Autonomic NS response

  • Stress activates the ANSàà fight or flight response –      Activation of the F/F response results in:
    • Increased blood flowàà increased blood pressure, heart rate, blood diverted away from gut and skin to muscles
    • Increased metabolismàà increased respiration, mobilization of energy states, increased metabolic rate
    • Armed defencesàà blood gets thicker to stop bleeding faster, mobilizes immune cells
    • Preparation for tissue repairàà mobilizing inflammatory hormones to help repair tissues damaged whilst dealing with the threat.
  • F/F response can be inappropriately and appropriately activated o It is activated when we need to escape or in an emergency- adaptive response o It is activated when we do not need it

 

Allostatic load: prolonged stress leads to wear and tear on the bodyàà mediated through the sympathetic nervous system

 

High allostatic load leads to:

  • Immune dysregulation
  • Hardening of the arteries which leads to cardiovascular disease
  • Metabolic syndrome- high blood pressure, high blood lipids, high blood glucose, increased weight around torso.
  • Thinning of bones
  • Loss of brain cells particularly in the hippocampus and prefrontal cortex which predisposes to Alzheimer’s disease in later life
  • Growth of amygdala
  • Many of these processes are seen in chronic depression and anxiety

 

These effects can be reversed over time with the regular practice of meditation.

Stress and performance

  • Stress can increase performance to a certain extent
  • Too much stress is associated with lack of focus, poor performance and an increased number of mistakes.
  • Depressed and stress doctors make six times as many errors to compared to healthy doctors

Telomeres

  • As we age, telomeres get shorter and shorter (biological marker for age) àà the shorter they are the older we are
  • Psychological stress is associated with higher oxidative stress and lower telomerase activity (repairs DNA telomeres) = shorter telomere length
  • Women with the highest levels of perceived stress compared with low stress women have shorter telomeres- average equivalent at least 9-17 years of additional ageing.
  • Mindfulness can slow down genetic aging and enhance genetic repair
  • Greater level of mind wandering = greater level of telomere shortening

Default brain

  • There are two main modes of brain activity: active tasks and default states
  • Default states: mind is inattentive, idle, recalling past, daydreaming
  • The default-mode network is a major resting-state network that supports most of the baseline brain
  • Default mode has been associated with: §    Stress

§ Anxiety

§ Depression

§ ADHD

§ Schizophrenia

§ Autism

§ Alzheimer’s disease

§ Criminal recidivism

§ Reduced performance

  • This distracted or unmindful state of mind has a number of effects:
    • Wastes time through a lack of focus o Inefficiency and increased errors
    • Poor communication o Lack of engagement and enjoyment of life  o Misreading what is taking place around us
  • Inattention is not healthy for the brainàà it is like physical inactivity for the body
  • Those who have less than average diversity in leisure activities, spend less time on them, and practice more passive leisure are nearly four times as likely to develop dementia – High default mental activity in psychopathology
  • Default activity is decreased or deactivated when paying attention
  • Active tasks: tasks that require attention, the brain is efficient and quiet

 

Attention deficit

  • Trying to deal with too much input (hyperkinetic environment) results in:
    • Black and white thinking
    • Difficulty staying organised and managing time o Feel a constant low of level of panic and guilt

 

Multi tasking

  • Multitasking is an illusion- reality is we are switching back and forth between tasks
  • Inattentional blindness: only see what we are looking for

 

Mental stimulation

  • No cognitive stimulation leads to changes associated with Alzheimer’s disease (amyloid plaque build up)

 

Mindfulness is voluntarily bringing back a wandering attention over and over again

  • Development of attention is gradual, progressive and requires regular practice – Mindfulness is a mental discipline involving training attention
  • It is not primarily a relaxation exercise although relaxation is a common side-effect – Mindfulness implies cultivating an attitude of openness, interest and acceptance.
  • What we give our attention to is important because we give the power to whatever the attention is directed toàà when we fight with thoughts we don’t want to have we actually feed them with more attention
  • Learning to notice these thoughts and be non-reactive of them is an important aspect of learning to be free of them
  • Mindfulness is not a method of distraction but a method of
  • Common practices: the full stop (5 to 30 mins) and the comma (15 secs to 2 mins)

 

Attention regulation

  • Mindfulness involves attention and attitude
  • Attention regulation has three aspects o To know where our attention is
    • To prioritize where the attention needs to be o For attention to go there and stay there
  • Mindfulness attitude o Openness o Curiosity
    • Acceptance

Benefits of mindfulness:

  • Mindfulness training stabilizes the prefrontal cortex and helps it to function well.
  • Improvements in immunity àà cancer patients show improvements in QOL, symptoms of stress, sleep quality are associated with improved immune responses with lower levels of the inflammatory hormones, which accelerate cancer growth.
  • Improves sleep quality, being able to go to sleep more easily, longer sleep duration, and less use of sleep medication.
  • Promising approach to the management of binge-eating disordersàà does this by increasing awareness of behaviour and physical cues, helping to deal with self-criticism, negative selfimage and managing eating impulses.
  • Reduction in chronic pain, fatigue and sleeplessness
  • Increased ability to feel compassion and empathy as well as reducing career fatigue or burnout (lack of compassion is a side effect of inattention)
  • Helps with management of cravings
  • It can slow down genetic ageing and enhance genetic repair
  • Reduces depressive symptoms and reactivity of the amygdala
  • Reduces anxiety, depression, somatic distress, and increased self-esteem in adolescents.
  • Enhances our executive functions, which are associated with an area of the brain called the prefrontal cortex (short term memory, processing information, knowing what to pay attention to, making decision, emotional regulation).
  • Allows us to utilize our time better, to focus, to foster a growth mindset, which is more conducive to learning.
  • Thickens grey matter in areas associated with senses, memory and executive functionattention, self-awareness
  • Reduce default mental activity
  • Helps us to have a more adaptive and less avoidant coping style
  • Reduction in depersonalization
  • Neuroprotective effects

 

Symptoms of depression àà from a mindfulness perspective

  • Depression can be understood as a disorder of attention
  • Depressive rumination- default mode
  • Not present- foreboding about future and reliving past – Poor functioning- distracted.
  • Adhedonia- lack of pleasure/enjoyment- they are not in the moment so they cannot experience what is going on around them
  • Reactivity- non-acceptance of state of thoughts and emotions

 

Roots of diagnostic error

  • An 8 week mindfulness program- improvements on all measures of wellbeing including; o Mindfulness o Burnout o Empathy and responsiveness to psychosocial aspects o Total mood disturbance o Personality
  • Improvements in mindfulness correlated with improvements on other scales
  • If doctors are not mindful they are also a lot more affected by confirmation bias
  • Anchoring bias: resistance to adapting appropriately to subsequent data that suggest alternative diagnoses
  • Confirmation bias: pursuit of data that supports a diagnosis rather than disputes it.
  • Self–monitoring leads to: early recognition of cognitive biases, avoidance of technical errors, awareness of emotional reactions, facilitation of self-correction

 

Emotional intelligence and mindfulness

  • The five domains of emotional intelligence include: self-awareness, self-regulation, motivation, empathy, and social skill.
  • Mindfulness related to aspects of personality and mental health o Lower neuroticism, psychological symptoms, experiential avoidance, dissociation o Higher emotional intelligence and absorption.
  • High on mindfulness= high on emotional intelligence

 

Mindfulness and health care quality

  • Observational study of clinicians
  • Comparing those with highest and lowest mindfulness scores o Those with high mindfulness scores were more patient-centred, there was more rapport building, more positive emotional tone with patients and higher overall satisfaction of patients

 

Child abuse

  • Adolescents brought up in hostile and unsupportive environments were predisposed to reproduce anti-social behaviours in later life because of overstimulation of the amygdala and underdevelopment of the prefrontal cortex
  • Adolescents who have issues with aggression, particularly young males, have significantly larger and more reactive amygdala’s along with less developed regions to regulate emotions- the prefrontal cortex- than those who do not have issues with aggression

 

Applications of mindfulness

  • Mental health
  • Neuroscience
  • Social
  • Clinical
  • Performance
  • Spiritual