’s group at Harvard has done some interesting work in which healthy volunteers and people with schizophrenia were asked to look at images. The people suffering from schizophrenia showed no gamma wave activity at all.
Interestingly, there is also a very recent paper out in the Journal of Psychoactive Drugs showing the same EEG gamma coherence in two experienced people using the Brazilian drug ayahuasca, which suggest further similarities between meditation and shamanic psychedelic practices.
Technorati tags: brain waves, hypnosis
Meditation and the Brain
1. There are many types of meditation: many are a form of intense concentration, others are a witnessing or watching of thoughts, yet others are a form of profound devotion. So it is no surprise that different forms will produce different effects in the brain.
2. The fact that the brain can be trained to produce certain types of electrical activity is in line with multiple lines of evidence demonstrating that the brain is not the static structure that we used to think it to be: it can learn and develop. We already knew that with motor functions and some cognitive abilities, but now we can extend those findings into the emotions: feelings of love and empathy can be developed, expanded and deepened. The old metaphor that the brain can be exercised like a muscle may not be a metaphor after all, but a biological fact.
3. The fact that there are neurological correlates of meditation or of any emotional or psychological state does not mean that we can reduce the experience to the firing of some neurons or the synchronization of regions of the brain. Some of this research has been misinterpreted to mean that meditative states or mystical insights are no more than the calming of neural activity. It is vital that we also acknowledge the subjective experiences and reports of individuals and recognize that they are as valid descriptors as changes in the brain.
4. Meditation has been shown to have a great many physiological and psychological effects, from lowering blood pressure, to improving the performance of sleep-deprived individuals, reducing age-related cortical thinning and ultimately leading to demonstrable psychological and spiritual development. So the neurological and psychological findings provide a partial explanation for those observations.
Technorati tags: meditation, Dalai Lama, brain, Neuroscience
