Authors@Google talk on Yoga for Pain Relief

Here's the video of my recent Authors@Google talk on Yoga for Pain Relief. I describe 3 key ideas that have changed the way medicine thinks about about pain, summarize some exciting studies on how yoga and meditation can help people with pain, take some fun and interesting questions from the audience, and then lead a 10 min breathing/gentle stretching/meditation practice (in chairs).

javascript:void(0)

Call for Articles! International Journal of Yoga Therapy

As some of you know, I'm the editor in chief of the International Journal of Yoga Therapy, a peer-reviewed journal of policy perspectives, research, and case studies/clinical advice.

The period of peer review for the Fall 2010 issue is wrapping up, and there's still room for several more articles.

So once your taxes are filed, why not put together a thoughtful argument about yoga as a healing practice or profession, polish up that masters thesis, put your clinical experience into advice other professionals can use, or write up the pilot data from your ongoing study?

Submit to editor [at] iayt [dot] org by April 15th for full consideration.

To learn more, below are the usual instructions for contributors. You can also see past tables of contents and article abstracts here.

Guidelines for Authors

Content

The International Journal of Yoga Therapy publishes articles about Yoga therapy, Yoga practice, and Yoga philosophy. We encourage submissions from Yoga therapists, Yoga teachers, researchers, and healthcare professionals. The journal aims to represent views, practices, and research from all major traditions in Yoga, as well as integrative medicine and psychology.

Perspectives

The journal invites submissions of letters and opinions. Perspectives are not peer-reviewed, and may be in response to specific articles, or on any topic relevant to the research and practice of Yoga therapy. Perspectives should be 500-1200 words.

Issues in Yoga Therapy

The journal welcomes scholarly articles that address issues, challenges, and controversies in the research and practice of Yoga therapy. Articles in this category include, but are not limited to: considerations of policy issues related to the integration of Yoga and healthcare, explorations of common challenges that Yoga therapists and teachers face in their work, and discussions of Yoga philosophy as it relates to contemporary Yoga therapy practice.

Research

The journal publishes reports of original research. We welcome pilot studies, feasibility studies, and preliminary reports on research in progress, when these reports examine challenges and early findings that may benefit other researchers and practitioners. Case studies should be reported in the context of a thorough review of the relevant literature, and a broader discussion of the case’s implications for future research or practice. Names and other identifying information should be changed to protect individuals’ privacy.

Continuing Education/Yoga Therapy in Practice

Continuing Education/Yoga Therapy in Practice articles should review a topic of importance and relevance to practicing Yoga teachers, Yoga therapists, and healthcare providers. Articles in this category include, but are not limited to: discussions of specific medical conditions and recommended Yoga practices, reviews of the history of some aspect of Yoga therapy or Yoga philosophy, and reviews of research on a topic of relevance to Yoga therapy. Articles should be supported by references to published research, research in progress, established interventions at Yoga therapy clinics, classical Yoga texts, and/or original interviews, and should not be based solely on the experience or opinions of the author(s).

Review and Selection of Manuscripts

All articles are initially evaluated by the Editor for suitability of topic and format. Articles that meet the basic requirements are assigned to a minimum of two peer reviewers, chosen on the basis of their expertise and experience. We invite (but do not require) authors to nominate additional potential reviewers at the time of article submission, particularly when knowledge of a Yoga lineage or other specialty is required. Peer review is blind, meaning that the author’s identity is not revealed to reviewers. Reviewers evaluate the article’s contribution to the field of Yoga therapy, and make specific suggestions for revisions. When making a recommendation to publish or reject an article, reviewers take into account the importance of the topic, the quality of scholarship, and the clarity of writing.

Potential authors wishing to view the current peer review guidelines for the type of article they plan to submit should email the Editor (editor [at] iayt.org) and indicate which category the intended submission falls into. The Editor makes the final decision whether to accept or reject a manuscript. Most manuscripts go through at least one round of revision before they are accepted. Following acceptance, articles are edited for clarity and adherence to journal style guidelines.

Preparation and Submission of Manuscripts

Articles should be 4000-6000 words. All articles should be submitted via email to editor [at] iayt.org. Include a brief introductory letter in the body of the email and attach the manuscript as a word document. All manuscripts should use AMA style formatting for citations/references (numbered endnotes). Research articles should include a note acknowledging any funding sources or potential conflicts of interest, as well as a statement of adherence to ethical guidelines for the use of human participants (when applicable) and informed consent to use photographs of or publish case information about students/clients.

We encourage authors to provide photos and figures, particularly for descriptions of Yoga practices or discussions of anatomy. However, please do not email photos or figures as separate files until requested from the Editor.

Check out my appearance on ABC's View from the Bay, talking about yoga for back pain relief.

New Guided Meditation Practice

I just created a new 10-minute meditation practice for my Stanford Continuing Studies course The Science of a Calmed Mind. It's an introduction to the practice of equaminity -- read below, and download/stream the guided practice for more support!

For more information about the philosophy behind this practice, check out this wonderful article by Aura Glaser in the Shambhala Sun.

Overview from Kelly: In all meditation traditions, it is believed that the foundation for true happiness is overcoming the basic sense of separation from others that most of us have most of the time. This sense of separation includes (but is not limited to) feeling different than, in competition with, judgmental about, or wronged by others.

This meditation will help you observe with mindfulness the thoughts, sensations, and emotions that arise when you think about three (self-created) categories of “others”: friends, enemies, and strangers. It then gives you the opportunity to choose to dissolve the sense of separation by cultivating a sense of “equanimity”—that is, reminding yourself of the essential sameness of friends, enemies, and strangers. This may not be what first comes to mind when you think of happiness, but there is a great deal of wisdom in this notion and in the meditation practice.

The Practice:

Start with some centering breaths and a minute or two of open awareness.

THE FRIEND

Then bring to your mind a “friend.” It could be any loved one, including a relative, a spouse, a child, a friend, a mentor, and even a pet. Choose someone who most naturally inspires in you a sense of trust, care, joy, or affection.
Allow yourself to think about this friend. You can visualize them, recall a favorite interaction, imagine hugging them, or anything that helps bring them to life in your mind. As you do so, bring mindful awareness to your thoughts, physical sensations, and emotions.

Now, for this “friend,” say to yourself:
Just like me, this person wishes to be happy.
Just like me, this person wishes to avoid suffering.
Just like me, this person wants to be loved, to be safe, and to be healthy.
Just like me, this person does not want to feel afraid, inadequate, or rejected.
And just like me, this person does not want to be sick, lonely, or depressed.

You can repeat this process for other “friends” if you like.

THE STRANGER

Next, bring to your mind a “stranger.” It could be anyone who is familiar to you but not well-known, including a co-worker, a neighbor, a checker at your grocery store, the receptionist at your dentist’s office, a celebrity, and so on. Choose someone you really don’t know well, and for whom you do not have any strong feelings of attraction or dislike.
Allow yourself to think about this person. You can visualize them, recall a recent interaction, imagine them doing whatever it is you know them from (e.g. their job), or anything that helps bring them to life in your mind. As you do so, bring mindful awareness to your thoughts, physical sensations, and emotions.

Now, for this “stranger,” say to yourself:
Just like me, this person wishes to be happy.
Just like me, this person wishes to avoid suffering.
Just like me, this person wants to be loved, to be safe, and to be healthy.
Just like me, this person does not want to feel afraid, inadequate, or rejected.
And just like me, this person does not want to be sick, lonely, or depressed.

You can repeat this process for other “strangers” if you like.

THE ENEMY

Finally, bring to your mind an “enemy.” It could be anyone you feel dislike, disgust, hostility, anger, envy, or conflict toward. In some cases, it may be someone who once was a “friend” but for whom you now feel a sense of anger or conflict.
Allow yourself to think about this person. You can visualize them, recall a recent interaction, or anything that helps bring them to life in your mind. As you do so, bring mindful awareness to your thoughts, physical sensations, and emotions. It can be easy to get carried away by these thoughts, especially if you really dive into memories and emotions. Remember to at some point come back to your breath to release the hook.

Now, for this “enemy,” say to yourself:
Just like me, this person wishes to be happy.
Just like me, this person wishes to avoid suffering.
Just like me, this person wants to be loved, to be safe, and to be healthy.
Just like me, this person does not want to feel afraid, inadequate, or rejected.
And just like me, this person does not want to be sick, lonely, or depressed.

You may find this challenging, or feel phony as you say these things about an “enemy.” With time and the sincere desire to cultivate equanimity, the fake-ness of the meditation transforms into a real sense of core human sameness. Have compassion for yourself and any challenges you experience as you work with this process.

You can repeat this process for other “enemies” if you like.

To conclude the practice, take a moment to acknowledge your own heartfelt desire to be happy and free of suffering, which you have honored with this practice.

New Guided Meditation Practice

I just added a guided meditation practice to the Yoga for Pain Relief resources page.

This 15-minute audio meditation is a concentration and mindfulness practice to help stabilize and focus your mind. I created it as a basic introductory meditation for a course I'm teaching at Stanford this quarter, The Science of a Calmed Mind. It's a great track for people who need a little extra encouragement to practice.

After I review the instructions, you will hear silence. Every five minutes, you will hear the sound of a meditation bowl being struck. You can finish your practice at 5 minutes, 10 minutes, or 15 minutes.

In the first 5-minute segment, I check in twice to remind you to notice where your mind is, in case it has wandered. At the first 5-minute mark, I invite you to drop the counting practice and focus on the sensations of breathing. At the 10-minute mark, I remind you to stay resting with the sensations of the breath and body.

When you finish, acknowledge the success of sitting, no matter how focused or distracted you were. Your focus will be different on different days, even as you cultivate more and more skill at concentration. The success of this practice is your sitting down and staying put, and honoring the intention of the practice.

For more guided practices, check out the Yoga for Pain Relief resources page.

Summary of Research on Meditation and Brain Changes

I prepared this summary of research on meditation and neuroplasticity for the Yoga Service Council. We're putting together research reviews and "best practices" recommendations across a wide range of topics to support individuals in the yoga and healthcare communities. We hope that these resources will help individuals apply for funding, bring yoga/meditation into a new clinical or educational setting, and develop evidence-based interventions.

****

The brain, once thought to be relatively fixed in structure and hard-wired in function, has been shown in the last decade to be remarkably responsive to experience. Mindfulness meditation and yoga appear to have positive neuroplastic effects, supporting both structure and function related to improved attention, memory, self-regulation, and mood.

For example, multiple studies have shown that long-term meditators have increased neuron density and preserved structure in areas of the brain (such as the prefrontal cortex, hippocampus, temporal gyrus, and insula) associated with attention, memory, self-awareness, self-control, and emotion regulation. (1-4) Long-term meditators have also shown increased gray matter density in the brain stem, which may be related to improved self-control and emotion regulation. (5)

Research also demonstrates positive differences in brain function. For example, experienced meditators, compared to those with less or no meditation experience, show increased activation in areas of the brain associated with attention during tasks that require focus. (6-7) Experienced meditators also perform better on tasks that require focused attention and cognitive flexibility. (8-10)

The neuroplastic effects of meditation and yoga also include positive mood changes. A single session of yoga has been shown to increase brain levels of GABA, which is associated with reduced anxiety and improved mood. (10) An eight-week training program in mindful meditation and yoga led to changes in frontal brain activation--increased left prefrontal activity--associated with positive emotions and well-being. (11) A similar training helped preserve increased left prefrontal activity in previously suicidal individuals, preventing further deterioration of mood. (12) Meditation experience is also associated with increased activation of brain regions (such as the cingulate cortex and insula) associated with empathy for others. (13) A meditation intervention has been shown to increase experience of positive emotions, and these changes in mood further predicted increased sense of purpose in life and social support, and decreased illness and depression. (14)

In summary, mindfulness and yoga are potentially valuable tools for improving cognitive function, self-regulation, and mood, in part because of how they influence the structure and function of the brain.

-Written and References Compiled by Kelly McGonigal, PhD

References
1. Luders E, Toga AW, Lepore N, Gaser C. The underlying anatomical correlates of long-term meditation: Larger hippocampal and frontal volumes of gray matter. NeuroImage. 2009;45:672–78.
2. Hölzel BK, Ott U, Gard T, Hempel H, Weygandt M, Morgen K, Vaitl D. Investigation of mindfulness meditation practitioners with voxel-based morphometry. Soc Cogn Affect Neurosci. 2008;3(1):55-61.
3. Lazar SW, Kerr CE, Wasserman RH, Gray JR, Greve DN, Treadway MT, McGarvey M, Quinn BT, Dusek JA, Benson H, Rauch SL, Moore CI, Fischl B. Meditation experience is associated with increased cortical thickness. Neuroreport. 2005;16(17):1893-7.
4. Pagnoni G, Cekic M. Age effects on gray matter volume and attentional performance in Zen meditation. Neurobiol Aging. 2007;28(10):1623-7.
5. Vestergaard-Poulsen P, van Beek M, Skewes J, Bjarkam CR, Stubberup M, Bertelsen J, Roepstorff A. Long-term meditation is associated with increased gray matter density in the brain stem. Neuroreport. 2009;20(2):170-4.
6. Brefczynski-Lewis JA, Lutz A, Schaefer HS, Levinson DB, Davidson RJ. Neural correlates of attentional expertise in long-term meditation practitioners. Proc Natl Acad Sci USA. 2007;104(27):11483-8.
7. Baron Short E, Kose S, Mu Q, Borckardt J, Newberg A, George MS, Kozel FA. Regional brain activation during meditation shows time and practice effects: An exploratory FMRI study. Evid Based Complement Alternat Med. 2007 Oct 27[Epub].
8. Slagter HA, Lutz A, Greischar LL, Francis AD, Nieuwenhuis S, Davis JM, Davidson RJ. Mental training affects distribution of limited brain resources. PLoS Biol. 2007;5(6):e138.
9. Moore A, Malinowski P. Meditation, mindfulness and cognitive flexibility.
Conscious Cogn. 2009;18(1):176-86.
10. Garland E, Gaylord S, Park J. The role of mindfulness in positive reappraisal. Explore (NY). 2009;5(1):37-44.
10. Streeter CC, Jensen JE, Perlmutter RM, Cabral HJ, Tian H, Terhune DB, Ciraulo DA, Renshaw PF. Yoga asana sessions increase brain GABA levels: A pilot study. J Altern Complement Med. 2007;13(4):419-26.
11. Davidson RJ, Kabat-Zinn J, Schumacher J, Rosenkranz M, Muller D, Santorelli SF, Urbanowski F, Harrington A, Bonus K, Sheridan JF. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med. 2003;65(4):564-70.
12. Barnhofer T, Duggan D, Crane C, Hepburn S, Fennell MJ, Williams JM. Effects of meditation on frontal alpha-asymmetry in previously suicidal individuals. Neuroreport. 2007;18(7):709-12.
13. Lutz A, Brefczynski-Lewis J, Johnstone T, Davidson RJ. Regulation of the neural circuitry of emotion by compassion meditation: effects of meditative expertise. PLoS One. 2008;3(3):e1897.
14. Fredrickson BL, Cohn MA, Coffey KA, Pek J, Finkel SM. Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. J Pers Soc Psychol. 2008;95(5):1045-62.

Mindfulness Reduces Medical Burnout

A new study from the University of Rochester Medical Center reports that mindfulness meditation can reduce burnout in physicians. And we know they need it, thanks to another recent report in the Journal of the American Medical Association (JAMA) that physician distress and fatigue significantly increase the risk of medical errors.

An important part of the mindfulness training was mindful communication. These communication skills led to an increased sense of support and connection with colleagues, as well as increased empathy for patients.

Coincidentally, my introduction to the now-ubiquitous Mindfulness Based Stress Reduction program developed by Jon Kabat Zinn was in an elective class for medical students at Stanford. Community members were also in the class -- people who had been recommended to take the class because of illness or pain -- which made the experience even more eye-opening and educational.

Physicians and physicians-in-training, heal thyself first! Get thee to a mindfulness meditation class.

New study: depression increases risk of dying in cancer patients

A new report in the November 15 issue of Cancer analyzed 26 studies that looked at how depression influences cancer progression and survival rates.

Cancer patients who experienced depression were at higher risk for dying. The increased risk was as high as 25% for mild symptoms and 39% for those diagnosed with clinical depression.

This study points to the importance of social support and complementary care, whether psychological, spiritual/religious, or mind-body interventions like yoga, meditation, and exercise. All of these have been shown to improve a sense of control, hope, or meaning during an experience that can feel dehumanizing, uncontrollable, and frightening.

The authors of the report are quick to point out that cancer patients should not be pressured into some forced kind of "positive thinking" or discouraged from feeling and expressing negative emotions.


Study citation: Jillian R. Satin, Wolfgang Linden, and Melanie J. Phillips. Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis. Cancer, 2009; DOI: 10.1002/cncr.24561

Yoga for Cancer Survivors

To get everyone excited for Yogapalooza this weekend, here's a recent radio interview I did with Yoga Bear founder Halle Tecco. The show is The Stupid Cancer Show, a radio podcast for young adult cancer survivors.

We talked about how yoga can benefit survivors, some of the myths about yoga and meditation, and how Yoga Bear connects survivors with free classes at yoga studios around the U.S. Our interview is in the second half of the episode.

1st Annual Summit on Yoga, Mindfulness, and Service

I just got back from the 1st Annual Summit on Yoga, Mindfulness, and Service at the Omega Institute in NY (May 17-21 2009). This was a gathering of leaders in the yoga community who are passionate about outreach, activism, service, and research on yoga and meditation. Many run their own non-profits that bring yoga and meditation to underserved populations, from teenagers in prison to women in recovery from addiction, eating disorders, and domestic violence. I was there representing several great organization I work with: the International Association of Yoga Therapists, Yoga Bear (offering yoga to cancer survivors), and the Art of Yoga (teaching yoga to girls in juvenile detention).

Check out this 2-part youtube conversation about service in yoga between summit attendees Mark Lily, founder of Street Yoga in Portland, OR, and Seane Corn, founder of Off the Mat Into the World.

The 12 attendees at the summit officially formed the Yoga Service Council. We look forward to harnessing energy, good will, skills, science, and --oh, yes-- funds to support individuals and organizations that serve communities through yoga and meditation. Stay tuned for more information about our projects and ways to get involved!