<p>This chapter from the book <em>MindScience : An East-West Dialogue</em> is a record of a presentation given by Harvard doctor Herbert Benson during a conference between the Dalai Lama and psychologists, psychiatrists, neuroscientists, and psychobiologists at Harvard Medical School on March 24, 1991. The purpose of the conference, in part, was to share with the Dalai Lama and the medical community some of the scientific studies performed by Herbert Benson with Tibetan monks practicing "Tummo" (gtum mo) or the meditative generation of inner heat.</p>
<p>Herbert Benson gives an account of his experiences and the scientific findings from studying the physiological effects of meditation, starting in 1967 with practitioners of transcendental meditation and then eventually working with Tibetan monks with an expertise in the practice of "inner heat" (gtum mo). He specifically discusses how these types of meditative practices can significantly increase or decrease metabolism. Dr. Benson describes the nature of the studies performed with Tibetan monks, including the specific physiological changes he measured such as skin temperature and oxygen consumption. He also gives a general overview of the medical understanding of temperature regulation, looking specifically at the how warm-blooded animals regulate temperature through (1) heat production and (2) heat conservation.</p>
<p>Heat production can result through muscle activity and through chemical changes, such as chemical changes effected by the hormones epinephrine and thyroxin. Heat conservation is achieved in a variety of ways such as reducing the amount of skin exposure to the cold, piloerection (raising of hair, humans replace this by wearing clothing), and reducing blood flow to the extremities (where it will cool more rapidly). When put in a cold environment, the body naturally reduces blood flow to the extremities. However, practitioners of inner heat do the opposite: they increase the surface temperature of the skin. They also increase their metabolism.</p>
<p>Dr. Benson also discusses how his studies on meditators, in general, relate to what he calls the "relaxation response." This system is the opposite of the "stress response" which is involved with physiological reactions of "fight-or-flight." Research on the relaxation response has opened the door for its use in clinical settings for treatment of hypertension, cardiac arrhythmias, chronic pain, insomnia, the side of effects of cancer and AIDS therapies, anxiety disorders, depression, menstrual tension and infertility, and is also being applied as a preparation for surgery.</p>
<p>Finally, Dr. Benson answers questions from the audience on how his work relates to hypnosis, the treatment of cancer, the effect of meditation on blood carbon dioxide levels and blood pH, as well as other issues involved in the study of meditation. (Zach Rowinski 2005-01-04)</p>
Acceptance and Mindfulness in Cognitive Behavior Therapy: Understanding and Applying the New Therapies brings together a renowned group of leading figures in CBT who address key issues and topics, including:Mindfulness-based cognitive therapy
Metacognitive therapy
Mindfulness-based stress reduction
Dialectical behavior therapy
Understanding acceptance and commitment therapy in context
Europe takes a rather cautious approach to herbal medicines. Traditional Herbal Medicines are regulated via European Union-directive 2001/83/EC, especially articles 16a-h. For Asian medicines, this new regulation poses several challenges, specifically the requirements on medicine 'quality' and on requirements of a proven record of at least 15 years of tradition or use within the EU. This makes it very hard for most of the medicines of Asian tradition to enter the EU market as medicines. The notion of 'tradition' in this directive may have been taken from a definition given by the World Health Organisation (WHO) on Traditional Medicine or from the existing label Traditional Chinese Medicine (TCM). Both concepts, although labelled as 'traditional', link themselves to a modernised and standardised practice of complementary medicine in a globalised setting. This essay investigates the function of the label 'traditional' in the European frame in connection with Tibetan medicine.
<p>The study of the Abhidharma is indispensable for understanding the history of Buddhist philosophy and practice. Originally a summary of terms according to subject matters, it was first systematized into a philosophical analysis of man and his world by the bainhasikas. Their analysis was accepted by all subsequent schools who elaborated the implications of this earliest philosophical system in Buddhism. This book gives a synoptic view of the significance of the Abhidharma as presented by the Theravadins & brought to its climax by the Vaibhasikas & Yogacara-Vijnanovadins. It analyzes the concepts of Mind and its States with reference to healthy and unhealthy attitudes towards life and deals with the psychological factors and problems in Meditation which is geared to an individual's capacity and temperament. Theories of perception, a predominant feature of Indian & Buddhist philosophies, are discussed together with the interpretation of the world on the basis of these theories as well as their critiques. The discussion of the Path as conceived by the various schools concludes this survey of the Abhidharma. Of particular significance are the accompanying tables of the structure of mind in Buddhist philosophy.</p>
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Mindfulness has become a fixture of both clinical treatment and popular culture. Much research and theoretical scholarship have operationalized “mindfulness” as clinicians use the term, yet no research has examined popular (i.e., lay) conceptions of mindfulness. Mindfulness trainings and interventions are now widely offered on college campuses. Thus, as a starting point for assessing lay conceptions of the construct, we examined how undergraduate college students at an urban university (N = 361) conceptualize mindfulness. In open-ended responses, participants linked mindfulness to awareness of external objects, internal sensations, or being in the present moment. When rating sentences on how well they represented mindfulness, participants strongly associated mindfulness with controlling emotions. In both the open-ended and sentence stem responses, mindfulness was rarely associated with psychological acceptance, which is notable because of the importance of acceptance in mindfulness-based clinical treatments. Implications and future directions are discussed.
OBJECTIVES: The purpose of this study was to examine the effects of a structured, 8-week, Mindfulness-Based Stress Reduction (MBSR) program on perceived stress, mood, endocrine function, immunity, and functional health outcomes in individuals infected with the human immunodeficiency virus (HIV).DESIGN: This study used a quasiexperimental, nonrandomized design.
METHODS: Subjects were specifically recruited (nonrandom) for intervention (MBSR) or comparison group. Data were collected at pretest and post-test in the MBSR group and at matched times in the comparison group. t Tests where performed to determine within-group changes and between-group differences.
RESULTS: Natural killer cell activity and number increased significantly in the MBSR group compared to the comparison group. No significant changes or differences were found for psychological, endocrine, or functional health variables.
CONCLUSIONS: These results provide tentative evidence that MBSR may assist in improving immunity in individuals infected with HIV.
OBJECTIVES: The purpose of this study was to examine the effects of a structured, 8-week, Mindfulness-Based Stress Reduction (MBSR) program on perceived stress, mood, endocrine function, immunity, and functional health outcomes in individuals infected with the human immunodeficiency virus (HIV).DESIGN: This study used a quasiexperimental, nonrandomized design.
METHODS: Subjects were specifically recruited (nonrandom) for intervention (MBSR) or comparison group. Data were collected at pretest and post-test in the MBSR group and at matched times in the comparison group. t Tests where performed to determine within-group changes and between-group differences.
RESULTS: Natural killer cell activity and number increased significantly in the MBSR group compared to the comparison group. No significant changes or differences were found for psychological, endocrine, or functional health variables.
CONCLUSIONS: These results provide tentative evidence that MBSR may assist in improving immunity in individuals infected with HIV.
Acceptance and commitment therapy (ACT) has a small but growing database of support. One hundred and one heterogeneous outpatients reporting moderate to severe levels of anxiety or depression were randomly assigned to traditional cognitive therapy (CT) or to ACT. To maximize external validity, the authors utilized very minimal exclusion criteria. Participants receiving CT and ACT evidenced large, equivalent improvements in depression, anxiety, functioning difficulties, quality of life, life satisfaction, and clinician-rated functioning. Whereas improvements were equivalent across the two groups, the mechanisms of action appeared to differ. Changes in “observing” and “describing” one's experiences appeared to mediate outcomes for the CT group relative to the ACT group, whereas “experiential avoidance,” “acting with awareness,” and “acceptance” mediated outcomes for the ACT group. Overall, the results suggest that ACT is a viable and disseminable treatment, the effectiveness of which appears equivalent to that of CT, even as its mechanisms appear to be distinct.
Acceptance and commitment therapy (ACT) has a small but growing database of support. One hundred and one heterogeneous outpatients reporting moderate to severe levels of anxiety or depression were randomly assigned to traditional cognitive therapy (CT) or to ACT. To maximize external validity, the authors utilized very minimal exclusion criteria. Participants receiving CT and ACT evidenced large, equivalent improvements in depression, anxiety, functioning difficulties, quality of life, life satisfaction, and clinician-rated functioning. Whereas improvements were equivalent across the two groups, the mechanisms of action appeared to differ. Changes in “observing” and “describing” one's experiences appeared to mediate outcomes for the CT group relative to the ACT group, whereas “experiential avoidance,” “acting with awareness,” and “acceptance” mediated outcomes for the ACT group. Overall, the results suggest that ACT is a viable and disseminable treatment, the effectiveness of which appears equivalent to that of CT, even as its mechanisms appear to be distinct.
Many university students suffer from test anxiety that is severe enough to impair performance. Given mixed efficacy results of previous cognitive-behavior therapy (CBT) trials and a theoretically driven rationale, an acceptance-based behavior therapy (ABBT) approach was compared to traditional CBT (i.e., Beckian cognitive therapy; CT) for the treatment of test anxiety. In this pilot study, 16 university students with test anxiety were randomly assigned to receive either a CT or ABBT 2-hr group workshop. The two treatments produced markedly different effects on test performance (measured by exam scores), with those receiving ABBT experiencing improvements in performance, whereas those receiving CT exhibited reduced performance. In addition, there was a suggestion that ABBT might have been more effective at reducing subjectively experienced test anxiety (i.e., a nonsignificant but medium-sized group by time interaction effect). Implications of these results for the treatment of test anxiety and for theoretical notions related to cognitive change strategies are discussed.
Many university students suffer from test anxiety that is severe enough to impair performance. Given mixed efficacy results of previous cognitive-behavior therapy (CBT) trials and a theoretically driven rationale, an acceptance-based behavior therapy (ABBT) approach was compared to traditional CBT (i.e., Beckian cognitive therapy; CT) for the treatment of test anxiety. In this pilot study, 16 university students with test anxiety were randomly assigned to receive either a CT or ABBT 2-hr group workshop. The two treatments produced markedly different effects on test performance (measured by exam scores), with those receiving ABBT experiencing improvements in performance, whereas those receiving CT exhibited reduced performance. In addition, there was a suggestion that ABBT might have been more effective at reducing subjectively experienced test anxiety (i.e., a nonsignificant but medium-sized group by time interaction effect). Implications of these results for the treatment of test anxiety and for theoretical notions related to cognitive change strategies are discussed.
Activation of the induced receptor for advanced glycation endproducts (RAGE) leads to initiation of NF-κB and MAP kinase signaling pathways resulting in propagation and perpetuation of inflammation. RAGE knock out animals are less susceptible to acute inflammation and carcinogen induced tumor development. We have reported that most forms of tumor cell death result in release of the RAGE ligand, HMGB1. We now report a novel role for RAGE in the tumor cell response to stress. Targeted knockdown of RAGE in the tumor cell, leads to increased apoptosis, diminished autophagy and decreased tumor cell survival . In contrast, overexpression of RAGE is associated with enhanced autophagy, diminished apoptosis and greater tumor cell viability. RAGE limits apoptosis through a p53 dependent mitochondrial pathway. Moreover, RAGE-sustained autophagy is associated with decreased phosphorylation of mTOR and increased Beclin-1/VPS34 autophagosome formation. These findings demonstrate that the inflammatory receptor RAGE plays a heretofore unrecognized role in the tumor cell response to stress. Furthermore, these studies establish a direct link between inflammatory mediators in the tumor microenvironment and resistance to programmed cell death. Our data suggest that targeted inhibition of RAGE or its ligands may serve as novel targets to enhance current cancer therapies.
When Dr. Herbert Benson introduced this simple, effective, mind/body approach to relieving stress twenty-five years ag, his book became an instant national bestseller. Since that time, millions of people have learned the secret--without high-priced lectures or prescription medicines. The Relaxation Response has become the classic reference recommended by most health care professionals and authorities to treat the harmful effects of stress.Discovered by Dr. Benson and his colleagues in the laboratories of Harvard Medical School and its teaching hospitals, this revitalizing, therapeutic approach is now routinely recommended to treat patients suffering from heart conditions, high blood pressure, chronic pain, insomnia, and many other physical ailments. It requires only minutes to learn, and just ten to twenty minutes of practice twice a day.
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<p>OBJECTIVES: The study objectives were to develop and objectively assess the therapeutic effect of a novel movement-based complementary and alternative medicine approach for children with an autism-spectrum disorder (ASD). DESIGN: A within-subject analysis comparing pre- to post-treatment scores on two standard measures of childhood behavioral problems was used. SETTINGS AND LOCATION: The intervention and data analysis occurred at a tertiary care, medical school teaching hospital. SUBJECTS: Twenty-four (24) children aged 3-16 years with a diagnosis of an ASD comprised the study group. INTERVENTION: The efficacy of an 8-week multimodal yoga, dance, and music therapy program based on the relaxation response (RR) was developed and examined. OUTCOME MEASURES: The study outcome was measured using The Behavioral Assessment System for Children, Second Edition (BASC-2) and the Aberrant Behavioral Checklist (ABC). RESULTS: Robust changes were found on the BASC-2, primarily for 5-12-year-old children. Unexpectedly, the post-treatment scores on the Atypicality scale of the BASC-2, which measures some of the core features of autism, changed significantly (p=0.003). CONCLUSIONS: A movement-based, modified RR program, involving yoga and dance, showed efficacy in treating behavioral and some core features of autism, particularly for latency-age children.</p>
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OBJECTIVES: The study objectives were to develop and objectively assess the therapeutic effect of a novel movement-based complementary and alternative medicine approach for children with an autism-spectrum disorder (ASD).DESIGN: A within-subject analysis comparing pre- to post-treatment scores on two standard measures of childhood behavioral problems was used.
SETTINGS AND LOCATION: The intervention and data analysis occurred at a tertiary care, medical school teaching hospital.
SUBJECTS: Twenty-four (24) children aged 3-16 years with a diagnosis of an ASD comprised the study group.
INTERVENTION: The efficacy of an 8-week multimodal yoga, dance, and music therapy program based on the relaxation response (RR) was developed and examined.
OUTCOME MEASURES: The study outcome was measured using The Behavioral Assessment System for Children, Second Edition (BASC-2) and the Aberrant Behavioral Checklist (ABC).
RESULTS: Robust changes were found on the BASC-2, primarily for 5-12-year-old children. Unexpectedly, the post-treatment scores on the Atypicality scale of the BASC-2, which measures some of the core features of autism, changed significantly (p=0.003).
CONCLUSIONS: A movement-based, modified RR program, involving yoga and dance, showed efficacy in treating behavioral and some core features of autism, particularly for latency-age children.
<p>The relaxation response (RR) is the counterpart of the stress response. Millennia-old practices evoking the RR include meditation, yoga and repetitive prayer. Although RR elicitation is an effective therapeutic intervention that counteracts the adverse clinical effects of stress in disorders including hypertension, anxiety, insomnia and aging, the underlying molecular mechanisms that explain these clinical benefits remain undetermined. To assess rapid time-dependent (temporal) genomic changes during one session of RR practice among healthy practitioners with years of RR practice and also in novices before and after 8 weeks of RR training, we measured the transcriptome in peripheral blood prior to, immediately after, and 15 minutes after listening to an RR-eliciting or a health education CD. Both short-term and long-term practitioners evoked significant temporal gene expression changes with greater significance in the latter as compared to novices. RR practice enhanced expression of genes associated with energy metabolism, mitochondrial function, insulin secretion and telomere maintenance, and reduced expression of genes linked to inflammatory response and stress-related pathways. Interactive network analyses of RR-affected pathways identified mitochondrial ATP synthase and insulin (INS) as top upregulated critical molecules (focus hubs) and NF-κB pathway genes as top downregulated focus hubs. Our results for the first time indicate that RR elicitation, particularly after long-term practice, may evoke its downstream health benefits by improving mitochondrial energy production and utilization and thus promoting mitochondrial resiliency through upregulation of ATPase and insulin function. Mitochondrial resiliency might also be promoted by RR-induced downregulation of NF-κB-associated upstream and downstream targets that mitigates stress.</p>
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The relaxation response (RR) is the counterpart of the stress response. Millennia-old practices evoking the RR include meditation, yoga and repetitive prayer. Although RR elicitation is an effective therapeutic intervention that counteracts the adverse clinical effects of stress in disorders including hypertension, anxiety, insomnia and aging, the underlying molecular mechanisms that explain these clinical benefits remain undetermined. To assess rapid time-dependent (temporal) genomic changes during one session of RR practice among healthy practitioners with years of RR practice and also in novices before and after 8 weeks of RR training, we measured the transcriptome in peripheral blood prior to, immediately after, and 15 minutes after listening to an RR-eliciting or a health education CD. Both short-term and long-term practitioners evoked significant temporal gene expression changes with greater significance in the latter as compared to novices. RR practice enhanced expression of genes associated with energy metabolism, mitochondrial function, insulin secretion and telomere maintenance, and reduced expression of genes linked to inflammatory response and stress-related pathways. Interactive network analyses of RR-affected pathways identified mitochondrial ATP synthase and insulin (INS) as top upregulated critical molecules (focus hubs) and NF-κB pathway genes as top downregulated focus hubs. Our results for the first time indicate that RR elicitation, particularly after long-term practice, may evoke its downstream health benefits by improving mitochondrial energy production and utilization and thus promoting mitochondrial resiliency through upregulation of ATPase and insulin function. Mitochondrial resiliency might also be promoted by RR-induced downregulation of NF-κB-associated upstream and downstream targets that mitigates stress.
Human groups maintain a high level of sociality despite a low level of relatedness among group members. This paper reviews the evidence for an empirically identifiable form of prosocial behavior in humans, which we call “strong reciprocity”, that may in part explain human sociality. A strong reciprocator is predisposed to cooperate with others and punish non-cooperators, even when this behavior cannot be justified in terms of extended kinship or reciprocal altruism. We present a simple model, stylized but plausible, of the evolutionary emergence of strong reciprocity.
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QUESTION: What evidence is there for alternative exercises to specific pelvic floor muscle training for treatment of stress urinary incontinence in women? DESIGN: A systematic review was conducted with searches of PubMed and PEDro to January 2013. The quality of randomised trials was evaluated using the PEDro scale. Each type of exercise was classified as being in a Development Phase, Testing Phase, or Refinement and Dissemination Phase. PARTICIPANTS: Women with stress or mixed urinary incontinence with predominantly stress urinary incontinence. INTERVENTION: Exercise regimens other than pelvic floor muscle training. OUTCOME MEASURES: The primary outcome was urinary leakage. RESULTS: Seven randomised controlled trials were found: three on abdominal training, two on the Paula method, and two on Pilates exercise. The methodological quality score ranged between 4 and 8 with a mean of 5.7. There was no convincing evidence for the effect of these exercise regimens so they remain in the Testing Phase. Because no randomised trials were found for posture correction, breathing exercise, yoga, Tai Chi, and general fitness training, these were classified as being in the Development Phase. CONCLUSION: There is not yet strong evidence that alternative exercise regimens can reduce urinary leakage in women with stress urinary incontinence. Alternative exercise regimens should not yet be recommended for use in clinical practice for women with stress urinary incontinence.
To examine the extent to which advanced meditative practices might alter body metabolism and the electroencephalogram (EEG), we investigated three Tibetan Buddhist monks living in the Rumtek monastery in Sikkim, India. In a study carried out in February 1988, we found that during the practice of several different meditative practices, resting metabolism ([Vdot]O2) could be both raised (up to 61%) and lowered (down to 64%). The reduction from rest is the largest ever reported. On the EEG, marked asymmetry in alpha and beta activity between the hemispheres and increased beta activity were present. From these three case reports, we conclude that advanced meditative practices may yield different alterations in metabolism (there are also forms of meditation that increase metabolism) and that the decreases in metabolism can be striking.
In the context of the network model of the organism, multimorbid states (≥ 2 chronic diseases at the same time) can be considered as a complex disease pattern which can be mapped as characteristic signatures. From the perspective of system theory, living systems such as the human body are viewed as networks of interacting parts. These in turn can themselves be subnetworks assigned to different complexity levels. They range, e.g., from the gene to the transcriptome, proteome, metabolome, and epigenome up to the network of the entire molecular interactions, the so-called interactome. In multimorbidity, the disease signature affects different networks at all levels, e.g., cell systems, organs, and functional systems. Based on this semiotics, certain signatures of effectiveness and profiles of action can be assigned to each drug. A drug signature represents the physicochemical stimuli that cause a reaction by the system, as well as the cross-links by which the entire connected system is affected at all levels. Phytotherapeutics, which chemically represent multi-component mixtures, have especially complex signatures. As multi-target medicines with a pleiotropic effect profile, they therapeutically affect different levels of the network, which is why they are also referred to as network medicines. Herbal formulas from traditional medicine systems such as Tibetan Medicine are an example for phytotherapeutics with a particularly complex pleiotropic signature. Also from the traditional point of view, a disease signature is set in relation with a corresponding drug signature. However, in this case, it is based on the traditional energetic understanding of diseases. Modern research results clearly indicate a widely diversified signature range of Tibetan Medicines and thus provide a rationale for their use in integrative treatment approaches for diseases with complex signatures, e.g. in multimorbidity. The system-theoretical approach discussed here represents a method to enable a connectivity of traditional methods from complementary and alternative medicine to the other disciplines of modern medicine.
Being one of the great medicine systems of the world, Tibetan Medicine developed in the 8th century AD and spread throughout central Asia over the intervening centuries. The first European contact with Tibetan remedies started around 1850 in Russia. By and by, they made their way as far a Switzerland where, in the meantime, they have been produced for more than 30 years and licensed by the health authorities. During the last years, comprehensive clinical and experimental research material has been generated on several formulas, especially on Padma 28 and Padma Lax. At the same time, a genuine European pool of experience was gained. Tibetan remedies are multicomponent mixtures. Special requirements on quality assessment, efficacy and safety arise on the path to a modern Tibetan multicompound. The production of such elaborately formulated com-positions has to take into account modern demands of GMPas well as traditional sources. In recent years, a rising popularity of Asian medicine can be observed. This need of patients, physicians and therapists also demands answers from the regulatory part. Aspects such as the justification of the composition (rationale of combination) and certain quality standards have to be newly defined by the authorities in this context. Only with adapted regulatory frameworks Tibetan medicines can find their place in Europe and, together with other medical traditions and biomedical research, integratively enrich the arsenal of intervention and prevention of Western industrial societies.
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