Link between psychological stressors and stroke risk

From the American Heart Association:

Higher levels of stress, hostility and depressive symptoms are associated with significantly increased risk of stroke or transient ischemic attack (TIA) in middle-age and older adults, according to new research in the American Heart Association journal Stroke.

This research finding isn't new or news to those of us in the mental health community but whenever there's data to corroborate what is, at times, conventional wisdom, I like to take the time to post it. What was particularly telling from this study was that hostility was also found to be linked.

When I teach mindfulness, I tend to emphasize the connection I've found between judgemental thoughts and emotion, particularly anger. As we know, hostility is a type of anger, whether that be directed towards others or ourselves. As we strive to live more mindful lives, it's worth examining the connection between our judgements and our long-term emotional and physical health.

TED Talk: All it takes is 10 mindful minutes

Most people assume that meditation is all about stopping thoughts, getting rid of emotions, somehow controlling the mind. But actually it's … about stepping back, seeing the thought clearly, witnessing it coming and going.

 (Andy Puddicombe)

He talks about meditation, but I believe that what he highlights applies equally well to mindfulness. While one might quibble with his emphasis on "doing nothing", the message is clear and relevant.

If You're Too Busy to Meditate, Read This

Mindfulness practice, sometimes equated with meditation, is a very big part of DBT. It helps us focus and manage our emotions more effectively. It helps us live in the moment without judgement and increases our awareness of our current experience. It helps us stay focused.

Research shows that an ability to resist urges will improve your relationships, increase your dependability, and raise your performance. If you can resist your urges, you can make better, more thoughtful decisions. You can be more intentional about what you say and how you say it. You can think about the outcome of your actions before following through on them.

Here's Mihaly Csikszentmihalyi talking about the concept of Flow. Flow is about being in the moment, without judgement. You melt into your experience and all other issues tend to fade away. It'd be a nice way to live your life, don't you think?

Kids and mindfulness

Jonah Lehrer, one of my favorite neuroscience writers in in the popular press writes:

Children who could better regulate their impulses and attention were four times less likely to have a criminal record, three times less likely to be addicted to drugs and half as likely to become single parents. In many instances, the ability to utilize executive control was more predictive of adult outcomes than either IQ scores or socioeconomic status.

This is an interesting perspective. While he doesn't mention mindfulness by name, it's essentially what he's talking about. Specifically, he's referring to the aspect of mindfulness that helps manage attention. Developing ability to choose where to focus your attention seems to have benefits across the lifespan.

Depression and physical activity

A while back, I bookmarked an interesting article (pdf link) that I've been meaning to write about. As I haven't had a chance to really digest the material and compose a longer entry, I thought I just get it up on the site for wider consumption. The gist of the research highlighted therein is that Tai Chi Chih seems to have a positive impact on geriatric depression. Given the relative reluctance some geriatric patients have to psychotherapy and the complicating factors of drug interactions, anything we can do to help that doesn't involve traditional medication management and/or psychotherapy is welcomed. The question remains what is the mechanism of change for this particular intervention. I suspect that it's a result of the increased ability to focus on an activity and the consequent ability to focus away from unwanted ruminations that helps, but that's just my slightly biased-towards-mindfulness explanation.

Group 05/27/2011

After going over the homework, we spent time discussing the importance of judgement in our lives. In light of the work we'll be doing on reducing judgement, it seemed important to make sure that we understood exactly what judgement does for us. Some of the relevant points that people made were:

• Judgement helps keep us safe
• Being judgmental allows us to make decisions more quickly
• Judgement can help us correct our behavior

We, of course, also discussed ways that being judgmental makes being mindful hard.

• Being judgmental makes us compare our current experience to past and/or imagined situations, moving us from being present in the moment to being elsewhere
• Being judgmental generates extra emotion; emotion that we probably don't need help creating
• Being judgmental also makes us focus on details to the exclusion of the bigger picture, again making it hard to see the whole situation as it is

Tying the non-judgmental stance work we're doing to the next module to be covered in group, Distress Tolerance, homework was to answer two questions:

1. How does being judgmental create distress?
2. How does being unmindful create distress?

Next week: beginning Distress Tolerance module.

Group 05/20/2011

In today's group, we reviewed making wise mind choices and discussed all the factors involved in making a wise mind choice. As we discussed last week, it's important to consider all the facts of a situation, how you feel about it and what your body tells you about it. There were a couple other key points addressed in the homework review: make sure you address both sides of the question and a wise mind choice does not need to be permanent. That is, you can decide to decide later.

The new material consisted of an overview of the Mindfulness "What" skills:

• Observe: Just notice using your senses, without words
• Describe: Just the facts. Only observable information should be described. No interpretations, assumptions or judgements.
• Participate: Just do it. Within the Participate skills, we broke it down to 6 levels of participation:
  1. Wake up
  2. Get up
  3. Show up
  4. Act as if you care
  5. Wholeheartedly
  6. Flow

Homework: choose one of the "what" skills and practice it.

Group 05/13/2011

Today in group we discussed the core mindfulness skills. We went over the pros and cons of each state of mind - Reason mind, Emotion mind, Body mind - and how they can be used to help make Wise Mind choices. The premise is simple: make sure you're attending to each of these states of mind, stop, synthesize and make a choice that balances each of these factors as appropriate to the situation. During the discussion of Wise Mind, we reviewed times each of us has been in a wise mind place and how it physically feels to be make a wise mind decision. For many people, wise mind lives in your diaphragm. It "feels right" in your body, particularly settled, in that place.

Homework: Making a wise mind choice. (Homework handouts)

Thinking faster

Training the brain through mindfulness practice is an essential part of Dialectical Behavior Therapy. We work on developing a way of sorting out what is important to attend to and what needs to be left out of awareness. It’s not ignoring information, but making quick decisions about where mental energy needs to be focused.

A recent study, described in the New York Times, highlights some of the differences between athletes and non-athletes in a decision making exercise:

They didn’t move faster,’ said Art Kramer, the director of the Beckman Institute and a leader in the study of exercise and cognition, who oversaw the research. “But it looks like they thought faster.”

The author, correctly, goes on to emphasize that athletes may not be better at making quick decisions because of their athletic participation but it could be that their participation in sports and their ability to make quick decisions are related to a 3rd factor. It may also be that there is a virtuous cycle between that unnamed 3rd factor and athletics:

Of course, it’s also possible that sports didn’t make the athletes better at information processing. Instead, they may have been blessed with naturally fine processing abilities and, as a result, became accomplished athletes. “I’d guess,” Dr. Kramer said, “that to some degree it’s both.” But, he added, the athletes handled the crossings better than the nonathletes, regardless of whether their sport required exquisite timing and tactical thinking — which strongly suggests, he said, that physical training does reshape the brain.

The take-home message for all of us non-athletes is that working on mental acuity exercises and being mindful while doing activities can help improve your ability to be mindful and effective in making decisions.